Effect of septoplasty on left ventricular functions, systemic immune inflammatory index and electrocardiographic parameters as arrhythmia predictors

Introduction: The deformities that occur in different forms in the bone and cartilage septum that divides the nasal cavity are called nasal septum deviation. Nasal septal deviation is one of the common causes of upper airway obstruction, and its relationship with some electrocardiographic, echocardiographic and laboratory parameters has been investigated in previous studies. Obstructive respiratory events have been shown to cause intermittent hypoxemia, increased ventricular load, and impaired sympathovagal balance. The frontal plane QRS-T angle is the difference between the QRS axis and T axis values in the standard 12-lead ECG. This difference, which indicates the deviation in the direction of depolarization and repolarization in the ventricle, has been shown to be associated with arrhythmias. In this study, we investigated whether there was a difference before and after septoplasty, especially in terms of arrhythmia and subclinical left ventricular functions in patients who underwent septoplasty for NSD. Method: The study included 70 patients with NSD who were candidates for septoplasty, aged 18-65 years, who were eligible for inclusion and exclusion criteria, and the data of this group at the 3rd month follow-up after septoplasty. Preoperative and postoperative socio-demographic characteristics, laboratory data, electrocardiographic and echocardiographic evaluations of the group were examined. In conventional echocardiographic examination, right and left ventricular systolic and diastolic diameters, estimated systolic pulmonary artery pressure measurements were evaluated.Left ventricular diastolic and systolic volumes, left ventricular ejection fraction, stroke volume and cardiac output were evaluated with 4-dimensional echocardiography.In addition, left ventricular strains were evaluated with 4D Strain echocardiography. Results: In the study, significant dilatation was observed in the biventricular and biatrial diameters of the patients after septoplasty in conventional echocardiography. Left ventricular ejection fraction, end-diastolic volume, stroke volume and cardiac vii output values evaluated by 4D echocardiography increased after septoplasty. A statistically significant increase was observed in the left ventricular strain values(Global Area, Radial, Circumferential, Longitudinal strain) after septoplasty compared to the values before septoplasty. In our study in addition to conventional echocardiographic parameters, we showed improvement in LV 4B strain values, which is an indicator of subclinical cardiac dysfunction, after septoplasty in patients with NSD.In addition, it was observed in the study that the fQRS-T angle decreased after septoplasty.In the analyzes performed, a significant correlation was observed between Left ventricular Global Field Strain change and Frontal QRS-T angle change. Conclusion: We determined that the frontal plane QRS-T angle can be used as an early indicator of myocardial dysfunction in patients with NSD. We think that our study will contribute to the literature as it evaluates the changes in cardiac functions in patients with NSD and correlates them with easily accessible ECG parameters. Keywords: 4D Echocardiography, Frontal QRS-T Angle, Nasal Septal Deviation,Septoplasty, Strain,