Korunmuş Ejeksiyon Fraksiyonlu Kalp Yetmezliği Hastalarında Sol Atriyum Mekaniğinin Kardiyovasküler Sonuçlar Üzerine Etkisi: Tek Merkezli Çalışma- Korunmuş Kalp Yetmezliği ve Atriyal Mekanik

Amaç: Sol atrium mekaniği, temelde iletim zamanı, kalp yetmezliği patofizyolojisinde özellikle de korunmuş ejeksiyon fraksiyonlu kalp yetmezliğinde (KEFKY), diyastolik fonksiyonların bozulmasına bağlı olarak değişmiştir, fakat hastalığın sonlanım noktası üzerine etkisi bilinmemektedir. Bundan dolayı, KEFKY hastalarında, doku Doppler görüntüleme ile elde edilen sol atrial iletim zamanı (SEMG) ile kalp yetmezliğine bağlı hastane yatışları arasındaki ilişkiyi araştırdık. Gereç ve Yöntem: Retrospektif olarak 112 ardışık KEFKY hastası (48 erkek, ortalama yaş 59.9±5) çalışmaya dahil edildi. KEFKY’li hastalar, kalp yetmezliği semptomu olan, diyastolik disfonksiyonu izlenen ve Ejeksiyon fraksiyonu (EF) ≥50% olanlar olarak tanımlandı. İlk sonlanma noktası olarak kalp yetmezliğine bağlı hastane yatışı belirlendi, ve bu bilgi 12 ay boyunca retrospektif olarak izlenen hastalardan elde edildi. Hasta popülasyonu SEMG değerleri baz alınarak istatiksel olarak 3 tertil gruba ayrıldı. 1. Tertil 42 ms olarak tanımlandı. Bulgular: Grupların demografik özellikleri arasında büyük oranda anlamlı farklılık saptanmadı, sol ventrikül boyutları ve EF gruplar arasında benzerdi (p>0.05). Hastalar 12 ay izlendi, toplam 41 olay kaydedildi. SEMG, olay gerçekleşen bireylerde diğer bireylere göre daha uzundu. Bunun yanında doku Doppler görüntüleme ile kaydedilen diyastolik disfonksiyon parametreleri SEMG ile pozitif korelasyon içindeydi (r=0.627, p

The Impact of Left Atrial Mechanics on Cardiovascular Outcome in HFpEF Patients: A Single Center Study-HFpEF and Atrial Mechanic

Objective: Left atrial (LA) mechanics, particularly conduction time is mostly altered in heart failure (HF), especially in preserved ejection fraction type (HFpEF) due to deterioration in diastolic features, but the impact on outcomes remains unknown. Therefore, we sought to investigate the association of LA conduction by coupling obtained from tissue Doppler imaging and HF-related hospitalization in patients with HFpEF. Methods: We retrospectively included 112 consecutive patients (48 men; mean age 59±5 years) with HFpEF. HFpEF was defined as the presence of at least one HF symptom, diastolic dysfunction and ejection fraction (EF) >50%. The primary outcome was HF-related hospitalization, and hospitalization data from over 12-month period were retrospectively obtained on all HFpEF patients. The cohort was stratified based on the tertiles of their LA– electromechanical delay (EMD) duration: Tertile 1 (42 ms). Results: Demographic features were mostly similar between all tertile groups, and there were no significant differences regarding left ventricular (LV) diameters and EF (p>0.05). The patients were followed up for 12-month, and a total of 41 events occurred as a primary outcome. LA-EMD duration was significantly longer in patients with cardiac events than in those without. Also, DF parameters were significantly correlated with LA-EMD (r=0.627, p

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez