Romatizmal mitral darlık hastalarında mitral kapak yaprakçık kalsifikasyonu ile prognostik nütrisyonel indeks ilişkisi

Amaç: Romatizmal mitral darlığı ve malnütrisyon, gelişmekte olan ülkelerde halen önemli bir sağlık sorunudur. Mitral kapak yaprakçık kalsifikasyonu, mitral darlığı hastalarının prognozlarını kötü yönde etkileyen klinik bir durumdur. Bu çalışmada, malnütrisyonun genel bir göstergesi olan prognostik nütrisyonel indeks (PNİ) ile mitral darlığı bulunan hastalarda mitral kapak yaprakçık kalsifikasyonu ilişkisi incelenmiştir. Yöntem: Mitral darlığı tanısı bulunan 675 hasta retrospektif olarak çalışmaya dahil edilmiştir. Mitral darlığı bulunan hastalar mitral kapak yaprakçık kalsifikasyonu bulunup bulunmamasına göre ve mitral kapak darlığının ciddiyetine göre sınıflandırılmıştır. Laboratuvar bulguları ve PNİ değerleri gruplar arası karşılaştırılmıştır. Bulgular: Mitral kapak yaprakçık kalsifikasyonu varlığına bağlı olarak yapılan sınıflamada gruplar arasında diabetes mellitus ve hipertansiyon sıklığı benzerdi. Serum albümin düzeyleri ve PNİ, mitral yaprakçık kalsifikasyonu bulunan grupta istatistiksel anlamlılığa erişecek şekilde düşük saptandı (sırasıyla 4.1±0.5’e karşı 3.9±0.5 p<0.001 ve 51.3±7.85’e karşı 48.5±7.4 p<0.001). Yapılan regresyon analizinde mitral kapak yaprakçık kalsifikasyonunun en önemli ön gördürücü belirteçleri olarak PNİ ve mitral kapak alanı saptandı. Sonuç: Mitral kapak yaprakçık kalsifikasyonu bulunan hastalarda, PNİ anlamlı olarak düşük saptanmıştır. Ayrıca düşük PNİ düzeyleri, mitral kapak yaprakçık kalsifikasyonunun ön gördürücülerinden biridir.

Anahtar Kelimeler:

Romatizmal mitral darlık, inflamasyon, prognostik nütrisyonel indeks

Relationship between mitral valve leaflet calcification and prognostic nutritional index in patients with rheumatic mitral stenosis

Aim: Rheumatic mitral stenosis and malnutrition are still important health problems in developing countries. Mitral valve leaflet calcification is a clinical condition that adversely affects the prognosis of patients with mitral stenosis. Thus we sought to investigate the relationship between the prognostic nutritional index (PNI), which is a general indicator of malnutrition, and mitral valve leaflet calcification in patients with mitral stenosis. Method: Retrospectively, 675 patients with a diagnosis of mitral stenosis were included. Patients with mitral stenosis were classified according to the coexistence of mitral valve leaflet calcification and the severity of mitral valve stenosis. Laboratory findings and PNI calculations were compared. Results: The frequency of diabetes mellitus and hypertension was similar between the groups based on mitral valve leaflet calcification. Mean serum albumin levels and PNI were lower in the mitral valve leaflet calcification group (4.1±0.5 vs. 3.9±0.5 p<0.001 and 51.3±7.85 vs. 48.5±7.4 p<0.001, respectively). Regression analysis revealed that PNI and mitral valve area are the strongest independent predictors of mitral valve leaflet calcification. Conclusion: PNI was found significantly lower for mitral valve leaflet calcification group and PNI was one of the strongest independent predictors of mitral valve leaflet calcification.

Keywords:

Rheumatic mitral stenosis, inflammation, prognostic nutritional index,

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