Akut miyokard infarktüsünde farklı reperfüzyon tedavisi uygulanan hastalarda miyokard performans değerinin ekokardiyografi ile ölçülerek karşılaştırılması
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Dosyalar
Tarih
2009
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Miyokard performans indeksi kalbin global fonksiyonlarını ölçmede kullanılan, akut miyokard infarktüsü hastalarında prognostik önemi iyi bilinen bir parametredir. Bu çalışma akut miyokard infarktüsü hastalarında pulsed wave doppler ve doku doppler ile elde edilen miyokard performans indeksi değerlerinin korelasyonu ve miyokard performans indeksi ile reperfüzyon arasındaki ilişkiyi saptamak için yapıldı. Çalışmaya 26 birincil perkutan koroner girişim ve 28 trombolitik tedavi verilen akut miyokard infarktüsü hastası ile 15 sağlam kontrol hastası alındı. Tüm hastalarda miyokard performans indeksi değeri PW doppler ve doku doppler yöntemleri ile ölçüldü. Her iki yöntemle miyokard performans indeksi hesaplamada kullanılan izovolümik gevşeme zamanı, izovolümik kasılma zamanı ve ejeksiyon zamanı değerleri saptandı. İki farklı yöntemle elde edilen zaman aralıkları arasında korelasyon değerlendirildi. Birincil perkutan koroner girişim ve trombolitik tedavi verilen hastalarda miyokard performans indeksi değişim incelendi. Konvansiyonel pulsed wave doppler ve doku doppler ile elde edilen miyokard performans indeksi değerleri arasında anlamlı derecede korelasyon saptandı (p<0,001). Bu korelasyon hesaplamada kullanılan izovolümik gevşeme zamanı, izovolümik kasılma zamanı ve ejeksiyon zamanı değerleri arasında da anlamlı bir şekilde mevcut idi (üç parametre içinde; p<0,001). Birincil perkutan koroner girişim ve trombolitik tedavi verilen hastalarda pulsed wave doppler ve doku doppler miyokard performans indeksi değerleri arasında anlamlı farklılık saptanmadı (anılan sıra ile;p=0,128, p=0,991). Hem pulsed wave doppler miyokard performans indeksi hem de doku doppler miyokard performans indeksi ile reperfüzyon süresi arasında ise anlamlı bir ilişki gösterildi ( anılan sıra ile; p=0,002, p<0,001). Sonuç olarak akut miyokard infarktüsünde prognostik önemi iyi bilinen miyokard performans indeksini belirlemede doku doppler yöntemi konvansiyonel pulsed wave doppler yerine iyi bir alternatif olarak kullanılabilir. Akut miyokard infarktüsü erken döneminde bakılan miyokard performans indeksi ile reperfüzyon şekli arasında bir ilişki bulunmamış olup, miyokard performans indeksi ile reperfüzyon başlama süresi arasında bağlantı tespit edilmiştir.
Abstract
Myocardial performance index is a well known prognostic parameter in acute myocardial infarction patients, which has been used to assess global cardiac functions. In this study, we aimed to evaluate the corelation between the myocardial performance index levels obtained by pulsed wave doppler and Tissue doppler ultrasonography with reperfusion in acute myocardial infarction patients. 54 acute myocardial infarction patients, 26 treated with primary percutaneous coronary intervention and 28 with thrombolitic therapy; and 15 healthy controls were included in the study. Myocardial performance index levels were measured with pulsed wave doppler and tissue doppler ultrasonography in all patients. The isovolumic relaxation time, isovolumic contraction time and ejection time values used to measure myocardial performance index levels were determined. Corelation between the time intervals obtained with both methods were evaluated. Myocardial performance index variations were evaluated in patients treated with primary percutaneous coronary intervention and thrombolitic therapy. A significant corelation was observed in myocardial performance index levels obtained with pulsed wave doppler and tissue doppler ultrasonography (p<0.001) as well as between isovolumic relaxation time, isovolumic contraction time and ejection time values (for all parameters; p<0.001). No significant corelation was observed between the myocardial performance index levels obtained with pulsed wave doppler and tissue doppler ultrasonography in patients treated with primary percutaneous coronary intervention and thrombolitic therapy (p=0.128, p=0.991, respectively). A significant corelation was observed between the myocardial performance index values obtained by pulsed wave doppler and tissue doppler ultrasonography with reperfusion interval (p=0.002, p<0.001, respectively). As a result, tissue doppler ultrasonography may be used as an alternative to pulsed wave doppler to evaluate myocardial performance index, which is a well known prognostic factor in acute myocardial infarction. No relation has been observed between myocardial performance index values in early phases of acute myocardial infarction with reperfusion pattern, while a connection has been observed between myocardial performance index and reperfusion interval.
Abstract
Myocardial performance index is a well known prognostic parameter in acute myocardial infarction patients, which has been used to assess global cardiac functions. In this study, we aimed to evaluate the corelation between the myocardial performance index levels obtained by pulsed wave doppler and Tissue doppler ultrasonography with reperfusion in acute myocardial infarction patients. 54 acute myocardial infarction patients, 26 treated with primary percutaneous coronary intervention and 28 with thrombolitic therapy; and 15 healthy controls were included in the study. Myocardial performance index levels were measured with pulsed wave doppler and tissue doppler ultrasonography in all patients. The isovolumic relaxation time, isovolumic contraction time and ejection time values used to measure myocardial performance index levels were determined. Corelation between the time intervals obtained with both methods were evaluated. Myocardial performance index variations were evaluated in patients treated with primary percutaneous coronary intervention and thrombolitic therapy. A significant corelation was observed in myocardial performance index levels obtained with pulsed wave doppler and tissue doppler ultrasonography (p<0.001) as well as between isovolumic relaxation time, isovolumic contraction time and ejection time values (for all parameters; p<0.001). No significant corelation was observed between the myocardial performance index levels obtained with pulsed wave doppler and tissue doppler ultrasonography in patients treated with primary percutaneous coronary intervention and thrombolitic therapy (p=0.128, p=0.991, respectively). A significant corelation was observed between the myocardial performance index values obtained by pulsed wave doppler and tissue doppler ultrasonography with reperfusion interval (p=0.002, p<0.001, respectively). As a result, tissue doppler ultrasonography may be used as an alternative to pulsed wave doppler to evaluate myocardial performance index, which is a well known prognostic factor in acute myocardial infarction. No relation has been observed between myocardial performance index values in early phases of acute myocardial infarction with reperfusion pattern, while a connection has been observed between myocardial performance index and reperfusion interval.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Akut miyokard İnfarktüsü, Miyokard Performans indeksi, PW Doppler, Doku Doppler, Reperfüzyon Tedavisi, Acute Myocardial Infarction, Myocard Performance Index, Pulsed Wave Doppler, Tissue Doppler, Reperfusion treatment
