Muhammed SÜLEYMANOĞLU, Cengiz BURAK, Ayça GÜMÜŞDAĞ, Mahmut YESİN

Akut Pulmoner Emboli ile Başvuran Hastalarda İnteratriyal Blok Varlığının Değerlendirilmesi

Giriş: Sağ ve sol atriyum arasında bir iletim gecikmesi olarak tanımlanan interatriyal blok (IAB), elektrokardiyografi (EKG)’deki P dalgasının uzaması ile karakterize edilir. Bu çalışmada, acil servise başvuran hastalarda akut pulmoner emboli (APE) ön tanısıyla IAB varlığı ile APE arasındaki ilişkinin araştırılması amaçlanmıştır. Hastalar ve Yöntem: Bu retrospektif olgu kontrol çalışmasına, APE ön tanısı ile acil servisimize başvuran toplam 82 hasta dahil edilmiştir. Bu hastaların 42’sine APE tanısı pulmoner bilgisayarlı tomografik anjiyografi ile konulmuştur. Tüm hastaların başvuru sırasındaki EKG kayıtları alınmıştır. Bulgular: Çalışma bulgularımız P dalga dispersiyonunun, P dalga süresinin ≥ 120 ms ve çentikli P dalgasının APE hastalarında anlamlı olarak yüksek olduğunu göstermiştir (p< 0.05). Ayrıca APE tanısı alan hastalarda kalp atım hızı daha yüksek ve sistolik kan basıncı daha düşük tespit edilmiştir (sırasıyla p= 0.022 ve p= 0.043). Çok değişkenli lojistik regresyon analizinde, P dalga süresinin ≥ 120 ms olması APE’nin bağımsız bir belirleyicisi olduğu bulunmuştur (OR: 3.958, %95 CI: 1.095-14.308, p= 0.036). Yapılan ROC eğri analizinde, IAB, APE’yi %40.5 duyarlılık ve %85 özgüllük ile öngörmüştür. Sonuç: Uzamış P dalga süresi, APE tespit edilen hastalarda daha sık gözlenmiştir. Çalışma bulguları, IAB’nin APE ön tanısı alan hastalarda önemli bir APE belirleyicisi olabileceğini göstermiştir.

Evaluation of Interatrial Block in Patients Presented with Acute Pulmonary Embolism

Introduction: Interatrial block (IAB), which is defined as a conduction delay between the right and left atrium, is characterized by the prolongation of P wave on the electrocardiography (ECG). In this study, we aimed to investigate the relationship between the presence of IAB and acute pulmonary embolism (APE) in patients admitted to emergency department with a preliminary diagnosis of APE. Patients and Methods: In this retrospective case-control study, a total of 82 patients with a preliminary diagnosis of APE were enrolled. Of these patients, 42 patients were diagnosed with APE via pulmonary computed tomographic angiography. In all patients, the ECGs were recorded on admission. Results: Our study findings revealed that P wave dispersion, P wave duration of ≥ 120 ms, and notched P wave were significantly higher in patients with APE (p< 0.05 for all). Also, elevated heart rate and lower systolic blood pressure were found in patients with APE (p= 0.022 and p= 0.043, respectively). In multivariable logistic regression analysis, P wave duration of ≥ 120 ms was found to be an independent predictor of APE (OR: 3.958; 95% CI: 1.095-14.308; p= 0.036). In a receiver operating characteristics curve analysis, IAB predicted the APE with a sensitivity of 40.5% and a specificity of 85%. Conclusion: Prolonged P wave duration was observed more frequently in patients with APE. The study findings showed that IAB may be an important predictor of APE in patients with a preliminary diagnosis of APE

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi