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Arterial stiffness as a predictor of recovery of left ventricular systolic function after acute myocardial infarction treated with primary percutaneous coronary intervention
Abstracts / Atherosclerosis 252 (2016) e1ee196
p ¼ 0.037), but not with age, gender, body mass index, baseline levels of HDL-C, triglyceride, hsCRP, uric acid, serum creatinine, and adiponectin. The baseline number of CD34 positive cells was significantly correlated with age, gender, body mass index, baseline value of LDL-C and HDL-C. Multiple logistic analysis demonstrated that lower CD34 positive cell number (<0.84/ml) (Odds ratio: 2.70, 95%confidential interval: 1.26e5.81, p ¼ 0.01) was an independent predictors of the CCS progression, even after adjustment of age, gender, hypertension, diabetes, and current smoking. Conclusions: The substudy demonstrated the lower number of circulating CD34 positive cell is a novel predictor of CCS progression in patients with hypercholesterolemia under statin therapy.
EAS16-0403, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. A GIANT LEFT ATRIUM Y. Saleh, A. Almaghraby, B. Hammad, M. Elbahey, A. Samoka, A. Ghoneem, M. Seleem. Faculty of Medicine, Cardiology, Alexandria, Egypt Objectives: We are reporting a case presenting with GLA measuring about 160 mm in diameter with an estimated volume of 2.5 liters using Echocardiography and a maximum diameter of 200 mm using computed tomography. Methods: A 65-year-old female patient with history of rheumatic heart disease and mitral valve replacement via a tilting disk 25 years ago. The patient started complaining of progression of her dyspnea in the past 3 weeks. Upon presentation, her blood pressure was 100/70 mmHg, heart rate was 90 bpm showing irregular irregularity. Chest and heart auscultation revealed a well heard mechanical click, a pansystolic murmur heard over the tricuspid area, accentuated pulmonary component of the second heart sound and diminished air entry over the right lung base. Electrocardiography revealed atrial fibrillation, chest X-ray showed significant cardiomegaly. Results: Echocardiography showed well-functioning mitral valve prosthesis, severe tricuspid regurgitation and a giant left atrium measuring about 160 mm with an estimated volume of 2.5 liters. Subsequently, Computed tomography revealed that the left atrium is hugely dilated occupying a considerable amount of the hemithorax measuring 200 155 182 mm and causing subtotal collapse of the right lower lobe. The patient was managed conservatively, and she reported improvement of her symptoms after uptitrating the furosemide. Conclusions: GLA is a rare disorder that results from mitral valve disease, most commonly secondary to rheumatic heart affection, however due to better screening in the developing countries its incidence is declining. To our knowledge, this case is one of the largest left atria reported in the literature up to date.
EAS16-0416, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. ARTERIAL STIFFNESS AS A PREDICTOR OF RECOVERY OF LEFT VENTRICULAR SYSTOLIC FUNCTION AFTER ACUTE MYOCARDIAL INFARCTION TREATED WITH PRIMARY PERCUTANEOUS CORONARY INTERVENTION G. Mandraffino 1, C.O. Aragona 1, S. Quartuccio 1, G. Trapani 1, A. Saitta 1, M. Vatrano 2, E. Imbalzano 1. 1 University of Messina, Department of Clinical and Experimental Medicine, Messina, Italy; 2 Hospital "Pugliese-Ciaccio", UTIC and Cardiology, Catanzaro, Italy Objectives: Left ventricular ejection fraction (LVEF) and pulse wave velocity (PWV) are to date acknowledged as independent risk factors in different high-risk populations. We investigated the predictive power of PWV as arterial stiffness index on LV function changes at 3 and 6 months after acute myocardial infarction. Methods: Changes in LVEF have been evaluated in 136 consecutive patients who were diagnosed with ST-segment elevation coronary syndrome
e189
and treated with primary percutaneous coronary intervention. Doppler guided by 2D ultrasound was used to measure carotid-femoral PWV. Results: According to tertiles of arterial stiffness, a significant correlation between higher PWV and worse recovery in LVEF was found (3 months EF change: 9.9 ± 5.0% vs 5.9 ± 3.4 vs 3.8 ± 1.6; p < 0.001 and 6 months EF change: 18.5 ± 7.0% vs 11.5 ± 5.2 vs 7.3 ± 3.0; p ¼0.002). By the multivariate analysis PWV showed the ability to predict the outcome in terms of EF recovery at 3 and 6 months also after any correction for age and other potential confounding variables (b¼ 0.566, p < 0.001). Conclusions: Arterial stiffening may result in a less effective recovery of LV function after acute myocardial infarction, moreover to evaluate PWV within 48 hours following acute myocardial infarction may provide additional information about recovery potential of LVEF.
