Tümer Erdem GÜLER, TOLGA AKSU, Veli KAYA, Omaç TÜFEKÇİOĞLU

Direk Radyografik Ölçümlerin Kapak Yetersizliklerinin Ciddiyetinde Belirleyici Olarak Ön Gördürücü Değeri

AMAÇ: Göğüs radyografisi (GR) kardiyak boşlukların genişlemesinin değerlendirilmesinde yaygın olarak kullanılan bir yöntemdir. Bu çalışmada GR ile belirlenen kardiyotorasik oran (KTO), kardiyak alan (KA) ve kardiyak volüm (KV) değerleri ile sol ventrikülün ekokardiyografik çapları ve kapak yetmezliklerinin ciddiyeti karşılaştırılmıştır. YÖNTEMLER: Çalışma popülasyonu izole ya da kombine mitral, aort veya triküspit yetersizliği olan 220 hastadan (125 Kadın, 95 Erkek) oluşmaktadır. Hastaların tümünde sol ventrikül ejeksiyon fraksiyonu > %40 olup normale yakındır. GR ve ekokardiyografik değerlendirme tüm hastalarda aynı gün içerisinde yapılmıştır. Hastalar kapak yetersizliğinin ciddiyeti yönünden hafif orta ve ciddi olmak üzere gruplandırılmıştır. BULGULAR: Basit linear pearson korelasyon testinde sol ventrikül sistol sonu çapı KV ile KA ve KTO'ya göre daha ilişkili bulunmuştur. Bununla beraber sol ventrikül diastol sonu çapı hem KA hem de KV ile koraledir. Çoklu karşılaştırma testlerinde mitral ve triküspit yetmezliği ciddiyeti ile KA ve KV'nin korelasyonu KTO'dan daha iyi bulunmuştur. Oysaki aort yetersizliği ciddiyeti yalnızca KV ile ilişkilidir. TARTIŞMA: GR ekokardiyografi ile karşılaştırıldığında daha ucuz ve kolay bir yöntemdir ve rutin klinik pratikte kullanımı bu çalışmadan sonra artabilir.

Predictive Value of Direct Radiographic Measurementsasa Marker of Severity of Valvular Regurgitation

INTRODUCTION: The chest radiography (CR) is widely available and frequently performed as a screening test for cardiac chamber enlargement. In this study, we compared cardiothoracic ratio (CTR), cardiac area (CA) and cardiac volume (CV) on CR and echocardiographic diamaters of left ventricule and severity of valvular regurgitation. METHODS: The studied population consisted of 220 patients (125 female, 95 male) with isolated or combined mitral, aortic and tricuspid regurgitation. All of the patients had near normal cardiac systolic function (Left ventriküler ejection fraction >40%). CR and echocardiographic examination were performed on the same day in every patient. The patients were grouped by the degree of valvular regurgitation as mild, moderate, or severe. RESULTS: In the simple linear pearson correlations test, left ventricular endsystolic diameter correlated better with CV than with CA and CTR. However left ventricular enddiastolic diameter correlated both with CA and CV. The results of the multiple comparison test were evaluated and severity of mitral and tricuspid regurgitation correlated better with CA and CV than with CTR. Whereas severity of aortic regurgitation only correlated with CV DISCUSSION: CR is a cheaper and easier method as compared to echocardiography and potential usage in routine clinic practice may increase after the present study

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