Fallot Tetralojisi Nedeni ile Ameliyat Edilen Hastaların 24 Saatlik Ritim Holter ve Kardiyopulmoner Egzersiz Testi ile Orta Dönemde Değerlendirilmesi

Yıl 2025, Cilt: 15 Sayı: 1, 78 - 84, 27.03.2025

Nazife Reyyan Gök , Figen Akalın , Elif Erolu

https://doi.org/10.31832/smj.1545544

Öz

Amaç: Bu çalışmada ameliyat edilen Fallot tetralojisi (FT) hastalarında egzersiz kapasitesinin ve aritmilerin kardiyopulmoner egzersiz testi (KPET) ve 24 saatlik ritim Holter ile orta dönemde değerlendirilmesi amaçlanmıştır.
Gereç ve yöntemler: Çalışma grubu FT nedeniyle tam düzeltme ameliyatı geçirmiş 6 yaş üzerindeki hastalardan, kontrol grubu ise benzer yaş grubundaki herhangi bir kalp hastalığına sahip olmayan sağlıklı çocuklardan oluşturuldu. Her iki gruba ekokardiyografi, 24 saatlik Holter monitorizasyonu ve KPET uygulandı.
Bulgular: Çalışmaya FT nedeniyle opere edilmiş 14 hasta ve kontrol grubu olarak da 9 sağlıklı çocuk alınmıştır. Hasta grubunda ekokardiyografik olarak aort çapı, pulmoner anulus, sağ ventrikül sistolik ve diyastolik alanları anlamlı olarak geniş bulunmuştur. (Sırasıyla p=0,044, p=0,017, p=0,05, p=0,012) Mitral ve triküspit kapak anuluslarından hesaplanan miyokardiyal performans indeksi (Tei indeksi- MPI) hasta grubunda anlamlı olarak yüksek bulundu (İkisi için p=0,05). KPET sırasında, hasta grubunun atım hacmi ve VO2max düzeyleri kontrol grubundan anlamlı olarak düşük bulunmuştur (Sırasıyla p=0,004, p=0,044).
Sonuç: Opere edilmiş FT hastaları orta dönemde asemptomatik olsalar da bu hastalardaki egzersiz kapasitesi sağlıklı bireylere göre düşüktür ve bu düşüklük sağ ventrikül boyutu ve disfonksiyonu ile ilişkilidir.

Anahtar Kelimeler

Fallot tetralojisi, Egzersiz Kapasitesi, Aritmi

Etik Beyan

Bu çalışmada sunduğum verileri, bilgileri akademik ve etik kurallar içinde elde ettiğimi , tüm bilgi ,belge, değerlendirme ve sonuçları bilimsel etik ve ahlak kurallarına uygun olarak sunduğumu, bu çalışmada yararlandığım eserlerin tümüne uygun atıfta bulunarak kaynak gösterdiğimi, kullanılan verilerde herhangi bir değişiklik yapmadığımı ve çalışmanın özgün olduğunu bildiririm. Aksi bir durumda aleyhime doğabilecek tüm hak kayıplarını kabullendiğimi beyan ederim.

Proje Numarası

09.2016.216

Mid Term Evaluation of Patients Undergoing Surgery for Tetralogy of Fallot with 24 Hour Rhythm Holter and Cardiopulmonary Exercise Testing

Öz

Objective: This study aimed to obtain mid-term evaluation of exercise capacity and arrhythmias with cardiopulmonary exercise testing (CPET) and 24-hour rhythm Holter in Tetralogy of Fallot (TOF) patients who underwent surgery.
Materials and Methods: The study group consisted of patients over 6 years of age who had undergone complete correction surgery for TOF, while the control group consisted of healthy children of a similar age group who did not have any heart disease. Echocardiography, 24-hour Holter monitoring and CPET were applied to both groups.
Results: Study group included 14 patients who were operated on due to TOF and 9 healthy children as the control group. During echocardiographic examination; aortic diameter, pulmonary annulus, right ventricular (RV) systolic and diastolic areas were found to be significantly larger in the patient group (p=0.044, p=0.017, p=0.05, p=0.012 respectively). Myocardial performance index (Tei index-MPI) calculated from mitral and tricuspid valve annulus was found to be significantly higher in the patient group (p=0.05 for both). During CPET, stroke volume and VO2max levels were significantly smaller in patients (p=0.004, p=0.044 respectively).
Conclusion: Although operated TOF patients are asymptomatic in the mid-term, the exercise capacity in these patients is lower than in healthy individuals and this decrease is related to right ventricular size and dysfunction.

Anahtar Kelimeler

Tetralogy of Fallot, Exercise Capacity, Arrhythmia

Etik Beyan

I have obtained the data and information presented in this study within academic and ethical rules, I have presented all information, documents, evaluations and results in accordance with the rules of scientific ethics and morality, that I have cited all of the works I have used in this study with appropriate attribution, I declare that I have not made any changes in the data used and that the study is original. Otherwise, I declare that I accept all loss of rights that may arise against me.

Proje Numarası

09.2016.216

Kaynakça

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