Kronik Obstrüktif Akciğer Hastalığında Solunum Fonksiyonlarının ve Pulmoner Arter Basıncının Sağ ve Sol Ventrikül Diyastolik Fonksiyonları Üzerine Etkisi

Yıl 2013, Cilt: 16 Sayı: 3, 205 - 213, 01.03.2012

Şeref Alpsoy Aydın Akyüz Dursun Çayan Akkoyun Mustafa Oran Levent Cem Mutlu Birol Topçu Hasan Değirmenci Banu Çiçek Yalçın

https://doi.org/10.5578/kkd.5835

Öz

Giriş: Bu çalışmada, kronik obstrüktif akciğer hastalığı (KOAH) olan kişilerde konvansiyonel ve doku Doppler ekokardiyografi yle sağ ve sol ventrikül diyastolik fonksiyonlarını değerlendirmeyi, solunum fonksiyonları ve pulmoner arter basıncının diyastolik fonksiyonlar üzerine etkisini araştırmayı amaçladık. Hastalar ve Yöntem: KOAH'lı 60 hasta ve 40 sağlıklı birey iki boyutlu, M-mode, konvansiyonel ve doku Doppler ekokardiyografi yle değerlendirildi. Tüm bireylere solunum fonksiyon testleri (SFT) ile birinci saniyedeki zorlu ekspiratuvar volüm [forced expiratory volume in 1 second (FEV1)] ve zorlu vital kapasite [forced vital capacity (FVC)] tayini yapıldı. FEV1, FEV1/FVC ve ortalama pulmoner arter basıncı (OPAB) ile diyastolik fonksiyon parametreleri arasındaki ilişkiyi araştırmak için korelasyon ve regresyon analizi yapıldı. Bulgular: KOAH grubunda sağ ventrikül çapı ve serbest duvar kalınlığı daha fazla, triküspit E ve E/A, triküspit lateral annulus E' ve E'/A', mitral annulus septal E' ve E'/A' değerleri daha düşük, mitral E/mitral annulus septal E' değeri daha yüksekti (p değerleri < 0.05). FEV1 ile triküspithastalılateral annulus E' ve E'/A' arasında pozitif korelasyon vardı. Triküspit E/A, triküspit lateral annulus E' ve E'/A', mitral annulus septal E' ve E'/A' değerleriyle FEV1/FVC arasında pozitif, OPAB arasında negatif korelasyon vardı. Mitral E/mitral annulus septal E'değeriyle FEV1/ FVC arasında negatif, OPAB ile pozitif korelasyon vardı. FEV1/FVC, triküspit lateral annulus E' ve E'/A', mitral annulus septal E' ve E'/A' için belirleyiciydi. Sonuç: KOAH hastalarında sağ ve sol ventrikül diyastolik fonksiyonları bozulmaktadır. Bu hastalarda, kronik hipoksi ve pulmoner basınç artışı sağ ve sol ventrikül diyastolik fonksiyon bozukluğu gelişmesinde etkili faktörlerdir.

Anahtar Kelimeler

Pulmoner hastalık, kronik obstrüktif, ekokardiyografi, solunum fonksiyon testleri, kalp yetersizliği; diyastolik.

The Effect of Respiratory Functions and Pulmonary Artery Pressure on Right and Left Ventricular Diastolic Function

Öz

Introduction: The aim of the study was to evaluate of biventricular diastolic function and to investigate the effect of pulmonary function and pulmonary artery pressure on diastolic functions in people with chronic obstructive pulmonary disease (COPD). Patients and Methods: Sixty patients with COPD and 40 healthy individuals were assessed by echocardiography and pulmonary function tests (PFTs). Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were determined. Correlation and regression analysis were performed to investigate the relationship between FEV1, FEV1/FVC, mean pulmonary artery pressure (MPAB) and diastolic function parameters. Results: Right ventricular diameter and free wall thickness and mitral E/mitral septal annulus E' were higher whereas tricuspid E and E/A, tricuspid lateral annulus E' and E'/A', mitral septal annulus E' and E'/A' values were lower in the COPD group (all p values of < 0.05). FEV1 was positively correlated with lateral tricuspid annulus E' and E'/A'. Tricuspid E/A, tricuspid lateral annulus E' and E'/A', mitral septal annulus E' and E'/A' values were positively correlated with FEV1/FVC, whereas negatively correlated with MPAB. Mitral E/mitral annulus septal E' was negatively correlated with FEV1/FVC, and positively correlated with MPAB. FEV1/FVC was decisive for tricuspid lateral annulus E' and E'/A', mitral annulus septal E' and E'/A' values. Conclusion: Right and left ventricular diastolic function are impaired in patients with COPD. Chronic hypoxia and increased pulmonary pressure are important factors in the development of diastolic dysfunction in patients with COPD.

Anahtar Kelimeler

Pulmonary disease, chronic obstructive, echocardiography, respiratory function tests, heart failure; diastolic.

Kaynakça

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