Hipoksik iskemik ensefalopatili yenidoğanlarda sol ve sağ ventrikül “pulsed” ve doku Doppler miyokart performans indeks değerlerinin Z-skorla karşılaştırması
Küçük Resim Yok
Tarih
2011
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmanın amacı; hipoksik iskemik ensefalopatili (HİE) ve sağlıklı term yenidoğan bebeklerde, kardiyak etkilenmeyi göstermek amacı ile pulsed (PD) ve doku Doppler (DD) tekniklerini kullanarak miyokart performans indeksini (MPİ/Tei indeksi) belirlemek ve bu iki teknik sonuçları arasında ortaya çıkan farklılıkları değerlendirmektir. Yöntemler: Çalışma prospektif gözlemsel bir çalışmadır. Postnatal ilk 24 saat içinde belirlenen kriterlere göre perinatal asfiksi tanısı konulan 20 term yenidoğan ve kontrol grubu olarak sağlıklı, 50 term yenidoğan bebek çalışmaya alındı. HİE grup Sarnat evrelemesine göre Sarnat Evre 1 ve 2-3 olmak üzere iki gruba ayrıldı. Kontrol ve hasta gruplarına doğumdan sonraki ilk 24 saat içerisinde ve bir yıl sonra, PD ve DD ekokardiyografi teknikleri uygulanarak MPI hesaplandı. Aynı ölçüm teknikler ile elde edilen veriler Kruskal-Wallis testi ile iki tekniğin birbirine üstünlüğü ise Z skoru olarak hesaplandı. Bulgular: Sarnat evre 2-3 grubunda, hayatın ilk gününde her iki ventrikülde PD (0.410.04, 0.510.02) ve DD (0.590.04, 0.510.02) ile bakılan bakılan MPİ kontrol grubuna göre anlamlı derecede yüksek bulundu (p0.01, p0.02, p0.03). Pulsed ve doku Doppler ile elde edilen MPİ için hesaplanan Z skoru, kontrol grubu ve Sarnat Evre 1 grubunda her iki ventrikül için benzer bulunurken, diğer Sarnat gruplarında anlamlı olarak farklı olduğu görüldü. Sonuç: Hipoksik iskemik ensefalopatili yenidoğanlarda kardiyak fonksiyonlar olumsuz yönde etkilenmekte olup bu durumun, hipoksinin ağırlığı ile ilişkili olduğu bulunmuştur. MPİ, hafif hipoksiye maruz kalan yenidoğanlarda kontrol grubundan farksız iken, orta ve ağır hipoksiye maruz kalmış yenidoğanlarda daha büyüktür. İki tekniğin ölçüm değerleri açısından birbirine üstünlüğü bulunamamış ancak orta ve ağır hipoksik grupta DD ile elde edilen MPİ’deki Z skor değişiminin daha büyük olduğu saptanmıştır. (Anadolu Kardiyol Derg 2011; 11: 719-25)
Objective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MPIs (Tei indexes) were calculated with PD and TD echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41±0.04, 0.51±0.02) and TD (0.59±0.04, 0.51±0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TD method, calculated from moderate and severe hypoxia group was detected. (Anadolu Kardiyol Derg 2011; 11: 719-25)
Objective: The aim of the study is determination of myocardial performance index (MPI/Tei index) using pulsed (PD) and tissue Doppler (TD) techniques to show cardiac response in newborns with hypoxic-ischemic encephalopathy (HIE) and healthy newborns and eventually evaluation of the differences between these two techniques. Methods: The study is a prospective observational study. Twenty term newborns diagnosed as perinatal asphyxia during postnatal 24 hours due to the defined criteria and fifty healthy term neonates as control group were included the study. Hypoxic group was divided into two groups with Sarnat stages, Sarnat Stage 1 and 2-3. MPIs (Tei indexes) were calculated with PD and TD echocardiographic techniques in all groups after the 24 hours of birth and one year later. The statistical differences between same techniques were calculated with Kruskal-Wallis test and Z score was used to compare the superiority of two techniques. Results: The MPI values calculated by PD (0.41±0.04, 0.51±0.02) and TD (0.59±0.04, 0.51±0.02) during the first day of life in Sarnat Stage 2-3 in both ventricles were significantly higher than the control group (p<0.01, p<0.02, p<0.03). While the Z score, calculated for MPI measured by PD and TD methods, were found similar in both ventricles in Sarnat Stage 1 and control groups, it was significantly different in other groups of Sarnat stages. Conclusion: The degree of cardiac response in neonates with HIE is associated with the severity of hypoxia. MPI values are not different from the controls in newborns received mild hypoxia while they are higher in the patients who were received moderate or severe hypoxia. Any advantage could not be found between two techniques according to the measurement values, but higher variability in the value of MPI, measured by TD method, calculated from moderate and severe hypoxia group was detected. (Anadolu Kardiyol Derg 2011; 11: 719-25)
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Anadolu Kardiyoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
8
