Efe EDEM, Zülkif TANRIVERDİ, Ümmü TAŞ, Muhammed Murat Necati AKSOY, Saadet DEMİRTAŞ, Mustafa Türker PABUCCU, Sabiye YILMAZ, Özhan GÖLDELİ, Sedat TAŞ, Barış ÜNAL

P dalga dispersiyonunun infarkt ilişkili arter açıklığını saptamadaki prediktif değeri

Giriş: Yüzey elektrokardiyografi (EKG) ile ölçülen P-dalga dispersiyonu (PDD) değerinin koroner iskemide uzadığı gösterilmiştir. ST elevasyonlu myokard infarktüs (STEMI) hastalarında da reperfüzyon tedavisi ile PDD değerlerinin başlangıç değerlere göre kısaldığı çeşitli çalışmalarla gösterilmiştir. Çalışmamızın amacı; STEMI tanısı ile ilk 12 saatte başvuran ve trombolitik tedavi uygulanan hastalarda, PDD değerinin başarılı reperfüzyonu ve infarkt ilişkili arter açıklığını öngördürmede ek bir parametre olarak kullanılıp kullanılamayacağını belirlemektir. Hastalar ve Yöntem: Çalışmamıza 01.01.2012-01.12.2013 tarihleri arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalına STEMİ tanısıyla başvuran ve semptomların ilk 12 saati içinde trombolitik tedavi uygulanan ardışık 150 hasta alındı. Veriler geriye dönük olarak incelendi. Hastaların demografik özellikleri, rutin laboratuvar parametreleri kaydedildi. Trombolitik tedavinin 0., 30., 60., 90. ve 120. dakikalarında çekilen 12 derivasyonlu EKG kayıtlarına ulaşıldı. Tüm EKGlerde maksimum, minimum P dalga süreleri ve PDD hesaplandı, ST segment rezolüsyon oranları belirlendi. Ayrıca hastaların koroner anjiyografi görüntüleri değerlendirilip infarkt ilişkili arterdeki TIMI kan akımı ve TIMI kare sayısı hesaplandı. PDD değerleri ile ST segment rezolüsyonu ve infarkt ilişkili arter açıklığı arasındaki ilişki değerlendirildi. Bulgular: Trombolitik tedavi başlangıcında ölçülen PDD değeri 50,79±14,12 msn iken 90. dk PDD değeri 48,34±15,60 ve 120. dkda ölçülen PDD değeri 47,85±10,87 msn olarak saptandı, aradaki fark istatistiksel olarak anlamlı değildi (p=0,07). PDD değerleri, ST segment rezolüsyon grupları ile karşılaştırıldığında; 120. dkda ölçülen PDD değerinin komplet rezolüsyon sağlanan grupta, inkomplet ve yetersiz rezolüsyon sağlanan gruplara göre anlamlı olarak daha düşük olduğu saptandı (sırasıyla; 42,10±9,55, 49,65±10,60, 56,08±7,44 msn; p

The predictive value of p wave dispersion in determination of ınfarct related artery patency

Introduction: The value of P-wave dispersion (PWD) on the surface electrocardiogram (ECG) has been shown to increase in coronary ischemia. Previous studies demonstrated that PWD decreased with reperfusion therapy in patients with ST segment elevation myocardial infarction (STEMI). The aim of current study was to investigate whether PWD is able to be used as an additional parameter to predict successful reperfusion and infarct related artery patency in patients with STEMI who were admitted in the first 12 hours of myocardial infarction and received thrombolytic therapy. Patients and Methods: A total of 150 patients who were referred to Dokuz Eylül University Faculty of Medicine Cardiology Department with STEMI between January 1, 2012 and December 1, 2013 and received thrombolytic therapy in the first 12 hours of the symptoms were included in this study. Hospital records of each patient were evaluated retrospectively. Demographical features and routine laboratory parameters were noted. Standard 12- lead surface ECG of each patient which were recorded before and at 30, 60, 90 and 120 minutes after the start of thrombolytic therapy were obtained. Maximum, minimum P-wave duration and PWD were calculated on each electrocardiogram and ST segment resolution was determined. Coronary angiography images were also evaluated to determine TIMI flow grade and TIMI frame count of the infarct related artery. The relationship between PWD and ST segment resolution and infarct related artery patency was investigated. Results: While PWD at the start of the thrombolytic therapy was 50.79±14.12 ms, PWD at 90th minute of thrombolytic therapy was calculated as 48.34±15.60 and PWD at 120th minute of thrombolytic therapy was calculated as 47.85±10.87 ms; the difference was not statistically significant (p= 0.07). The comparison of PWD values with ST segment resolution groups demonstrated that PWD at 120 th minute of thrombolytic therapy was

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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