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0363 : Epidemiological, clinical, paraclinical and therapeutical features of Chronic Heart Failure (CHF) among hypertensive patients
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Archives of Cardiovascular Diseases Supplements (2016) 8, 244-246
Topic 23 – Hypertension, remodeling, arterial stiffness, pulmonary hypertension – A
The aim of our study is to investigate the epidemiological, clinical, paraclinical and therapeutic features of patients followed for Chronic Heart Failure and hypertension by comparing them to non-hypertensive patients. Methods Retrospective study of all CHF patients registered in the therapeutic Unit of Chronic Heart failure over a period of 8 years, between June 2006 and March 2015.During this period 3000 cases of CHF were collected and divided into two groups: hypertensive’s patients (40.1 %) and non-hypertensive’s patients (59.9 %).
April 07th, Thursday 2016
0369 The optimized omega-3 EPA:DHA 6:1 product prevents the monocrotaline-induced pulmonary arterial hypertension and vascular remodeling in rats Said Amissi * (1), Zahid Rasul Niazi (1), Mélanie Burban (2), Romain Kessler (3), Mathieu Canuet (3), Florence Toti (1), Laurent Monassier (4), Nelly Boehm (5), Cyril Auger (1), Ferhat Meziani (2), Valérie B. Schini-Kerth (1) (1) Université de Strasbourg, UMR CNRS 7213, Strasbourg, France – (2) Université de Strasbourg, EA 7293, Strasbourg, France – (3) Pneumologie-addictologie clinique, Strasbourg, France – (4) Laboratoire de neurologie et pharmacologie cardiovasculaire, EA 7296, Strasbourg, France – (5) Institut d’histologie, INSERM U1119, Strasbourg, France * Corresponding author: [email protected] (Said Amissi) Background Pulmonary arterial hypertension (PAH) is characterized by an increased pulmonary vascular resistance, right ventricular hypertrophy and increased systolic pressure. Omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA) have been shown to protect the cardiovascular system and reduce inflammatory responses. We have investigated the cardiopulmonary protective effects of an optimized omega-3 fatty acid formulation (EPA:DHA 6:1) on the monocrotaline (MCT)-induced PAH in rats. Methods Male Wistar rats received 500 mg/kg/day of either EPA:DHA 6:1 or corn oil by daily gavage. After one week, PAH was induced by a single subcutaneous injection of MCT (60 mg/kg). Three weeks following MCT, echocardiography was used to examine cardiac function, right ventricular (RV) systolic pressure, and pulmonary artery dimension. Endothelial function was assessed in pulmonary artery rings by vascular reactivity, right ventricular hypertrophy and pulmonary vascular morphometry by histology and immunohistochemistry, and oxidative stress using dihydroethidium. Results MCT induced pulmonary vascular remodeling, RV hypertrophy, endothelial dysfunction, and increased RV pressure and vascular ROS formation. Compared to the MCT group, EPA:DHA 6:1 treatment protected the pulmonary artery acceleration time, cardiac remodeling and prevented the elevation of right ventricular systolic pressure. Moreover, EPA:DHA 6:1 prevented the MCT-induced pulmonary artery endothelial dysfunction and increased wall thickness of pulmonary arterioles. This effect was associated with prevention of the MCT-induced upregulation of eNOS, AT1R, COX-2, COX-1 and the NADPH oxidase subunits (p22phox and p47phox). Conclusion The present findings indicate that the optimized EPA:DHA 6:1 formulation has a cardioprotective effect in PAH, by preventing right ventricular failure and pulmonary arterial remodeling, endothelial dysfunction and oxidative stress. The author hereby declares no conflict of interest
0363 Epidemiological, clinical, paraclinical and therapeutical features of Chronic Heart Failure (CHF) among hypertensive patients Abdelaziz Hadadi *, Chafia Chehbouni, Karim Hafdi, Anass Inchaouh, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Abdelaziz Hadadi)
Results Within the sample studied, 537 patients (17.9 %) had a balanced hypertension, and 667 patients (22.2 %) had an unbalanced hypertension. The mean age was higher in the hypertensive group 84 +/– 2 years vs 53 years with a male predominance in both groups. The etiology of HF (Heart Failure) in the hypentensive and non hypertensive groups was respectively: ischemic heart disease (51.1% vs 65.8), valvular disease (29% vs 19.8%), toxic (2.1% vs 2.2), idiopathic (6.4% vs 9.5%) and others (5% vs 2.6 %). Clinically, the study has shown that the hypertensive group was less supportive than non hypertensive. The alteration in diastolic function in echocardiography was more frequent in the hypertension group (25.1%) vs non-hypertension group (18.4%). The proportion of the AF in the hypertensive and non hypertensive groups was respectively 11.9% and 10%. Blood pressure did not influence the risk of re-hospitalization (16.5% in the hypertensive group vs 18.2% in the non-hypertensive group). Conclusion Hypertension is more associated with supraventricular rhythm disorders, renal failure and diastolic LV dysfunction but has no influence on the occurrence of cardiac decompensation and hospitalization in our contexte. The author hereby declares no conflict of interest
