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OP-072 Accuracy of Malcoaptation Area in Aortic Regurgitation for Evaluation of Aortic Regurgitation Severity
MARCH 26e29, 2015
O R A L A B S T R A C T S
- OP-072 Accuracy of Malcoaptation Area in Aortic Regurgitation for Evaluation of Aortic Regurgitation Severity. Fariba Bayat1, Erfan Naghshbandi1, Niloufar Samiei2, Mehdi Nazmdeh1, Saeed Nateghi1, Amirsaeed Karimi3. 1 Cardiovascular Research Center.Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Cardiovascular Research Center of Rajaee Hospital, Tehran, Iran; 3Emergency Deparment of Hasheminejad Hospital, Tehran, Iran. Subject: The measurement of malcoaptation Surface Area assessed by trans-esophageal echocardiography has been introduced to differentiate severity of Aortic regurgitation(AR), but its value has not been accurately determined. The present study aimed to determine the accuracy of malcoaptation area in Aortic Regurgitation for evaluation of AR severity. Methods: In this cross-sectional study, 88 patients with aortic regurgitation referred to our hospital in 2013 were assessed. These patients were randomly selected from all patients who undergoing transthoracic echocardiography and then were assessed by trans-esophageal echocardiography for further assessment of the status of aortic valve regarding Malcoaptation Surface Area. Results: According to the area under the ROC curve analysis, the accuracy of Malcoaptation Surface Area for detection of severe aortic regurgitation was 97% that in cutoff point of 0.3 yielded a sensitive of 80.0% and a specificity of 100% for discriminating severe aortic regurgitation. The accuracy of Malcoaptation Surface Area for detection of mild aortic regurgitation was 96% so the cutoff point of 0.1 for Malcoaptation Surface Area yielded a sensitive of 89.7% and a specificity of 98.3%. Considering a range of 0.1 to 0.3 for Malcoaptation Surface Area yielded a sensitive of 96.6% and a specificity of 84.7% for discriminating moderate aortic regurgitation. Conclusion: Malcoaptation Surface Area is a reliable index for evaluation of AR severity, with the defined cut off points.
- OP-073 Neutrophil to Lymphocyte Ratio is Increased in Patients with Rheumatic Mitral Valve Disease. Mehmet Kadri Akbo ga1, Ahmet Akyel2, Asife S¸ahinarslan3, Ça grı Yayla3, Yakup Alsancak3, Gökhan Gökalp3, Serdar Nurkoç3, Adnan Abacı3. 1Ministry of Health Etimesgut State Hospital, Department of Cardiology, Ankara, Turkey; 2 Dıs¸kapı Yıldırım Beyazıt Education and Research Hospital, Department of Cardiology, Ankara, Turkey; 3Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey. Objective: The role of systemic and chronic inflammatory processes in the pathophysiology of rheumatic heart valve disease is well-known. Neutrophil to lymphocyte ratio (NLR) was shown to be an indicator of systemic inflammation. In this study we aimed to investigate relationship between NLR as a marker of systemic inflammation and rheumatic mitral valve disease (RMVD). Methods: This is a retrospective study. Among the patients who underwent transthoracic echocardiography between January 2008-March 2013, 314 patients with RMVD were included retrospectively in the study. The control group included 57 healthy persons who underwent thransthorasic echocardiography during the study period. Basal characteristics and NLR were compared between two groups. Independent predictors of RMVD were determined by logistic regression analysis. Results: Basal characteristics were similar among the groups (age, 50.214.2 vs 49.213.0, p¼0.60). The NLR was significantly higher in patients with RMVD [2.9 (0.6-13.0) vs 2.1 (0.7-5.8), p<0.001]. Besides, C-reactive protein (CRP) was also higher in RMVD group [5.99 (0.3-23.7) vs 2.98 (0.6-6.3), p¼0.001]. In regression analysis,
Figure. NLR (OR: 2.24, p¼0.04), CRP (OR: 1.34, p¼0.03) and left atrial diameter (OR: 1.21, p¼0.001) were independent predictors of RMVD. In correlation analysis, there was a significant positive correlation between NLR and CRP (r¼0.43, p<0.001). Conclusions: We found that NLR was significantly increased in RMVD. Furthermore, NLR was an independent predictor of presence of RMVD in our study population. According to these findings NLR can be used as a predictor of RMVD. Since, it is an easily available and cheap method, it can easily be used in daily clinical practice. Increased NLR can also be a sign of ongoing chronic inflammation in patients with RMVD.
