Obez ve metabolik sendromlu hastaların yeni ekokardiyografi parametreleri ile değerlendirilmesi
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Tarih
2006
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Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Metabolik sendrom kriteri taşıyan obezler ile metabolik sendrom kriteri taşımayan obezlerde, sol ventrikül sistolik ve diyastolik fonksiyonlarını konvansiyonel metodlar ve yeni ekokardiyografik parametreleri kullanarak değerlendirmeyi amaçladık. Materyal-Metod: Hastalar metabolik sendrom tanısı alan obezler (grup 1), metabolik sendrom tanısı almamış obezler (grup 2) ve kontrol grubu olmak üzere 3 gruba ayrıldı. Metabolik sendrom tanısı almış 20 obez hasta, metabolik sendrom kriteri taşımayan 20 obez, kontrol grubu olarak 19 sağlıklı birey alındı. Beden kütle indeksi >30 kg/m² olanlar obez olarak kabul edildi. Metabolik sendrom tanısı için NCEP-2001 ATP III MS tanı kriterleri kullanıldı. Metabolik sendrom kriterlerinden en az 3 tanesine sahip, BK >30 kg/m² olan hastalar obez-metabolik sendrom grubuna dahil edildi. Kontrol gurubu için tamamen sağlıklı olan gönüllülerden BK <30 kg/m² olanlar seçildi. Hasta ve kontrol grubunun konvansiyonel ve doku Doppler yöntemleri ile SV çapları, kütlesi, diyastolik fonksiyonları ve miyokard performans indeksleri hesaplandı. statiksel değerlendirmede, gruplar arası değerlerin araştırılmasında One Way Annova testi, gruplar arası anlamlılık için bazal değerlerdeki farklılıkların sonuca etkisini engellemek için ?univariate covariance? analiz yapıldı. Tüm istatistikler için p<0.05 olması anlamlı olarak kabul edildi. Bulgular: Gruplar arsında yaş ve cinsiyet açısından istatistiksel olarak fark yoktu. Beden kütle indeksi ve bel çevresi; grup 1 ve grup 2 de benzer ancak kontrol grubundan anlamlı olarak daha yüksekti. Sistolik ve diyastolik kan basınçları, grup 1'de, grup 2 ve kontrol grubundan anlamlı olarak daha yüksek, grup 2 ve kontrol grubu arasında ise fark yoktu. Konvansiyonel ekokardiyografi parametreleri açısından gruplar karşılaştırıldığında; sol ventrikül çaplarında gruplar arasında anlamlı fark bulunamazken, septum kalınlığı, kontrol grubunda grup 1 ve grup 2 ye göre daha düşüktü. Sol ventrikül kütlesi beklenildiği üzere grup 1 ve grup 2 de kontrol grubuna göre yüksek bulundu. Grup 1 ve 2 ise benzerdi (137.09±32.61 gr, 142.73±29.85 gr ve 129.72±32.60 gr, p<0.05, sırasıyla). Gruplar arasında diyastolik fonksiyonlar karşılaştırıldığında; E/A oranı, grup 1 de, diğer 2 gruptan anlamlı olarak düşüktü, grup 2'de de kontrol grubundan anlamlı olarak daha düşük bulundu (0.78±0.15, 1.04±0.32 ve 1.38±0.44, p<0.05, sırasıyla). EDZ, grup 1 ve 2 arasında benzerken, kontrol grubundan anlamlı olarak daha yüksekti (195.5±47.5 msn, 194.8±42.1 msn ve 158.9±35.6 msn, p<0.05, sırasıyla). Doku Doppler parametrelerinden; ortalama Em/Am, grup 1'de diğer gruplara göre daha düşük bulundu. Grup 2 ise kontrol grubundan anlamlı olarak daha düşüktü (0.72±0.16, 0.98±0.40, 1.24±0.37, p=0.06, sırasıyla). E/Ortalama Em ve Ps/Pd açısısndan gruplar arasında 37 anlamlı fark gözlenmedi. Gruplar sol ventrikül MP 'leri açısından değerlendirildiğinde grup 1 ve grup 2'de kotrol grubuna göre MP 'ler anlamlı olarak yüksek bulundu. Doku Doppler ile hesaplanan ortalama MP , grup1 ve grup 2 arasında benzerken, her iki grup için de kontrol grubuna göre anlamlı olarak yüksek bulundu (0.58±0.07, 0.62±0.12 ve 0.49±0.06, p<0.05, sırasıyla). Konvansiyonel metodla hesaplanan MP grup 1 ve grup 2'de kontrol grubuna göre anlamlı olarak yüksekti, grup 1 ve grup 2 arasında fark yoktu (0.54±0.14, 0.55±0.18 ve 0.37±0.12, p<0.05, sırasıyla). Sonuç: Obezite MS'un diğer parametreleri olmasa da tek başına SV fonksiyonlarını bozabilir. Doppler EKO bu hastalarda kolay uygulanabilir, ucuz bir yöntemdir. Doku Doppler ise yine obezitede fizyolojik koşullardan daha az etkilenerek konvansiyonel Dopplere iyi bir alternatif olabilir.
