Hormon replasman tedavisinin kardiyak fonksiyonlar üzerine etkisinin yeni parametrelerle değerlendirilmesi
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Tarih
2004
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info:eu-repo/semantics/openAccess
Özet
Amaç: Menopoz nedeniyle meydana gelen değişikliklerden en çok etkilenen sistemlerden biri de kardiyovasküler sistemdir. Bu çalışma, sağlıklı postmenopozal kadınlarda HRTnin kardiyak fonksiyonlar üzerine etkilerinin yeni parametreler kullanılarak değerlendirilmesi amacıyla planlanmıştır. Yöntem: Çalışmaya HRT uygulanacak 35 ve kontrol grubu olarak da aynı özelliklere sahip 32 sağlıklı postmenopozal kadın alındı. Tüm bireylere standart ekokardiyografi yapıldı. Ardından doku Doppler pulsed wave yöntemi uygulanarak miyokardiyal hızlar ile sistolik ve diyastolik zaman intervalleri ölçülerek miyokard performans indeksi (MPİ) hesaplandı. Üç ay sonra elde edilen parametreler, bazal değerlerle karşılaştırıldı. Bulgular: Sol ventrikül (SV) segmenter sistolik miyokardiyal hız (Sm), ortalama Sm ve triküspit Sm değerlerinde her iki grupta da 3 ay sonra değişiklik tespit edilemedi. HRT grubunda SV için ortalama erken miyokardiyal hızı (Em) artarken geç miyokardiyal hız (Am) azaldı. Em/Am oranı ve mitral erken diyastolik doluş hızı/mitral geç diyastolik hızı oranı arttı. MPİ değerlerinde HRT alan grupta üç ay sonra azalma eğilimi vardı. Fakat bu değişiklikler istatistiki anlamlılığa ulaşmadı. Sonuç: Anlamlı olmasa da, 3 ay süreli HRT özellikle SV diyastolik fonksiyonlarında düzelmeye neden olabilir. Bu düzelme eğiliminin anlamlı olup olmadığının ortaya çıkarılması için uzun süreli geniş katılımlı randomize çalışmalara ihtiyaç vardır.
Objective: Cardiovascular system is one of the most affected system in menopause. It is aimed to investigate the effects of HRT on cardiovascular functions in healthy postmenopausal women. Methods: Thirty-seven patients given HRT were taken as study group and 32 healthy postmenopausal women were taken as control group. Standard echocardiography were performed to all cases. Sequentially, systolic and diastolic time intervals were measured with pulsed wave tissue Doppler and myocardial performance index was calculated. The same parameters obtained after 3 months of HRT and compared with the basal values. Results: There was no change at left ventricle (LV) segmental systolic myocardial velocity (Sm) and tricuspid Sm values after 3 months according to basal values in both groups. While the mean early myocardial velocity (Em) of LV increased, late myocardial velocity (Am) decreased and Em/Am ratio increased in HRT group. In addition it was determined that the mitral early inflow velocity/late inflow velocity ratio increased. Mean LV myocardial performance index was also decreased after the 3 months of HRT. Nevertheless, these changes could not reach to a statistically significance. Conclusion: Although it is not significant, HRT may cause improvement in LV diastolic function. Long term, wide spectrum randomized studies are needed to expose whether this improvement trend will be significant or not.
Objective: Cardiovascular system is one of the most affected system in menopause. It is aimed to investigate the effects of HRT on cardiovascular functions in healthy postmenopausal women. Methods: Thirty-seven patients given HRT were taken as study group and 32 healthy postmenopausal women were taken as control group. Standard echocardiography were performed to all cases. Sequentially, systolic and diastolic time intervals were measured with pulsed wave tissue Doppler and myocardial performance index was calculated. The same parameters obtained after 3 months of HRT and compared with the basal values. Results: There was no change at left ventricle (LV) segmental systolic myocardial velocity (Sm) and tricuspid Sm values after 3 months according to basal values in both groups. While the mean early myocardial velocity (Em) of LV increased, late myocardial velocity (Am) decreased and Em/Am ratio increased in HRT group. In addition it was determined that the mitral early inflow velocity/late inflow velocity ratio increased. Mean LV myocardial performance index was also decreased after the 3 months of HRT. Nevertheless, these changes could not reach to a statistically significance. Conclusion: Although it is not significant, HRT may cause improvement in LV diastolic function. Long term, wide spectrum randomized studies are needed to expose whether this improvement trend will be significant or not.
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Genel ve Dahili Tıp
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14
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4
