The Relationship Between Aortic Aneurysms, Inflammatory Markers, and ECG Parameters

Abstract

Objective: Aortic aneurysms are vascular diseases that exhibit different pathophysiological features depending on their location and where inflammation plays an important role. In this study, the aim was to evaluate the relationship between electrocardiographic parameters and indices reflecting systemic inflammation in patients with ascending and abdominal aortic aneurysms. Methods: This retrospective study included 43 patients who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm and 27 consecutive patients who were scheduled for surgical intervention due to ascending aortic aneurysm at a tertiary centre. Preoperative routine blood samples were analysed. Patients' NLR, PLR, and SII were calculated, and C-reactive protein, and RDW levels, along with other laboratory tests and ECG data, were recorded. The two groups were compared. Results: In this study of 70 patients, the mean age of the abdominal aortic aneurysm group (Group 2) was significantly higher than that of the ascending aortic aneurysm group (Group 1) (69.6±9.6 years vs. 59.97±11.8 years; P<.001). Women were more frequently observed in the ascending aortic aneurysm group, while smoking was more common in the abdominal aortic aneurysm group (P<.001). No significant differences were observed between the groups in CRP, NLR, PLR, SII, MPV, diabetes mellitus, hypertension, or prevalence of coronary artery disease (P>.05 for all comparisons). In electrocardiographic analysis, P-wave dispersion was significantly increased in the ascending aortic aneurysm group, while QRS dispersion was also higher in this group, though it reached only borderline statistical significance. Conclusion: According to our study, increased P-wave and QRS dispersion in patients with ascending aortic aneurysm may reflect distinct atrial remodeling and vascular pathophysiological mechanisms rather than differences in traditional cardiovascular risk burden. Larger prospective studies are needed to further clarify the relationship between aneurysm localization, inflammation, and ECG abnormalities.

Keywords

• Systemic immune-inflammation index
• Aortic aneurysm
• Neutrophil lymphocyte ratio
• P wave dispersion

Aort Anevrizmaları, İnflamatuar Belirteçler ve EKG Parametreleri Arasındaki İlişki

Abstract

Amaç: Aort anevrizmaları, yerleşim yerine bağlı olarak farklı patofizyolojik özellikler gösteren ve inflamasyonun önemli rol oynadığı vasküler hastalıklardır. Bu çalışmada, torasik ve abdominal aort anevrizması olan hastalarda elektrokardiyografik parametreler ile sistemik inflamasyonu yansıtan indeksler arasındaki ilişkinin değerlendirilmesi amaçlandı. Yöntemler: Retrospektif olarak merkezimize Abdominal aort anevrizması nedeniyle Abdominal Endovasküler Anevrizma Onarımı (EVAR) planlanan 43 hasta ve çıkan aort anevrizması nedeniyle ameliyat planlanan 27 ardışık hasta dahil edildi. Ameliyat öncesi rutin kan örnekleri analiz edildi. Hastaların NLR, PLR, SII hesaplanarak RDW, C-reaktif protein düzeyleri, diğer laboratuvar testleri ve EKG verileri kaydedildi. Her iki grup birbiriyle karşılaştırıldı. Bulgular: 70 hastanın dahil edildiği çalışmada abdominal aort anevrizması grubunun (Grup 2) yaş ortalaması, çıkan aort anevrizması grubuna (Grup 1) kıyasla anlamlı derecede daha yüksek bulundu (69,6±9,6 yıl’a karşı 59,97±11,8 yıl; P<,001)). Kadın cinsiyet çıkan aort grubunda daha sık görülürken, sigara kullanımı abdominal anevrizması grubunda daha yüksekti (P<,001). CRP, NLR, PLR, SII, MPV, diyabet, hipertansiyon veya koroner arter hastalığı prevalansı açısından gruplar arasında anlamlı fark bulunmamıştır (tüm karşılaştırmalar için P>,05). Elektrokardiyografik analizde, çıkan aort anevrizması grubunda P dalga dispersiyonunun anlamlı olarak arttığı gözlenirken, QRS dispersiyonunun da bu grupta daha yüksek olmakla birlikte istatistiksel olarak sınırda anlamlılık gösterdiği belirlendi. Sonuç: Çalışmamızda çıkan aort anevrizması olan hastalarda P dalga ve QRS dispersiyonunun daha yüksek olması; geleneksel kardiyovasküler risk yükünden ziyade belirgin atriyal yeniden şekillenme ve vasküler patofizyolojik farklılıkları yansıtmaktadır. Anevrizma lokalizasyonu, inflamasyon ve EKG anormallikleri arasındaki ilişkiyi daha iyi anlamak için daha büyük prospektif çalışmalar gerekmektedir.

Keywords

• Aort anevrizması
• Sistemik immün-inflamatuar indeks
• Nötrofil lenfosit oranı
• P dalga dispersiyonu

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