Akut Pankreatitli Hastalarda Tp-e Aralığı, Tp-e/QT Oranı and Tp-e/QTc Oranı’nın Değerlendirilmesi

Yıl 2020, Cilt: 4 Sayı: 1, 88 - 94, 02.03.2020

Yilmaz Güler , Can Ramazan Öncel

https://doi.org/10.30565/medalanya.625432

Öz

Amaç: Akut pankreatit etyoolojisinden bağımsız olarak kardiyovasküler sistemi etkileyebilir. QT aralığı, düzeltilmiş QT aralığı (QTc), Tp-e aralığı ve Tp-e/QT, Tp-e/QTc oranları gibi elektrokardiyografik parametreler myokardiyal repolarizasyonun değerlendirilmesinde kullanılabilir. Çalışmamızda akut pankreatitin kardiyovasküler sistem üzerine olan etkilerini incelemeyi ve hastalığın ağırlığı ile ventriküler repolarizasyon parametreleri arasındaki ilişkiyi ortaya koymayı amaçladık.

Yöntem: Akut pankreatit tanısı alan hastalarda ventriküler repolarizasyon parametreleri (QT aralığı, QTc aralığı, Tp-e/QT, Tp-e/QTc oranı) kontrol grubu hastaları ile karşılaştırıldı. Ayrıca tüm hastalarda bu parametreler yanında Ranson ve APACHE II skorları ile amilaz değerleri hesaplanarak hastalığın şiddeti ile kardiyak parametreler arasındaki ilişki incelendi.

Bulgular: Çalışmada 60 hasta (30 akut pankreatit ve 30 kontrol ) incelendi. Tp-e aralığı, Tp-e/QT ve Tp-e/QTc oranlarının akut pankreatitli hastalarda kontrol grubuna göre istatistiksel olarak anlamlı düzeyde daha yüksek olduğu tespit edildi. Ayrıca Tp-e aralığı, Tp-e/QT ve Tp-e/QTc oranlarının Ranson ve APACHE II skorları ile pozitif korelasyon gösterdiği, Tp-e aralığının amilaz düzeyi ile pozitif korelasyon gösterdiği tespit edildi.

Sonuç: Akut pankreatitli hastalarda Tp-e aralığı, Tp-e/QT ve Tp-e/QTc oranları ventriküler aritmi riskinin tespitinde kullanılabilir ve Tp-e/QT ve Tp-e/QTc oranlarının yükselmesi akut pankreatitin şiddetiyle doğru orantılı olup, Tp-e oranı amilaz düzeyi ile paralel olarak yükselmektedir. Tek başına amilaz düzeyi akut pankreatitli hastalarda ventriküler aritmi riskinin belirleyicisi olarak kullanılabilir.

Anahtar Kelimeler

Akut pankreatit, Elektrokardiyografi, Tp-e aralığı, Tp-e/QT oranı, Tp-e/QTc oranı

Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with acute pancreatitis

Öz

Aim: Acute pancreatitis may affect cardiovascular system regardless of etiology. Electrocardiographic parameters such as QT interval, corrected QT interval (QTc), Tp-e interval and Tp-e/QT, Tp-e/QTc ratio can be used to evaluate myocardial repolarization. We aimed to investigate the effects of acute pancreatitis on the cardiovascular system and the relationship between ventricular repolarization parameters and the severity of the disease.

Methods: Ventricular repolarization parameters (QT interval, QTc interval, Tp-e/QT, Tp-e/QTc ratio) of the patients who were included in the study and diagnosed with acute pancreatitis were compared with the control group patients. In addition, these parameters and Ranson, APACHE II and amylase values were taken into account in all patients in the pancreatitis group and the relationship between the severity of the disease and cardiac parameters was investigated.

Results: 60 patients (30 acute pancreatitis and 30 control) were examined. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were significantly higher in the acute pancreatitis group compared to the control. In addition, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios showed a positive correlation with the Ranson and APACHE II scores and Tp-e interval displayed a positive correlation with amylase levels.

Conclusions: Tp-e interval, Tp-e/QT and Tp-e/QTc ratios can be used as a marker for the detection of ventricular arrhythmia risk in acute pancreatitis patients and Tp-e/QT and Tp-e/QTc ratios increased depending on the severity of AP and Tp-e interval increased in parallel with higher levels of amylase. Amylase level alone could be an indicator for increased risk of ventricular arrhythmia in patients with acute pancreatitis.

Anahtar Kelimeler

Acute pancreatitis, Electrocardiography, Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio

Kaynakça

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