Akut Dekompanse Sistolik Kalp Yetersizliği Hastalarında BNP Değişimi ile Korele Ekokardiyografik Parametrelerin Araştırılması

Abstract

Giriş: Sistolik kalp yetmezliği hastalarında genellikle değişen derecelerde diyastolik disfonksiyon da eşlik etmektedir. Akut dekompanse kalp yetersizliği hastalarında tedavi ile sağlanan B tipi natriüretik peptit (BNP) düşüşüyle korelasyon gösteren ekokardiyografik parametreler hakkında yeterli veri yoktur. Bu çalışmanın amacı dekompanse kalp yetersizliği ile başvuran hastalarda tedavi ile sağlanan BNP değişimleriyle ekokardiyografi parametrelerinin ilişkisinin değerlendirilmesidir.

Hastalar ve Yöntem: Sinüs ritminde olup sistolik dekompanse kalp yetersizliği tanısıyla hastaneye yatırılan ardışık 30 hasta çalışmaya dahil edildi. Bütün hastalar optimal medikal tedavi ile tedavi edildi. Hastaların hastaneye kabulünde ve taburculuk öncesinde BNP düzeyleri ölçüldü ve transtorasik ekokardiyografi uygulandı. Tedavi ile sağlanan BNP düzeyindeki düşüş ile korelasyon gösteren transtorasik ekokardiyografi bulguları, bunların değişimi ve birbirleri ile olan bağıntısı değerlendirildi.

Bulgular: Hastaların ortalama hastanede yatış süresi 4.7 ± 1.3 gün olarak tespit edildi. Tedavi sonrası sol atriyum çapı ve sol atriyum alanında azalma ile BNP düşüşü arasında anlamlı bir ilişki izlendi. BNP düzeyindeki azalma ile LV E dalgası amplitüdündeki değişim, septalden ve lateralden elde edilen E/E’ oranı değişimleri arasında anlamlı yüksek düzeyde pozitif ilişki olduğu saptandı. Sol ventrikül lateral mitral anulusundan bakılan Sm’sinde ise anlamlı, zayıf düzeyde negatif bağıntı olduğu görüldü.

Sonuç: Çalışmamızın sonuçları göstermektedir ki, ekokardiyografik parametreler akut dekompanse sistolik kalp yetersizliği ile hastaneye yatırılan hastalarda tıpkı BNP gibi tedaviye yanıtın değerlendirilmesinde kullanılabilinir.

Keywords

• Kalp yetersizliği,B-tipi natriüretik peptit,ekokardiyografi

Investigation of Echocardiographic Parameters Correlated with Changes in BNP Levels in Patients with Acute Decompensated Systolic Heart Failure

Abstract

Introduction: Patients with systolic heart failure usually have concomitant diastolic dysfunction. There are limited data regarding the association between a decrease in B-type natriuretic peptide (BNP) levels and echocardiographic parameters after the treatment of acute decompensated systolic heart failure. The aim of this study was to investigate the association between echocardiographic parameters and the changes in BNP levels after the treatment of acute decompensated systolic heart failure.

Patients and Methods: Thirty consecutive patients with acute decompensated systolic heart failure and having sinus rhythm were included in the study. BNP levels were measured before and after the treatment of acute decompensated systolic heart failure. All patients underwent a detailed echocardiographic study on admission and before discharge. We compared the correlation between echocardiographic parameters and BNP levels after the treatment of acute decompensated systolic heart failure.

Results: The mean duration of hospital stay was 4.7 ± 1.3 days. There was a statistical significant relationship between a decrease in the left atrium diameter and area and a decrease in BNP levels. There was a significant positive correlation between a change in the LV E wave amplitude and BNP levels. The E/E’ ratio, measured from the lateral medial mitral annulus, had a significantly positive and strong correlation with the changes in BNP levels. Sm, measured using tissue Doppler from the lateral mitral annulus, had a negative significant correlation with the changes in BNP levels.

Conclusion: Our findings suggest that similar to the changes in BNP levels, echocardiographic parameters demonstrate a response to an optimal medical therapy in patients with acute decompensated systolic heart failure.

Keywords

• Heart failure,B-type natriuretic peptide,echocardiography

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