Emrullah KIZILTUNÇ, Burcu UĞURLU ILGIN, Harun KUNDİ, Hülya ÇİÇEKÇİOĞLU, Canan TOPÇUOĞLU, Mustafa ÇETİN, Ender ÖRNEK

Tanısal Egzersiz Elektrokardiyografi Testi Yapılan Hastalarda Serum Tiyol Disulfid Dengesi ve Endokan Düzeyleri

Giriş: İnflamasyon ve oksidatif stres artmış kardiyovasküler risk ile ilişkilidir. Duke koşu bandı skoru ve kalp hızı toparlanması (KHT) gibi egzersiz elektrokardiyografi (EKG) testinden türetilen parametreler prognostik öneme sahiptir ve kardiyovasküler risk tahmini için kullanılabilir. Endokan ve tiyol/disülfid dengesi, inflamatuvar ve oksidatif durumu yansıtan yeni biyolojik belirteçlerdir. Bu çalışmanın amacı, bir egzersiz EKG testi yapılan hastalarda serum tiyol/disülfid dengesi ve endokan düzeylerini araştırmak ve bu belirteçlerin Duke treadmill skoru ve KHT ile ilişkisini değerlendirmektir. Hastalar ve Yöntem: Tanısal egzersiz EKG testi yapılan hastalar Duke skoru ve KHT’ye göre iki gruba ayrıldı. Yüksek Duke skoru-orta/düşük Duke skoru grupları ile künt ve normal KHT grupları arasında serum endokan düzeyleri ve tiyol/disülfid dengesi karşılaştırıldı. Bulgular: Serum endokan düzeyleri, Duke treadmill skoru ve KHT’ye göre gruplar arasında benzerdi. Tiyol /disülfid oranı, azalmış KHT’li hastalarda normal KHT’li hastalara göre anlamlı derecede düşüktü. Yüksek/Duke skoru olan hastalarda, düşük/orta Duke skoru olan hastalara göre, serum nativ tiyol düzeyleri, total tiyol düzeyleri ve total tiyol/disülfid oranı anlamlı olarak yüksekti. Doğal tiyol düzeyleri ve total tiyol düzeyleri Duke skoru ile anlamlı korelasyon göstermekteydi. Çok değişkenli regresyon analizinde, azalmış KHT’inin bağımsız öngördürücüleri hipertansiyon ve diyabet varlığı; düşük/orta Duke skorunun bağımsız öngördürücüleri ise hipertansiyon varlığı ve düşük endokan düzeyleridir. Sonuç: Serum tiyol düzeyleri Duke skoru ile ilişkilidir ve düşük endokan seviyeleri düşük/orta Duke skoru ile ilişkilidir.

Anahtar Kelimeler:

İnflamasyon, oksidatif stres, Duke skoru, tiyol disülfid dengesi, endokan

Serum Thiol/Disulfide Homeostasis and Endocan Levels in Patients Who Underwent Diagnostic Exercise Electrocardiography Test

Introduction: Inflammation and oxidative stress are associated with increased risk of cardiovascular diseases. Parameters derived from exercise electrocardiography (ECG) test, such as Duke treadmill score and heart rate recovery (HRR), have prognostic importance and can be used to predict cardiovascular risk. Endocan and thiol/disulfide homeostasis are emerging biomarkers that reflect the inflammatory and oxidative status. The aim of this study was to investigate serum thiol/disulfide homeostasis and endocan levels in an exercise ECG testing patient cohort and to evaluate the association of these markers with Duke treadmill score and HRR. Patients and Methods: Patients who underwent diagnostic exercise ECG test were divided into two groups according to Duke treadmill score and HRR. Serum endocan levels and thiol/disulfide homeostasis were compared between high and low/intermediate Duke treadmill score groups and blunted and normal HRR groups. Results: Serum endocan levels were similar between the groups according to Duke treadmill score and HRR. Thiol/disulfide ratio was significantly lower in patients with blunted HRR than in those with normal HRR. Serum native thiol levels, total thiol levels, and total thiol/disulfide ratio were significantly elevated in patients with a high Duke treadmill score than in those with low/intermediate Duke treadmill score. Native thiol levels and total thiol levels were significantly correlated with Duke treadmill score. Multivariate regression analysis revealed that hypertension and diabetes were independent predictors of blunted HRR, whereas hypertension and low endocan levels were those of low/intermediate Duke treadmill score. Conclusion: Serum thiol levels are correlated with Duke treadmill score, and low endocan levels are associated with low/intermediate Duke treadmill score.

Keywords:

Inflammation oxidative stress, Duke score, heart rate recovery, thiol/disulfide homeostasis, endocan,

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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