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Kronik Aort Yetmezliği Olan Hastalarda Hipertansiyon Sıklığı

Yıl 2022, Cilt: 17 Sayı: 2, 167 - 171, 15.07.2022
https://doi.org/10.17517/ksutfd.848436

Öz

Amaç: Bu çalışmanın amacı kronik aort yetersizliğinde hipertansiyon sıklığını ve hipertansiyon ile kronik aort yetersizliğinin ciddiyeti arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntemler: Çalışma retrospektif olarak dizayn edilmiş olup aralık 2006 ile ocak 2009 tarihleri arasında Cumhuriyet Üniversitesi Tıp Fakültesi kardiyoloji polikliniğine başvuran ekokardiyografi ve 24 saatlik kan basıncı monitörizasyon yapılan 2457 hasta taranmıştır. Bu hastalardan orta ya da ileri
derecede sol ventrikül sistolik fonksiyon bozukluğu olan hastalar, herhangi bir başka kalp kapak hastalığı olanlar, aort darlığı, protez kalp kapağı veya herhangi bir kalp kapak hastalığından dolayı kardiyak cerrahi geçiren, kronik böbrek yetersizliği, kronik antihipertansif tedavi altında olan hastalar çalışma dışı
bırakılmış olup 135 kronik aort yetersizliği hastası çalışmaya dahil edilmiştir. Hastalar ekokardiyografik olarak aort yetersizliğinin ciddiyetine göre iki gruba ayrılmıştır. Bu iki grup sistolik ve diyastolik tansiyon değerlerine ve sıklığına göre karşılaştırılmıştır.
Bulgular: Ciddi aort yetersizliği olan hasta gurubunda gündüz ortalama diyastolik tansiyon arteriyel değerleri, gece ortalama diyastolik tansiyon değerleri ve tüm gün ortalama diyastolik tansiyon değerleri düşük olarak bulundu (p <0.001, p=0.002, p=0.001 sırası ile). Ayrıca ciddi aort yetersizliği olan grupta sistolik hipertansiyon varlığı daha sık izlendi (p=0.013).
Sonuç: Sonuç olarak aort yetersizliği olan hastalarda hipertansiyon daha sık rastlanmaktadır. Bu nedenle aort yetersizliği olan hastalar sistolik hipertansiyon açısından ayrıntılı bir şekilde araştırılmalı ve kılavuzların önerileri doğrultusunda tedavi edilmelidir.

