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Vazovagal Senkoplu Hastaların Elektrokardiyografi Ve Ekokardiyografilerinin Değerlendirilmesi

Yıl 2016, Cilt: 13 Sayı: 2, 148 - 153, 29.08.2016

Öz

Amaç: Senkop genel popülasyonda oldukça sıkça görülür ve en sık görülen tipi, nöral (reflex) aracılı senkop
olarak, tanımlanan vazovagal senkop türüdür. Bu çalışmada vazovagal senkop tanısı alan hastaların
ekokardiyografi ve elektrokardiyografilerinin değerlendirilmesi amaçlanmıştır
Materyal ve metod: Kardiyoloji polkliniğinde vazovagal senkop tanısı konan 60 hasta ve kardiyak
değerlendirme sonucu herhangi bir patoloji saptanmayan, benzer demografik özelliklere sahip ardışık 30
sağlıklı birey, kontrol grubu olarak çalışmaya dâhil edildi. Hastaların ayrıntılı anamnez, öykü ve fizik
muayene sonrası elektrokardiyografik (EKG) ve ekokardiyografi değerlendirmeleri yapıldı
Sonuçlar: Vazovagal senkoplu hasta grubu ve kontrol grubu arasında yaş, cinsiyet, temel EKG ve
ekokardiyografik bulgular açısından anlamlı farklılık izlenmedi (tüm p değerleri >0,05). Bununa beraber
senkoplu hasta grubunda, EKG'de kalp hızı anlamlı olarak daha yüksek iken, E/Em oranı ise anlamlı olarak
daha düşük saptandı (sırasıyla, 85±8,7 vs 77±6,9, p=0,033 ve 8,6±1,2 vs 9,2±1,1 p=0,020).
Tartışma: Senkoplu hastaların EKG ve ekokardiyografik değerlendirmeleri kardiyak patolojilerin
tanınmasının yanında, vazovagalsenkoplu hastalarda sol ventikül doluş basınçlarının değerlendirilmesinde
ek ilgiler sağlayabilir

Kaynakça

  • 1.Angel M, Richard S, Fabrizio A, et al. Guidelines on diagnosis and management of Syncope- Eur Heart J 2009;30:2631-71.
  • 2.Day SC, Cook EF, Funkenstein H, et al. Evaluation and outcome of emergency room patients with transient loss of consciousness. Am J Med 1982;73:15-23.
  • 3.Brignole M, Disertori M, Menozzi C, et al. Management of syncope referred urgently to general hospitals with and without syncope units. Europace 2003;5:293-8.
  • 4.Bartoletti A, Fabiani P, Adriani P, et al. Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope. Eur Heart J 2006;27:83-8
  • 5.Alboni P. The different clinical presentations of vasovagal syncope. Heart. 2015 May;101(9):674-8.
  • 6.Jardine DL. Vasovagal syncope: new physiologic insights. CardiolClin. 2013 Feb;31(1):75-87.
  • 7.Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am SocEchocardiogr. 2015;28:1–39.
  • 8.Strickerger SA, Benson DW, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA. AHA/ACCF Scientific statementionThe evaluation of syncope. Circulation 2006;113(2):316- 327
  • 9.Grubb BP. Clinicalpractice. Neurocardiogenicsyncope. N Engl J Med. 2005;352:1004–1010
  • 10.Ammirati F, Colaceci R, Cesario A, Strano S, DellaScala A, Colangelo I, De Santo T, Toscano E, Ricci R, S a n t i n i M. Ma n a g eme n t o f s y n c o p e : clinicalandeconomicimpact of a SyncopeUnit. Europace. 2008;10(4):471–476.
  • 11.Douglas PS, Garcia MJ, Haines DE, Lai WW, Manning WJ, Patel AR, Picard MH, Polk DM, Ragosta M , W a r d R P , W e i n e r R B . ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SC CT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, AmericanSociety of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical CareMedicine, Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians. J Am Coll Cardiol. 2011 Mar 1;57(9):1126-66.
  • 12.Chang NL, Shah P, Bajaj S, Virk H, Bikkina M, Shamoon F. Diagnostic Yield of Echocardiography in Syncope Patients with Normal ECG. Cardiol Res Pract. 2016;2016:1251637. doi: 10.1155/2016/1251637. Epub 2016 Jan 4.
  • 13.Sarasin FP, Junod AF, Carballo D, Slama S, Unger PF, Louis-Simonet M. Role of echocardiography in theevaluation of syncope: a prospectivestudy. Heart. 2002 Oct;88(4):363-7.
  • 14.Anderson KL, Limkakeng A, Damuth E, Chandra A. Cardiac evaluation for structura labnormalitiesmay not be required in patients presenting with syncope and a normal ECG result in an observation unit setting. AnnEmergMed. 2012Oct;60(4):478-84.e1.
  • 15.Wieling W, Colman N, Krediet CT, Freeman R (2004) Nonpharmacological treatment of reflex syncope. ClinAutonRes 14(Suppl 1):62–70

