Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study

CEYHAN, Köksal; ÇELİK, ATAÇ; KADI, Hasan; KOÇ, FATİH; Erkorkmaz, Ünal

Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study

Ataç ÇELİK, (Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Tokat, Türkiye)

Fatih KOÇ, (Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Tokat, Türkiye)

Hasan KADI, (Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Tokat, Türkiye)

Köksal CEYHAN, (Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Tokat, Türkiye)

Ünal ERKORKMAZ (Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Tokat, Türkiye)

Anadolu Kardiyoloji Dergisi

2 1

Yıl: 2012 Cilt: 12 Sayı: 3 Sayfa Aralığı: 233 - 240 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study

Öz:

Amaç: Enflamasyonun, hem hipertansiyona sebep olan mekanizmalarda, hem de hipertansiyonla birlikte ateroskleroza sebep olan mekanizmalar içerisinde role sahip olduğu bilinmektedir. Birçok çalışmada otonom sinir sistemi ile enflamatuvar sistem aktivasyonunun ilişkisi gösterilmiştir. Çalışmanın amacı hipertansif hastalarda enflamasyon ile kardiyak otonomik fonksiyonlar arasındaki ilişkiyi değerlendirmektir. Yöntemler: Hipertansiyon tanısı almış 121 hasta (ortalama yaş 59±11 yıl, 60 erkek) ile 34 sağlıklı gönüllü (ortalama yaş 58±11 yıl, 18 erkek) eninekesitli gözlemsel çalışmaya alındı. Tüm katılımcılardan 24 saatlik ambulatuvar elektrokardiyogram kayıtları alınarak analizleri Pathfinder programı ile yapıldı. Kalp hızı değişkenliğinin (KHD) zaman bağımlı parametreleri aynı program kullanılarak hesaplandı. Kalp hızı türbülansı (KHT) parametreleri olan türbülans başlangıcı (TO) ve türbülans eğimi (TR) otomatik olarak HRT programı ile hesaplandı. İstatistiksel analiz eşleştirilmemiş t-testi, Mann-Whitney U testi, tek-yönlü ANOVA, Kruskal-Wallis varyans analizi, Ki-kare testi ve Spearman korelasyon katsayısı analizi ile yapıldı. Hipertansiyon ile yüksek duyarlıklı C-reaktif protein (hs-CRP), KHD ve KHT arasındaki ilişki yaş ve kreatinin seviyesi gibi karıştırıcı değişkenler için düzeltildikten sonra analiz edildi. Bulgular: Sağlıklı gönüllüler ile karşılaştırıldığında, hastaların hs-CRP değerlerinde artış, KHD parametrelerinde hafif, KHT parametrelerinde ise belirgin bozulma tespit edildi [SDNN; 132±28 karşın 112±34 msn, RMSSD; 27 (23-35) karşın 22 (16-28) msn, TO; -2.80±2.15 karşın %-0.96±2.36, TS; 7.56 (5.24-10.60) karşın 4.65 (2.44-7.26) msn/RR, hepsi için p<0.01]. Hastaların hs-CRP değerlerine göre en yüksek tertilde olanların, orta ve düşük varitertilde olanlara göre tüm KHD ve KHT değerleri daha çok bozulmuş olarak gözlendi [SDNN; 93±34 msn, RMSSD; 17 (13-22) msn, TO; %0.03±2.22, TS; 2.43 (1.84-3.89) msn/RR, hepsi için p<0.05]. Korelasyon analizine göre hs-CRP ile KHD ve KHT parametreleri arasında güçlü bir ilişki saptandı (SDNN; r=-0.690, RMSSD; r=-0.277, TS; r:-0.417, TO; r=0.267, hepsi için p<0.05). Sonuç: Hipertansif hasta popülasyonunda kardiyak otonomik fonksiyonlardaki dengesizlik enflamasyon ile ilişkilidir. (Anadolu Kardiyol Derg 2012; 12: 233-40)

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Hipertansiyonda enflamasyon kardiyak otonomik fonksiyonlarda dengesizlik ile ilişkilidir: Gözlemsel bir çalışma

Öz:

