Nihat POLAT, Yahya İSLAMOĞLU, Tuba KURT, Murat YÜKSEL, Nizamettin TOPRAK, Sait ALAN, Abdulkadir YILDIZ, Mesut AYDIN

Romatizmal mitral kapak darlığı olan hastalarda atriyal fibrilasyon öngördürücüleri

Amaç: Bu çalışmada romatizmal mitral darlığı (RMD) olan hastalarda negatif akut faz proteini olan serum albümin değerinin atriyal fibrilasyon (AF) varlığı ile ilişkisini araştırmayı amaçladık. Yöntemler: Tek merkezli, geriye dönük 2011-2014 tarihleri arasında RMD teşhisi konulmuş olup serum albümin değeri olan hastalar çalışmaya dahil edildi. Daha sonra hastalar AF olup olmamasına göre iki gruba ayrıldı. Bu iki grubun klinik ve laboratuar verileri karşılaştırıldı. Bulgular: Çalışmaya dahil edilme kriterlerini sağlayan 74 hasta çalışmaya alındı. Hastaların %77'si bayan olup, yaş ortalaması 44±12 yıl saptandı. Hastaların %34'ünde AF olduğu görüldü. Atriyal fibrilasyonu olan grupta hipertansiyon varlığı, yaş, sol atriyum çapı, kreatinin, C-reaktif protein yüksek; albümin, sol ventrikül ejeksiyon fraksiyonu ve ortalama transmitral basınç farkı belirgin olarak düşük bulundu. Çok değişkenli lojistik regresyon analizinde yaş, albümin düşüklüğü ve anemi varlığı ( sırasıyla, odds oranı [OO]:1.124, %95 güven aralığı [GA] ; [1.049-1.205], OO: 0.022, %95 GA; [0.002-0.268] ve OO: 5.941, %95 GA; [1.031-34.222]) AF varlığının bağımsız belirteçleri olduğu saptandı. Sonuç: Serum albümin düşüklüğü ile birlikte artan yaş ve anemi varlığı RMD hastalarında AF varlığıyla ilişkilidir. Albümin düşüklüğü bu hasta grubunda artmış inflamasyonun negatif belirteci olarak AF gelişimi için risk faktörü olabilir

The predictors of atrial fibrillation in patients with rheumatic mitral stenosis

Objective: In this study we aimed to investigate the relationship between the presence of atrial fibrillation (AF) and serum albumin levels which is a negative acute phase protein.Methods: This study is single-center and has a retrospective design. We included patients with a diagnosis of rheumatic mitral stenosis (RMS) and having serum albumin levels between 2011 and 2014. Then the patients were divided into two groups according to presence of AF. Clinical and laboratory data of these two groups were compared.Results: The study included 74 patients having the inclusion criteria. Seventy seven percent of patients were female, mean age was 44±12 years. Atrial fibrillation was detected in 34% of the patients. Hypertension presence, age, left atrial diameter, creatinine, C-reactive protein were higher in AF group while serum albumin, left ventricular ejection fraction and mean transmitral gradient was significantly lower. Multivariate logistic regression analysis showed that aging, lower albumin and anemia (respectively, odds ratio [OR]: 1.124, 95% confidence interval [CI], [1.049-1.205], OR: 0.022, 95% CI; [0.002-0.268] and OR: 5.941, 95% CI; [1.031-34.222]) were found to be independent predictors of AF presence.Conclusion: Lower serum albümin levels, aging and anemia were associated with the presence of AF in patients with RMD. Low albümin levels can be a surrogate marker of increased inflammation and may serve as a risk factor for AF development. J Clin Exp Invest 2014; 5 (3): 435-440

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