Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?

KAPLAN, Şahin; SAHIN, Mursel; KIRIŞ, ABDULKADİR; KIRIŞ, Gülhanım; Karaman, Kayıhan; Orem, Asım; KUTLU, Merih; GEDIKLI, Omer; KAZAZ, Zeynep

Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?

Abdulkadir KIRIŞ, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Trabzon, Türkiye)

Gülhanım KIRIŞ, (Kırşehir Ahi Evran Üniversitesi, Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Kırşehir, Türkiye)

Kayıhan KARAMAN, (Sütçü İmam Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Kahramanmaraş, Türkiye)

Mürsel ŞAHİN, (Boş)

Ömer GEDİKLİ, (Boş)

Şahin KAPLAN, (Boş)

Asım ÖREM, (Karadeniz Teknik Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, Trabzon, Türkiye)

Merih KUTLU, (Boş)

Zeynep KAZAZ (Trabzon, Devlet Hastanesi Kardiyoloji Anabilim Dalı, Trabzon, Türkiye)

Türk Kardiyoloji Derneği Arşivi

3 0

Yıl: 2012 Cilt: 40 Sayı: 7 Sayfa Aralığı: 581 - 588 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?

Öz:

Amaç: Sol ventrikül (SV) eş zamanlı kasılma bozukluğu hipertansiyonlu hastalarda sık rastlanılan bir bulgu olup SV hipertrofisi ile ilişkilidir. Arteriyel katılık (AK) ve merkezi (aortik) kan basıncı, SV hipertrofisi gibi hipertansiyon kaynaklı hedef organ hasarında önemli rol oynar. Bu çalışmada, AK, merkezi sistolik ve diyastolik kan basınçları (KB) ve SV senkronizasyon bozukluğu arasındaki ilişki incelendi. Çalışma planı: Yeni hipertansiyon tanısı konmuş 35 hasta ve 40 kontrol çalışmaya alındı. Tüm çalışma popülasyonuna doku senkronizasyon görüntülemesini (DSG) de içeren kapsamlı ekokardiyografik inceleme yapıldı. SVnin pik sistolik doku hız zamanı (Zs) 12 segment modeli ile ölçüldü ve iki eş zamanlı kasılma bozukluğu indeksi hesaplandı. Nabız dalga hızı (NDH) ve artış indeksini (AIx@75) içeren AK parametreleri ile merkezil sistolik ve diyastolik KB aplanasyon tonometresi ile değerlendirildi. Bulgular: Kan basınçları dışında her iki grubun temel klinik ve ekokardiyografik parametreleri benzerdi. Eş zamanlı kasılma bozukluğu indeksleri hipertansiyonlu hastalarda kontrol grubuna göre uzamıştı: 12 segmentin Zsnın standart sapması (48.7±18.8 ve 25.8±13.1, p<0.001); herhangi iki segmentin maksimum Zs farkı (143.9±52.2 ve 83.8±39.4, p<0.001), NDH (11.9±2.5 ve 9.5±1.4, p<0.001), AIx@75 (27.4±8.3 ve 18.3±9, p=0.009), merkezi sistolik (147.6±20.8 ve 105.4±11, p<0.001) ve diyastolik (99.8±14.4 ve 72.8±9.5, p<0.001) basınçlar hipertansiyonlu hastalarda kontrol grubundan daha yüksekti. Çok değişkenli analizde, merkezi sistolik KB (β=0.496, p=0.03), SV kitle indeksi (β=0.232, p=0.027) ve beden kütle indeksi (β=0.308, p=0.002) eş zamanlı kasılma bozukluğu ile bağımsız ilişkili bulundu. Sonuç: Merkezi sistolik KB, yeni tanı konmuş hipertansiyonlu hastalarda SVnin eş zamanlı kasılma bozukluğunun bağımsız öngördürücüsüdür. Ancak AIx@75, SV eş zamanlı kasılması üzerinde doğrudan etkiye sahip değildir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Hipertansiyonlu hastalarda sol ventrikülün eş zamanlı kasılmasını etkileyen faktörler: Arteriyel katılık ve merkezi kan basıncı etkili mi?

Öz:

