Sol ventrikül anevrizması saptanan olgularda koroner anjiyografik bulgular ve kollateral dolaşımın değerlendirilmesi
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Date
2004-05-10
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Uludağ Üniversitesi
Abstract
Sol ventrikül anevrizması (SVA), akut miyokard infarktüsü (Mİ) sonrası mortalite için, ejeksiyon fraksiyonundan bağımsız bir risk faktörüdür. Çalışmanın amacı, kateter laboratuvarında SVA saptanan olgularda, koroner arter hastalığının yaygınlığı ve kollateral dolaşımı değerlendirmektir. Çalışmaya, koroner anjiyografi uygulanarak SVA saptanan 802 olgu alındı. Olgular, SVA yerleşimi, tutulan damar sayısı, koroner arter hastalığının ağırlığı, kollateral dolaşım (Rentrop grade 0, 1, 2 grup I, grade 3 grup II) değerlendirilerek sınıflandırıldı. Anevrizma olguların % 63’ünde apikal, anterolateral ve septal bölgede, % 37’sinde ise posterobazal, inferior ve lateral bölgede yerleşmişti. Olguların % 50’sinde tek damar, % 32’sinde iki damar, % 18’inde üç damar hastalığı mevcuttu. Sol ön inen arter lezyonlarının % 46’sı tam tıkalı, kollateral akım açısından % 68’i grup I’deydi. Sirkumfleks lezyonlarının % 33’ü tam tıkalı, % 66’sı grup I’de, sağ koroner arter lezyonlarının % 47’si tam tıkalı, % 60’ı grup I’deydi. Tam tıkalı lezyonlarda kollateral dolaşım yetersiz olarak değerlendirildi (p<0.05). Sonuç olarak tek damar tutulumu ve yetersiz kollateral dolaşımın sadece anterior değil, tüm bölgelerde yerleşen anevrizmalarla ilişkili olduğu söylenebilir.
Left ventricular aneurysm is a independent risk factor for mortality rate after acute myocardial infarction. The aim of our study was to evaluate the severity of coronary disease and collateral circulation in a large group of patients with left ventricular aneurysm. To our study 802 cases that were found to have LV aneurysm during cardiac catheterization were enrolled. The localization of aneurysms, number of vessels with significant stenosis, the burden of coronary artery disease and collateral circulation (Rentrop grade 0, 1, 2: group I and grade 3: group II) were evaluated and the cases were grouped accordingly. The aneurysms were located in apical, anterolateral, septal region in 63% of the cases, while they were located in posterobasal, inferior and lateral regions in 37% of them. Among cases 50% had one, 32% had two and 18% had three vessel diseases. Of the LAD lesions 46% were totally occluded and 68% of these totally occluded lesions were included in group I (in terms of the collateral circulation). 32% of the circumflex lesions were totally occluded and 66% of them were included in group I. Right coronary lesions were totally occluded in 47% and 60% of them were in group I. The collateral circulation was insufficient in totally occluded lesions (p<0.05). As a result, single vessel involvement and insufficient collateral circulation are not only associated with anterior region but also with these in other locations.
Left ventricular aneurysm is a independent risk factor for mortality rate after acute myocardial infarction. The aim of our study was to evaluate the severity of coronary disease and collateral circulation in a large group of patients with left ventricular aneurysm. To our study 802 cases that were found to have LV aneurysm during cardiac catheterization were enrolled. The localization of aneurysms, number of vessels with significant stenosis, the burden of coronary artery disease and collateral circulation (Rentrop grade 0, 1, 2: group I and grade 3: group II) were evaluated and the cases were grouped accordingly. The aneurysms were located in apical, anterolateral, septal region in 63% of the cases, while they were located in posterobasal, inferior and lateral regions in 37% of them. Among cases 50% had one, 32% had two and 18% had three vessel diseases. Of the LAD lesions 46% were totally occluded and 68% of these totally occluded lesions were included in group I (in terms of the collateral circulation). 32% of the circumflex lesions were totally occluded and 66% of them were included in group I. Right coronary lesions were totally occluded in 47% and 60% of them were in group I. The collateral circulation was insufficient in totally occluded lesions (p<0.05). As a result, single vessel involvement and insufficient collateral circulation are not only associated with anterior region but also with these in other locations.
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Keywords
Sol ventrikül anevrizması, Koroner anjiyografi, Kollateral dolaşım, Left ventricular aneurysm, Coronary angiography, Collateral circulation
Citation
Gemici, K. vd. (2004). "Sol ventrikül anevrizması saptanan olgularda koroner anjiyografik bulgular ve kollateral dolaşımın değerlendirilmesi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 30(2), 67-70.