Süleyman KALAYCI, Ekrem ŞAHAN, Omaç TÜFEKÇİOĞLU

Pulmoner arteriyel hipertansiyonlu hastalarda vagal-nöroimmünomodülasyon endeksinin rolü

Amaç: Vagal nöroimmünomodülasyon (NIM) indeksi, birçok klinik durumda olduğu kadar sağlıklı bireylerde de kolinerjik inflamatuar tonusun bir yansımasıdır. Biz bu çalışmada NIM indeksinin pulmoner arteriyel hipertansiyon (PAH) hastalarının klinik seyri üzerindeki ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: Bu çalışmaya pulmoner arteriyel hipertansiyon (PAH) tanısı alan toplam 31 hasta dahil edildi. Elektrokardiyografi (EKG) ve C-reaktif protein (CRP) verileri geriye dönük olarak hastaların elektronik dosyalarından elde edildi. Vagal NIM indeksi, kalp hızı değişkenliği (HRV) ile CRP oranı (HRV/CRP) olarak hesaplandı. Bulgular: Klinik takip sırasında, hastaların çoğunda en az bir kez hastaneye yatış gerekmiştir (21'e karşı 10 hasta). BNP değerlerinde güncel literatürle uyumlu ve beklendiği gibi gruplar arasında anlamlı fark vardı (394 ng/L'ye karşı 55 ng/L, p=0,005). HRV, CRP ve NIM-indeks değerleri açısından gruplar arasında anlamlı fark bulunmadı. Sonuç: NIM-indeksi ile PAH hastalarında hastaneye yatış ihtiyacı arasında ilişkili bulunamamıştır.

Anahtar Kelimeler:

kalp hızı değişkenliği, pulmoner arteriyel hipertansiyon, C-reaktif protein (CRP), nöroimmünomodülasyon

The role of vagal-neuroimmunomodulation index in patients with pulmonary arterial hypertension

Aim: The vagal neuroimmunomodulation (NIM) index is reflective of the cholinergic inflammatory tone in many clinical circumstances as well as in healthy individuals. We aimed to investigate the relationship of NIM-index on the clinical course patients with PAH. Material and Method: A total of 31 patients diagnosed with pulmonary arterial hypertension (PAH) were included in this study. Data on electrocardiography (ECG) and C-reactive protein (CRP) were retrospectively obtained from patients’ electronic files retrospectively. The vagal NIM index was calculated as heart rate variability (HRV) to CRP ratio (HRV/CRP). Results: During clinical follow-up, most patients required hospitalization at least once (21 vs. 10 patients). Consistent with the current literature and as expected, there was a significant difference between the groups in BNP values (394 ng/L vs 55 ng/L, p=0.005). HRV, CRP, and NIM-index values were not found to be significant between the groups. Conclusion: NIM-index values were not associated with the need for hospitalization in patients with PAH.

Keywords:

heart rate variability, pulmonary arterial hypertension, C-reactive protein (CRP), neuroimmunomodulation,

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