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Amaç: Bu çalÕúmada amacÕPÕz, iskemik inme, hemorajik inme ve geçici iskemik atakhastalarÕnda ventriküler aritmilerin yeni göstergeleri olan Tpe, Tpe-d ve Tpe/QT oranÕQÕnnasÕl etkilendi÷ini incelemektir.Materyal ve Metod: Necmettin Erbakan Üniversitesi Meram TÕp Fakültesi Nöroloji ve AcilServisine baúvuran akut serebrovasküler olay geçiren hastalar alÕndÕ. Hastalar 30 akut iskemikinme, 20 akut hemorajik inme ve 30 geçici iskemik atak olmak üzere üç gruba ayrÕldÕ. Kontrolgrubu olarak yaú ve cinsiyet uyumlu, herhangi bir nedenle EKG çekilmiú 30 sa÷OÕklÕ bireyalÕndÕ. Tüm katÕOÕmcÕlarÕn baúvuruda rutin olarak çekilen EKG'leri manuel olarak incelendi.QT, QTc ve QTc dispersiyonu (QTcd) tüm leadlerde incelenirken, Tpeak-Tend (Tpe), Tpedispersiyonu (Tpe-d) ve Tpe/QT oranÕ sadece prekordial leadlerde incelendi.Bulgular: øskemik inme (ort. yaú 61.17 ± 14.14 yÕl; 15 kadÕn/15 erkek) ve hemorajik inme(ort. yaú 65.05 ± 9.50 yÕl; 10 kadÕn/10 erkek) grubunda hem eski (QT, QTc, QTcd) hem deyeni (Tpe, Tpe-d, Tpe/QT oranÕ) aritmi parametreleri kontrol (ort. yaú 58.27 ± 10.45 yÕl; 15kadÕn/15 erkek) ve geçici iskemik atak (ort. yaú 58.10 ± 13.32 yÕl; 15 kadÕn/15 erkek)hastalarÕna kÕyasla anlamlÕúekilde uzamÕúWÕ. Bu uzama V5 ve V6. derivasyona özgüydü. Eskiparametreler, ek olarak DII leadinde de uzamÕúWÕ. Yaú ile Tpe, QTcmax ve QTd arasÕndapozitif korelasyon vardÕ (sÕrasÕyla r= 0.21, p= 0.028; r= 0.19, p= 0.032 ve r= 0.22, p= 0.013).Sonuç: Hem iskemik inme, hem de hemorajik inme hastalarÕnda ventrikülün globalrepolarizasyonuna ek olarak transmural repolarizasyonu da artmÕúWÕr. EKG üzerinde V5 ve V6leadleri aritmilerin tespitinde akut inme hastalarÕ için oldukça önemlidir. Bu konuda ileriçalÕúmalara ihtiyaç vardÕr.Anahtar Kelimeler: ønme, Elektrokardiyografi, Aritmi As The Risk Indicators of Malign Ventricular Arhytmia, The Tpe, Tpe Dispersion andRate of Tpe/QT in Acute Cerebrovascular Events, Nihal Tekinalp, Expertise Thesis,Konya, 2013Objective: To investigate how Tpe, Tpe-d and Tpe/QT rate, the novel indicators ofventricular arhytmias, are affected in patients with ischemic stroke, hemorrhagic stroke andtransient ischemic attacks.Materials and Methods: Experiencing acute cerebrovascular events, the patients that wereadmitted to Departments of Neurology and Emergency of Meram Medical School, NecmettinErbakan University were included. Patients were put into three groups as 30 with acuteischemic stroke, 20 with acute hemorrhagic stroke and 30 with transient ischemic attack.Thirty healthy individuals matched as age and sex, and undergoing ECG due to any reasonconstituted controls. All ECG results taken routinely on admission were manually assessed.While QT, QTc and QTc dispersion (QTcd) were investigated in all leads, Tpeak-tend (Tpe),Tpe dispersion (Tpe-d) and Tpe/QT rate were investigated only in precordial leads.Results: In ischemic stroke group (mean age rate, 61.17±14.14 years; 15 women/15 men) andhemoorrhagic stroke group (mean age rate, 65.05±9.50 years; 10 women/10 men), bothprevious (QT, QTc and QTcd) and new (Tpe, Tpe-d and Tpe/QT rate) arhytmic parameterswere significantly more prolonged, compared to controls (mean age rate, 58.27±10.45 years;15 women/15 men) and patients with transient ischemic attack (mean age rate 58.10±13.32years; 15 women/15 men). The prolonged parameter was specific to the derivations of V5 andV6. Previous parameters were also prolonged to the lead of DII. A positive correlation waspresent between the age, and Tpe, QTcmax and QTd (r= 0.21, p= 0.028; r= 0.19, p= 0.032;and, r= 0.22, p= 0.013, respectively).Conclusion: As well as global repolarization of ventricle both in patients with ischemicstroke and in those with hemorrhagic stroke, transmural repolarization was also increased. V5and V6 leads on ECG are quite significant in the determination of arhytmias for patients withacute stroke, and further studies concerning the condition are needed. 76 |
