Fibromiyalji sendromunda kardiyovasküler sistemin değerlendirilmesi: doku Doppler ekokardiyografik inceleme
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Tarih
2010
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Biz Fibromiyalji (FM) hastalarında kardiyak yapı ve fonksiyonların hem geleneksel hem de yeni ve faydalı bir metot olan doku Doppler ekokardiyografik (DDE) yöntemle incelemeyi amaçladık. Ayrıca, hastalığın patogenezinde olası mekanizmalardan biri olarak gösterilen otonom fonksiyon bozukluğunu elektrokardiyografik olarak QT parametrelerini (QT maksimum, QT minimum ve QT dispersiyonu) ölçerek değerlendirdik. Yöntem: Çalışma aynı kliniğe başvuran 42 hasta (ortalama yaş 41, 38 kadın ) ve kontrol grubu olarak alınan tamamen sağlıklı 38 kişi üzerinde yapıldı. Bireylerin her birine tam bir fizik muayene, elektrokardiyografik (50 mm/s hızla kaydedilen) ve ekokardiyografik (hem geleneksel, hem de DDE) ile değerlendirme yapıldı. Bulgular: Elektrokardiografik kayıtların analizinde QT dispersiyonunda hafif fakat istatistiksel olarak anlamlı olmayan bir artış saptandı. Geleneksel ekokardiyografik parametreler açısından hasta grubu ile kontrol grubu benzerdi. Bununla birlikte bu çalışmanın önemli bir bulgusu hasta grubunda DDE yöntemi ile saptanan gevşeme bozukluğu idi. Em dalga hızı ve Em/Am oranları FM hastalarında kontrollere kıyasla anlamlı düzeyde düşüktü (sırasıyla, p 0.005, p 0.01). Sm ve Am dalga hızları ise her iki grupta da benzerdi. Sonuç: Bu çalışmada hasta grubunda DDE yöntemi ile saptanan sol ventrikülün gevşeme bozukluğu FM’de görülen yorgunluk ve nefes darlığı gibi bazı semptomları kısmen açıklayabilir. Ayrıca tam bir kardiyak değerlendirme yapılması ile fibromiyaljinin patogenezindeki otonomik disfonksiyon teorisini destekleyecek bulgular elde edilebilir.
Aim: We aim to investigate besides the cardiac structures and functions by both conventional methods and Tissue Doppler Echocardiography (TDE) which is a new and useful method in patients with Fibromyalgia (FM). Additionally, we evaluated QT parameters (QT maximum, QT minimum and QT dispertion) with the use of electrocardiography in order to measure the autonomic dysfunction which is a possible mechanism in the pathogenesis of the disease. Methods: The study was performed on 42 patients (mean age 41 years, 38 female) and 38 completely healthy subjects (35 female, mean age of 42 years) who were admitted to the same clinic were collected as the control group. All the individuals were undergone a complete physical examination, electrocardiography (recordings were displayed at 50 mm/s speed) and echocardiography evaluation (both conventional methods and TDE). Results: Analysis of electrocardiographic recordings revealed mildly increased mean QT dispertion in the patient group, but this difference was statistically insignificant. Analysis of conventional echocardiographic parameters revealed similar results between the patient group and the control cases. However, an important finding of this study is that significant diastolic dysfunction was found in the patient group which was recorded with the TDE technique. Em wave velocity and Em/Am ratios were significantly lower in patients with FM compared with controls (p<0.005, p<0.01, respectively). Sm and Am waves velocities were similar in both groups. Conclusion: In this study, significant left ventricular diastolic dysfunction which was detected by TDE technique can partly explain several symptoms such as fatigue and dyspnea in FM. In addition, fully cardiac evaluation of patients with FM might be obtained supporting findings the autonomic dysfunction theory in fibromyalgia pathogenesis.
Aim: We aim to investigate besides the cardiac structures and functions by both conventional methods and Tissue Doppler Echocardiography (TDE) which is a new and useful method in patients with Fibromyalgia (FM). Additionally, we evaluated QT parameters (QT maximum, QT minimum and QT dispertion) with the use of electrocardiography in order to measure the autonomic dysfunction which is a possible mechanism in the pathogenesis of the disease. Methods: The study was performed on 42 patients (mean age 41 years, 38 female) and 38 completely healthy subjects (35 female, mean age of 42 years) who were admitted to the same clinic were collected as the control group. All the individuals were undergone a complete physical examination, electrocardiography (recordings were displayed at 50 mm/s speed) and echocardiography evaluation (both conventional methods and TDE). Results: Analysis of electrocardiographic recordings revealed mildly increased mean QT dispertion in the patient group, but this difference was statistically insignificant. Analysis of conventional echocardiographic parameters revealed similar results between the patient group and the control cases. However, an important finding of this study is that significant diastolic dysfunction was found in the patient group which was recorded with the TDE technique. Em wave velocity and Em/Am ratios were significantly lower in patients with FM compared with controls (p<0.005, p<0.01, respectively). Sm and Am waves velocities were similar in both groups. Conclusion: In this study, significant left ventricular diastolic dysfunction which was detected by TDE technique can partly explain several symptoms such as fatigue and dyspnea in FM. In addition, fully cardiac evaluation of patients with FM might be obtained supporting findings the autonomic dysfunction theory in fibromyalgia pathogenesis.
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Düzce Tıp Fakültesi Dergisi
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12
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1