Destekleyen Kurum

YOK

Kaynakça

  • Zendaoui A, Lachance D, Roussel E, Couet J, Arsenault M. Usefulness of carvedilol in the treatment of chronic aortic valve regurgitation. Circ Heart Fail. 2011;4(2):207-213.
  • Baumgartner H, Falk V, Bax JJ, Bonis MD, Hamm C, Holm PJ et al. ESC Scientific Document Group, 2017 ESC/EACTS Guidelines for the management of valvular heart disease, European Heart Journal 2017;38(36):2739–2791.
  • Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M et al. Prevalence and correlates of aortic regurgitation in American Indians: The Strong Heart Study. J Am Coll Cardiol. 2000;36(2):461-467.
  • Klodas E, Enriquez-Sarano M, Tajik AJ, Mullany CJ, Bailey KR, Seward JB. Optimizing timing of surgical correction in patients with severe aortic regurgitation: role of symptoms. J Am Coll Cardiol 1997;30:746-752.
  • Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ. Mortality and morbidity of aortic regurgitation in clinical practice: a long-term follow up study. Circulation 1999;99:1851-1857.
  • Levine H, Gaasch WH. Vasoactive drugs in chronic regurgitant lesions of the mitral and aortic valves. J Am Coll Cardiol 1996;28:1083-1091.
  • Piayda K, Hellhammer K, Veulemans V, Afzal S, Heidari H, Wimmer AC et al. Performance of the CoreValve Evolut R and PRO in Severely Calcified Anatomy: A Propensity Score Matched Analysis. Heart Lung Circ. 2020;29(12):1847-1855.
  • Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M et al. Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study. J Am Coll Cardiol. 2000;36 (2):461-467.
  • Wermelt JA, Schunkert H. Management der arteriellen Hypertonie [Management of arterial hypertension]. Herz. 2017;42(5):515-526.
  • Katsi V, Georgiopoulos G, Oikonomou D, Aggeli C, Grassos C, Papadopoulos DP et al. Aortic Stenosis, Aortic Regurgitation and Arterial Hypertension. Curr Vasc Pharmacol. 2019;17(2):180-190.
  • Pinto E. Blood pressure and ageing. Postgrad Med J. 2007;83(976):109-114.
  • Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M; Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281-1357.
  • Von Homeyer P, Oxorn DC. Aortic Regurgitation: Echocardiographic Diagnosis. Anesth Analg. 2016;122(1):37-42.
  • Flint N, Wunderlich NC, Shmueli H, Ben-Zekry S, Siegel RJ, Beigel R. Aortic Regurgitation. Curr Cardiol Rep.2019 3;21(7):65.
  • Akinseye OA, Pathak A, Ibebuogu UN. Aortic Valve Regurgitation: A Comprehensive Review. Curr Probl Cardiol. 2018;43(8):315-334.
  • Gregor P, Línková H. Aortální regurgitace [Aortic regurgitation]. Vnitr Lek. 2013;59(2):99-104.
  • Kim M, Roman MJ, Cavallini MC, Schwartz JE, Pickering TG, Devereux RB. Effect of hypertension on aortic root size and prevalence of aortic regurgitation. Hypertension. 1996;28:47–52.
  • Supino PG, Borer JS, Herrold EM, Hochreiter CA, Preibisz J, Schuleri K et al. Prognostic impact of systolic hypertension on asymptomatic patients with chronic severe aortic regurgitation and initially normal left ventricular performance at rest. Am J Cardiol. 2005 1;96(7):964-970.
  • Elder DH, Wei L, Szwejkowski BR, Libianto R, Nadir A, Pauriah M. The impact of renin-angiotensin-aldosterone system blockade on heart failure outcomes and mortality in patients identified to have aortic regurgitation: a large population cohort study. J Am Coll Cardiol 2011;58:2084–2091.
  • Lin M, Chiang HT, Lin SL, Chang MS, Chiang BN, Kuo HW et al. Vasodilator therapy in chronic asymptomatic aortic regurgitation: enalapril versus hydralazine therapy. J Am Coll Cardiol. 1994;24(4):1046-1053.

Frequency of Hypertension in Patients with Chronic Aortic Regurgitation

Yıl 2022, Cilt: 17 Sayı: 2, 167 - 171, 15.07.2022
https://doi.org/10.17517/ksutfd.848436

Öz

Objective: The aim of this study is to investigate the frequency of hypertension and the relationship between hypertension and the severity of chronic aortic regurgitation in chronic aortic regurgitation.
Material and Methods: The study was designed retrospectively and 2457 patients who applied to the Cumhuriyet University Faculty of Medicine Cardiology Clinic between December 2006 and January 2009, who underwent echocardiography and 24-hour blood pressure monitoring were screened. Among these
patients, patients with moderate or severe left ventricular systolic dysfunction, patients with any other valvular heart disease, patients who have undergone cardiac surgery due to aortic stenosis, prosthetic heart valve or any valvular heart disease, chronic renal failure, patients under chronic antihypertensive treatmentwere excluded from the study while 135 chronic aortic regurgitation patients were included in the study. The patients were divided into two groups according to the severity of aortic insufficiency echocardiographically. These two groups were compared according to systolic and diastolic blood pressure values and their frequency.
Results: In the patient group with severe aortic regurgitation , the mean diastolic blood pressure arterial values during the day, the mean diastolic blood pressure arterial values at night and the average diastolic blood pressure values all day were found to be low (p<0.001, p=0.002, p=0.001, respectively). In addition, presence of systolic hypertension was observed more frequently in the group with severe aortic regurgitation. (p=0.013).
Conclusion: As a result, hypertension is more common in patients with aortic regurgitation. Therefore, patients with aortic insufficiency should be investigated in detail in terms of systolic hypertension and should be treated according to the recommendations of the guidelines.

