Son 1 yıl içinde düşme öyküsü olan geritrik olguların barorefleks sensitivitesinin holter elektrokardiyografi ile değerlendirilmesi
Assesment of baroreflex hypersensitivity by holter electrocardiografic nmethod for the geriatric patients that have fallen in the last 1 year period.
- Tez No: 203153
- Danışmanlar: PROF.DR. SERVET ARIOĞUL
- Tez Türü: Tıpta Uzmanlık
- Konular: Hastaneler, Hospitals
- Anahtar Kelimeler: Falls, baroreflex hypersensitivity, holter electro cardiography, heatr rate variability
- Yıl: 2007
- Dil: Türkçe
- Üniversite: Hacettepe Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: İç Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
Özet yok.
Özet (Çeviri)
Isik M. Assesment of baroreflex hypersensitivity by holter electrocardiografic method for the geriatric patients that have fallen in the last 1 year period. Hacettepe University Faculty of Medicine, Thesis in Internal Medicine, Ankara 2007. Falls occur frequently in the geriatric population and as results an morbid and mortal syndrom. Yearly nearly 1/3 of the geriatric population falls at least once. It is nearly impossible to cure the results of falls; both the physiologycal and the psycologycal results of falls. So it is most important to keep the elderly away from falls. One of the important and curable etiological factors for falls is baroreflex hypersensitivity. Here we wanted to find the prevelance of baroreflex hypersensitivity by non-invasive methods in the elderly population who had fallen free of known etiology. We evaluated 33 patients who have fallen in the last 1 year but does not have diagnosis of diabetes, dementia, hypohyperthyroidism, serebrovascular accident, uncontrolled hypertension, cardiac failure, anemia, arrythmia, vitamin B12 deficiency, and who had a surgery for coronary heart disease. We also evaluated 31 control patients. All the patient are evaluated by the tinetti-poma walk and balance test for the risk of fall. All the labarotory test for anemia, liver function test, renal function tests, thyroid function tests, sedimantation, urine tests, vitamin B12 levels were done. Also all the patient were evaluated with the 24 hour holter electrocardiography. The patients that have fallen were also evaluated for the baroreflex hypersensitivity by the carotid sinus massage. 3 of 33 patients that have fallen were positive for the massage. All were offered to imlant a cardiak pace maker but only 1 accepted. The patiant that accepted did not fall again for the 3 months after the implantation of dual chamber cardiac pacemaker. The scores on the tinetti-poma walk and balance test were of course different tahat the fallers had lower scores. The parameters of holter electrocardiography that are related to the heart rate variability are also evaluated and only SDNN.N was istatistically different. This is a general parameter for HRV and means that there is a general autonomic dysfunction but for the localization of dysfunction the other parameters are not helpfull so new studies are needed. But the parameters for QT dynamicity and heart rate turbulance were istatistically different. This is meaningfull for the fact that all the pelderly patients must be evaluated for the baroreflex hypersensitivity if he or she has fallen free of external factors.
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