Behçet hastalarında QT dispersiyonunun biyokimyasal parametreler ile ilişkisi

Yıl 2019, Cilt: 11 Sayı: 4, 372 - 377, 01.12.2019

Emine Altuntaş , Hülya Nazik , Feride Çoban Gül Betül Demir

https://doi.org/10.21601/ortadogutipdergisi.474956

Öz

Amaç: Multisistemik vaskülit ile karakterize olan Behçet Hastalığı’nda (BH) ventriküler aritmi ve ani kardiyak ölüm sıklığı normal popülasyona göre daha sık olması nedeni ile bu çalışmada QT dispersiyonu (QTd) ile BH ve hastalık ile ilişkili biyokimyasal parametreler arasındaki ilişkinin ortaya konulması amaçlanmıştır.
Materyal ve metot: Çalışmaya uluslararası sınıflandırma kriterlerine uygun olarak BH tanısı konulmuş 35 hasta ile yaş ve cinsiyet açısından benzer 47 sağlıklı kontrol olgu dahil edildi. Tüm katılımcıların 12 derivasyonlu yüzey EKG’si çekilerek kalp hızı ve QT mesafeleri ölçüldü. Ardından düzeltilmiş QT (QTc) Bazzet formülü ile hesaplandı. Tüm derivasyonlardaki en küçük QT ve QTc mesafesi ile en büyük QT ve QTc mesafesi arasındaki fark alınarak QTd, QTcd hesaplandı.12 saatlik açlık sonrası kan testleri yapılarak kaydedildi.
Bulgular: Gruplar en uzun QT ve QTc, en kısa QT ve QTc, QTd, QTcd değerleri açısından karşılaştırıldı. En uzun QT ve QTc’ de istatistiksel olarak fark oluştuğu görüldü (p=0,004, 0,018). Eritrosit sedimantasyon hızı (ESH) Behçet’li grupta kontrol grubuna göre yüksek iken; MPV ve albumin kontrol grubunda daha yüksek ölçüldü ve gruplar arasında anlamlı fark oluştu (p=0,002; 0,000; 0,000). Ayrıca en uzun QT ve QTc ile ESH ve albumin arasında negatif korelasyon olduğu; ortalama trombosit hacmi (MPV) ile pozitif korelasyon olduğu saptandı. İstatistiksel veriler Tablo 2-3-4‘te sunuldu.
Sonuç: Bu çalışmada BH’de en uzun QT ve QTc’nin uzadığı ve hastalık ile ilişkili diğer biyokimyasal parametrelerle arasında korelasyon olduğu tespit edilmiştir.

Anahtar Kelimeler

Behçet Hastalığı, QT mesafesi, aritmi

Relationship between QT dispersion and biochemical parameters in Behçet’s disease

Öz

Objective: Ventricular arrhythmia and sudden cardiac death are more frequently in Behçet’s disease (BD) patients than normal population. Therefore in this study it was aimed to find out relationship among QT dispersion, Behçet’s disease and biochemical parameters related with disease.
Material and Method: The study consisted of 35 patients which diagnosed Behçet’s disease (BD) according to international diagnose criteria and 47 healthy controls which were matched with regard to age and gender. 12-channel surface electrocardiography (ECG) was performed to all participants. QT distances, corrected QT (QTc) distances which is calculated by using Bazett formula were calculated. The longest QT, and the shortest QT, the longest QTc, the shortest QTc were found in the ECG. Afterwards QTd and QTcd were calculated. Blood samples were taken from participants after 12 hours fasting.
Findings: The groups were compared in terms of the longest QT-QTc, the shortest QT-QTc, QTd, QTcd. It was seen that there was meaningful difference in terms of the longest QT and QTc (respectively p; 0.004; 0.018). Mean platelet volume (MPV) and albumin were higher in control group while erythrocyte sedimentation rate (ESR) was higher in BH group (respectively p; 0.000; 0,000; 0,002).  Additionally there was negative correlation among the longest QT-QTc and ESR, albumin, but there was established positive correlation between the longest QT -QTc and MPV.  Statistical results were presented in table 2-3-4.
Conclusion: Consequently in this study, it was established that the longest QT and QTc was increased and there was relationship between biochemical parameters and the longest QT-QTc.

