- Email: [email protected]
Multimodality imaging in invasive treatment of pulmonary embolism
260
Archives of Cardiovascular Diseases Supplements (2017) 9, 260-261
Session 8 – Ischemic Heart Disease, StressEcho, Pericardium, Emergency Friday June 16 – 15.30 – 16.00
a known history of AF. A pre-operative transthoracic echocardiography was performed in all patients, the LA area and volume index was enregistred, PALS and PACS was collected by studying the curve of LA longitudinal 2D strain in the apical view : 4 and 2 chamber. Patients were divided in two groups: Patients with post-operative atrial fibrillation (FAPO, n=17, 24,2%) or without post-operative atrial fibrillation (FAPO, n=53): POAF was detected with continuous electrocardiography monitoring. Results The mean age was 68.42 ± 6.26 years (Gp FAPO +: 69.28 ± 4.2 years / Gp FAPO-: 62.23 ± 5.2 years, p <0.01) . The left atrium area was significantly greater in the FAPO + Gp (23.4 ± 3.2cm² / 19.6 ± 2.8 cm², p <0.01 ), LA volume index was significantly greater in the Gp FAPO+ (31.4 ± 3,6ml/m² versus 28.5 ± 3.1 ml/m², p <0.001), PALS and PACS were significantly decreased in the Gp FAPO + (PALS = 21.3 ± 2.6% vs 36 ± 7.2%, p <0.001/ PACS : 7,2±3,2% vs 10,2 ±2,1%, p <0.001).
48 Interest of The Study of Left Ventricular Function by 2D strain in Acute Coronary Syndrome H. Ben Gaid Hassine*, W. Daly, H. Ben Slima, A. Ben Khalfallah Cardiology Department – Menzel Bourguiba Hospital, Bizerte, Tunisie. *Corresponding author : [email protected] Introduction The 2D Strain is a new echo-cardiographic technique allowing the study of the myocardial deformation based on a follow-up of the acoustic markers of the left ventricle (LV) wall.The aim of our study is to validate the contribution of this technique in the detection of the ischemia and in the prediction of the culprit coronary axis and the number of vessels affected and also to analyze the correlation of this parameter with the left ventricle ejection fraction (LVEF) and the Wall Motion Score Index (WMSI). Methods This prospective study included 173 consecutive patients admitted for acute coronary syndrome (ACS) during the period between January 2015 and October 2016.All the patients had echocardiography with analysis of function by 2D Strain and a coronary angiography .The data have been listed on an SPSS database. Results The mean age of patients was 62±10 years with male predominance 6M/1F.The mean LVEF is 50 ± 10%, the mean global longitudinal peak systolic strain (GLPSS) is –14 ± 4% .The study showed that GLPSS is more impaired when the left anterior descending (LAD) is affected with an average of –13.9% versus –17.2% and –17.8% for left circumflex (LCx) and right coronary artery (RCA) respectively.The statistical study showed a significant correlation between GLPSS and the age;the type of ACS;the LVEF and the WMSI.The study showed a significant correlation between GLPSS and the severity of coronary artery disease (p <0.001) and especially a significant correlation with the culprit coronary axis (p <0.001).In Fact;the longitudinal strain has been predicted the culprit coronary axis in 92% of the cases in our study. Conclusion The 2D Longitudinal Strain represents an excellent parameter which allows a reliable detection of an alteration in the systolic function of the LV in ischemic heart disease and it’s very useful in prediction of the culprit coronary axis and the number of vessels affected. The authors declare that they have no competing of interest
Conclusion Significantly older age, significantly greater LA volume index, and significantly decreased PALS and PACS were observed in patients with FAPO. These findings may be useful in the management of such patients. It could be used to better identify patients at greater risk of developing POAF. The authors declare that they have no competing of interest
50 Multimodality imaging in invasive treatment of pulmonary embolism L. Masmoudi*, R. Bourezak, M. Aouiche EHS Abderrahmani – Alger (Algérie). Corresponding author: [email protected] Introduction this study retrospectively reviews an agressive multidisciplinary approach to the treatement of submassive or massive pulmonary embolism, centering on rapid diagnosis with contrast enhanced computed tomography of the chest to define the location of obstruction and transthoracic echocardiography to document right ventricular function, followed by immediate surgery when appropriate. Methods 19 patients underwent emergency surgical embolectomy for massive or submassive central pulmonary embolism. The indication for surgical intervention were: right ventricular dysfonction, hemodynamic instability or non cruoric embol. Echocardiography and computed tomography was systematic. Results Our series included 19 patients operated in emergency of pulmonary embolism, whose etiology was fibrinocruoric in 37% of cases, iatrogenic in 37%, tumoral in 16%, and parasitic in 10%. All patients were referred to us after hemodynamic stabilization in intensive care units. Echocardiography was systematic to evaluate cardiac cavity repercussions and pulmonary pressures, thus enabling the surgical team to evaluate the operative risks, and the resuscitation team to plan the management per and postoperative. Pulmonary arterial pressures were between 50 and 70mmhg, with dilation of the right cavities and pulmonary trunk. Mortalitywas 5%. The postoperative monitoring of patients recorded normalization of Pulmonary pressures in 16 patients (84%), the other three kept pulmonary pressures > 40 mmhg . Conclusion An agressive approach to large pulmonary embolus, including rapid diagnosis and prompt surgical intervention has improved results with surgical embolectomy.
