Kašnjenje električnog impulsa između dve pretkomore je rani marker usporene propagacije impulsa kod odraslih osoba sa blago povišenim krvnim pritiskom

  • Dijana Djikić Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia
  • Nebojša Mujović Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia
  • Vojislav Giga Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia
  • Milan Marinković Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia
  • Goran Trajković University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Snežana Lazić University of Priština, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Vedrana Pavlović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Vladan Perić University of Priština, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Dragan Simić Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP180417101D
Ključne reči: krvni pritisak, hipertenzija, ehokardiografija, doppler, elektrokardiografija, dijagnoza

Sažetak


Uvod/Cilj. Kašnjenje električnog impulsa između dve pret­komore je rani marker usporene propagacije impulsa kod odraslih osoba sa povišenim krvnim pritiskom. Cilj ovog rada bio je da se, koristeći novu ehokardiografsku metodu za procenu vremena provođenja impulse kroz pretkomoru, identifikuju odrasle osobe sa blago povišenim krvnim pri­tiskom i arterijskom hipertenzijom. Metode. Ispitivano je 149 odraslih osoba sa normalnim i povišenim krvnim pri­tiskom: 46 normotenzivnih zdravih osoba (grupa 1), 28 osoba sa blago povišenim krvnim pririskom i hipertenzijom stepena 1 (grupa 2) i 75 bolesnika sa arterijskom hiper­ten­zijom stepena 2 (grupa 3), prema poslednjim Joint National Committee (JNC) 8 preporukama. Ispitivana je funkcija rezervoara, prikazana kao totalni volumen pražnjenja leve pretkomore (TEV) i totalna frakcija pražnjenja leve pretkomore (TEF). Vreme provođenja impulsa je izmereno pulsnim tkivnim Doplerom, uključujući vreme provođenja impulsa u levoj pretkomori i vreme provođenja impulse između dve pretkomore. Rezultati. Vrednosti TEF su se progresivno smanjivale od grupe 1, preko grupe 2 do grupe 3 (p < 0,001). Disperzija P talasa (55,1 ± 9,8 ms vs. 46,8 ± 3,1 ms vs. 43,1 ± 2,6 ms; p < 0,01) i vreme provođenja impulsa unutar leve pretkomore (22,7 ± 11,0 ms vs. 8,4 ± 4,7 ms vs. 5,6 ± 2,4 ms; p < 0,001) su bili značajno produženi samo u grupi 3. Vreme provođenja impulsa između dve pretkomore značajno se povećavalo od grupe 1, preko grupe 2 do grupe 3 (15,6 ± 3,9 ms vs. 24,6 ± 5,7 ms vs. 50,4 ± 20 ms; p < 0,05 i p < 0,05). Vrednost kašnjenja impulsa između dve pretkomore od 19,5 ms može odvojiti odrasle osobe sa povišenim krvnim pritiskom od normo­ten­zivnih zdravih osoba sa osetljivošću od 85%, i specifičnošću od 89% [površina ispod receiver operating characteristic (ROC) krive 0,911). Zaključak. Produženo vreme provođenja impulsa između dve pretkomore procenjeno pulsnim tkiv­nim Dople­rom može biti korisno za identifikovanje osoba sa blago povišenim krvnim pritiskom i arterijskom hiper­ten­zijom prvog stepena.

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Objavljeno
2021/04/19
Broj časopisa
Vol. 77 Br. 6 (2020): Vojnosanit pregl
Rubrika
Originalni članak