Önyük azalmasının sağ ventrikül fonksiyonuna etkisi: Doku doppler çalışması
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Dosyalar
Tarih
2005
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Önyük azalması ile doku Dopplerle saptanan sol ventrikül hızlarında oluşan değişimler çok sayıda çalışmada incelenmesine karşın sağ ventrikülde yapılan çalışmalar yetersizdir. Çalışmamızda diyaliz hastalarında ultrafiltrasyonla oluşturulan intravasküler sıvı azalmasının sağ ventrikül doku Doppler hızlarına etkisi incelenmiştir. Gereç ve Yöntem: Çalışmaya daha önce son dönem böbrek yetmezliği tanısı konmuş, hipervolemisi olan ve hemodiyalizle birlikte ultrafiltrasyon yapılacak 30 hasta alındı. Diyalizden bir saat önce ve bir saat sonra sağ ventrikül doku Doppler ekokardiyografik incelemeleri yapıldı. Önce ve sonra yapılan ekokardiyografik ölçümler karşılaştırıldı. Bulgular: Hastaların yaşları 41±15, diyaliz süreleri 4.5±4.3 yıldı. Ortalama 3.9±1.9 kg ultrafiltrasyon yapıldı. Doku Dopplerle triküspid lateral anulustan kaydedilen sistolik, erken ve geç diyastolik hızlar diyaliz öncesinde 0.107±0.028, 0.091±0.035, 0.110±0.041 m/sn, sonrasında sırasıyla 0.098±0.028, 0.083±0.032, 0.107±0.036 m/sn (p>0.05). Doku Dopplerde saptanan lateral ve septal anular ve myokardiyal erken diyastolik hızlar azalma meyli göstermekle birlikte bu azalma sadece triküspid septal anulus için istatistiksel anlamlılığa ulaşmıştır. Geç diyastolik hızlarda istatistiksel anlamlılığa ulaşmayan değişme görülürken sistolik hızlardaysa anlamlı değişiklik izlenmemiştir. Sonuç: Doku Dopplerle saptanan sağ ventrikül sistolik ve diyastolik hızları belirgin olarak önyükten etkilenmemektedir. Sağ ventrikül diyastolik fonksiyonların belirlenmesinde doku Dopplerle saptanan e/a oranıysa en az etkilenen kullanışlı bir parametre gibi görünmektedir.
Objective: Although there is plenty of data about the differences in left ventricular tissue Doppler velocities by preload reduction, studies regarding right ventricular function are not frequent. This study sought to investigate the effect of intravascular volume reduction on right ventricular function, by ultra filtration in dialysis patients. Material and Methods: 30 end-stage renal failure patients who had hypervolemia and will undergo hemodialysis were included in the study. Tissue Doppler (TD) studies of right ventricle were performed before and 1 h after dialysis. This data were compared. Results: Mean age of the patients was 41±15 years and mean time that the patients were undergoing dialysis was 4.5±4.3 years. Mean volume of filtration was 3.9±1.9 liters. Systolic, early and late diastolic tissue Doppler velocities derived from lateral annulus of the tricuspid valve before dialysis were 0.107±0.028, 0.091±0.035, and 0.110±0.041 m/s, respectively. The same variables after dialysis were 0.098±0.028, 0.083±0.032 and 0.107±0.036 m/s, respectively (p>0.05). Lateral, septal annular and myocardial early diastolic TD velocities were decreased but only tricuspid septal annular velocities reached significance. Late diastolic and systolic velocity changes were insignificant. Conclusions: Right ventricular systolic and diastolic velocities detected by TD were not affected by preload reduction. e/a ratio derived from TD measurements is the most valuable variable that can predict right ventricular diastolic function.
Objective: Although there is plenty of data about the differences in left ventricular tissue Doppler velocities by preload reduction, studies regarding right ventricular function are not frequent. This study sought to investigate the effect of intravascular volume reduction on right ventricular function, by ultra filtration in dialysis patients. Material and Methods: 30 end-stage renal failure patients who had hypervolemia and will undergo hemodialysis were included in the study. Tissue Doppler (TD) studies of right ventricle were performed before and 1 h after dialysis. This data were compared. Results: Mean age of the patients was 41±15 years and mean time that the patients were undergoing dialysis was 4.5±4.3 years. Mean volume of filtration was 3.9±1.9 liters. Systolic, early and late diastolic tissue Doppler velocities derived from lateral annulus of the tricuspid valve before dialysis were 0.107±0.028, 0.091±0.035, and 0.110±0.041 m/s, respectively. The same variables after dialysis were 0.098±0.028, 0.083±0.032 and 0.107±0.036 m/s, respectively (p>0.05). Lateral, septal annular and myocardial early diastolic TD velocities were decreased but only tricuspid septal annular velocities reached significance. Late diastolic and systolic velocity changes were insignificant. Conclusions: Right ventricular systolic and diastolic velocities detected by TD were not affected by preload reduction. e/a ratio derived from TD measurements is the most valuable variable that can predict right ventricular diastolic function.
Açıklama
Anahtar Kelimeler
Sağ Ventrikül, Doku Doppler, Önyük, Right Ventricle, Tissue Doppler, Preload
Kaynak
MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
12
Sayı
2