Trombosit dağılım genişliği, perkütan mitral balon valvüloplasti sonrası azalmış trombosit aktivitesinin yararlı bir göstergesi olabilir

Amaç: Romatizmal mitral darlığı (RMD) olan hastalarda artmış trombosit aktivitesi ve yüksek ortalama trombosit hacmi (MPV) gösterilmiştir. Bununla birlikte, trombosit dağılım genişliği (PDW) ve perkütan mitral balon valvüloplasti'nin (PMBV) PDW üzerindeki etkisi hiç çalışılmamıştır. Bu nedenle, RMD'lı hastalarda PMBV işleminin PDW üzerine etkisini araştırmayı amaçladık.Gereç ve Yöntemler: PMBV uygulanan ciddi RMD'lı semptomatik hastalar dahil edildi. Ekokardiyografik özellikler ve hematolojik parametreler PMBV işleminden hemen önce ve bir ay sonra ölçüldü.Bulgular: Çalışmaya toplam 30 hasta (24 kadın, ortalama yaş: 49,8 ± 13,2 yıl) dahil edildi. Ortalama transmitral basınç gradyanı, pulmoner arter basınçları ve sol atriyum çapı azaldı, ancak mitral kapak alanı PMBV'den sonra anlamlı olarak arttı. PMBV prosedürü RMD'lı hastalarda PDW'yi anlamlı şekilde azalttı (sırasıyla 13.5 ± 2.3 vs 12.4 ± 1.9 fL, prosedürden önce ve sonra; p <0.0001). MPV, PMBV'den sonra azaldı, ancak istatistiksel olarak anlamlı değildi (10.9 ± 0.8'e karşılık 10.6 ± 0.9 fL, p = 0.056). Trombosit sayısı işlem sonrası anlamlı olarak arttı (250 ± 62.6 vs 273.5 ± 78.6 x 103 / ul, p = 0.035). Lineer regresyon analizinde, PDW azalmasının büyüklüğü ile mitral kapak alanındaki artışın büyüklüğü arasında bağımsız bir ilişki bulundu (ẞ: 0.491, p = 0.046). Sonuç: PMBV, işlemden 1 ay sonra PDW'de belirgin bir azalma ile ilişkilidir. PMBV'den sonra PDW'deki düşüşün büyüklüğü ile mitral kapak alanındaki artışın büyüklüğü arasında anlamlı bir ilişki vardır.

Anahtar Kelimeler:

Trombosit dağılım genişliği, trombosit aktivitesi, perkütan mitral balon valvüloplasti

Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty

Aim: Increased platelet activity and elevated mean platelet volume (MPV) has been demonstrated in patients with rheumatic mitral stenosis (RMS). However, platelet distribution width (PDW) and the impact of percutaneous mitral balloon valvuloplasty (PMBV) on PDW has never been studied. Therefore, we aimed to investigate whether PMBV decreases PDW in patients with RMS.Material and Methods: Symptomatic patients with severe RMS undergoing PMBV were included. Echocardiographic characteristics and hematologic parameters was measured just before and 1 month after the PMBV procedure.Results: A total of 30 patients (24 female, mean age: 49.8±13.2 years) were included the study. Mean transmitral pressure gradient, pulmonary artery pressures and left atrium diameter decreased but mitral valve area increased significantly after PMBV. PMBV procedure significantly decreased PDW in patients with RMS (13.5±2.3 vs 12.4±1.9 fL, before and after procedure, respectively; p<0.0001). MPV was decreased after PMBV but it was not statistically significant (10.9±0.8 vs 10.6±0.9 fL, p=0.056). Platelet count was significantly increased after procedure (250±62.6 vs 273.5±78.6 x103/ul, p=0.035). In linear regression analysis, an independent relationship was found in magnitude of PDW decrease and magnitude of increase in mitral valve area (ẞ:0.491, p=0.046). Conclusion: PMBV is associated with a significant decrease in PDW 1 month after the procedure. There was a significant correlation between the magnitude of decrease in PDW and magnitude of increase in mitral valve area after PMBV.

Keywords:

platelet distribution width, platelet activity, percutaneous mitral balloon valvuloplasty,

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