0193 Arrhythmogenic potential of hypertensive heart disease Anass Inchaouh *, Abdelaziz Hadadi, Laila Bouzoubaa, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Anass Inchaouh) Introduction Left ventricular hypertrophy (LVH) in hypertensive heart disease promots the occurrence of atrial and ventricular arrhythmias exposing the hemodynamic and embolic risk. The aim of our study was to evaluate the prevalence of cardiac arrhythmias in this population and to offer suitable support. Patients and methods This is a prospective, analytical study of 13 months including 186 hypertensive patients with and without LVH hypertensive. We placed these patients a 24-hour holter electrocardiography. We excluded all patients with other types of heart disease and those taking beta-blocker treatment and / or antiarrhythmic. Results The average age of our patients was 63 ± 6 years with female predominance. 59 % of patients with LVH showed heart rhythm disorders versus 7% of patients without LVH. Ventricular premature beats occurred in 21.1% with LVH versus 4.1% without LVH, nonsustained ventricular tachycardia in 2.4% with LVH against 0,4% without LVH, the supraventricular extrasystoles occurred in 57.2% with LVH against 14.1%. ACFA and atrial tachycardia in 11.7% with LVH versus 1.3%. The variability of the heart rate was altered in 35,4% with LVH versus 6.8% without LVH. Discussion and conclusion Arrhythmias represent the third face of hypertensive heart disease after coronary artery disease and heart failure. Holter ECG recording information on the three factors of atrial or ventricular arrhythmias: the trigger, the state of the autonomic nervous system and the search for silent ischemia. An early and effective management of hypertension is necessary to prevent the onset or regress left ventricular hypertrophy, determining factor in the genesis of these arrhythmias. The author hereby declares no conflict of interest
Introduction Hypertension is the most common cause for developing chronic heart failure. However, few studies has investigated the consequences of hypertension among patients followed for chronic heart failure.
© Elsevier Masson SAS. All rights reserved.
Archives of Cardiovascular Diseases Supplements (2016) 8, 244-246
Topic 23 – Hypertension, remodeling, arterial stiffness, pulmonary hypertension – A
The aim of our study is to investigate the epidemiological, clinical, paraclinical and therapeutic features of patients followed for Chronic Heart Failure and hypertension by comparing them to non-hypertensive patients. Methods Retrospective study of all CHF patients registered in the therapeutic Unit of Chronic Heart failure over a period of 8 years, between June 2006 and March 2015.During this period 3000 cases of CHF were collected and divided into two groups: hypertensive’s patients (40.1 %) and non-hypertensive’s patients (59.9 %).
April 07th, Thursday 2016
0369 The optimized omega-3 EPA:DHA 6:1 product prevents the monocrotaline-induced pulmonary arterial hypertension and vascular remodeling in rats Said Amissi * (1), Zahid Rasul Niazi (1), Mélanie Burban (2), Romain Kessler (3), Mathieu Canuet (3), Florence Toti (1), Laurent Monassier (4), Nelly Boehm (5), Cyril Auger (1), Ferhat Meziani (2), Valérie B. Schini-Kerth (1) (1) Université de Strasbourg, UMR CNRS 7213, Strasbourg, France – (2) Université de Strasbourg, EA 7293, Strasbourg, France – (3) Pneumologie-addictologie clinique, Strasbourg, France – (4) Laboratoire de neurologie et pharmacologie cardiovasculaire, EA 7296, Strasbourg, France – (5) Institut d’histologie, INSERM U1119, Strasbourg, France * Corresponding author: [email protected] (Said Amissi) Background Pulmonary arterial hypertension (PAH) is characterized by an increased pulmonary vascular resistance, right ventricular hypertrophy and increased systolic pressure. Omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA) have been shown to protect the cardiovascular system and reduce inflammatory responses. We have investigated the cardiopulmonary protective effects of an optimized omega-3 fatty acid formulation (EPA:DHA 6:1) on the monocrotaline (MCT)-induced PAH in rats. Methods Male Wistar rats received 500 mg/kg/day of either EPA:DHA 6:1 or corn oil by daily gavage. After one week, PAH was induced by a single subcutaneous injection of MCT (60 mg/kg). Three weeks following MCT, echocardiography was used to examine cardiac function, right ventricular (RV) systolic pressure, and pulmonary artery dimension. Endothelial function was assessed