Kronik obstrüktif akciğer hastalığı akut alevlenmelerinde sağ kalp fonksiyonlarının ekokardiyografi ile değerlendirilmesi
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Tarih
2020
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Kronik obstrüktif akciğer hastalığı (KOAH)'ın atak döneminin başta sağ kalp olmak üzere kalbin anatomik ve fonksiyonel değişiklikleri üzerine olan etkisinin incelenmesi amaçlandı. Materyal ve Metot: Çalışmaya hastanemiz göğüs hastalıkları polikliniğine başvuran 30 KOAH atak ve 30 kontrol hastası çalışmaya dahil edildi. Hastaların demografik özellikleri, fizik muayene bulguları, solunum fonksiyon testleri sonuçları, ekokardiyografi bulguları değerlendirildi. KOAH atak hastalarının 2.-3. haftalar esnasında kontrol solunum fonksiyon testi ve ekokardiyografik bulguları tekrar değerlendirildi. Bulgular: Çalışmamızda KOAH'lı hastaların yaş ortalaması62,6±11,6 yıl, olup; hastaların %63,3'ü erkekti. Vaka ve kontrol grubu arasında yaş, cinsiyet, BMI, meslek,sigara içiciliği, komorbidite açısından farklılık saptanmadı (sırasıyla p:0,923; p:1,000; p:0,056; p:0,839; p:0,842; p:1,000). Sigara içme sıklığı, KOAH'lı grupta yüksek saptandı (p:0,003).Gruplar arasında aort kökü, asendan aorta çapı, IVSD, LVPWD, mitral yetmezlik derecesi, aort kapağı yetmezlik derecesi, pulmoner yetmezlik derecesi, triküspüt yetmezlik derecesi, TAPSE, FAC, RV E', RV A' ve RV S' açısından farklılık saptanmadı (sırasıyla p:0,986; p:0,680; p:0,883; p:0,720; p:0,738; p:0,338; p:0,600; p:0,690; p:0,669; p:0,886; p:0,402; p:0,927; p:0,619). KOAH grubunda LA,LVSSÇ, LVDSÇ, PAB, RV anlamı olarak büyük (sırasıyla p:0,001;p:0,002; p:0,002; p:0,008; p:0,000). EF, RA anlamlı olarak küçük saptandı (sırasıyla p:0,036; p:0,006).KOAH hastalarında PAB'ın atak döneminde arttığı(p:0,022);TAPSE ve FAC'ın anlamlı olarak azaldığısaptandı (sırasıyla p:0,017; p:0,001). Sonuç: KOAH akut atak döneminde anatomik değişiklikler olmazsa da, PAB'ın atak döneminde arttığı, TAPSE ve FAC'ın atak döneminde azaldığısaptandı. Bu durumun kronik dönemde olan değişikliklerin temelini oluşturduğu kanısındayız.
Objective: The aim of the present study was to investigate the effect of Chronic obstructive pulmonary disease (COPD) during attack period on anatomic and functional changes of the heart, and mainly on the right heart. Material and Method:This study included 30 patients with COPD attack who have referred and 30 individuals for the control group. Demographic characteristics, physical examination findings, respiratory function test results, and echocardiography findings of the patients were reviewed. Respiratory function test and echocardiographic findings of the patients with COPD attack were re-evaluated for the control within weeks 2 and 3. Results: In the present study, the age average of the patients with COPD was 62,6±11,6 years; 63,3% of the patients ere male. There was not any difference between the patient and control groups for age, gender, BMI, occupation, smoking status, and co-morbidity (respectively; p:0,923; p:1,000; p:0,056; p:0,839; p:0,842; p:1,000). Smoking prevalence was detected higher in the COPD group (p:0,003). There was not any difference detected between the groups for aortic root, diameter of the ascending aorta, IVSD, LVPWD, mitral failure grade, aortic valve failure grade, pulmonary failure grade, tricuspide failure grade, TAPSE, FAC, RV, E', RV A' and RV S' respectively; p:0,986; p:0,680; p:0,883; p:0,720; p:0,738; p:0,338; p:0,600; p:0,690; p:0,669; p:0,886; p:0,402; p:0,927; p:0,619). In the COPD group, LA, LVSSD, LVDSD, PAB, RV were significantly higher(respectively; p:0,001; p:0,002; p:0,002; p:0,008; p:0,000); however, EF and RA were significantly lower (respectively; p:0,036; p:0,006). It was detected that PAB increased(p:0,022); and TAPSE and FAC significantly decreased in COPD patients during attack period (respectively; p:0,017; p:0,001) Conclusion: Although there is not any anatomic change during acute period of COPD, it was detected that PAB increased, TAPSE and FAC decreased during attack period. We believe that this constitutes the basis for the changes during chronic period. Key words: COPD exacerbation, right heart functions
Objective: The aim of the present study was to investigate the effect of Chronic obstructive pulmonary disease (COPD) during attack period on anatomic and functional changes of the heart, and mainly on the right heart. Material and Method:This study included 30 patients with COPD attack who have referred and 30 individuals for the control group. Demographic characteristics, physical examination findings, respiratory function test results, and echocardiography findings of the patients were reviewed. Respiratory function test and echocardiographic findings of the patients with COPD attack were re-evaluated for the control within weeks 2 and 3. Results: In the present study, the age average of the patients with COPD was 62,6±11,6 years; 63,3% of the patients ere male. There was not any difference between the patient and control groups for age, gender, BMI, occupation, smoking status, and co-morbidity (respectively; p:0,923; p:1,000; p:0,056; p:0,839; p:0,842; p:1,000). Smoking prevalence was detected higher in the COPD group (p:0,003). There was not any difference detected between the groups for aortic root, diameter of the ascending aorta, IVSD, LVPWD, mitral failure grade, aortic valve failure grade, pulmonary failure grade, tricuspide failure grade, TAPSE, FAC, RV, E', RV A' and RV S' respectively; p:0,986; p:0,680; p:0,883; p:0,720; p:0,738; p:0,338; p:0,600; p:0,690; p:0,669; p:0,886; p:0,402; p:0,927; p:0,619). In the COPD group, LA, LVSSD, LVDSD, PAB, RV were significantly higher(respectively; p:0,001; p:0,002; p:0,002; p:0,008; p:0,000); however, EF and RA were significantly lower (respectively; p:0,036; p:0,006). It was detected that PAB increased(p:0,022); and TAPSE and FAC significantly decreased in COPD patients during attack period (respectively; p:0,017; p:0,001) Conclusion: Although there is not any anatomic change during acute period of COPD, it was detected that PAB increased, TAPSE and FAC decreased during attack period. We believe that this constitutes the basis for the changes during chronic period. Key words: COPD exacerbation, right heart functions
Açıklama
Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases, KOAH alevlenme, sağ kalp fonksiyonları
