Aort darlığında anjiyotensin dönüştürücü enzim geni insersiyon/delesyon polimorfizminin fonksiyonel kapasite belirteçleri ve ekokardiyografik parametrelerle ilişkisi
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Date
2012
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Abstract
Amaç: Fonksiyonel durumda bozulma aort darlığının doğal seyrinde kritik bir nokta olup kapak değişimi operasyonun en önemli endikasyonunu oluşturur. Bu çalışmada hafif ve orta dereceli aort darlığı (AD) olan hastalarda anjiyotensin dönüştürücü enzim (ADE) geni insersiyon/delesyon (I/D) polimorfizminin fonksiyonel kapasite belirteçleri ve ekokardiyografide sol ventrikül fenotipi ile ilişkisi araştırıldı. Gereç ve Yöntem: Ekokardiyografi ile doğrulanmış hafif-orta dereceli AD’si olan 22 asemptomatik hastanın ADE gen polimorfizmleri ile fonksiyonel kapasiteleri New York Kalp Cemiyeti sınıflaması, 6 dakika yürüme testi, plazma NT-proBNP ölçümleri yapılarak değerlendirildi. Bulgular: Yaş, hipertansiyon, dejeneratif darlık ve aort kapak kalsifikasyonu daha kötü fonksiyonel kapasiteyle ilişkili bulundu (p0.05). ADE gen polimorfizmi ile fonksiyonel kapasite arasında ilişki saptanmadı. DD genotipi normotansif hastalarda egzantrik şekillenmeyle ilişkili bulundu (p:0,03) Hipertansif hastalarda ve 40 yaş üzeri DD genotipli hastalarda daha belirgin sol ventrikül hipertrofisi saptandı (sırasıyla 190,122,2g/m2 vs 132,112,8g/m2; p:0,004 ve 181,929,6g/m2 vs 143,836,3g/m2; p:0,02) . Sonuç: Yaşlı, hipertansif, dejeneratif veya kalsifik hafif orta dereceli AD’si olan hastaların fonksiyonel kapasitenin bozulması açısından daha yakın takip edilmeleri uygun olabilir. DD genotipli hipertansif ve 40 yaş üstünde hafif-orta dereceli aort darlığı olan hastalarda sol ventrikül hipertrofisi daha belirgindir.
Aim: Deterioration of functional status is a critical point being the most important indication for valve replacement surgery. In this study on patients with mild or moderate aortic stenosis (AS), association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with functional capacity markers and left ventricular phenotype in echocardiography was evaluated. Material and Method: ACE gene polymorphism and functional capacity which was measured with New York Heart Association clas- sification, 6 minute walk test and plasma NT-proBNP levels were assessed in twenty two asymptomatic patient with echocardio- graphically documented mild-moderate AS. Results: Age, hypertension, degenerative stenosis and aortic valvular calsification were related with worse functional capacity (p<0,05). ACE gene polymorphism was not associated with functional capacity. DD genotype was associated with eccentric modelling in normotensive patients (p:0.03). Among either hypertensive patients or patients over 40 years subjects with DD genotype had more significant left ventricular hypertrophy (190.1±22.2 g/m2 vs 132,1±12,8 g/m2; p:0.004 and 181,9±29,6 g/m2 vs 142,8±36,3 g/m2; p:0,02 respectively). Conclusion: Closer follow up of elderly, hypertensive, degenerative and calcified mild-moderate AD patients for deterioration of func- tional capacity may be suitable. Mild-moderate AD patients older than 40 years or with hypertension have more significant left ventricular hypertrophy if they have DD genotype.
Aim: Deterioration of functional status is a critical point being the most important indication for valve replacement surgery. In this study on patients with mild or moderate aortic stenosis (AS), association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with functional capacity markers and left ventricular phenotype in echocardiography was evaluated. Material and Method: ACE gene polymorphism and functional capacity which was measured with New York Heart Association clas- sification, 6 minute walk test and plasma NT-proBNP levels were assessed in twenty two asymptomatic patient with echocardio- graphically documented mild-moderate AS. Results: Age, hypertension, degenerative stenosis and aortic valvular calsification were related with worse functional capacity (p<0,05). ACE gene polymorphism was not associated with functional capacity. DD genotype was associated with eccentric modelling in normotensive patients (p:0.03). Among either hypertensive patients or patients over 40 years subjects with DD genotype had more significant left ventricular hypertrophy (190.1±22.2 g/m2 vs 132,1±12,8 g/m2; p:0.004 and 181,9±29,6 g/m2 vs 142,8±36,3 g/m2; p:0,02 respectively). Conclusion: Closer follow up of elderly, hypertensive, degenerative and calcified mild-moderate AD patients for deterioration of func- tional capacity may be suitable. Mild-moderate AD patients older than 40 years or with hypertension have more significant left ventricular hypertrophy if they have DD genotype.
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Kalp ve Kalp Damar Sistemi
Journal or Series
MN Kardiyoloji
WoS Q Value
Scopus Q Value
Volume
19
Issue
1
Citation
Tulmaç, M., Şimşek, V., Şimşek, F., Yazıcı, H. U., Poyraz, F. ,Turfan, M., Kaya, M. G., Ebinç, H., Çengel, A. (2012). Aort darlığında anjiyotensin dönüştürücü enzim geni insersiyon/delesyon polimorfizminin fonksiyonel kapasite belirteçleri ve ekokardiyografik parametrelerle ilişkisi. MN Kardiyoloji, 19(1), 19 - 26
