Pulmoner arter doku dopplerinin tanımlanması ve pulmomer hipertansiyonu olan ve olmayan olgular arasında pulmoner arter doku doppler açısından farkın araştırılması
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Dosyalar
Tarih
2015
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Pulmoner hipertansiyonda tarama amaçlı kullanılan yöntem ekokardiyografidir. Ancak triküspit kapak yetersizliliği olmayan olgularda pulmoner arter basıncın ekokardiyografi ile belirlenmesi güçtür. Çalışmamızın amacı doku Dopplerinin tanımlanması ve pulmoner arter basıncının hesaplanması için kullanılabilirliğinin araştırılmasıdır. Çalışmamıza Mart 2013 ile Mart 2014 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı polikliniğine başvuran 180 olgu dahil edildi. Olguların 60 tanesi pulmoner hipertansiyonlu hastalardı. Pulmoner arter basıncı normal olan olgular kontrol grubuna dahil edildi. Pulmoner arter doku doppler kaydı parasternal kısa aks yaklaşımda ana pulmoner arter üzerinden ve suprasternal yaklaşımda sağ pulmoner arter üstünden alındı. Alınan kayıtlardan erken sistolik dalga, geç sistolik dalga, sistolik dalgalar arası süre ve erken sistolik dalganın akselerasyon zamanı tanımlandı. Bu parametreler açısından yapılan karşılaştırmada sağ pulmoner geç sistolik dalga dışında diğer bütün parametrelerde pulmoner hipertansiyon olan ve olmayan olgular arasında anlamlı fark saptandı (p<0.05). Lineer regresyon analizi ile ana pulmoner arterden elde edilen değerler ile sistolik pulmoner arter basıncı hesaplamak için 84.9 – 193 x [ana pulmoner erken sistolik dalganın hızı - 0.21 x ana pulmoner sistolik dalgalar arası süre], sağ pulmoner arterden bulduğumuz değerler ile sistolik pulmoner arter basıncını hesaplamak için 58.6 - 137.8 x [(sağ pulmoner erken sistolik dalganın hızı - 0.29 x sağ pulmoner sistolik dalgalar arası süre) + 0.42 x sağ pulmoner erken sistolik dalganın akselerasyon zaman] formülleri elde edildi. Çalışmamızın sonucunda ana pulmoner arter ve sağ pulmoner arter üzerinden doku Doppler kaydı yapılabileceği ve bu kayıtların pulmoner arter basıncın hesaplanmasında bir alternatif olabileceği düşünülmüştür.
Abstract
Transthoracic echocardiogram the screening method for pulmonary hypertension. However, it is difficult to determine the pulmonary artery pressure in cases without tricuspid insufficiency. The goal of our study is to figure out whether tissue Doppler evaluation of pulmonary artery can be used for estimating (measuring) pulmonary artery pressure. 180 cases, who were registered to Trakya University Cardiology Clinic between March 2013 and March 2014 were included in our study. Sixty of the cases had pulmonary hypertension. Control group included subjects with normal pulmonary artery pressure (n:120). Pulmonary artery tissue Doppler data was recorded from main pulmonary artery in short axis view and from right pulmonary artery in suprasternal view. Early systolic peak velocity, late systolic peak velocity, time intervals between systolic peaks and early systolic peak acceleration time were measured based on the data recorded. A comparison of these values between two groups, revealed that there was a significant difference in all parameters except the right pulmonary late systolic flow velocity (p<0.05). Using regression analysis, the formulas 84.9-[193 x main pulmonary artery early systolic peak velocity - 0.21 x main pulmonary artery time intervals between systolic peaks] and 58.6- [(137.8 x right pulmonary artery early systolic peak velocity – 0.29 x right pulmonary artery time intervals between systolic peaks) +0.42 x right pulmonary artery early systolic peak acceleration time] were used to calculate the systolic pulmonary artery pressure from the values gathered from main pulmonary artery and right pulmonary artery respectively. In conclusion, it is thought that it is possible to perform tissue Doppler study on main pulmonary artery and right pulmonary artery and that these recordings might be an alternative for calculating pulmonary artery pressure.
Abstract
Transthoracic echocardiogram the screening method for pulmonary hypertension. However, it is difficult to determine the pulmonary artery pressure in cases without tricuspid insufficiency. The goal of our study is to figure out whether tissue Doppler evaluation of pulmonary artery can be used for estimating (measuring) pulmonary artery pressure. 180 cases, who were registered to Trakya University Cardiology Clinic between March 2013 and March 2014 were included in our study. Sixty of the cases had pulmonary hypertension. Control group included subjects with normal pulmonary artery pressure (n:120). Pulmonary artery tissue Doppler data was recorded from main pulmonary artery in short axis view and from right pulmonary artery in suprasternal view. Early systolic peak velocity, late systolic peak velocity, time intervals between systolic peaks and early systolic peak acceleration time were measured based on the data recorded. A comparison of these values between two groups, revealed that there was a significant difference in all parameters except the right pulmonary late systolic flow velocity (p<0.05). Using regression analysis, the formulas 84.9-[193 x main pulmonary artery early systolic peak velocity - 0.21 x main pulmonary artery time intervals between systolic peaks] and 58.6- [(137.8 x right pulmonary artery early systolic peak velocity – 0.29 x right pulmonary artery time intervals between systolic peaks) +0.42 x right pulmonary artery early systolic peak acceleration time] were used to calculate the systolic pulmonary artery pressure from the values gathered from main pulmonary artery and right pulmonary artery respectively. In conclusion, it is thought that it is possible to perform tissue Doppler study on main pulmonary artery and right pulmonary artery and that these recordings might be an alternative for calculating pulmonary artery pressure.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Pulmoner Arter Basıncı, Pulmoner Arter Doku Doppler, Ekokardiyografi, Pulmoner Hipertansiyon, Pulmonary Artery Pressure, Pulmonary Artery Tissue Doppler, Pulmonary Hypertension, Echocardiography
