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OP-89 First Steps in Cardiac Resynchronization Therapy (CRT): A Single Center Experience
MARCH 26e29, 2015 Table 1 Comparison of NtProBnp, cTnI, and Galectin3 and echocardiographic parameters of LV, LA, and LV EF among the patients with CHF and control group *Mann Whitney U test Control (n¼40) CHF (n¼42) Serum Markers NtProBnp 377.65317.24 cTnI 235.40145.49 Galectin3 317.5590.68 Echocardiographic parameters LvidD 48,634,00 LvidS 30,003,37 EFsimpson 64,583,34 LvVolSis 40,1011,42 LvVolDias 110,2530,79
528.55461.64 276.79158.74 475.21299.32 61,608,17 50,079,19 37,368,28 98,1743,99 150,9558,60
p* 0.124 0.323 0.003 <0.001 <0.001 <0.001 <0.001 <0.001
heart failure. Its diagnostic capability in CHF with preserved LVEF could be studied and also its prognostic value could be sought in large populated studies.
- OP-88 Chronic Systolic (Left Ventricular low Ejection Fraction) Heart Failure; Plans of Management; Proper Patient, Selection for Every Plan. Maher Mohammed Al Najjar, Mussab Fayez Rajab, Walid Abdul Karim Abu Khudair, Ahmed Attia Badawy, Tamer Said Saleh, Amr Yussef Mubasher, Ali Al Mash Hor. Adult Cardiac Surgery Department, King Fahd Armed Forces Hospital, Jeddah. Background: Chronic heart failure is a common health problem with poor prognosis, high mortality rate and the incidence of this disease is increasing continuously. Prognosis of chronic systolic heart failure can be improved by several different medications and through special cardiac interventions based on the newly-published European and American guidelines. In case of severe systolic dysfunction the hospitalization and mortality can be reduced using angiotensin converting enzyme inhibitors, angiotensin receptor blocking drugs, betareceptor blocking agents and aldosterone antagonists, as evidenced in multi-centric studies. In selected cases of cardiac interventions, such as intra-cardiac defibrillator and/or cardiac resynchronization device implantation can be used for supporting the failing left ventricle. Also, some surgical procedures, as repair of functional regurgitant valves and surgical ventricular reconstruction are considered. In terminal stage, special devices (ventricular assist device, intra-aortic balloon pump, artificial heart) and, finally, heart transplantation can be applied. Purpose: To provide practical and evidence-based strategies to assist physicians in selecting and modifying management plan for a particular patient with chronic systolic heart failure considering financial and social issues and availability of medical resources, interventional and surgical expertise for every treating center. Methods: Reviewing recommendations of the latest guidelines from the European Society of Cardiology (ESC) and American Heart Association/American Colleague of Cardiology (AHA/ACC) as well as other societies and organizations and results of multi-centric studies and large Randomized Controlled Trials (RCTs) and subsequently incorporating all to create complete management plans suitable for every chronic systolic heart failure patient. Results and Conclusions: The authors highlight therapeutic options of chronic systolic heart failure helping physicians in proper selection and creation of management strategies individualized for every patient.
- OP-89
O R A L
First Steps in Cardiac Resynchronization Therapy (CRT): A Single Center Experience. Amel Boudrifa, Seddik Aït Messaoudene, Yazid Aoudia, Riad Benkouar, Hiba El Nagger, Nora Ali Tatar, Yacine Bouhouita, Tarek Boumedien, Hakima Amirat, Mohand Tayeb Chentir. Cardiology Department, Mustapha Pacha Hospital, Algiers, Algeria. Background: In addition to the conventional treatment by drugs, the CRT has proven its effectiveness for survival and quality of life in patients (pts) with congestive heart failure. Objectives: The aim of our work is to provide an overview of the profile of our patients who received CRT as well as the early outcomes in a new center. Method: 40 patients, divided into 28 men and 12 women, mean age 59,8 15,1 years, received a CRT device between January 2010 and June 2014, mean age 59,8 15,1 years. Ten of them had atrial fibrillation managed by drugs to control the rate in 6 cases and by ablation of the atrioventricular node in the other 4 cases. Results: 23 patients achieved an evolution of at least 6 months, 4 died including 2 for extra-cardiac causes diagnosed after the implantation. There was a predominance of non-ischemic dilated cardiomyopathy (27pts, 70%) (NIDCM) compared to the ischemic dilated cardiomyopathy(4patients,10%) (IDCM). The defibrillation function (CRT-D) was added in 18 patients who had ventricular rhythm disorder or who had a resuscitated sudden death. After CRT, we noticed a clear improvement of symptoms in all patients. The Ejectional Fraction (EF) of Left ventricle increased in 66% of pts. Conclusions: It comes out of our series a clear unexplained male predominance in implanted patients despite the small percentage of ischemic heart disease in the series. Predominance of NIDCM compared to IDCM nourishes the debate between implantation of CRT-P and CRTD. The effectiveness of CRT in our series is evident with a significant improvement Evolution in functional states and ventricular reverse remodelling parameters despite the advanced stage of implanted patients. This leads to emphasize early screening of these patients for best outcomes of CRT which is now available in our center permanently.
