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Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.554940

Health Care Administration

Sağlık Kurumları Yönetimi

Assessment of Left Ventricular Functions With Strain and Strain Rate Echocardiography in Children with Duchenne Muscular Dystrophy

Keskin

Mahmut

SÜLEYMAN DEMİREL ÜNİVERSİTESİ, TIP FAKÜLTESİ Ceylan

Özben

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ Özgür

Senem

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ Örün

Utku Arman

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ Doğan

Vehbi

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ Yılmaz

Osman

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ Şenocak

Filiz

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ Karademir

Selmin

DAHİLİ TIP BİLİMLERİ BÖLÜMÜ

03 01 2020

27 1 59 66 04 17 2019 06 09 2019

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

ÖzetAmaç: Çalışmamızda konvansiyonel ekokardiyografi ile kalp fonksiyonlarınormal bulunan Duchenne Musküler Distrofili (DMD) hastaların miyokardfonksiyonlarının pulse wave doku dopplergörüntüleme (PWDDG) ve strain/strain rate (S/SR) ekokardiyografi aracılığıyla ölçülmesi ve kontrol grubu ilekarşılaştırılması amaçlandı. Materyal ve Metod: Bu çalışmada;ortalama yaşı 85,2 ± 38,4 ay olan 32 DMD’li erkek hasta ve 89 ± 38,9 ay olan 31sağlıklı çocuk değerlendirildi. Demografik özellikler olgular ve kontrolgrubunda değerlendirildi. Cinsiyet, yaş, vücut kitle indeksi, konvansiyonel ekokardiyografi verileri, pulse wave doku Dopplergörüntüleme (PW-TDI) verileri ve iki boyutlu (2D) longitudinal strain (LS) / longitudinalstrain rate (LSR) ekokardiyografi değerleri karşılaştırıldı.Bulgular: Hasta ve kontrol grupları arasında kalp hızı bakımından istatistikselolarak anlamlı fark saptandı (p<0.001) ve DMD’li grupta kalp hızı dahayüksekti. Ventriküler septumda bazal ölçümlerinde Em, S amplitüdü, izovolümetrik relaksasyon zamanı (İVRZ), miyokardperformans indeksi (MPİ) bakımından istatistiksel yönden anlamlı fark saptanırken(p<0,05), sol ventrikü serbest duvar bazalindeki ölçümlerde de Em, S amplitüdü ve İVRZ bakımından istatistiksel yönden anlamlı farkbulundu (p<0,05). Sol ventrikülün serbest duvar bazalindeki strain ve strainrate değerlerinde DMD’ligrup ve kontrol grubu arasında istatistiki yönden anlamlı fark saptandı (p<0.001). Yapılan apikaldört boşluk pozisyondaki global strain değerlerinde DMD’li grup ve kontrolgrubu arasında istatistiki yönden anlamlı fark saptandı ( p<0,001).Sonuç: Transtorasik ekokardiyografide normal aralık içinde solventrikül sistolik fonksiyon saptanan DMD'li asemptomatik hastalarda kontrolgrubu ile karşılaştırıldığında sol ventrikül anterolateral duvarında LS ve LSRdeğerleri anlamlı olarak düşük bulundu.Anahtarkelimeler: Longitudinalstrain, longitudinal strain rate, Duchenne musküler distrofiAbstractAim:The goal of our study was to detect the left ventricular functions of duchenne musculardystrophy (DMD)patients using, pulsed-wavetissue Doppler imaging (PW-TDI, longitudinal strain (LS) and longitudinalstrain rate (LSR)echocardiography who had normal left ventricular functions in standartechocardiography before, and to match them with the results of the controlgroup. Material and Methods:İn this study compared 32boys with DMD whose mean age was 85.2 ± 38.4 months were matched with 31healthy males whose mean age was 89.0 ± 38.9 months. The following demographic features were assesed inboth DMD patients and controls: gender,age, body mass index, standard echocardiography parameters, pulsed-wave tissueDoppler imaging (PW-TDI) findings, and two-dimensional (2D) LS/LSRechocardiography measurements.Results:Asymptomatic boys with DMD were established to have high heart rate(p<0.001). In the calculations performed from the base of the ventricularseptum, statistically considerable differences were determined between the Em, S amplitude and isovolumetricrelaxation time (IVRT), myocard performance index (MPI) values of the twogroups (p<0.05). In the evaluates made from the base of the left ventricularfree wall, Em, S amplitude and IVRT, MPI values were demonstrated to be more considerablydifferent (p<0.05). The results of the LS and LSR measurements done from thebase of the left ventricular free wall were considerably different between DMD andcontrol group (p<0.001), and in the global strain measurement performed fromthe four chamber apical position, considerable distinction was noted betweenthe two groups (p<0.001).Conclusion: In patients with DMD in whom standartechocardiography had assesed left ventricular systolic function within thenormal range showed significantly lower LS and LSR values at the leftventricular anterolateral wall compared with the control group.Keywords: Longitudinal strain, longitudinal strain rate,duchenne muscular dystrophy,

Longitudinal strain longitudinal strain rate duchenne muscular dystrophy

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