Gestasyonel Diabetes Mellitus öyküsü olan hastalarda sol Ventrikül fonksiyonlarının iki boyutlu Speckle Tracking Ekokardiyografi ile değerlendirilmesi
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Dosyalar
Tarih
2020
Yazarlar
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Yayıncı
Medical Network Yayıncılık
Erişim Hakkı
Attribution-NonCommercial-NoDerivs 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Diabetes mellitusun kardiyovasküler hastalıklarla ilişkisi net olarak ortaya konulmasına rağmen, gestasyonel diabetes mellitusun kardiyovasküler hastalıklarla ilişkisi net değildir. Bu çalışmada speckle tracking ekokardiyografi ile önceden gestasyonel diabetes mellitus tanısı alanlarda sol ventrikül fonksiyonları değerlendirilmiştir. Gereç ve Yöntem: Çalışmaya en az 5 yıl önce gestasyonel diabetes mellitus tanısı almış speckle tracking ekokardiyografi ile değerlendirilen 52 hasta (yaş 33±8 yıl) ve demografik verileri uygun 51 sağlıklı kontrol grubu olmak üzere toplamda 103 hasta alındı. Sol ventrikül fonksiyonlarını etkileyebilecek tüm klinik hastalıklar dışlama kriteri olarak alındı. Ekokardiyografik incelemeler, hasta ve kontrol grubuna sol lateral dekübid pozisyonunda medikal ultrasound sistem cihazı kullanılarak yapıldı. Sol ventrikül longitudinal olarak apikal 4-3-2 boşluk görüntülerle mevcut software kullanılarak analiz edildi (QLAB 6.0). Bulgular: İki grup arasında yaş, kan basıncı düzeyi, kalp hızı, temel ekokardiyografi ölçümleri ve Doppler parametreleri arasında fark yoktu. Önceden gestasyonel diabetes mellitus tanısı alanlarda doku Doppler yöntemi ile ölçülen parametrelerde anlamlı azalma görüldü. Speckle tracking ekokardiyografi ölçümlerinde sol ventrikülün hem sistolik hemde diyastolik parametreleri (SRS-2C, SRE-4C, SRE-3C, SRE- 2C,GLSRE, SRA-4C, SLA-3C, SLA-2C, GLSRA, S-4C, S-3C, S-2C, GLS, SRS-4C,SRS-3C ve GLSRS) kontrol grubu ile karşılaştırıldığında anlamlı olarak azalmıştı (p<0,05). Gestasyonel diabetes mellitus tanı süresi ile global longitudinal strain arasında anlamlı negatif korelasyon tespit edildi. Sonuç: Çalışmamızda en az 5 yıl önce gestasyonel diabetes mellitus tanısı alan hastalarda yeni doku Doppler tekniği olan speckle tracking ekokardiyografi yöntemi kullanılarak sol ventrikül fonksiyonlarında bozulma tespit edilmiştir. Ayrıca bu bozulma hastalığın tanı süresi ile korele bulunmuştur. Bu teknikle elde edilen ölçümlerin yüksek düzeydeki uygulanabilirliği ve güvenilirliği, henüz kliniğe ve konvansiyonel ekokardiyografi parametrelerine yansımayan erken miyokardiyal hasarın tespitinde kullanılıp, uygun terapilerden faydalanacak hastaların seçilmesine imkan tanıyabilir.
