Etiyolojik Faktör Olarak Non-Valvuler Atriyal Fibrilasyon Saptanan İnme Hastalarında Beyin Damar Alanlarının İncelenmesi

Yıl 2018, Cilt: 5 Sayı: 2, 14 - 18, 01.08.2018

Serkan Demir Mustafa Karaoglan

Öz

Bu çalışmada; non-valvuler atriyal fibrilasyon (NVAF) etyolojisine sahip inme hastalarında serebral vasküler bölgeleri araştırmak amaçlandı. Ocak 2015-Eylül 2016 tarihleri arasında hastanemize başvuran ve 55 yaşın üzerinde olan, tıbbi öykülerinde standart EKG veya Holter EKG kaydı bulunan veya NVAF tanısı konan ve iskemik serebrovaskuler hastalık teşhisi alan 208 hasta çalışmaya dahil edildi. Çalışmamız retrospektif verilerin bir analizi olarak tasarlanmıştır. Hastaların ayrıntılı öykü, fizik muayene ve elektrokardiyografi (EKG) değerlendirmeleri yapıldı. Bulguların tespitinde tanımlayıcı istatistikler kullanılmış ve t-testi, Pearson ki-kare ve Fisher'in kesin testi, farklılıklar analizi için kullanılmıştır. Hastaların %53.8'i (n=112) erkek, %46.2'si (n=96) kadındı. Yaş ortalaması 73.5 idi. Orta serebral arter (MCA), NVAF'ye bağlı inmelerde en sık vasküler tutulum alanıydı. Superior serebellar arter (SCA) ve posterior serebral arter (PCA), MCA'yı takip etti. NVAF ile ilişkili inmelerin yaklaşık %64'ü ön sirkülasyon enfarktüsü (ACI) ve %22'si arka sirkülasyon enfarktüsü (PCI) idi. Yaş ve geçmiş inme öyküsü faktörlerinde ACI lehine anlamlı bir fark vardı (p <0.05). Hipertansiyon, kardiyak öykü ve diabetüs mellitüs faktörlerinde ACI ve PCI arasında anlamlı fark yoktu (p> 0.05). Sonuç olarak, akut olarak ortaya çıkan enfarktlarda iskemiye uğrayan damar alanının ve bu damar alanı için etiyolojik faktörün tahmin edilebileceği vurgulanmıştır.

Anahtar Kelimeler

Beyin Damar Alanları, İskemik Serebrovaskuler Olay, Non-Valvuler Atriyal Fibrilasyon

Investigation of Brain Vascular Territories in Stroke Patients Detected Non-Valvular Atrial Fibrillation as an Etiological Factor

Öz

It was aimed to investigate the cerebral vascular territories in stroke patients with NVAF as an etiologic factor. A total of 208 patients who were referred to our hospital between January 2015 and September 2016, who were over 55 years of age, identified or documented as having a standard ECG or Holter ECG record on their medical history, and diagnosed with stroke were included. Our study was designed as a retrospective analysis of prospective data. Detailed history, physical examination and electrocardiography (ECG) evaluations of the patients were performed. Descriptive statistics were used in the detection of findings, and t-test, Pearson’s chi-square and Fisher's exact test were used for differences analysis. 53.8% (n=112) of the patients were male and 46.2% (n=96) were female. The mean age was 73.5. MCA was the most common site of vascular involvement in NVAF-dependent strokes. SCA and PCA followed MCA. Approximately 64% of the NVAF-related strokes were anterior circulation infarction (ACI) and 22% were posterior circulation infarct (PCI). There was a significant difference in age and past stroke history factors in favor of ASE (p < 0.05). There was no significant difference between ACI and PCI in hypertension, cardiac history and diabetus mellitus factors (p > 0.05). It was emphasized that the area of the vessel that underwent ischemia in the acutely displayed infarcts and the etiological factor for this vessel area could be predicted.

Anahtar Kelimeler

Brain Vessel, Ischemic Stroke, Non-Valvular Atrial Fibrillation

Kaynakça

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