Akut Dekompanse Sistolik Kalp Yetersizliği Hastalarında BNP Değişimi ile Korele Ekokardiyografik Parametrelerin Araştırılması

Yıl 2016, Cilt: 19 Sayı: 2, 91 - 96, 01.08.2016

Mehmet Akif Ekinci Mehmet Eyüboğlu , Özer Badak

Öz

Giriş: Sistolik kalp yetmezliği hastalarında genellikle değişen
derecelerde diyastolik disfonksiyon da eşlik etmektedir. Akut dekompanse kalp
yetersizliği hastalarında tedavi ile sağlanan B tipi natriüretik peptit (BNP)
düşüşüyle korelasyon gösteren ekokardiyografik parametreler hakkında yeterli
veri yoktur. Bu çalışmanın amacı dekompanse kalp yetersizliği ile başvuran
hastalarda tedavi ile sağlanan BNP değişimleriyle ekokardiyografi
parametrelerinin ilişkisinin değerlendirilmesidir.

Hastalar
ve Yöntem: Sinüs ritminde olup sistolik
dekompanse kalp yetersizliği tanısıyla hastaneye yatırılan ardışık 30 hasta
çalışmaya dahil edildi. Bütün hastalar optimal medikal tedavi ile tedavi
edildi. Hastaların hastaneye kabulünde ve taburculuk öncesinde BNP düzeyleri
ölçüldü ve transtorasik ekokardiyografi uygulandı. Tedavi ile sağlanan BNP
düzeyindeki düşüş ile korelasyon gösteren transtorasik ekokardiyografi
bulguları, bunların değişimi ve birbirleri ile olan bağıntısı değerlendirildi.

Bulgular: Hastaların ortalama hastanede yatış süresi 4.7 ± 1.3 gün
olarak tespit edildi. Tedavi sonrası sol atriyum çapı ve sol atriyum alanında
azalma ile BNP düşüşü arasında anlamlı bir ilişki izlendi. BNP düzeyindeki
azalma ile LV E dalgası amplitüdündeki değişim, septalden ve lateralden elde
edilen E/E’ oranı değişimleri arasında anlamlı yüksek düzeyde pozitif ilişki
olduğu saptandı. Sol ventrikül lateral mitral anulusundan bakılan Sm’sinde ise
anlamlı, zayıf düzeyde negatif bağıntı olduğu görüldü.

Sonuç: Çalışmamızın sonuçları
göstermektedir ki, ekokardiyografik parametreler akut dekompanse sistolik kalp
yetersizliği ile hastaneye yatırılan hastalarda tıpkı BNP gibi tedaviye yanıtın
değerlendirilmesinde kullanılabilinir.

Anahtar Kelimeler

Kalp yetersizliği, B-tipi natriüretik peptit, ekokardiyografi

Investigation of Echocardiographic Parameters Correlated with Changes in BNP Levels in Patients with Acute Decompensated Systolic Heart Failure

Öz

Introduction: Patients
with systolic heart failure usually have concomitant diastolic dysfunction.
There are limited data regarding the association between a decrease in B-type
natriuretic peptide (BNP) levels and echocardiographic parameters after the
treatment of acute decompensated systolic heart failure. The aim of this study
was to investigate the association between echocardiographic parameters and the
changes in BNP levels after the treatment of acute decompensated systolic heart
failure.

Patients and Methods: Thirty
consecutive patients with acute decompensated systolic heart failure and having
sinus rhythm were included in the study. BNP levels were measured before and
after the treatment of acute decompensated systolic heart failure. All patients
underwent a detailed echocardiographic study on admission and before discharge.
We compared the correlation between echocardiographic parameters and BNP levels
after the treatment of acute decompensated systolic heart failure.

Results: The mean
duration of hospital stay was 4.7 ± 1.3 days. There was a statistical
significant relationship between a decrease in the left atrium diameter and
area and a decrease in BNP levels. There was a significant positive correlation
between a change in the LV E wave amplitude and BNP levels. The E/E’ ratio,
measured from the lateral medial mitral annulus, had a significantly positive
and strong correlation with the changes in BNP levels. Sm, measured using
tissue Doppler from the lateral mitral annulus, had a negative significant
correlation with the changes in BNP levels.

Conclusion: Our findings suggest that similar to
the changes in BNP levels, echocardiographic parameters demonstrate a response
to an optimal medical therapy in patients with acute decompensated systolic
heart failure.

Anahtar Kelimeler

Heart failure, B-type natriuretic peptide, echocardiography

Kaynakça

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