The Value of Tissue Doppler Imaging in Prediction of Multivessel Disease in Patients with Acute Inferior Myocardial Infarction Treated by Thrombolytic Therapy

Yıl 2015, Cilt: 4 Sayı: 1, 20 - 27, 01.01.2015

Hikmet Geleri Mustafa Yılmaz Kemal Karaağaç Fahriye Vatansever Ağca Erhan Tenekecioğu Özlem Arıcan Özlük Tezcan Peker Mustafa Kuzeytemiz

https://doi.org/10.5505/abantmedj.2015.70883

Öz

OBJECTIVE: Acute inferior myocardial infarctions AIMI consists the 40-50% of all ST elevated MI. Studies have showed that the rate of multivessel disease MVD is 40-45% in AIMI. Our study was designed to investigate whether tissue Doppler imaging can be used to determine MVD in patients with AIMI who were treated by thrombolytic therapy.METHODS: 49 patients with AIMI who were admitted to our hospital and refused primary percutaneous angioplasty were enrolled in this study. Pateints were treated with streptokinase as a thrombolytic therapy. All patients underwent to two dimensional echocardiographic and pulse wave tissue Doppler imaging examination on the day of admission and evaluated by coronary angiography within 10 days of admission. Patients with one vessel disease consisted the group I and patients with 2 or 3 vessel disease consisted the group II. Tissue Doppler imaging was performed and Sm, SmVTİ, Em, Am, Em/Am, DT, Q-Sm, CT, IVRT values were estimated.RESULTS: In our study group, 45% of patients were found to have MVD. The differences between the groups according to traditional Doppler parameters and LVEF were not significant. Tissue Doppler imaging showed that in group II when compared to group I; Sm, Em, Em/Am values were reduced, whereas DT, Q-Sm, IVRT values were increased. In regression analyses mitral lateral and septal Sm were found to be independant indicators of MVD.CONCLUSION: We argued that the tissue Doppler imaging can be a usefull tool as a non invasive method for determining of MVD in patients with AIMI

Anahtar Kelimeler

Myocardial infarction, multivessel disease, tissue Doppler echocardiography

Trombolitik Tedavi Uygulanan Akut Alt Duvar Miyokard İnfarktüsünde Doku Doppler Görüntülemenin Çok Damar Hastalığını Belirlemedeki Yeri

Öz

AMAÇ: Akut alt duvar miyokard infarktüsü AAMİ ST elevasyonlu Mİ’nin %40-50‘sini oluşturur ve genellikle mortalitesi ön duvar Mİ’ne göre daha düşüktür. Çalışmalarda AAMİ'de çok damar hastalığı 40-45% oranında gösterilmiştir. Bu çalışma trombolitik tedavi uygulanan akut alt duvar miyokard infarktüslerinde çok damar hastalığını saptamada doku Doppler görüntüleme yönteminin kullanılıp kullanılmayacağını araştırmak için yapıldı. YÖNTEMLER: Çalışmaya ST elevasyonlu AAMİ tanısı ile servisimize yatırılan, primer perkütan girişimi kabul etmeyen ve streptokinaz uygulanan 49 hasta alındı. Tüm hastalara yatışlarının ilk gününde 2-D Eko ve PW doku Doppler incelemesi, İlk 10 gün içerisinde ise koroner anjıyografileri yapıldı. Hastalar anjiyografilerine göre tek damar lezyonu saptananlar Grup-I, 2 ve 3 damar lezyonu saptananlar ise Grup-II olarak belirlendi. Doku Doppler incelemesi ile Sm, SmVTİ, Em, Am, Em/Am oranı, DT, Q-Sm, CT, İVRT değerleri ölçüldü. BULGULAR: Çalışmaya alınan hastaların %45’de çok damar hastalığı saptandı. Çok damar hastalarında duvar hareket skor indeksi yüksek bulundu. Ancak geleneksel Doppler parametreleri açısından gruplar arasında anlamlı fark saptanmadı. Doku Doppler görüntülemede ise sistolik ve diyastolik parametreler açısından istatiksel olarak anlamlı fark bulundu. Grup II’de mitral anulus lateral, septal, posterior ve anterior bölgelerde Sm, Em, Em/Am’nin azaldığı, DT, Q-Sm, IVRT’nin uzadığı saptandı. Regresyon analizinde, çok damar hastalığının bağımsız belirleyicileri mitral lateral Sm r=079, p

Anahtar Kelimeler

Akut Miyokard infarktüsü, çok damar hastalığı, doku Doppler ekokardiyografi

Kaynakça

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