Ahmet BARUTÇU, Ahmet TEMİZ, Emine GAZİ, Yücel ÇÖLKESEN, Burak ALTUN

Koroner Yavaş Akım Hastalarında Klinik Özelliklerin Değerlendirilmesi: İnfl amasyon ve Aterosklerozun Belirteçleri

Giriş: Koroner yavaş akım, koroner arterlerde darlık olmaksızın akım hızının yavaşlaması ile tanımlanan bir patolojidir ve etiyolojisi tam olarak aydınlatılamamıştır. Bu çalışmada koroner yavaş şakım için risk faktörlerini araştırmak amaçlanmıştır.Hastalar ve Yöntem:Ocak 2011-Haziran 2012 tarihleri arasında yapılan koroner anjiyografi lerde koroner yavaş akım saptanan 38 (ortalama yaş 55 ± 10) hasta ile kontrol grubu olarak normal lkoroner arter akımı saptanan 51 (ortalama yaş 54 ± 11) hasta çalışmaya alındı. Koroner kan akı-mının değerlendirilmesinde TIMI kare sayısı yöntemi kullanıldı. Hastaların demografi k özellikleri, kardiyovasküler hastalık için risk faktörleri, laboratuvar değerleri, rutin ekokardiyografi k ölçümleri i ve epikardiyal yağ dokusu ölçümleri ayrıntılı olarak kaydedildi. Grupların karşılaştırılmasındaa sürekli değişkenler için student-t veya Mann-Whitney U testi ve kategorik değişkenler için ki-kare etesti kullanıldı. Koroner yavaş akım için bağımsız prediktörlerin değerlendirmesi lineer regresyonn analiziyle yapıldı. p< 0.05 değeri anlamlı olarak kabul edildi.Bulgular:Gruplar arasında, erkek cinsiyet değişkeni dışında (%60.5 ve %31.4, p= 0.006) demografi k özellikler bakımından fark yoktu. Serum ürik asit düzeyi koroner yavaş akım hastala-rında daha yüksek bulundu (5.7 ± 1.1 mg/dL ve 4.8 ± 0.8 mg/dL; p= 0.001). Koroner yavaş akım hastalarında sol ventrikül sistol sonu çapı (ortanca 28 mm vs. 31 mm, p= 0.011) daha fazla ve e ejeksiyon fraksiyonu (ortanca %59 ve %64, p= 0.001) daha düşük bulundu. Koroner yavaş akım hastalarının epikardiyal yağ dokusu kalınlığı [8.2 mm ve 6.2 mm , p= 0.001] ve aort tkökü genişliği anlamlı olarak daha fazla saptandı [30 mm ve 26 mm , p= 0.001].Ürik asit düzeyi (p= 0.025; ?= 2.14), epikardiyal yağ dokusu (p= 0.015; ?= 1.49) ve aort kökü ü genişliği (p= 0.001; ?= 1.38) koroner yavaş akım için bağımsız öngördürücüler olarak bulundu.Sonuç: Bu çalışma infl amasyon ve ateroskleroz ile ilişkili olduğu bilinen ürik asit düzeyi, epikardiyal yağ dokusu ve aort kökü genişliğinin koroner yavaş akım için risk faktörleri arasındaa olabileceğini göstermiştir.

Evaluation of Clinical Findings in Patients with Coronary Slow Flow: Signs of Infl ammation and Atherosclerosis

Introduction: Coronary slow fl ow is a phenomenon characterized by delayed of fl ow in epicardial coronary arteries in absence of stenosis and its etiology is unclear. Hence, we aimed to investigate the risk factors of coronary slow fl ow.Patients and Methods: Thirty-eight patients with coronary slow fl ow (mean age 55 ± 10) and 51 subjects with normal coronary fl ow (mean age 54 ± 11) were enrolled in this study. Demographic parameters, risk factors of cardiovascular disease, laboratory fi ndings, echocardiographic measurements include epicardial adipose tissue of study population were recorded. Comparisons of groups were performed by Mann-Whitney U or student-t tests for continuous variables and chi-square test for categorical variables. Linear regression analysis was performed for determined independent predictors of coronary slow fl ow. p values < 0.05 were accepted as statistically signifi cant.Results: Demographic parameters were similar in both groups except male ratio more in coronary slow fl ow group (60.5% vs. 31.4%, p= 0.006). Uric acid was higher in patients with coronary slow fl ow (5.7 ± 1.1 mg/dL vs. 4.8 ± 0.8 mg/dL; p= 0.001). Left ventricle end-systolic diameter (median 28 mm vs. 31 mm, p= 0.011) was higher and ejection fraction (median 59% vs. 64%, p= 0.001) was lower in coronary slow fl ow group. Epicardial adipose tissue [8.2 mm vs. 6.2 , p= 0.001] and aortic root dimension were found higher in coronary slow fl ow group [30 mm vs. 26 mm , p= 0.001]. Uric acid level, epicardial adipose tissue and aortic root dimension (?= 2.14; ?= 1.49; ?= 1.38 p< 0.05 for each, respectively) were found independent risk factors of coronary slow fl ow.Conclusion: These results suggested that uric acid, epicardial adipose tissue and aortic root dimension that known related to infl ammation and atherosclerosis are possible risk factors of coronary slow flow.

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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