Yıl: 2009 Cilt: 37 Sayı: 3 Sayfa Aralığı: 168 - 173 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow

Öz:
Amaç: Çalışmamızda yavaş koroner kan akımı (YKA) olan hastalarda serum gama-glutamiltransferaz (GGT) aktivitesi ile koroner kan akımı arasındaki ilişki araştırıldı. Ça­lış­ma pla­nı: Çalışmaya YKA saptanan 90 hasta (47 erkek, 43 kadın; ort. yaş 50.8±9.4) ve koroner arter hastalığı (KAH) olan 88 hasta (45 erkek, 43 kadın; ort. yaş 50.8±9.4) alındı. Yavaş koroner kan akımı ve KAH tanıları koroner anjiyografi ile kondu. Koroner arter hastalığı olan grupta normal koroner akım vardı. Tüm hastalarda koroner akım düzeltilmiş TIMI kare sayısı ile değerlendirildi ve serum GGT düzeyleri ölçüldü. Sonuçlar, yaş ve cinsiyet uyumlu ve koroner arterleri ve koroner akımı normal bulunan 86 hastadan oluşan kontrol grubuyla karşılaştırıldı. Bul­gu­lar: Gruplar arasında beden kütle indeksi, hipertansiyon ve diyabet varlığı, lipit profili ve açlık kan şekeri açısından fark yoktu. Koroner arter hastalığı olan grupta ilaç kullanımı anlamlı derecede fazlaydı (p<0.01). Kontrol grubuyla karşılaştırıldığında, serum GGT aktivitesi YKA’lı ve KAH’li gruplarda anlamlı derecede yüksek bulundu (p<0.01); ancak, iki grup arasında bu açıdan fark yoktu (p=0.71). Epikardiyal koroner arterlerde ölçülen TIMI kare sayıları ve ortalama TIMI kare sayısı YKA grubunda anlamlı derecede yüksek bulundu (p<0.01). TIMI kare sayıları açısından KAH grubu ile kontrol grubu arasında fark yoktu. Ortalama TIMI kare sayısı serum GGT düzeyi ile orta düzeyde pozitif ilişki gösterdi (r=0.326; p<0.001). Regresyon analizinde, serum GGT aktivitesi ortalama TIMI kare sayısını öngörmede tek bağımsız değişken idi (β=0.309; p<0.001). So­nuç: Çalışmamızda artmış serum GGT aktivitesi ile YKA arasındaki ilişki ilk kez gösterilmiş olmaktadır. Serum GGT aktivitesinin YKA’da tam patofizyolojik rolünü ortaya koymak için ileri çalışmalara ihtiyaç vardır.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Yüksek serum gama-glutamiltransferaz aktivitesi ile yavaş koroner akım arasındaki ilişki

Öz:
Objectives: We evaluated the relationship between coronary blood flow and serum gamma-glutamyltransferase(GGT) activity in patients with slow coronary flow (SCF).Study design: The study included 90 patients (47 men,43 women; mean age 50.8±9.4 years) with SCF and 88patients (45 men, 43 women; mean age 51.4±8.8 years)with coronary artery disease (CAD), whose diagnoses weremade by coronary angiography. Patients with CAD had nor- mal coronary flow. Coronary flow was quantified using thecorrected TIMI frame count (TFC) method and serum levelsof gamma-glutamyltransferase were measured. The resultswere compared with those of a control group consisting of86 age- and sex-matched patients who had normal coronaryarteries and normal coronary flow. Results: The three groups were similar with respect tobody mass index, presence of hypertension and diabetesmellitus, lipid profiles, and fasting glucose. The use of medi- cations was significantly more common in the CAD group(p<0.01). Compared to the control group, serum GGT activ- ity was significantly increased in both SCF and CAD groups(p<0.01), but these two groups did not differ significantly inthis respect (p=0.71). The TFCs for all the epicardial coro- nary arteries and the mean TFC were significantly higher inthe SCF group (p<0.01). Patients with CAD and the controlshad similar TFC parameters. The mean TFC showed apositive and moderate correlation with serum GGT activ- ity (r=0.326; p<0.001). In regression analysis, serum GGTactivity was found as the only independent predictor of themean TFC (&#946;=0.309; p<0.001). Conclusion: We have shown for the first time an asso- ciation between increased serum GGT activity and SCF.Further clinical studies are needed to clarify the physio- pathologic role of serum GGT activity in SCF.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Tambe AA, Demany MA, Zimmerman HA, Mascarenhas E. Angina pectoris and slow flow velocity of dye in coronary arteries-a new angiographic finding. Am Heart J 1972;84:66-71.
