Behçet hastalarında sistemik ve pulmoner arteriyel parametrelerin hastalıkla ilişkisi ve hastalığın seyrinde öngördürücü değeri
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Dosyalar
Tarih
2020
Yazarlar
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Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada, Behçet Hastalarının rutin kontrolleri esnasında non-invaziv ve pratik şekilde bakılabilen temel ekokardiyografik parametreler, pulmoner pulse wave transit time, pulmoner stiffness, interatrial ve intratrial gecikme süreleri ile tansiyon holter cihazıyla bakılabilen aort sertliğine yönelik verilerin toplanması sonrasında sistemik ve pulmoner arteriyel parametrelerin Behçet Hastalığıyla ilişkisi ve hastalığın seyrindeki öngördürücü değerinin araştırılması amaçlandı. Yöntem: Çalışmaya merkezimiz dermatoloji polikliniğinde takipli daha önce Behçet Hastalığı tanısı almış rutin kontrolüne gelen 96 hasta ve kardiyoloji polikliniğindeki muayene ve tetkileri soncunda normal olarak değerlendirilen 51 sağlıklı gönüllü alındı. Ekokardiyografi ile değerlendirme konvansiyonel ekokardiyografi yöntemleri ve doku doppler görüntüleme yöntemleriyle yapıldı. Aort sertliğine yönelik değerlendirme PWA monitörle yapıldı. Hastalar demografik özellikler, laboratuvar bulguları, ekokardiyografik bulgular ve PWA monitör kayıtlarına göre kontrol grubuyla karşılaştırıldı. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 37.2 olup, hastaların %45.8'i erkeklerden oluşmaktaydı. Çalışmamızda Behçet Hastalarında kontrol grubuna göre pulmoner arteriel sertlik artmış (20.8+-5.8 /15.0+-2.7 kHz/s, p<0.001), pulmoner pulse wave taransit time (pPTT) kısalmış (0.16+-0.04/ 0.23+-0.05, p<0.001) olarak bulundu. Hasta grubunda ana pulmoner arter çapında genişleme (21.6+-2.5/18.2+-1.9 mm, p<0.001), interatrial gecikme süresinde uzama (30.9+-8.9/25.5+-9.5 ms, p:0.001), sağ atrium intraatrial gecikme süresinde uzama (12.9+-7.2/10.4+-5.7 ms, p:0.03), sol atrium intraatrial gecikme süresinde uzama (18.9+-8.9/15.1+-7.1 ms, p:0.008) kontrol grubuna göre istatistiki olarak anlamlıydı. PAS'nin; hastalığın süresiyle (r:0.361, p<0.001), ana pulmoner arter çapıyla (r:0.539, p<0.001), sistolik PAB ile (r:0.334, p<0.001), EMCT ile (r:0.279, p:0.001), RA intraatrial gecikme zamanı ile (r:0.306, p<0.001) ve CRP değerleriyle (r:0.377, p<0.001) pozitif korelasyon gösterdiği; aynı zamanda PAS'nin ejeksiyon fraksiyonuyla (r:-0.278, p<0.001), E/A oranıyla (r:-0.269, p<0.001), TAPSE ile (r:-0.358, p<0.001), RV-Sm ile (r:-0.209, p:0.011), ve Pulmoner pulse wave transit time (pPTT) (r:-0.438, p<0.001) ile negatif korelasyon gösterdiği bulunmuştur. Pulmoner arter sertliğine yönelik yapılan lineer regresyon analizinde ise PAS ile hastalığın süresi (Beta:0.281, p:0.027) ve CRP (Beta:0.215, p:0.035) arasında korelasyon varken yaş (p:0.857), ejeksiyon fraksiyonu (p:0.395), PWV (0.954) ve hastalık aktivite skoru (p:0.859) arasında anlamlı korelasyon izlenmemiştir. pPTT'nin ise EF ile (r:0.221, p:0.07), TAPSE ile (r:0.454, p<0.001), RV-Sm ile (r:0.258, p:0.02), RV-FAC ile (r:0.398, p<0.001) pozitif korelasyon gösterdiği ve aynı zamanda pPTT'nin ana pulmoner arter çapı ile (r:-0.441, p<0.001), sPAB ile (r:-0.371, p<0.001), EMCT ile (r:-0.251, p:0.002), hastalık aktivite skoru ile (r:-0.228, p:0.025) ve PAS ile (r:-0.438, p<0.001) negatif korelasyon gösterdiği bulunmuştur. Aort sertliğine yönelik bakılan PWA monitör kayıtlarında ise hasta ve kontrol grubu arasında istatistiki olarak anlamlı farklılık izlenmemiştir. Sonuç: Behçet hastalarında non-invaziv yöntemlerle bakılabilen pulmoner arteriel sertlik, pulmoner pulse wave transit time, temel sistolik ve diyastolik parametreler, interatrial ve intraatrial gecikme süreleri gibi parametreler hastalığın şiddetinde ve hastalığın sistemik ve pulmoner dolaşım üzerine etkisinin tahmininde kullanılabilir.
