İnflamatuvar Bağırsak Hastalığının Pulmoner Hemodinami ve Sağ Ventrikül Fonksiyonu Üzerine Etkisi: Pulmoner Pulse Transit Time’ın Pulmoner Stiffness ve Sağ Ventrikül Fonksiyonunun Değerlendirilmesindeki Rolü

Öz

Amaç: İnflamatuvar bağırsak hastalığı (İBH), sistemik etkileri olan kronik bir hastalık olup kardiyovasküler sistemi de etkileyebilmektedir. Bu çalışmada, İBH’nin sağ ventrikül (SV) fonksiyonları ve pulmoner hemodinami üzerindeki etkileri araştırılmış; özellikle pulmoner pulse transit time (pPTT) ile diğer ekokardiyografik göstergeler arasındaki ilişki incelenmiştir. Gereç ve Yöntemler: Çalışmaya 50 İBH hastası ile yaş ve cinsiyet açısından eşleştirilmiş 50 sağlıklı kontrol birey dahil edildi. Tüm katılımcılarda ekokardiyografi ile SV fonksiyonları değerlendirildi. Bu kapsamda SV miyokardiyal performans indeksi (SVMPI), SV ejeksiyon fraksiyonu (SV EF) ve triküspit anüler düzlem sistolik ekskursiyonu (TAPSE) gibi parametreler analiz edildi. Pulmoner hemodinamik değerlendirme ise pPTT ve pulmoner arteriyel stiffness (PAS) ölçümleri ile yapıldı. İBH ile bu ekokardiyografik parametreler arasındaki ilişkiler istatistiksel olarak incelendi. Bulgular: Gruplar arasında sistolik pulmoner arter basıncı (sPAP) ve TAPSE açısından anlamlı fark bulunmazken, İBH hastalarında PAS düzeyleri belirgin şekilde artmış, pPTT süreleri ise anlamlı olarak kısalmıştı. pPTT; PAS, İBH süresi, SV EF, SV fraksiyonel alan değişimi (SVFAC), TAPSE, triküspit S', SVMPI ve C-reaktif protein (CRP) ile anlamlı korelasyon gösterdi. Ayrıca, pPTT’nin PAS üzerinde bağımsız bir belirleyici olduğu saptandı (p < 0,001). Sonuç: İBH hastalarında sağ ventrikül fonksiyonlarında bozulma ve pulmoner damar sertliğinde artış gözlenmektedir. pPTT, pulmoner vasküler değişikliklerin erken tanısında pratik ve erişilebilir bir belirteç olarak PAS’ın yerini alabilecek potansiyele sahiptir

Anahtar Kelimeler

• İnflamatuvar bağırsak hastalığı
• sağ ventrikül fonksiyonu
• pulmoner pulse transit time
• pulmoner arteriyel stiffness

Impact of Inflammatory Bowel Disease on Pulmonary Hemodynamics and Right Ventricular Function: The Role of Pulmonary Pulse Transit Time in Assessing Pulmonary Stiffness and Right Ventricular Function

Öz

Aim: Inflammatory bowel disease (IBD) is a chronic disease with systemic implications, including cardiovascular effects. The aim of this study was to investigate the impact of IBD on right ventricular (RV) function and pulmonary hemodynamics, focusing on the relationship between pulmonary pulse transit time (pPTT) and other echocardiographic markers. Material and Methods: Fifty IBD patients and 50 matched healthy controls underwent echocardiographic evaluation to assess RV function, including parameters such as RV myocardial performance index (RVMPI), RV ejection fraction (RV EF) and tricuspid annular plane systolic excursion (TAPSE). Pulmonary hemodynamics were assessed by pPTT and pulmonary arterial stiffness (PAS). Statistical analyses explored the associations between IBD and these echocardiographic parameters. Results: No differences in systolic pulmonary artery pressure (sPAP) or TAPSE were observed between the groups. PAS was increased and pPTT was shortened in IBD patients compared to controls. pPTT correlated with PAS, IBD duration, RV EF, RV fractional area change (RVFAC), TAPSE, tricuspid S', RVMPI and C-reactive protein (CRP). pPTT was an independent predictor of PAS (p < 0.001). Conclusion: IBD patients show impaired RV function and increased pulmonary stiffness. pPTT may serve as a practical marker for early detection of pulmonary vascular changes in IBD, replacing PAS for hemodynamic assessment.

Anahtar Kelimeler

• Inflammatory bowel disease
• right ventricular function
• pulmonary pulse transit time
• pulmonary arterial stiffness

Kaynakça

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