Koroner arter hastalarında efor testi sonrası kan basıncı toparlanma oranı ile syntax skoru arasındaki ilişki
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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: Koroner arter hastalığı yaygınlığını gösteren SYNTAX skoru ile efor testi sonrası kan basıncı toparlanma oranı arasındaki ilişkinin araştırılması amaçlandı. Yöntem:Çalışmamıza kardiyoloji polikliniğine başvuran, efor testi sonucunda KAG kararı alınan 142 hastadan KAG sonucunda en az bir damarda >%50 lezyon saptanan 98 hasta (79erkek, 19kadın; ortalama yaş: 57.3 ± 7.3) alındı.SYNTAX skoru ≤ 22 olanlar düşük SYNTAX skoru grubunu, >23 olanlar orta-yüksek SYNTAX skoru grubunu oluşturdu. Tüm verilerbu iki grup arasındakarşılaştırılmıştır. SKB toparlanma oranı toparlanma dönemi üçüncü dakika sistolik kan basıncının egzersizde tepe sistolik kan basıncına bölünmesiyle hesaplandı. Bulgular:Sistolik kan basıncı toparlanma oranı düşük SS grubunda 0,87± 0,06 iken orta-yüksek SS grubunda 0,96 ± 0,05 olarak saptanmıştır (p<0,001). Ekokardiyografi bulgularından EF, lateral anüler e′ velositesi, septal annüler velosite ve E/e′orta-yüksek SS grubunda anlamlı olarak düşük(hepsi için p<0,05),SVEDÇ, sol atriyum çapı ve sol atriyum hacmi orta-yüksek SS grubunda anlamlı olarak daha yüksek(hepsi için p<0,05)saptandı.SYNTAX skoru ile ilişkili sürekli değişkenlerin korelasyon analizinde, EF,e′ lateral,E/e′, LA hacmi, SKB toparlanma oranıSYNTAX skoruile korele bulunmuştur. Çok değişkenli lojistik regresyon analizinde SKB toparlanma oranı(OR:1,446, p<0.001) ve EF(OR:0,802, p:0.005)orta-yüksek SYNTAX skorunun bağımsız belirleyicileri olarak saptandı.Yapılan ROC analizinde,cut-off değeri 0,928 olarak alındığında SKB toparlanma oranının%86,1sensitivite,%82,3spesifite ile orta-yüksek SYNTAX skorunu öngördürdüğü saptandı. Eğri altında kalan alan (AUC) 0,892 olarak bulundu (p<0,001). Sonuç: SYNTAX skoru ile sistolik kan basıncı toparlanma oranı arasında güçlü bir korelasyon bulundu. Egzersiz testi sırasında kan basıncı ölçümlerinden kolaylıkla elde edilebilen kan basıncı toparlanma oranı, koroner arter hastalığı yaygınlığı göstermede egzersiz testinin öngördürücülüğünüartırabilir.
Aim:We aimed to investigate the relationship between SYNTAX score, which shows the extent and complexity of coronary artery disease, and systolic blood pressure recovery ratio after exercise test. Methods: Of the 142 patients who underwent coronary angiography after exercise stress test,98 patients (79 males, 19 females; mean age 57,3 ± 7,3) who had at least > 50% occlusion in one coronary artery were includedin our study. Patients were divided into two group as thelow SYNTAX score group (SYNTAX score ≤ 22) and the intermediate-high SYNTAX score group(SYNTAX score > 23). All parameters were compared between these two groups. The systolic blood pressure recovery ratio was calculated by dividing the third minute systolic blood pressure by the peak exercise systolic blood pressure. Results: The SBP recovery ratio was 0.87 ± 0.06 in the low SS group, and 0.96 ± 0.05 in the intermediate-high SS group (p <0.001). Among the echocardiographic findings, EF, lateral e′, septal e′ and E/e ′ were significantly lower (p <0.05 for all), LVEDD, LA diameter and LA volume were significantly higher in the intermediate-high SS group (p <0.05 for all).In the correlation analysis, EF, laterale′ velocity, E/e ′, LA volume, SBP recovery ratiowere correlated with the SYNTAX score. In multivariate logistic regression analysis, we found SBP recovery ratio (OR: 1.446, p <0.001) and EF (OR: 0.802, p= 0.005) to be independent predictors of the intermediate-high SYNTAX score. The cut-off value of SBP recovery ratio obtained by ROC curve analysis was 0.928for prediction of intermediate-high SYNTAX score (sensitivity: 86.1%, specificity: 82.3%). The area under the curve (AUC) was 0.892 (p<0.001). Conclusion: We found a strong correlation between the SYNTAX score and the systolic blood pressure recovery ratio. The SBP recovery ratio, which can be xiv easily obtained during the exercise test, may increasethe predictive ability ofthe exercise test forprediction of the extent of coronary artery disease.
Aim:We aimed to investigate the relationship between SYNTAX score, which shows the extent and complexity of coronary artery disease, and systolic blood pressure recovery ratio after exercise test. Methods: Of the 142 patients who underwent coronary angiography after exercise stress test,98 patients (79 males, 19 females; mean age 57,3 ± 7,3) who had at least > 50% occlusion in one coronary artery were includedin our study. Patients were divided into two group as thelow SYNTAX score group (SYNTAX score ≤ 22) and the intermediate-high SYNTAX score group(SYNTAX score > 23). All parameters were compared between these two groups. The systolic blood pressure recovery ratio was calculated by dividing the third minute systolic blood pressure by the peak exercise systolic blood pressure. Results: The SBP recovery ratio was 0.87 ± 0.06 in the low SS group, and 0.96 ± 0.05 in the intermediate-high SS group (p <0.001). Among the echocardiographic findings, EF, lateral e′, septal e′ and E/e ′ were significantly lower (p <0.05 for all), LVEDD, LA diameter and LA volume were significantly higher in the intermediate-high SS group (p <0.05 for all).In the correlation analysis, EF, laterale′ velocity, E/e ′, LA volume, SBP recovery ratiowere correlated with the SYNTAX score. In multivariate logistic regression analysis, we found SBP recovery ratio (OR: 1.446, p <0.001) and EF (OR: 0.802, p= 0.005) to be independent predictors of the intermediate-high SYNTAX score. The cut-off value of SBP recovery ratio obtained by ROC curve analysis was 0.928for prediction of intermediate-high SYNTAX score (sensitivity: 86.1%, specificity: 82.3%). The area under the curve (AUC) was 0.892 (p<0.001). Conclusion: We found a strong correlation between the SYNTAX score and the systolic blood pressure recovery ratio. The SBP recovery ratio, which can be xiv easily obtained during the exercise test, may increasethe predictive ability ofthe exercise test forprediction of the extent of coronary artery disease.
Açıklama
Anahtar Kelimeler
Kardiyoloji, Cardiology, Kararlı koroner arter hastalığı, Egzersiz testi, SYNTAX skoru, Sistolik kan basıncı toparlanma oranı, Stable coronary artery disease, Exercise test, SYNTAX score, Systolic blood pressure recovery ratio
