Pages 16-25

Abstract

The aim of this study was to evaluate the value of BNP for detecting silent myocardial ischemia in dialysis patients. 53 hemodialysis patients with no anginal symptoms were included. Ambulatory electrocardiographic monitorisation were done to all patients in order to determine silent myocardial ischemia. BNP assays were done to all patients before the second hemodialysis session of the week. The median age of the participants was 50 (60 % male). Male sex and hyperlipidemia were more frequent in the silent ischemia group. Other demographic and echocardiographic parameters were similar in both groups. The median BNP concentration was significantly higher in the silent ischemia group (682,7 pg/mL vs 503,2, p= 0,006). Left ventricular mass index (r=0,502, p<0,001) and mitral E/ Em mean (r=0,604, p<0,001) showed significant positive correlation with basal BNP concentrations. Logistic regression analysis revealed BNP as an independent predictor of silent myocardial ischemia development in patients with no known coronary artery disease (OR=1,08, %95 CI: 1,006-1,159). ROC analysis in order to determine the usefulness of BNP as a screening test revealed %90 sensitivity and %57 specificity (area under the curve=0,773, p=0,006) for predicting silent myocardial ischemia. BNP might be of value in predicting silent myocardial ischemia determined with ambulatory electrocardiographic monitorisation in hemodialysis patients.

Keywords

• Silent myocardial ischemia, B-type natriuretic peptide, end stage renal disease, hemodialysis

Son Dönem Böbrek Yetmezliği Olan Olgularda B-Tipi Natriüretik Peptidin Sessiz Miyokard İskemisini Öngördürmedeki Rolü

Abstract

Bu çalışmanın amacı hemodiyaliz hastalarında sessiz miyokard iskemisini belirlemede BNP’nin ön gördürücü rolünü araştırmaktır. Çalışmaya anjinal yakınması olmayan toplam 53 hemodiyaliz hastası dâhil edildi. Sessiz miyokard iskemisini belirlemek amacı ile tüm olgulara saatlik ambulatuar elektrokardiyografik monitorizasyon yapılarak sessiz iskemisi olanlar ve olmayanlar olarak gruplandı. BNP düzeyleri için kanlar tüm hastalardan haftanın 2.hemodiyaliz seansı öncesi alındı. Çalışmaya katılan hastaların ortanca yaşı 50 (%60 erkek) idi. Erkek cinsiyet ve hiperlipidemi sıklığı sessiz iskemi olan grupta daha fazla idi bunun dışındaki demografik ve ekokardiyografik parametreler açısından gruplar arasında fark yoktu. Ortanca BNP konsantrasyonu sessiz iskemi olan grupta anlamlı derecede artmış bulundu [sırası ile 682,7 (234,7) pg/ml vs 503,2 (103,7) pg/ml, p=0.006]. Sol ventrikül kitle indeksi (r=0.502,p < 0.001) ilemitral E/Em ortalama (r=0.604,p

Keywords

• Sessiz miyokard iskemisi, B-tipi natriüretik peptid, son dönem böbrek yetmezliği, hemodiyaliz

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