KOAH’lı hastalarda arteriyel sertlik ve pulmoner arter basıncı arasındaki ilişki

Year 2025, Volume: 50 Issue: 1, 148 - 156, 31.03.2025

Efraim Güzel , Oya Baydar Toprak , Yasemin Saygideger , Sedat Kuleci

https://doi.org/10.17826/cumj.1619930

Abstract

Amaç: KOAH'ta kronik inflamasyonun neden olduğu endotel hasarı, vasküler yatağın yanı sıra hava yollarını da etkileyerek pulmoner hipertansiyon (PH) gelişimini hızlandırabilir. Çalışmamızda, KOAH hastalarında arteriyel sertlik ile PH gelişimi ve şiddeti arasındaki ilişkiyi araştırmayı planladık.
Gereç ve Yöntemː Bu çalışma 2016-2022 yılları arasında KOAH tanısı alan hastaların verilerine dayanan retrospektif bir çalışmadır. Sosyodemografik veriler, klinik, radyolojik ve solunum fonksiyon bulguları kaydedildi. Arteriyel sertlik ölçümleri literatür verilerine göre yapıldı. Hastalar ekokardiyografi (EKO) bulgularına göre pulmoner arter basıncı artmış olanlar ve olmayanlar olarak 2 gruba ayrılarak risk faktörleri ve ilgili bulgular analiz edildi.
Bulgularː Çalışmamıza dahil edilen 224 KOAH hastasının %89,3'ü erkek ve yaş ortalaması 60,45 ± 9,59 idi. Çalışmamızda artmış sistolik pulmoner arter basıncı (es_PAP) prevalansı %41,5 idi. Olguların %9,4'ü öldü. Ortalama yaşın 64.60 ve üzeri olması, yalnız yaşama, sık hastaneye yatma ve çalışma durumunun es_PAP ile ilişkili olabileceği bulunmuştur. Ayrıca evre 3-4 tıbbi araştırma konseyi (MRC) düzeyi, ortalama 340 metre ve altında 6 dakikalık yürüme testi (6DYT) mesafesinin, vücut kitle indeksinin (VKİ) ortalama 24.45 ve altında, bel çevresinin ortalama 94 cm ve altında, ortalama BODE skorunun 3.66 ve üzerinde, ortalama depresyon skorunun 4.73 ve üzerinde olmasının es_PAP ile ilişkili olabileceğini bulduk.
Sonuçː Çalışmamızda arteriyel sertlik ile KOAH şiddeti ve es_PAP arasında anlamlı bir ilişki bulamadık. Ancak es_PAP ile ilişkili olarak bulduğumuz durumlar ve risk faktörleri açısından daha yakından takip edilmeli ve iyi yönetilmelidir.

Keywords

KOAH, arteriyel sertlik, pulmoner hipertansiyon, mortalite, solunum fonksiyon testleri

Relationship between arterial stiffness and pulmonary artery pressure in patients with COPD

Abstract

Purpose: By impacting both the vascular bed and the airways, endothelial damage brought on by chronic inflammation in COPD may hasten the onset of pulmonary hypertension (PH). The purpose of the study that was presented was to look into the connection between arterial stiffness and the onset and intensity of pulmonary hypertension in COPD.
Materials and Methodsː Data from patients who were diagnosed with COPD between 2016 and 2022 served as the basis for this retrospective investigation. Clinical, radiologic, pulmonary function, and sociodemographic information were documented. Measurements of arterial stiffness were conducted using data from the literature. Based on the results of echocardiogram (ECHO), patients were split into two groups: those with and without high systolic pulmonary artery pressure (es_PAP). The pertinent data were then examined.
Resultsː The mean age of the 224 COPD patients in our study was 60.45 ± 9.59 years, and 89.3% of them were male. In our investigation, the prevalence of es_PAP was 41.5%. 9.4% of patients passed away. es_PAP was found to be connected with a mean age of 64.60 years and older, living alone, frequent hospitalization, and employment status. Additionally, it is discovered that mean 6-minute walk test (6MWT) distance of 340 meters or less, mean body mass index (BMI) of 24.45 or less, mean waist circumference of 94 cm or less, mean BODE score of 3.66 or more, mean depression score of 4.73 or more, and stage 3–4 Medical Research Council (MRC) levelwas linked to es_PAP.
Conclusionː Although arterial stiffness, the severity of COPD, and es_PAP did not significantly correlate in our study, the conditions and risk factors that we did discover to be linked to es_PAP should be regularly monitored and well managed.

Keywords

arterial stiffness, pulmonary hypertension, mortality, pulmonary function tests, COPD

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