Abstract
References
- 1. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA guidelines for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction: executive summary and recommendations. Circulation. 2000;102(10):1193-209.
- 2. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. New England Journal of Medicine. 1992;326(4):242-50.
- 3. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. Journal of the American College of Cardiology. 2007;50(7):e1-e157.
- 4. Orlova IA, Nuraliev EY, Yarovaya EB, Ageev FT. Prognostic value of changes in arterial stiffness in men with coronary artery disease. Vascular health and risk management. 2010;6:1015.
- 5. Stefanadis C, Wooley CF, Bush CA, Kolibash AJ, Boudoulas H. Aortic distensibility abnormalities in coronary artery disease. The American journal of cardiology. 1987;59(15):1300-4.
- 6. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;55(13):1318-27.
- 7. Lim HE, Park CG, Shin SH, Ahn JC, Seo HS, Oh DJ. Aortic pulse wave velocity as an independent marker of coronary artery disease. Blood pressure. 2004;13(6):369-75.
- 8. Levent E, Ozyürek AR, Ülger Z. Evaluation of aortic stiffness in tobacco-smoking adolescents. Journal of adolescent health. 2004;34(4):339-43.
- 9. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, et al. Arterial stiffness and risk of coronary heart disease and stroke. Circulation. 2006;113(5):657-63.
- 10. Pfeffer M, Ph. D, Marc A. Left ventricular remodeling after acute myocardial infarction. Annual review of medicine. 1995;46(1):455-66.
- 11. Tomaszuk-Kazberuk A, Korecki J, Kochman W, Dobrzycki S, Musiał W. Rapid resolution of ST segment elevation predicts recovery of left myocardial contraction in patients with acute myocardial infarction treated with percutaneous coronary angioplasty. Przeglad lekarski. 2001;59(8):638-41.
- 12. Araszkiewicz A, Lesiak M, Grajek S, Mularek-Kubzdela T, Popiel M, Cieśliński A. Value of ST-segment elevation resolution after primary coronary angioplasty in predicting early and late left ventricular function in patients with anterior acute myocardial infarction. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 2005;19(109):16-9.
- 13. Hirsch GA, Ingkanisorn WP, Schulman SP, Gerstenblith G, Dyke CK, Rhoads KL, et al. Age‐Related Vascular Stiffness and Left Ventricular Size After Myocardial Infarction. The American journal of geriatric cardiology. 2007;16(4):222-8.
- 14. Fleg JL, O'connor F, Gerstenblith G, Becker L, Clulow J, Schulman S, et al. Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. Journal of Applied Physiology. 1995;78(3):890-900.
- 15. Hedström E, Åström-Olsson K, Öhlin H, Frogner F, Carlsson M, Billgren T, et al. Peak CKMB and cTnT accurately estimates myocardial infarct size after reperfusion. Scandinavian Cardiovascular Journal. 2007;41(1):44-50.
- 16. Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. European Heart Journal. 1990;11(11):990-6.
- 17. Galiuto L, Garramone B, Scarà A, Rebuzzi AG, Crea F, La Torre G, et al. The extent of microvascular damage during myocardial contrast echocardiography is superior to other known indexes of post-infarct reperfusion in predicting left ventricular remodeling: results of the multicenter AMICI study. Journal of the American College of Cardiology. 2008;51(5):552-9.
ST Segment Yükselmeli Miyokart Enfarktüslü Hastalarda Aortik Sertliğin Primer Perkütan Koroner Girişim Sonrasında Elektrokardiyografik Reperfüzyon Üzerine Etkisi
Abstract
ST Segment Yükselmeli Miyokart Enfarktüslü Hastalarda
Aortik Sertliğin Primer Perkütan Koroner Girişim Sonrasında
Elektrokardiyografik Reperfüzyon Üzerine Etkisi
Amaç:
Aortik sertlik iyi bilinen bir vasküler yaşlanma göstergesidir ve koroner
ateroskleroz ile ilişkisi de bilinmektedir. Ancak aortik sertliğin miyokart
enfarktüsü sonrası sol ventrikül fonksiyonları üzerine etkisi hakkında elimizde
yeterli bilgi yoktur. Bu çalışmamızda aortik sertliğin, ST eleve miyokart
enfarktüsünde (STEMI) primer perkütan koroner girişim(PKG) sonrası
elektrokardiyografik reperfüzyon ve enfarkt genişliği üzerine etkisini
incelemeyi planladık.
Yöntem:
STEMI tanısıyla PKG yapılan 253 hastanın başlangıçta ve işlemden hemen sonra
çekilen EKG’lerinde total ST rezolüsyonuna bakılmıştır. Hastaların işlem
sonrası 48-72. saatlerinde ekokardiyografileri yapılmış ve aortik çaplar ile
arteriyel tansiyon ölçümleri kullanılarak aortik sertlik parametreleri elde
edilmiştir. Ejeksiyon fraksiyon (EF) değerleri biplane modifiye simpson metodu
ile ortalama alınarak saptanmıştır. Enfarkt alanı göstergesi olarak pik CK-MB
değerleri kullanılmıştır.