In this study, we aimed to investigate the relationship and predictive value between systemic and pulmonary arterial parameters with Behçet's disease and the course of the disease after collecting data for non-invasive and practically observable basic echocardiographic parameters, pulmonary pulse wave transit time, aortic stiffness during the routine controls of Behçet Patients. Materials and Methods: Our study included 96 patients who were followed-up in our dermatology outpatient clinic, who had been diagnosed with Behçet's disease before, and 51 healthy volunteers who were evaluated as normal after their physical examinations and analysis in the cardiology outpatient clinic. Evaluation with echocardiography was done using conventional echocardiography methods and tissue doppler imaging methods. Assessment of aortic stiffness was made with a PWA monitor. The patients were compared with the control group according to demographic characteristics, laboratory findings, echocardiographic findings and PWA monitor records. Results: The average age of the patients included in the study was 37.2, and 45.8% of the patients were men. In our study, we found as pulmonary arterial stiffness increased (20.8 + -5.8 /15.0+-2.7 kHz/s, p <0.001), pulmonary pulse wave transverse time (pPTT) shortenedin Behçet's patients compared to the control group (0.16 + -0.04 / 0.23 + -0.05, p <0.001). In the patient group enlargement of the main pulmonary artery diameter (21.6 + -2.5 / 18.2 +-1.9 mm, p <0.001), increasing in the interatrial delay time (30.9 + -8.9 / 25.5 + -9.5 ms,p: 0.001), increasing in the right atrium intraatrial delay time ( 12.9 + -7.2 / 10.4 + -5.7 ms, p: 0.03) and increasing of the left atrium intraatrial delay time (18.9 + -8.9 / 15.1 + -7.1 ms, p: 0.008) was statistically significant compared to the control group. We found that the PAS had positive corelation with the duration of the disease (r: 0.361, p <0.001), with the main pulmonary artery diameter (r: 0.539, p <0.001), with systolic PAB (r: 0.334, p <0.001), with EMCT (r: 0.279, p: 0.001), with RA intraatrial delay time (r: 0.306, p <0.001) and CRP values (r: 0.377, p <0.001). Also the PAS was correlated negatively with ejection fraction (r: -0.278, p <0.001), E / A ratio (r:-0.269, p <0.001), TAPSE (r: -0.358, p <0.001), RV-Sm (r: - 0.209, p: 0.011), and Pulmonary pulse wave transit time (pPTT) (r:-0.438, p<0.001). In the linear regression analysis for pulmonary artery stiffness, there was vii a correlation between the duration of the disease (Beta: 0.281, p: 0.027) and CRP (Beta: 0.215, p: 0.035) but there is no significant correlation was observed between age (p: 0.857), ejection fraction (p: 0.395), PWV (0.954) and disease activity score (p: 0.859). The pPTT have positive correlation with EF (r: 0.221, p: 0.07), TAPSE (r: 0.454, p <0.001), RV-Sm (r: 0.258, p: 0.02), RV-FAC (r: 0.398, p <0.001) and also pPTT have negative correlation with the main pulmonary artery diameter (r: -0.441, p <0.001), sPAP (r: -0.371, p <0.001), EMCT (r: -0.251, p: 0.002), disease activity score (r: -0.228, p: 0.025) and PAS (r: -0.438, p <0.001). In the PWA monitor records for aortic stiffness, there was no statistically significant difference between the patient and control groups. Conclusion: Parameters such as pulmonary arterial stiffness, pulmonary pulse wave transit time, basic systolic and diastolic parameters, interatrial and intraatrial delay times in Behçet's patients can be used to predict the effect of the disease on the severity of the disease, systemic and pulmonary circulation.
