Ayşe Saatcı YAŞAR, Nurcan BAŞAR, İsa Öner YÜKSEL, Ahmet KASAPKARA, Hatice TOLUNAY, Mehmet BİLGE

Sol dal bloğunun TIMI kare sayısı üzerine etkisi

Amaç: Sol dal bloğu, kardiyak mortalite için bağımsız bir risk faktörüdür. Bu çalışmadaki amacımız anjiyograﬁk olarak normal koroner arterlere sahip ve sol dal bloğu olan hastalarda koroner kan akımını TIMI kare sayısı ile değerlendirmektir. Gereç ve yöntemler: Bu retrospektif çalışmaya elektrokardiyograﬁsinde sol dal bloğu olan 17 hasta ve kontrol grubu olarak sol dal bloğu olmayan 16 hasta dahil edildi. Tüm hastalar anjiyograﬁk olarak normal koroner arterlere sahipti. Sol dal bloğu tanısı standart elektrokardiyograﬁ kriterlerine göre konuldu. Hastalarda her üç koroner damar için TIMI kare sayısı ölçüldü. Bulgular: Sol dal bloğu olan hastalarda sol ön inen koroner arter için düzeltilmiş TIMI kare sayısı sol dal bloğu olmayan hastalara göre istatistiksel olarak anlamlı derecede daha yüksek bulundu (35.4±16.7 ve 23.8±4.5, p=0.012). Sirkumfeks ve sağ koroner arterler için TIMI kare sayılarının sol dal bloğu olan ve olmayan hastalarda farklı olmadığı görüldü (sirkumfeks arter için TIMI kare sayısı: 32.4±15.4 ve 27.7±7.6, p=0.275; sağ koroner arter için TIMI kare sayısı: 31.9±9.6 ve 27.0±8.6, p=0.141). Sonuç: Çalışmamızda sol ön inen koroner arterde TIMI kare sayısı sol dal bloğu olan hastalarda sol dal bloğu olmayan hastalara göre daha yüksek bulunurken, sirkumfleks ve sağ koroner arterler için fark izlenmemiştir. Sol ön inen arterde koroner kan akımının bozulmuş olması sol dal bloğu olan hastalarda septumda izlenen sintigraﬁk perfüzyon defektlerini açıklamaya yardım edebilir.

Effect of left bundle branch block on TIMI frame count

Aim: Left bundle branch block is an independent risk fac tor for cardiac mortality. In this study we aimed to evalu ate coronary blood fow with TIMI frame count in patients with left bundle branch block and angiographically proven normal coronary arteries. Materials and methods: We retrospectively studied 17 patients with left bundle branch block and as a contro group 16 patients without left bundle branch block. All pa tients had angiographically proven normal coronary arter ies. Left bundle branch block was determined according to standart electrocardiographic criteria. The TIMI frame count was measured for each major coronary artery in each patient. Results: TIMI frame count for left anterior descending coronary artery was found to be signiﬁcantly higher in pa tients with left bundle branch block compared with patients without left bundle branch block (35.4±16.7 ve 23.8±4.5 p=0.012). TIMI frame counts for circumfex and right coro nary arteries were similar in patients with and without lef bundle branch block (TIMI frame count for circumfex ar tery: 32.4±15.4 ve 27.7±7.6, p=0.275; TIMI frame coun for right coronary artery: 31.9±9.6 ve 27.0±8.6, p=0.141) Conclusion: We have found that TIMI frame count fo left anterior descending coronary artery was higher in patients with left bundle branch block compared with patients without left bundle branch block whereas there were no difference for TIMI frame counts for circumfex and right coronary arteries. Impaired coronary blood fow in left anterior descending artery may help to explain the sintigraphic perfusion defects in septum of patients with left bundle branch block.

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