Hipertansiyonda sol ventrikül geometrik şekillerinin ventriküler aritmi riski ve QT dispersiyonu ile ilişkisi
Küçük Resim Yok
Tarih
2001
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hipertansiyona bağlı sol ventrikül hipertrofisinde tehlikeli ventriküler aritmi sıklığının arttığı çeşitli çalışmalarla gösterilmiştir. Farklı sol ventrikül geometrik paternlerde aritmi riski tam olarak bilinmemektedir. Bu çalışmada sol ventrikül hipertrofisinin, sol ventrikül geometrik yapısının, aritmi riski ve non invaziv aritmi göstergelerinden olan QT dispersiyonu ile ilişkisini araştırmayı amaçladık. Bu amaçla çalışmaya alman 80 hastanın (45 'i kadın, ortalama yaş 52.8 ±11) 30'unda konsantrik sol ventrikül hipertrofîsi (KH), 15'inde konsantrik remodeling (KR) ve 3 5' inde ise normal sol ventrikül geometrisi (NG) tespit edilerek üç gruba ayrıldı. Bu hastalarda 24 saatlik holter monitorizasyonu ve QT dispersiyonu incelendi. Çalışmamızda Lown 2 ve üzeri ventriküler aritmileri sol ventrikül hipertrofîsi olanlarda %80; sol ventrikül hipertrofîsi olmayanlarda ise %10 oranında olduğunu bulduk. Otuz hastada (%37) Lown 2 ve üzeri ventriküler aritmi, 17 hastada (%21) ise Lown evre 4a ve 4b ventriküler aritmi saptandı. Konsantrik hipertrofili hasta grubunda ventriküler aritmi (Lown 2 ve üzeri) normal geometrili ve konsantrik remodelingli hasta gruplarına göre istatistiki anlamlı olarak yüksek oranda bulundu (p<0.01). QT ve QTc dispersiyonu konsantrik hipertrofili grupta konsantrik remodelingli ve normal geometrili gruplara göre uzundu. Konsantrik hipertrofi ile normal geometri arasındaki fark istatistiksel olarak anlamlıydı (srasıyla p< 0.001, p<0. 05). Konsantrik remodelingli grupta normal geometrili gruba göre QT ve QTc dispersiyonu daha uzundu ama istatistiki olarak anlamlı değildi. QT ve QTc dispersiyonu ventriküler aritmisi olan hastalarda istatistiksel anlamlı olarak daha uzundu (p<0.001). Sol ventrikül kitle indexi ile QT dispersiyonu ve QTc dispersiyonu arasında istatistiksel anlamlı pozitif korelasyon saptandı (sırasıyla r=0.33, p=0.007 ve r=0.26, p=0.03). Sol ventrikül kitle indexi ile ventriküler aritmi (Lown 2 ve üzeri) ve ciddi ventriküler aritmi 47(Lown4a ve 4b) arasında da istatistiksel anlamlı pozitif korelasyon vardı ( sırasıyla r=0.59, p=0.001 ve r=0.53 p=0.001 ). Sonuç olarak; hipertansif hastalarda sol ventrikül hipertroflsi ile birlikte ventriküler aritmi sıklığmın arttığını, konsantrik hipertrofisi olanlarda bunun daha belirgin olduğunu, hipertansiyona bağlı sol ventrikül hipertrofılerinde ventriküler aritmi gelişiminin QT dispersiyonu ile yakından ilişkili olduğunu düşündük.
