Atriyoventriküler Nodal Reentran ve Atriyoventriküler Reentran Taşikardili Hastaların Ayırıcı Tanısında Epikardiyal Yağ Kalınlığı Kullanılabilir

Yıl 2019, Cilt: 22 Sayı: 3, 188 - 192, 24.12.2019

Atilla Bulut

Öz

Giriş: Epikardiyal yağ kalınlığı (EYK) aritmik olaylarda rolü olduğu bilinmektedir. Biz bu çalışmada supraventriküler aritmilerin ayırıcı tanısında EYK’nın kullanılabilirliğini araştırdık.

Hastalar ve Yöntem: Kliniğimize çarpıntı şikayeti ile başvuran veya yüzeyel EKG’de SVT tanısı olan ve elektrofizyolojik çalışma (EFÇ) yapılmış 259 hasta dahil edildi. Hastaların demografik, ekokardiyografik verileri ile birlikte EFÇ ile belirlenmiş tanıları kaydedildi.

Bulgular: Çalışmamıza; 88 adet kontrol, 95 adet AVNRT ve 66 adet AVRT’li hastayı dahil ettik. TTE verileri karşılaştırıldığında ise; epikardiyal yağ kalınlığı (p= 0.001) AVRT’li hasta grubunda anlamlı oranda artmış olarak tespit edildi. Binominal lojistik regresyon analizinde EYK bağımsız prediktor olarak tespit edildi (OR:2.2 %95 GA: 1.456-5.478, p< 0.001). Yapılan ROC analizinde, EYK kesim değeri 15 mm olarak alındığında %77.3 sensitivite ve %58.9 spesifite ile AVNRT, AVRT ayrımının yapılabileceği tespit edildi.

Sonuç: Epikardiyal yağ kalınlığı AVRT’li hastalarda artmış olabilir ve ayırıcı tanıda kullanılabilir.

Anahtar Kelimeler

Epikardiyal yağ kalınlığı, supraventriküler aritmi, ayırıcı tanı

Epicardial Fat Thickness May be Used in the Differential Diagnosis of Atrioventricular Nodal Re-entrant and Atrioventricular Re-entrant Tachycardia

Öz

Introduction: Epicardial fat thickness (EFT) is known to play a role in arrhythmic events. In this study, we analysed the feasibility of using EFT in the differential diagnosis of supraventricular arrhythmias.

Patients and Methods: A total of 259 patients were included in the study, all of whom had applied to our outpatient clinic with palpitation complaints or who had been diagnosed with SVT by surface electrocardiogram (ECG) and had undergone complete electrophysiological studies (EPS). The patients’ demographic and echocardiography data along with their EPS-based diagnoses were recorded.

Results: We included 88 control patients, 95 atrioventricular nodal re-entrant tachycardia (AVNRT) patients and 65 atrioventricular re-entrant tachycardia (AVRT) patients. Transthoracic echocardiography (TTE) data showed that the EFT in AVRT group was increased significantly (p= 0.001). In multinomial logistic regression analysis, EFT was identified as an independent predictor (OR:2.2 95% CI: 1.456-5.478, p< 0.001). receiver operating characteristic analysis showed that, when EFT is given at 15 mm, AVNRT and AVRT differentiation can be performed with 77.3% sensitivity and 58.9% specificity.

Conclusion: EFT may be increased in patients with AVRT and can be used in differential diagnoses.

Anahtar Kelimeler

Epicardial fat thickness, supraventricular arrhythmia, differential diagnosis

Kaynakça

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