Sağ koroner arter morfolojisinin aterosklerotik belirteçler ve kardiyak diyastolik fonksiyonlar ile ilişkisi
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Tarih
2022
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Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda sağ koroner arter (RCA) morfolojisinin, karotis intima-media kalınlığı (KİMK), arteriyel sertlik ve epikardiyal yağ dokusu kalınlığı (EYDK) gibi aterosklerotik belirteçler ve mitral inflow akım hızı ile mitral annulus akım hızı gibi kardiyak diyastolik fonksiyonlar ile ilişkisini araştırmayı amaçladık. Yöntem: Çalışmaya kliniğimizde koroner anjiyografi yapılan ve obstrüktif koroner arter hastalığı saptanmayan 111 hasta alındı. Hastalar, RCA morfolojileri incelenerek 58 adet C-şekilli RCA ve 53 adet sigma-şekilli RCA' ya sahip hasta olmak üzere iki gruba ayrıldı. Ekokardiyografik değerlendirme konvansiyonel ekokardiyografi yöntemleri ve doku doppler görüntüleme ile yapıldı. EYDK ekokardiyografi ile değerlendirildi. KİMK B-mod ultrasonografi ile değerlendirildi. Arteriyel sertlik, osilometrik metotla ölçüm yapan PWA (nabız dalga analizi) monitör kullanılarak elde edilen parametrelerle değerlendirildi. C-şekilli RCA ile sigma-şekilli RCA grubu; demografik özellikler, klinik bulgular, temel laboratuvar parametreleri, arteriyel sertlik parametreleri, KİMK, EYDK, mitral inflow ve mitral annulus akım hızlarını da içeren ekokardiyografik bulgular açısından karşılaştırıldı. Bulgular: Çalışmaya dahil olan hastaların yaş ortalaması 57,82 olup, hastaların %52,30'u kadın ve %47,70'i erkeklerden oluşmaktaydı. C-şekilli RCA grubunda EYDK (p=0,001), KİMK (p=0,005) ve arteriyel sertliğe yönelik parametrelerden nabız dalga hızı (PWV) (p=0,005), sigma-şekilli RCA grubuna kıyasla istatistiksel olarak anlamlı düzeyde yüksek saptandı. Mitral inflow akım hızı ile mitral annulus akım hızı gibi diyastolik fonksiyon parametreleri ise her iki grupta benzer saptandı. Sonuç: C-şekilli RCA sigma-şekilli RCA' ya kıyasla EYDK, KİMK ve arteriyel sertlik gibi aterosklerotik belirteçlerle daha yakın ilişkilidir. Dolayısıyla C-şekilli RCA ateroskleroza yatkınlık oluşturan bir vasküler fenotip ve RCA morfolojisi bir geometrik risk faktörü olarak değerlendirilebilir. Ayrıca RCA morfolojisinin mitral inflow akım hızı ve mitral annulus akım hızı gibi kardiyak diyastolik fonksiyonlar üzerine etkisi bulunmamaktadır. Anahtar Kelimeler: C-şekilli RCA, sigma-şekilli RCA, karotis intima-media kalınlığı, epikardiyal yağ dokusu kalınlığı, arteriyel sertlik
In our study, we aimed to investigate the relationship of RCA morphology with atherosclerotic markers such as carotid intima-media thickness (CIMT), arterial stiffness and epicardial adipose tissue thickness (EATT), and cardiac diastolic functions such as mitral inflow velocity and mitral annulus flow velocity. Materials and Methods: 111 patients who underwent coronary angiography in our clinic and were not found to have obstructive coronary artery disease were included in the study. The patients were divided into two groups, 58 C-shaped RCAs and 53 sigma-shaped RCAs, by examining their RCA morphology. Echocardiographic evaluation was performed with conventional echocardiography methods and tissue Doppler imaging. EATT was evaluated with echocardiography. CIMT was evaluated with B-mode ultrasonography. Arterial stiffness was evaluated with the parameters obtained using the PWA (pulse wave analysis) monitor measuring with the oscillometric method. C-shaped RCA and sigma-shaped RCA group were compared in terms of demographic features, clinical findings, basic laboratory parameters, arterial stiffness parameters, CIMT, EYDK, echocardiographic findings including mitral inflow and mitral annulus flow velocities were compared. Results: The