Koroner Arter Hastalığı ile Myokardiyal Köprüleşme Arasındaki İlişki

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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