Aortik sertliğin primer perkütan koroner girişim sonrasında elektrokardiyografik reperfüzyon üzerine etkisi

Yıl 2012, Cilt: 22 Sayı: 3, 92 - 97, 01.01.2012

Tolga Çimen Abdulkadir Yıldız Mehmet Fatih Karakaş Omaç Tüfekçioğlu Mehmet Doğan Ekrem Yeter Uğur Arslantaş Belma Uygur

Öz

Amaç: Aortik sertlik iyi bilinen bir vasküler yaşlanma göstergesidir ve koroner ateroskleroz ile ilişkisi bilinmektedir. Ancak aortik sertliğin miyokart enfarktüsü sonrası sol ventrikül üzerine etkisi hakkında elimizde yeterli bilgi bulunmamaktadır. Bu çalışmamızda aortik sertliğin, ST yükselmeli miyokart enfarktüsünde STYMİ primer perkütan koroner girişim PKG sonrası elektrokardiyografik reperfüzyon ve enfarkt genişliği üzerine etkisini incelemeyi planladık. Yöntem: STYMİ tanısıyla PKG yapılan 71 hastanın işlemden hemen sonra çekilen EKG’lerinde total ST rezolüsyonuna bakılmıştır. Hastaların işlem sonrası 48-72. saatlerinde ekokardiyografileri yapılmış ve aortik çaplar ile arteriyel tansiyon ölçümleri kullanılarak aortik sertlik parametreleri elde edilmiştir. Ejeksiyon fraksiyon EF değerleri biplane modifiye simpson metodu ile ortalama alınarak saptanmıştır. Enfarkt alanı göstergesi olarak pik CK-MB değerleri kullanılmıştır. Bulgular: Çalışmamızda PKG sonrası elektrokardiyografik olarak başarılı reperfüzyon saptanan hastalarda aortik esneklik parametreleri daha yüksek aortik strain için % 5,63 vs % 4,7, p=0,043; aortik distensibilite için 3,35 vs 2,51, p=0,027 ve pik CK-MB değerleri daha düşük saptanmıştır 144±22 mg/dl vs 239±44 mg/dl, p

Anahtar Kelimeler

Miyokart enfarktüsü, koroner reperfüzyon, ateroskleroz

Effect of aortic stiffness on electrocardiographic reperfusion after primary percutaneous coronary intervention

Öz

Objective: Aortic stiffness is a well-known indicator of vascular aging and the relationship with atherosclerosis is well defined. However the effect of aortic stiffness on left ventricle after myocardial infarction is not so clear. In the present study we studied the effect of aortic stiffness on infarct area and electrocardiographic reperfusion in patients with ST-elevation myocardial infarction STEMI who underwent primary percutaneous coronary intervention PCI . Methods: Total ST resolution was examined on the electrocardiograms ECG of 71 patients who underwent PCI for the diagnosis of STEMI, taken right after the procedure. Echocardiographic measurements were performed at 48-72 hours after the procedure and aortic stiffness parameters were obtained using the measurements of aortic diameter and arterial pressure. Ejection fraction EF was detected by taking the average with the biplane modified simpson method. Peak creatine kinase MB CK-MB isoenzyme levels were used as the indicator of infarct area. Results: Our study showed that in patients that have shown electrocardiographic successful reperfusion, have better aortic stiffness values aortic strain 5.63% vs. 4.7%; p=0.043 and distensibility 3.35 vs. 2.51; p=0.027 and smaller peak CK-MB levels 144±22 mg/dl vs. 239±44 mg/dl, p

Anahtar Kelimeler

Myocardial infarction, reperfusion, atherosclerosis

Kaynakça

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