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RENAL TRANSPLANTASYONLA HASTALARDA QT DİSPERSİYONUNUN ÖNEMİ

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Abstract (2. Language): 
The importance of QT dispersion in renal transplant patients. Cardiovascular disease is the leading cause of death in renal transplant patients. QT dispersion is a predictor of serious car-diac arrythmias and it may be related to cardiovascular morbidity and mortality. The aim of our study is to investigate the effect of two different calcineurin inhibitors namely cyclosporin A and tacrolimus ,on QT dispersion in renal transplant patients. In order to rule out other fac-toıs affecting QT dispersion, such as hypertension and myocardial hypertrophy, 20 hypertensi-ve patients and 20 healthy controls were also included in the study. Two dimensional echocar-diography vvas performed to ali the groups. Among 39 renal transplant patients, 20 of the patients were using cyclosporin A and the rest were using tacrolimus. QTc dispersion values vvere 73.5 ± 32.8, 64.5 ± 28.1, 34.3 ± 13.2, 21.7 ± 9.5 ms. in patients using cyclosporin A, tacrolimus, lıypertensives and the healthy controls respectively. It was found that QTc dispersion was significantly higher in renal transplant patients when compared to hypertensive patients and the controls. Echocardiographic parameters of the left ventricle were similar between the hypertensive patients and the renal transplant patients. As a result, increased QT dispersion is a frequent finding in renal transplant patients and in this regard, it may be concluded that patients with high QTc dispersion values are more prone to cardiac arrythmias and that they need further cardiological and even more invasive tests.
Abstract (Original Language): 
Renal transplantasyon yapılmış hastalar arasında kardiovasküler hastalıklar ölüm sebepleri arasında en başta gelmektedir. QT dispersiyonu kalpte ciddi aritmi potansiyelinin bir göstergesidir ve kardiyovasküler morbidite ve mortalite ile yakından ilgilidir. Bu çalışmadaki amacımız renal transplantasyon yapılmış olan hastalarda bağışıklığı baskılamada en çok kullanılan kalsinörin inhibitörleri olan siklosporin A ve takrolimus'un QT dispersiyonu üzerine etkilerini araştırmaktı. Hipertansiyon ya da miyokard hipertrofisi gibi QT dispersiyonunu etkileyebilecek parametrelerin etkilerini ayırd edebilmek amacı ile çalışmaya 20 hipertansif hasta ve 20 sağlıklı kontrol de dahil edilmişti. Tüm hastaların iki boyutlu ekokardiyografik incelemeleri yapıldı ve karşılaştırıldı. Renal transplantasyon yapılmış olan hastaların 20 tanesi siklosporin A, diğer 19'u ise takrolimus kullanmakta idi. QTc dispersiyonu değerleri siklosporin A kullananlarda 73.5 ± 32.8, takrolimus kullananlarda 64.5 ±28.1, hipertansif hasta grubunda 34.3 ± 13.2 ve son olarak sağlıklı kontrollerde 21.7 ± 9.5 milisaniye bulundu. Diğer iki grupla karşılaştırıldığında renal transplantasyon yapılmış hastalarda QTc dispersiyonunun anlamlı derecede yüksek olduğu saptandı. Sol ventrikül ekokardiyografi bulgularının, hipertansif hasta grubu ve renal transplantasyon yapılmış hastalarda benzer olduğu görüldü. Sonuç olarak renal transplantasyonlu hastalarda iyi bilinen birçok kardiyovasküler risk faktörü yanında, kardiyak aritmi gelişimi ve ani ölüm riski açısından prediktif önem taşıyabilen QTc dispersiyonu artışının da saptanmasının büyük önem taşıdığı kanaatine varıldı. Bu hastaların kardiyovasküler açıdan daha detaylı ve gerekirse invazif tetkiklerle incelenmesinin yararlı olabileceği sonucuna varıldı.
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