Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis

Özkan, Mehmet; Kalçık, Macit; Karakoyun, Süleyman; Gündüz, Sabahattin; Kalkan, Semih; Yesin, Mahmut; Bayam, Emrah; Güner, Ahmet; Gürsoy, Mustafa Ozan; Çakal, Beytullah

doi:10.5543/tkda.2020.23621

Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis

Beytullah ÇAKAL, (İstanbul Medipol Üniversitesi Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Macit KALÇIK, (Hitit Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Çorum, Türkiye)

Ahmet GÜNER, (Mehmet Akif Ersoy Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Mustafa Ozan GÜRSOY, (İzmir Katip Çelebi Üniversitesi, Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İzmir, Türkiye)

Mahmut YESİN, (Kafkas Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Kars, Türkiye)

Süleyman KARAKOYUN, (Kafkas Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Kars, Türkiye)

Sabahattin GÜNDÜZ, (Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Semih KALKAN, (Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Emrah BAYAM, (Ümraniye Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Mehmet ÖZKAN (Ardahan Üniversitesi, Sağlık Bilimleri Bölümü, Ardahan, Türkiye)

Türk Kardiyoloji Derneği Arşivi

0 3

Yıl: 2020 Cilt: 48 Sayı: 6 Sayfa Aralığı: 566 - 575 Metin Dili: İngilizce DOI: 10.5543/tkda.2020.23621 İndeks Tarihi: 05-12-2020

Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis

Öz:

Objective: Prosthetic valve thrombosis (PVT) is a seriouscomplication among patients with prosthetic heart valves.Thrombolytic therapy (TT) is now widely used as first-line treatment for PVT. Endothelial dysfunction has previously beenreported in patients with PVT. The aim of this study was to investigate the changes in endothelial function soon after TT inPVT patients.Methods: The study group included 85 patients with PVT [female: 53 (62.3%); age: 48.7±13.9 years] who were evaluatedprospectively before and shortly after TT. All of the patients wereevaluated using transthoracic and transesophageal echocardiography. TT was administered in all cases with a low-dose,ultra-slow infusion regimen. Endothelial function was evaluatedusing a noninvasive measurement of flow-mediated dilatation(FMD) of the brachial artery during reactive hyperemia.Results: The study population included 38 (44.7%) obstructive and 47 (55.3%) non-obstructive PVT patients. The obstructive PVT patients had lower baseline FMD values thanthe non-obstructive PVT group (5.31±0.76% vs. 5.87±0.84%;p=0.003). TT was successful in 79 patients (92.9%). FMDwas significantly increased in the successfully thrombolyzedpatients after TT (5.65±0.86% vs. 7.13±1.26%; p<0.001).There was no significant difference in the FMD values afterTT in patients who were unresponsive to TT (5.07±0.61%vs. 5.38±0.95%; p=0.371). There was a significant increasein FMD values after TT in patients with obstructive PVT(5.31±0.76% vs. 8.22±1.15%; p<0.001). However, this difference was not statistically significant for patients with non-obstructive PVT (5.87±0.84% vs. 6.11±0.95%; p=0.276).Conclusion: This study demonstrated that successful TTmay contribute to improvement of impaired endothelial function in patients with obstructive PVT

Anahtar Kelime:

Protez kalp kapak trombozu olan hastalarda trombolitik tedavinin hemen sonrasında endotel fonksiyonlarında gözlenen iyileşme

Öz:

Amaç: Protez kapak trombozu (PKT) gelişimi protez kalp kapaklı hastalarda ciddi bir komplikasyondur. Son zamanlarda trombolitik tedavi (TT) PKT tedavisinde ilk tercih olarak yaygın olarak kullanılmaktadır. Daha önceki çalışmalarda PKT hastalarında endotel disfonksiyonunun varlığı bildirilmiştir. Bu çalışmada, PKT hastalarında TT sonrasında endotel fonksiyonlarında olan değişiklikleri araştırmayı amaçladık. Yöntemler: Bu çalışmaya TT öncesi ve sonrası prospektif olarak takip edilen 85 PKT hastası [kadın: 53 (%62,3), ortalama yaş: 48,7±13,9 yıl] dahil edildi. Tüm hastalar transtorasik ve transözofajiyal ekokardiyografi ile değerlendirildi. Tüm hastalarda düşük doz ultra yavaş infüzyon rejimine göre TT uygulandı. Endotel fonksiyonları reaktif hipereminin neden olduğu akım aracılı genişleme (Flow Mediated Dilation, FMD) ölçülmesi ile değerlendirildi. Bulgular: Çalışmaya 38 (%44,7) tıkayıcı ve 47 (%55,3) tıkayıcı olmayan PKT hastası alındı. Tıkayıcı PKT hastaları tıkayıcı olmayan PKT hastalarına göre daha düşük bazal FMD değerlerine sahiplerdi (%5,31±0,76 ve %5,87±0,84; p=0,003). TT 79 (%92,9) PKT hastasında başarılı idi. Ortama FMD değerleri başarılı TT grubunda TT sonrasında anlamlı olarak yükseldi (%5,65±0,86 ve %7,13±1,26; p<0,001). Başarısız TT grubunda TT sonrası FMD değerlerinde anlamlı değişiklik izlenmedi (%5,07±0,61 ve %5,38±0,95; p=0,371). Tıkayıcı PKT olan hastalarda TT sonrasında FMD değerleri anlamlı olarak yükseldi (%5,31±0,76 ve %8,22±1,15; p<0,001). Fakat, tıkayıcı olmayan PKT hastalarında TT sonrası FMD değerlerinde anlamlı değişiklik izlenmedi (%5,87±0,84 ve %6,11±0,95; p=0,276). Sonuç: Bu çalışmada, tıkayıcı PKT hastalarında başarılı TT’nin bozulan endotel fonksiyonlarının düzelmesine katkı sunabildiği gösterilmiştir.