It's shown that the frequency of dangerous ventricular arhytmi is increased in left ventricle hypertrophy which is related with hypertension. The risk of arhythmi is not exactly known in different left ventricle geometrical patterns. The aim of this study is to show the connection between the left ventricle hypertrophy, the geometrical structure of the left ventricle, the risk of arhythm and the dispersion of QT which is a non-invasive indicator of arhythm. We took 80 patients for this study; 45 of these were women and the median age was 52.8 ±11. The number of patients with concentric left ventricle hypertrophy (CH) was 30, concentric remodelling (CR) was 15 and finally 35 of the patients had normal left ventricle geometry(NG). The QT dispersion and the 24 houred holter monitorisation was examined in all these 80 patients. In our study, the percentage of Lown 2 and over ventricular arhytmies were %80 in the patients with left ventricule hypertropy and %10 in the patients wihout left ventricle hypertrophy. There was Lown 2 and over arhythm in 30 of the patients (%37) ; and Lown stage IVa -IVb ventricular arhythm in 17 of the patients(%21). The Lown 2 and over ventricular arhythm was found statistically meaningful (p < 0.01) in the patients with concentric left ventricule hypertrophy which is compared to the patients with concentric remodellig and the patients with normally geometrical left ventricle. QT and QTc dispersion was long in the group of patients with concentric left ventricle hypertrophy, compared to the group of the patients with concentric remodelling and the group of the patients with normally geometrical left ventricle. The statistically difference between the group who had concentric hypertrophy (p < 0.001) and the group which had a normal geometry (p< 0.05) was meaningful. The QT and QTc dispersion was long in the group of the patients who had a concentric remodelling compared to the group of the patients with normal geometry of the left 49ventricle : but this wasn't statistically meaningful. The QT and QTc dispersion was long in the patients who had a ventricular arhythm; and this was statistically meaningful (P<0.001). There was statistically meaningful positive corelation between the left ventricle mass index and both the QT dispersion (r=0.33, p=0.007) and the QTc dispersion (r=0.26, p= 0.03 ). The positive corelation betweeen the left ventricle mass index and both the Lown 2 and over ventricular arhythm (r=0.59, p=0.001) and the Lown 4a and 4b ventricular arhythm (r= 0.53, p=0.001) was also statistically meaninful. Finally; as a result we found that the freqnency of ventricular arhythm and the frequnency of left ventricle hypertrophy is increased in the patients who had hypertension. In deed this increase is much more visible in the group of patients who had a concentric hypertrophy. Also; the progress of the ventricular arhythmies in the patients who had a left ventricle hypertrophy which is related to hypertension has a strong relationship between the QT dispersion.
It's shown that the frequency of dangerous ventricular arhytmi is increased in left ventricle hypertrophy which is related with hypertension. The risk of arhythmi is not exactly known in different left ventricle geometrical patterns. The aim of this study is to show the connection between the left ventricle hypertrophy, the geometrical structure of the left ventricle, the risk of arhythm and the dispersion of QT which is a non-invasive indicator of arhythm. We took 80 patients for this study; 45 of these were women and the median age was 52.8 ±11. The number of patients with concentric left ventricle hypertrophy (CH) was 30, concentric remodelling (CR) was 15 and finally 35 of the patients had normal left ventricle geometry(NG). The QT dispersion and the 24 houred holter monitorisation was examined in all these 80 patients. In our study, the percentage of Lown 2 and over ventricular arhytmies were %80 in the patients with left ventricule hypertropy and %10 in the patients wihout left ventricle hypertrophy. There was Lown 2 and over arhythm in 30 of the patients (%37) ; and Lown stage IVa -IVb ventricular arhythm in 17 of the patients(%21). The Lown 2 and over ventricular arhythm was found statistically meaningful (p < 0.01) in the patients with concentric left ventricule hypertrophy which is compared to the patients with concentric remodellig and the patients with normally geometrical left ventricle. QT and QTc dispersion was long in the group of patients with concentric left ventricle hypertrophy, compared to the group of the patients with concentric remodelling and the group of the patients with normally geometrical left ventricle. The statistically difference between the group who had concentric hypertrophy (p < 0.001) and the group which had a normal geometry (p< 0.05) was meaningful. The QT and QTc dispersion was long in the group of the patients who had a concentric remodelling compared to the group of the patients with normal geometry of the left 49ventricle : but this wasn't statistically meaningful. The QT and QTc dispersion was long in the patients who had a ventricular arhythm; and this was statistically meaningful (P<0.001). There was statistically meaningful positive corelation between the left ventricle mass index and both the QT dispersion (r=0.33, p=0.007) and the QTc dispersion (r=0.26, p= 0.03 ). The positive corelation betweeen the left ventricle mass index and both the Lown 2 and over ventricular arhythm (r=0.59, p=0.001) and the Lown 4a and 4b ventricular arhythm (r= 0.53, p=0.001) was also statistically meaninful. Finally; as a result we found that the freqnency of ventricular arhythm and the frequnency of left ventricle hypertrophy is increased in the patients who had hypertension. In deed this increase is much more visible in the group of patients who had a concentric hypertrophy. Also; the progress of the ventricular arhythmies in the patients who had a left ventricle hypertrophy which is related to hypertension has a strong relationship between the QT dispersion.
Açıklama
Anahtar Kelimeler
Hipertansiyon, Hypertension, sol ventrikül, left ventricle
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Özdemir, A. (2001). Hipertansiyonda sol ventrikül geometrik şekillerinin ventriküler aritmi riski ve QT dispersiyonu ile ilişkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
