Son dönem böbrek yetmezliği nedeniyle düzenli hemodiyalize giren hastalarda kalpte ortaya çıkan yapısal ve fonksiyonel değişikliklerin ekorkardiyografik olarak değerlendirilmesi
Küçük Resim Yok
Tarih
2002
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Bu çalışmada son dönem böbrek yetersizliği (SDBY) nedeniyle düzenli hemodiyalize giren hastalarda kalpte ortaya çıkan fonksiyonel ve yapısal değişikliklerin transtorasik ekokardiyografi (TTE) ile araştırılması amaçlandı. GEREÇ VE YÖNTEM: Çalışmaya SDBY'i olan 52 hasta (ortalama yaşları:48±13 yıl, 21 kadın ve 31 erkek) alındı. Hastalar dialize girdikleri süre dikkate alınarak 2 gruba ayrıldı; diyalize girdiği süre 24 aydan kısa (3-23 ay) olan 23 hasta (1.grup), 24 aydan uzun (24-96 ay) olan 29 hasta (2.grup). BULGULAR: İki boyutlu (2-D) ekokardiyografik incelemede olguların %79'unda yapısal değişiklikler (Miyokardda buzlu cam görünümü (MBCG), 39 (%75); sol ventrikül hipertrofisi (SVH), 37 (%67); mitral anuler kalsifikasyon (MAK), 17(%32); aort kapak kalsifikasyonu (AKK), 29 (%56); perikardiyal effüzyon (PEF), 25 (%48) hastada saptandı. SVH, MBCG, MAK ve AKK yönünden iki grup arasında istastistiksel olarak anlamlı fark bulundu (sırasıyla: p=0.04, p=0.038, p=0.041, p=0.033). Doppler ekokardiyografik incelemelerinde hastaların %81'inde (40/52) patolojik diyastolik akım paterni mevcuttu (E/A oranı<1). İki grup arasında E/A oranı ve izovolümetrik gevşeme zamanı (IVGZ) yönünden anlamlı fark (II.grup uzamış IVGZ ve azalmış E/A'ya sahipti) saptandı (sırasıyla: p=0.041, p= 0.022). SONUÇ: Bu çalışmada SDBY hastalarının büyük bir kısmında kalpte yapısal değişiklikler ve patolojik diyastolik akım biçimleri saptandı. Ekokardiyografik bulgular arasında hastalığın süresinden en çok SVH, MBCG, MAK , AKK , E/A ve İVGZ etkilenmiştir.
AIM: The aim of this study was to investigate the morphologic and functional changes of cardiac structures in hemodialysis patients with end stage renal disease (ESDR) by transthoracic echocardiography. MATERIALS AND METHODS: Fifty-two patients with ESDR (mean age:48±13 years, 21 female 31 male) were recruited. Patients were divided into two groups according to duration of hemodialysis; 23 ESDR patients with duration shorter than 24 months (3-23), Group I and 29 ESDR patients with a duration longer than 24 months (24-96) , Group II. RESULTS: In 79% of the cases, cardiac morphologic changes were detected by two-dimensional echocardiography [Icy-glass appearance (IGA) in 75 % of the cases, left ventricular hypertrophy (LVH) in 67% of the cases, aortic valve calsification (AVC) in 56% of cases pericardial effusion (PEF) in %48 of cases, mitral annular calcification (MAC) in 32 % of cases]. Statisticaly significant differecences were detected when the groups were compared for LVH, IGA, MAC and AVC (p=0.04, p=0.038, p=0.041, p=0.033, respectively). Pathologic diastolic flow pattern was determined in 81% (40/52) of the cases by echocardiographic examination. Statisticaly significant differecences were detected when the groups were compared for IVRT and E/A ratios ( group II had prolonged IVRT and decreased E/A ratio, p=0.041, p=0.022, respectively) CONCLUSION: In conclusion, cardiac morphologic changes and pathological diastolic flow patterns were determined by echocardiography, in most of the patients with ESRD. Among the echocardiographic findings, presence of LVH, IGA, MAC, AVC, E/A and IVRT were more influenced by the duration of disease.
AIM: The aim of this study was to investigate the morphologic and functional changes of cardiac structures in hemodialysis patients with end stage renal disease (ESDR) by transthoracic echocardiography. MATERIALS AND METHODS: Fifty-two patients with ESDR (mean age:48±13 years, 21 female 31 male) were recruited. Patients were divided into two groups according to duration of hemodialysis; 23 ESDR patients with duration shorter than 24 months (3-23), Group I and 29 ESDR patients with a duration longer than 24 months (24-96) , Group II. RESULTS: In 79% of the cases, cardiac morphologic changes were detected by two-dimensional echocardiography [Icy-glass appearance (IGA) in 75 % of the cases, left ventricular hypertrophy (LVH) in 67% of the cases, aortic valve calsification (AVC) in 56% of cases pericardial effusion (PEF) in %48 of cases, mitral annular calcification (MAC) in 32 % of cases]. Statisticaly significant differecences were detected when the groups were compared for LVH, IGA, MAC and AVC (p=0.04, p=0.038, p=0.041, p=0.033, respectively). Pathologic diastolic flow pattern was determined in 81% (40/52) of the cases by echocardiographic examination. Statisticaly significant differecences were detected when the groups were compared for IVRT and E/A ratios ( group II had prolonged IVRT and decreased E/A ratio, p=0.041, p=0.022, respectively) CONCLUSION: In conclusion, cardiac morphologic changes and pathological diastolic flow patterns were determined by echocardiography, in most of the patients with ESRD. Among the echocardiographic findings, presence of LVH, IGA, MAC, AVC, E/A and IVRT were more influenced by the duration of disease.
Açıklama
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MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
4