  • 2. Pekdemir H, Cin VG, Çiçek D, Çamsarı A, Akkuş N, Döven O, et al. Slow coronary flow may be a sign of diffuse atherosclerosis. Contribution of FFR and IVUS. Acta Cardiol 2004;59:127-33.
  • 3. Graham IM, Daly LE, Refsum HM, Robinson K, Brattström LE, Ueland PM, et al. Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project. JAMA 1997;277:1775-81.
  • 4. Tawakol A, Omland T, Gerhard M, Wu JT, Creager MA. Hyperhomocyst(e)inemia is associated with impaired endothelium-dependent vasodilation in humans. Circulation 1997;95:1119-21.
  • 5. Mosseri M, Yarom R, Gotsman MS, Hasin Y. Histologic evidence for small-vessel coronary artery disease in patients with angina pectoris and patent large coronary arteries. Circulation 1986;74:964-72.
  • 6. Lee DH, Jacobs DR Jr, Gross M, Kiefe CI, Roseman J, Lewis CE, et al. Gamma-glutamyltransferase is a predic tor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem 2003;49:1358-66.
  • 7. Emdin M, Passino C, Michelassi C, Titta F, L’abbate A, Donato L, et al. Prognostic value of serum gammaglutamyl transferase activity after myocardial infarction. Eur Heart J 2001;22:1802-7.
  • 8. Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879-88.
  • 9. Mangieri E, Macchiarelli G, Ciavolella M, Barillà F, Avella A, Martinotti A, et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet Cardiovasc Diagn 1996;37:375-81.
  • 10. De Bruyne B, Hersbach F, Pijls NH, Bartunek J, Bech JW, Heyndrickx GR, et al. Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but “Normal” coronary angiography. Circulation 2001;104:2401-6.
  • 11. Li JJ, Xu B, Li ZC, Qian J, Wei BQ. Is slow coronary flow associated with inflammation? Med Hypotheses 2006;66:504-8.
  • 12. Turhan H, Saydam GS, Erbay AR, Ayaz S, Yaşar AS, Aksoy Y, et al. Increased plasma soluble adhesion molecules; ICAM-1, VCAM-1, and E-selectin levels in patients with slow coronary flow. Int J Cardiol 2006;108:224-30.
  • 13. Lanza GA, Andreotti F, Sestito A, Sciahbasi A, Crea F, Maseri A. Platelet aggregability in cardiac syndrome X. Eur Heart J 2001;22:1924-30.
  • 14. Gökçe M, Kaplan S, Tekelioğlu Y, Erdoğan T, Küçükosmanoğlu M. Platelet function disorder in patients with coronary slow flow. Clin Cardiol 2005;28:145-8.
  • 15. Camsarl A, Pekdemir H, Çicek D, Polat G, Akkuş MN, Döven O, et al. Endothelin-1 and nitric oxide concentrations and their response to exercise in patients with slow coronary flow. Circ J 2003;67:1022-8.
  • 16. Pekdemir H, Polat G, Cin VG, Çamsarı A, Çiçek D, Akkuş MN, et al. Elevated plasma endothelin-1 levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow. Int J Cardiol 2004;97:35-41.
  • 17. Yıldız A, Gür M, Yılmaz R, Demirbağ R, Polat M, Selek S, et al. Association of paraoxonase activity and coronary blood flow. Atherosclerosis 2008;197:257-63.