Objective: Nevertheless, the relationship between diabetes mellitus and cardiovascular diseases is clearly illustrated, but the relationship between gestational diabetes mellitus and cardiovascular diseases is not clear. In this study, speckle tracking echocardiography was used to evaluate the left ventricular functions in patients, previously diagnosed with gestational diabetes mellitus. Material and Method: A total of 103 patients were included in the study, 52 patients (age 33±8 years) were those who were evaluated with speckle tracking echocardiography diagnosed with gestational diabetes mellitus at least 5 years ago, and 51 from healthy control group whose demographic data were appropriate. All clinical diseases that could affect left ventricular function were taken as an exclusion criterion. Echocardiographic investigations were performed in the left lateral decubitus position of the patient and control group using a medical ultrasound system. The left ventricle was analyzed longitudinally with apical 4-3-2 space images using the available software (QLAB 6.0). Results: There was no difference between the two groups in terms of age, blood pressure, heart rate, baseline echocardiography measurements and Doppler parameters. A significant decrease was observed in the parameters measured by tissue Doppler method in the patients who were previously diagnosed with gestational diabetes mellitus. In speckle tracking echocardiography measurements of the left ventricle, both systolic and diastolic parameters (SRS-2C, SRE-2C, SRE-2C, SRE-2C, GLSRE, SRA-4C, SLA-3C, SLA-2C, GLSRA, S-4C, 2C, GLS, SRS-4C, SRS-3C and GLSRS) were notably decreased (p <0.05) compared to the control group. A remarkable negative correlation, between the duration of gestational diabetes mellitus diagnosis and global longitudinal strain, was noticed. Conclusion: In our study, deterioration of left ventricular function was detected by using the new tissue Doppler technique (speckle tracking echocardiography method) in patients diagnosed with gestational diabetes mellitus at least 5 years ago. This deterioration was also correlated with the duration of the disease diagnosis. The high level of applicability and reliability of the measurements obtained by this technique can be used to detect early myocardial damage that is not yet reflected in the clinical and conventional echocardiographic parameters and may allow the selection of patients to benefit from appropriate therapies.
Objective: Nevertheless, the relationship between diabetes mellitus and cardiovascular diseases is clearly illustrated, but the relationship between gestational diabetes mellitus and cardiovascular diseases is not clear. In this study, speckle tracking echocardiography was used to evaluate the left ventricular functions in patients, previously diagnosed with gestational diabetes mellitus. Material and Method: A total of 103 patients were included in the study, 52 patients (age 33±8 years) were those who were evaluated with speckle tracking echocardiography diagnosed with gestational diabetes mellitus at least 5 years ago, and 51 from healthy control group whose demographic data were appropriate. All clinical diseases that could affect left ventricular function were taken as an exclusion criterion. Echocardiographic investigations were performed in the left lateral decubitus position of the patient and control group using a medical ultrasound system. The left ventricle was analyzed longitudinally with apical 4-3-2 space images using the available software (QLAB 6.0). Results: There was no difference between the two groups in terms of age, blood pressure, heart rate, baseline echocardiography measurements and Doppler parameters. A significant decrease was observed in the parameters measured by tissue Doppler method in the patients who were previously diagnosed with gestational diabetes mellitus. In speckle tracking echocardiography measurements of the left ventricle, both systolic and diastolic parameters (SRS-2C, SRE-2C, SRE-2C, SRE-2C, GLSRE, SRA-4C, SLA-3C, SLA-2C, GLSRA, S-4C, 2C, GLS, SRS-4C, SRS-3C and GLSRS) were notably decreased (p <0.05) compared to the control group. A remarkable negative correlation, between the duration of gestational diabetes mellitus diagnosis and global longitudinal strain, was noticed. Conclusion: In our study, deterioration of left ventricular function was detected by using the new tissue Doppler technique (speckle tracking echocardiography method) in patients diagnosed with gestational diabetes mellitus at least 5 years ago. This deterioration was also correlated with the duration of the disease diagnosis. The high level of applicability and reliability of the measurements obtained by this technique can be used to detect early myocardial damage that is not yet reflected in the clinical and conventional echocardiographic parameters and may allow the selection of patients to benefit from appropriate therapies.
Açıklama
Anahtar Kelimeler
Gestasyonel Diabetes Mellitus, Sol Ventrikül Fonksiyonlar, Speckle Tracking Ekokardiyografi, Left Ventricular Functions, Speckle Tracking Echocardiography
Kaynak
MN Kardiyoloji (MN Cardiology)
WoS Q Değeri
Scopus Q Değeri
Cilt
27
Sayı
3