- OP-074 Association of Red Blood Cell Distribution Width with The Presence and Severity of Rheumatic Mitral Valve Stenosis. Mehmet Kadri Akboga1, Adnan Abacı2, Ugur Canpolat1, Çagrı Yayla1, Asife S¸ahinarslan2, Kadri Açıkgöz1, Serkan Çay1, Serkan Topaloglu1, Dursun Aras1, Sinan Aydogdu1. 1Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey; 2Gazi University Faculty of Medicine, Department of Cardiology, Ankara, Turkey. Objectives: Red cell distribution width (RDW) as an indicator of the variability in the circulating erythrocyte sizes was linked to chronic inflammatory state. The association of rheumatic heart valve stenosis and inflammation is also well-known. Thus, in this study, we aimed to assess the relationship between RDW and the presence and severity of rheumatic mitral valve stenosis (RMVS). Methods: A total of 417 consecutive patients with RMVS and 81 age- and -gender matched healthy control subjects were included in the study between February 2008-September 2013. Transthoracic echocardiography and demographical characteristics were recorded for all participants. Results: Baseline characteristics were similar in between study groups. However, RDW was significantly higher in patients with RMVS compared to control group [14.4% (11.3-19.6) vs 13.6% (11.618.1), p<0.001]. Additionally, both C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) were also higher in RMVS group [6.1 (0.4-24.2) vs 3.6 (0.3-15.3) mg/dl, p¼0.001 for CRP and 2.8 (0.410.6) vs 2.1 (0.7-5.7), p<0.001 for NLR, respectively]. In regression analysis, RDW (OR:1.504, p¼0.005), CRP (OR:1.139, p¼0.008), NLR (OR:1.528, p¼0.018) and left atrial diameter (OR:1.218, p<0.001) were found as independent predictors of RMVS. Furthermore, there was
S32 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
O R A L A B S T R A C T S
- OP-072 Accuracy of Malcoaptation Area in Aortic Regurgitation for Evaluation of Aortic Regurgitation Severity. Fariba Bayat1, Erfan Naghshbandi1, Niloufar Samiei2, Mehdi Nazmdeh1, Saeed Nateghi1, Amirsaeed Karimi3. 1 Cardiovascular Research Center.Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Cardiovascular Research Center of Rajaee Hospital, Tehran, Iran; 3Emergency Deparment of Hasheminejad Hospital, Tehran, Iran. Subject: The measurement of malcoaptation Surface Area assessed by trans-esophageal echocardiography has been introduced to differentiate severity of Aortic regurgitation(AR), but its value has not been accurately determined. The present study aimed to determine the accuracy of malcoaptation area in Aortic Regurgitation for evaluation of AR severity. Methods: In this cross-sectional study, 88 patients with aortic regurgitation referred to our hospital in 2013 were assessed. These patients were randomly selected from all patients who undergoing transthoracic echocardiography and then were assessed by trans-esophageal echocardiography for further assessment of the status of aortic valve regarding Malcoaptation Surface Area. Results: According to the area under the ROC curve analysis, the accuracy of Malcoaptation Surface Area for detection of severe aortic regurgitation was 97% that in cutoff point of 0.3 yielded a sensitive of 80.0% and a specificity of 100% for discriminating severe aortic regurgitation. The accuracy of Malcoaptation Surface Area for detection of mild aortic regurgitation was 96% so the cutoff point of 0.1 for Malcoaptation Surface Area yielded a sensitive of 89.7% and a specificity of 98.3%. Considering a range of 0.1 to 0.3 for Malcoaptation Surface Area yielded a sensitive of 96.6% and a specificity of 84.7% for discriminating moderate aortic regurgitation. Conclusion: Malcoaptation Surface Area is a reliable index for evaluation of AR severity, with the defined cut off points.
