Visceral Leishmaniasis

6. SONUÇ VE ÖNERİLER

Gerek miyokarditis, gerekse aritmiler Leishmaniasisli hem insan hem de köpeklerde meydana gelebildiğinden EKG değişiklikleri, özellikle Pd ile cTnI konsantrasyonlarının bir arada değerlendirilmesi elzemdir. Bu çalışmada her iki parametrenin birlikte değerlendirilmesi, özellikle de CVL ile enfekte köpeklerde evrelere göre yapılan değerlendirme oldukça önemlidir. İnsan hekimliğinde miyokardiyal işemi ve nekrozisin saptanmasında serum cTnI konsantrasyonlarının önemli bir belirteç olarak kullanılmakta, primer veya sekonder kardiyak bozukluğu bulunan hayvanlarda da yüksek sensitivite ve spesifitiveye sahip olduğuda bildirilmektedir (Schober ve ark, 1999; Schober ve ark, 2002; Oyama ve ark, 2004; O’Brien ve ark, 2006; Wells ve ark, 2008; Sharkey ve ark, 2009). Serum cTnI, yalnızca kardiyak kas gruplarında yer almakta ve miyokardiyal hasarın derecesine ve miyosit membranının yıkımlanmasına bağlı olarak dolaşıma salınmaktadır (O’Brien ve ark, 2006). Yapılan birçok çalışma ile anılan bu belirtecin kardiyak hasarın ya da buna neden olan pankreatitis, anemi ve neoplastik oluşumlar gibi birçok diğer nedene bağlı durumlarda kullanılabileceği bildirilmiştir (Serra ve ark, 2010). Köpeklerde Babesiozis (Lobetti ve ark, 2002), Monositik Ehrlichiozis (Diniz ve ark, 2008), Chagas hastalığı (Barr ve ark, 2005) ve Leptospirozis (Mastrolelly ve ark, 2007) gibi hastalıklarda gizli miyokardiyal hasarı belirlemede serum cTnI seviyelerinin belirlendiği çalışmalar mevcuttur. Serum cTnI konsantrasyonları yaş ve leishmaniasis’li köpeklerde anemi ve azotemi ile ilişkili değişiklikler gösterdiği saptanmıştır (Silvestrini ve ark, 2012). Çalışmamızda da söz konusu değişikliklerin saptanmasıyla sonradan gerçekleştirilecek araştırmalara yol göstereceği muhakkaktır.

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