Stabil Koroner Arter Hastalığı Olan Hastalarda Bazal T-Dalgası Pik-Son İntervali ile Kalp Atış Hızı Düzelme İndeksi Arasındaki İlişki

Year 2021, , 279 - 287, 29.06.2021

Hüseyin Ören

https://doi.org/10.31832/smj.807503

Abstract

AMAÇ: Koroner arter hastalığı olan hastalarda otonom disfonksiyon kötü prognozun göstergesidir. Bu çalışmanın amacı, sol ventrikül ejeksiyon fraksiyonu (EF)>% 50 ve <% 50 olan stabil koroner arter hastalığı olan hastalarda başlangıç T-dalgası tepe-son intervali (Tp-e) ve kalp hızı geri kazanım indeksi (HRR-I) değerlerini karşılaştırmaktır.
GEREÇ VE YÖNTEMLER: Grup 1'de 2 aydan uzun süredir eforlu göğüs ağrısı olan 107 hasta ve koroner anjiyografide EF <% 50 olan sınıf 1-2 anjina, 3 damar hastalığı vardı. Grup 2'de koroner anjiyografide EF>% 50 olan, 3 damar hastalığı olan 76 hasta vardı. Başlangıçta her iki grubun başlangıç Tp-e ve kalp hızı değerleri ölçüldü ve transtorasik ekokardiyogramlar yapıldı. Daha sonra Grup 1 ve 2, Bruce protokolüne göre egzersiz testine tabi tutuldu ve egzersizin zirvesinde ve 1., 2. ve 3. dakikalarında kalp hızları ölçüldü.
BULGULAR: Bazal Tp-e açısından grup 1 [95,8 ± 6,8 msec] ve grup 2 [71,4 ± 5,1 msec] arasında istatistiksel olarak anlamlı fark vardı [P<0,0001]. cTp-e (düzeltilmiş T dalgası tepe-son aralığı) değerleri açısından grup 1 [108,1±7,9] ve grup 2 [79,3±7,7] arasında anlamlı fark vardı [P<0,0001]. 1. dakika iyileşme fazında HRR-I'e bakıldığında [14,4 ± 2,1 vs 20,1 ± 3,5], 2. dakika iyileşme fazında HRR-I'e bakıldığında [26,3 ± 2,2 vs 45,1 ± 2,4], 3. dakika iyileşme fazında HRR-I'e bakıldığında [42,6 ± 2,9 vs 64,1 ± 2,6], gruplar arasında istatistiksel olarak anlamlı bir fark vardı [P<0,00001]. .
SONUÇ: Stabil anjinası olan ve EF <% 50 olan hastalarda otonomik gecikme daha belirgindir, Tp-e aralığı değeri daha yüksek ve HRR-I değerleri daha düşüktür.

Keywords

ateroskleroz, elektrokardiyografi, egzersiz testi, kalp hızı, indeks

The Relatioship Between Basal T-Wave Peak-End Interval and Heart Rate Recovery Index Values in Patients with Stable Coronary Artery Disease

Abstract

OBJECTIVES: Autonomic dysfunction is detected in patients with coronary artery disease and is indicative of poor prognosis. The aim of this study was to compare baseline T peak-end interval (Tp-e) and heart rate recovery index [HRR-I] values in patients with stable coronary artery disease who had a left ventricular ejection fraction [EF] > 50 % and < 50 %.
MATERIALS AND METHODS: In Group 1, there were 107 patients with exertional chest pain for more than 2 months and class 1-2 angina with EF < 50 %, had 3-vessel diseases on coronary angiography. In Group 2, there were 76 patients with EF > 50 %, had 3-vessel diseases on coronary angiography. Baseline Tp-e and heart rate values of both groups were measured and transthoracic echocardiograms were performed at the beginning. Both Group 1 and 2 were then subjected to exercise testing according to the Bruce protocol and heart rates were measured at the peak and 1st, 2nd, and 3rd minutes of exercise.
RESULTS: There was a statistically significant difference between group 1 [95.8 ± 6.8 msec] and group 2 [71.4 ± 5.1 msec] with regard to basal Tp-e [P<0.0001]. There was a significant difference between group 1 [108.1±7.9] and group 2 [79.3±7.7] in terms of corrected Tp-e(cTp-e) values [P<0.0001]. Looking at HRR-I at the 1st-minute recovery phase [14.4 ± 2.1 vs 20.1 ± 3.5], when looking at HRR-I at the 2nd-minute recovery phase [26.3 ± 2.2 vs 45.1 ± 2.4], when looking at HRR-I at the 3rd-minute recovery phase [42.6 ± 2.9 vs 64.1 ± 2.6], there was a statistically significant difference between the groups [P<0.00001].
CONCLUSION: Autonomic delaying is more prominent, the Tp-e interval value was higher and HRR-I values were lower in patients with stable angina with EF < 50%.

Keywords

Atherosclerosis, Electrocardiography, exercise test, heart rate, index

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