- OP-073 Neutrophil to Lymphocyte Ratio is Increased in Patients with Rheumatic Mitral Valve Disease. Mehmet Kadri Akbo ga1, Ahmet Akyel2, Asife S¸ahinarslan3, Ça grı Yayla3, Yakup Alsancak3, Gökhan Gökalp3, Serdar Nurkoç3, Adnan Abacı3. 1Ministry of Health Etimesgut State Hospital, Department of Cardiology, Ankara, Turkey; 2 Dıs¸kapı Yıldırım Beyazıt Education and Research Hospital, Department of Cardiology, Ankara, Turkey; 3Gazi University Medical Faculty, Department of Cardiology, Ankara, Turkey. Objective: The role of systemic and chronic inflammatory processes in the pathophysiology of rheumatic heart valve disease is well-known. Neutrophil to lymphocyte ratio (NLR) was shown to be an indicator of systemic inflammation. In this study we aimed to investigate relationship between NLR as a marker of systemic inflammation and rheumatic mitral valve disease (RMVD). Methods: This is a retrospective study. Among the patients who underwent transthoracic echocardiography between January 2008-March 2013, 314 patients with RMVD were included retrospectively in the study. The control group included 57 healthy persons who underwent thransthorasic echocardiography during the study period. Basal characteristics and NLR were compared between two groups. Independent predictors of RMVD were determined by logistic regression analysis. Results: Basal characteristics were similar among the groups (age, 50.214.2 vs 49.213.0, p¼0.60). The NLR was significantly higher in patients with RMVD [2.9 (0.6-13.0) vs 2.1 (0.7-5.8), p<0.001]. Besides, C-reactive protein (CRP) was also higher in RMVD group [5.99 (0.3-23.7) vs 2.98 (0.6-6.3), p¼0.001]. In regression analysis,
Figure. NLR (OR: 2.24, p¼0.04), CRP (OR: 1.34, p¼0.03) and left atrial diameter (OR: 1.21, p¼0.001) were independent predictors of RMVD. In correlation analysis, there was a significant positive correlation between NLR and CRP (r¼0.43, p<0.001). Conclusions: We found that NLR was significantly increased in RMVD. Furthermore, NLR was an independent predictor of presence of RMVD in our study population. According to these findings NLR can be used as a predictor of RMVD. Since, it is an easily available and cheap method, it can easily be used in daily clinical practice. Increased NLR can also be a sign of ongoing chronic inflammation in patients with RMVD.
- OP-074 Association of Red Blood Cell Distribution Width with The Presence and Severity of Rheumatic Mitral Valve Stenosis. Mehmet Kadri Akboga1, Adnan Abacı2, Ugur Canpolat1, Çagrı Yayla1, Asife S¸ahinarslan2, Kadri Açıkgöz1, Serkan Çay1, Serkan Topaloglu1, Dursun Aras1, Sinan Aydogdu1. 1Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey; 2Gazi University Faculty of Medicine, Department of Cardiology, Ankara, Turkey. Objectives: Red cell distribution width (RDW) as an indicator of the variability in the circulating erythrocyte sizes was linked to chronic inflammatory state. The association of rheumatic heart valve stenosis and inflammation is also well-known. Thus, in this study, we aimed to assess the relationship between RDW and the presence and severity of rheumatic mitral valve stenosis (RMVS). Methods: A total of 417 consecutive patients with RMVS and 81 age- and -gender matched healthy control subjects were included in the study between February 2008-September 2013. Transthoracic echocardiography and demographical characteristics were recorded for all participants. Results: Baseline characteristics were similar in between study groups. However, RDW was significantly higher in patients with RMVS compared to control group [14.4% (11.3-19.6) vs 13.6% (11.618.1), p<0.001]. Additionally, both C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) were also higher in RMVS group [6.1 (0.4-24.2) vs 3.6 (0.3-15.3) mg/dl, p¼0.001 for CRP and 2.8 (0.410.6) vs 2.1 (0.7-5.7), p<0.001 for NLR, respectively]. In regression analysis, RDW (OR:1.504, p¼0.005), CRP (OR:1.139, p¼0.008), NLR (OR:1.528, p¼0.018) and left atrial diameter (OR:1.218, p<0.001) were found as independent predictors of RMVS. Furthermore, there was
S32 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral