Öz
Amaç
Anjiyotensin reseptör neprisilin inhibitörlerinin (ARNI) günlük klinik uygulamaya dahil edilmesi, kalp yetmezliği (KY) tedavisinde yapısal ve elektriksel yeniden şekillenme yoluyla mortaliteyi ve hastaneye yatışları azaltması nedeniyle en önemli gelişmelerden biridir. Bu çalışmada, sacubitril/valsartanın azalmış ejeksiyon fraksiyonlu KY (HFrEF) olan hastalarda anormal ventriküler repolarizasyonu yansıtan frontal QRS-T açısı (f-QRS/Ta) üzerindeki etkisi araştırıldı.
Yöntem
Azalmış ejeksiyon fraksiyonlu KY olan hastalarda yüzey elektrokardiyogramlarından (EKG) elde edilen f-QRS/Ta farkı, ARNI tedavisinin başlatılmasından önce ve sonra retrospektif olarak değerlendirildi. Demografik, klinik ve EKG özellikler hastane verilerinden toplandı ve bir yıllık takipte karşılaştırıldı.
Bulgular
Çalışmaya toplam 45 hasta dahil edildi ve bunların 15’i kadın (%33,3) idi. Çalışma popülasyonunun ortalama NYHA sınıfı 2, sol ventrikül ejeksiyon fraksiyonu (EF) ise %30’du. ARNI tedavisi, QRS süresi ve f-QRS/Ta değerlerinde başlangıç EKG parametrelere kıyasla anlamlı bir azalmaya neden oldu. Ortalama QRS süresi, başlangıçta 106,9±10,3 ms’den 12 aylık takipte 105±9,8 ms’ye düştü. Başlangıç f-QRS/Ta değeri ise 72,3±12° iken tedavi sonrası 67,4±12,6°’ye düştü ve sırasıyla p-değerleri 0,008 ve <0,001 olarak tespit edildi.
Sonuç
Çalışmamız, HFrEF hastalarında sacubitril/valsartan tedavisinin QRS süresi ve f-QRS/Ta değerlerinde anlamlı bir azalmaya yol açtığını göstermiştir.
Anahtar Kelimeler: Anahtar kelimeler: ARNI, kalp yetmezliği, frontal QRS/Ta
Kaynakça
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