Hafif ve orta dereceli aort darlığı ciddiyeti ile global sol ventrikül yüklenme endeksi, kontraktilite rezervi ve kalp hızı toparlanmasının karşılaştırılması

Yıl 2022, Cilt: 13 Sayı: 47, 379 - 384, 15.12.2022

Ülker Kaya

https://doi.org/10.17944/mkutfd.1074650

Öz

Amaç: Aort darlığı kalp kapağı hastalıkları içinde en sık görülenidir. Hastalar semptomatik olup, kapak cerrahisi uygulanamadığı durumlarda yaşam beklentisi kısalır. Hastaların asemptomatik dönemde tespiti önemlidir. Bu çalışmada daha önce ciddi aort darlığında çalışılan kalp hızı toparlanması, kontraktilite rezervi ve global sol ventrikül hacim yüklenme endeksi parametrelerinin asemptomatik hafif ve orta derece aort darlığı olan hastalarda aort kapak ciddiyeti ile ilişkisini değerlendirmek amaçlanmıştır.

Yöntem: Çalışmaya 36 hafif aort darlığı, 24 orta aort darlığı olan hasta kabul edildi. Hastaların kalp hızı toparlanması, kontraktilite rezervi ve global sol ventrikül hacim yüklenme endeksi hesaplandı ve bulunan değerler ve hasta sayıları arasındaki fark istatiksel olarak değerlendirildi.

Bulgular: Hafif ve orta aort darlığı olan hastalarda kontraktilite rezervi ortalaması arasında anlamlı farklılık saptandı (%5.31±1.21 vs %3.87±1.06, sırasıyla, p<0.05). Aynı hastalarda global sol ventrikül yüklenme endeksi ortalaması arasında anlamlı farklılık saptandı (3.08±0.42 vs 5.59±0.63 mmHg/ml/m2, sırasıyla p<0.05). Hafif ve orta aort darlığı olan hastalarda birinci dakikadaki kalp hızı toparlanması ortalaması arasında istatiksel olarak anlamlı fark saptandı (19.9±13.8 vs26.8±7.3 atım/dakika, sırasıyla p<0.05).

Sonuç: Hastaların asemptomatik olduğu bir dönemde global sol ventrikül yüklenme endeksi, kontraktilite rezervi ve kalp hızı toparlanması normal olmayan hastaları daha sık muayene etmek gerekebilir.

Anahtar Kelimeler

Aort Kapak Darlığı, Dobutamin Stress Ekokardiyografi, Kalp Hızı, Kalp kasılması, Egzersiz Efor Testi, Sol Ventrikül Sistolik Disfonksiyon

Comparison of mild and moderate aortic stenosis severity with global left ventricular load index, contractility reserve and heart rate recovery time

Öz

Objective: Aortic stenosis is the most common heart valve disease. Patients are symptomatic and life expectancy is shortened in cases where valve surgery cannot be performed. It is important to detect patients in the asymptomatic period. Aim of this study was to evaluate the relationship between heart rate recovery time, contractility reserve and global left ventricular volume loading index parameters, which have been studied before in severe aortic stenosis, with aortic valve severity in patients with asymptomatic mild and moderate aortic stenosis.

Method: 36 and 24 patients with mild and moderate aortic stenosis were included in the study respectively. The patients’ heart rate recovery time, contractility reserve and global left ventricular volume load index were calculated and the difference between the values found and the number of patients was evaluated statistically.

Results: A significant difference was found between the mean contractility reserve (5.31±1.21 vs 3.87±1.06%, respectively, p<0.05), and between the mean global left ventricular load index (3.08±0.42 vs 5.59±0.63 mmHg/ml/m2, respectively, p<0.05), and between the mean heart rate recovery time in the first minute in patients with mild and moderate aortic stenosis (19.9±13.8 vs. 26.8±7.3 beats/min, p<0.05, respectively).

Conclusion: It may be necessary to examine more frequently the patients whose global left ventricular load index, contractility reserve and heart rate recovery time are not normal during a period when patients are asymptomatic.

Anahtar Kelimeler

Aortic Valve Stenosis, Dobutamine Stress Echocardiography, Left Ventricular Dysfunction, Heart Rate, Heart Contractility, Exercise Test

Kaynakça

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