Murat SUCU, Fatma COŞKUN YILMAZ, Gökhan ALTUNBAŞ, Fuat BAŞANALAN

Vasovagal senkop gelişimine sol atrium fonksiyonu ve hacminin katkısı

Amaç: Vasovagal Senkop (VVS) sık görülen klinik bir durum olmakla birlikte altta yatan mekanizmalar henüz tam olarak anlaşılamamıştır.Bu çalışma, eğik masa testi pozitif olan VVS'lu hastalarda, sol atrial sistolik fonksiyonun VVS gelişimindeki rolünü araştırmak amacıyla yapılmıştır.Yöntemler: Açıklanamayan senkop nedeniyle eğik masa testi ve ekokardiyografi uygulanan toplam 95 hasta çalışmaya alındı. Eğik masa testi pozitif olan 45 hasta (n=45), eğik masa testi negatif olan 40 hasta (n=40) ile karşılaştırıldı. Bulgular: Yaş ve cinsiyet dağılımı açısından guruplar arasında fark gözlenmedi (sırasıyla p=0,27 ve 0,11). Ekokardiyografik değerlendirmede sol atrium hacmi, sol atrium hacim indeksi ve sol atrial ejeksiyon kuvveti eğik masa testi pozitif olan gurupta anlamlı olarak daha düşük bulundu (sırasıyla p=0,03, 0,05 ve 0,05). Mitral kapak anulusünden kaydedilen Doppler akımları açısından guruplar arasında fark saptanmadı fakat E/A oranı eğik masa testi pozitif olan gurupta anlamlı olarak daha düşük bulundu (p=0,02).Sonuç: olarak bu çalışma bazalde daha düşük atrial hacim ve kontraksiyon kuvvetine sahip bireylerin ortastatik stres esnasında ventriküler doluşun devamını sağlamada yetersiz kalabileceklerini düşündürmektedir.

Contribution of left atrial volume and function in neurocardiogenic syncope

Objective: In this study, we aimed to investigate the presence of atrial volume and decrease in contraction force by measuring left atrial volume and contraction with the head-up tilt table (HUTT) test in patients who were diagnosed with neurocardiogenic syncope (NCS).Methods: Overall, 45 patients (26 females/19 males, mean age: 26.4±9.2 years) who experienced vasovagal syncope in HUTT (HUTT+) and 40 healthy controls (17 females/23 males, mean age:28.8±10.5 years; HUTT-) were included in the study.Results: When comparing the groups in terms of left atrial ejection force, there was a significant difference between the HUTT+ and HUTT-vasovagal syncope groups (p=0.05). In both groups, there was a positive correlation between atrial ejection force and left atrial volume (r=0.287, p=0.016) and left atrial volume index (r=0.261, p=0.029).Conclusion: We showed that the left atrial ejection force and the left atrial volume index were significantly lower in positive vasovagal syncope patients than those in the negative vasovagal syncope patients.

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