Mustafa TUNCER, Yüksel KAYA, Yılmaz GÜNEŞ, Hasan Ali GÜMRÜKÇÜOĞLU, Hakkı ŞİMŞEK, Musa ŞAHİN, Cengiz DEMİR

Demir eksikliği anemisi ve tedavisinin P dalga süreleri ve diyastolik fonksiyon parametreleri üzerine etkileri

Amaç: Bu makalenin amacı kronik demir eksikliği anemisinin (DEA) hastaların sol ventrikül (SV) diyastolik fonksiyon parametreleri ile P dalga sürelerine etkisi ve anemi tedavisinin bu parametreler üzerinde yapabileceği değişiklikleri araştırmaktır.Gereç ve yöntem: Çalışmaya kalp-damar hastalığı olmayan 56 kronik DEA hastası ve 50 sağlıklı birey alındı. Vakalar başlangıçta ve anemi tedavi edildikten sonra anamnez, fizik muayene, elektrokardiyografi (EKG) ve transtorasik ekokardiyografi (TTE) ile değerlendirildi. TTE ile konvansiyonel parametrelerin yanı sıra doku doppler yapıldı. 12 derivasyonlu EKG de en uzun P dalga süresinden (Pmaks) en kısa P dalga süresi (Pmin) çıkarılarak P dalga dispersiyonu (PDD) hesaplandı.Bulgular: Kontrol grubuna göre, DEA hastalarında sol atriyum (SA) çapı (p=0.02), sol ventrikül diastol sonu çapı (LVDÇ) (p=0.001), diastolik disfonksiyon sıklığı (p=0.02), Pmaks (p=0.002) ve PDD (p=0.001) anlamlı derecede artmıştı. Korelasyon analizi ile diastolik disfonksiyon sıklığının (r=0.231, p=0.02) ve PDD’nin (r=0.367, p=0.001) anemi derinliğiyle anlamlı derecede ilişkili olduğu saptandı. Tedavi öncesiyle kıyaslandığında tedavi sonrasında SA çapı (p=0.001), LVDÇ (p=0.001), diastolik disfonksiyon sıklığı (p=0.001), Pmaks (p=0.001), Pmin ( p=0.001) ve PDD (p=0.001) anlamlı derecede azalmıştı.Sonuç: DEA’nin şiddetine paralel olarak PDD, sol kalp boyutları ve SV diyastolik disfonksiyon sıklığının arttığı gözlendi. Aneminin tedavisiyle bozulan bu değişkenlerde düzelme sağlandı.

The effects of iron deficiency anemia and its treatment on P wave durations and parameters of diastolic function

Objectives: We aimed to compare P wave variables and LV diastolic function between patient with iron deficiency anemia (IDA) and healthy control group and to investigate the effects of anemia treatment on these parameters.Materials and methods: The study included 56 patients having IDA without cardiovascular dissease and 50 healthy subjects. The cases were evaluated with clinical examination, ECG and transthoracic echocardiography (TTE) before and after treatment of IDA. Tissue Doppler imaging was assessed in addition to conventional TTE. The difference between maximum (Pmax) and minimum P wave duration on the 12-leads ECG was defined as PWD.Results: Compared to control group left atrium (LA) diameter (p=0.02), left ventricular enddiastolic diameter (LVED) (p=0.001), frequency of LV diastolic dysfunction (LVDD) (p=0.02), Pmax (p=0.002) and PWD (p=0.001) were significantly increased in patients with IDA. Correlations analysis revealed that PWD (r=0.367, p=0.001) and frequency of LVDD(r=0.231, p=0.02) were significantly correlated with severity of anemia. Compared to pre treatment period; LA diameter (p=0.001), LVED (p=0.001), frequency of LVDD (p=0.001), Pmax (p=0.001), Pmin (p=0.001) and PWD (p=0.001) were significantly decreased after treatment.Conclusion: IDA may be associated with increased PWD, left heart dimensions and frequency of LVDD in paralel with severity of anemia. These parameters may improve with treatment of anemia.

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