Pulmoner arter hipertansiyonu olan KOAH olgularında sağ ve sol ventrikül fonksiyonlarının değerlendirilmesi

Özet

Kliniğimizde yatarak tedavi gören 1'i kadın 15 kronik obstrüktif akciğer hastalığı (KOAH), kor pulmonaleli (KP) olgu değerlendirildi.Tümünde "Grandjean" yöntemine dayanan sağ kalp mikrokateteri yapıldı. Solunum semptomlarının süresi, sigara öyküsü, arter kan gazı, solunum fonksiyon testleri (SFT), PA akciğer grafileri, elektrokardiyografileri ve radyonüklid ventrikülografıleri (MUGA) değerlendirildi. Olgularımızın kan gazı parametrelerinden PaO2 ile ortalama pulmoner arter basınçları (PAB) arasında negatif korelasyon tespit edildi (r= -0.52, p 2.0 EDV/s, %100'ünde SLV TPER 2.5 EDV/s, %80'inde SĞV TPFR 2.5 EDV/s, %53.3 SLV TPFR < 180 ms idi. Sonuç olarak; KOAH'lı olgularda SĞV fonksiyon bozulması yanında SLV fonksiyonları da bozulabilir.

Abstract

In our clinics, 15 patients with chronic obstructive pulmonary disease (COPD) and CP were observed during hospitalization. Right heart microcatheterization to all patients were performed with Grandjean method. Patients were evaluated according to respiratory symptom duration, smoking history, arterial blood gas analysis, pulmonary function tests, chest radiography, electrocardiography and radionuclide ventriculography (MUGA). A negative correlation was determined between PaO2 and mean PAP value (r= -0.52, p< 0.05). A significant correlation was not found between pH, PaCO2, O2 saturation and mean PAP even not MUGA. There is no correlation between respiratory function tests and mean PAP value. A lot of correlation were established between MUGA and respiratory function tests. Correlation analysis between forced vital capacity (FVC %) and RV time of peak ejection rate (TPER) was negative (r= -0.71, p< 0.05), FVC (%) and RV time of peak flow rate (TPFR) was positive (r= 0.77, p< 0.05;, FVC (%) and LV 1/3 of flow rate (1/3 FR) was positive (r= 0.62, p< 0.05), forced expiratory volume in one second (FEV1 %) and RV TPER was negative (r= -0.77, p< 0.05), FEV1 (%) and RV TPFR was positive (r= 0.76, p< 0.05), FEV1 (%) and LV 1/3 FR was positive (r= 0.71, p< 0.05), forced expiratory flow during the middle half of FVC (MMF %) and RV TPER was negative (r= -0.77, p< 0.05), MMF (%) and RV TPFR was positive (r= 0.61, p< 0.05), MMF (%) and LV 1/3 FR was positive (r = 0. 69, p< 0.05). A significant correlation was obtained between mean PAP value and both RV EF, RV TPFR with MUGA. A negative correlation between mean PAP value and RV EF (r= -0.53, p< 0.05) and positive correlation between mean PAP value and RV TPFR (r= 0.59, p< 0.05) were revealed. RV EF was below 45% in 66.7% of patients, LV EF was below 50% in 13.3% of patients. As a result; beside the right ventricular dysfunction, left ventricular dysfunction can be seen on the patients with COPD.