Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Abstract
Metabolik sendrom kriteri taşıyan obezler ile metabolik sendrom kriteri taşımayanobezlerde, sol ventrikül sistolik ve diyastolik fonksiyonlarını konvansiyonel metodlar ve yeniekokardiyografik parametreleri kullanarak değerlendirmeyi amaçladık.Materyal-Metod: Hastalar metabolik sendrom tanısı alan obezler (grup 1), metaboliksendrom tanısı almamış obezler (grup 2) ve kontrol grubu olmak üzere 3 gruba ayrıldı.Metabolik sendrom tanısı almış 20 obez hasta, metabolik sendrom kriteri taşımayan 20 obez,kontrol grubu olarak 19 sağlıklı birey alındı. Beden kütle indeksi >30 kg/m² olanlar obezolarak kabul edildi. Metabolik sendrom tanısı için NCEP-2001 ATP III MS tanı kriterlerikullanıldı. Metabolik sendrom kriterlerinden en az 3 tanesine sahip, BK >30 kg/m² olanhastalar obez-metabolik sendrom grubuna dahil edildi. Kontrol gurubu için tamamen sağlıklıolan gönüllülerden BK 30 kg/m² accepted as obese. NCEP-2001ATP III MS criterias were used for diagnosis of metabolic syndrome. BMI >30 kg/m² patientswith 3 criterias metabolic syndrome were added to metabolic syndrome group. Control groupwas formed with normal patients with BMI <30 kg/m². Left ventricul diameters, mass,diastolic functions and myocard performance index of patients and control group wereobtained with conventional ecocardiography and tissue doppler methods. One way Annovatest and univariate coveriance analyses were performed. p value <0.05 was consideredsignificant.Results: There was no statistically significant difference in age and gender between 3 groups.BMI and waist circumference were similar in group 1 and group 2 but significantly higherthan group 3. Systolic and diastolic blood pressures were significantly higher in group 1 thanother 2 groups and were similar between group 2 and group 3. When the conventionalecocardiographic parameters were compared; there were no difference between 3 groups inleft ventricul diameters. Septum thickness was lower in control group than other 2 groups.Left ventricul mass was higher in group 1 and group 2 than control group and was similarbetween in group 1 and group 2 (137.09±32.61 gr, 142.73±29.85 gr and 129.72±32.60 gr,p<0.05, respectively). Comprasion of diastolic parameters; E/A ratio was significantly lowerin group 1 than other 2 groups. E/A ratio was lower in group 2 than control group (0.78±0.15,1.04±0.32 and 1.38±0.44, p<0.05, respectively). EDZ was similar in group 1 and group 2 andsignificantly higher than control group (195.5±47.5 msn, 194.8±42.1 msn and 158.9±35.6msn, p<0.05, respectively). Comprasion of Tissue Doppler parameters; mean Em/Am waslower in group 1 than other 2 groups. Mean Em/Am was significantly lower in group 2 thancontrol group (0.72±0.16, 0.98±0.40 and 1.24±0.37, p=0.06, respectively). There were nostatistically significant difference in E/mean Em and Ps/Pd between 3 groups. Whencompared with Left Ventricul MPI; MPI was significantly higher in group 1 and group 2 than39control group. Mean MPI with tissue Doppler wall was similar in group 1 and group 2 andsignificantly higher than control group (0.58±0.07, 0.62±0.12 and 0.49±0.06, p<0.05,respectively). MPI with conventional methods was similar in group 1 and group 2 andsignificantly higher than control group (0.54±0.14, 0.55±0.18 and 0.37±0.12, p<0.05,respectively).Conclusions: Obesity can damage left ventricul functions without the other importantcriterias of metabolic sydrome. Doppler ecocardiography is a widespread method to evaluatethe potential risks of these patients. Tissue Doppler ecocardiography is a good alternative ofconventional ecocardiography and less affected from physiological conditions in obespatients