Figure. Evolution of dyspnea and left ventricular function. Etiology of cardiomiopathy in implanted patients
men women
NICM
ICM
valvular CM
16 11
04 00
08 01
Predominance of NIDCM compared to IDCM. NIDCM¼Non Ischemic Dilated Cardiomyopathy IDCM¼ Ischemic Dilated Cardiomyopathy
The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
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A B S T R A C T S
528.55461.64 276.79158.74 475.21299.32 61,608,17 50,079,19 37,368,28 98,1743,99 150,9558,60
p* 0.124 0.323 0.003 <0.001 <0.001 <0.001 <0.001 <0.001
heart failure. Its diagnostic capability in CHF with preserved LVEF could be studied and also its prognostic value could be sought in large populated studies.
- OP-88 Chronic Systolic (Left Ventricular low Ejection Fraction) Heart Failure; Plans of Management; Proper Patient, Selection for Every Plan. Maher Mohammed Al Najjar, Mussab Fayez Rajab, Walid Abdul Karim Abu Khudair, Ahmed Attia Badawy, Tamer Said Saleh, Amr Yussef Mubasher, Ali Al Mash Hor. Adult Cardiac Surgery Department, King Fahd Armed Forces Hospital, Jeddah. Background: Chronic heart failure is a common health problem with poor prognosis, high mortality rate and the incidence of this disease is increasing continuously. Prognosis of chronic systolic heart failure can be improved by several different medications and through special cardiac interventions based on the newly-published European and American guidelines. In case of severe systolic dysfunction the hospitalization and mortality can be reduced using angiotensin converting enzyme inhibitors, angiotensin receptor blocking drugs, betareceptor blocking agents and aldosterone antagonists, as evidenced in multi-centric studies. In selected cases of cardiac interventions, such as intra-cardiac defibrillator and/or cardiac resynchronization device implantation can be used for supporting the failing left ventricle. Also, some surgical procedures, as repair of functional regurgitant valves and surgical ventricular reconstruction are considered. In terminal stage, special devices (ventricular assist device, intra-aortic balloon pump, artificial heart) and, finally, heart transplantation can be applied. Purpose: To provide practical and evidence-based strategies to assist physicians in selecting and modifying management plan for a particular patient with chronic systolic heart failure considering financial and social issues and availability of medical resources, interventional and surgical expertise for every treating center. Methods: Reviewing recommendations of the latest guidelines from the European Society of Cardiology (ESC) and American Heart Association/American Colleague of Cardiology (AHA/ACC) as well as other societies and organizations and results of multi-centric studies and large Randomized Controlled Trials (RCTs) and subsequently incorporating all to create complete management plans suitable for every chronic systolic heart failure patient. Results and Conclusions: The authors highlight therapeutic options of chronic systolic heart failure helping physicians in proper selection and creation of management strategies individualized for every patient.
- OP-89
O R A L
First Steps in Cardiac Resynchronization Therapy (CRT): A Single Center Experience. Amel Boudrifa, Seddik Aït Messaoudene, Yazid Aoudia, Riad Benkouar, Hiba El Nagger, Nora Ali Tatar, Yacine Bouhouita, Tarek Boumedien, Hakima Amirat, Mohand Tayeb Chentir. Cardiology Department, Mustapha Pacha Hospital, Algiers, Algeria. Background: In addition to the conventional treatment by drugs, the CRT has proven its effectiveness for survival and quality of life in patients (pts) with congestive heart failure. Objectives: The aim of our work is to provide an overview of the profile of our patients who received CRT as well as the early outcomes in a new center. Method: 40 patients, divided into 28 men and 12 women, mean age 59,8 15,1 years, received a CRT device between January 2010 and June 2014, mean age 59,8 15,1 years. Ten of them had atrial fibrillation managed by drugs to control the rate in 6 cases and by ablation of the atrioventricular node in the other 4 cases. Results: 23 patients achieved an evolution of at least 6 months, 4 died including 2 for extra-cardiac causes diagnosed after the implantation. There was a predominance of non-ischemic dilated cardiomyopathy (27pts, 70%) (NIDCM) compared to the ischemic dilated cardiomyopathy(4patients,10%) (IDCM). The defibrillation function (CRT-D) was added in 18 patients who had ventricular rhythm disorder or who had a resuscitated sudden death. After CRT, we noticed a clear improvement of symptoms in all patients. The Ejectional Fraction (EF) of Left ventricle increased in 66% of pts. Conclusions: It comes out of our series a clear unexplained male predominance in implanted patients despite the small percentage of ischemic heart disease in the series. Predominance of NIDCM compared to IDCM nourishes the debate between implantation of CRT-P and CRTD. The effectiveness of CRT in our series is evident with a significant improvement Evolution in functional states and ventricular reverse remodelling parameters despite the advanced stage of implanted patients. This leads to emphasize early screening of these patients for best outcomes of CRT which is now available in our center permanently.
Figure. Evolution of dyspnea and left ventricular function. Etiology of cardiomiopathy in implanted patients
men women
NICM
ICM
valvular CM
16 11
04 00
08 01
Predominance of NIDCM compared to IDCM. NIDCM¼Non Ischemic Dilated Cardiomyopathy IDCM¼ Ischemic Dilated Cardiomyopathy
The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S39
A B S T R A C T S