Yıl: 2009 Cilt: 39 Sayı: 2 Sayfa Aralığı: 259 - 265 Metin Dili: Türkçe

Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity

Öz:
Amaç: Artmış ortalama trombosit hacmi (OTH) trombosit aktivasyonundaki artışı yansıtır ve bağımsız bir koroner risk faktörü olarak kabul edilir. Adrenerjik sistemin trombosit aktivasyonu ve trombosit oluşumunda etkileri vardır. Bu çalışmada, akut miyokard enfarktüslü (ME) hastalarda otonomik sinir sistemi aktivasyonunun OTH üzerine etkileri araştırılmıştır. Yöntem ve Gereç: Akut ön duvar enfarktüslü 47 hasta koroner arterleri normal olan 32 hasta ile karşılaştırılmıştır. Tüm hastalara 24 saatlik holter monitörizasyonu ile kalp hız değişikliği analizi yapılmış ve OTH ölçümü için kan örnekleri alınmıştır. Bulgular: Akut ME’lü hastalarda ortalama kalp hızı (KH), Düşük frekans (LF), LF/Yüksek frekans (HF) oranı, OTH kontrol grubundan daha yüksek, Tüm NN aralıklarının standart sapması (SDNN), takip eden farkların kare kökü (RMSSD), bir sonrakinden 50 ms’den fazla farklılık gösteren NN aralıklarının tüm NN aralıklarına oranı (PNN50), HF ve trombosit sayısı daha düşük bulunmuştur. Her iki grupta gündüz LF, LF/HF, ve OTH değerleri geceki değerlerden daha yüksek bulunmuş ancak akut ME’lü hastalarda bu farkın çok daha anlamlı olduğu görülmüştür. Korelasyon analizinde OTH ile ventrikül skoru, sol ön inen arterdeki darlık derecesi, ortalama KH, LF, LF/HF arasında pozitif bir ilişki; SDNN, HF ve trombosit sayısı arasında negatif bir ilişki olduğunu göstermiştir. Multivaryant analiz OTH’nin ventrikül skoru ve LF/HF oranından etkilendiğini göstermiştir. Sonuç: ME’lü hastalarda OTH anlamlı olarak yüksektir. Her iki çalışma grubunda da gündüz ve gece OTH değerlerinde önemli değişim görülmekte ve bu değişim otonomik sinir sistemindeki değişimden kaynaklanmaktadır. Miyokard enfarktüslü hastalarda artmış OTH’nin prognostik değerinin bu hastalardaki artmış sempatetik aktivite ve azalmış kalp hızı değişikliği ile yakın ilişkili olduğu düşünülebilir.
Anahtar Kelime: Miyokard enfarktüsü Kan trombositleri Kalp hızı Risk faktörleri Otonom sinir sistemi

Ortalama trombosit hacmi ve otonomik sinir sistemi fonksiyonları arasındaki ilişki: Artmış ortalama trombosit hacmi sempatetik aktivite artışını yansıtır

Öz:
Aim: Increased mean platelet volume (MPV) may reflect increased platelet activation and accepted as an independent coronary risk factor. Adrenergic system has effects on platelet activation and thrombocytopoiesis. In this study, we assessed the effects of autonomic nervous system activity on MPV in patients with acute myocardial infarction (MI). Materials and Methods: Forty-seven patients with acute anterior MI were compared with 32 patients having normal coronary arteries. All patients underwent heart rate variability analysis by 24-h holter monitoring and blood samples were taken for MPV measurements during day and night times during holter monitoring. Results: Mean heart rate (HR), Low frequency (LF), LF/High frequency (HF) ratio, MPV were higher, standard deviation of all NN intervals (SDNN), root mean square of successive differences (RMSSD), the number of NN intervals that differed by more than 50 ms from adjacent interval divided by the total number of all NN intervals (PNN50), HF and platelet counts were lower in the patients with anterior MI compared to the control group. Day time LF, LF/HF, and MPV were significantly higher and HF were significantly lower compared to those measured during night time in both groups. Pearson’s correlation analysis showed that MPV was positively correlated with ventricle score, degree of left anterior descending artery stenosis, mean HR, LF, LF/HF, and negatively correlated with SDNN, HF, and platelet count. Multivariate analysis revealed that MPV was affected by ventricle score and LF/HF ratio. Conclusions: MPV is significantly higher in the patients with MI and MPV in both groups shows great diurnal and nocturnal variation that is attributed to the alterations in the autonomic nervous system. We suggest that prognostic role of increased MPV in patients with MI are closely associated with increased sympathetic activity and decreased heart rate variability in these patients.
Anahtar Kelime: Blood Platelets Myocardial Infarction Risk Factors Autonomic Nervous System Heart Rate

