Ali Rıza GÜLCAN, Mustafa Serkan KARAKAŞ, Refik Emre ALTEKİN, Sinan Cemgil ÖZBEK, Barış AKDEMİR, Hüseyin YILMAZ

Metabolik sendromlu hastalarda sol atriyal volüm indeksi'nin subklinik ateroskleroz ile ilişkisi 3,4, 3,

Metabolik sendrom (MetS) ateroskleroza, sol ventrikül yapı ve fonksiyonlarında bozulmaya neden olur. Diyastolik disfonksiyon (DD) subklinik kardiyak hasarın erken dönem bulgusudur. Sol atriyal volüm DD'un ciddiyetini ve süresini göstermede bir belirteç olarak kullanılabilir. Çalışmamızda, MetS'lu hastalarda sol ventrikül DD ve derecesini, sol atriyal volüm indeksi (SAVİ) ile birlikte değerlendirdik ve bunun karotis intima media kalınlığı (KİMK) ile tespit edilen subklinik aterosklerozla ilişkisini araştırdık. Çalışmaya MetS'lu 82 hasta alındı. Hastalar KİMK ölçümüne göre, KİMK≥1,0 mm olan 35 hasta grup 1, KİMK

Anahtar Kelimeler:

Diyastolik disfonksiyon; karotis intima-media kalınlığı; metabolik sendrom; sol atriyal volüm indeks; subklinik ateroskleroz.

Relation of left atrial volume index with subclinical atherosclerosis at patients with metabolic syndrome

Metabolic syndrome (MetS) increases the frequency of cardivovascular events by causing atherosclerosis and impairment at left ventricle structure and function. Diastolic dysfunction (DD) is an early finding of subclinical cardiac injury. Left atrial volume may be used as an indicator for demonstrating severity and duration of DD. With this study, we investigated the relationship between subclinical atherosclerosis ,evaluated by carotid intima-media thickness (CIMT) measurement and subclinical cardiac injury evaluated by diastolic functions and left atrial volume index (LAVI) in MetS patients. 82 patients with MetS were enrolled to the study. Patients were divided into 2 groups according to CIMT measurement: 35 patients with CIMT≥1.0 mm were at group 1 and 47 patients with CIMT

Keywords:

Carotis intima-media thickness; diastolic dysfunction; left atrial volume index; subclinical atherosclerosis; metabolic syndrome.,