Objectives: Left ventricular (LV) dyssynchrony is a common finding in patients with hypertension and is associated with LV hypertrophy. Arterial stiffness (AS) and central (aortic) blood pressures play a significant role in end-organ damage such as LV hypertrophy caused by hypertension. The objective of this study was to investigate the relationship between AS, central blood pressures (BP) and LV dyssynchrony. Study design: Thirty-five newly diagnosed hypertensive patients and 40 controls were enrolled in the study. The entire study population underwent a comprehensive echocardiographic study including tissue synchrony imaging. The 12 segmental model was used to measure the time to regional peak systolic tissue velocity (Ts) in the LV and two dyssynchrony indices were computed. Parameters of AS including pulse wave velocity (PWV), augmentation index (AIx@75), and central systolic and diastolic BP were evaluated by applanation tonometry. Results: The baseline clinical and echocardiographic parameters of both groups were similar except for their BPs. Dyssynchrony indices were prolonged in patients with hypertension as compared to the controls. The standart deviation of Ts of 12 LV segments in patients with hypertension and the controls were 48.7±18.8 vs. 25.8±13.1, respectively (p<0.001), and the maximal difference in Ts between any 2 of 12 LV segments was 143.9±52.2 for hypertension patients vs. 83.8±39.4 for controls (p<0.001). PWV (11.9±2.5 vs. 9.5±1.4, p<0.001), AIx@75 (27.4±8.3 vs. 18.3±9, p=0.009), and central systolic (147.6±20.8 vs. 105.4±11, p<0.001) and diastolic (99.8±14.4 vs. 72.8±9.5, p<0.001) pressures were higher in patients with hypertension than in the controls, respectively. In multivariable analysis, central systolic BP (β=0.496, p=0.03), LV mass index (β=0.232, p=0.027), and body mass index (β=0.308, p=0.002) were found to be independently related to dyssynchrony. Conclusion: Central systolic BP is an independent predictor of LV dyssynchrony, but AIx@75 did not have an independent effect on LV synchronicity in patients with newly-diagnosed hypertension.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KIRIŞ A, KIRIŞ G, Karaman K, SAHIN M, GEDIKLI O, KAPLAN Ş, Orem A, KUTLU M, KAZAZ Z (2012). Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. , 581 - 588.
Chicago	KIRIŞ ABDULKADİR,KIRIŞ Gülhanım,Karaman Kayıhan,SAHIN Mursel,GEDIKLI Omer,KAPLAN Şahin,Orem Asım,KUTLU Merih,KAZAZ Zeynep Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. (2012): 581 - 588.
MLA	KIRIŞ ABDULKADİR,KIRIŞ Gülhanım,Karaman Kayıhan,SAHIN Mursel,GEDIKLI Omer,KAPLAN Şahin,Orem Asım,KUTLU Merih,KAZAZ Zeynep Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. , 2012, ss.581 - 588.
AMA	KIRIŞ A,KIRIŞ G,Karaman K,SAHIN M,GEDIKLI O,KAPLAN Ş,Orem A,KUTLU M,KAZAZ Z Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. . 2012; 581 - 588.
Vancouver	KIRIŞ A,KIRIŞ G,Karaman K,SAHIN M,GEDIKLI O,KAPLAN Ş,Orem A,KUTLU M,KAZAZ Z Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. . 2012; 581 - 588.
IEEE	KIRIŞ A,KIRIŞ G,Karaman K,SAHIN M,GEDIKLI O,KAPLAN Ş,Orem A,KUTLU M,KAZAZ Z "Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?." , ss.581 - 588, 2012.
ISNAD	KIRIŞ, ABDULKADİR vd. "Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?". (2012), 581-588.

APA	KIRIŞ A, KIRIŞ G, Karaman K, SAHIN M, GEDIKLI O, KAPLAN Ş, Orem A, KUTLU M, KAZAZ Z (2012). Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. Türk Kardiyoloji Derneği Arşivi, 40(7), 581 - 588.
Chicago	KIRIŞ ABDULKADİR,KIRIŞ Gülhanım,Karaman Kayıhan,SAHIN Mursel,GEDIKLI Omer,KAPLAN Şahin,Orem Asım,KUTLU Merih,KAZAZ Zeynep Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. Türk Kardiyoloji Derneği Arşivi 40, no.7 (2012): 581 - 588.
MLA	KIRIŞ ABDULKADİR,KIRIŞ Gülhanım,Karaman Kayıhan,SAHIN Mursel,GEDIKLI Omer,KAPLAN Şahin,Orem Asım,KUTLU Merih,KAZAZ Zeynep Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. Türk Kardiyoloji Derneği Arşivi, vol.40, no.7, 2012, ss.581 - 588.
AMA	KIRIŞ A,KIRIŞ G,Karaman K,SAHIN M,GEDIKLI O,KAPLAN Ş,Orem A,KUTLU M,KAZAZ Z Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. Türk Kardiyoloji Derneği Arşivi. 2012; 40(7): 581 - 588.
Vancouver	KIRIŞ A,KIRIŞ G,Karaman K,SAHIN M,GEDIKLI O,KAPLAN Ş,Orem A,KUTLU M,KAZAZ Z Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?. Türk Kardiyoloji Derneği Arşivi. 2012; 40(7): 581 - 588.
IEEE	KIRIŞ A,KIRIŞ G,Karaman K,SAHIN M,GEDIKLI O,KAPLAN Ş,Orem A,KUTLU M,KAZAZ Z "Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?." Türk Kardiyoloji Derneği Arşivi, 40, ss.581 - 588, 2012.
ISNAD	KIRIŞ, ABDULKADİR vd. "Factors affecting left ventricular synchronicity in hypertensive patients: are arterial stiffness and central blood pressures influential?". Türk Kardiyoloji Derneği Arşivi 40/7 (2012), 581-588.