Diyastolik mitral akım örneklerinin sol ventrikül içindeki seyrinin diyastolik fonksiyonları değerlendirmedeki yeri
Küçük Resim Yok
Tarih
1997
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu klinik çalışmamızda, normal kalplerde varolan intraventriküler pozitif basınç gradiyentinin sol ventrikül (LV) diyastolik disfonksiyon (DDF) durumlarında azaldığının hayvan deneylerinde bulunmasından yola çıkarak,PW-Doppler Ekokardiyografi ile mitral kapaktan apekse doğru gidildikçe diyastolik mitral akım örneklerinde (DMAÖ) oluşan değişiklikleri inceleyerek;(a) intraventriküler pozitif basınç gradiyentinin varlığını veya yokluğunu ,(b) DDF'lerde intraventriküler pozitif basınç gradiyentinin ve bu gradiyentinin indirekt etkilerinin nasıl değiştiğini, (c) böyle bir etki varsa,bu etkinin DMAÛ'nin diyastolik fonksiyonları değerlendirmede yetersiz kaldığı olgularda kullanışlı olup olamayacağını araştırmayı amaçladık. Çalışmaya 54'ü (% 56.2) erkek, 42'si (% 43.7) kadın ve yaş ortalaması 53.310.4 yıl olan 96 olgu alındı.Çalışma sağlıklı kişilerden oluşan kontrol grubuyla (n:27), psödonormalizasyon (PN)-grubu (n: 17),diyastolik disfonksiyon (DDF)-grubu (n:19) ve atrial fıbrilasyon (AF)-grubundan (n:28) oluşan hasta grupları (n:64) arasında gerçekleştirildi. Sol ventrikül boyutlarıfranksiyonel kısalma ve duvar hareket bozukluğu indeksi gibi LV sistolik fonksiyon parametreleri, DDF-grubu hariç diğer hasta gruplarında kontrol grubuna göre istatistiki anlamlılıkta bozuktu.DMAÖ 'nden E velositesi kontrol grubunda LV içinde azalmazken, DDF'lilerde intraventriküler 3.cm'de istatistiki olarak anlamlı oranda azaldığı saptandı (p0.01). PN ve AF gruplarında böyle bir azalma yoktu.A velositesi ise kontrol grubu (p 0.05) ve DDF-grubunda (p0.02) LV içinde istatistiki olarak anlamlı oranda (p0.05) azalma gösterdi.İzovolümetrik relaksasyon zamanı (IRT) ve akserelerasyon zamanının (AT) intraventriküler seyri çalışma gruplarının hiçbirinde anlamlı bir değişiklik göstermedi.Ancak AF-grubunda deselerasyon zamanının (DT),LV-içinde 1.cm'den itibaren 3.cm'ye kadar istatistiki olarak anlamlı uzama oluşturduğu ve bu uzamanın apekse yaklaştıkça istatistiki anlamlılığınınprogresif arttığı belirlendi (p0.05,p0.002 ve p0.001). Sonuç olarak, daha fazla çalışmayla desteklenmesi önkoşuluyla, klasik Eko yöntemleriyle LV diyastolik fonksiyonlarının değerlendirilemediği olgularda, mevcut yöntemlerle birlikte DMAÖ'nün LV içindeki seyrinin incelenmesinin faydalı sonuçlar vereceği ümit e-dilebilir.
The Value of Examining The Progress of Diastolic Mitral Flow Patterns in Left Ventricle in Defining Diastolic Functions In this clinical study,by examining changes in diastolic mitral flow patterns (DMFP) as going from mitral leaflets to the apex of left ventricular with PW-Doppler Echocardiography. We aimed to investigate ; (a) presence or absence of intraventricular positive pressure gradient, (b) changes in intraventricular pressure gradients in diastolic dysfunction, (c) if there, is such an indirect effect,usefullness of this effect in whom that DMFP are insufficient in the evaluation of diastolic dysfunction.This study includes 96 cases of whom 54( 56.2 %) were men,42 (43.7 %) were women with a mean age of 53.5±70.4 years .In the study population there were 27 healthy adults in control group and 64 patients in the patients group.Patients were divided into 3 subgroups and there were 17 patients in pseudonormalization (PN) group , 19 patients in diastolic dysfunction (DDF) group and 28 patients in atrial fibrilation (AF) group. In the patients group except DDF group systolic function parameters such as left ventricular end systolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD),fractional shortening (FS),wall motion abnormality index (WMA) were statistically significantly impaired according to the control group.From the DMFPs,E velocity was statistically significantly decreased (p<0.01) at 3rd cm intraventricularly in the cases with DDF (p<0.01) while it was not decreased in control and PN and AF-groups.On the other hand,A velocity was statistically significantly decreased in left ventricular cavity in control group (p<0.05) and DDF-group (p<0.02) and there was not any significant change in intraventricular progress of isovolumetric relaxation time (IRT) and acceleration lime (AT) in any of the study groups. However in patients with AF,there"wasa significant increase in deceleration time (DT) while going from mitral tips to the apex and also it was getting statistical significance by getting nearer to the apex (p<0.05,p<0.002,p<0.0001) In conclusion ,while it should be supported by other studies,in cases in whom diastolic functions could not be evaluated by classical echocardiographic strategies,we hope that examining of all diastolic functional parameters in the LV cavity may give beneficial results.
The Value of Examining The Progress of Diastolic Mitral Flow Patterns in Left Ventricle in Defining Diastolic Functions In this clinical study,by examining changes in diastolic mitral flow patterns (DMFP) as going from mitral leaflets to the apex of left ventricular with PW-Doppler Echocardiography. We aimed to investigate ; (a) presence or absence of intraventricular positive pressure gradient, (b) changes in intraventricular pressure gradients in diastolic dysfunction, (c) if there, is such an indirect effect,usefullness of this effect in whom that DMFP are insufficient in the evaluation of diastolic dysfunction.This study includes 96 cases of whom 54( 56.2 %) were men,42 (43.7 %) were women with a mean age of 53.5±70.4 years .In the study population there were 27 healthy adults in control group and 64 patients in the patients group.Patients were divided into 3 subgroups and there were 17 patients in pseudonormalization (PN) group , 19 patients in diastolic dysfunction (DDF) group and 28 patients in atrial fibrilation (AF) group. In the patients group except DDF group systolic function parameters such as left ventricular end systolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD),fractional shortening (FS),wall motion abnormality index (WMA) were statistically significantly impaired according to the control group.From the DMFPs,E velocity was statistically significantly decreased (p<0.01) at 3rd cm intraventricularly in the cases with DDF (p<0.01) while it was not decreased in control and PN and AF-groups.On the other hand,A velocity was statistically significantly decreased in left ventricular cavity in control group (p<0.05) and DDF-group (p<0.02) and there was not any significant change in intraventricular progress of isovolumetric relaxation time (IRT) and acceleration lime (AT) in any of the study groups. However in patients with AF,there"wasa significant increase in deceleration time (DT) while going from mitral tips to the apex and also it was getting statistical significance by getting nearer to the apex (p<0.05,p<0.002,p<0.0001) In conclusion ,while it should be supported by other studies,in cases in whom diastolic functions could not be evaluated by classical echocardiographic strategies,we hope that examining of all diastolic functional parameters in the LV cavity may give beneficial results.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
4
Sayı
4
