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

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

Amaç: Treadmill egzersiz testi (TET)’ne hipertansif yanıt gelecekteki hipertansiyon gelişiminin erken belirtisidir. Bu kesitsel vaka kontrol çalışmasında TET’ne hipertansif yanıtla aortun elastik özellikleri, endotel fonksiyonları ve sol ventrikül fonksiyonları arasındaki ilişkiyi değerlendirdik. Yöntem ve gereç: Çalışma grubunu miyokardiyal iskemi şüphesi ile TET uygulanan ancak herhangi iskemi bulgusu olmayan ve TET’ne hipertansif yanıt gösteren 33 hasta ve kontrol grubunu yaş ve cinsiyetleri uyumlu 29 sağlıklı birey oluşturdu. Tüm katılımcılarda sol ventrikül fonksiyonlarını değerlendirmek için Doppler ve doku Doppler ekokardiyografi , endotel fonksiyonlarını değerlendirmek için brakiyal arter ultrasonografi siyle akım aracılı dilatasyon ve trinitrogliserin aracılı dilatasyon ve aortun elastik özellikleri aort kapağın 3 cm proksimalinden aort çapı ölçülerek belirlendi. Bulgular: Her iki grup arasında ekokardiyografi k sol ventrikül fonksiyonları ve istirahat brakiyal arter çapında fark yoktu. 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 özellikleri kontrol grubuyla karşılaştırıldığında çalışma grubunda bozulmuştu. Sonuç: Ultrasonografi yle belirlenen akım aracılı dilatasyon ve ekokardiyografi k değişkenler TET’ne hipertansif yanıt gösteren grupta ateroskleroz gelişiminin erken bulgusu olan hem endotel fonksiyonlarının hem de aortun elastik özelliklerinin bozulduğunu göstermektedir.

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

Aim: 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: Th e 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 fl ow-mediated dilatation and trinitroglycerine-mediated dilatation, and aortic elastic properties by measuring the aortic diameter 3 cm proximal to the aortic valve. Results: Th ere was no diff erence 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 diff er 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.

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