| Abstract | Cilj:
Pokazati mijenjaju li se hemodinamski parametri i pokazatelji arterijske elastičnosti u zdravih perimenopauzalnih žena tijekom vremenskog perioda od godine dana.
Ispitanici i metode:
Istraživanje je provedeno na kohorti od 8 zdravih ispitanica koje su na temelju pregleda i laboratorijskog nalaza koncentracije estradiola i FSH–a ušle u razdoblje perimenopauze. Isključni kriteriji su bili: dijabetes, arterijska hipertenzija, hiperlipidemija, autoimune bolesti, ovariektomija, hipergonadizam, anamneza koronarne bolesti, pušenje, pretilost, uzimanje hormonske nadomjesne terapije i oralne kontracepcije. U siječnju i veljači 2015. godine provedeno je prvo mjerenje, a nakon godinu dana drugo mjerenje istih ispitanica. Hemodinamski parametri i pokazatelji arterijske elastičnosti bili su mjere ishoda: periferni sistolički i dijastolički arterijski tlak te tlak pulsa, središnji sistolički arterijski tlak i središnji tlak pulsa, središnji augmentacijski indeks i brzina širenja pulsnog vala. Mjerenja su učinjena primjenom uređaja Arteriograph (TensioMed TM Kft, Budimpešta, Mađarska), čiji se princip rada temelji na oscilometriji.
Rezultati:
Najmlađa ispitanica imala je 47 godina, a najstarija 54 godine. Indeks tjelesne mase ispitanica bio je u rasponu od 20,9 kg/m2 do 24,8 kg/m2. Tijekom vremenskog perioda od godine dana između mjerenja nije bilo promjena u mjerenim antropometrijskim obilježjima ispitanica. Tijekom vremenskog perioda od godinu dana nije došlo do značajnog porasta ni sistoličkog (P=0,844), niti dijastoličkoga tlaka (P=0,609). Medijan vrijednosti početnih mjerenja (1. mjerenje) bio je 111 mmHg za sistolički tlak i 73 mmHg za dijastolički tlak. Medijan vrijednosti nakon godine dana (2. mjerenje) bio je 112 mm Hg za sistolički, a 76 mm Hg za dijastolički tlak. Nije se mijenjao niti tlak pulsa (P=0,328). Medijan tlaka pulsa u prvom mjerenju bio je 41 mmHg, a u drugom mjerenju 38 mmHg. Vrijednosti središnjeg sistoličkog tlaka pokazale su veću varijabilnost, ali se također nisu mijenjale tijekom godine. Medijan je u oba mjerenja bio 110 mmHg. Središnji tlak pulsa se neznačajno smanjio (P=0,148), od 32 mmHg u 1. mjerenju na 29 mmHg u 2. mjerenju. Središnji augmentacijski indeks (AIx) i brzina prenošenja pulsnoga vala nisu se značajno promijenile tijekom godine dana. Središnji je augmentacijski indeks u prvom mjerenju bio 36,6 %, a u drugom mjerenju 38,1 %, P=0,109. Medijan je vrijednosti brzine prenošenja pulsnog vala u prvom mjerenju bio 9,2 m/s, a u drugom mjerenju 9,6 m/s, P=0,297.
Zaključak:
Iako su koncentracije estradiola i FSH-a te ginekološki nalaz ukazivali da su ispitanice ušle u razdoblje perimenopauze nije došlo do očekivanog smanjivanja arterijske elastičnosti tijekom godine dana. U istraživanje su uključene zdrave žene, te su svi izmjereni hemodinamski parametri i pokazatelji arterijske elastičnosti bili u rasponima fizioloških vrijednosti. Zaključujemo da u relativno kratkom vremenskom periodu od godine dana nije došlo do izražaja mogućih početnih patofizioloških zbivanja na stjenkama „zdravih” arterija koji bi se očitovali smanjivanjem arterijske elastičnosti. |
| Abstract (english) | Objectives:
To study if the hemodynamic parameters and arterial elasticity indicators of healthy perimenopausal women change during the course of a year.
Patients and Methods:
The study has been conducted in a cohort of eight healthy patients who have reached menopause based on the physical examination and the results of estradiol and FSH concentration laboratory tests. Exclusion criteria have been a history of diabetes, arterial hypertension, hyperlipidaemia, autoimmune disease, ovariectomy, hypergonadism, coronary disease anamnesis, smoking, obesity, taking hormone replacement therapy and oral contraceptives. The first measurement was taken in January and February 2015 and a year later the same patients´ measurements were taken once more. Hemodynamic parameters and arterial elasticity indictors served as outcome measures: peripheral systolic and diastolic arterial pressure as well as pulse pressure, central systolic arterial pressure and central pulse pressure, central augmentation index and pulse pressure velocity. The measurements were taken by means of Arteriograph (TensioMed TM Kft, Budapest, Hungary), a device employing the oscillometric principle
Results:
The youngest test subject was forty-seven years old and the oldest one was fifty-five. The patients' body mass index varied from 20.9 kg/ m2 to 24.8 kg/m2.During the course of a year there have been no differences in the measured anthropometric variables. During this period of time there have been no significant rise of the systolic (P=0.844) of diastolic pressure (P=0.609). Initial measurements' median (the first measurements) was 111mmHg for systolic pressure and 73 mmHg for diastolic pressure. A year later, the measurements' median (the second measurements) was 112 mmHg for systolic and 76 mmHg for diastolic pressure. Pulse pressure has neither changed (P=0.328). Initial pulse pressure median was 41 mmHg while the second measurement's median was 38 mmHg. Central systolic pressure's values have displayed greater variability; however there has been no change during the course of a year. Both measurements' median was 110 mmHg. The central pulse pressure has insignificantly decreased (P=0.148) from 32 mmHg in the initial measurement to 29 mmHg in the second measurement. Central augmentation index (AIx) and pulse wave velocity has not changed significantly. Central augmentation index of the initial measurements was 36.6% and in the following measurements it was 38.1%, P=0.109. Pulse wave velocity median of the initial measurement was 9.2 m/s and in the second measurement it was 9.6 m/s, P=0.297.
Conclusion:
Even though the estradiol and FSH concentration as well as the gynaecological examination have shown that the patients have reached perimenopause, there have been no expected decrease in the arterial elasticity in the course of a year. The study has included healthy women and all the measured hemodynamic parameters and arterial elasticity indicators have been within the physiological values. Thus, it is possible to conclude that during a relatively short period of time – one year, there has been no indications of possible pathophysiological processes on the “healthy“ arterial walls that would be indicated by means of decreased arterial elasticity. |
