Korunmuş ejeksiyon fraksiyonlu kalp yetmezliği hastalarında sistemik ve pulmoner arteriyel sertlik parametrelerinin, HFPEF skorları (H2FPEF, HFA-PEFF) ve diyastolik disfonksiyon parametreleriyle olan ilişkisi
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Dosyalar
Tarih
2021
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 HFpEF hastalarının rutin kontrolleri esnasında non-invaziv
şekilde ekokardiyografik olarak ölçülebilen pulmoner pulse wave transit time (pPTT),
pulmoner arteryel sertlik (PAS) ve tansiyon holter cihazıyla bakılabilen aortik sertliğe yönelik
parametrelerin; HFpEF skorlamaları (H2FPEF, HFA-PEFF), bu skorlamalar kılavuzluğunda
tanı konan HFpEF hastaları ve diyastolik disfonksiyon ile olan ilişkisini ortaya koymaktır.
Yöntem: Çalışmamıza merkezimiz kardiyoloji kliniğinde takipli klinik, laboratuvar ve
ekokardiyografik olarak tanı konmuş 52 HFpEF hastası ve Kardiyoloji polikliniğine muayene
olup kalp yetmezliği olmayan 49 adet kontrol grubu hasta olmak üzere toplam 101 vaka alındı.
Ekokardiyografi ile değerlendirme konvansiyonel ekokardiyografi, doku doppler
görüntüleme, strain görüntüleme yöntemleriyle yapıldı. HFpEF tanısını destekleyen
diyastolik parametreler ve pulmoner arteryel sertliğe yönelik ekokardiyografik parametreler
hesaplandı. Aort sertliğine yönelik değerlendirme PWA monitörle yapıldı. Hastaların
demografik özellikleri, laboratuar bulguları, pulmoner arteryel parametreleri de içeren
ekokardiyografi bulguları ve aort sertliğine yönelik sonuçları kontrol grubuyla karşılaştırıldı.
Bulgular: Yaş, cinsiyet, diyabet, hipertansiyon, hiperlipidemi, koroner arter hastalığı ve
sigara öyküsünü içeren temel özellikler HFpEF ve kontrol grubu arasında benzerdi. PAS,
HFpEF grubunda kontrol grubuna kıyasla daha yüksek (18.4(15.7-21.8) / 14.2(13-16.3),
Objective: Our aim in this study is to determine the parameters of pulmonary pulse wave transit time (pPTT), pulmonary arterial stiffness (PAS), and aortic stiffness that can be measured with a blood pressure holter device, which can be measured non-invasively echocardiographically during routine controls of HFpEF patients; HFpEF scores (H2FPEF, HFA-PEFF) are to reveal the relationship between HFpEF patients diagnosed under the guidance of these scores and diastolic dysfunction. Method: A total of 101 cases, 52 HFpEF patients followed up in the cardiology clinic of our center, diagnosed clinically, laboratory and echocardiographically, and 49 control group patients who were examined in the cardiology outpatient clinic and did not have heart failure, were included in our study. Evaluation with echocardiography was performed with conventional echocardiography, tissue Doppler imaging, and strain imaging methods. Diastolic parameters supporting the diagnosis of HFpEF and echocardiographic parameters for pulmonary arterial stiffness were calculated. Evaluation of aortic stiffness was made with a PWA monitor. Demographic characteristics, laboratory findings, echocardiographic findings including pulmonary arterial parameters and results of aortic stiffness were compared with the control group. Results: Baseline features including age, gender, diabetes, hypertension, hyperlipidemia, coronary artery disease, and smoking history were similar between HFpEF and control group. PAS was higher in the HFpEF group compared to the control group (18.4(15.7- 21.8) / 14.2(13-16.3), p<0.001), significantly and positively correlated with the scores in the study group (r:0.35, p<0.001 (H2FPEF) / r:0.55, p<0.001 (HFA-PEFF)). pPTT was found to be higher in the HFpEF group compared to the control group (0.184(0.16-0.21) / 0.13(0.12-0.15), p<0.001), and it was significantly and positively correlated with the scores in the study group (r:0.35, p< 0.001 (H2FPEF) / r:0.66, p<0.001 (HFA-PEFF)). In the PWA monitor recordings for aortic stiffness, it was found that PWV was significantly higher in the HFpEF group than in the control group (9.5±1.9 / 7.7±2.4, p<0.001), and it was significantly and positively correlated with the scores in the study group (r:0.35, p. <0.001 (H2FPEF) / r:0.37, p<0.001 (HFA-PEFF)). vii Conclusion: Pulmonary arterial stiffness, pulmonary pulse wave transit time and aortic stiffness parameters, which can be measured by non-invasive methods, were found to be statistically significantly higher in HFpEF patients. In our study; These parameters, which have been shown to be significant and correlated with many values in H2FPEF and HFAPEFF scoring, are important in that they play a complementary role in the diagnosis of HFpEF and can be used as a predictive value in the diagnosis process.