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Gören B, Fen T. Metabolik Sendrom. Türkiye Klinikleri J Med Sci 2008;28(5):686-96.
Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and metaanalysis of longitudinal studies. J Am Coll Cardiol 2007;49(4):403-14
Roes SD, Alizadeh Dehnavi R, Westenberg JJ, Lamb HJ, Mertens BJ, Tamsma JT, et al. Assessment of aortic pulse wave velocity and cardiac diastolic function in subjects with and without the metabolic syndrome: HDL cholesterol is independently associated with cardiovascular function. Diabetes Care 2008;31(7):1442-4. von Bibra H, St John Sutton M. Diastolic dysfunction in diabetes and the metabolic syndrome: promising potential for diagnosis and prognosis. Diabetologia 2010;53(6):1033-45.
Fang ZY, Prins JB, Marwick TH. Diabetic cardiomyopathy: evidence, mechanisms, and therapeutic implications. Endocr Rev 2004;25(4):543-67
Widlansky ME, Gokce N, Keaney JF Jr, Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol 2003;42(7):1149-60.
Mallika V, Goswami B, Rajappa M. Atherosclerosis pathophsiology and the role of novel risk factors: a clinicobiochemical perspective. Angiology 2007;58(5):513-22. Sinha AK, Eigenbrodt M, Mehta JL. Does carotid intima media thickness indicate coronary atherosclerosis? Curr Opin Cardiol 2002;17(5):526-30.
Leung DY, Chi C, Allman C, Boyd A, Ng AC, Kadappu KK, et al. Prognostic implications of left atrial volume index in patients in sinus rhythm. Am J Cardiol 2010;105(11):1635-9. http://www.idf.org/webdata/docs/IDF_Metasyndrome_def .pdf (Erişim tarihi 04.10.2005).
Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1997;55(4):613-8.
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18(12):1440-63.
Leung DY, Boyd A, Ng AA, Chi C, Thomas L. Echocardiographic evaluation of left atrial size and function: current understanding, pathophysiologic correlates, and prognostic implications. Am Heart J 2008;156(6):1056-64.
Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109(3):433-8.
Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24(4):683-9.
Lebovitz HE. Insulin resistance: definition and consequences. Exp Clin Endocrinol Diabetes 2001;109 Suppl 2:S135-48.
Sonoda M, Yonekura K, Yokoyama I, Takenaka K, Nagai R, Aoyagi T. Common carotid intima-media thickness is correlated with myocardial flow reserve in patients with coronary artery disease: a useful non-invasive indicator of coronary atherosclerosis. Int J Cardiol 2004;93(2-3):131-6.
Yambe M, Tomiyama H, Hirayama Y, Gulniza Z, Takata Y, Koji Y, et al. Arteriel stiffening as a possible risk factor both atherosclerosis and diastolic heart failure. Hypertens Res 2004;27(9):625-31.
Masugata H, Senda S, Goda F, Yoshihara Y, Yoshikawa K, Fujita N, et al. Left ventricular diastolic dysfunction as assessed by echocardiography in metabolic syndrome. Hypertens Res 2006;29(11):897-903.
Uzun M, Koz C, Yildirim M, Kirilmaz A, Yokusoglu M, Kilicaslan F, et al. Does accompanying metabolic syndrome contribute to heart dimensions in hypertensive patients? Turk Kardiyol Dern Ars 2008;36(7):446-450.
Koç F, Tokaç M, Kaya C, Kayrak M, Yazıcı M, Karabağ T, et al. Diastolic functions and myocardial performance index in obese patients with or without metabolic syndrome: a tissue Doppler study. Turk Kardiyol Dern Ars 2010;38(6):400-4
Hwang YC, Jee JH, Kang M, Rhee EJ, Sung J, Lee MK. Metabolic syndrome and insulin resistance are associated with abnormal left ventricular diastolic function and structure independent of blood pressure and fasting plasma glucose level. Int J Cardiol 2012;159(2):107-11.
Bertoni AG, Wong ND, Shea S, Ma S, Liu K, Preethi S, et al. Insulin resistance, metabolic syndrome, and subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2007;30(11):2951-6.
Chahal NS, Lim TK, Jain P, Chambers JC, Kooner JS, Senior R. The distinct relationships of carotid plaque disease and carotid intima-media thickness with left ventricular function. J Am Soc Echocardiogr 2010;23(12):1303-9.
Pirat B, Zoghbi WA. Echocardiographic assessment of left ventricular diastolic function. Anadolu Kardiyol Derg 2007;7(3):310-5.
Sohn DW, Chai IH, Lee DJ, Kim HC, Kim HS, Oh BH, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997;30(2):474-80.
Oki T, Tabata T, Yamada H, Wakatsuki T, Shinohara H, Nishikado A, et al. Clinical application of pulsed Doppler tissue imaging for assessing abnormal left ventricular relaxation. Am J Cardiol 1997;79(7):921-8. van Heerebeek L, Hamdani N, Handoko ML, Falcao-Pires I, Musters RJ, Kupreishvili K, et al. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation 2008;117(1):43-51.
Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S, Gentile F, et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 2010;23(4):351-69.
Gong HP, Tan HW, Fang NN, Song T, Li SH, Zhong M, et al. Impaired left ventricular systolic and diastolic function in patients with metabolic syndrome as assessed by strain and strain rate imaging. Diabetes Res Clin Pract 2009;83(4):300-7.
Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol 2002;90(12):1284-9.
Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J 2007;28(20):2539-50.