P-Wave and QT Dispersion in Pregnant Women with Preeclampsia

Preeklampsi dünyada maternal ve fetal mortalite ve morbiditenin en önde gelen nedenlerinden biridir. P-dalga (Pd) ve QT aralığı (QTd) dispersiyonu elektrokardiyografide (EKG) sırasıyla atrial depolarizasyon ve ventriküler repolarizasyon homojenitesinin olmamasının direkt ölçümleridir. Güncel çalışmalar uzamış Pd ve QTd'nin çeşitli kardiyovasküler hastalıklarda rolü olduğunu bildirmişlerdir. Preeklampsi gibi akut basınç yüklenmesinin olduğu durumların intra/inter-atrial ve ventriküler ileti zamanı üzerine olan etkileri bilinmediğinden, biz bu çalışmada Pdve QTd'nin preeklampsi varlığı ve şiddeti ile olan ilişkisini incelemeyi amaçladık. Yöntemler: Bu retrospektif çalışmaya, Ocak-Eylül 2015 dönemleri arasında 48 ardışık preeklamptik gebe ile 55 yaş uyumlu sağlıklı gebeler dahil edildi. Preeklamptik gebeler hastalık şiddetine göre, hafif ve ağır şeklinde iki gruba ayrıldı. Sezaryen operasyonu öncesinde tüm gebelere standart 12-derivasyonlu EKG çekildi.Bulgular: Pd ve QTd preeklamptik gebelerde sağlıklı gebelerle karşılaştırıldığında anlamlı derecede uzamış olarak saptandı. Ayrıca preeklamptik gebe alt grubunda, şiddetli preeklampside Pd anlamlı şekilde artmış olarak bulundu. Pd ve QTd preeklampsi şiddeti için iyi bilinen ve onaylanmış belirteçler olan sistolik ve diastolik kan basıncıyla anlamlı direkt ilişkili saptandı. Sonuç: Preeklampsi Pd ve QTd gibi EKG parametrelerinin uzamasıyla kendini gösteren atrial depolarizasyon ve ventriküler repolarizasyon değişikliğini tetiklemektedir. EKG preeklamptik gebe kadınlarda atrial ve ventriküler elektriksel aktiviteyi değerlendirmede kullanılabilecek invaziv olmayan, basit ve kolay bulunan tanısal araçtır

Preeklampsili Gebelerde P-Dalgası ve QT Dispersiyonu

Preeclampsia is an important cause of maternal and fetal mortality and morbidity worldwide. P-wave dispersion (Pd) and QT interval dispersion (QTd) are direct measures of the nonhomogenity of atrial depolarization and ventricular repolarization, respectively, in electrocardiography (ECG). Recent studies have reported a significant role of prolonged Pd and QTd in various cardiovascular diseases. Because the effect of acute pressure overload, which occurs in a preeclamptic setting, on the intra- and/or interatrial and ventricular conduction times remains unknown, we aimed to investigate the relation of Pd and QTd with the presence and severity of preeclampsia.Methods: Forty-eight consecutive pregnant women with preeclampsia and 55 healthy, age-matched pregnant women were included in this retrospective study between January and September 2015. The pregnant women with preeclampsia were divided into two groups according to disease severity as follows: mild and severe preeclampsia. A 12-lead ECG was performed for all the pregnant women before cesarean section operation.Results: Compared with the healthy pregnant women, Pd and QTd were significantly prolonged in patients with preeclampsia. Moreover, in the subgroups of preeclampsia, Pd was significantly increased in the severe group. Pd and QTd were directly related to systolic and diastolic blood pressure, which are well-known validated indicators for the severity of preeclampsia.Conclusion: Preeclampsia triggers an alteration of atrial depolarization and ventricular repolarization, which are evidenced by the prolongation of ECG parameters such as Pd and QTd. ECG is a noninvasive, easy to use, and easily available diagnostic tool, which can be used in the assessment of atrial and ventricular electrical activity in pregnant women with preeclampsia

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