Migrenli Hastalarda Kalp Hızı Değişkenliği Kullanılarak Ani Kardiyak Ölüm Riskinin Araştırılması

Yıl 2025, Cilt: 20 Sayı: 1, 45 - 51

Şeyda Çevik Güneri , Mehmet Celalettin Güneri , Gülay Aydın

https://doi.org/10.17517/ksutfd.1474483

Öz

Amaç: Migren sempatik sinir sisteminin disfonksiyonundan kaynaklanan ve çeşitli klinik özelliklerden oluşan epizodik bir sendromdur. Çalışmamızın amacı, migrenli hastalarda ani kardiyak ölüm riskinin ve otonom disfonksiyonun kalp hızı türbülansı (KHT) ve kalp hızı değişkenliği (KHD) ile değerlendirilmesidir.
Gereç ve Yöntem: Bu çalışmaya 18 yaş üstü ve 70 yaş altı nöroloji kliniği tarafından takipte olan 35 kronik migrenli ve 42 sağlıklı birey olmak üzere 77 kişi dahil edildi. Tüm katılımcıların 24 saatlik holter kaydı yapıldı. Kalp hızı değişkenliği ve kalp hızı türbülansı parametreleri Avrupa Kardiyoloji Derneği çalışmaları kullanılarak hesaplandı.
Bulgular: Tonset ölçümleri bakımından migren ve kontrol grubu arasında anlamlı farklılık bulunmuştur (P=0,004). Diğer değişkenler bakımından istatistiki olarak anlamlı fark bulunmamıştır.
Sonuç: Bulgularımız migrenli hastalarda kalp hızı türbülans parametrelerinden Tonset’in migrenlilerde otonomik fonksiyonla ilişkili olduğunu gösterirken kalp hızı değişkenliği parametrelerinin migrenli hastalarda otonomik disfonksiyonla ilişkili olmadığını göstermiştir.

Anahtar Kelimeler

Migren, Kalp Hızı Türbülansı, Kalp Hızı Değişkenliği

Investigation of the Risk of Sudden Cardiac Death Using Heart Rate Variation in Migraineurs

Öz

Objective: Migraine is an episodic syndrome that results from dysfunction of the sympathetic nervous system and consists of various clinical features. The aim of our study is to evaluate the risk of sudden cardiac death and autonomic dysfunction in patients with migraine by heart rate turbulence (HRT) and heart rate variability (HRV). In addition, it is aimed to inform patients about their cardiovascular risks.
Material and Method: A total of 77 individuals, 35 of whom were chronic migraine sufferers and 42 healthy individuals, who were followed up by the neurology clinic over the age of 18 and under the age of 70, were included in this study. A 24-hour holter recording was made for all participants. Heart rate variability and heart rate turbulence parameters were calculated using European Society of Cardiology studies.
Findings: A significant difference was found between the migraine and control groups in terms of Tonset measurements (p=0.004). There was no statistically significant difference in terms of other variables.
Conclusion: Our findings showed that Tonset, one of the heart rate turbulence parameters, was associated with autonomic function in patients with migraine, whereas heart rate variability parameters were not associated with autonomic dysfunction in patients with migraine.

Anahtar Kelimeler

Migraine, heart rate variability, Heart Rate Turbulence

Etik Beyan

Ethical Approval: The study was conducted in accordance with the Declaration of Helsinki and the protocol was approved by the Ethics Committee of the Cumhuriyet University Medical School Medical Ethic Committee on 22.02.2011 number 2011-02/02 Funding: This work has not received any funding. Declaration of Competing Interest: None. Author Contribution Statement: The authors declarate they equally contributed to the manuscript.

Kaynakça

• Laffitte C, Even C, Henry-Lebras F,et.al. Migraine and angina pectoris by coronary artery spasm. Headache 1996; 36: 332–4.
• Yakinci C, Mungen B, Er H,et.al. Autonomic nervous system func- tion in childhood migraine. Pediatr Int 1999; 41: 529–33.
• Kayıkçıoğlu M, Payzın S. Kalp hızı değişkenliği Türk Kardiyoloji Derneği Arş. 2001;29:238-45
• Pieper SJ, Hammill SC. Heart rate variability:tecnique and investigational applications in cardiovascular medicine. Mayo Clin Proc 1995;70:955-64
• Schwartz PJ, Zipes DP. Autonomic modulation of cardiac arrhymias. In:Zipes DP, Jalife I, eds. Cardiac Elektrophisology. From cell to Bedside. Philadelphia:W. B. Saunders, 2000;300-14
• Kleiger RE, Stein PK, Bosner MS,et.al. Time domain measurements of heart rate variability Cardiol Clin 1992;10:487-498
• Task Force of the European Society of Cardiology and North American Society of Pacing and Electrophysiology Heart rate variability:standarts of measurement, physiological interpretation, and clinical use. Circulation 1996;93:10431065
• Schmidt G, Malik M, Barthel P,et.al. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet 1999; 353:1390– 1396.
• Lin LY, Lai LP, Lin JL,et.al. Tight mechanism correlation between heart rate turbulence and baroreflex sensitivity: sequential autonomic blockade analysis. J Cardiovasc Electrophysiol 2002; 13:427–431.
• Mari A. Watanabe, MD, Heart Rate Turbulence: a Review,PhDIndian Pacing and Electrophysiology Journal 2003;3(1):10-22
• Francis J, Watanabe MA, Schmidt G. Heart rate turbulence: A new predictor for sudden cardiac death. Ann Noninv Electrocardiol 2005;10:102–109.
• Miglis, M. G. Migraine and Autonomic Dysfunction: Which Is the Horse and Which Is the Jockey? Current Pain and Headache Reports 2018;22(3).
• Mosek A, Novak V, Opfer-Gehrking TL,et.al. Autonomic dysfunctionin migraineurs. Headache J Head Face Pain [Internet]. 1999 [cited 2017 Nov 8];39(2):108–17
• Kleiger RE, Stein PK, Bigger JT. Heart rate variability: Measurement and clinical utility. Ann Noninvasive Electrocardiol 2005;10:88–101.
• Zipes DP, Camm AJ, Borggrefe M et al. ACC/AHA/ESC 2006 guidelines management of patients with ventricular arrhytmias and the prevention of sudden cardiac death Europen Heart J 2006;27:2099-2140
• Fauchier L, Babuty D, Cosnay P,et.al. Heart rate variability in idiopathic dilate cardomyopathy: characteristics and prognostic value. J Am Coll Cardiol 1997;30:1009-1014
• Togo F. ,Takahashı, M. Heart Rate Variability in Occupational Health ―A Systematic Review. Industrial Health, 2009). 47(6), 589–602.
• Stein, P. K., Barzilay, J. I., Chaves, P. H. M., et.al. Heart rate variability and its changes over 5 years in older adults. Age and Ageing 2008;38(2):212–218.
• Pogacnik T, Sega S, Pecnik B, et.al. Autonomic function testing in patients with migraine. Headache 1993; 33: 545–50.
• Mikamo K, Takeshima T, Takahashi K. Cardiovascular sympathetic hypofunction muscle contraction headache and migraine. Headache 1989;29: 86–9.
• Avşar, A., Yaman, M., Kilit, C., et.al. A Heart Rate Turbulence Study to Assess Cardiac Autonomic Function in Migraineurs Turbulence. Česká a Slovenská neurologie a neurochirurgie 2007;70(2):174-177