Tanısal Egzersiz Elektrokardiyografi Testi Yapılan Hastalarda Serum Tiyol Disulfid Dengesi ve Endokan Düzeyleri

Yıl 2017, Cilt: 20 Sayı: 3, 217 - 223, 03.12.2017

Emrullah Kızıltunç , Burcu Uğurlu Ilgın Harun Kundi Hülya Çiçekçioğlu Canan Topçuoğlu Mustafa Çetin Ender Örnek

Öz

Giriş: İnflamasyon ve oksidatif stres artmış kardiyovasküler risk ile ilişkilidir.
Duke koşu bandı skoru ve kalp hızı toparlanması (KHT) gibi egzersiz
elektrokardiyografi (EKG) testinden türetilen parametreler prognostik öneme
sahiptir ve kardiyovasküler risk tahmini için kullanılabilir. Endokan ve
tiyol/disülfid dengesi, inflamatuvar ve oksidatif durumu yansıtan yeni
biyolojik belirteçlerdir. Bu çalışmanın amacı, bir egzersiz EKG testi yapılan
hastalarda serum tiyol/disülfid dengesi ve endokan düzeylerini araştırmak ve bu
belirteçlerin Duke treadmill skoru ve KHT ile ilişkisini değerlendirmektir.

Hastalar ve
Yöntem: Tanısal egzersiz EKG testi yapılan hastalar Duke skoru
ve KHT’ye göre iki gruba ayrıldı. Yüksek Duke skoru-orta/düşük Duke skoru
grupları ile künt ve normal KHT grupları arasında serum endokan düzeyleri ve
tiyol/disülfid dengesi karşılaştırıldı.

Bulgular: Serum endokan düzeyleri, Duke treadmill skoru ve KHT’ye göre gruplar
arasında benzerdi. Tiyol /disülfid oranı, azalmış KHT’li hastalarda normal
KHT’li hastalara göre anlamlı derecede düşüktü. Yüksek/Duke skoru olan
hastalarda, düşük/orta Duke skoru olan hastalara göre, serum nativ tiyol
düzeyleri, total tiyol düzeyleri ve total tiyol/disülfid oranı anlamlı olarak
yüksekti. Doğal tiyol düzeyleri ve total tiyol düzeyleri Duke skoru ile anlamlı
korelasyon göstermekteydi. Çok değişkenli regresyon analizinde, azalmış
KHT’inin bağımsız öngördürücüleri hipertansiyon ve diyabet varlığı; düşük/orta
Duke skorunun bağımsız öngördürücüleri ise hipertansiyon varlığı ve düşük
endokan düzeyleridir.

Sonuç: Serum tiyol düzeyleri Duke
skoru ile ilişkilidir ve düşük endokan seviyeleri düşük/orta Duke skoru ile
ilişkilidir.

Anahtar Kelimeler

İnflamasyon, oksidatif stres, Duke skoru, tiyol disülfid dengesi, endokan

Serum Thiol/Disulfide Homeostasis and Endocan Levels in Patients Who Underwent Diagnostic Exercise Electrocardiography Test

Öz

Introduction:
Inflammation
and oxidative stress are associated with increased risk of cardiovascular
diseases. Parameters derived from exercise electrocardiography (ECG) test, such
as Duke treadmill score and heart rate recovery (HRR), have prognostic
importance and can be used to predict cardiovascular risk. Endocan and
thiol/disulfide homeostasis are emerging biomarkers that reflect the
inflammatory and oxidative status. The aim of this study was to investigate
serum thiol/disulfide homeostasis and endocan levels in an exercise ECG testing
patient cohort and to evaluate the association of these markers with Duke
treadmill score and HRR.

Patients
and Methods: Patients who underwent diagnostic exercise ECG test were
divided into two groups according to Duke treadmill score and HRR. Serum
endocan levels and thiol/disulfide homeostasis were compared between high and
low/intermediate Duke treadmill score groups and blunted and normal HRR groups.

Results: Serum
endocan levels were similar between the groups according to Duke treadmill
score and HRR. Thiol/disulfide ratio was significantly lower in patients with
blunted HRR than in those with normal HRR. Serum native thiol levels, total
thiol levels, and total thiol/disulfide ratio were significantly elevated in
patients with a high Duke treadmill score than in those with low/intermediate
Duke treadmill score. Native thiol levels and total thiol levels were
significantly correlated with Duke treadmill score. Multivariate regression
analysis revealed that hypertension and diabetes were independent predictors of
blunted HRR, whereas hypertension and low endocan levels were those of
low/intermediate Duke treadmill score.

Conclusion: Serum thiol levels are
correlated with Duke treadmill score, and low endocan levels are associated
with low/intermediate Duke treadmill score.

Anahtar Kelimeler

Inflammation, oxidative stress, Duke score, heart rate recovery, thiol/disulfide homeostasis, endocan

Kaynakça

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