Kaynakça

  • Zendaoui A, Lachance D, Roussel E, Couet J, Arsenault M. Usefulness of carvedilol in the treatment of chronic aortic valve regurgitation. Circ Heart Fail. 2011;4(2):207-213.
  • Baumgartner H, Falk V, Bax JJ, Bonis MD, Hamm C, Holm PJ et al. ESC Scientific Document Group, 2017 ESC/EACTS Guidelines for the management of valvular heart disease, European Heart Journal 2017;38(36):2739–2791.
  • Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M et al. Prevalence and correlates of aortic regurgitation in American Indians: The Strong Heart Study. J Am Coll Cardiol. 2000;36(2):461-467.
  • Klodas E, Enriquez-Sarano M, Tajik AJ, Mullany CJ, Bailey KR, Seward JB. Optimizing timing of surgical correction in patients with severe aortic regurgitation: role of symptoms. J Am Coll Cardiol 1997;30:746-752.
  • Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ. Mortality and morbidity of aortic regurgitation in clinical practice: a long-term follow up study. Circulation 1999;99:1851-1857.
  • Levine H, Gaasch WH. Vasoactive drugs in chronic regurgitant lesions of the mitral and aortic valves. J Am Coll Cardiol 1996;28:1083-1091.
  • Piayda K, Hellhammer K, Veulemans V, Afzal S, Heidari H, Wimmer AC et al. Performance of the CoreValve Evolut R and PRO in Severely Calcified Anatomy: A Propensity Score Matched Analysis. Heart Lung Circ. 2020;29(12):1847-1855.
  • Lebowitz NE, Bella JN, Roman MJ, Liu JE, Fishman DP, Paranicas M et al. Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study. J Am Coll Cardiol. 2000;36 (2):461-467.
  • Wermelt JA, Schunkert H. Management der arteriellen Hypertonie [Management of arterial hypertension]. Herz. 2017;42(5):515-526.
  • Katsi V, Georgiopoulos G, Oikonomou D, Aggeli C, Grassos C, Papadopoulos DP et al. Aortic Stenosis, Aortic Regurgitation and Arterial Hypertension. Curr Vasc Pharmacol. 2019;17(2):180-190.
  • Pinto E. Blood pressure and ageing. Postgrad Med J. 2007;83(976):109-114.
  • Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M; Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281-1357.
  • Von Homeyer P, Oxorn DC. Aortic Regurgitation: Echocardiographic Diagnosis. Anesth Analg. 2016;122(1):37-42.
  • Flint N, Wunderlich NC, Shmueli H, Ben-Zekry S, Siegel RJ, Beigel R. Aortic Regurgitation. Curr Cardiol Rep.2019 3;21(7):65.
  • Akinseye OA, Pathak A, Ibebuogu UN. Aortic Valve Regurgitation: A Comprehensive Review. Curr Probl Cardiol. 2018;43(8):315-334.
  • Gregor P, Línková H. Aortální regurgitace [Aortic regurgitation]. Vnitr Lek. 2013;59(2):99-104.
  • Kim M, Roman MJ, Cavallini MC, Schwartz JE, Pickering TG, Devereux RB. Effect of hypertension on aortic root size and prevalence of aortic regurgitation. Hypertension. 1996;28:47–52.
  • Supino PG, Borer JS, Herrold EM, Hochreiter CA, Preibisz J, Schuleri K et al. Prognostic impact of systolic hypertension on asymptomatic patients with chronic severe aortic regurgitation and initially normal left ventricular performance at rest. Am J Cardiol. 2005 1;96(7):964-970.
  • Elder DH, Wei L, Szwejkowski BR, Libianto R, Nadir A, Pauriah M. The impact of renin-angiotensin-aldosterone system blockade on heart failure outcomes and mortality in patients identified to have aortic regurgitation: a large population cohort study. J Am Coll Cardiol 2011;58:2084–2091.
  • Lin M, Chiang HT, Lin SL, Chang MS, Chiang BN, Kuo HW et al. Vasodilator therapy in chronic asymptomatic aortic regurgitation: enalapril versus hydralazine therapy. J Am Coll Cardiol. 1994;24(4):1046-1053.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Oguzhan Yücel Bu kişi benim 0000-0002-6076-9482

Hakan Güneş 0000-0003-3853-5046

Mehmet Birhan Yılmaz 0000-0002-8169-8628

Erken Görünüm Tarihi 11 Temmuz 2022
Yayımlanma Tarihi 15 Temmuz 2022
Gönderilme Tarihi 28 Aralık 2020
Kabul Tarihi 29 Nisan 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 17 Sayı: 2

Kaynak Göster

AMA Yücel O, Güneş H, Yılmaz MB. Kronik Aort Yetmezliği Olan Hastalarda Hipertansiyon Sıklığı. KSÜ Tıp Fak Der. Temmuz 2022;17(2):167-171. doi:10.17517/ksutfd.848436