Koroner Arter Ektazisi olan hastalarda Kardiyo-elektrofizyolojik denge indeksi ve Tp-e/QT oranının değerlendirilmesi

Year 2019, Volume: 3 Issue: 3, 223 - 226, 15.03.2019

Yakup Alsancak , Ahmet Seyfettin Gürbüz , Beyza Saklı Abdullah İçli

https://doi.org/10.28982/josam.485247

Cited By: 2

Abstract

Amaç: QRS süresine bölünmüş QT intervali olarak hesaplanan, kardiyak elektrofizyolojik denge indeksi (iCEB), malign ventriküler aritmileri öngörmek için yeni bir risk belirleyicisi olarak tanımlanmıştır. iCEB'nin artmış seviyeleri torsades de pointes (TdP) ve azalan iCEB düzeylerinin ise torsades de pointes olmayan ventriküler taşikardi veya ventriküler fibrilasyona neden olduğunu öngörmektedir. Bu çalışmanın amacı koroner ektazisi (KAE) olan hastalarda iCEB kullanılarak, bu hastalardaki aritmojenik riski değerlendirmektir.

Yöntemler: Vaka kontrolü olarak tasarlanan çalışmamıza polikliniğimize başvuran 130 hasta dahil edildi. İzole KAE'si olan 75 hasta (çalışma grubu) ve 55 sağlıklı birey (kontrol grubu) çalışmaya dahil edildi. Her iki gruba da 12 adet standart elektrokardiyografi çekildi. Tp-Te intervali, QT intervali, QRS intervali, Tp-Te / QT oranı ve QT / QRS oranları (iCEB) kaydedilerek gruplar arasında karşılaştırma yapıldı.

Bulgular: Tp-e intervalleri ve Tp-e / QT oranı çalışma grubunda anlamlı olarak daha yüksek saptandı (p=0,001). Ayrıca iCEB'in, çalışma grubunda sayısal olarak daha yüksek olma eğilimi olduğu bulunmuştur, ancak gruplar arasında istatistiksel olarak anlamlı bir fark bulunamamıştır (p=0,118). Tp-e ve Tpe / QT oranı, iki veya üç damar KAE'si olan hastalarda, tek damar ektazisi olanlardan daha yüksekti (Tp-e için p≤0,024 ve Tpe/QT oranı için p=0,028). iCEB, etkilenen koroner arter sayısı ile daha yüksek bulunmasına rağmen, gruplar arasında istatistiksel olarak fark saptanmadı.

Sonuç: Bulgularımız, KAE hastalarının sağlıklı kontrollere göre daha yüksek Tp-Te ve Tp-Te / QT değerlerine sahip olduğunu göstermektedir. KAE'li bireyler için iCEB kullanılarak artmış aritmojenik riski göstermek için daha fazla çalışmaya ihtiyacımız vardır.

Keywords

Aritmi, Koroner arter ektazisi, iCEB, QT/QRS oranı

Evaluation of index of cardio-electrophysiological balance and Tp-e/QT ratio in patients with coronary artery ectasia

Abstract

Aim: Index of cardiac electrophysiological balance (iCEB), calculated as QT interval divided by QRS duration, has been described as a novel risk marker for predicting malignant ventricular arrhythmia. Increased levels of iCEB predict to torsades de pointes (TdP) and decreased levels of iCEB predict to non-torsades de pointes mediated ventricular tachycardia or ventricular fibrillation. The aim of this study is to evaluate arrhythmogenic risk by using iCEB in patients with coronary ectasia (CAE).

Methods: Our study, designed as case-control, included 130 patients who were admitted to our outpatient clinic. 75 patients with isolated CAE (study group) and 55 healthy subjects (control group) were included in the study. Both groups underwent a standard 12-lead surface electrocardiogram and Tp-Te interval, QT interval, QRS interval, Tp-Te/QT ratio and QT/QRS ratio (iCEB) of patients were recorded and compared between groups.

Results: Tp-e intervals and Tp-e/QT ratio is significantly higher in study group (p=0.001). And, İCEB was found as tend to be numerically higher in study group, but we could not match a statistically difference between groups (p=0.118). Tp-e and Tpe/QT ratio were higher in patients with two or three vessels CAE than one vessel (p value; for Tp-e p=0.024 and Tpe/QT ratio p=0.028). Although iCEB was found as higher with affected number of coronary artery, there was no statistically difference between groups.

Conclusion: Our results demonstrate that CAE patients have significantly higher values of Tp-Te and Tp-Te/QT than controls. We need further studies to show increased arrhythmogenesis risk using iCEB for individuals with CAE.

Keywords

Arrhythmia, Coronary artery ectasia, iCEB, QT/QRS ratio

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