Karotid Cisim Boyutlarının Hipertansiyon ve Komorbid Hastalıklarla İlişkisi: BT Anjiyografik Çalışma

Amaç: Karotid cisim (KC) boyutlarının hipertansiyon, sempatik sistem hiperaktivasyonunun görüldüğü diğer hastalıklar ve sigara ile ilişkisinin araştırılması. Gereç ve Yöntemler: Son bir yıl içerisinde kliniğimizde boyun bilgisayarlı tomografi (BT) anjiyografi tetkiki yapılmış olan hastalar çalışmaya dahil edildi. Hastaların klinik öykülerinden hipertansiyon, konjestif kalp yetmezliği (KKY), diyabetes mellitus (DM), kronik obstrüktif akciğer hastalığı ve sigara içiciliği durumları kaydedildi. Hastalar yalnız sigara içen ve hiç komorbid hastalığı olmayan (Grup S, n=21), yalnızca hipertansiyonu olan (Grup HT, n=26), en az 2 komorbid hastalığa sahip olan (Grup KH, n=78) hastalar ve kontrol grubu (n=33) olmak üzere 4 gruba ayrıldı. BT anjiografi kesitlerinde KC’nin aksiyal planda en uzun aksı ölçüldü. Bulgular: KC boyutu 158 hastada ölçülebildi. KC boyutu, grup HT’de (2,77±3.28 mm, p=0,02) ve grup KH’de (2,77±3,28 mm, p=0,02) kontrol grubu (2,22±3,41 mm) ile karşılaştırıldığında anlamlı olarak daha fazlaydı. Grup S (2,47±3,44 mm) ile kontrol grubu arasında anlamlı farklılık saptanmadı (p=0,123). Tekrarlanan ölçümlerde her iki taraf için yüksek gözlemci içi uyum saptandı (ICC=0,91/0,94). Sonuçlar: Hipertansiyonu olan hastalarda KC boyutu artmaktadır. Ayrıca KC boyutu hipertansiyon, KKY ve DM gibi sempatik hiperaktivasyonun görüldüğü diğer hastalıklarda da anlamlı olarak artış göstermektedir. BT anjiyografi, KC ile sempatik hiperaktivasyonun görüldüğü hastalıklar arasındaki ilişkinin daha iyi anlaşılmasının yanında bu alandaki çalışmalarda ve tedavi seçeneklerinde yol gösterici olabilir.

Anahtar Kelimeler:

bilgisayarlı tomografi, karotid cisim, hipertansiyon

Carotid Body Enlargement in Patients with Hypertension and Comorbid Diseases: a CT Angiographic Study

Aim: To determine the carotid body (CB) size and its relationship with hypertension, other sympathetically mediated disorders and smoking. Materials and Methods: Neck CT angiographies of 180 patients performed in our clinic in the previous year were included in the study. The patients' histories were assessed for hypertension (HT), congestive heart failure (CHF), diabetes mellitus (DM), chronic obstructive pulmonary disease and smoking. The study groups were smokers without any chronic condition (S group, n=21), patients with HT alone (HT group, n=26), patients that had at least two chronic disorders (CD+S group, n=78) and the controls (n=33). The widest axial diameter of the CB was measured on axial sections. Results: CB diameter could be measured in 158 patients. The CB diameter was significantly greater in HT (2.77±3.28 mm, p=0.02) and CD+S (2.76±3.38 mm, p<0.01) groups compared to the controls (2.22±3.41 mm). There was no significant difference between the S group (2.47±3.44 mm) and the control group (p=0.123). Repeated measurements showed a high intra-observer correlation for both sides. Conclusion: HT causes a significant increase in CB size. CB size also increases significantly in individuals with the combination of sympathetically mediated disorders, including HT, CHF, and DM. CTA may provide a better understanding of the relationship between CB and sympathetically mediated diseases and guide further studies as well as therapies targeting CB.

Keywords:

computed tomography, carotid body, hypertension,

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