Esansiyel hipertansif hastalarda sol ventrikül hipertrofisinin gelişimine ve sol ventrikül geometrik paternlerine aldosteronun etkisi
Küçük Resim Yok
Tarih
2003
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sol ventrikül hipertrofisi, hipertansif hastalardaki kardiyovasküler mortalite ve morbidite için bağımsız bir risk faktörüdür ve bu nedenle de sol ventriküldeki büyümeyi başlatan faktörlerin tespit edilmesi çok önemlidir. Bu çalışmada, diğer faktörlerden bağımsız olarak, aldosteronun esansiyel hipertansiyonu olan hastalarda gelişen sol ventrikül hipertrofîsiyle ve sol ventrikülün farklı geometrik şekilleriyle olan ilişkisini araştırmayı amaçladık. Bu amaçla çalışmaya alınan esansiyel hipertansiyonlu 44'ü kadın (yaş ortalaması 51±8 yıl), 39'u erkek (yaş ortalaması 57+10 yıl) toplam 83 hastadan 32'sinde ekokardiyografik sol ventrikül hipertrofisi tespit edildi. Ayrıca hastalar sol ventrikül geometrik şekillenmesine göre gruplandırıldığmda ise, 18 hastanın konsantrik sol ventrikül hipertrofisine, 14 hastanın eksantrik sol ventrikül hipertrofisine, 17 hastanın konsantrik remodelinge ve 34 hastanın ise normal sol ventrikül geometrisine sahip olduğu görüldü. Bütün hastalardan kullanmakta oldukları antihipertansif ilaçlar iki hafta süre ile kesildikten sonra plazma aldosteron düzeyi ve renin aktivitesi ölçümü yapıldı. Plazma aldosteron düzeyi sol ventrikül hipertrofisi olan hastalarda olmayanlara kıyasla istatistiksel anlamlı olarak daha yüksek tespit edilirken (sırasıyla 9,92+6,34ng/dl ve 5,83±3,5ng/dl, p<0.01), plazma renin aktivitesindeki fark istatistiksel anlamlı değildi. Sol ventrikül geometrik şekillenmesine göre gruplar karşılaştırıldığında ise sol ventrikül konsantrik hipertrofisi bulunan hastaların plazma aldosteron düzeylerinin (10,3±5,6ng/dl), normal geometriye sahip hastalardan (5,97±3,9ng/dl) ve konsantrik remodelingi olan hastalardan (5,54±3,2ng/dl) istatistiksel olarak anlamlı yüksek olduğu görüldü (sırasıyla p=0.018, p=0.027). Plazma renin aktiviteleri arasında istatistiksel anlamlı fark yoktu. Sonuç olarak; esansiyel hipertansif hastalarda plazma aldosteron düzeylerinin diğer faktörlerden bağımsız olarak sol ventrikül hipertrofisi ile, özellikle de konsantrik sol ventrikül hipertrofisi ile ilişkili olduğunu düşünmekteyiz.
Left ventricular hypertrophy is an independent risk factor for cardiovascular morbidity and mortality in hypertensive patients, therefore it is very important to determine the factors triggering the growth of left ventricle. In this study, we aimed to investigate the relationship of aldosteron, free from other factors, with left ventricular hypertrophy and different geometrical shapes of left ventricle developing in patients with essential hypertension. Fourty four women (mean age 51±8 years) and 39 men (mean age 57±10 years), totaly 83 patients with essential hypertension were included in the study and left ventricular hypertrophy was determined in 32 of them echocardiographically. Morovere, the patients were divided into groups according to the geometrical shape of left ventricle as concentric hypertrophy of left ventricle (18 patients), eccentric hypertrophy of left ventricle (14 patients), concentric remodeling of left ventricle (17 patients) and normal ventricular geometry (34 patients). Plasma aldosteron levels and renin activity were measured in all patients following the cessation of antihypertensive medication for two weeks. Plasma aldosteron levels of the patients with left ventricular hypertrophy were found significantly higher compared to those of the patients without left ventricular hypertrophy (respectively 9.92 ±6.34 ng/dl and 5.83±3.5 ng/dl, p< 0.01), however there was no significant difference between two groups considering plasma renin activity. When the groups based on geometrical shapes of the left ventricle were compared, it was seen that plasma aldosteron levels of the patients with concentric hypertrophy of left ventricle (10.3±5.6 ng/dl) were significantly higher than those of the patients with normal left ventricular geometry (5.97±3.9 ng/dl) and those of the patients with concentric remodeling of left ventricle (5.54±3.2 ng7dl) (respectively p=0.018, p=0.027). Plasma renin activity did not differ significantly in these groups. In conclusion, we suggest that plasma aldosteron level, free from other factors, is related with left ventricular hypertrophy, especialy concentric type, in patients with essential hypertension.
Left ventricular hypertrophy is an independent risk factor for cardiovascular morbidity and mortality in hypertensive patients, therefore it is very important to determine the factors triggering the growth of left ventricle. In this study, we aimed to investigate the relationship of aldosteron, free from other factors, with left ventricular hypertrophy and different geometrical shapes of left ventricle developing in patients with essential hypertension. Fourty four women (mean age 51±8 years) and 39 men (mean age 57±10 years), totaly 83 patients with essential hypertension were included in the study and left ventricular hypertrophy was determined in 32 of them echocardiographically. Morovere, the patients were divided into groups according to the geometrical shape of left ventricle as concentric hypertrophy of left ventricle (18 patients), eccentric hypertrophy of left ventricle (14 patients), concentric remodeling of left ventricle (17 patients) and normal ventricular geometry (34 patients). Plasma aldosteron levels and renin activity were measured in all patients following the cessation of antihypertensive medication for two weeks. Plasma aldosteron levels of the patients with left ventricular hypertrophy were found significantly higher compared to those of the patients without left ventricular hypertrophy (respectively 9.92 ±6.34 ng/dl and 5.83±3.5 ng/dl, p< 0.01), however there was no significant difference between two groups considering plasma renin activity. When the groups based on geometrical shapes of the left ventricle were compared, it was seen that plasma aldosteron levels of the patients with concentric hypertrophy of left ventricle (10.3±5.6 ng/dl) were significantly higher than those of the patients with normal left ventricular geometry (5.97±3.9 ng/dl) and those of the patients with concentric remodeling of left ventricle (5.54±3.2 ng7dl) (respectively p=0.018, p=0.027). Plasma renin activity did not differ significantly in these groups. In conclusion, we suggest that plasma aldosteron level, free from other factors, is related with left ventricular hypertrophy, especialy concentric type, in patients with essential hypertension.
Açıklama
Anahtar Kelimeler
hipertansif, hypertensive, Hipertrofi, Hypertrophy
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Soylu, A. (2003). Esansiyel hipertansif hastalarda sol ventrikül hipertrofisinin gelişimine ve sol ventrikül geometrik paternlerine aldosteronun etkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