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Haft JI. Role of blood platelets in coronary artery disease. Am J Cardiol 1979; 43: 1197-206.
  • 2. Sinzinger H. The role of platelets in atherosclerosis. Sem Thromb Hemost 1986; 12: 124-33.
  • 3. Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002; 117: 399-404.
  • 4. Martin JF, Bath PMW, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338: 1409-11.
  • 5. Burr ML, Holliday RM, Fehily AM, Whitehead PJ. Hematological prognostic indices after myocardial infarction: evidence from the diet and reinfarction trial (DART). Eur Heart J 1992; 13: 166-70.
  • 6. Martin JF, Plumb J, Kilbey RS, Kishk YT. Changes in volume and density of platelets in myocardial infarction. Br Med J 1983; 287: 456-9.
  • 7. Thompson CB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size as a determinant of platelet function. J Lab Clin Med 1983; 101: 205-13.
  • 8. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301-6.
  • 9. Nadeau RA, de Champlain J. Plasma catecholamines in acute myocardial infarction. Am Heart J 1979; 98: 548-54.
  • 10. Mills DC, Roberts G. Effects of adrenaline on human platelets. J Physiol 1963; 169: 82-3.
  • 11. Task force of the european society of cardiolgy and the north american society of pacing and electrophysiology. Heart rate variability, standarts of measurement, physiogical ınterpretation and clinical use. Circulation 1996; 93: 1043- 1065.
  • 12. Kleiger RE, Miller JP, Bigger JT, Moss AR. Multicenter postinfarction research group: Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987; 59: 256-62.
  • 13. La Rovere MT, Bigger JT Jr, Marcus FI, Moratara A, Schwartz PJ. Baroreflex sensitivity and heart rate variability in prediction of total cardiac mortality after myocardial infarction. Lancet 1998; 351: 478-84.
  • 14. Huikuri HV, Makikallio TH, Peng CK, Goldberger AL, Hintze U, Moller M for the Diamond Study Group. Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. Circulation 2000; 101: 47-53.
  • 15. Ozdemir O, Soylu M, Demir AD, Topaloglu S, Alyan O, Geyik B, Kutuk E. Increased sympathetic nervous system activity as a cause of exercise-induced ventricular tachycardia in patients with normal coronary arteries. Tex Heart Inst J 2003; 30: 100-4.
  • 16. Gelberg HJ, Brundage BH, Glanz S, Parmley WW. Quantitative left ventricle wall motion analysis: a comparison of area, chord and radial methods. Circulation 1979; 59: 991- 1000.
  • 17. Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, Pizzinelli P et al. Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho- vagal ınteraction ın man and conscious dog. Circ Res 1986; 59: 178- 193.
  • 18. Trowbridge EA, Martin JF. The platelet volume distribution: a signature of prethrombotic state in coronary heart disease? Thromb Haemost 1987; 58: 714-7.
  • 19. Pizzulli L, Yang A, Martin JF, Lüderitz B. Changes in platelet size and count in unstable angina compared to stable angina or noncardiac chest pain. Eur Heart J 1998; 19: 80-4.
  • 20. Jackson SR, Carter JM. Platelet volume: Laboratory measurement and clinical application. Blood Reviews 1993; 7: 104-113.
  • 21. Thompson CB, Love DG, Quinn PG, Valeri CR. Platelet size does not correlate with platelet age. Blood 1983; 62: 487-94.
  • 22. Kristensen SD, Milner PC, Martin JF. Bleeding time and platelet volume in acute myocardial infarction- a 2 year follow-up study. Thromb Haemost 1988; 59: 353-6.
  • 23. Kishk YT, Trowbridge EA, Martin JF. Platelet volume subpopulation in acute myocardial infarction. An investigation of their homogeneity for smoking, infarct size and site. Clin Sci 1985; 68: 419-25.
