Vazovagal Senkoplu Hastalarda Arteriel Sertlik ve Nabız Dalga Hızının Değerlendirilmesi

Abstract

Amaç: Çalışmamızın amacı Vazovagal senkoplu hastalarda hemodinamik mekanizmayı etkileyebilecek kardiyovasküler otonomik modülasyonlardan biri olan arteriyel sertlik parametrelerini değerlendirmek. Gereç ve yöntemler: Çalışmamız retrospektif bir çalışmadır. Ocak 2012-Ocak 2016 tarihleri arasında kardiyoloji polikliniğine başvuran en az iki senkop atağı olan ve eğik masa testi pozitif olan 42 hastanın eğik masa testi sonuçlarını ve arteriyel sertlik parametrelerini topladık. Kontrol grubu olarak da yaş ve cinsiyete göre eşleştirilmiş 41 kişi aldık. Hastalardan damar özelliklerini etkileyebilecek durumları olan, ritim bozukluğu ve psikiyatrik bozukluğu olan hastaları çalışma dışı bıraktık. Hastaların arteriyel sertlik ölçümleri, tilt testi sonuçları, tıbbi öyküleri, sosyodemografik ve klinik bilgileri ile ilgili veriler tıbbi kayıtlarından elde edildi. Arteriyel sertliğinin belirteçleri olarak augmentasyon indeksi, merkezi nabız basıncı ve karotid ila radyal nabız dalga hızı dahil olmak üzere merkezi aort basıncı parametreleri elde edildi. Ardından 2 grup arasında değişkenler karşılaştırıldı. Bulgular: Periferik sistolik (125 ± 16,6 ve 121,1 ± 14,9, p: 0,31) ve diyastolik kan basınçları (79,6 ± 8,9 ve 77,7 ± 9,7, p: 0,38) VVS ve kontrol grupları arasında benzerdi. Merkezi sistolik kan basınçları ve merkezi güçlendirme basınçları da gruplar arasında anlamlı farklılık göstermedi. Vazovagal senkoplu hastalarda nabız dalga hızı sağlıklı kontrollere göre anlamlı derecede düşüktü (5.4 (1.4) and 5.9 (1.8), p= 0.04). Aort augmentasyon indeksi gruplar arasında istatistiksel olarak farklı olmasa da hasta grubunda daha yüksek bulduk. Sonuç: Çalışmamızda VVS grubunda nabız dalga yayılımı sağlıklı gruba göre daha düşük bulundu. Bu sonuçlar VVS hastalarında patofizyolojinin anlaşılmasına katkıda bulunabilir. Vazovagal senkoplu hastalarda nabız dalga hızının önemini anlamak için daha ileri çalışmalara ihtiyaç vardır.

Keywords

• senkop
• arteriel sertlik
• nabız dalga hızı
• eğik masa testi

The Evaluation of Arterial Stiffness and Pulse Wave Velocity in Patients with Vasovagal Syncope

Abstract

Objective: The aim of our study is to evaluate the arterial stiffness parameters that one of cardio-vascular autonomic modulation that may influence the hemodynamic mechanism in patients with Vasovagal syncope. Method: This is a retrospective study. We collected the head-up tilt test results and arterial stiffness parameters of 42 patients with at least two syncopal attack and positive head-up tilt test were enrolled in the study between January 2015 and January 2016. We evaluated also 41, age and sex matched, healthy subjects. We excluded patients with conditions that can affect vascular properties and those with arrhythmias and psychiatric disorders. Data regarding the patients’arterial stiffness, head-up tilt test, medical history, and sociodemographic and clinical information were obtained from their medical records. Central aortic pressure parameters including augmentation index ,central pulse pressure and carotid to radial pulse wave velocity (PWV) as markers of aortic stiffness were obtained. The variables were compared between the 2 groups. Results: Peripheral systolic (125 ± 16.6 and 121.1 ± 14.9, p= 0.31) and diastolic blood pressures (79.6 ± 8.9 and 77.7 ± 9.7, p= 0.38) were similar between VVS and control groups. Central systolic blood pressures and central augmentation pressures also did not significantly differ between groups. In patients with vasovagal syncope, the PWV was significantly lower than the healthy controls (5.4 (1.4) and 5.9 (1.8), p= 0.04). Although aortic augmentation index (AIx) isn’t statistically different between the groups, we found higher at the patient group Conclusion: In our study, PWV was found to be lower in the VVS group compared to the healthy group. These results may contribute to the understanding of the pathophysiology in VVS patients. Further studies are needed to understand the importance of PWV in patients with vasovagal syncope

Keywords

• syncope
• arterial stiffness
• pulse wave velocity
• head-up tilt test

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