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Kardiyak Resenkronizasyon Tedavisi Sonrası 6 Dakikalık Yürüme Mesafesinde İyileşme ile QRS Süresindeki Daralma Arasındaki İlişki

Amaç: Kardiyak resenkronizasyon tedavisinin, elektriksel dissenkroniye bağlı azalmış ejeksiyon fraksiyonlu kalp yetmezliği olan hastalarda etkili olduğu kanıtlanmıştır. Bu çalışmanın amacı, kardiyak resenkronizasyon tedavisi sonrası QRS süresindeki daralma ile fonksiyonel kapasitenin bir göstergesi olan 6 dakikalık yürüme mesafesi ile arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Çalışmaya sol ventrikül ejeksiyon fraksiyonu ≤%35 olan kronik kalp yetmezliği ile takip edilen (%38 iskemik, %62 iskemik olmayan) toplam 39 semptomatik (New York Heart Association sınıf II-IV) hasta (24 kadın, 19 erkek) dahil edildi. Bulgular: Kardiyak resenkronizasyon tedavisi öncesine kıyasla, kardiyak resenkronizasyon tedavisi sonrası değerlendirmede QRS süresinde istatistiksel olarak anlamlı azalma (153.62 ± 8.49 ve 131.44 ± 9.86 msn, p <0.001) ve 6 dakikalık yürüme mesafesinde artış (247.77 ± 52.93 vs. 361.15 ± 66.17 m, p <0.001). QRS süresindeki daralma ile kardiyak resenkronizasyon tedavisi sonrası 6 dakikalık yürüme mesafesi arasında orta derecede negatif korelasyon (r = -0.52, p <0.001) tespit edildi. Sonuç: Çalışmamız, azalmış ejeksiyon fraksiyonlu kalp yetmezliği ve kardiyak resenkronizasyon tedavisi hastalarında, kardiyak resenkronizasyon tedavisi implantasyonu sonrası QRS süresindeki daralmanın 6 dakikalık yürüme mesafesindeki artış ile ilişkili olduğunu göstermiştir.

Anahtar Kelimeler:

altı dakikalık yürüme testi, Kardiyak resenkronizasyon tedavisi, kronik kalp yetmezliği

The Relationship Between Narrowing Of The QRS Duration And Improvement In The 6-Minute Walking Distance After Cardiac Resynchronization Theraphy

Objective: Cardiac resynchronization therapy has been proved to be effective in patients suffering from reduced ejection fraction heart failure related to electrical dyssynchrony. The aim of this study was to investigate the relationship among narrowing of the QRS duration after cardiac resynchronization therapy and the evaluation of functional capacity by 6-minute walking test.Material and Method: A total of 39 symptomatic (NYHA class II-IV) patients (24 females, 19 males) with chronic heart failure (38% ischemic, 62% non-ischemic) who had left ventricle ejection fraction ≤ 35% were included into the study.Results: The evaluation after cardiac resynchronization therapy revealed statistically significant decrease in QRS duration (153.62 ± 8.49 vs. 131.44 ± 9.86 msec, p < 0.001) and increase in 6-minute walking distance (247.77 ± 52.93 vs. 361.15 ± 66.17 m, p < 0.001) compared to before cardiac resynchronization therapy. It was detected moderate negative correlation (r = -0.52, p < 0.001) between narrowing of the QRS duration and 6-minute walking distance after cardiac resynchronization therapy.Conclusion: In patients with reduced ejection fraction heart failure and cardiac resynchronization therapy, our study has shown that increase in narrowing QRS duration after cardiac resynchronization therapy implantation is associated with development in 6-minute walking distance.

Keywords:

cardiac resynchronization theraphy, chronic heart failure, six-minute walking test,

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