Prediyabetik bireylerde subklinik sol ventrikül sistolik disfonksiyonunun yeni bir ekokardiyografik modalite olan "automated function imaging" metodu ile değerlendirilmesi
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Tarih
2013
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Yayıncı
Maltepe Üniversitesi, Tıp Fakültesi
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CC0 1.0 Universal
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Diyabetik kardiyomiyopati, diyabetin mortalite ve morbiditesi yüksek olan önemli bir komplikasyonudur. Diyabetik kardiyomyopati; koroner arter hastalığı, hipertansiyon gibi diğer faktörlerden bağımsız olarak sol ventrikül sistolik ve diyastolik fonksiyonlarının bozulması ile gelişen kalp yetersizliği olarak tanımlanmaktadır. Prediyabet, diyabet gelişimini ön gördüren güçlü bir risk faktörü olarak değerlendirilir ve diyabet öncesi uzun bir süreci kapsamaktadır. Prediyabetik bireylerde kardiyak fonksiyonların erken dönemde değerlendirilmesi hedef organ hasarının engellenmesi açısından önem taşımaktadır. Bu çalışmanın amacı; konvansiyonel ekokardiyografik yöntemler ile korunmuş sol ventrikül sistolik fonksiyonu olan prediyabetik hastalarda yeni ekokardiyografik modalitelerden olan speckle tracking ekokardiyografi yöntemi ile sol ventrikül global longitudinal strain değerlendirilerek subklinik miyokard disfonksiyonunun saptanmasıdır. ÇALIŞMA PLANI: Çalışmaya 41?i prediyabetik, 37?si kontrol olmak üzere toplam 78 birey alındı. Çalışmaya katılan tüm bireylerin konvansiyonel, doku Doppler ve speckle tracking ekokardiyografiye dayalı (AFI) global longutidunal strain verileri ekokardiyografik olarak değerlendirildi. SONUÇLAR: Yaş, cinsiyet, sigara, BMI, kan basıncı açısından her iki grup arasında anlamlı fark bulunmazken, prediyabetik bireylerde sol ventrikül longitudinal sistolik strain değerleri (19 % ± 2 % ye 20 % ± 2, P= ,034) ve E/A oranı (1,03 ± 0,22 ye 1,29 ± 0,44, P= ,002) kontrol grubuna göre anlamlı derecede düşük, E/E? oranı ise anlamlı derecede yüksek (9,53 ± 2,3?e 7,61 ± 2,59, P= ,001) bulundu. Kolesterol (220,22 ± 47,23?e 191,41 ± 38,83, P= ,005), LDL(147,06 ± 40,43?e 119,93 ± 32,76, P= ,002) ve TG (155,20 ± 107,06?e 88,11 ± 59,53, P= ,001) düzeyleri ile boy (169,00 ± 8,66? ya 165,11 ±7,38, p= ,037), kilo (78,07 ± 13,31? e 71,92 ± 13,77, P= ,048) ve bel çevresi (90,50 ± 9,70?e 84,70 ± 10,08, P = ,012) ölçümleri de prediyabetiklerde kontrol grubuna göre anlamlı derecede yüksek bulundu. TARTIŞMA: Çalışmanın sonucunda; diyabet gelişiminden önce prediyabetik dönemde bile subklinik LV sistolik disfonksiyonu gelişebileceği gösterilmiştir. Prediyabetik bireylerde subklinik LV sistolik disfonksiyonunun saptanması; diyabet ve komplikasyonlarının gelişmesi açısından yüksek risk gruplarının belirlenmesi ve önleyici tedbirlerin alınması ile ilgili sağlık politikalarının belirlenmesine katkıda bulunacaktır.
