Troponin t'nin kronik böbrek yetmezlikli olgularda kardiyak etkilenmeyi göstermedeki yeri

Abstract

Giriş: Bu çalışmada kardiak troponin T(CTNT) kronik böbrek yetmezlikli çocuklarda kardiyak etkilenmedeki yerini göstermeyi ve kardiak tutulumu göstererek takipte mortaliteyi belirleme üzerindeki etkisini göstermeyi amaçladık.Method:33 (%47.9) kız olmak üzere 69 evre 3-4-5 ve son dönem kronik böbrek yetmezlikli olguya ekokardiografik inceleme yapıldı. Bu çalışmada ekokardiografi bulguları ile normal ve yüksek kardiak troponin T'li olguların ververileri karşılaştırıldı.Sonuç: 69 hastanın 13'ünde(%19) cTNT seviyeleri yüksek saptandı.cTNT seviyeleri normal ve yüksek olan hastaların ekokardiografik bulguları karşılaştırıldığında , cTNT yüksek olanlarda ortalama ejeksiyon fraksiyonuve fraksiyonel kısalma seveyeleri daha düşüktü (sırasıyla p:0.003 ve p:0.013), sol ventrikül sistolik disfonksiyon 5.5 kat daha fazla idi ve sol ventriküler hipertrofi 3 kat daha fazla idi(p:0.004,p:0.011)Sonuç:Serum cTNT ölçümü ile klinik semptommatik olmadan kardiak etkilenme hakkında fikir sahibi olmamızı sağlayabilir.

Background: In this study, we aimed to evaluate the role of cardiac troponin T (cTnT) in detecting myocardial involvement in children with chronic kidney disease (CKD) and to investigate whether it contributes to predicting cardiac involvement and mortality in follow-up. Methods: Echocardiographic (ECHO) evaluations were performed on a sample of 69 patients, of which 33 (47.8%) were female, with grade 3, 4 and 5 chronic renal failure and end-stage renal failure. In the study, echo findings of patients with normal cTnT levels and patients with high cTnT levels were compared. Results: In the study, cTnT levels were observed to be high in 13 (19%) of the 69 patients. The comparison between the patients with normal cTnT levels and patients with high cTnT level with regards to the echo findings revealed that in patients with high cTnT level, the average ejection fraction and fractional shortening levels were lower (p=0.003, p=0.013 respectively), the detection rate of left ventricular systolic dysfunction was 5.5 times higher and the rate of detection of left ventricular hypertrophy (LVH) was 3 times higher (p=0.004, p=0.011). Conclusions: In this study, it was shown that it is possible to obtain information about cardiac effects by examining the serum cTnT level before clinical symptoms occur in children with CKD, and that cTnT can be used for screening purposes. Key words: Chronic kidney disease, Cardiac troponin T, Cardiac influence