49 Left atrial strain as assessed by two-dimensional speckle tracking predicts post-operative atrial fibrillation
The authors declare that they have no competing of interest
K. Taamallah* Department of cardiology and cardiac surgery, military hospital, Tunis, Tunisie. *Corresponding author: [email protected]
51
Introduction Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied for evaluation of left atrial (LA) function. We aimed to evaluate the correlation of LA dysfunction assessed by 2D speckle tracking imaging with the occurrence of POAF after cardiac surgery.
F. Zghal Mghaieth*1, B. Rekik2, Z. Jabberi1, S. Boudiche1, M. Ben Halima1, A. Farhati1, N. Larbi1, S. Ouali1, M.S. Mourali1 1 Rabta hospital, faculté de médecine, Université Tunis el manar, Tunis, Tunisie, 2 Rabta hospital, Tunis, Tunisie. *Corresponding author: [email protected]
Methods In this prospective study, we enrolled 70 patients (25 women / 45 men), over a period of 2 years (01/01/ 2015- 31/12/ 2016), undergoing coronary bypass grafting. All patients were in the sinus rhythm and did not have
© Elsevier Masson SAS. All rights reserved.
Is the post systolic shortening in ST segment elevation myocardial infarction patients a prognostic factor?
Introduction Background: There is divergent hypothesis regarding the physiopathological significance of post systolic shortening (PSS) in ST
Archives of Cardiovascular Diseases Supplements (2017) 9, 260-261
Session 8 – Ischemic Heart Disease, StressEcho, Pericardium, Emergency Friday June 16 – 15.30 – 16.00
a known history of AF. A pre-operative transthoracic echocardiography was performed in all patients, the LA area and volume index was enregistred, PALS and PACS was collected by studying the curve of LA longitudinal 2D strain in the apical view : 4 and 2 chamber. Patients were divided in two groups: Patients with post-operative atrial fibrillation (FAPO, n=17, 24,2%) or without post-operative atrial fibrillation (FAPO, n=53): POAF was detected with continuous electrocardiography monitoring. Results The mean age was 68.42 ± 6.26 years (Gp FAPO +: 69.28 ± 4.2 years / Gp FAPO-: 62.23 ± 5.2 years, p <0.01) . The left atrium area was significantly greater in the FAPO + Gp (23.4 ± 3.2cm² / 19.6 ± 2.8 cm², p <0.01 ), LA volume index was significantly greater in the Gp FAPO+ (31.4 ± 3,6ml/m² versus 28.5 ± 3.1 ml/m², p <0.001), PALS and PACS were significantly decreased in the Gp FAPO + (PALS = 21.3 ± 2.6% vs 36 ± 7.2%, p <0.001/ PACS : 7,2±3,2% vs 10,2 ±2,1%, p <0.001).
