Aort darlığında plazma homosistein yüksekliği koroner arter hastalığı varlığını gösterebilir mi?
Küçük Resim Yok
Tarih
2003
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Kalsifik aort kapak hastalığı tespit edilen hastalardaki kardiyak risk faktörleri koroner arter hastalığı (KAH) ile benzer olup, koroner arter hastalığı prevalansı artmıştır. Son zamanlarda yapılan çalışmalarda; artmış plazma homosistein konsantrasyonunun koroner arter hastalığı için bağımsız bir risk faktörü olduğu, çeşitli mekanizmalarla ateroskleroza yol açarak aterosklerotik damar hastalıklarını ve venöz sistemde trombüs oluşumunu kolaylaştırıcı etki gösterdiği tespit edilmiştir. Fakat aort darlığı olan hastalarda plazma homosistein düzeyinin koroner arter hastalığı varlığı ile ilişkisi araştırılmamıştır. Bu çalışmanın amaçları; orta-ileri aort darlığı olan hastalarda plazma homosistein düzeyininin koroner arter hastalığı varlığını ne şekilde etkilediğini araştırmak ve aort darlığında homosistein düzeyi, koroner arter hastalığı varlığının noninvaziv bir belirleyicisi olabilir mi sorusuna cevap aramaktır. Gereç ve Yöntem: Çalışmaya transtorasik ekokardiyografi ile orta-ileri derecede aort darlığı tespit edilen ve sonrasında koroner anjiyografi yapılan toplam 58 hasta (koroner arter hastalığı olan 30, koroner arter hastalığı olmayan 28 hasta) alındı. Hastaların 12 saatlik açlık sonrası venöz kan örnekleri alınarak serum total kolesterol, LDL ve HDL kolesterol, trigliserid ve ELİSA yöntemiyle homosistein düzeyleri ölçüldü. Bulgular: Koroner arter hastalığı olan hastalarda (17 erkek,13 kadın, ortalama yaş 66±10 yıl) total kolesterol 266±45 mg/dL, trigliserid 194±93 mg/dL, LDL mg/dL 174±44, HDL 45±5 mg/dL, Homosistein düzeyi 13.2±3.1 µmol/l bulundu. Koroner arter hastalığı olmayan hastalarda ise (18 erkek,10 kadın, ortalama yaş 61±12 yıl) total kolesterol 204±38 mg/dL trigliserid 122±73 mg/dL, LDL 132±33 mg/dL, HDL 48±5 mg/dL, homosistein düzeyi 8.3±2.2 µmol/l bulundu. Koroner arter hastalığı olan hastalarda total kolesterol (p<0.01), LDL (p<0.05) ve homosistein düzeyi (p<0.01) anlamlı olarak yüksek bulundu. Sonuç: Bu sonuçlar orta-ileri aort darlığı olan hastalarda plazma homosistein düzeyindeki yüksekliğin koroner arter hastalığı varlığı ile korele olduğunu göstermektedir. Ayrıca aort darlığında koroner arter hastalığı varlığını gösteren bir noninvaziv test olarak araştırılması gerektiğini düşündürtmektedir.
Aim: In patients diagnosed with calcific aortic stenosis (AS), cardiac risk factors are similar to coronary artery disease (CAD) and the incidence of coronary atherosclerosis is increased. Recent studies have shown that increased homocysteine concentration is an independant risk factor of CAD, causes atherosclerosis through several mechanisms and promotes thrombosis in venous vessels. However; correlation between plasma homocysteine levels and CAD in patients with AS has not been studied. The aim of this study is to investigate the influence of homocysteine levels on the coexistance of CAD in patients with moderate to severe AS and weather homocysteine levels can be a noninvasive marker of coronary artery disease presence in these patients. Material and Method: Fifty eight patients (30 with CAD and 28 without) who were diagnosed as moderate-severe AS with transthorasic echocardiography and later underwent coronary angiography were included in our study. Twelve hour fasting venous blood samples were collected and total cholesterol, LDL, HDL, triglycerides and homocysteine levels were measured. Result: In patients with CAD (17 male, 13 female, averge age 66±10 years) total cholesterol was 266 mg/dL, triglycerides 194 mg/dL, LDL 174 mg/dL, HDL 45 mg/dL, and homocysteine 13.2 µmol/l. In patients without CAD (18 male, 10 female, averge age 61 years) total cholesterol was 204 mg/dL, triglycerides 122 mg/dL, LDL 132 mg/dL, HDL 48 mg/dL, homocysteine 8.3 µmol/l. Patients with CAD had significantly higher total cholesterol (p< 0.01), LDL (p<0.05) and homocysteine (p<0.01) levels. Conclusion: These findings show that in moderate-severe AS high plasma homocysteine levels correlate with CAD coexistance. Therefore homocysteine should be further investigaed as a noninvasive test indicating coronary artery disease in patients with AS.
Aim: In patients diagnosed with calcific aortic stenosis (AS), cardiac risk factors are similar to coronary artery disease (CAD) and the incidence of coronary atherosclerosis is increased. Recent studies have shown that increased homocysteine concentration is an independant risk factor of CAD, causes atherosclerosis through several mechanisms and promotes thrombosis in venous vessels. However; correlation between plasma homocysteine levels and CAD in patients with AS has not been studied. The aim of this study is to investigate the influence of homocysteine levels on the coexistance of CAD in patients with moderate to severe AS and weather homocysteine levels can be a noninvasive marker of coronary artery disease presence in these patients. Material and Method: Fifty eight patients (30 with CAD and 28 without) who were diagnosed as moderate-severe AS with transthorasic echocardiography and later underwent coronary angiography were included in our study. Twelve hour fasting venous blood samples were collected and total cholesterol, LDL, HDL, triglycerides and homocysteine levels were measured. Result: In patients with CAD (17 male, 13 female, averge age 66±10 years) total cholesterol was 266 mg/dL, triglycerides 194 mg/dL, LDL 174 mg/dL, HDL 45 mg/dL, and homocysteine 13.2 µmol/l. In patients without CAD (18 male, 10 female, averge age 61 years) total cholesterol was 204 mg/dL, triglycerides 122 mg/dL, LDL 132 mg/dL, HDL 48 mg/dL, homocysteine 8.3 µmol/l. Patients with CAD had significantly higher total cholesterol (p< 0.01), LDL (p<0.05) and homocysteine (p<0.01) levels. Conclusion: These findings show that in moderate-severe AS high plasma homocysteine levels correlate with CAD coexistance. Therefore homocysteine should be further investigaed as a noninvasive test indicating coronary artery disease in patients with AS.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi, Endokrinoloji ve Metabolizma
Kaynak
MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
5