Çalışmamızda PA sertliği parametrelerinin değerlendirilmesinde kardiyak MRG ve SKK yöntemleri karşılaştırılmış 2 yöntem arasında orta, yüksek ve çok yüksek düzeyde korelasyon tespit edilmiştir. Bu korelasyonun yapılacak daha geniş çalışmalarla
desteklenmesi, doğrulanması ve validasyonu; PA sertliğinin günlük pratikteki kullanımına olanak sağlayabilir ve PHT tanı, takip ve tedavisinin yönetiminde non-invaziv yöntemlerin kullanımını arttırarak invaziv yöntemlerin gerekliliğini azaltabilir. Bu yöntemlerin
korelasyonunun doğrulanması ve standardize edilmesi halinde; fonksiyonel sınıfı kötü olup SKK‟yi tolere edemeyen hastalarda, klinik yanıtın değerlendirilmesinde PA sertliği objektif bir parametre olarak katkı sağlayabilir. Bu korelasyon çalışması hastaların izlemi ile
91 yönlendirici olup olmayacağı ve sağ kalp kateterizasyonu ile PA basınçları normal saptansa bile PA sertliğindeki bozulma ile vakaların daha erkenden tanınıp tanınamayacağı konusunda bilgi sağlayabilir. Bu hastaların izlemleri ile ilgili yapılacak yeni çalışmalar ile PA sertliği- prognoz ilişkisi konusunda daha geniş bilgiler sağlayabilir. Daha yüksek hasta sayısı ve hasta izlemi ile tekrarlayan çalışmalarla bu korelasyonun doğrulanması ve standardize edilmesi halinde kardiyak MRG, pulmoner arteriyel sertliğinin/sağ yapıların bozulduğu göstererek PAH açısından risk altındaki grubun daha yakın izlemi açısından uyarıcı olabilir.
Çalışmamızda, TTE ile saptanmamış olan bazı kardiyak anomalilerin kardiyak MRG ile tanınabildiği gözlenmiştir. 2 boyutlu transtorasik ekokardiyografi ile rutin pratik ekokardiyografik değerlendirme sırasında venöz dönüş anomalileri vb. konjenital defektleri olan olgular tanımlanmayabilmektedir. Bu durum PAH‟lı olgularda doğumsal kalp hastalığı sıklığının beklenenin üstünde olabileceğini düşündürmüştür. Kardiyak MRG‟nin PHT tanısında kullanımının yaygınlaşması bu anlamda da önem taşıyacaktır.
92
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