Kronik böbrek hastalarında anormal kalp geometrisi ve sol ventrikül hipertrofisi

Year 2020, Volume: 45 Issue: 3, 1089 - 1098, 30.09.2020

Bülent Kaya , Saime Paydas , Neslihan Seyrek , Mustafa Balal , İbrahim Karayaylalı

https://doi.org/10.17826/cumj.661790

Abstract

Amaç: Bu çalışmanın amacı kronik böbrek hastalığı (KBH) olan hastalarda sol ventrikül geometrisi (SVG) çeşit ve sıklığını araştırmaktır.
Gereç ve Yöntem: Evre 2-5 KBH’lı, yaşı 17-79 aralığında, 100’ü erkek toplam 162 hasta çalışmaya dahil edildi. SVG ekokardiyografik parametrelere göre; sol ventrikül normal geometrisi (SVNG), sol ventrikül konsantrik remodelling (SVKR), konsatrik sol ventrikül hipertrofisi (SVKH) ve eksantrik sol ventrikül hipertrofisi (ESVH) olarak hesaplandı.
Bulgular: Hastalarımızda SVH sıklığı % 45.1 idi. SVG paternleri: ESVH 18 (% 11.1), KSVH 42 (% 25.9), SVKR 51 (% 31.5) ve SVNG 51 (% 31.5) saptandı. SVNG evre 2 KBH ve diyaliz hastalarında sırasıyla %10.38 ve %34.27 idi. SVKR, evre 2 KBH’da yüksek sıklıkta (% 62.3) saptandı. Non-diyaliz evre 5 KBH ve diyaliz hastalarında KSVH ve ESVH sıklığı sırasıyla % 35.92 ve % 29.13 bulundu. Klinik özellikler ile SVG değerlendirildiğinde; yaş ve GFR SVKR ile, HbA1C, serum albumin ve sodyum seviyeleri KSVH ile, yaş ve serum albumin ESVH ile ilişkiliydi.
Sonuç: KBH hastalarımızda, evre 2 KBH aşamasında bile anormal SVG saptandı. KBH’ın ileri evrelerinde KSVH ve ESVH insidansı daha yüksekti. Volum durumu ve beslenme gibi geleneksel olmayan faktörler de sol ventrikül yeniden şekillenmesinde önemliydi.

Keywords

Sol ventrikül geometrisi, kronik böbrek hastalığı, sol ventriül kitle indeksi

Supporting Institution

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Abnormal geometry and hypertrophy of left ventricle in patients with chronic kidney disease

Abstract

Purpose: The aim of this study was to investigate the incidence of left ventricular geometric patterns in patients with chronic kidney disease (CKD).
Materials and Methods: A total of 162 patients (100 males) with stage 2–5 CKD were included in the study. Patient age was between 17 and 79 years. Left ventricular geometry (LVG) patterns were calculated as left ventricular normal geometry (LVNG), left ventricular concentric remodeling (LVCR), concentric left ventricular hypertrophy (cLVH) and eccentric left ventricular hypertrophy (eLVH) by echocardiographic parameters.
Results: The incidence of LVH was 45.1%. LVG patterns were found as follows: eLVH in patients 18(11.1%), cLVH in 42(25.9%), LVCR in 51(31.5%), and LVNG 51(31.5%). LVNG was found 10.38% and 34.27% in CKD stage 2 and dialysis, respectively. LVCR was as high as 62.3% in CKD stage2. cLVH and eLVH were found as 35.92% and 29.13% in stage 5 non-dialysis and dialysis, respectively. There was a relationship between clinical characteristics and LVG as follows age and GFR with LVCR, HbA1C and serum levels of albumin and sodium with cLVH, and age and serum albumin with eLVH
Conclusions: In our CKD patients, abnormal LVG was found as earlier as CKD stage 2. The incidence of cLVH and eLVH was higher in advanced stages of CKD. Nontraditional factors such as volume status and nutrition were also crucial for left ventricular remodeling.

Keywords

Left ventricular geometry, Left venticular hypertrophy, Chronic Kidney Disease

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