Koroner Arter Hastalığı ile Myokardiyal Köprüleşme Arasındaki İlişki

Year 2019, , 195 - 201, 31.08.2019

Levent Cerit

https://doi.org/10.24938/kutfd.539647

Abstract

Amaç: Miyokardiyal
köprüleşme, bir epikardiyal koroner arterin bir bölümünün intramüsküler bir
seyir içine girdiği bir koroner arterin konjenital varyantıdır. İyi huylu
olarak görülmesine rağmen, miyokard iskemisi, akut koroner sendromlar, koroner
spazm, egzersize bağlı aritmiler ve hatta ani ölüm gibi komplikasyonlara yol
açabilir. SYNTAX skoru anjiyografik skorlama sistemidir ve genellikle koroner
arter hastalığının yaygınlık ve ciddiyetini değerlendirmek için kullanılır. Bu
çalışma, myokard köprüleşmesi ve SYNTAX skoru arasındaki ilişkiyi
değerlendirmek amacıyla yapıldı.

Gereç ve Yöntemler: Koroner arter
bypass greft ameliyatı yapılan ardışık hastaların tıbbi kayıtları retrospektif
olarak incelendi. Çalışma grubu 267 hastadan oluşuyordu. Myokardial köprüleşme
prevalansı %13.4 saptandı. Tüm hastalarda biyokimyasal, klinik,
ekokardiyografik parametreler ve SYNTAX skoru değerlendirildi. Hastalar SYNTAX
skoruna göre iki gruba ayrıldı (≥23: yüksek, <23 düşük).

Bulgular: Yüksek SYNTAX
skoru grubu daha yaşlıydı ve hiperlipidemi, sigara içme ve diabet prevalansı
daha yüksekti. Tek değişkenli analizlerde yaş, diabet, sigara içme ve
hiperlipidemi yüksek SS ile ilişkiliydi. Çok değişkenli analizlerde diabet ve
hiperlipidemi yüksek SYNTAX skoru’nun bağımsız belirleyicileriydi (OR 2.957;
95% CI: 1.391–5.183; p<0.001, OR 3.267; 95% CI: 1.973-6.739; p<0.001; sırasıyla).

Sonuç: Çalışmamızda,
diabet ve hiperlipideminin yüksek SYNTAX skoru’nun bağımsız belirleyicileri
olduğunu bulduk. Her iki grup arasında myokardiyal köprüleşme varlığı yönünden
anlamlı fark yoktu.

Keywords

Koroner arter hastalığı, myokardiyal köprüleşme, diyabet, hiperlipidemi

ASSOCIATION BETWEEN MYOCARDIAL BRIDGING AND CORONARY ARTERY DISEASE

Abstract

Objective: Myocardial bridging is a congenital variant of a coronary
artery in which a portion of an epicardial coronary artery takes an
intramuscular course. Although it is considered
as benign, it may lead to complications such as myocardial ischemia, acute
coronary syndromes, coronary spasm, exercise-induced
dysrhythmias or even sudden death. SYNTAX score is the angiographic scoring
system and is commonly used to evaluate the severity and complexity of coronary
artery disease. This study was conducted
with the aim to evaluate the association between myocardial bridging and SYNTAX
score.

Material and Methods: The medical records of consecutive
patients, who underwent coronary artery bypass graft surgery, were
retrospectively reviewed. The study group consisted of 267 patients. The
prevalence of myocardial bridging was found to
be 13.4%. Biochemical, clinical, echocardiographic parameters and SYNTAX score were evaluated in all patients. The patients were divided into two groups according to the SYNTAX score (≥23: high, <23 low).

Results: The High SYNTAX score group was older and had higher prevalence of hyperlipidemia, smoking, and diabetes
mellitus. On univariate analysis age, diabetes mellitus, smoking, and
hyperlipidemia were associated with
higher SYNTAX score. On multivariate analysis diabetes mellitus and hyperlipidemia were
independent predictors of higher SYNTAX score (OR 2.957; 95% CI: 1.391–5.183; p<0.001,
OR 3.267; 95% CI: 1.973-6.739; p<0.001;
respectively).

Conclusion: In our study, we have found that
diabetes mellitus and hyperlipidemia were independent
predictors of high SS. There was no
significant difference between both groups regarding the presence of myocardial
bridging.

Keywords

Coronary artery disease, myocardial bridging, diabetes mellitus, hyperlipidemia

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