Aim: Our aim was to assess the systolic and diastolic functions of left ventricul with conventional methods and ecocardiographic parameters in obese patients with metabolic syndrome criterias and obese patients without metabolic syndrome criterias. Methods: The patients were divided into 3 groups. Obese patients with diagnosis of metabolic syndrome (Group 1), obese patients without diagnosis of metabolic syndrome (Group 2) and control group (Group 3). 20 obese patients with diagnosis of metabolic syndrome , 20 obese patients without diagnosis of metabolic syndrome and 19 patients as control group were enrolled to our study. BMI >30 kg/m² accepted as obese. NCEP-2001 ATP III MS criterias were used for diagnosis of metabolic syndrome. BMI >30 kg/m² patients with 3 criterias metabolic syndrome were added to metabolic syndrome group. Control group was formed with normal patients with BMI <30 kg/m². Left ventricul diameters, mass, diastolic functions and myocard performance index of patients and control group were obtained with conventional ecocardiography and tissue doppler methods. One way Annova test and univariate coveriance analyses were performed. p value <0.05 was considered significant. Results: There was no statistically significant difference in age and gender between 3 groups. BMI and waist circumference were similar in group 1 and group 2 but significantly higher than group 3. Systolic and diastolic blood pressures were significantly higher in group 1 than other 2 groups and were similar between group 2 and group 3. When the conventional ecocardiographic parameters were compared; there were no difference between 3 groups in left ventricul diameters. Septum thickness was lower in control group than other 2 groups. Left ventricul mass was higher in group 1 and group 2 than control group and was similar between in group 1 and group 2 (137.09±32.61 gr, 142.73±29.85 gr and 129.72±32.60 gr, p<0.05, respectively). Comprasion of diastolic parameters; E/A ratio was significantly lower in group 1 than other 2 groups. E/A ratio was lower in group 2 than control group (0.78±0.15, 1.04±0.32 and 1.38±0.44, p<0.05, respectively). EDZ was similar in group 1 and group 2 and significantly higher than control group (195.5±47.5 msn, 194.8±42.1 msn and 158.9±35.6 msn, p<0.05, respectively). Comprasion of Tissue Doppler parameters; mean Em/Am was lower in group 1 than other 2 groups. Mean Em/Am was significantly lower in group 2 than control group (0.72±0.16, 0.98±0.40 and 1.24±0.37, p=0.06, respectively). There were no statistically significant difference in E/mean Em and Ps/Pd between 3 groups. When compared with Left Ventricul MPI; MPI was significantly higher in group 1 and group 2 than 39 control group. Mean MPI with tissue Doppler wall was similar in group 1 and group 2 and significantly higher than control group (0.58±0.07, 0.62±0.12 and 0.49±0.06, p<0.05, respectively). MPI with conventional methods was similar in group 1 and group 2 and significantly higher than control group (0.54±0.14, 0.55±0.18 and 0.37±0.12, p<0.05, respectively). Conclusions: Obesity can damage left ventricul functions without the other important criterias of metabolic sydrome. Doppler ecocardiography is a widespread method to evaluate the potential risks of these patients. Tissue Doppler ecocardiography is a good alternative of conventional ecocardiography and less affected from physiological conditions in obes patients.
