Prognostičko značenje elektrokardiografskih kriterija za hipertrofiju i opterećenje lijeve klijetke u hipertoničara sa simptomatskom perifernom arterijskom bolesti

master's thesis

• Title (english): Prognostic value of electrocardiographic criteria for left ventricular hyperthrophy and left ventricular strain in hypertensive patients with symptomatic peripheral artery disease
• Author: Ana Bojko
• Mentor: Mislav Vrsalović (mentor)
• Committee member: Diana Delić-Brkljačić (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Mislav Vrsalović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Periferna arterijska bolest (PAB) aterosklerotska je okluzivna bolest donjih ekstremiteta povezana s povećanim rizikom za nastanak kardiovaskularnih događaja. Uloga elektrokardiografskih kriterija za HLK kao pretkazatelja lošijeg kardiovaskularnog ishoda u bolesnika s cerebrovaskularnom bolesti, koronarnom bolesti i hipertenzijom visokog rizika potvrđena je u brojnim studijama, no nije dosad istraživana u bolesnika s PAB. Retrospektivna studija provedena je na 144 bolesnika sa simptomatskom PAB i očuvanom sistoličkom funkcijom lijeve klijetke (ejekcijska frakcija >50%) hospitalizirana na Klinici od siječnja 2010. do siječnja 2014. godine. Tijekom perioda praćenja od 36 ± 16 mjeseci 49 (34%) bolesnika razvilo je veliki kardiovaskularni događaj. Svi su istraživani elektrokardiografski kriteriji u univarijatnoj analizi bili signifikantno povezani s nastankom velikih kardiovaskularnih događaja. Nakon multivarijatne analize samo su bubrežna funkcija (HR 0,979; 95% Cl 0,965-0,994), Framinghamski bodovni sustav (HR 2,698; 95% Cl 1,205-6,041) te voltažni kriteriji za HLK udruženi sa znakovima opterećenja lijeve klijetke (HR 2,876; 95% Cl 1,463-5,653) bili nezavisno povezani s nepovoljnim kardiovaskularnim ishodom. Zaključno, elektrokardiografski Framinghamski bodovni sustav te kombinacija kriterija za HLK i opterećenje lijeve klijetke nezavisni su pretkazatelji povećanog rizika za pojavu velikog nepovoljnog kardiovaskularnog događaja u hipertoničara sa simptomatskom PAB i očuvanom sistoličkom funkcijom lijeve klijetke.

Abstract (english)

Peripheral artery disease (PAD), an occlusive disease affecting lower extremities, is associated with an increased risk of major adverse cardiovascular events (MACE). The value of electrocardiographic criteria for left ventricular hypertrophy (LVH) as a predictor of MACE has been confirmed in patients (pts) with cerebrovascular disease, coronary disease and high-risk hypertension, but hasn’t yet been investigated in patients with PAD. The retrospective study was conducted on 144 pts with symptomatic PAD and preserved left ventricular ejection fraction (LVEF >50%) at the University Hospital between January 2010 and January 2014. During median follow-up period of 36 ± 16 months 49 (34%) pts experienced MACE. The univariate analysis showed that all of the investigated electrocardiographic criteria were significantly associated with the occurrence of MACE. After multivariate analysis only renal function (HR 0,979; 95% Cl 0,965-0,994), Framingham criteria (HR 2,698; 95% Cl 1,205-6,041) and voltage criteria for LVH combined with left ventricular strain (HR 2,876; 95% Cl 1,463-5,653) were independently associated with adverse cardiovascular outcome. In conclusion, electrocardiographic Framingham criteria and the combination of both the criteria for LVH and left ventricular strain are independent predictors for the occurrence of MACE in hypertensive patients with symptomatic PAD and preserved left ventricular ejection fraction.

• Keywords: periferna arterijska bolest; elektrokardiografija; hipertrofija lijeve klijetke; opterećenje lijeve klijetke; kardiovaskularni ishod
• Keywords (english): peripheral artery disease; electrocardiography; left ventricular hypertrophy; left ventricular strain; cardiovascular outcome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:036226
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-11-21 08:55:08