AYDIN AKYÜZ, ŞEREF ALPSOY, AYŞE MURAT AYDIN, NİYAZİ GÜLER, Ahmet GÜREL, Dursun Çayan AKKOYUN

İleri kalp yetersizliği hastalarında levosimendanın eritrosit dağılım genişliği üzerine etkisi

Amaç: Levosimendan dekompanse kalp yetersizliğinde kullanılan, olumlu hemodinamik etkileri de olan pozitif inotropik bir ilaçtır. Bu çalışmanın amacı levosimendan tedavisi almış ileri kalp yetersizliği hastalarının tedavi öncesi ve sonrası eritrosit dağılım genişliğinin (RDW) değişimlerini belirlemektir. Gereç ve yöntem: İleri kalp yetersizliği ile yatarak levosimendan tedavisi uygulanmış 108 hasta geriye dönük olarak tarandı. Hastaların levosimendan tedavisi öncesindeki ve bir ay sonrasındaki kontrollerinde kaydedilmiş hemogram ve ekokardiyografi verileri karşılaştırıldı. Bulgular: Sonuçlar incelendiğinde levosimendan tedavisi sonrası RDW, sol ventrikül diyastol sonu çapı ve sol ventrikül sistol sonu çapı ortalamasının, tedavi öncesinden anlamlı düzeyde azaldığı, sol ventrikül ejeksiyon fraksiyonu ortalamasının ise tedavi öncesine göre anlamlı düzeyde arttığı görüldü. Diğer özellikler üzerine tedavinin anlamlı düzeyde etki etmediği görüldü. Sonuç: Kardiyovasküler hastalıklarda prognostik önemi gösterilmiş olan eritrosit dağılım hacminin levosimendan tedavisi sonrası istatistiksel olarak anlamlı düzeyde azaldığı gösterildi. Levosimendan tedavisi almış hastalarda olumlu hemodinamik etkileri takipte, kolaylıkla ölçülebilen eritrosit dağılım genişliği fayda sağlayabilir.

The effect of levosimendan treatment on red cell distribution width in advanced heart failure patients

Purpose of this study is to compare the red cell distribution width (RDW) in advanced heart failure patients who were treated with levosimendan before and after the treatment. Material and methods: One hundred and eight advanced heart failure patients who had levosimendan treatment during hospitalization were screened retrospectively. Echocardiographic and hemogram data before and one month after the treatment were obtained from retrospective records. Values before and after the treatment were compared. Results: Mean RDW was 15.4% before the treatment and mean RDW was 15.2% after the treatment. Mean change was 0.70 and this decrease was found to be statistically significant (p=0.019). Mean left ventricular end diastolic diameter and mean left ventricular end systolic diameter were decreased significantly and mean left ventricular ejection fraction (before 29,3%, after 30.3%, mean change 1,61%, p<0.001) increased significantly after the treatment. There was no change with regard to hemogram, RBC, MCV, MCHC, WBC, NE, LY, PLT, MPV values before and after the treatment. Conclusion: RDW which was shown to have prognostic value in cardiovascular disease was demonstrated to be decreased significantly in patients with advanced heart failure after the levosimendan treatment.

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