Markers of arrhythmia in patients with left ventricular outflow tract stenosis and coartation of aort

Özlem Saraç Sandal; Timur Meşe; Rahmi Özdemir; Cem Karadeniz

doi:10.7197/223.vi.539328

EN TR

Markers of arrhythmia in patients with left ventricular outflow tract stenosis and coartation of aort

Abstract

Objective: Arrhythmias due to congenital heart diseases are found to be the second most common cause of mortality after ischemic heart diseases in several studies. Coarctation of the aorta, hypertrophic cardiomyopathy and aort stenosis increase afterload of the left ventricle and as a result of this, they cause an increase in wall stress in the early and hypertophy of the wall in the late phase. This condition leads a corruption in ventricular and atrial conduction and predisposes to arrhythmias. In this study, we intended to examine the risks with indicators like P dis, QT dis, Tp-e for arrhythmias in diseases with left ventricular outflow tract stenosis in children.

Method: 101 patients with with left ventricular outflow tract stenosis (coarctation of the aorta, idiopathic hypertrophic subaortic stenosis, hypertrophic cardiomyopathy and aortic stenosis) in pediatric age group who were diagnosed between 2008-2014 in Dr. Behçet Uz Children’s Training and Research Hospital were included in this study. 110 healthy children were included in this study as a control group. Pdis, corrected QT, QT dis ve Tp-e and Tp-e /QT indices in both groups were were calculated and compared using standard 12-lead ECG.

Results: P max, corrected QT, Pdis, QTdis, Tp-e and Tp-e/QT in patient group were found to be significantly higher than the control group. There was no difference between sub-groups of patient group according to Pmax, corrected QT, P dis, QT dis, Tp-e and Tp-e/QT. There was also no difference between beta blocker users and non-users according to P max, corrected QT, P dis, QT dis, Tp-e and Tp-e/QT.

Conclusions: High P max, corrected QT, P dis, QT dis, Tp-e and Tp-e/QT in the patient group showed the risk for ventricular arrhythmias and atrial fibrillation in patients with left ventricular outflow tract stenosis.

Keywords

sudden cardiac death,QT dispersion,arrhythmia,electrocardiography

Sol ventrikül çıkış yolu darlığı ve aort koarktasyonu olan olgularda aritmi belirteçleri

Öz

Amaç: Konjenital kalp hastalıklarına ait aritmilerin ani kardiyak ölüm riski açısından iskemik hastalıklara bağlı aritmilerden sonra en sık mortalite nedeni olduğu gösterilmiştir. Aort koarktasyonu, hipertrofik kardiyomyopati ve aort stenozu gibi hastalıkların varlığında sol ventikül ard yükü belirgin artmakta bunun sonucu olarak da erken dönemde artmış duvar stresi ve geç kompansatuvar ventrikül hipertrofisi ortaya çıkmaktadır. Tüm bunlar da ventrikül ve atriyal iletimi bozarak aritmilere yatkınlık oluşturabilmektedir. Bu çalışmada, çocukluk çağında sol ventrikül çıkış yolunda darlığa yol açan kardiyak patolojilerde aritmilere yatkınlığın ortaya konması amaçlanmıştır.

Yöntem: 2008-2014 yılları arasında tanısı konan ve hastanemizde izlenen sol ventrikül çıkış yolunda darlığa neden olacak kardiyak patolojisi olan 101 hasta çalışmaya dahil edildi. Kontrol grubu olarak 110 sağlıklı çocuk alındı.Standart 12 derivasyonlu EKG’de hastaların P dispersiyonu(dis), QTd(değişkenlik), QT intervali, QTdis ve Tp-e ve Tp-e /QT indeks değerleri hesaplandı.

Bulgular: Hasta grubunda Pmaks, QTd, Pdis, QTdis, Tp-e ve Tp-e/QT indeksleri kontrol grubuna göre belirgin yüksek saptandı. Hasta grubunu oluşturan alt gruplarda Pmaks, QTd, Pdis, QTdis, Tp-e ve Tp-e/QT indeksleri açısından gruplar arası anlamlı istatistiksel fark saptanmadı. Beta bloker kullanan ve kullanmayan hasta gruplarında da bu parametreler açısından anlamlı fark saptanmadı.

Sonuç: Çalışmamızda aritmi belirteçleri olarak değerlendirdiğimiz Pmaks, Pdis, QTd, QTdis, Tp-e, Tp-e/QT hasta grubunda kontrol grubuna göre belirgin artmış izlenmiş ve bu da bu hastaların hem atriyal fibrilasyon hem de ventriküler aritmiler açısından risk altında olduğunu göstermiştir.

Anahtar Kelimeler

aritmi,ani kardiyak ölüm,dispersiyon,elektrokardiyografi

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Özlem Saraç Sandal ^*
Türkiye

Timur Meşe
Türkiye

Rahmi Özdemir
Türkiye

Cem Karadeniz
Türkiye

Yayımlanma Tarihi

28 Mart 2019

Gönderilme Tarihi

13 Mart 2019

Kabul Tarihi

26 Mart 2019

Yayımlandığı Sayı

Yıl 2019 Cilt: 41 Sayı: 1

DOI

https://doi.org/10.7197/223.vi.539328

IZ

https://izlik.org/JA27MB34XM

Kaynak Göster

RIS / Bibtex

AMA

1.Saraç Sandal Ö, Meşe T, Özdemir R, Karadeniz C. Markers of arrhythmia in patients with left ventricular outflow tract stenosis and coartation of aort. CMJ. 2019;41(1):19-27. doi:10.7197/223.vi.539328