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Geri dönüşümlü iskeminin miyokard hasarı ile ilgili biyokimyasal belirteçlerin serum düzeyleri üzerine olan etkisinin araştırılması

Investigation of the effect of the reversible myocardial ischemia on serum levels of biochemical indicators associated with myocardial injury

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
The aim of this study was to evaluate the effect of the reversible myocardial ischemia induced by treadmill exercise test and determined by gated myocardial perfusion SPECT on the secretion of AST and LDH localized in the cytoplasm of the myocytes. Fifty one patients with risk factors of coronary artery disease were enrolled into the study. The patients were divided into three subgroups as normal (24), ischemia (17) and infarct (10) according to the results of gSPECT performed after treadmill exercise test. Preexercise, postexercise and 4th hr serum LDH and AST levels of the patients were measured. According to the enzyme results, there were no statistically significant differences among the subgroups (p>0.05). Postexercise AST and LDH levels were significantly higher than those of the preexercise in the normal group (p=0.011, p=0.001, respectively). Postexercise AST levels were significantly higher than those of the preexercise in the ischemia group (p=0.002). Preexercise and postexercise levels of the enzymes were not statistically different in the infarct group. Functions of the left ventricle were prominently decreased in patients with myocardial infarct and severity of the ischemia in this group was significantly higher than those of the other subgroups (p<0.001). There were not statistically significant differences between the scintigraphic parameters of normal and ischemia subgroups, except for STSS (p>0.05 and p<0.001, respectively). There was not a significant correlation between the enzyme levels and scintigraphic parameters. In conclusion, reversible myocardial ischemia seems not to have prominent effect on the secretion of the non-specific biochemical markers of myocardial injury.
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Abstract (Original Language): 
Çalışmanın amacı, egzersiz ile tetiklenen ve "gated" miyokard perfüzyon sintigrafisi (gSPECT) ile saptanan miyokard iskemisinin, miyosit sitoplazmasında lokalize aspartat aminotransferaz (AST) ve laktat dehidrogenaz (LDH) enzimlerinin salınımı üzerine olan etkisini araştırmaktır. Koroner arter hastalığı yönünden risk faktörlü 51 olgu çalışmaya dahil edildi. "Gated" miyokard perfüzyon sintigrafisi sonuçlarına göre olgular normal (24), iskemi (17) ve infarkt (10) olmak üzere üç gruba ayrıldı. Olguların, efor öncesi, sonrası ve 4. saatteki venöz kanlarından, AST ve LDH ölçümleri yapıldı. Gruplar arasında her iki enzim düzeyleri için istatistiksel olarak anlamlı bir fark bulunmadı (p>0.05). Normal grupta, egzersiz sonrası AST ve LDH değerleri egzersiz öncesi değerlere göre anlamlı olarak yüksek bulunmuştur (sırası ile, p=0.011 ve p=0.001). İskemi grubunda ise egzersiz sonrası AST değerleri egzersiz öncesi değerlere göre istatistiksel olarak anlamlı düzeyde yüksektir (p=0.002). İnfarktlı olguların sol ventrikül fonksiyonları diğer gruplara göre anlamlı derecede bozulmuştur (p<0.001) ve bu gruptaki iskeminin şiddeti diğer gruplara göre istatistiksel olarak anlamlı yüksektir (p<0.001). Normal ve iskemi grupları arasında ise STSS hariç (p<0.001) diğer parametreler için istatistiksel olarak anlamlı bir fark bulunmamıştır (p>0.05). Enzim düzeyleri ile sintigrafik parametreler arasında anlamlı bir korelasyon saptanmamıştır. Sonuçta, geri dönüşümlü miyokard iskemisinin sitoplazmik yerleşimli ve miyokarda özgül olmayan serum belirteçlerinin salınımı üzerine belirgin bir etkisinin bulunmadığı saptanmıştır.
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PDF icon arastirmax-geri-donusumlu-iskeminin-miyokard-hasari-ile-ilgili-biyokimyasal-belirteclerin-serum-duzeyleri-uzerine-olan-etkisinin-arastirilmasi.pdf
  • 2
87-93
  • Turkish

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