Normal koroner anjiografisi olan dipper ve non-dipper hipertansif hasta gruplarında tımı frame skorunun karşılaştırılması
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Dosyalar
Tarih
2012
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Koroner kan akımının ölçülmesinde standart bir indeks oluşturmak amacıyla ilk defa Gibson tarafından TIMI frame skoru tarif edilmiştir. Gibson TIMI'4 çalışmasının anjiyografik görüntülerini inceleyerek basit, verimli, objektif ve kantitatif bir ölçüm tekniği olan bu yöntemi ortaya koymuştur. Yüksek TIMI frame skoru endotelyal disfonksiyon ve koroner yavaş akımla ilişkilidir. Arteryal kan basıncı sirkadiyan ritim gösterir. Normalde gece kan basıncında %10'dan fazla düşüş beklenir ve dipper hipertansiyon olarak bilinir, %10'dan az düşüş non-dipper hipertansiyon olarak bilinir. Yaptığımız bu çalışmada koroner anjiografisi normal olan non-dipper ve dipper hasta gruplarında TIMI frame skoronu karşılaştırdık. Çalışmamızın sonucunda dipper hipertansif hasta grubunda her üç koroner arterdeki TIMI frame skoru ve ortalama TIMI frame skoru non-dipper hipertansif hasta grubuna göre anlamlı olarak daha düşüktü. (sağ koroner arter TIMI frame skoru: 16.83±3.70; 21.63±3.44 p<0.001; sirkumfleks arter TIMI frame skoru: 21.28±3.52; 25.65±3.61 p<0.001; sol ön inen arter TIMI frame skoru: 34.20±2.80; 37.05±3.30 p=0.001; düzeltilmiş sol ön inen arter TIMI frame skoru: 20.05±1.63; 21.74±1.95 p=0.001; ortalama TIMI frame skoru: 19.31±2.3; 22.94±2.61 p<0.001). Dipper hasta grubununda vucüt kitle indeksi 23.79±2.81, non-dipper grupta vucüt kitle indeksi 25.47±2.92 idi. Non-dipper grupta vücut kitle indeksi dipper gruba göre anlamlı olarak daha yüksekti (p=0.027). Dipper hasta grubunda ortalama nabız değeri 66.57±4.92 iken, non-dipper hasta grubunda ortalama nabız değeri 72.70±4.86 olarak saptandı. Dipper hasta grubunda dakika nabız sayısı non-dipper grubundan anlamlı olarak daha düşüktü (p=0.001). Dipper ve non-dipper hipertansif hasta grubunun TIMI frame skorunu ilk kez karşılaştıran bu çalışmada, endotel disfonksiyonun ve koroner yavaş akımın bir göstergesi olan TIMI frame skorunu, kardiyovasküler mortalitenin daha fazla olduğu bilenen non-dipper hipertansif hasta grubunda beklenildiği gibi daha yüksek bulduk. Anahtar kelimeler: TIMI frame skor, dipper, non-dipper
Abstract
In order to generate a standart index for calculating coronary blood flow, TIMI frame score was describe for the first time by Gibson. As invastigating angiographic images of TIMI-4 trial, Gibson composed a simple, objective, efficient and quantitative mesaurement techniqe. High TIMI frame score is correlated with endothelial dysfunction and coranary slow flow. Blood pressure displays a circadian rhythm. Normally blood pressure is expected to decrease more than 10 percent this is known as dipper hypertension, decrease less than 10 percent is known as non-dipper hypertension. We compared TIMI frame scores of non-dipper and dipper patients with normal coronary angiography in this trial. As a consequence of our trial, at the dipper hypertension group, TIMI frame score and mean TIMI frame score of all three coronary arteries were lesser significantly when compared with the non-dipper patient group. (right coronary artery TIMI frame score: 16.83±3.70 vs. 21.63±3.44 p<0.001; circumflex artery TIMI frame score: 21.28±3.52 vs. 25.65±3.61 p<0.001; left anterior descending artery TIMI frame score: 34,20±2,80 vs. 37,05±3,30 p=0.001 ; corrected left anterior descending artery frame score: 34.20±2.80 vs. 37.05±3.30 p=0.001; mean TIMI frame score: 19.31±2.3 vs. 22.94±2.61 p<0.001). At the dipper patient group body mass index was 23.79±2.81 and was 25.47±2.92 at the non-dipper group. At the non-dipper group body mass index was significantly higher than dipper group (p=0.027). While mean pulse rate was 66.57±4.92 at the dipper group was 72.70±4.86 at the non-dipper patient group. Pulse rate per minute at the dipper patient group was significantly lesser than the non-dipper group (p=0.001). This is the first trial comparing the TIMI frame scores of dipper and non-dipper hypertension groups in this trial, as an indicator of endotelial dysfunction and coronary slow flow TIMI frame score was higher as were expected for non-dipper hypertensive patients that were known to have higher risks for cardiovascular mortality. Key words: TIMI frame score, dipper, non-dipper.
Abstract
In order to generate a standart index for calculating coronary blood flow, TIMI frame score was describe for the first time by Gibson. As invastigating angiographic images of TIMI-4 trial, Gibson composed a simple, objective, efficient and quantitative mesaurement techniqe. High TIMI frame score is correlated with endothelial dysfunction and coranary slow flow. Blood pressure displays a circadian rhythm. Normally blood pressure is expected to decrease more than 10 percent this is known as dipper hypertension, decrease less than 10 percent is known as non-dipper hypertension. We compared TIMI frame scores of non-dipper and dipper patients with normal coronary angiography in this trial. As a consequence of our trial, at the dipper hypertension group, TIMI frame score and mean TIMI frame score of all three coronary arteries were lesser significantly when compared with the non-dipper patient group. (right coronary artery TIMI frame score: 16.83±3.70 vs. 21.63±3.44 p<0.001; circumflex artery TIMI frame score: 21.28±3.52 vs. 25.65±3.61 p<0.001; left anterior descending artery TIMI frame score: 34,20±2,80 vs. 37,05±3,30 p=0.001 ; corrected left anterior descending artery frame score: 34.20±2.80 vs. 37.05±3.30 p=0.001; mean TIMI frame score: 19.31±2.3 vs. 22.94±2.61 p<0.001). At the dipper patient group body mass index was 23.79±2.81 and was 25.47±2.92 at the non-dipper group. At the non-dipper group body mass index was significantly higher than dipper group (p=0.027). While mean pulse rate was 66.57±4.92 at the dipper group was 72.70±4.86 at the non-dipper patient group. Pulse rate per minute at the dipper patient group was significantly lesser than the non-dipper group (p=0.001). This is the first trial comparing the TIMI frame scores of dipper and non-dipper hypertension groups in this trial, as an indicator of endotelial dysfunction and coronary slow flow TIMI frame score was higher as were expected for non-dipper hypertensive patients that were known to have higher risks for cardiovascular mortality. Key words: TIMI frame score, dipper, non-dipper.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
TIMI Frame Skor, Dipper, Non-dipper, TIMI Frame Score, Koroner Anjiografisi, Hipertansif Hasta Grupları, Frame Skoru