  • 18. Enli Y, Türk M, Akbay R, Evrengül H, Tanrıverdi H, Kuru O, et al. Oxidative stress parameters in patients with slow coronary flow. Adv Ther 2008;25:37-44.
  • 19. Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999;340:115-26.
  • 20. Lee RT, Libby P. The unstable atheroma. Arterioscler Thromb Vasc Biol 1997;17:1859-67.
  • 21. Berliner JA, Heinecke JW. The role of oxidized lipoproteins in atherogenesis. Free Radic Biol Med 1996; 20:707-27.
  • 22. Paolicchi A, Minotti G, Tonarelli P, Tongiani R, De Cesare D, Mezzetti A, et al. Gamma-glutamyl transpeptidase-dependent iron reduction and LDL oxidation-apotential mechanism in atherosclerosis. J Investig Med 1999;47:151-60.
  • 23. Wannamethee G, Ebrahim S, Shaper AG. Gammaglutamyltransferase: determinants and association with mortality from ischemic heart disease and all causes. Am J Epidemiol 1995;142:699-708.
  • 24. Epstein SE, Cannon RO 3rd, Talbot TL. Hemodynamic principles in the control of coronary blood flow. Am J Cardiol 1985;56:4E-10E.
  • 25. Erdoğan D, Çalışkan M, Güllü H, Sezgin AT, Yıldırır A, Müderrisoğlu H. Coronary flow reserve is impaired in patients with slow coronary flow. Atherosclerosis 2007;191:168-74.
  • 26. Beltrame JF, Turner SP, Leslie SL, Solomon P, Freedman SB, Horowitz JD. The angiographic and clinical benefits of mibefradil in the coronary slow flow phenomenon. J Am Coll Cardiol 2004;44:57-62.
  • 27. Chen JW, Hsu NW, Wu TC, Lin SJ, Chang MS. Longterm angiotensin-converting enzyme inhibition reduces plasma asymmetric dimethylarginine and improves endothelial nitric oxide bioavailability and coronary microvascular function in patients with syndrome X. Am J Cardiol 2002;90:974-82.
  • 28. Pizzi C, Manfrini O, Fontana F, Bugiardini R. Angiotensin converting enzyme inhibitors and 3-hydroxy-3-methylglutaryl coenzyme A reductase in cardiac Syndrome X: role of superoxide dismutase activity. Circulation 2004; 109:53-8.
  • 29. Li JJ, Zheng X, Li J. Statins may be beneficial for patients with slow coronary flow syndrome due to its anti-inflammatory property. Med Hypotheses 2007;69:333-7.
  • 30. Çakmak M, Tanrıverdi H, Çakmak N, Evrengül H, Çetemen S, Kuru O. Simvastatin may improve myocardial perfusion abnormality in slow coronary flow. Cardiology 2008;110:39-44.
  • 31. Roberts WC, Jones AA. Quantitation of coronary arterial narrowing at necropsy in sudden coronary death: analysis of 31 patients and comparison with 25 control subjects. Am J Cardiol 1979;44:39-45.
  • 32. Ge J, Erbel R, Gerber T, Görge G, Koch L, Haude M, et al. Intravascular ultrasound imaging of angiographically normal coronary arteries: a prospective study in vivo. Br Heart J 1994;71:572-8.
  • 33. Abacı A, Oğuzhan A, Eryol NK, Ergin A. Effect of potential confounding factors on the thrombolysis in myocardial infarction (TIMI) trial frame count and its reproducibility. Circulation 1999;100:2219-23.
APA ŞEN N, ÖZLÜ M, BAŞAR N, ozcan f, GÜNGÖR Ö, TURAK O, MALÇOK Ö, ÇAĞLI K, Orhan O, ERBAY A, DEMİR A (2009). Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. , 168 - 173.