Anahtar Kelime:

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

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APA	Çakal B, Kalçık M, Güner A, Gürsoy M, Yesin M, Karakoyun S, Gündüz S, Kalkan S, Bayam E, Özkan M (2020). Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. , 566 - 575. 10.5543/tkda.2020.23621
Chicago	Çakal Beytullah,Kalçık Macit,Güner Ahmet,Gürsoy Mustafa Ozan,Yesin Mahmut,Karakoyun Süleyman,Gündüz Sabahattin,Kalkan Semih,Bayam Emrah,Özkan Mehmet Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. (2020): 566 - 575. 10.5543/tkda.2020.23621
MLA	Çakal Beytullah,Kalçık Macit,Güner Ahmet,Gürsoy Mustafa Ozan,Yesin Mahmut,Karakoyun Süleyman,Gündüz Sabahattin,Kalkan Semih,Bayam Emrah,Özkan Mehmet Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. , 2020, ss.566 - 575. 10.5543/tkda.2020.23621
AMA	Çakal B,Kalçık M,Güner A,Gürsoy M,Yesin M,Karakoyun S,Gündüz S,Kalkan S,Bayam E,Özkan M Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. . 2020; 566 - 575. 10.5543/tkda.2020.23621
Vancouver	Çakal B,Kalçık M,Güner A,Gürsoy M,Yesin M,Karakoyun S,Gündüz S,Kalkan S,Bayam E,Özkan M Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. . 2020; 566 - 575. 10.5543/tkda.2020.23621
IEEE	Çakal B,Kalçık M,Güner A,Gürsoy M,Yesin M,Karakoyun S,Gündüz S,Kalkan S,Bayam E,Özkan M "Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis." , ss.566 - 575, 2020. 10.5543/tkda.2020.23621
ISNAD	Çakal, Beytullah vd. "Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis". (2020), 566-575. https://doi.org/10.5543/tkda.2020.23621

APA	Çakal B, Kalçık M, Güner A, Gürsoy M, Yesin M, Karakoyun S, Gündüz S, Kalkan S, Bayam E, Özkan M (2020). Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. Türk Kardiyoloji Derneği Arşivi, 48(6), 566 - 575. 10.5543/tkda.2020.23621
Chicago	Çakal Beytullah,Kalçık Macit,Güner Ahmet,Gürsoy Mustafa Ozan,Yesin Mahmut,Karakoyun Süleyman,Gündüz Sabahattin,Kalkan Semih,Bayam Emrah,Özkan Mehmet Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. Türk Kardiyoloji Derneği Arşivi 48, no.6 (2020): 566 - 575. 10.5543/tkda.2020.23621
MLA	Çakal Beytullah,Kalçık Macit,Güner Ahmet,Gürsoy Mustafa Ozan,Yesin Mahmut,Karakoyun Süleyman,Gündüz Sabahattin,Kalkan Semih,Bayam Emrah,Özkan Mehmet Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. Türk Kardiyoloji Derneği Arşivi, vol.48, no.6, 2020, ss.566 - 575. 10.5543/tkda.2020.23621
AMA	Çakal B,Kalçık M,Güner A,Gürsoy M,Yesin M,Karakoyun S,Gündüz S,Kalkan S,Bayam E,Özkan M Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. Türk Kardiyoloji Derneği Arşivi. 2020; 48(6): 566 - 575. 10.5543/tkda.2020.23621
Vancouver	Çakal B,Kalçık M,Güner A,Gürsoy M,Yesin M,Karakoyun S,Gündüz S,Kalkan S,Bayam E,Özkan M Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis. Türk Kardiyoloji Derneği Arşivi. 2020; 48(6): 566 - 575. 10.5543/tkda.2020.23621
IEEE	Çakal B,Kalçık M,Güner A,Gürsoy M,Yesin M,Karakoyun S,Gündüz S,Kalkan S,Bayam E,Özkan M "Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis." Türk Kardiyoloji Derneği Arşivi, 48, ss.566 - 575, 2020. 10.5543/tkda.2020.23621
ISNAD	Çakal, Beytullah vd. "Improvement of endothelial function early after thrombolytic therapy in patients with prosthetic heart valve thrombosis". Türk Kardiyoloji Derneği Arşivi 48/6 (2020), 566-575. https://doi.org/10.5543/tkda.2020.23621