In this study, we aimed to investigate the relationship and predictive value between systemic and pulmonary arterial parameters with Behçet's disease and the course of the disease after collecting data for non-invasive and practically observable basic echocardiographic parameters, pulmonary pulse wave transit time, aortic stiffness during the routine controls of Behçet Patients. Materials and Methods: Our study included 96 patients who were followed-up in our dermatology outpatient clinic, who had been diagnosed with Behçet's disease before, and 51 healthy volunteers who were evaluated as normal after their physical examinations and analysis in the cardiology outpatient clinic. Evaluation with echocardiography was done using conventional echocardiography methods and tissue doppler imaging methods. Assessment of aortic stiffness was made with a PWA monitor. The patients were compared with the control group according to demographic characteristics, laboratory findings, echocardiographic findings and PWA monitor records. Results: The average age of the patients included in the study was 37.2, and 45.8% of the patients were men. In our study, we found as pulmonary arterial stiffness increased (20.8 + -5.8 /15.0+-2.7 kHz/s, p <0.001), pulmonary pulse wave transverse time (pPTT) shortenedin Behçet's patients compared to the control group (0.16 + -0.04 / 0.23 + -0.05, p <0.001). In the patient group enlargement of the main pulmonary artery diameter (21.6 + -2.5 / 18.2 +-1.9 mm, p <0.001), increasing in the interatrial delay time (30.9 + -8.9 / 25.5 + -9.5 ms,p: 0.001), increasing in the right atrium intraatrial delay time ( 12.9 + -7.2 / 10.4 + -5.7 ms, p: 0.03) and increasing of the left atrium intraatrial delay time (18.9 + -8.9 / 15.1 + -7.1 ms, p: 0.008) was statistically significant compared to the control group. We found that the PAS had positive corelation with the duration of the disease (r: 0.361, p <0.001), with the main pulmonary artery diameter (r: 0.539, p <0.001), with systolic PAB (r: 0.334, p <0.001), with EMCT (r: 0.279, p: 0.001), with RA intraatrial delay time (r: 0.306, p <0.001) and CRP values (r: 0.377, p <0.001). Also the PAS was correlated negatively with ejection fraction (r: -0.278, p <0.001), E / A ratio (r:-0.269, p <0.001), TAPSE (r: -0.358, p <0.001), RV-Sm (r: - 0.209, p: 0.011), and Pulmonary pulse wave transit time (pPTT) (r:-0.438, p<0.001). In the linear regression analysis for pulmonary artery stiffness, there was vii a correlation between the duration of the disease (Beta: 0.281, p: 0.027) and CRP (Beta: 0.215, p: 0.035) but there is no significant correlation was observed between age (p: 0.857), ejection fraction (p: 0.395), PWV (0.954) and disease activity score (p: 0.859). The pPTT have positive correlation with EF (r: 0.221, p: 0.07), TAPSE (r: 0.454, p <0.001), RV-Sm (r: 0.258, p: 0.02), RV-FAC (r: 0.398, p <0.001) and also pPTT have negative correlation with the main pulmonary artery diameter (r: -0.441, p <0.001), sPAP (r: -0.371, p <0.001), EMCT (r: -0.251, p: 0.002), disease activity score (r: -0.228, p: 0.025) and PAS (r: -0.438, p <0.001). In the PWA monitor records for aortic stiffness, there was no statistically significant difference between the patient and control groups. Conclusion: Parameters such as pulmonary arterial stiffness, pulmonary pulse wave transit time, basic systolic and diastolic parameters, interatrial and intraatrial delay times in Behçet's patients can be used to predict the effect of the disease on the severity of the disease, systemic and pulmonary circulation.
Açıklama
Anahtar Kelimeler
Behçet Hastalığı, pulmoner arteriel sertlik, pulmoner pulse wave transit time, aort sertliği, interatrial ve intraatrial gecikme süreleri, Behçet's Disease, pulmonary arterial stiffness, pulmonary pulse wave transit time, aortic stiffness, interatrial and intraatrial delay times
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Künye
Kandemir, Ş. A. (2020). Behçet hastalarında sistemik ve pulmoner arteriyel parametrelerin hastalıkla ilişkisi ve hastalığın seyrinde öngördürücü değeri. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
