Sevinç BOSTANOĞLU, Levent ALTIN, Mehmet Alp KARADEMİR, İzzet Selçuk PARLAK, Mehmet DEVELER

Valvüler Kalp Hastalıklarında Karotis Arterlerde Renkli Doppler Değişiklikleri

Amaç: Bu çalışmanın amacı kalp kapak hastalığı olan hastalarda Renkli Doppler ultrasonografi (RDUS) ile karotisarterlerdeki dalga formlarını şekil, hız, upstroke (akselerasyon eğimi) gibi niceliksel ya da niteliksel parametreler de- ğerlendirerek incelemektir.Yöntem ve Gereçler: Romatizmal kalp kapak hastalığı olan 24 hastaya ve bunlarla yaş uyumlu 14 kontrol hastasınakarotis arter RDUS tetkiki yapıldı.Bulgular: Kapak hastalarından 2. ve 3. derece aort yetmezliği (AY) olan toplam 14 hastada (%58.3), daha çok anakarotis arterlerde (CCA) olmak üzere ikinci sistolik tepe saptandı. 2. ve 3. derece AY olan 8 hastada (% 33.3) diyas- tolik geri akım saptanmışken, kontrol grubunda diyastolik geri akım saptanmadı. 2. ve 3. AY olan ve bunlara 2. ve 3.derece mitral darlığının (MD) eşlik ettiği 6 hastada (%25) multiple sistolik tepe gözlendi. Spektral incelemeler sonu- cunda hasta grubundaki hızlar (ortalama 46,3 cm/sn), kontrol grubundaki hızlardan (ortalama 52 cm/sn) daha düşükölçülmüştür. Ayrıca kapak hastalarında akselerasyon zamanlarında (AT) uzama, dalgalarda yuvarlaklaşma ve künt- leşme, diyastol sürelerinde uzama dikkati çekmiştir.Sonuç: Herhangi bir nedenle karotis arter RDUS incelemesi yapılan bir hastada, anormal dalga paternleriyle karşı- laşıldığında, bu paternlerin asemptomatik bir valvuler kapak hastalığı yönünden uyarıcı olarak erken tanıya katkıdabulunabileceğini düşünmekteyiz.

Carotid Artery Color Doppler Changes In Valvular Heart Diseases

Aim:The aim of this study is to examine carotid artery waveforms including qualitative and quantitative parameterssuch as shape, velocity, upstroke in valvular heart diseases (VHD) using color Doppler ultrasonograhy(CDUS).Material and Methods: Carotid artery CDUS was performed to 24 patients with valvular heart diseases and age- matched 14 control patients.Results: Two systolic peaks were seen in 14 patients (%58.3) with 2nd and 3rd degree aortic reguritation (AR).Although diastolic reverse flow was detected in 8 patients (%33.3) with 2nd and 3rd degree AR, it was not detectedin control group. Multiple systolic peaks were seen in 6 patients (%25) with 2nd and 3rd degree AR combined with2nd and 3rd degree mitral stenosis (MS). The systolic flow velocities (mean 46,3 cm/sn) were lower in patient groupthan control group (mean 52 cm/sn). Prolonged acceleration times, prolonged diastols and rounded waveforms werealso detected in patient group.Conclusion: We think that when abnormal carotid artery waveforms are seen on CDUS with any cause, these abnor- mal patterns can be warning for early diagnosis of asymptomatic VHD.

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