Aim: Our aim was to assess the systolic and diastolic functions of left ventricul with conventional methods and ecocardiographic parameters in obese patients with metabolic syndrome criterias and obese patients without metabolic syndrome criterias. Methods: The patients were divided into 3 groups. Obese patients with diagnosis of metabolic syndrome (Group 1), obese patients without diagnosis of metabolic syndrome (Group 2) and control group (Group 3). 20 obese patients with diagnosis of metabolic syndrome , 20 obese patients without diagnosis of metabolic syndrome and 19 patients as control group were enrolled to our study. BMI >30 kg/m² accepted as obese. NCEP-2001 ATP III MS criterias were used for diagnosis of metabolic syndrome. BMI >30 kg/m² patients with 3 criterias metabolic syndrome were added to metabolic syndrome group. Control group was formed with normal patients with BMI <30 kg/m². Left ventricul diameters, mass, diastolic functions and myocard performance index of patients and control group were obtained with conventional ecocardiography and tissue doppler methods. One way Annova test and univariate coveriance analyses were performed. p value <0.05 was considered significant. Results: There was no statistically significant difference in age and gender between 3 groups. BMI and waist circumference were similar in group 1 and group 2 but significantly higher than group 3. Systolic and diastolic blood pressures were significantly higher in group 1 than other 2 groups and were similar between group 2 and group 3. When the conventional ecocardiographic parameters were compared; there were no difference between 3 groups in left ventricul diameters. Septum thickness was lower in control group than other 2 groups. Left ventricul mass was higher in group 1 and group 2 than control group and was similar between in group 1 and group 2 (137.09±32.61 gr, 142.73±29.85 gr and 129.72±32.60 gr, p<0.05, respectively). Comprasion of diastolic parameters; E/A ratio was significantly lower in group 1 than other 2 groups. E/A ratio was lower in group 2 than control group (0.78±0.15, 1.04±0.32 and 1.38±0.44, p<0.05, respectively). EDZ was similar in group 1 and group 2 and significantly higher than control group (195.5±47.5 msn, 194.8±42.1 msn and 158.9±35.6 msn, p<0.05, respectively). Comprasion of Tissue Doppler parameters; mean Em/Am was lower in group 1 than other 2 groups. Mean Em/Am was significantly lower in group 2 than control group (0.72±0.16, 0.98±0.40 and 1.24±0.37, p=0.06, respectively). There were no statistically significant difference in E/mean Em and Ps/Pd between 3 groups. When compared with Left Ventricul MPI; MPI was significantly higher in group 1 and group 2 than 39 control group. Mean MPI with tissue Doppler wall was similar in group 1 and group 2 and significantly higher than control group (0.58±0.07, 0.62±0.12 and 0.49±0.06, p<0.05, respectively). MPI with conventional methods was similar in group 1 and group 2 and significantly higher than control group (0.54±0.14, 0.55±0.18 and 0.37±0.12, p<0.05, respectively). Conclusions: Obesity can damage left ventricul functions without the other important criterias of metabolic sydrome. Doppler ecocardiography is a widespread method to evaluate the potential risks of these patients. Tissue Doppler ecocardiography is a good alternative of conventional ecocardiography and less affected from physiological conditions in obes patients.
Açıklama
Anahtar Kelimeler
Obezite, Obesity, Metabolik sendrom, Metabolic syndrome, Ekokardiyografi parametreleri, Echocardiography parameters
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Koç, F. (2006). Obez ve metabolik sendromlu hastaların yeni ekokardiyografi parametreleri ile değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
