Koroner ektazisi ile trimethylamine n-oxide arasındaki ilişkinin değerlendirilmesi
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Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmadaki amacımız bağırsakta bulunan mikrobiyotanın konakçı tarafından besinlerle alınan betain, kolin ve betainden trimetilamin sentezlemesi sonrası konakçı tarafından trimetilamin-N-okside dönüştürülmesi ve bu oluşan metabolitin koroner ektazi üzerine etkisi araştırmaktır. Yöntem: Ç alış mamıza merkezimiz kardiyoloji kliniğ indestabil anjinapektoris tanısı ile koroner anjiografi yapılan ve izole koroner arter ektazisi (KAE) saptanan 81 hasta ve obstrüksiyona neden olacak aterskleroz, koroner arter anevrizma/ektazisi ve diseksiyon gibi patolojik koroner anatomiye sahip olmayan (normal koroner anatomi) 74 vaka kontrol grubu olarak alındı. Hastaların demografik ö zellikleri, laboratuar bulguları ve bazal EKG (elektrokardiyografi) bulguları karşılaştırıldı. Tüm vakalardan alınan rutin tetkiklerinin yanında trimetilamin-N-oksid (TMAO)plazma düzeyleri ölçülerek karşılaştırıldı. Ayrıca tüm vakalar ekokadiyografik değerlendirme olarak ejeksiyon fraksiyonu (EF), sol ventrikül diyastol sonuçap (LVEDD), sol ventrikül sistol sonu çap (LVESD) ve sol atriyum (LA) çapı karşılaştırıldı. Bulgular: Çalışmaya dahil edilen ektazik koronere sahip hastaların 50 (%61.7)’si erkek ve 31 (%38.3)’i kadın hasta idi. Çalışmadaki popülasyonun yaş ortalaması56.52±10 iken hasta grubunun 56±10, kontrol grubununki ise 57±10 olarak ölçüldü. Bunun yanında çalışma grubunun her iki kolunda yer alan diyabetis mellitus, hipertansiyon, hiperlipidemi ve sigara öyküsünü içeren temel demografik özellikler açısından anlamlı fark izlenmedi. Koroner ektazi grubunda TMAO seviyesi (0.649/0.527μM, p:0.02) ve LA çapı (36.6±4/34.8±5mm, p:0.021) kontrol grubuna göre istatistiksel olarak anlamlı yüksek saptandı.
Sonuç: Çalışmamızda plazmadan çalışılarak elde edilen mikrobiyota metaboliti olan TMAO, KAE’si olan hastalarda kontrol grubuna göre istatistiksel olarak artmış izlendi. Ayrıca KAE grubunda LA boyutlarında remodeling meydana gelmiş olup LA çapı KAE grubunda istatistiksel olarak anlamlı artmış izlendi. Bunun yanında her iki grupta bakılan temel ekokardiyografik değer olan EF, LVEDD, LVESD, sistolikpulmoner arter basıncı
(sPAB) arasında anlamlı fark izlenmemiştir. Bu bilgiler ışığında TMAO; koroner arter hastalığı (KAH) ve KAE’de olduğu gibi birçok endotelyal hastalık patofizyolojisinde yer alabileceğini düşündürmektedir. Ayrıca KAE, LV diastolik fonksiyonlarda bozulmalara ve LA’ da remodelinge neden olarak yapısal kalp hastalığına neden olabilmektedir.