mean age of the patients included in the study was 57.82, and 52.30% of the patients were female and 47.70% were male. EATT (p=0,001), CIMT (p=0,005) and pulse wave velocity (PWV) (p=0,005), which is one of the parameters for arterial stiffness, was found to be statistically significantly higher in the C-shaped RCA group compared to the sigma-shaped RCA group. Diastolic function parameters such as mitral inflow velocity and mitral annulus flow velocity were similar in both groups. Conclusion: C-shaped RCA is more closely associated with atherosclerotic markers such as EATT, CIMT and arterial stiffness compared to sigma-shaped RCA. Therefore, C-shaped RCA is a vascular phenotype that predisposes to atherosclerosis, and RCA morphology can be evaluated as a geometric risk factor. In addition, RCA morphology has no effect on cardiac diastolic functions such as mitral inflow velocity and mitral annulus flow velocity. Keywords: C-shaped RCA, sigma-shaped RCA, carotid intima-media thickness, epicardial adipose tissue thickness, arterial stiffness
In our study, we aimed to investigate the relationship of RCA morphology with atherosclerotic markers such as carotid intima-media thickness (CIMT), arterial stiffness and epicardial adipose tissue thickness (EATT), and cardiac diastolic functions such as mitral inflow velocity and mitral annulus flow velocity. Materials and Methods: 111 patients who underwent coronary angiography in our clinic and were not found to have obstructive coronary artery disease were included in the study. The patients were divided into two groups, 58 C-shaped RCAs and 53 sigma-shaped RCAs, by examining their RCA morphology. Echocardiographic evaluation was performed with conventional echocardiography methods and tissue Doppler imaging. EATT was evaluated with echocardiography. CIMT was evaluated with B-mode ultrasonography. Arterial stiffness was evaluated with the parameters obtained using the PWA (pulse wave analysis) monitor measuring with the oscillometric method. C-shaped RCA and sigma-shaped RCA group were compared in terms of demographic features, clinical findings, basic laboratory parameters, arterial stiffness parameters, CIMT, EYDK, echocardiographic findings including mitral inflow and mitral annulus flow velocities were compared. Results: The mean age of the patients included in the study was 57.82, and 52.30% of the patients were female and 47.70% were male. EATT (p=0,001), CIMT (p=0,005) and pulse wave velocity (PWV) (p=0,005), which is one of the parameters for arterial stiffness, was found to be statistically significantly higher in the C-shaped RCA group compared to the sigma-shaped RCA group. Diastolic function parameters such as mitral inflow velocity and mitral annulus flow velocity were similar in both groups. Conclusion: C-shaped RCA is more closely associated with atherosclerotic markers such as EATT, CIMT and arterial stiffness compared to sigma-shaped RCA. Therefore, C-shaped RCA is a vascular phenotype that predisposes to atherosclerosis, and RCA morphology can be evaluated as a geometric risk factor. In addition, RCA morphology has no effect on cardiac diastolic functions such as mitral inflow velocity and mitral annulus flow velocity. Keywords: C-shaped RCA, sigma-shaped RCA, carotid intima-media thickness, epicardial adipose tissue thickness, arterial stiffness
Açıklama
Anahtar Kelimeler
Koroner arter, Morfoloji, Karotis intima- media kalınlığı, Arteriyel sertlik, Coronary artery, Morphology, Carotid intima-media thickness, Arterial stiffness
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
İnan, Z. (2022). Sağ koroner arter morfolojisinin aterosklerotik belirteçler ve kardiyak diyastolik fonksiyonlar ile ilişkisi (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