Anahtar Kelimeler

Behçet’s disease, QT distance, arrhythmia

Kaynakça

• Valenti S, Gallizzi R, De Vivo D, Romano C. Intestinal Behçet and Crohn’s disease: two sides of the same coin. Pediatr Rheumatol Online J, 2017;15:33.
• Alpsoy E, Akman A. Behçet Hastalığı; Etyopatogenezde Yeni Kavramlar. Türkiye Klinikleri J Int Med Sci, 2007;3:8-14.
• Kaya EB, Yorgun H, Akdogan A, et al. Heart-Rate Recovery Index Is Impaired in Behçet’s Disease Tex Heart Inst J, 2009;36:282–286.
• Doss J, England J, Fuchs H, Zaas AK. Coughing up Blood: Behçet’s Disease. American Journal of medicine, 2014; 127: 386–389
• Davatchi F. Diagnosis/Classification Criteria for Behcet’s Disease. Pathology Research International, 2012(2012):Article ID 607921.
• Aktürk E, Yağmur J, Kurtoğlu E et al. Left atrial volume and function in patients with Behçet’s Disease assesed by real-time three dimensional echocardiography. Eur. Heart J Cardiovascular İmagining, 2012;13:650-655. (doi: 10.1093/ejechocard/jer301).
• Dagli N, Turgut B, Tanyildizi R, Kobat S, Kobat MA, Doğdu O. QT interval dispersion in the patients with central serous chorioretinopathy. Int J Ophthalmol. 2015;8:61–65.
• Aytemir K, Ozer N, Aksoyek S Özcebe O, Kabakçı G, Oto A. Increased QT dispersion in theabsence of QT prolongation in patients with Behçet’s disease and ventricular arrhythmias. Int J Cardiol 1998;67:171-175.
• Day CP, McComb JM, Campbell RW. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. BrHeart J 1990;63:342-344.
• Helming H, Holm E, Jun L, et al. The prognostic value of QT interval and QT dispersion in all cause and cardiac mortality and morbidity in a population of Danish citizens. EurHeart J 1998;19:1391-1400.
• Davey PP, Bateman J, Mulligan IP, Forfar C, Barlow C, Hart G. QT interval dispersion in chronic heart failure and left ventricular hypertrophy: relation to autonomic nervous system and Holtertape abnormalities. BrHeart J 1994;71:268-273. 54
• Linker NJ, Colonna P, Kekwick CA, Till J, Camm AJ, Ward DE. Assessment of QT dispersion in symptomatic patients with congenital long QT syndromes. Am J Cardiol 1992;69:634-638.
• Dritsas A, Sbarouni E, Gilligan D, Nihoyannopoulos P, Oakley CM. QT interval abnormalities in hypertrophic cardiomyopathy. Clin Cardiol 1992;15:739-742.
• Day CP, Mccomb JM, Matthews J, Campbell RW. Reduction İn QT dispersion by sotalol following myocardial infarction. EurHeart J 1991;12:423-427.
• Grimm W, Steder U, Menz V, Hoffmann J, Maisch B. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol 1996;78:458-461.
• Moreno-Navarrete JM, Ortega F, Serrano M, et al. Irisin is expressed and produced by human muscle and adipose tissue in association with obesity and insulin resistance. J Clin Endocrinol Metab 2013;98:769–78.
• Icli A, Cure E, Cure MC, et al. Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behçet’s disease. J Investig Med. 2016;64:875–881.
• Kim SK, Choe JY, Park SH, Lee SW, Lee GH, Chung WT. Increased Insulin Resistance and Serum Resistin in Korean Patients with Behcet’s Disease. Archives of Medical Research 2010;41:269-274.
• Messedi M, Frigui M, Mahfoudh KB et al. Intima-media Thickness of Carotid Artery in Patients with Behcet’s Disease. Archives of Medical Research. 2011;42:398-404
• Dogan FB, Cicek D, Aydin S et al. Serum Preptin and Amylin Values in Psoriasis Vulgaris and Behçet’s Patients. J Clin Lab Anal. 2016;30:165-8.
• Lee WS, Kim TY. Is mean platelet volume increased in Behçet’s disease with thrombosis? Tohoku J.Exp. Med. 2010;222:225-226.
• Alan S, Tuna S, Türkoğlu EB. The relation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume with the presence and severity of Behçet’s syndrome. Kaohsiung J Med Sci. 2015;31:626-31.
• Açıkgöz N, Karıncıoğlu Y, Ermiş N, et al.Increased mean platelet volume in Behçet’s Disease with thrombotic tendency. Tohoku J. Exp. Med. 2010;221:119-123.
• Aksoy ŞN, Savaş E, Sucu M, Kısacık B, Kul S, Zengün O. Association between red blood cell distribution width and disease activity in patients with Behçet’s disease. J Int Med Res. 2015;43:765-73.
• Özşeker B, Şahin C, Özşeker HS, Efe SC, Kav T, Bayraktar Y. The Role of Fecal Calprotectin in Evaluating Intestinal Involvement of Behçet’s Disease Volume 2016. (doi: 10.1155/2016/5423043).