Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Sol Ventrikülün Yeniden Şekillenme Tipleri ile İnflamatuar Belirteçleri Arasındaki İlişki
The Relationship Between Left Ventricle Remodelling Types and Inflammatory Markers
Ömer KÜMETa, Berat ENGİNb, Remzi SARIKAYAa, Semih SÜRMENc, İmran ÖNÜRd, Dursun ATILGANc
aSağlık Bilimleri Üniversitesi Van Bölge Eğitim ve Araştırma Hastanesi, Kardiyoloji ABD, Van, TÜRKİYE
bManavgat Devlet Hastanesi, Kardiyoloji Kliniği, Antalya, TÜRKİYE
cİstanbul Üniversitesi Tıp Fakültesi, Kardiyoloji ABD, İstanbul, TÜRKİYE
dMemorial Bahçelievler Hastanesi, Kardiyoloji Kliniği, Van, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2021;41(3):266-73
doi: 10.5336/medsci.2021-82586
Article Language: TR
ÖZET
Amaç: Birçok kardiyovasküler hastalıkta, prognoz belirleyici ve risk faktörü olarak inflamatuar biyobelirteçler gösterilmiş. Bu çalışmamızda, Nötrofil/Lenfosit oranı (NLO), Platelet/Lenfosit oranı (PLO) ve yüksek duyarlılıklı-C-reaktif proteinin [high sensitivity-C-reactive protein (hs-CRP)] sol ventrikül yeniden şekillenme ile ilişkisi araştırılmıştır. Gereç ve Yöntemler: Bu çalışmaya, İstanbul Üniversitesi Tıp Fakültesi Kardiyoloji polikliniğine başvuran 122 hasta dâhil edilmiştir. Tüm hastalardan 12 saatlik açlık sonrası kan örnekleri alınmış olup, ekokardiyografik değerlendirmeler sonrası hastalar erkek ve kadın farkı gözetilerek normal geometri, konsantrik sol ventrikül hipertrofisi (SVH), eksantrik SVH ve konsantrik yeniden şekillenme (KYŞ) olmak üzere 4 gruba ayrıldı. Bulgular: Bu çalışmadaki 30 kişi, ekokardiyografide sol ventrikül fonksiyonları ve geometrisi normal olan kontrol grubuydu. Otuz hastada konsantrik SVH, 30 kişide eksantrik SVH ve 32 kişide KYŞ mevcuttu. Sol ventrikül geometrisi değişmiş tüm hastalarda, nötrofil değerleri normallere göre anlamlı olarak artmıştı. Ayrıca bu hasta gruplarında hs-CRP ve NLO düzeyleri normal geometrisi olanlara göre daha yüksekti ancak bu fark sadece NLO'da istatistiksel olarak anlamlı olma eğilimindeydi (p=0,05). Bu fark özellikle eksantrik SVH'ye sahip hasta grubunda daha belirgindi. PLO değeri ise tüm hasta gruplarında anlamlı farklılık göstermedi. Sonuç: Çalışmamızda, NLO parametresi, sol ventrikül remodeling geçiren tüm hastalarda normale göre daha yüksektir. Hs-CRP düzeyleri ise özellikle KYŞ alt grubunda olmak üzere tüm gruplarda normal geometriye sahip, kontrol grubuna göre daha yüksek saptanmıştır.

Anahtar Kelimeler: Sol ventrikül hipertrofisi; inflamasyon; inflamatuar biyobelirteçler
ABSTRACT
Objective: Inflammatory markers have been shown as prognostic and risk factors in many cardiovascular diseases. In this study, the relationship between Neutrophil/Lymphocyte ratio (NLR), Platelet/Lymphocyte ratio (PLO) and high sensitivity-C-reactive protein (hs-CRP) with left ventricular remodeling was investigated. Material and Methods: This study included 122 patients who applied to the İstanbul University Faculty of Medicine Cardiology outpatient clinic. Blood samples were taken from all patients after 12 hours of fasting, and after echocardiographic evaluations, the patients were divided into 4 groups as normal geometry, concentric left ventricular hypertrophy (LVH), eccentric LVH and concentric remodeling, taking into account the difference between men and women. Results: The 30 subjects in this study were the control group with normal left ventricular functions and geometry on echocardiography. Thirty patients had concentric LVH, 30 patients had eccentric LVH, and 32 patients had concentric remodeling. Neutrophil values were significantly increased in all patients with altered left ventricular geometry compared to normal. In addition, hs-CRP and NLR levels were higher in these patient groups than those with normal geometry, but this difference tended to be statistically significant only in the NLR (p=0.05). This difference was more pronounced in the patient group with eccentric LVH. PLO value did not differ significantly in all patient groups. Conclusion: In our study, the NLR parameter is higher than normal in all patients with left ventricular remodeling. Hs-CRP levels were higher in all groups than the control group with normal geometry, especially in the concentric remodeling subgroup.

Keywords: Left ventricular hypertrophy; inflammation; inflammatory biomarkers
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