  • 24. Trowbridge EA, Slater DN, Kishk YT, Woodcock BW, Martin JF. Platelet production in myocardial infarction and sudden cardiac death. Thromb Haemost. 1994; 52: 167-71.
  • 25. Maestroni GJ. Neurohormones and catecholamines as functional components of the bone marrow microenvironment. Ann N Y Acad Sci 2000; 917: 29-37.
  • 26. Maestroni GJ. Adrenergic regulation of haematopoiesis. Pharmacol Res 1995; 32: 249-53.
  • 27. Gol'dberg cED, Dygai AM, Khlusov IA, Shakhov VP. The role of the autonomic nervous system in the mechanisms regulating hemopoiesis in stress. Patol Fiziol Eksp Ter 1991; 3: 14-7.
  • 28. Hjemdahl P, Larsson T, Wallen H. Effects of stress and β- Blockade on platelet function. Circulation 1991; 84(suppl VI): 44-61.
  • 29. Thompson CB, Eaton KA, Princiotta SM, Rushin CA, Valeri CR. Size dependent platelet subpopulations: Relationship of platelet volume to ultrastructure, enzymatic activity and function. Br J Haematol 1982; 50: 509-19.
  • 30. Frojmovic M, Milton J. Human platelet size, shape and related functions in health and disease. Physiol Rev 1982; 62: 185-261.
  • 31. Lande K, Gjesdal K, Fonstelien E, Kjeldsen SE, Eide I. Effects of adrenaline infusion on platelet number, volume and release reaction. Thromb Haemost 1985; 54: 450-3.
  • 32. Chamberlain KG, Tong M, Pennington DG. Properties of exchangeable splenic platelets released into the circulation during exercise-induced thrombocytosis. Am J Hematol 1990; 34: 161-8.
  • 33. Peatfield RC, Gawel MJ, Clifford-Rose F, Guthrie DL, Pearson TC. The effects of exercise on platelet numbers and size. Med Lab Sci 1985; 42: 40-3.
  • 34. Freden K, Olsson LB, Vilen L, Kutti J. Peripheral platelet count in response to salbutamol before and after adrenergic beta-receptor blockade. Acta Haematol. 1978; 60: 310-5.
  • 35. Negrev N, Ganchev T. Influence of nonselective beta-adrenergic impacts on the effects of thrombocytopoietin in mice. Acta Physiol Pharmacol Bulg 1987; 13: 35-40.
  • 36. Mehta J, Mehta P, Pepine CJ. Platelet aggregation in aortic and coronary venous blood in patients with and without coronary heart disease: 3. Role of tachycardia stress and propranolol. Circulation 1978; 58: 881-6.
  • 37. Ford HC, Toomath RJ, Carter JM, Delahunt JW, Fagerstrom JN. Mean platelet volume is increased in hyperthyroidism. Am J Hematol 1988; 27: 190-3.
APA DURMAZ T, ÖZDEMİR Ö, KELEŞ T, BAYRAM A, AKÇAY M, YETER E, AYHAN H, BOZKURT E (2009). Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity. Turkish Journal of Medical Sciences, 39(2), 259 - 265.
Chicago DURMAZ Tahir,ÖZDEMİR Özcan,KELEŞ Telat,BAYRAM Akar Nihal,AKÇAY Murat,YETER Ekrem,AYHAN HÜSEYİN,BOZKURT Engin Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity. Turkish Journal of Medical Sciences 39, no.2 (2009): 259 - 265.
MLA DURMAZ Tahir,ÖZDEMİR Özcan,KELEŞ Telat,BAYRAM Akar Nihal,AKÇAY Murat,YETER Ekrem,AYHAN HÜSEYİN,BOZKURT Engin Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity. Turkish Journal of Medical Sciences, vol.39, no.2, 2009, ss.259 - 265.
AMA DURMAZ T,ÖZDEMİR Ö,KELEŞ T,BAYRAM A,AKÇAY M,YETER E,AYHAN H,BOZKURT E Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity. Turkish Journal of Medical Sciences. 2009; 39(2): 259 - 265.
Vancouver DURMAZ T,ÖZDEMİR Ö,KELEŞ T,BAYRAM A,AKÇAY M,YETER E,AYHAN H,BOZKURT E Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity. Turkish Journal of Medical Sciences. 2009; 39(2): 259 - 265.
IEEE DURMAZ T,ÖZDEMİR Ö,KELEŞ T,BAYRAM A,AKÇAY M,YETER E,AYHAN H,BOZKURT E "Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity." Turkish Journal of Medical Sciences, 39, ss.259 - 265, 2009.
ISNAD DURMAZ, Tahir vd. "Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity". Turkish Journal of Medical Sciences 39/2 (2009), 259-265.