Povezanost ehokardiografskih pokazatelja funkcije desne klijetke srca i vrijednosti širine distribucije volumena eritrocita u bolesnika sa sustavnom sklerozom [Relationship between echocardiographic right ventricular function parameters and red cell distribution width in patients with systemic sclerosis]

Jakšić Jurinjak, Sandra (2018) Povezanost ehokardiografskih pokazatelja funkcije desne klijetke srca i vrijednosti širine distribucije volumena eritrocita u bolesnika sa sustavnom sklerozom [Relationship between echocardiographic right ventricular function parameters and red cell distribution width in patients with systemic sclerosis]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Objective: The aim of this study was to evaluate echocardiographic parameters of right ventricular function in patients with systemic sclerosis (SSc) without pulmonary hypertension and its correlation to red cell distribution width (RDW). Methods: 21 consecutive SSc patient undervent echocardiography with tissue Doppler imaging to assess RV function. 19 study patients were investigated at baseline and in four visits of one year follow up. Echocardiographic measuremets and RDW was assessed at each visit (0-month visit, 4-month visit, 8-month visit, 12-month visit). Results: In the highest tertile RDW group (>14,25 for first follow-up visit) RV FAC was significantly lower 48,00 (45,00-51,00) compared to 50,80 (49,08-53,40); P=0,023., and in the highest tertile RDW group (>13,95 for second follow-up visit) PV Acct was significantly lower (P=0,007) in the follow-up at first and second visit respectively. In the highest tertile RDW group (>14,25 for first follow-up visit) RV FAC was significantly lower 48,00 (45,00-51,00) compared to 50,80 (49,08-53,40); P=0,023., and in the highest tertile RDW group (>13,95 for second follow-up visit) PV Acct was significantly lower (P=0,007) in the follow-up at first and second visit respectevely. RDW showed a positive correlation with RIMP (rho=0,537, P=0,012) on the first visit and negative correlation with PVAcct on the firs (rho=-0,495, P=0,023) and second (rho=-0,497, P=0,022) visit during the follow-up, respectively. Conclusion: RDW in SSc may represent an integrative measure of multiple pathological processes including fibrosis and ongoing inflammation. An increase in RDW may indicate an impairment of cardiorespiratory function and right ventricular function but further investigation is needed.

Abstract in Croatian

Cilj ispitivanja je ehokardiografska procjena funkcije desne klijetke srca u bolesnika sa sustavnom sklerozom koji nemaju plućne hipertenzije te povezanost ehokardiokrafskih parametara funkcije desne klijetke srca sa volumenom širine distribucije eritrocita (RDW). Metode: U 21 ispitanika učinjeno je ehokardiografsko ispitivanje, a 19 ispitanika su praćeni prospektivno, longitudinalnim ispitivanjem u četiri ehokardiografska mjerenja i mjerenjem RDW-a kroz godinu dana u četiri posjete (1. mjesec, 4. mjesec, 8. mjesec, 12. mjesec). Rezultati: U najvišoj tercilnoj RDW skupini (>14,25 u prvoj viziti) RV FAC bio je značajno niži 48,00 (45,00-51,00) naspram 50,80 (49,08-53,40); P=0,023.u prvoj viziti, te u najvišoj tercilnoj RDW skupini (>13,95 u drugoj viziti) PVAcct bio je značajno niži u drugoj viziti. Korelacije izmjerenih vrijednosti RDW na prvoj viziti pokazuju značajno srednje jaku pozitivnu korelaciju razine RDW-a s RIMP-om (rho=0,537, P=0,012) te srednje jaku negativnu korelaciju RDW-a s PVAcct (rho=-0,495, P=0,023). Korelacije izmjerenih vrijednosti RDW i na drugoj viziti pokazuju da razina RDW-a značajno negativno korelira s PVAcct (rho=-0,497, P=0,022). Zaključak: RDW u SSc može predstavljati integriranu mjeru multiplih patoloških procesa uključujući preimarnu fibrozu miokarda i trajnu upalu. Više vrijednosti RDW-a u bolesnika sa SSc mogu ukazivati na oštećenu kardiopulmonalnu funkciju i funkciju desne klijetke srca no potrebna su daljna ispitivanja koja uključuju tkivno senzitivne ehokardiografske metode.

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