in pulmonary artery rings by vascular reactivity, right ventricular hypertrophy and pulmonary vascular morphometry by histology and immunohistochemistry, and oxidative stress using dihydroethidium. Results MCT induced pulmonary vascular remodeling, RV hypertrophy, endothelial dysfunction, and increased RV pressure and vascular ROS formation. Compared to the MCT group, EPA:DHA 6:1 treatment protected the pulmonary artery acceleration time, cardiac remodeling and prevented the elevation of right ventricular systolic pressure. Moreover, EPA:DHA 6:1 prevented the MCT-induced pulmonary artery endothelial dysfunction and increased wall thickness of pulmonary arterioles. This effect was associated with prevention of the MCT-induced upregulation of eNOS, AT1R, COX-2, COX-1 and the NADPH oxidase subunits (p22phox and p47phox). Conclusion The present findings indicate that the optimized EPA:DHA 6:1 formulation has a cardioprotective effect in PAH, by preventing right ventricular failure and pulmonary arterial remodeling, endothelial dysfunction and oxidative stress. The author hereby declares no conflict of interest
0363 Epidemiological, clinical, paraclinical and therapeutical features of Chronic Heart Failure (CHF) among hypertensive patients Abdelaziz Hadadi *, Chafia Chehbouni, Karim Hafdi, Anass Inchaouh, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Abdelaziz Hadadi)
Results Within the sample studied, 537 patients (17.9 %) had a balanced hypertension, and 667 patients (22.2 %) had an unbalanced hypertension. The mean age was higher in the hypertensive group 84 +/– 2 years vs 53 years with a male predominance in both groups. The etiology of HF (Heart Failure) in the hypentensive and non hypertensive groups was respectively: ischemic heart disease (51.1% vs 65.8), valvular disease (29% vs 19.8%), toxic (2.1% vs 2.2), idiopathic (6.4% vs 9.5%) and others (5% vs 2.6 %). Clinically, the study has shown that the hypertensive group was less supportive than non hypertensive. The alteration in diastolic function in echocardiography was more frequent in the hypertension group (25.1%) vs non-hypertension group (18.4%). The proportion of the AF in the hypertensive and non hypertensive groups was respectively 11.9% and 10%. Blood pressure did not influence the risk of re-hospitalization (16.5% in the hypertensive group vs 18.2% in the non-hypertensive group). Conclusion Hypertension is more associated with supraventricular rhythm disorders, renal failure and diastolic LV dysfunction but has no influence on the occurrence of cardiac decompensation and hospitalization in our contexte. The author hereby declares no conflict of interest
0193 Arrhythmogenic potential of hypertensive heart disease Anass Inchaouh *, Abdelaziz Hadadi, Laila Bouzoubaa, Rachida Habbal CHU Ibn Rochd, Casablanca, Maroc * Corresponding author: [email protected] (Anass Inchaouh) Introduction Left ventricular hypertrophy (LVH) in hypertensive heart disease promots the occurrence of atrial and ventricular arrhythmias exposing the hemodynamic and embolic risk. The aim of our study was to evaluate the prevalence of cardiac arrhythmias in this population and to offer suitable support. Patients and methods This is a prospective, analytical study of 13 months including 186 hypertensive patients with and without LVH hypertensive. We placed these patients a 24-hour holter electrocardiography. We excluded all patients with other types of heart disease and those taking beta-blocker treatment and / or antiarrhythmic. Results The average age of our patients was 63 ± 6 years with female predominance. 59 % of patients with LVH showed heart rhythm disorders versus 7% of patients without LVH. Ventricular premature beats occurred in 21.1% with LVH versus 4.1% without LVH, nonsustained ventricular tachycardia in 2.4% with LVH against 0,4% without LVH, the supraventricular extrasystoles occurred in 57.2% with LVH against 14.1%. ACFA and atrial tachycardia in 11.7% with LVH versus 1.3%. The variability of the heart rate was altered in 35,4% with LVH versus 6.8% without LVH. Discussion and conclusion Arrhythmias represent the third face of hypertensive heart disease after coronary artery disease and heart failure. Holter ECG recording information on the three factors of atrial or ventricular arrhythmias: the trigger, the state of the autonomic nervous system and the search for silent ischemia. An early and effective management of hypertension is necessary to prevent the onset or regress left ventricular hypertrophy, determining factor in the genesis of these arrhythmias. The author hereby declares no conflict of interest
Introduction Hypertension is the most common cause for developing chronic heart failure. However, few studies has investigated the consequences of hypertension among patients followed for chronic heart failure.
© Elsevier Masson SAS. All rights reserved.