Sol ventrikül diyastolik fonksiyon bozukluğu ile P dalga dispersiyonu arasındaki ilişki
Küçük Resim Yok
Tarih
2003
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türk Kardiyoloji Derneği
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hipertrofiye veya iskemik ventrikülde görülen diyastolik fonksiyon bozukluğu sol ventrikül diyastol sonu basıncında ve sol atriyum boyutunda artışa yol açmakta, sinüs ritminin idamesi ve atriyal kontraksiyonların varlığı kardiyak debinin devamı için büyük önem taşımaktadır. Çalışmamızın amacı yüzey elektrokardiyogramından kolayca elde edilen ve atriyal fibrilasyon gelişme riskini belirlemede kullanılan P dalga dispersiyonunun sol ventrikül diyastolik fonksiyonu ile olan ilişkini araştırmaktır. Çalışmaya kardiyoloji kliniğimizde trantorasik ekokardiyografi ile diyastolik fonksiyon bozukluğu belirlenen 73 olgu ( 39 erkek, 34 kadın, ortalama yaş 60±6 ) ve belirlenmeyen 60 olgu (27 erkek, 33 kadın, ortalama yaş 55±8 ) olmak üzere toplam 133 olgu alındı. Yüzey elektro kardiyogramlarından P maksimum ve P minimum değerleri ölçülerek P dalga dispersiyonları hesaplandı. P dispersiyonunun diyastolik fonksiyon bozukluğunun varlığı, etyolojisi, şiddeti ve ekokardiyografık ölçümlerle olan ilişkisi araşt ırıldı. Diyastolik fonksiyon bozukluğu olan hastalarda P dispersiyonu 53±9 ms, kontrol grubunda ise 43±9 ms idi ve iki grup arasında anlamlı fark mevcuttu (p<0.01). Diyastolik fonksiyon bozukluğu olan hastalar evrelendirildiğinde; P dispersiyonu evre 1'de 48±7 ms, evre 2?de 54±8 ms, evre 3'te 58±9 ms idi. Diyastolik disfonksiyonunun şiddeti arttıkça P dispersiyonunun arttığı görüldü ancak bu artış istatistiksel olarak anlamlı değildi (p>0.05). Diyastolik fonksiyon bozukluğu yapan etyoloji gözönüne alındığında P dispersiyonu iskemik kalp hastalığı olanlarda 53±8 ms, sol ventrikül hipertrofisi olanlarda 52±9 ms idi ve iki grup arasında anlamlı fark tespit edilmedi (p>0.05). Sonuç olarak diyastolik fonksiyon bozukluğu olan hastalarda P dıspersiyonun arttığı, bu artışın diyastolik fonksiyon bozukluğunun şiddeti ve etyolojisi ile ilişkili olmadığı, P dispersiyonu ile klinik ve ekokardiyografik parametrelerden sadece sol ventrikül ejeksiyon fraksiyonu arasında zayıf ancak anlamlı ilişki olduğu tespit edildi.
Diastolic dysfunction of hypertrophic or ischemic left ventricle causes an increase in ventricular enddiastolic pressure and left atrial size. In this situation, continuity of sinus rhythm and atrial contractions are of great value for the maintenance of cardiac output. The aim of our study was to investigate the relationship between P wave dispersion, which is easily measured on the surface ECG and used in assessing the risk of atrial fibrillation, and left ventricular diastolic function. In our study, a total of 133 patients were included (73 patients with diastolic dysfunction assessed by transthorasic echocardiography and 60 patients without). P wave dispersions were calculated by measuring the P minimum and P maximum values on the surface ECG. The relation between P wave dispersion and presence of diastolic dysfunction, its etiology, severity and echocardiographic measurements were investigated. P dispersion was 53±9 ms in patients with diastolic dysfunction and 43±9 ms in the control group ( p< 0.01). W hen the patients were grouped according to the stage of diastolic dysfunction, P dispersion was 48±7 ms in stage 1, 54±8 ms in stage 2 and 58±9 ms in stage 3. It was noted that as the severity of diastolic dysfunction increased, P dispersion also increased without reaching statistical significance (p> 0.05). When the etiology of diastolic dysfunction was considered, P dispersion was 53±8 ms in patients with ischemic heart disease, and 52±9 ms in patients with left ventricular hypertrophy and a significant difference was not present (p> 0.05). Hence, in patients with diastolic dysfunction, P dispersion increases but this increase is not related to the severity of diastolic dysfunction or its etiology. When clinical and echocardiographic parameters are taken into account, there was a weak but significant correlation only between P dispersion and left ventricular ejection fraction.
Diastolic dysfunction of hypertrophic or ischemic left ventricle causes an increase in ventricular enddiastolic pressure and left atrial size. In this situation, continuity of sinus rhythm and atrial contractions are of great value for the maintenance of cardiac output. The aim of our study was to investigate the relationship between P wave dispersion, which is easily measured on the surface ECG and used in assessing the risk of atrial fibrillation, and left ventricular diastolic function. In our study, a total of 133 patients were included (73 patients with diastolic dysfunction assessed by transthorasic echocardiography and 60 patients without). P wave dispersions were calculated by measuring the P minimum and P maximum values on the surface ECG. The relation between P wave dispersion and presence of diastolic dysfunction, its etiology, severity and echocardiographic measurements were investigated. P dispersion was 53±9 ms in patients with diastolic dysfunction and 43±9 ms in the control group ( p< 0.01). W hen the patients were grouped according to the stage of diastolic dysfunction, P dispersion was 48±7 ms in stage 1, 54±8 ms in stage 2 and 58±9 ms in stage 3. It was noted that as the severity of diastolic dysfunction increased, P dispersion also increased without reaching statistical significance (p> 0.05). When the etiology of diastolic dysfunction was considered, P dispersion was 53±8 ms in patients with ischemic heart disease, and 52±9 ms in patients with left ventricular hypertrophy and a significant difference was not present (p> 0.05). Hence, in patients with diastolic dysfunction, P dispersion increases but this increase is not related to the severity of diastolic dysfunction or its etiology. When clinical and echocardiographic parameters are taken into account, there was a weak but significant correlation only between P dispersion and left ventricular ejection fraction.
Açıklama
Anahtar Kelimeler
Elektrokardiyografi, Ventriküler disfonksiyon, sol, Risk değerlendirmesi, Risk Assessment, Ventricular Dysfunction, Left, Electrocardiography
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
31
Sayı
11
Künye
Gündüz, H., Binak, E., Akdemir, R. vd. (2003). Sol ventrikül diyastolik fonksiyon bozukluğu ile P dalga dispersiyonu arasındaki ilişki / Relation ship between P wave dispersion and diastolic dyssfunction. Türk Kardiyoloji Derneği Arşivi, Türk Kardiyoloji Derneği. 31(11), s. 679-686.
