Yalçın BODUROĞLU, Duygu ZORLU, Arzu ERTÜRK

Astımlı hastalarda farklı bir bakış açısıyla ekokardiyografik değerlendirme

Giriş: Astım ile kardiyovasküler fizyopatoloji arasında karmaşık bir etkileşim olduğu bilinmektedir. Astımlı hastalarda ekokardiyografik (EKO) ve elektrokardiyografik (EKG) değerlendirmelerle yapılan araştırmalarda, pulmoner hipertansiyon (PHT) ve aritmiye neden olduğu tespit edilmiştir. Bu çalışmada, astım tanılı hastalarda, EKG'de aritmi indeksi, Doku Doppler görüntüleme (TDIE) ve konvansiyonel ekokardiyografik (CEI) değerlendirme amaçlanmıştır. Materyal ve Metod: Çalışmaya 63'ü kadın (%70,8), 26'sı erkek (%29,2) toplam 89 hasta dahil edildi. Hastalar üç gruba ayrıldıktan sonra her grup hafif-orta ve ağır astım olmak üzere iki gruba ayrıldı. Bulgular: Gruplar arasında yaş, cinsiyet ve antropometrik veriler açısından fark yoktu. EKG'de aritmi indeksleri açısından da gruplar arasında fark yoktu (p> 0,05). Ağır astım tanılı hastalarda daha yüksek olan sol ventrikül A dalga hızı dışında, mitral anüler düzlem sistolik hareketi (MAPSE), triküspit kapak anüler planın apekse doğru sistolik hareketi (TAPSE) ve her iki ventriküler diyastolik CEI hızları gruplar arasında benzerdi (p< 0,05). Mitral lateral, septal ve triküspit lateral anulusta her iki ventriküler diyastolik dolum hızlarının (e’ ve a’) zaman aralıkları incelendiğinde TDEI’ye göre Pa’m-3 ve Pa’s-3 aralıklarında anlamlı farklılık saptandı (p< 0,05). Ağır astım tanılı hastalarda LA’nın sadece maksimum hacmi daha yüksekti (p< 0,05). Ancak LA-VpreA ve LA-Vmin arasında anlamlı bir fark yoktu (p> 0,05). Sonuç: Bu sonuçlara dayanarak ağır astım tanılı hastalarda SA mekanik fonksiyonlarının ve intraatriyal SA elektromekanik sürelerinin bozulduğu ileri sürülebilir.

Echocardiographic evaluation from a different perspective in asthmatic patients

Introduction: It is known that there is a complex interaction between asthma and cardiovascular physiology. Some investigations on echocardiography and electrocardiography (ECG) in asthmatic patients have revealed many findings such as pulmonary hypertension (PHT) and arrhythmia. In this study, we aimed to perform tissue Doppler imaging (TDIE) and conventional echocardiographic (CEI) assessment with many indexes of arrhythmia on electrocardiography (ECG) in asthmatic patients. Materials and Methods: A total of 89 patients, 63 females (70.8%) and 26 males (29.2%), were included in this study. Patients were divided into three groups, and then each group was separated in two groups as mild-moderate and severe asthma. Results: There was no difference among groups with respect to age, sex and anthropometric data. There was no difference between the groups with respect to indexes of arrhythmia on ECG (p> 0.05). Mitral annular plane systolic excursion (MAPSE), tricuspid annular alane systolic excursion (TAPSE) and both ventricular diastolic velocities on CEI were similar between the groups, except for left ventricular A wave velocity which was higher in severe asthmatic patients (p< 0.05). Investigation of time intervals of both ventricular diastolic filling velocities (e’ and a’) at the mitral lateral, septal and tricuspid lateral annulus revealed significant difference at Pa’m-3 and Pa’s-3 intervals based on TDEI (p< 0.05). Only maximal volume of the LA was higher in severe asthmatic patients (p< 0.05). However, there was no significant difference between LA-VpreA and LA-Vmin (p> 0.05). Conclusion: Based on these results, it can be suggested that LA mechanical functions and intra-atrial LA electromechanical durations were impaired in severe asthmatic patients.

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