Presistolik dalga ankilozan spondilitte subklinik sol ventrikül diyastolik disfonksiyonu için bir belirteç olabilir mi?

Yıl 2020, Cilt: 45 Sayı: 3, 880 - 890, 30.09.2020

Çağlar Özmen Neslihan Gökçen Rabia Akıllı Cuma Yeşildaş Ayhan Usal

https://doi.org/10.17826/cumj.690505

Öz

Amaç: Bu çalışmanın amacı, ankilozan spondilit hastalarında diyastolik disfonksiyonun saptanmasında presistolik dalganın önemini değerlendirmektir.
Gereç ve Yöntem: Kesitsel çalışmamıza 59 hasta ve 65 sağlıklı kontrol dahil edildi. Ankilozan Spondilit Hastalığı Aktivite Skoru, Bath Ankilozan Spondilit Metrology indeks, Maastricht Ankilozan Spondilit Entesit Skoru ve Bath Ankilozan Spondilit Fonksiyonel İndeksi değerlendirildi. Doppler doku görüntüleme ve presistolik dalga ölçümleri yapıldı.
Bulgular: Hastaların % 37.3'ünde ve kontrol grubunun % 16.9'unda olmak üzere tüm çalışma popülasyonunun% 26.6'sında presistolik dalga saptandı. Hasta ve kontrol grupları presistolik dalganın varlığına veya yokluğuna göre iki gruba ayrıldığında; miyokardiyal performans indeksi, transmitral E dalga hızı, E/A oranı, sol ventrikül çıkış yolu velositesi ve septal e 'dalga hızı, her iki grupta da presiktolik dalgası olanlarda istatistiksel olarak anlamlı oranda farklıydı. Tek değişkenli modelde, yüksek c-reaktif protein seviyesi, artmış BASMI ve BASFI skorları ve artmış miyokard performans indeksi, ankilozan spondilit hastalarında presistolik dalga varlığı için risk faktörü olarak belirlenmiştir.
Sonuç: Ekokardiyografik incelemede presistolik dalganın varlığı, ankilozan spondilit hastalarında prognostik önemi olan sol ventrikül diyastolik fonksiyonu hakkında önemli bilgiler sağlayabilir.

Anahtar Kelimeler

Ankilozan spondilit, Diyastolik fonksiyon bozukluğu, Kalp yetmezliği, Presistolik dalga

Could presystolic wave be a predictor for subclinical left ventricular diastolic dysfunction in ankylosing spondylitis?

Öz

Purpose: The aim of this study was to evaluate the clinical significance of presystolic wave in the detection of diastolic dysfunction in ankylosing spondylitis patients.
Materials and Methods: In this cross-sectional study, 59 patients and 65 healthy controls were included in the study. Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Metrology Index, Maastricht Ankylosing Spondylitis Enthesitis Score and Bath Ankylosing Spondylitis Functional Index was eveluated. The Doppler tissue-imaging and presystolic wave measurements were performed by same cardiologist who was blinded to study details.
Results: Presystolic wave was detected in 26.6% of the whole study population; in 37.3% of patients and 16.9% of the control group. When the patient and control groups were divided into two subgroups according to the presence or absence of presystolic wave; myocardial performance index, transmitral E wave velocity, E/A ratio, left ventricular outflow tract velocity and septal e’ wave velocity were statistically significant in subjects with presence presystolic wave in both groups. In the univariate model, high c-reactive protein level, increased BASMI and BASFI scores and elevated myocardial performance index were determined as risk factors for the presence of presystolic wave in ankylosing spondylitis patients.
Conclusion: The assessment of presystolic wave on echocardiography examination may provide important information about the left ventricul diastolic function, which has a prognostic impact for ankylosing spondylitis patients. 

Anahtar Kelimeler

Ankylosing spondylitis, Heart failure, Diastolic dysfunction, Presystolic wave

Kaynakça

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