Trombolitik tedavi uygulanarak reperfüzyon sağlanan akut miyokard infarktüslü olgularda periferik monositoz ile miyokard hasarının ilişkisi
Loading...
Date
2005-12-19
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Akut miyokard infarktüsü sonrası infarktüs alanının iyileşmesinde monosit ve makrofajların rolü olduğu bilinmektedir. Ortaya çıkan iyileşme ile miyokardın yerine bağ dokusu geçerek sol ventrikül fonksiyonunun bozulmasına neden olmaktadır. Çalışmamız, akut ST elevasyonlu miyokard infarktüsü (Mİ) sonrası sol ventrikül fonksiyonları ile periferik kandaki monositoz arasındaki ilişkiyi değerlendirmek üzere planlandı. Çalışmaya akut Mİ tanısıyla yatırılıp, trombolitik tedavi uygulanan ve reperfüzyon sağlanan 30 olgu alındı. Olgularda başvuruda, 2-4’üncü günlerde hemogram, 3-5. günler arasında ekokardiyografik değerlendirme yapıldı. Hastaların bazal ve 4. günde periferik kanda bulunan monosit, nötrofil yüzdeleri, lökosit sayıları ile sol ventrikül ejeksiyon fraksiyonu karşılaştırıldı. Ejeksiyon fraksiyonu, olguların 17’sinde %45’in altında (grup I), 13’ünde % 45’ten yüksek (grup II) bulundu. Grup I’de 4. gündeki monosit yüzdesinde bazale göre anlamlı miktarda artış (grup I’de %5.2±4.4-%10.8±3.0, p<0.001) izlenirken, grup II’de anlamlı farklılık gözlenmedi (Grup II %7.3±3.1-7.7±2.5, p<0.001 ). Sonuç olarak akut Mİ sonrası periferik kandaki monosit oranı artışının, sol ventrikül hasarının göstergesi olabileceği görüşüne varıldı.
Monocytes and macrophages are known to play a role in recovery of enfarct zone after myocardial infarction. Connective tissue replaces myocardium and in turn causes deterioration of the ventricular functions. This study was planned to investigate the associaton of left ventricular functions with monocytosis in peripheral blood in myocardial infarction (MI) with acute ST elevation. In the study were enrolled 30 patients with acute myocardial infarction treated by thrombolysis in success of reperfusion of the artery involved. Hemograms were evaluated at baseline, at 2-4 days. Echocardiography was performed at 3-5 days. Baseline and the fourth day values of the monocyte count, percent of neutrophiles, leucocyte count and left ventricular ejection fraction were compared. Ejection fraction was below 45% in 17 cases (Group I), above 45% in 13 cases (Group II). While in group I a significant increase in monocyte percent at 4th day compared to baseline was noticed (in group I %5.2±4.4-%10.8±3.0, p<0.001), there was no significant change in group II (Grup II %7.3±3.1-7.7±2.5, p<0.001). As a result, it was concluded that the increase in monocyte increase in peripheral blood after acute MI may be an indicator of left ventricular damage.
Monocytes and macrophages are known to play a role in recovery of enfarct zone after myocardial infarction. Connective tissue replaces myocardium and in turn causes deterioration of the ventricular functions. This study was planned to investigate the associaton of left ventricular functions with monocytosis in peripheral blood in myocardial infarction (MI) with acute ST elevation. In the study were enrolled 30 patients with acute myocardial infarction treated by thrombolysis in success of reperfusion of the artery involved. Hemograms were evaluated at baseline, at 2-4 days. Echocardiography was performed at 3-5 days. Baseline and the fourth day values of the monocyte count, percent of neutrophiles, leucocyte count and left ventricular ejection fraction were compared. Ejection fraction was below 45% in 17 cases (Group I), above 45% in 13 cases (Group II). While in group I a significant increase in monocyte percent at 4th day compared to baseline was noticed (in group I %5.2±4.4-%10.8±3.0, p<0.001), there was no significant change in group II (Grup II %7.3±3.1-7.7±2.5, p<0.001). As a result, it was concluded that the increase in monocyte increase in peripheral blood after acute MI may be an indicator of left ventricular damage.
Description
Bu çalışma 18. Ulusal Kardiyoloji Kongresi’nde (5-8 Ekim 2002, Antalya) poster olarak tebliğ edilmiştir.
Keywords
Akut miyokard infarktüsü, Monositoz, Remodeling, Acute myocardial infarction, Remodeling, Monocytosis
Citation
Baran, İ. vd. (2005). ''Trombolitik tedavi uygulanarak reperfüzyon sağlanan akut miyokard infarktüslü olgularda periferik monositoz ile miyokard hasarının ilişkisi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 31(2), 95-98.