Objective: Inflammation plays a role both in the mechanisms leading to hypertension alone and in the mechanisms leading to atherosclerosis with hypertension. Previous studies have shown the relationship between the autonomic functions and inflammatory system activation. The aim of the study was to evaluate the relationship between inflammation and cardiac autonomic functions in hypertensive patients. Methods: One hundred twenty one hypertensive patients (mean age 59±11 years, 60 male) and 34 healthy volunteers (mean age 58±11 years, 18 male) were included in the present cross-sectional observational study. The 24-hour ambulatory electrocardiogram recordings were taken using Pathfinder Software. The heart rate variability (HRV) analysis was performed using time domain parameters using the same software. Heart rate turbulence (HRT) parameters, turbulence onset and turbulence slope were calculated with HRT software. Statistical analysis was performed using unpaired t-test or Mann-Whitney U test, one-way ANOVA or Kruskal-Wallis analysis of variance, Chi-square test, and Spearman rank order correlation analysis. The association of hypertension with high sensitivity C-reactive protein (hs-CRP), HRV and HRT was analyzed after adjustment for confounding variables as age and creatinine levels. Results: The mean hs-CRP was higher, HRV was slightly reduced while HRT was markedly blunted in hypertensive patients in comparison with control group [SDNN; 132±28 vs. 112±34 msec, RMSSD; 27 (23-35) vs. 22 (16-28) msec, TO; -2.80±2.15 vs. -0.96±2.36%, TS; 7.56 (5.24-10.60) vs. 4.65 (2.44-7.26) msec/RR, p<0.01 for all]. All of the HRV and HRT parameters were more deteriorated in the highest tertile hs-CRP group [SDNN; 93±34 msec, RMSSD; 17 (13-22) msec, TO; 0.03±2.22%, TS; 2.43 (1.84-3.89) msec/RR, p<0.05 for all]. There were correlations between hs-CRP and HRV and HRT parameters (SDNN; r=-0.690, RMSSD; r=-0.277, TS; r:-0.417, TO; r=0.267, p<0.05 for all). Conclusion: There is an inflammatory process in hypertensive patients and inflammation is related with unbalanced cardiac autonomic functions. (Anadolu Kardiyol Derg 2012; 12: 233-40)

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÇELİK A, KOÇ F, KADI H, CEYHAN K, Erkorkmaz Ü (2012). Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. , 233 - 240.
Chicago	ÇELİK ATAÇ,KOÇ FATİH,KADI Hasan,CEYHAN Köksal,Erkorkmaz Ünal Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. (2012): 233 - 240.
MLA	ÇELİK ATAÇ,KOÇ FATİH,KADI Hasan,CEYHAN Köksal,Erkorkmaz Ünal Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. , 2012, ss.233 - 240.
AMA	ÇELİK A,KOÇ F,KADI H,CEYHAN K,Erkorkmaz Ü Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. . 2012; 233 - 240.
Vancouver	ÇELİK A,KOÇ F,KADI H,CEYHAN K,Erkorkmaz Ü Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. . 2012; 233 - 240.
IEEE	ÇELİK A,KOÇ F,KADI H,CEYHAN K,Erkorkmaz Ü "Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study." , ss.233 - 240, 2012.
ISNAD	ÇELİK, ATAÇ vd. "Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study". (2012), 233-240.

APA	ÇELİK A, KOÇ F, KADI H, CEYHAN K, Erkorkmaz Ü (2012). Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. Anadolu Kardiyoloji Dergisi, 12(3), 233 - 240.
Chicago	ÇELİK ATAÇ,KOÇ FATİH,KADI Hasan,CEYHAN Köksal,Erkorkmaz Ünal Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. Anadolu Kardiyoloji Dergisi 12, no.3 (2012): 233 - 240.
MLA	ÇELİK ATAÇ,KOÇ FATİH,KADI Hasan,CEYHAN Köksal,Erkorkmaz Ünal Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. Anadolu Kardiyoloji Dergisi, vol.12, no.3, 2012, ss.233 - 240.
AMA	ÇELİK A,KOÇ F,KADI H,CEYHAN K,Erkorkmaz Ü Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. Anadolu Kardiyoloji Dergisi. 2012; 12(3): 233 - 240.
Vancouver	ÇELİK A,KOÇ F,KADI H,CEYHAN K,Erkorkmaz Ü Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study. Anadolu Kardiyoloji Dergisi. 2012; 12(3): 233 - 240.
IEEE	ÇELİK A,KOÇ F,KADI H,CEYHAN K,Erkorkmaz Ü "Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study." Anadolu Kardiyoloji Dergisi, 12, ss.233 - 240, 2012.
ISNAD	ÇELİK, ATAÇ vd. "Inflammation is related to unbalanced cardiac autonomic functions in hypertension: aAn observational study". Anadolu Kardiyoloji Dergisi 12/3 (2012), 233-240.