Stabil kronik obstrüktif akciğer hastalığı olan hastalarda koroner arter hastalığı erken tanısında miyokard perfüzyon sintigrafisi ve koroner kalsiyum skorunun değeri
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Date
2012
Authors
Alişir, Mehmet Fethi
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Sigara, yaş, obezite gibi ortak risk faktörleri ve inflamatuvar bir patofizyolojiye sahip olan koroner arter hastalığı ve kronik obstrüktif akciğer hastalığı (KOAH) sıklıkla birlikte bulunmaktadır. İleri evre KOAH hastalarında miyokard infarktüs riskinin yüksek olduğu ve ölümlerin %25'inin kardiyovasküler hastalıklardan olduğu bilinmektedir. Erken evre de ise bu konudaki bilgilerimiz sınırlıdır. Ancak biliyoruz ki, toplumda önemli bir morbidite ve mortalite nedeni olan koroner arter hastalığında erken tanı, ilerde gelişebilecek miyokard infarktüs, malign aritmi, kalp yetersizliği ve mortaliteyi azaltmaktadır.Çalışmamızda GOLD sınıflamasına göre Evre II KOAH hastalarında koroner arter hastalığı erken tanısında, miyokard perfüzyon sintigrafisi ve koroner kalsiyum skoru'nun kullanılabilirliğinin belirlenmesi, risk faktörleri göz önüne alınarak daha riskli hastaların seçilebilmesi amaçlandı.Çalışmada 40-50 yaş arası, daha öncesinde koroner arter hastalığı ve kalp yetersizliği olmayan, GOLD sınıflamasına göre Evre II olan 30 KOAH hastası alındı. Risk faktörleri belirlendi ve hastaların hepsine miyokard perfüzyon sintigrafisi ve koroner kalsiyum skoru yapıldı.Sonuç olarak FEV1 değeri düşük, 10 yıl ve üzerinde KOAH tanısı bulunan, fiziksel inaktivite ve/veya aile öyküsü olan, erkek hastalarda koroner kalsiyum skoru yüksek olarak saptandı.Çalışma örneklemi az olsa da; koroner arter hastalığı açısından diyabet, hipertansiyon, hiperlipidemi gibi risk faktörlerinden bağımsız olarak erkek olup, 10 yıl üzerinde KOAH tanısı bulunan, fiziksel inaktivite ve/veya aile öyküsü olan Evre II KOAH hastaları mutlaka koroner arter hastalığı açısından erken dönemde incelenmeli ve koroner olaylar açısından takip edilmelidir.
Coronary artery disease and chronic obstructive pulmonary disease (COPD); which have the common risk factors such as obesity, smoking, age and have an inflammatory pathophysiology are often seen together. The high risk of myocardial infarction in patients with advanced stage of COPD and 25% of deaths from cardiovascular diseases have been known. The information about early stages of topic is limited. However, we know that, the early diagnosis of coronary artery disease a major cause of morbidity and mortality in the community, reduces the risk of myocardial infarction, malignant arrhythmia, heart failure and mortality.In our study, it was aimed to determine the availability of coronary calcium score and myocard perfusion scintigraphy in the early diagnosis of coronary artery disease in GOLD classification stage II patients with COPD and to select patient having high risk.In the study, 40-50 years old, 30 patients with GOLD classification stage II COPD who have no coronary artery disease and heart failure was included. The risk factors were determined and all patients were applied the myocard perfusion scintigraphy and coronary calcium scores.As a result, the coronary calcium score was higher in patients having low FEV1 value, 10 years and over COPD, physical inaktivite and/or family history and in male patients.Although the study sample was small; regardless of risk factors of coronary artery disease as diabetes, hypertension, hyperlipidemia , male stage II COPD patients who diagnosis of COPD over 10 years and have physical inaktivite and/or a family history should be investigated about coronary artery disease early period and should be followed for the coronary events.
Coronary artery disease and chronic obstructive pulmonary disease (COPD); which have the common risk factors such as obesity, smoking, age and have an inflammatory pathophysiology are often seen together. The high risk of myocardial infarction in patients with advanced stage of COPD and 25% of deaths from cardiovascular diseases have been known. The information about early stages of topic is limited. However, we know that, the early diagnosis of coronary artery disease a major cause of morbidity and mortality in the community, reduces the risk of myocardial infarction, malignant arrhythmia, heart failure and mortality.In our study, it was aimed to determine the availability of coronary calcium score and myocard perfusion scintigraphy in the early diagnosis of coronary artery disease in GOLD classification stage II patients with COPD and to select patient having high risk.In the study, 40-50 years old, 30 patients with GOLD classification stage II COPD who have no coronary artery disease and heart failure was included. The risk factors were determined and all patients were applied the myocard perfusion scintigraphy and coronary calcium scores.As a result, the coronary calcium score was higher in patients having low FEV1 value, 10 years and over COPD, physical inaktivite and/or family history and in male patients.Although the study sample was small; regardless of risk factors of coronary artery disease as diabetes, hypertension, hyperlipidemia , male stage II COPD patients who diagnosis of COPD over 10 years and have physical inaktivite and/or a family history should be investigated about coronary artery disease early period and should be followed for the coronary events.
Description
Keywords
Koroner arter hastalığı, Kronik obstrüktif akciğer hastalığı, Miyokard perfüzyon sintigrafisi, Koroner kalsiyum skoru, Coronary artery disease, Chronic obstructive pulmonary disease, Myocard perfusion scintigraphy, Coronary calcium score
Citation
Alişir, M. F. (2012). Stabil kronik obstrüktif akciğer hastalığı olan hastalarda koroner arter hastalığı erken tanısında miyokard perfüzyon sintigrafisi ve koroner kalsiyum skorunun değeri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.