Objective: Our aim in this study is to determine the parameters of pulmonary pulse wave transit time (pPTT), pulmonary arterial stiffness (PAS), and aortic stiffness that can be measured with a blood pressure holter device, which can be measured non-invasively echocardiographically during routine controls of HFpEF patients; HFpEF scores (H2FPEF, HFA-PEFF) are to reveal the relationship between HFpEF patients diagnosed under the guidance of these scores and diastolic dysfunction. Method: A total of 101 cases, 52 HFpEF patients followed up in the cardiology clinic of our center, diagnosed clinically, laboratory and echocardiographically, and 49 control group patients who were examined in the cardiology outpatient clinic and did not have heart failure, were included in our study. Evaluation with echocardiography was performed with conventional echocardiography, tissue Doppler imaging, and strain imaging methods. Diastolic parameters supporting the diagnosis of HFpEF and echocardiographic parameters for pulmonary arterial stiffness were calculated. Evaluation of aortic stiffness was made with a PWA monitor. Demographic characteristics, laboratory findings, echocardiographic findings including pulmonary arterial parameters and results of aortic stiffness were compared with the control group. Results: Baseline features including age, gender, diabetes, hypertension, hyperlipidemia, coronary artery disease, and smoking history were similar between HFpEF and control group. PAS was higher in the HFpEF group compared to the control group (18.4(15.7- 21.8) / 14.2(13-16.3), p<0.001), significantly and positively correlated with the scores in the study group (r:0.35, p<0.001 (H2FPEF) / r:0.55, p<0.001 (HFA-PEFF)). pPTT was found to be higher in the HFpEF group compared to the control group (0.184(0.16-0.21) / 0.13(0.12-0.15), p<0.001), and it was significantly and positively correlated with the scores in the study group (r:0.35, p< 0.001 (H2FPEF) / r:0.66, p<0.001 (HFA-PEFF)). In the PWA monitor recordings for aortic stiffness, it was found that PWV was significantly higher in the HFpEF group than in the control group (9.5±1.9 / 7.7±2.4, p<0.001), and it was significantly and positively correlated with the scores in the study group (r:0.35, p. <0.001 (H2FPEF) / r:0.37, p<0.001 (HFA-PEFF)). vii Conclusion: Pulmonary arterial stiffness, pulmonary pulse wave transit time and aortic stiffness parameters, which can be measured by non-invasive methods, were found to be statistically significantly higher in HFpEF patients. In our study; These parameters, which have been shown to be significant and correlated with many values in H2FPEF and HFAPEFF scoring, are important in that they play a complementary role in the diagnosis of HFpEF and can be used as a predictive value in the diagnosis process.
Açıklama
Anahtar Kelimeler
Korunmuş ejeksiyon fraksiyonlu kalp yetmezliği (HFpEF), Pulmoner pulse wave transit time, Pulmoner arteryel sertlik, Aortik sertlik, Heart failure with preserved ejection fraction (HFpEF), Pulmonary pulse wave transit time, Pulmonary stiffness, Aortic stiffness
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
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Künye
Yavuz, Y. E. (2021). Korunmuş ejeksiyon fraksiyonlu kalp yetmezliği hastalarında sistemik ve pulmoner arteriyel sertlik parametrelerinin, HFPEF skorları (H2FPEF, HFA-PEFF) ve diyastolik disfonksiyon parametreleriyle olan ilişkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
