Kardiyovasküler Risk Faktörü Olmayan Ankilozan Spondilit Hastalarında Kardiyak Fonksiyonel Değişikliklerin Araştırılması

Yıl 2013, Cilt: 16 Sayı: 2, 107 - 114, 01.02.2012

Alper Kepez Lknur Aktaş Zeynep Demet İlgezdi Fatma Doğan Metin Feyza Ünlü Özkan Duygu Şilte Meryem Yılmaz Kaysın Kürşat Tigen Okan Erdoğan

https://doi.org/10.5578/kkd.4711

Öz

Giriş: Bu çalışmada amacımız eş zamanlı kardiyovasküler risk faktörü olmayan ankilozan spondilit hastalarında kardiyak fonksiyonel değişiklikleri araştırmaktır. Hastalar ve Yöntem: Çalışma popülasyonu kardiyovasküler risk faktörü olmayan sıralı 37 ankilozan spondilit hastasından (yaş: 41.4 ± 11.1; 28 erkek) oluşturuldu. Tüm hastaların 12 derivasyonlu elektrokardiyografi leri (EKG) çekildi ve tüm hastalara detaylı transtorasik ekokardiyografi k çalışma yapıldı. 12 derivasyonlu EKG'lerden QRS süresi, p dalga dispersiyonu ve düzeltilmiş QT dispersiyonu değerleri hesaplandı. Ekokardiyografi k çalışmada sol ventrikül sistolik ve diyastolik fonksiyonlarını yansıtan veriler elde edildi. Hastaların verileri yaş ve cinsiyet açısından benzer 28 sağlıklı bireyin (yaş: 40.1 ± 10.5; 19 erkek) verileri ile karşılaştırıldı. Bulgular: Hasta ve kontrol grupları arasında QRS süreleri, p dalga dispersiyonu ve düzeltilmiş QT dispersiyonu değerleri arasında anlamlı farklılık saptanmadı. Hasta ve kontrol gruplarının sol ventrikül sistolik ve diyastolik fonksiyonlarını yansıtan ekokardiyografi k parametrelerinin de benzer olduğu görüldü. Doku Doppler ile elde edilen mitral ve triküspid anülüs hızlarında da anlamlı farklılık saptanmadı. Ankilozan spondilit grubunda 2 (%5.4) hastada ve kontrol grubunda 2 (%7.2) bireyde minimal aort yetmezliği olduğu izlendi (p= 0.51). Sonuç: Kardiyovasküler risk faktörü olmayan ankilozan spondilit hastaları kullanılarak yapılan çalışmamızda, ankilozan spondilit hastalarının elektrokardiyografi k ve ekokardiyografi k bulgularının kontrol grubu ile benzer olduğu görüldü. Ankilozan spondilit hastalarındaki kardiyovasküler patoloji prevalansı hakkındaki çelişkili literatür verilerine eş zamanlı bulunan kardiyovasküler risk faktörlerinin katkısı olabileceği düşünüldü.

Anahtar Kelimeler

Spondilit, ankilozan; aritmiler, kalp; ekokardiyografi; elektrokardiyografi

Assessment of Cardiac Functional Alterations of Ankylosing Spondylitis Patients without Cardiovascular Risk Factors

Öz

Introduction: The aim of this study is to evaluate cardiac functional alterations of ankylosing spondylitis patients without any cardiovascular risk factors. Patients and Methods: Thirty seven consecutive akylosing spondylitis patients without any cardiovascular risk factors constituted our study patient population (age: 41.4 ± 11.1 years, 28 male). Electrocardiographs (ECG) of all patients were obtained and all patients underwent comprehensive transthoracic echocardiographic examination. QRS durations, p wave dispersion and corrected QT dispersion (QTcd) values were calculated from 12-lead ECG's. Data refl ecting left ventricular systolic and diastolic functions were obtained from echocardiographic examinations. Data of patients were compared with the data of 28 age-and gender matched healthy control subjects (age: 40.1 ± 10.5 years, 19 male). Results: There were no signifi cant differences between patients and controls regarding QRS durations, p wave dispersion and QTcd values. There were also no signifi cant differences between patients and controls regarding parameters refl ecting left ventricular systolic and diastolic functions. Annular velocities at mitral and tricuspid annulus levels evaluated with pulsed-wave tissue Doppler imaging were also similar as well. Two (7.2%) subjects in the control group and 2 (5.4%) patients in the akylosing spondylitis group had minimal aortic regurgitation (p= 0.51). Conclusion: We could not demonstrate any electrocardiographic or echocardiographic evidence of structural myocardial alterations in a small sample of akylosing spondylitis patients free of cardiovascular risk factors. Effects of frequently encountered co-existent cardiovascular risk factors of ankylosing spondylitis patients might have contributed to the confl icting literature data related with this topic.

Anahtar Kelimeler

Spondylitis, ankylosing; arrhythmias, cardiac; echocardiography; electrocardiography

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