OBJECTIVE: Diabetic cardiomyopathy is a major complication of diabetes which has high morbidity and mortality. Diabetic cardiomyopathy is defined as the heart failure resulting from left ventricular systolic and diastolic dysfunction which is independent from factors such as coronary artery disease and hypertension. Prediabetes is known as a strong risk factor for the development of diabetes which needs a long time before formation of diabetes. Early evaluation of cardiac function is important for the prevention of target organ damage in prediabetic individuals. The aim of this study is to evaluate subclinical myocardial dysfunction with a new echocardiographic modalities method, namely speckle tracking echocardiographic method (AFI), in prediabetic patients who has preserved left ventricular systolic function which is evaluated by using conventional echocardiographic method. METHODS: 78 subjects (41 with prediabetes and 37 as control) were included in this study. All subjects? conventional, tissue Doppler and longitudinal strain based on speckle tracking imaging (AFI) data were evaluated by echocardiographic methods. RESULTS: There were no significant differences between the two groups from the aspects of age, gender, smoking, BMI and blood pressure. The mean longitudinal systolic strain values (19,22 % ± 2,68 % vs 20,37 % ± 2,02, P= ,034) and the ratio of Em/Ea (1,03 ± 0,22 vs 1,29 ± 0,44, P= ,002) were found significantly lower in prediabetic patients than those in controls, whereas the ratio of E/E?(9,53 ± 2,3 vs 7,61 ± 2,59, P= ,001) was significantly higher. The mean total cholesterol (220,22 ± 47,23 vs 191,41 ± 38,83, P= ,005), LDL (147,06 ± 40,43 vs 119,93 ± 32,76, P= ,002) and trigliserid (155,20 ± 107,06 vs 88,11 ± 59,53, P= ,001) levels and the measures of mean height (169,00 ± 8,66 vs 165,11 ± 7,38, P= ,037), weight (78,07 ± 13,31 vs 71,92 ± 13,77, P= ,048) and waist circumference (90,50 ± 9,70 vs 84,70 ± 10,08, P= ,012) were statistically higher in prediabetic patients compared with the ones in control group. CONCLUSION: The results of this study revealed that the subclinical LV systolic dysfunction may develop also in the period of prediabetes before the development of diabetes. Detection of subclinical LV systolic dysfunction in prediabetic individuals will contribute to determine high-risk groups for the development of diabetes and its complications, and also to specify health policies regarding to take preventive eactions.
OBJECTIVE: Diabetic cardiomyopathy is a major complication of diabetes which has high morbidity and mortality. Diabetic cardiomyopathy is defined as the heart failure resulting from left ventricular systolic and diastolic dysfunction which is independent from factors such as coronary artery disease and hypertension. Prediabetes is known as a strong risk factor for the development of diabetes which needs a long time before formation of diabetes. Early evaluation of cardiac function is important for the prevention of target organ damage in prediabetic individuals. The aim of this study is to evaluate subclinical myocardial dysfunction with a new echocardiographic modalities method, namely speckle tracking echocardiographic method (AFI), in prediabetic patients who has preserved left ventricular systolic function which is evaluated by using conventional echocardiographic method. METHODS: 78 subjects (41 with prediabetes and 37 as control) were included in this study. All subjects? conventional, tissue Doppler and longitudinal strain based on speckle tracking imaging (AFI) data were evaluated by echocardiographic methods. RESULTS: There were no significant differences between the two groups from the aspects of age, gender, smoking, BMI and blood pressure. The mean longitudinal systolic strain values (19,22 % ± 2,68 % vs 20,37 % ± 2,02, P= ,034) and the ratio of Em/Ea (1,03 ± 0,22 vs 1,29 ± 0,44, P= ,002) were found significantly lower in prediabetic patients than those in controls, whereas the ratio of E/E?(9,53 ± 2,3 vs 7,61 ± 2,59, P= ,001) was significantly higher. The mean total cholesterol (220,22 ± 47,23 vs 191,41 ± 38,83, P= ,005), LDL (147,06 ± 40,43 vs 119,93 ± 32,76, P= ,002) and trigliserid (155,20 ± 107,06 vs 88,11 ± 59,53, P= ,001) levels and the measures of mean height (169,00 ± 8,66 vs 165,11 ± 7,38, P= ,037), weight (78,07 ± 13,31 vs 71,92 ± 13,77, P= ,048) and waist circumference (90,50 ± 9,70 vs 84,70 ± 10,08, P= ,012) were statistically higher in prediabetic patients compared with the ones in control group. CONCLUSION: The results of this study revealed that the subclinical LV systolic dysfunction may develop also in the period of prediabetes before the development of diabetes. Detection of subclinical LV systolic dysfunction in prediabetic individuals will contribute to determine high-risk groups for the development of diabetes and its complications, and also to specify health policies regarding to take preventive eactions.
Açıklama
Anahtar Kelimeler
Diyabetik kardiyomiyopati, Prediyabet, Speckle-tracking imaging, LV longitudinal strain, Diabetic cardiomyopathy, Prediabetes
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Demirbaş Yalçın, İ. (2013). Prediyabetik bireylerde subklinik sol ventrikül sistolik disfonksiyonunun yeni bir ekokardiyografik modalite olan "automated function imaging" metodu ile değerlendirilmesi / The evaluation of subclinical left ventricular systolic dysfunction in prediabetic patients with a new echocardiographic modality (afi, automated function imaging) method (Yayımlanmamış Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.