Atriyal fibrilasyon hastalarında nabız basıncı indeksinin kardiyoembolik olaylar ve mortalite ile ilişkisi

Year 2022, Volume: 27 Issue: 2, 142 - 149, 24.05.2022

Serhat Karadavut Murat Çetin İsmail Altıntop

https://doi.org/10.21673/anadoluklin.1024948

Abstract

Amaç: Nabız basınç indeksi (NBİ), nabız basıncının (NB) sistolik kan basıncına oranı ile elde edilir. Arteriyel sertlik ve kardiyovasküler hastalıkların (KVH) değerlendirilmesinde NB ölçümlerine göre daha güvenilir ve daha objektif bilgi verir. Bilindiği üzere atriyal fibrilasyonda (AF) vasküler hastalık mevcudiyeti emboli riskini artırmaktadır. Bu çalışmada, KVH prediktörü olan NBİ değerlerini kullanarak AF hastalarında gelişen kardiyoembolik olaylar (KEO) ve/veya mortalite ile ilişkisini incelemeyi amaçladık.

Yöntemler: Çalışma, Şubat 2019 ile Haziran 2020 arasında prospektif olarak 191 AF hastası alınarak yapıldı. Hastalar; inme, geçici iskemik atak, periferik emboli ve bunlara bağlı ölüm gerçekleşmeyen (Grup-1, n=156) ve gerçekleşen (Grup-2, n=35) şeklinde ikiye ayrıldı.

Bulgular: Grup-2’nin NBİ değerleri Grup-1’e göre anlamlı derecede yüksek olarak tespit edildi (0,38±0,05 ve 0,41±0,04, p<0,001). Çoklu regresyon analizi sonrası NBİ AF hastalarında KEO
açısından bağımsız öngörücü olarak bulundu (Olasılık oranı: 2,82 [%95 Güven Aralığı: 1,68-4,71], p<0,001). Ayrıca, yapılan ROC analizinde NBİ, NB’ye göre KEO tahmin etmede daha güçlü bir parametre olarak saptandı (sırasıyla, eğri altındaki alan [AUC]=0,734 ve AUC=0,661).

Sonuç: AF hastalarında NBİ istenmeyen KEO ve buna bağlı ölümleri predikte etmek için kullanılabilecek non-invaziv ve ucuz bir fizik muayene bulgusudur.

Keywords

atriyal fibrilasyon, emboli;, nabız basıncı

The relationship of pulse pressure index with cardioembolic events and mortality in atrial fibrillation patients

Abstract

Aim: Pulse pressure index (PPI) is the ratio of pulse pressure (PP) to systolic blood pressure. PPI measurements yield more reliable and objective data than PP in evaluating arterial stiffness and cardiovascular diseases. It is well known that the presence of vascular disease increases embolism in atrial fibrillation (AF). The present study investigated the relationship between cardioembolic events and mortality with PPI, a predictor of cardiovascular disease, in AF patients.

Methods: This study was conducted prospectively between February 2019 and June 2020 in 191 AF patients. The patients were divided into two groups based on the cardiovascular outcomes’ nonpresence (Group 1, n=156) or presence (Group 2, n=35).

Results: PPI values of Group 2 were significantly higher than Group 1 (0.38±0.05 and 0.41±0.04, p <0.001). PPI was also independently associated with cardiovascular outcomes after adjusting for potential covariates (OR = 2.82, 95%CI = 1.68 to 4.71, P < 0.001). Additionally, in the ROC analysis, PPI was more powerful in predicting cardioembolic events than PP (AUC= 0.734 vs. 0.661, respectively).

Conclusion: PPI is a non-invasive and low-cost physical examination finding that may be used to predict undesirable cardioembolic outcomes and related mortality in AF patients.

Keywords

atrial fibrillation, embolism;, pulse pressure

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