Fethi KILIÇASLAN, Bekir Sıtkı CEBECİ, Ata KIRILMAZ, Oben BAYSAN, Mehmet YOKUŞOĞLU, Rifat Eralp ULUSOY

Treadmil egzersiz testine hipertansif yanıtı olan hastalarda ventrikül fonksiyonları, aortun elastik özellikleri ve endotel fonksiyonları

Amaç: Treadmill egzersiz testi (TET)’ne hipertansif yanıt gelecekteki hipertansiyon gelişiminin erken belirtisidir. Bukesitsel vaka kontrol çalışmasında TET’ne hipertansif yanıtla aortun elastik özellikleri, endotel fonksiyonları ve solventrikül fonksiyonları arasındaki ilişkiyi değerlendirdik.Yöntem ve gereç: Çalışma grubunu miyokardiyal iskemi şüphesi ile TET uygulanan ancak herhangi iskemi bulgusuolmayan ve TET’ne hipertansif yanıt gösteren 33 hasta ve kontrol grubunu yaş ve cinsiyetleri uyumlu 29 sağlıklıbirey oluşturdu. Tüm katılımcılarda sol ventrikül fonksiyonlarını değerlendirmek için Doppler ve doku Dopplerekokardiyografi , endotel fonksiyonlarını değerlendirmek için brakiyal arter ultrasonografi siyle akım aracılı dilatasyonve trinitrogliserin aracılı dilatasyon ve aortun elastik özellikleri aort kapağın 3 cm proksimalinden aort çapı ölçülerekbelirlendi.Bulgular: Her iki grup arasında ekokardiyografi k sol ventrikül fonksiyonları ve istirahat brakiyal arter çapında farkyoktu. Çalışma grubunda kontrol grubuna gore brakiyal arter akım aracılı dilatasyonda % 46 bozulma gözlendi (P <0,05). Endotel bağımsız trinitrogliserin aracılı dilatasyon ise her iki grupta benzerdi (P > 0,05). Aortun elastik özelliklerikontrol grubuyla karşılaştırıldığında çalışma grubunda bozulmuştu.Sonuç: Ultrasonografi yle belirlenen akım aracılı dilatasyon ve ekokardiyografi k değişkenler TET’ne hipertansif yanıtgösteren grupta ateroskleroz gelişiminin erken bulgusu olan hem endotel fonksiyonlarının hem de aortun elastiközelliklerinin bozulduğunu göstermektedir.

Anahtar Kelimeler:

Aortun elastik özellikleri, endotel fonksiyonları, treadmil egzersiz testi, akım aracılı dilatasyon

Ventricular functions, aortic elastic properties, and endothelial functions in patients with hypertensive response to treadmill exercise testing

Hypertensive response to treadmill exercise testing (TET) is an early marker of future development of hypertension. In this cross-sectional, case-control study we evaluated the relationship of hypertensive response to TET with aortic elastic properties, endothelial functions, and left ventricular functions. Materials and methods: The study group comprised 33 individuals who underwent TET with suspicion of myocardial ischemia, but no evidence of ischemia and with hypertensive response to TET, and the control group comprised 29 age- and gender-matched subjects. All participants underwent echocardiographic examination, brachial artery ultrasonography, and aortic ultrasonography for the assessment of left ventricular functions, endothelial functions by determining brachial artery flow-mediated dilatation and trinitroglycerine-mediated dilatation, and aortic elastic properties by measuring the aortic diameter 3 cm proximal to the aortic valve. Results: There was no difference between the groups in terms of echocardiographic left ventricular functions and baseline brachial artery diameters. Flow mediated dilatation showed 46% impairment in the study group compared with control (P < 0.05). Endothelium-independent trinitroglycerine dilatation did not differ in the groups (P > 0.05). Aortic elastic properties demonstrated impairment in the study group compared to the controls. Conclusion: Flow mediated dilatation assessed with ultrasonography and echocardiographic variables demonstrated impairment for both endothelial function and aortic elastic properties in the study group in terms of early vascular development of atherosclerosis.

Keywords:

endothelial function, treadmill exercise test, flow mediated dilation, Aortic elastic properties,

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