Kalp kapak hastalığı ile NT-proBNP ilişkisi
The relationship between NT-proBNP with valvular heart disease
Yazar: FERHAT ÖZYURTLU
Danışman: Y.DOÇ.DR. ÖZGÜR BAYTURAN
Celal Bayar Üniversitesi / Tıp Fakültesi / Kardiyoloji Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2007
Konu: Kardiyoloji = Cardiology

Özet:
Bu gahsmada NT-proBNP' nin kalp kapak hastahgi ile iliskisi, kapak hastahgiciddyeti ile korelasyonunu, kapak replasmani yapilmis, olan hastalardaki seyiyesinindaha dusuk olup olmadigini ve kapak replasmani yapilmis hastalarda kapakfonksiyonu ile iliskisinin olup olmadigini arastirdik. Aynca NYHA fonksiyonel sinifi ilekorelasyonu, ekokardyografk parametreler, yas, vucut kitle ndeksi ve atriyalfibrilasyonla ili§kisi ara§tinldi.Qahsmaya kalp kapak hastahgi olan 81 hasta ve kontrol grubunu olusturmakuzere hi?bir kalp kapak problemi olmayan 12 birey ahndi.Qahsma grubunun ayni cihazla ve ayni kisi tarafindan Vivid-3 Image Pointekokardyografi cihazi ile 1,7 MHz kardyak prob kullanilarak ekokardyografkdegerlendrmeleri yapildi.Qahsma grubundan ahnan kan ornekleri ile Elecys ProBNP sandwchmmunoassay yontemi ile NT-proBNP gahsjldi.Kalp kapak hastahgi olanlarda NT-proBNP duzeyleri ve atriyal fibrilasyonanlamh olarak daha yuksek bulundu. Sol ventrikul gaplan, duvar kahnhklan, solatriyum gapi, Edt degerleri kalp kapak hastahgi olanlarda daha yuksek, SVEF dahadusuk gikti. NT-proBNP duzeyleri ile yas, sol atriyum, NYHA fonksiyonel sinifi, MY veAY ciddyeti arasinda pozitif korelasyon gozlendi fakat VKI ile anlamh iliskigozlenmedi. Aynca AF' u olanlarda anlamh olarak daha yuksek gikti. AVR ve MVR' lihastalarda mtral kapak ve aort kapak hastahgi olanlara gore daha dusuk NT-proBNPseviyeleri gozlendi. Son olarak benzer dger gahsmalardan farkh olarak olasidsfonksiyone AVR' li hastalarda normal fonksiyone AVR' lilere gore daha yuksek NTproBNPduzeyi saptandi.Kalp kapak hastahginin tanisinda , izlemnde, hastahgin progresyonunu erkendonemde saptamada, cerrahi zamanlamasinda ve tedavisinde NT-proBNP onemli birbiyokimyasal parametre olarak kullanilabilir.

Abstract:
In this study we investigated the relationship between NT-proBNP withvalvular heart disease, any correlation in degrees of valvular heart disease with NTproBNP,whether the levels of NT-proBNP are lower in patients had undergone heartvalve replacement and there is a relationship in NT-proBNP values with function ofthe valve in these patients. Also, we observed any relationship in NYHA functionalclass, echocardiographic parameters, age, body mass index (BMI), atrial fibrillationwith NT-proBNP.81 patients with valvular heart diseases as study group and 12 persons withno heart valve problems as control group added the study.Vivid-3 Image Point apparatus with 1.7 MHz cardiac probe used forechocardiographic examination in the study group.Blood samples taken from the study group used to calculate NT-proBNPvalues by using Elecys proBNP sandwich immunassay method.In patients who had valvular heart disease NT-proBNP values and atrialfibrillation were found higher than the control group. Left ventricle size, wallthicknesses, left atrium size, Edt values were higher, LVEF were lower. NT-proBNPvalues were positive correlated with age, left atrium, NYHA functional class, mitraland aortic insufficiency degrees, but there was no correlation in NT-proBNP valuesand BMI. NT-proBNP values also were higher in patients with AF. Patients with AVRor/and MVR had lower NT-proBNP values than patients had mitral and aortic valvedisease. The difference from similar recent studies, in patients had probabledisfunctional AVR, NT-proBNP values are higher than patients had normal functionalAVR.NT-proBNP can be used as an important biochemical marker in diognosis andfollowing up valvular heart disease, to find out the progression of the disease at earlystage and timing of surgery.