Kronik obstrüktif akciğer hastalarında egzersizin QT dispersiyonu üzerine etkisi ve egzersizin tetiklediği ventriküler aritmiler
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda Kronik Obstruktif Akciğer Hastalığında (KOAH), egzersizin QT dispersiyonu (QTD) üzerine etkisi ve QTD değişimi ile ventriküler aritmiler ve KOAH'ın ciddiyeti arasındaki ilişkiyi araştırdık. Gereç ve Yöntem: Çalışmaya 41 KOAH'lı (ort.yaş:61±11, erkek/kadın:33/8) ve 45 sağlıklı birey (ort.yaş:60±11, erkek/kadın: 34/11) alındı. Hastalar 1.saniye zorlu ekspirasyon volümü (FEV1, yaş ve cinse göre beklenenin %'si) değerlerine göre üç gruba ayrıldı: 1.grup (Hafif, FEV1:%60-79), 2.grup (orta, FEV1:%40-59), 3.grup (ileri, FEV1: >%40). Tüm bireylere Bruce protokolü ile semptom-sınırlı treadmill egzersiz testi (EST) uygulandı. QT intervali, QRS kompleksinin başlangıcından T dalgasının sonuna kadar olan aralıktan olçüldü. QT Bazzet formülüyle hıza göre düzeltildi (QTcD). QTcD değeri, 12 derivasyonun her birinde maximum ve minimum QTc intervalleri arasındaki fark olarak hesaplandı. Bulgular: EST öncesinde, yalnız 3.gruptaki QTcD değerlerinin kontrollerden yüksek olduğu saptandı (41.6±7.6ms ve 27.9±6.3 ms; p<0.001). Pik egzersizde, 2. ve 3.grubun QTcD'sinde anlamlı bir artış (sırasıyla; 32.3±4.6 ms ve 39.7±4.7 ms; p<0.01, 49.1±7.9 ms ve 41.6±6.7ms; p<0.01) oldu. EST sonrası 2 ve 3.grupta QTcD azalmasına rağmen kontrollere (27.6±6.9 ms) göre yine yüksekti (sırasıyla: 43.5±5.9 ms; p<0.001, 34.7±5.1ms; p<0.05). Ayrıca 3.grupta pik QTcD ile FEV1 arasında negatif (r=-0.39, p<0.01) ve ventriküler erken vuru sayısı ile pozitif bir korelasyon saptandı (r=0.29, p<0.05). Sonuç: Bu sonuçlar, ileri KOAH'lı hastalarda QTcD'deki artışın egzersizin tetiklediği ventriküler aritmi ve ani ölüm sıklığındaki artışla ilişkili olabileceğini düşündürmektedir.
Aim: In the present study, we investigated the effects of excercise on QT dispersion in patients with COPD. We also sought relationship between QTD variation and ventricular arrythmias and severity of COPD. Material and Methods: 41 patients with COPD (M/F:33/8, age:61±11) and 45 healthy subjects (M/F:34/11, age:60±11) were recruited for the study. COPD patients were divided into three subgroup according to forced expiratory volume in 1 second (FEV1, as % of expected age and gender adjusted values): group I (mild, FEV1:60-79%), group II (moderate, FEV1:40-59%), group III (severe, FEV1<40%). Symptom-limited treadmill exercise testing (TET) was performed according to Bruce protocole to all subjects. The QT interval was measured from the onset of the QRS complex to the end of the T wave. Using Bazzet formula, QT intervals were corrected (QTcD) for heart rate using Bazett's formula. QTcD was defined as the difference between the maximal and minimal QTc and QTc values and it was measured in each of the 12 leads. Results: Before exercise, QTcD values were higher than controls only in (41.6±7.6 ms vs 27.9±6.3 ms; p <0.001). At the peak exercise, QTcD values of group II and III were significantly increased (39.7±4.7ms vs 32.3±4.6 ms; p<0.01, 49.1±7.9 ms vs 41.6±6.7ms; p<0.01, respectively). Although QTcD values of group II and III were decreased following exercise, they were still higher (43.5±5.9 ms; p<0.001, 34.7± 5.1ms; p<0.05, respectively) than those of the control group (27.6±6.9 ms). In only group III, QTcD was negatively correlated with FEV1 values (r=-0.39, p<0.01) and QTcD was positively correlated with number of ventricular premature beats (r =0.29, p<0.05). Conclusions: The result of this study suggest that inreased QTcD may related with increased frequency of exercise induced ventricular arrhytmias and sudden death in patients with severe COPD.
Aim: In the present study, we investigated the effects of excercise on QT dispersion in patients with COPD. We also sought relationship between QTD variation and ventricular arrythmias and severity of COPD. Material and Methods: 41 patients with COPD (M/F:33/8, age:61±11) and 45 healthy subjects (M/F:34/11, age:60±11) were recruited for the study. COPD patients were divided into three subgroup according to forced expiratory volume in 1 second (FEV1, as % of expected age and gender adjusted values): group I (mild, FEV1:60-79%), group II (moderate, FEV1:40-59%), group III (severe, FEV1<40%). Symptom-limited treadmill exercise testing (TET) was performed according to Bruce protocole to all subjects. The QT interval was measured from the onset of the QRS complex to the end of the T wave. Using Bazzet formula, QT intervals were corrected (QTcD) for heart rate using Bazett's formula. QTcD was defined as the difference between the maximal and minimal QTc and QTc values and it was measured in each of the 12 leads. Results: Before exercise, QTcD values were higher than controls only in (41.6±7.6 ms vs 27.9±6.3 ms; p <0.001). At the peak exercise, QTcD values of group II and III were significantly increased (39.7±4.7ms vs 32.3±4.6 ms; p<0.01, 49.1±7.9 ms vs 41.6±6.7ms; p<0.01, respectively). Although QTcD values of group II and III were decreased following exercise, they were still higher (43.5±5.9 ms; p<0.001, 34.7± 5.1ms; p<0.05, respectively) than those of the control group (27.6±6.9 ms). In only group III, QTcD was negatively correlated with FEV1 values (r=-0.39, p<0.01) and QTcD was positively correlated with number of ventricular premature beats (r =0.29, p<0.05). Conclusions: The result of this study suggest that inreased QTcD may related with increased frequency of exercise induced ventricular arrhytmias and sudden death in patients with severe COPD.
Açıklama
Anahtar Kelimeler
Kaynak
MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
5