Objective: Our aim in this study is to investigate the conversion of the intestinal microbiota to trimethylamine-N-oxide by the host after the synthesis of trimethylamine from betaine, choline and betain eingested by the host, and to investigate the effect of this metabolite on coronary ectasia. Materials and Methods: In ourstudy, 81 patients with isolated coronary artery ectasia who under went coronary angiography with the diagnosis of stable angina pectoris in the our cardiology clinic and 74 patients who did not have pathological coronary anatomy such as atherosclerosis, coronary artery aneurysm/ectasia and dissection (normal coronary anatomy) that would cause obstruction were included in the control group. Demographic characteristics, laboratory findings and baseline ECG findings of the patients were compared. In additiont other out in examinations taken from all cases, TMAO serum levels were measured and scratched. Inaddition, EF, LVEDD, LVESD and LA diameters of all cases were compared as echocardiographic evaluation. Results: The patients included in the study, 50 (61.7%) were male and 31 (38.3%) were female. The mean age of the population in the study was 56.52±10, 56±10 in the patient group and 57±10 in the control group. In addition, no significant difference was observed in terms of basic demographic characteristics including diabetes mellitus, hypertension, hyperlipidemia and smoking history in both arms of the study group. TMAO level (0.649/0.527μM, p:0.02) and LA diameter (36.6±4/34.8±5mm, p:0.021) in the coronary ectasia group were found to be statistically significantly higher than the control group. Conclusion: In our study, TMAO, a microbiota metabolite obtained from plasma, was statistically increased in patients with CAE compared to the control group. In addition, remodeling occurred in LA dimensions in the CAE group, and a statistically significant increase in LA diameter was observed in the CAE group. Inaddition, no significant difference was observed between EF, LVEDD, LVESD, and sPAB, which are the basic echocardiographic values measured in both groups. In the light of this information, TMAO; It suggests that it may be involved in the pathophysiology of many endothelial diseases, as in CAD and CAE. In addition, CAE may cause structural heart disease by causing deterioration in LV diastolic functions and remodeling in LA
Objective: Our aim in this study is to investigate the conversion of the intestinal microbiota to trimethylamine-N-oxide by the host after the synthesis of trimethylamine from betaine, choline and betain eingested by the host, and to investigate the effect of this metabolite on coronary ectasia. Materials and Methods: In ourstudy, 81 patients with isolated coronary artery ectasia who under went coronary angiography with the diagnosis of stable angina pectoris in the our cardiology clinic and 74 patients who did not have pathological coronary anatomy such as atherosclerosis, coronary artery aneurysm/ectasia and dissection (normal coronary anatomy) that would cause obstruction were included in the control group. Demographic characteristics, laboratory findings and baseline ECG findings of the patients were compared. In additiont other out in examinations taken from all cases, TMAO serum levels were measured and scratched. Inaddition, EF, LVEDD, LVESD and LA diameters of all cases were compared as echocardiographic evaluation. Results: The patients included in the study, 50 (61.7%) were male and 31 (38.3%) were female. The mean age of the population in the study was 56.52±10, 56±10 in the patient group and 57±10 in the control group. In addition, no significant difference was observed in terms of basic demographic characteristics including diabetes mellitus, hypertension, hyperlipidemia and smoking history in both arms of the study group. TMAO level (0.649/0.527μM, p:0.02) and LA diameter (36.6±4/34.8±5mm, p:0.021) in the coronary ectasia group were found to be statistically significantly higher than the control group. Conclusion: In our study, TMAO, a microbiota metabolite obtained from plasma, was statistically increased in patients with CAE compared to the control group. In addition, remodeling occurred in LA dimensions in the CAE group, and a statistically significant increase in LA diameter was observed in the CAE group. Inaddition, no significant difference was observed between EF, LVEDD, LVESD, and sPAB, which are the basic echocardiographic values measured in both groups. In the light of this information, TMAO; It suggests that it may be involved in the pathophysiology of many endothelial diseases, as in CAD and CAE. In addition, CAE may cause structural heart disease by causing deterioration in LV diastolic functions and remodeling in LA
Açıklama
Anahtar Kelimeler
Mikrobiyota, trimetilamin-N-oksid, Koroner Ektazi, Microbiota, trimethylamine-N-oxide, Coronary Ectasia
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Sarı, H. (2022). Koroner ektazisi ile trimethylamine n-oxide arasındaki ilişkinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
