Asemptomatik Düşük Ejeksiyon Fraksiyonlu Hastalarda Koroner Arter Hastalığı
Sıklığı
Amaç: Semptomu olmayan ve rastlantısal olarak ejeksiyon fraksiyonu (EF) düşük saptanan hastalarda etiyolojinin aydınlatılması için rutin olarak koroner anjiografi (KAG) önerilmemektedir. Ancak ejeksiyon fraksiyonunu düşüklüğü nedeninin iskemik kaynaklı olması kötü prognozla ilişkilidir ve etiyolojinin aydınlatılması amaçlı KAG yapılması faydalı olabilir. Çalışmamızda semptomu olmayan ve sol ventrikül EF si düşük olup KAG uygulanan hastalarda koroner arter hastalığı sıklığı araştırılmıştır. Yöntemler: Düşük ejeksiyon fraksiyonunun aydınlatılması amacıyla hastanemizde KAG yapılan 100 hasta çalışmaya alınmıştır. Bu hastaların hiçbirisinin kalp yetmezliği semptomu ya da göğüs ağrısı bulunmamaktaydı. Bulgular: Hastaların yaş ortalaması 61 ve erkek cinsiyet oranı %75’dir. Ortala EF %33,8 dır. KAG sonrası iskemik etiyoloji %26 olarak saptanmıştır. 19 hasta girişim yapılan tedavi grubuna alınmış ve bu hastaların 8 ine koroner arter bypass cerrahisi (KABG) uygulanmış, 11 hastaya ise stent implante edilmiştir.17 hastada koroner arterler normal saptanmıştır.64 hastada ise medikal tedavi kararı alınmıştır. Bu gruptaki hastaların 7 si iskemik olan gruba, 57 si ise iskemik olmayan gruba dahil edilmiştir. Sonuç: Çalışmamızda göğüs ağrısı ya da kalp yetersizliği semptomu olmayan, ejeksiyon fraksiyonu düşük hastalarda koroner arter hastalığı sıklığı değerlendirilmiştir.
Coronary Artery Disease Frequency in Asymptomatic Low Ejection Fraction Patients
Objective: In asymptomatic and incidentally detected low ejection fraction patients, performing a coronary angiography (CAG) is not recommended routinely. But the prognosis for patients with ischemic etiology remains worse and performing CAG for the elucidation of the etiology may be beneficial. In our study, in asymptomatic and low EF patients who underwent CAG, coronary artery disease frequency was investigated. Methods: Totally 100 coronary angiography were performed at our institution for the elucidation of the etiology. The patients do not have angina or heart failure symptoms. Results: The median age was 61 years with 75% male ratio. Mean ejection fraction was 33.8%. Ischemic etiology was 26% after coronary angiography. The prevalence of CABG was 8 and stenting was 11 patients, CABG and stenting group was defined as invasive therapy group with 19 patients. The prevalence of normally coronary artery was 17. The prevalence of medical therapy decision was 64 patients. The medical therapy patients were divided into two groups. 7 patients were in ischemic group and 57 patients were in non-ischemic group. Conclusion: In our study, in patients without chest pain or symptoms of heart failure with low ejection fraction, incidence of coronary artery disease were evaluated.
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