Perimenopozal dönemin kalp yetersizliği seyrine etkileri

Yıl 2023, Cilt: 48 Sayı: 1, 136 - 144, 31.03.2023

Emine Tuğçe Şahin , Gülsüm Meral Yılmaz Öztekin , Ahmet Genç , Anıl Şahin , Mehmet Özen

https://doi.org/10.17826/cumj.1186283

Öz

Amaç: Kadın yaşamında östrojen seviyesindeki düşüşün kardiyovasküler sistem üzerinde olumsuz etkileri olduğu bilinmektedir. Bu çalışmada, kalp yetersizliği (KY) olan hastaların menopoza geçiş döneminde klinik durumlarındaki değişikliklerin ve tedavi gereksinimlerinin aydınlatılması amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif, tek merkezli çalışmaya 2015-2020 yılları arasında KY polikliniğinde takip edilen toplam 26 hasta dahil edildi. Hastaların demografik verileri, New York Heart Association fonksiyonel sınıfı, ekokardiyografik bulguları, rutin biyokimyasal parametreleri ile KY belirti, semptom ve tedavileri incelendi. Menopoz döneminin başlangıcındaki ve 12 ay sonraki veriler karşılaştırıldı.
Bulgular: 12 aylık takip sonunda, kullanılan günlük furosemide dozunda (50,5 mg/gün vs. 72,4 mg/gün) istatistiksel olarak anlamlı bir artış bulundu. Hastaların ortalama kalp hızı başlangıçta 80,4±20,1 atım/dk iken, 12 aylık takip sonunda 69,3±10,1 atım/dk idi. Hastaların ekokardiyografik olarak ölçülen sol ventrikül (LV) sistolik çapları, kontrol vizitinde başlangıca göre önemli ölçüde arttı (41,2±7,4 vs. 45,8±7,0 mm).
Sonuç: Çalışmamızda KY ile takip edilen hastalarda, menopozal dönemin tedavi ihtiyacında artışa neden olduğu belirlendi. Bu nedenle KY hastalarının değerlendirilmesinde menopozal durumun ayrıntılı olarak sorgulanması ve menopoza geçiş döneminde hastaların daha yakından takip edilmesi yararlı bir yaklaşım olacaktır.

Anahtar Kelimeler

Kalp yetersizliği, Menopoz, Östrojen

Effects of the perimenopausal period on the course of heart failure

Öz

Purpose: It is known that the decrease in estrogen level in women's life has negative effects on the cardiovascular system. In this study, it was aimed to elucidate the changes in the clinical status and treatment requirement of patients with heart failure (HF) during the menopausal transition period.
Materials and Methods: A total of 26 patients followed up in the HF outpatient clinic between 2015–2020 were included in this retrospective, single-center study. Demographic data of the patients, New York Heart Association class, echocardiographic findings, routine biochemical parameters and HF signs, symptoms and therapies were examined. Data at the beginning of the menopause period and after 12 months were compared.
Results: At the end of the 12-month follow-up, a statistically significant increase was found in the daily dose of furosemide (50.5 mg/day vs. 72.4 mg/day). While the mean heart rate of the patients was 80.4±20.1 beats/min at the beginning, it was 69.3±10.1 beats/min in the control visit. Echocardiographically measured left ventricular (LV) systolic diameters of the patients were significantly increased compared to baseline in the control visit (41.2±7.4 mm vs 45.8±7.0 mm,).
Conclusion: The menopausal period caused an increase in the need for treatment in patients followed up with HF. Therefore, in evaluation of the patients with HF, it would be a useful approach to question the menopausal status in detail and to follow the patients more closely during the menopausal transition period.

Anahtar Kelimeler

Estrogen, heart failure, menopause

Kaynakça

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