Mustafa DOĞDUŞ, İlhan KOYUNCU, Mustafa YENERÇAĞ

Obez hastalarda P dalga süresinin uzamasının asendan aort dilatasyonu ile ilişkisi

Amaç: Asendan aort dilatasyonu (AAD), akut aort sendromlarıyla yakından ilişkili olan ve erken bir aşamada tespit edilmezse ölümcül olabilen klinik bir antitedir. İnteratriyal blok (İAB) her iki atriyum arasında bir iletim gecikmesidir ve kardiyovasküler hastalıklar ile ilişkilidir. İAB'nin AAD'li obez hastalara eşlik edebileceğini ve asendan aort çapı ile P-dalga süresinin ilişkili olabileceğini düşündük. Bu nedenle, bu çalışmada obez hastalarda AAD ve İAB arasındaki ilişkiyi değerlendirdik. Materyal ve metod: Rutin takip için polikliniğimize başvuran 318 ardışık obez hasta çalışmaya dahil edildi. Standart 12 derivasyonlu EKG’ler kaydedildi. Hastaların klinik özellikleri, ekokardiyografik verileri ve laboratuvar sonuçları kaydedildi. Bulgular: Hastaların ortalama yaşı 62.7 ± 10.3 yıl idi ve hastaların 199'u (% 62.5) kadındı. İAB sıklığı ve uzamış P dalga süresi AAD (+) hastalarında AAD (-) gruba göre anlamlı olarak daha yüksekti (p <0.001 ve p < 0.001, sırasıyla). En güçlü korelasyon, asendan aort çapı ile P-dalga süresi arasında bulundu (r = 0.713, p <0.001). Lineer regresyon analizinde, P-dalga süresi (β = 0.695, p <0.001) ve sol atriyal volüm indeksi (LAVI) (β = 0.611, p = 0.005) asendan aort çapının bağımsız belirleyicileri olarak bulundu. Sonuç: P-dalga süresinin uzamasının ve artmış LAVI değerlerinin asendan aort çapı ile anlamlı bir ilişkisinin olduğunu gösterdik. Bu nedenle, P dalgası süresinin AAD hastalarının takibinde kullanılabileceğini düşünüyoruz.

Anahtar Kelimeler:

Asendan aort dilatasyonu, interatriyal blok, obezite, P-dalga süresi

The Association of The Prolongation Of P-Wave Duration With Ascending Aortic Dilatation In Obese Patients

Background: Ascending aortic dilatation (AAD) is a clinical entity, which is closely related to acute aortic syndromes and can be mortal if not detected at an early stage. Interatrial block (IAB) is a conduction delay between the both atriums, and is associated with cardiovascular diseases. We think that IAB may accompany with obese patients with AAD, and the diameter of ascending aorta may be correlated with P-wave duration. Thus, in the current study, we aimed to evaluate the association between AAD and IAB in obese patients. Methods: A total of 318 consecutive obese subjects who were presented to our outpatient clinic for routine follow-up were enrolled into the study. Standard 12-lead ECGs were recorded. Clinical characteristics, echocardiographic data, and laboratory results of the patients were obtained. Results: The mean age of the patients was 62.7 ± 10.3 years, and 199 (62.5%) of the patients were female. The frequency of IAB was significantly higher and P-wave duration was significantly increased in the AAD (+) patients than in the AAD (-) subjects (p < 0.001 and p < 0.001, respectively). The strongest correlation was found between ascending aortic diameter and P-wave duration (r = 0.713, p < 0.001). In linear regression analysis, P-wave duration (β = 0.695, p < 0.001) and left atrial volume index (LAVI) (β = 0.611, p = 0.005) were found to be independent predictors of ascending aortic diameter. Conclusion: We demonstrated that prolongation of P-wave duration and increased LAVI values were significantly associated with ascending aortic diameter. Therefore, we think that P-wave duration may be used in the follow-up of the AAD patients.

Keywords:

Ascending aortic dilatation, interatrial block, obesity, P-wave duration,

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