Copeptin in Severe Mitral Regurgitation Caused by Degenerative Mitral Disease

Yıl 2017, Cilt: 20 Sayı: 3, 195 - 199, 03.12.2017

Alev Kılıçgedik Ahmet Seyfettin Gürbüz Süleyman Çağan Efe Ahmet Güler Ali Yaman Gökhan Kahveci İbrahim Akın İzgi Cevat Kırma

Öz

Introduction:
Copeptin
is known to be increased in cardiac heart failure. The role of copeptin in
patients with severe mitral regurgitation has not been assessed in patients
with preserved ejection fraction. The objective of this study is to evaluate
the role of severe mitral regurgitation caused by degenerative mitral disease
in copeptin release.

Patients
and Methods: 39 patients with degenerative mitral regurgitation (DMR
group) and 30 control subjects (control group) were included in the study. The
clinical and echocardiographic findings were recorded. Blood samples were
obtained in 15 min before echocardiographic examination for determination of
plasma copeptin. Global left ventricular longitudinal and circumferential
strains were evaluated by applying 2D speckle-tracking imaging.

Results: There was
no statistical difference among copeptin levels of all groups (median values
are for DMR:10.7 (9.0-17.1); control group:13.2 (10.6-20.7; p= 0.42). GCSTR and
GLSTR were significantly lower in the DMR group (-19.2 ± 5.5 vs. -23.8 ± 5.3;
p= 0.002 and -17.1 ± 4.3 vs. -19.9 ± 2.4 p= 0.002 respectively). LAV (83.7 ±
38.8 vs. 34.1 ± 7.5 p= 0.0001), E/e’ (9.6 ± 4.0 vs. 6.0 ± 1.4; p= 0.0001), and
E/A (1.79 ± 0.5 vs. 0.9 ± 0.24 p= 0.0001) ratios were significantly higher in
the DMR group.

Conclusion: Our study demonstrated that
there is no significant change in serum copeptin concentrations in severe
mitral regurgitation due to degenerative mitral disease. This can be attached
to the filling changes of left atrium, atrial stretch receptors, and increased
stroke volume.

Anahtar Kelimeler

Copeptin, mitral regurgitation

Dejeneratif Mitral Hastalığa Bağlı İleri Mitral Yetersizliğinde Kopeptin

Öz

Giriş: Kopeptinin kalp yetersizliğinde yükseldiği bilinmektedir.
Korunmuş ejeksiyon fraksiyonlu ileri mitral yetersizliği olan hastalarda
kopeptinin rolü bilinmemektedir. Bu çalışmanın amacı kopeptin salınımında
dejeneratif mitral hastalığa bağlı ileri mitral yetersizlikliğinin rolünü
değerlendirmektir.

Hastalar ve Yöntem: Dejeneratif ileri mitral
yetersizliği olan 39 hasta (DMR grubu) ve 30 kontrol deneği (kontrol grubu)
çalışmaya alındı. Klinik ve ekokardiyografik bulgular kayıt altına alındı.
Plasma kopeptin düzeyini belirlemek için ekokardiyografik incelemeden 15 dakika
önce kan örnekleri alındı. Global sol ventriküler longitudinal ve
sirkumferensiyal değerlendirme 2D specle tracking görüntüleme ile yapıldı.

Bulgular: Gruplar arasında kopeptin düzeyleri açısından anlamlı
fark yoktu (median değerleri DMR: 10.7 (9.0-17.1); kontrol grup:13.2
(10.6-20.7) (p= 0.42)). GCSTR ve GLSTR değerleri DMR grubunda control grubuna
göre daha düşüktü ( -19.2 ± 5.5 vs. -23.8 ± 5.3; p= 0.002 ve -17.1 ± 4.3 vs.
-19.9 ± 2.4 p= 0.002 sırasıyla). LAV (83.7 ± 38.8 vs. 34.1 ± 7.5 p= 0.0001),
E/e’ (9.6 ± 4.0 vs. 6.0 ± 1.4; p= 0.0001) ve E/A (1.79 ± 0.5 vs. 0.9 ± 0.24 p=
0.0001) oranları DMR grubunda anlamlı olarak yüksekti.

Sonuç: Bizim çalışmamız;
dejeneratif mitral hastalığa bağlı ileri mitral yetersizliğinde kontrol grubuna
göre kopeptin düzeylerinde anlamlı değişiklik olmadığını göstermiştir. Bu bulgu
sol atriyal dolum değişiklikleri, atriyal stretch reseptörleri ve artmış stroke
volüm ile ilişkilidir.

Anahtar Kelimeler

Kopeptin, mitral yetersizlik

Kaynakça

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