Markeri opterećenja desnog srca u akutnoj plućnoj emboliji

master's thesis

• Title (english): Markers of right ventricular dysfunction in acute pulmonary embolism
• Author: Sara Soraja Nasri
• Mentor: Gordana Pavliša (mentor)
• Committee member: Mateja Janković Makek (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Gordana Pavliša (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Aktuna plućna embolija (PE) i duboka veska tromboza (DVT) dio su entiteta venski tromboembolizam ( VTE). Rizični čimbenici za nastanak VTE su oštećenje endotela, staza krvi i hiperkoaguabilnost krvi, tvz. Virhovljew trijas. U patofiziologiji PE dolazi do ventilacijsko – perfuzijskog nesrazmjera, a kod opsežnije opstrukcije plućne cirkulacije može se razviti i opterećenja desnog srca. Opterećenje desnog srca povezano je s lošijim ishodom bolesti i većom stopom smrtnosti. Serumska razina troponina i B-tipa natriuretičkog peptida (BNP) odražavaju težinu disfunkcije i hemodinamskog opterećenja desnog ventrikla u akutnoj PE. U hemodinamski stabilnih bolesnika, serumska razina troponina važan je element u procjeni težine kliničke slike i rizika rane smrti. Uloga drugih biokemijskih markera, kao što su srčani protein koji veže masne kiseline (H-FABP), faktor diferencijacije rasta -15, cistatin-C, kopeptin, se još istražuje. Osim laboratorijskih markera, klinička procjena te procjena morfologije i funkcije desnog ventrikla pomoću ehokardiografije i kompjuterizirane tomografije važne su metode za prognostičku procjenu normotenzivnih bolesnika s akutnom PE. Liječenje PE zasniva se na stabilizaciji hemodinamski i respiratorno ugroženih bolesnika, antikoagulatnoj terapiji, a u visokorizičnih bolesnika u obzir dolazi sistemska tromboliza, kateterska tromboliza ili kirurška embolektomija.

Abstract (english)

Acute pulmonary embolism (PE) and deep vein thrombosis (DVT) are part of the entity venous thromboembolism (VTE). Risk factors for the development of VTE are endothelial damage, blood pathways and hypercoagulability of blood, the so called Virhow's Triad. In the pathophysiology of PE, there is a ventilation - perfusion mismatch, and with more extensive obstruction of the pulmonary circulation, dysfuntion of the right heart can develop. Right heart dysfunction is common in severe PE cases and is associated with worse disease outcome and higher mortality rates. Serum troponin and B-type natriuretic peptide (BNP) levels reflect the severity of right ventricular dysfunction and hemodynamic load in acute PE. In hemodynamically stable patients, serum troponin levels are an important element in assessing the severity of the clinical picture and the risk of early death. The role of other biochemical markers, such as cardiac fatty acid binding protein (H-FABP), growth differentiation factor -15, cystatin-C, and kopeptin, is still being investigated. In addition to laboratory markers, clinical assessment and the assessment of right ventricular morphology and function using echocardiography and computed tomography are important methods for prognostic assessment of normotensive patients with acute PE. Treatment of PE is based on the stabilization of hemodynamically and respiratory endangered patients, anticoagulant therapy, and in high-risk patients, systemic thrombolysis, catheter thrombolysis or surgical embolectomy is considered.

• Keywords: akutna plućna embolija; troponin; B-tip natriuretički peptid; opterećenje desnog srca
• Keywords (english): acute pulmonary embolism; troponin; B-type natriuretic peptide; right ventricular dysfunction
• Language: croatian
• URN:NBN: urn:nbn:hr:105:045417
• 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: 2022-03-24 10:15:43