Kronik Böbrek Yetmezliği Hastalarında Diyaliz Tipinin Sağ Kalp Fonksiyonları Üzerindeki Etkilerinin Karşılaştırılması

Yıl 2021, Cilt: 23 Sayı: 1, 87 - 92, 30.04.2021

Yasemin Kaya Muhammet Özbilen Seçkin Dereli Harun Düğeroğlu Saadet Yılmaz Mustafa Yenerçağ Yeliz Kaşko Arıcı

https://doi.org/10.18678/dtfd.843109

Öz

Amaç: Bu çalışmanın amacı diyaliz tipinin sağ kalp fonksiyonlarına etkilerinin iki boyutlu speckle tracking ekokardiyografi (2D-STE) ile karşılaştırılmasıdır.
Gereç ve Yöntemler: Kardiyoloji ve nefroloji polikliniklerine başvuran, periton diyalizi yapan ve hemodiyalize giren toplam 53 hasta çalışmaya dahil edildi. Sol kalp yetmezliği, koroner arter hastalığı, primer ve sekonder pulmoner hipertansiyon, pulmoner emboli, derin ven trombozu, orta ve ileri derecede kalp kapak yetmezliği ve darlığı olanlar çalışma dışı bırakıldı. Hastaların sosyodemografık özellikleri ve biyokimyasal parametreleri kaydedildi. 2D-STE ile hastaların sağ kalp fonksiyonları değerlendirildi.
Bulgular: Yaş açısından gruplar arasında fark yoktu (p=0,496), hemodiyaliz grubunda erkek oranı daha yüksekti (p=0,006). 2D-STE ölçümleri karşılaştırıldığında; sağ atriyum (right atrium, RA) maksimum hacmi ve RA minimum hacmi hemodiyaliz hastalarında anlamlı olarak yüksekti (sırasıyla p=0,006; p=0,007). RA maksimum hacim indeksi, RA minimum hacim indeksi ve triküspit anulusunun sistolde apikale yer değiştirmesi (tricuspid annular plane systolic excursion, TAPSE) açısından gruplar arasında fark yoktu. Hemodiyaliz hastalarında RAS strain ve RAA strain anlamlı olarak daha düşüktü (sırasıyla p=0,001; p=0,012). Hemodiyaliz hastalarında TAPSE ile RA maksimum hacmi arasında (r=0,484; p=0,036) ve periton diyalizi hastalarında TAPSE ile RA minimum hacmi arasında (r=0,486; p=0,025) pozitif korelasyon bulundu.
Sonuç: Sağ ventrikül fonksiyonları periton diyalizi ve hemodiyaliz hastalarında benzer bulundu. Sağ atriyal fonksiyonların periton diyalizi hastalarında hemodiyaliz hastalarına göre daha iyi korunduğu görüldü.

Anahtar Kelimeler

diyaliz, sağ kalp fonksiyonları, Speckle Tracking Ekokardiyografi

Comparison of the Effects of Dialysis Type on Right Heart Functions in Chronic Renal Failure Patients

Öz

Aim: The aim of this study was to compare the effects of dialysis type on right heart functions with two-dimensional speckle tracking echocardiography (2D-STE).
Material and Methods: A total of 53 patients who have peritoneal dialysis and hemodialysis, applied to cardiology and nephrology outpatient clinics, were included in the study. Those with left heart failure, coronary artery disease, primary and secondary pulmonary hypertension, pulmonary embolism, deep vein thrombosis, moderate and severe heart valve failure and stenosis were excluded from the study. Sociodemographic characteristics and biochemical parameters of the patients were recorded. Right heart functions of the patients were evaluated using 2D-STE.
Results: There was no difference between groups with respect to age (p=0.496), the rate of male was higher in hemodialysis group (p=0.006). In comparison of 2D-STE measurements; right atrium (RA) maximum volume and RA minimum volume were significantly higher in hemodialysis patients (p=0.006, p=0.007, respectively). There were no difference between the groups in RA maximum volume index, RA minimum volume index and tricuspid annular plane systolic excursion (TAPSE). RAS strain and RAA strain were significantly lower in hemodialysis patients (p=0.001, p=0.012, respectively). A positive correlation was found between TAPSE and RA maximum volume in hemodialysis patients (r=0.484, p=0.036), and between TAPSE and RA minimum volume in peritoneal dialysis patients (r=0.486, p=0.025).
Conclusion: Right ventricular functions were found to be similar in peritoneal dialysis and hemodialysis patients. It was observed that right atrial functions were better protected in peritoneal dialysis patients than hemodialysis patients.

Anahtar Kelimeler

Dialysis, ; right heart functions, Speckle Tracking Echocardiography

Kaynakça

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