UTICAJ TEŽINE HRONIČNE OPSTRUKTIVNE BOLESTI PLUĆA NA SISTOLNU FUNKCIJU DESNE KOMORE
Sažetak
Prema navodima Svetske zdravstvene organizacije, najčešća komplikacija hronične opstruktivne bolesti pluća (HOBP) jeste hronično plućno srce (cor pulmonale chronicum); ono podrazumeva hipertrofiju miokarda desne komore, dilataciju i insuficijenciju desne komore, koja nastaje kao posledica promena funkcije/strukture pluća, u odsustvu bolesti leve strane srca. Ehokardiografski pregled je zlatni standard u otkrivanju promena funkcije desne strane srca kod obolelih od HOBP-a. Glavni cilj ovog istraživanja bio je da se utvrdi uticaj stepena težine HOBP-a na vrednosti parametara sistolne funkcije desne komore. Sporedni cilj istraživanja bio je da se odredi učestalost trikuspidne regrugitacije u odnosu na stepen HOBP-a. Radi detaljne procene sistolne funkcije desne komore, značajne za ciljeve ove studije, ispitani su sledeći parametri: procentualna frakcija promene površine desne komore (engl. fractional area change – FAC), trikuspidna regurgitacija (TR), amplituda sistolne pokretljivosti trikuspidnog prstena (engl. tricuspid annular plane systolic excursion – TAPSE) (mm). U ispitivanju su učestvovala 44 bolesnika sa HOBP-om, podeljena u četiri grupe prema GOLD (engl. global initiative for obstructive lung disease) kriterijumima. Nije bilo statistički značajne razlike među grupama u pogledu antropometrijskih pokazatelja i vrednosti FEV1(%) (p > 0,05). Na osnovu Kruskal‒Wallisovog testa uočeno je da su vrednosti TAPSE indeksa i FAC-a bile značajno veće kod osoba sa teškim i veoma teškim HOBP-om (p < 0,05). Prilikom poređenja učestalosti TR-a u blagom HOBP-u sa onom u umerenom i u teškom HOBP-u, zapažena je statistički značajna razlika; kada je reč o ovom parametru, statistički značajna razlika postojala je i između umerenog i teškog HOBP-a (p < 0,05). Rezultati našeg istraživanja pokazali su da su ehokardiografski parametri desne komore, kakvi su TAPSE, FAC i TR, veoma važni za procenu njene sistolne funkcije, kao i da je opadanje ovih vrednosti srazmerno sa progresijom HOBP-a.
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