Bulgular:
Çalışmamızda PKG sonrası elektrokardiyografik olarak başarılı reperfüzyon
saptanan hastalarda aortik sertlik daha düşük (aortik strain için 14,5±3,7 vs
7,8±1,8 p=0,0001;aortik distensibilite için 7,4±3,0 vs 2,5±0,8 p=0,0001;
aortik sertlik indeksi için 3,1±0,9 vs 7,2±2,4 p=0,0001; aortik elastik modülüs
için 303±105 vs 863±321 p=0,0001) ve pik CK-MB değerleri daha düşük
saptanmıştır (103,1±15,5 mg/dl vs 121,2±22,4mg/dl p<0,001). Ayrıca sol
ventrikül ejeksiyon fraksiyonu da (SVEF) düşük aortik sertlikle ilişkili
saptanmıştır (p=0,001).
Sonuç:
Çalışmamızda, PKG uygulanan STEMİ hastalarında artmış aortik sertliğin, daha
kötü elektrokardiyografik reperfüzyon ve daha büyük enfarkt alanları ile
ilişkili olduğu belirlendi. Bu durum miyokart enfarktüsü sonrası yeniden
yapılanma gelişiminde bir role sahip olabilir.
Anahtar kelimeler: Koroner Arter Hastalığı, aortik sertlik, miyokart enfarktüsü, koroner
reperfüzyon, elektrokardiyografi.
Keywords
Koroner Arter Hastalığı Aortik Sertlik miyokart enfarktüsü koroner reperfüzyon elektrokardiyografi
References
- 1. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA guidelines for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction: executive summary and recommendations. Circulation. 2000;102(10):1193-209.
- 2. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes. New England Journal of Medicine. 1992;326(4):242-50.
- 3. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. Journal of the American College of Cardiology. 2007;50(7):e1-e157.
- 4. Orlova IA, Nuraliev EY, Yarovaya EB, Ageev FT. Prognostic value of changes in arterial stiffness in men with coronary artery disease. Vascular health and risk management. 2010;6:1015.
- 5. Stefanadis C, Wooley CF, Bush CA, Kolibash AJ, Boudoulas H. Aortic distensibility abnormalities in coronary artery disease. The American journal of cardiology. 1987;59(15):1300-4.
- 6. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;55(13):1318-27.
- 7. Lim HE, Park CG, Shin SH, Ahn JC, Seo HS, Oh DJ. Aortic pulse wave velocity as an independent marker of coronary artery disease. Blood pressure. 2004;13(6):369-75.
- 8. Levent E, Ozyürek AR, Ülger Z. Evaluation of aortic stiffness in tobacco-smoking adolescents. Journal of adolescent health. 2004;34(4):339-43.
- 9. Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML, Schalekamp MA, et al. Arterial stiffness and risk of coronary heart disease and stroke. Circulation. 2006;113(5):657-63.
- 10. Pfeffer M, Ph. D, Marc A. Left ventricular remodeling after acute myocardial infarction. Annual review of medicine. 1995;46(1):455-66.
- 11. Tomaszuk-Kazberuk A, Korecki J, Kochman W, Dobrzycki S, Musiał W. Rapid resolution of ST segment elevation predicts recovery of left myocardial contraction in patients with acute myocardial infarction treated with percutaneous coronary angioplasty. Przeglad lekarski. 2001;59(8):638-41.
- 12. Araszkiewicz A, Lesiak M, Grajek S, Mularek-Kubzdela T, Popiel M, Cieśliński A. Value of ST-segment elevation resolution after primary coronary angioplasty in predicting early and late left ventricular function in patients with anterior acute myocardial infarction. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 2005;19(109):16-9.
- 13. Hirsch GA, Ingkanisorn WP, Schulman SP, Gerstenblith G, Dyke CK, Rhoads KL, et al. Age‐Related Vascular Stiffness and Left Ventricular Size After Myocardial Infarction. The American journal of geriatric cardiology. 2007;16(4):222-8.
- 14. Fleg JL, O'connor F, Gerstenblith G, Becker L, Clulow J, Schulman S, et al. Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. Journal of Applied Physiology. 1995;78(3):890-900.
- 15. Hedström E, Åström-Olsson K, Öhlin H, Frogner F, Carlsson M, Billgren T, et al. Peak CKMB and cTnT accurately estimates myocardial infarct size after reperfusion. Scandinavian Cardiovascular Journal. 2007;41(1):44-50.
- 16. Stefanadis C, Stratos C, Boudoulas H, Kourouklis C, Toutouzas P. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. European Heart Journal. 1990;11(11):990-6.
- 17. Galiuto L, Garramone B, Scarà A, Rebuzzi AG, Crea F, La Torre G, et al. The extent of microvascular damage during myocardial contrast echocardiography is superior to other known indexes of post-infarct reperfusion in predicting left ventricular remodeling: results of the multicenter AMICI study. Journal of the American College of Cardiology. 2008;51(5):552-9.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Article |
| Authors | |
| Publication Date | March 21, 2019 |
| Submission Date | January 13, 2019 |
| Published in Issue | Year 2019 Volume: 10 Issue: 1 |
Cite
SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.