Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
Kompanse Kalp Yetersizlikli Hastalarda Fiziksel Aktivite Alışkanlığı ve Uyku Kalite İndeksi ile İlgili Klinik ve Ekokardiyografik Parametreler
CLINICAL AND ECHOCARDIOGRAPHIC PARAMETERS RELATED WITH THE PHYSICAL ACTIVITY HABITUDE AND SLEEP QUALITY INDEX IN PATIENTS WITH COMPENSATED HEART FAILURE
Nurcan ARATa, Nesligül YILDIRIMa, Hakan ALTAYa, Onur ŞAHİNa, Yeliz SÖKMENa, İrfan SABAHa
aKardiyoloji Kliniği, Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, ANKARA
Turkiye Klinikleri J Cardiovasc Sci. 2006;18(3):196-205
Article Language: TR
Full Text
ÖZET
 Amaç: Kompanse kalp yetersizlikli hastalarda fiziksel aktivite alışkanlıklarını ve uyku kalitesini ekileyen klinik ve ekokardiyografik parametrelerin belirlenmesi amaçlandı. Gereç ve Yöntemler: Kliniğimizce takip edilmekte olan, kompanse sol kalp yetersizliği saptanan 100 hastanın demografik özellikleri, klinik ve laboratuvar bulguları ile ekokardiyografik ölçümleri incelendi. Tüm hastalara Pittsburgh uyku kalite indeksi formu ve Baecke fiziksel aktivite alışkanlık anketi uygulandı. Bulgular: Global PSQİ skoru ; cinsiyet, fonksiyonel kapasite, istirahat ağrısı, beta bloker kullanımı, iş indeksi ve boş zaman indeksi ile ilişkili bulundu (p< 0.05). Yaş, cinsiyet, diyabet, hipertansiyon, geçirilmiş Mİ, sol ventrikül ejeksiyon fraksiyonu, pulmoner arter basıncı, serum potasyum düzeyi, iş indeksi, boş zaman indeksi, fonksiyonel kapasite, istirahatte göğüs ağrısının olup olmaması ve beta bloker kullanımının uyku kalitesi belirleyicilerinin farklı komponentleri ile ilişkili olduğu gözlendi. Beta bloker kullanan hastalarda uyku süresi, uyku etkinliği, gündüz disfonksiyonu ve global PSQİ skorları beta bloker kullanmayan hastalara göre daha düşük bulundu (beta bloker kullanan ve kullanmayan hastalarda sırasıyla, uyku süresi;1.6 ± 1.0, 3.0 ± 0.01, p= 0.02, uyku etkinliği; 1.5 ± 1.4, 3.0±0.01, p= 0.001, gündüz disfonksiyonu; 2.0±0.8, 3.0 ± 0.002, p= 0.03, global PSQİ; 13.1 ± 4.8, 18.0, ± 0.01, p= 0.01). Sonuç: Kompanse kalp yetersizlikli hastalarda uyku problemleri oldukça sık görülmekte olup, hastalığa ait faktörler yanında hastaların egzersiz aktivite alışkanlıkları da uyku ile ilgili değişik parametrelerle ilişkili bulundu. Hastane içi ve dışında standart medikal tedavilerin yanında, hastaların yaşam kalitesini yükseltebilecek olumlu egzersiz ve günlük aktivite alışkanlıklarının geliştirilebilmesi için özel programlar planması düşünülmelidir.

Anahtar Kelimeler: Kalp yetersizliği; ekokardiyografi; fiziksel aktivite
ABSTRACT
 Objective: We aimed to evaluate the clinical and echocardiographic parameters that affect the physical activity habitude and sleep quality in patients with compensated heart failure. Metareial and Methods: The demographic variables, clinical and laboratory findings and echocardiographic parameters of 100 compensated left heart failure patients followed in our institution were examined. The Pittsburgh Sleep Quality Index (PSQI) and Baecke Questionnaire of Habitual Physical Activity were performed to all of the study patients. Results: Global PSQİ was found to be associated with sex, functional capacity, resting pain, beta-blockers, work-index and leisure-index (p< 0.05). Age, sex, diabetes mellitus, hypertension, functional capacity, pulmonary artery pressure, left ventricule ejection fraction, the presence or absence of pain durind resting, prior myocardial infarction, serum potassium level and physical activity habitude were found to be associated with the different components of the sleep quality in patients with compensated heart failure (p< 0.05). Sleep duration, sleep efficacy, daytime dyfunction and global PSQI scores were significanty lower in beta blockers users as compared with those who do not use these drugs, (sleep duration; 1.6 ± 1.0 vs. 3.0 ± 0,01, p= 0.02, sleep efficacy; 1.5 ± 1.4 vs. 3.0 ± 0.01, p= 0.001, daytime dysfunction; 2.0 ± 0.8 vs. 3.0 ± 0.002, p= 0.03, global PSQI; 13.1 ± 4.8 vs. 18.0, ± 0.01, p= 0.01, respectively). Conclusion: Sleep problems were highly prevalent in compensated heart failure patients. Not only the factors associated with the disease but also the physical activity habitude were found to be related to the components of the sleep quality. Daily physical activities that may improve the life quality of patients must be encouraged with standard in and out-hospital medical therapies.

Keywords: Heart failure, congestive; echocardiography; motor activity

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30.03.2014

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