Chicago ŞEN Nihat,ÖZLÜ Mehmet F.,BAŞAR Nurcan,ozcan firat,GÜNGÖR Ömer,TURAK Osman,MALÇOK Özgül,ÇAĞLI Kumral,Orhan Orhan,ERBAY Ali R.,DEMİR Ahmet D. Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. (2009): 168 - 173.
MLA ŞEN Nihat,ÖZLÜ Mehmet F.,BAŞAR Nurcan,ozcan firat,GÜNGÖR Ömer,TURAK Osman,MALÇOK Özgül,ÇAĞLI Kumral,Orhan Orhan,ERBAY Ali R.,DEMİR Ahmet D. Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. , 2009, ss.168 - 173.
AMA ŞEN N,ÖZLÜ M,BAŞAR N,ozcan f,GÜNGÖR Ö,TURAK O,MALÇOK Ö,ÇAĞLI K,Orhan O,ERBAY A,DEMİR A Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. . 2009; 168 - 173.
Vancouver ŞEN N,ÖZLÜ M,BAŞAR N,ozcan f,GÜNGÖR Ö,TURAK O,MALÇOK Ö,ÇAĞLI K,Orhan O,ERBAY A,DEMİR A Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. . 2009; 168 - 173.
IEEE ŞEN N,ÖZLÜ M,BAŞAR N,ozcan f,GÜNGÖR Ö,TURAK O,MALÇOK Ö,ÇAĞLI K,Orhan O,ERBAY A,DEMİR A "Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow." , ss.168 - 173, 2009.
ISNAD ŞEN, Nihat vd. "Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow". (2009), 168-173.
APA ŞEN N, ÖZLÜ M, BAŞAR N, ozcan f, GÜNGÖR Ö, TURAK O, MALÇOK Ö, ÇAĞLI K, Orhan O, ERBAY A, DEMİR A (2009). Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. Türk Kardiyoloji Derneği Arşivi, 37(3), 168 - 173.
Chicago ŞEN Nihat,ÖZLÜ Mehmet F.,BAŞAR Nurcan,ozcan firat,GÜNGÖR Ömer,TURAK Osman,MALÇOK Özgül,ÇAĞLI Kumral,Orhan Orhan,ERBAY Ali R.,DEMİR Ahmet D. Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. Türk Kardiyoloji Derneği Arşivi 37, no.3 (2009): 168 - 173.
MLA ŞEN Nihat,ÖZLÜ Mehmet F.,BAŞAR Nurcan,ozcan firat,GÜNGÖR Ömer,TURAK Osman,MALÇOK Özgül,ÇAĞLI Kumral,Orhan Orhan,ERBAY Ali R.,DEMİR Ahmet D. Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. Türk Kardiyoloji Derneği Arşivi, vol.37, no.3, 2009, ss.168 - 173.
AMA ŞEN N,ÖZLÜ M,BAŞAR N,ozcan f,GÜNGÖR Ö,TURAK O,MALÇOK Ö,ÇAĞLI K,Orhan O,ERBAY A,DEMİR A Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. Türk Kardiyoloji Derneği Arşivi. 2009; 37(3): 168 - 173.
Vancouver ŞEN N,ÖZLÜ M,BAŞAR N,ozcan f,GÜNGÖR Ö,TURAK O,MALÇOK Ö,ÇAĞLI K,Orhan O,ERBAY A,DEMİR A Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow. Türk Kardiyoloji Derneği Arşivi. 2009; 37(3): 168 - 173.
IEEE ŞEN N,ÖZLÜ M,BAŞAR N,ozcan f,GÜNGÖR Ö,TURAK O,MALÇOK Ö,ÇAĞLI K,Orhan O,ERBAY A,DEMİR A "Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow." Türk Kardiyoloji Derneği Arşivi, 37, ss.168 - 173, 2009.
ISNAD ŞEN, Nihat vd. "Relationship between elevated serum gamma-glutamyltransferase activity and slow coronary flow". Türk Kardiyoloji Derneği Arşivi 37/3 (2009), 168-173.