The Assessment of Electrocardiography And Echocardiography in Vasovagal Syncope

Yıl 2016, Cilt: 13 Sayı: 2, 148 - 153, 29.08.2016

Öz

Objective: Syncope is a common clinical problem in the general population. Vasovagal syncope (a type of
neural –reflex syncope) is the most common form of syncope. The aim of this was to evaluate the
electrocardiography and echocardiographic parameters in patients with vasovagal syncope
Material and method: Atotal of 60 consequently patients with vasovagal syncopeand 30 randomly age/sex
matched subjects with no cardiovascular or systemic disease were recruited in this study. Afterall study
population underwent a detailed history and physical examination, the electrocardiography (ECG) and
echocardiographic evaluation performed. Results: Vasovagal syncope group and control group were similar in terms ofthe age, sex, basic ECG and
echocardiographic parameters (all p values >0.05).However, heart rate on ECG was significantly higher,
while E/Em ratio was significantly lower in vasovagal syncope group (85±8,7vs77±6,9, p=0,033 ve 8,6±1,2
vs 9,2±1,1 p=0,020, respectively).
Conclusion: In addition to reveal the possible underlying cardiac pathologyin syncope patients, the
assessment of ECG and echocardiography can provide a usefulcontributionregardingleft ventricular filling
pressure in patients with vasovagal syncope

Kaynakça

  • 1.Angel M, Richard S, Fabrizio A, et al. Guidelines on diagnosis and management of Syncope- Eur Heart J 2009;30:2631-71.
  • 2.Day SC, Cook EF, Funkenstein H, et al. Evaluation and outcome of emergency room patients with transient loss of consciousness. Am J Med 1982;73:15-23.
  • 3.Brignole M, Disertori M, Menozzi C, et al. Management of syncope referred urgently to general hospitals with and without syncope units. Europace 2003;5:293-8.
  • 4.Bartoletti A, Fabiani P, Adriani P, et al. Hospital admission of patients referred to the Emergency Department for syncope: a single-hospital prospective study based on the application of the European Society of Cardiology Guidelines on syncope. Eur Heart J 2006;27:83-8
  • 5.Alboni P. The different clinical presentations of vasovagal syncope. Heart. 2015 May;101(9):674-8.
  • 6.Jardine DL. Vasovagal syncope: new physiologic insights. CardiolClin. 2013 Feb;31(1):75-87.
  • 7.Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am SocEchocardiogr. 2015;28:1–39.
  • 8.Strickerger SA, Benson DW, Biaggioni I, Callans DJ, Cohen MI, Ellenbogen KA. AHA/ACCF Scientific statementionThe evaluation of syncope. Circulation 2006;113(2):316- 327
  • 9.Grubb BP. Clinicalpractice. Neurocardiogenicsyncope. N Engl J Med. 2005;352:1004–1010
  • 10.Ammirati F, Colaceci R, Cesario A, Strano S, DellaScala A, Colangelo I, De Santo T, Toscano E, Ricci R, S a n t i n i M. Ma n a g eme n t o f s y n c o p e : clinicalandeconomicimpact of a SyncopeUnit. Europace. 2008;10(4):471–476.
  • 11.Douglas PS, Garcia MJ, Haines DE, Lai WW, Manning WJ, Patel AR, Picard MH, Polk DM, Ragosta M , W a r d R P , W e i n e r R B . ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SC CT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, AmericanSociety of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical CareMedicine, Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians. J Am Coll Cardiol. 2011 Mar 1;57(9):1126-66.
  • 12.Chang NL, Shah P, Bajaj S, Virk H, Bikkina M, Shamoon F. Diagnostic Yield of Echocardiography in Syncope Patients with Normal ECG. Cardiol Res Pract. 2016;2016:1251637. doi: 10.1155/2016/1251637. Epub 2016 Jan 4.
  • 13.Sarasin FP, Junod AF, Carballo D, Slama S, Unger PF, Louis-Simonet M. Role of echocardiography in theevaluation of syncope: a prospectivestudy. Heart. 2002 Oct;88(4):363-7.
  • 14.Anderson KL, Limkakeng A, Damuth E, Chandra A. Cardiac evaluation for structura labnormalitiesmay not be required in patients presenting with syncope and a normal ECG result in an observation unit setting. AnnEmergMed. 2012Oct;60(4):478-84.e1.
  • 15.Wieling W, Colman N, Krediet CT, Freeman R (2004) Nonpharmacological treatment of reflex syncope. ClinAutonRes 14(Suppl 1):62–70
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Eyyup Tusun

Abdulselam İlter Bu kişi benim

Feyzullah Beşli

Yayımlanma Tarihi 29 Ağustos 2016
Gönderilme Tarihi 26 Ocak 2016
Kabul Tarihi 9 Şubat 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 13 Sayı: 2

Kaynak Göster

Vancouver Tusun E, İlter A, Beşli F. Vazovagal Senkoplu Hastaların Elektrokardiyografi Ve Ekokardiyografilerinin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2016;13(2):148-53.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty