The Role of Right Ventricular Contractility in Patients Who Experienced Neurogenic Syncope

Yıl 2018, Cilt: 21 Sayı: 2, 169 - 173, 19.08.2018

Volkan Emren , Uğur Kocabaş Fatih Levent Ersin Çağrı Şimşek Emre Özdemir Nihan Kahya Eren Cem Nazlı Mehmet Tokaç

Öz

Introduction:
Left
ventricular hyper contractility has been thought to have a major role at early
phases of vasovagal syncope. However the right ventricular function during
syncope has not been delineated clearly. The present study evaluated the right
myocardial contractility in patients who experienced vasovagal syncope during
head-up tilt test (HUTT).

Patients
and Methods: A total of 89 Patients, who experienced syncope between
January 2012 and March 2014, were included in the study. All the patients
underwent HUTT and were followed by transthoracic echocardiography.

Results: Fifty
patients experienced syncope during HUTT. There was no significant difference
between the patients, who experienced syncope versus who did not, in terms of
gender, age, ejection fraction (p> 0.05). Mitral lateral annular systolic
(s’) velocity (14 ± 3.8 vs. 13.3 ± 3.6; p= 0.625), septal annular s’ velocity
(11 ± 3.7 vs. 10.3 ± 2; p= 0.951) were similar following HUTT in patients with
and without syncope respectively. However, tricuspid valve lateral annular s’
velocity after tilt testing was higher in patients, who experienced syncope (17
± 2.7 vs. 15.1 ± 3.0; p= 0.003).

Conclusion: While left ventricular
functions are not affected, right ventricular contraction is more powerful in
patients who experience syncope during HUTT.

Anahtar Kelimeler

Echocardiography, head-up tilt testing, neurogenic syncope

Nörojenik Senkop Geçiren Hastalarda Sağ Ventrikül Kontraksiyonunun Rolü

Öz

Giriş: Nörojenik senkopun erken safhasında sol ventrikül
kontraktilite artışının önemli rolü olduğu düşünülmektedir. Fakat senkop
esnasında sağ ventrikül fonksiyonu net olarak ortaya konmamıştır. Bu çalışmada
eğik masa testinde (EMT) nörojenik senkop geçiren hastalarda sağ ventrikül
fonksiyonu değerlendirilmiştir.

Hastalar ve Yöntem: Ocak 2016 ve Mart 2017 tarihleri
arasında senkop geçiren 89 hasta çalışmaya dahil edilmiştir. Tüm hastalara EMT
ve ardından transtorasik ekokardiyografi uygulanmıştır.

Bulgular: Eğik masa testinde 50 hastada senkop gelişmiştir. Senkop
gelişen ve  gelişmeyen hastalarda
cinsiyet, yaş ve ejeksiyon fraksiyonu açısından fark gözlenmemiştir (p>  0.05). Mitral lateral anüler sistolik (s’)
velositesi (14 ± 3.8’e karşı 13.3 ± 3.6 
p= 0.625), septal anuler s’ velositesi (11 ± 3.7’ye karşı 10.3 ± 2 p=
0.951) senkop gelişen ve gelişmeyen hastalarda benzer izlenmiştir. Fakat senkop
geçiren hastalarda triküspit lateral anüler s’ velositesi daha yüksek
saptanmıştır (17 ± 2.7’e karşı 15.1 ± 3.0, p= 0.003).

Sonuç: Eğik masa testinde senkop
gelişen hastalarda sol ventrikül fonksiyonları değişmezken sağ ventrikül
kontraksiyonunda artış gözlenmiştir.

Anahtar Kelimeler

Ekokardiyografi, eğik masa testi, nörojenik senkop

Kaynakça

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