48 Interest of The Study of Left Ventricular Function by 2D strain in Acute Coronary Syndrome H. Ben Gaid Hassine*, W. Daly, H. Ben Slima, A. Ben Khalfallah Cardiology Department – Menzel Bourguiba Hospital, Bizerte, Tunisie. *Corresponding author : [email protected] Introduction The 2D Strain is a new echo-cardiographic technique allowing the study of the myocardial deformation based on a follow-up of the acoustic markers of the left ventricle (LV) wall.The aim of our study is to validate the contribution of this technique in the detection of the ischemia and in the prediction of the culprit coronary axis and the number of vessels affected and also to analyze the correlation of this parameter with the left ventricle ejection fraction (LVEF) and the Wall Motion Score Index (WMSI). Methods This prospective study included 173 consecutive patients admitted for acute coronary syndrome (ACS) during the period between January 2015 and October 2016.All the patients had echocardiography with analysis of function by 2D Strain and a coronary angiography .The data have been listed on an SPSS database. Results The mean age of patients was 62±10 years with male predominance 6M/1F.The mean LVEF is 50 ± 10%, the mean global longitudinal peak systolic strain (GLPSS) is –14 ± 4% .The study showed that GLPSS is more impaired when the left anterior descending (LAD) is affected with an average of –13.9% versus –17.2% and –17.8% for left circumflex (LCx) and right coronary artery (RCA) respectively.The statistical study showed a significant correlation between GLPSS and the age;the type of ACS;the LVEF and the WMSI.The study showed a significant correlation between GLPSS and the severity of coronary artery disease (p <0.001) and especially a significant correlation with the culprit coronary axis (p <0.001).In Fact;the longitudinal strain has been predicted the culprit coronary axis in 92% of the cases in our study. Conclusion The 2D Longitudinal Strain represents an excellent parameter which allows a reliable detection of an alteration in the systolic function of the LV in ischemic heart disease and it’s very useful in prediction of the culprit coronary axis and the number of vessels affected. The authors declare that they have no competing of interest
Conclusion Significantly older age, significantly greater LA volume index, and significantly decreased PALS and PACS were observed in patients with FAPO. These findings may be useful in the management of such patients. It could be used to better identify patients at greater risk of developing POAF. The authors declare that they have no competing of interest
50 Multimodality imaging in invasive treatment of pulmonary embolism L. Masmoudi*, R. Bourezak, M. Aouiche EHS Abderrahmani – Alger (Algérie). Corresponding author: [email protected] Introduction this study retrospectively reviews an agressive multidisciplinary approach to the treatement of submassive or massive pulmonary embolism, centering on rapid diagnosis with contrast enhanced computed tomography of the chest to define the location of obstruction and transthoracic echocardiography to document right ventricular function, followed by immediate surgery when appropriate. Methods 19 patients underwent emergency surgical embolectomy for massive or submassive central pulmonary embolism. The indication for surgical intervention were: right ventricular dysfonction, hemodynamic instability or non cruoric embol. Echocardiography and computed tomography was systematic. Results Our series included 19 patients operated in emergency of pulmonary embolism, whose etiology was fibrinocruoric in 37% of cases, iatrogenic in 37%, tumoral in 16%, and parasitic in 10%. All patients were referred to us after hemodynamic stabilization in intensive care units. Echocardiography was systematic to evaluate cardiac cavity repercussions and pulmonary pressures, thus enabling the surgical team to evaluate the operative risks, and the resuscitation team to plan the management per and postoperative. Pulmonary arterial pressures were between 50 and 70mmhg, with dilation of the right cavities and pulmonary trunk. Mortalitywas 5%. The postoperative monitoring of patients recorded normalization of Pulmonary pressures in 16 patients (84%), the other three kept pulmonary pressures > 40 mmhg . Conclusion An agressive approach to large pulmonary embolus, including rapid diagnosis and prompt surgical intervention has improved results with surgical embolectomy.
49 Left atrial strain as assessed by two-dimensional speckle tracking predicts post-operative atrial fibrillation
The authors declare that they have no competing of interest
K. Taamallah* Department of cardiology and cardiac surgery, military hospital, Tunis, Tunisie. *Corresponding author: [email protected]
51
Introduction Postoperative atrial fibrillation (POAF) is common after cardiac surgery and is associated with increased morbidity, mortality, and prolonged hospital stay. Speckle tracking echocardiography (STE) has been applied for evaluation of left atrial (LA) function. We aimed to evaluate the correlation of LA dysfunction assessed by 2D speckle tracking imaging with the occurrence of POAF after cardiac surgery.
F. Zghal Mghaieth*1, B. Rekik2, Z. Jabberi1, S. Boudiche1, M. Ben Halima1, A. Farhati1, N. Larbi1, S. Ouali1, M.S. Mourali1 1 Rabta hospital, faculté de médecine, Université Tunis el manar, Tunis, Tunisie, 2 Rabta hospital, Tunis, Tunisie. *Corresponding author: [email protected]
Methods In this prospective study, we enrolled 70 patients (25 women / 45 men), over a period of 2 years (01/01/ 2015- 31/12/ 2016), undergoing coronary bypass grafting. All patients were in the sinus rhythm and did not have
© Elsevier Masson SAS. All rights reserved.
Is the post systolic shortening in ST segment elevation myocardial infarction patients a prognostic factor?
Introduction Background: There is divergent hypothesis regarding the physiopathological significance of post systolic shortening (PSS) in ST