EAS16-0424, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. EVALUATION OF CHANGES OF GLOBAL LONGITUDINAL STRAIN IN PATIENTS WITH STEMI AFTER MYOCARDIAL REVASCULARIZATION V. Oleynikov, V. Galimskaya, E. Romanovskaya. Penza State University, Therapy, Penza, Russia Objectives: To determine the change in parameters of global longitudinal strain (GLS) in patients with STEMI by dimensional Strain techniques depending on the effectiveness of revascularization. Methods: The study included 49 patients with STEMI (one infarct-related coronary artery), 51,3 ± 9,1 years, and control group consisting of 21 healthy volunteers 44,9 ± 6,8 years. Echocardiography was performed by MyLab 90 ultrasound scanner with X-Strain™ software (Esaote, Italy) at 7e8 days after the onset of the disease, and at 3 months follow-up. Results: Based on the TIMI scale the patients of group 1 were divided into two subgroups. Subgroup 1a included 34 patients with good angiographic result (TIMI 2e3), in 1be15 patients of unsatisfactory result (TIMI 0e1). In the subgroup 1a a decrease of GLS (20,2 ± 4,1) by 11% (p < 0,01) was found, in subgroup1b GLS were reduced by 50% (11,5 ± 4,8; p < 0,001) compared to control (22,8 ± 2,5). In 6 patients of 1a subgroup a reduction in GLS (15,2 ± 1,6) was revealed. Repeated examination in group TIMI 2e3 has shown a reduction of GLS (20,7 ± 3,4) by 9% of control values, while in the above mentioned 6 patients an increase of parameter (19,4 ± 4,3) by 28% from the baseline was revealed. In group TIMI 0e1 GLS (13,6 ± 3,6) was lower compared to control by 40% (p < 0,01) and increased by 18% compared to baseline. Conclusions: In the group TIMI 2e3 a decline in GLS may reflect a partial endocardial damage. In the group TIMI 0e1 a significant reduction in the data value confirms the ineffectiveness of conducted PCI and more severe LV myocardial ischemic injury.
EAS16-0430, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. ASSESSMENT OF EFFICIENT REVASCULARIZATION ON DYNAMICS OF VELOCITY PARAMETERS IN PATIENTS WITH STEMI V. Oleynikov, V. Galimskaya, E. Romanovskaya, I. Avdeeva. Penza State University, Therapy, Penza, Russia Objectives: To evaluate the impact of revascularization on dynamic of velocity parameters in patients with STEMI. Methods: The study included 49 patients with STEMI (one infarct-related coronary artery), 51,3 ± 9,1 years, and control group consisting of 21 healthy volunteers 44,9 ± 6,8 years. Echocardiography was performed by MyLab 90 ultrasound scanner with X-Strain™ software (Esaote, Italy) at 7e8 days after the onset of the disease, and at 3 months follow-up with evaluation of global longitudinal, circular and radial strain (GLSR, GCSR, GRSR). Results: Based on the TIMI scale the patients with STEMI were divided into two subgroups. Subgroup 1a included 34 patients with good angiographic result (TIMI 2e3), in 1be15 patients of unsatisfactory result (TIMI 0e1). In
p ¼ 0.037), but not with age, gender, body mass index, baseline levels of HDL-C, triglyceride, hsCRP, uric acid, serum creatinine, and adiponectin. The baseline number of CD34 positive cells was significantly correlated with age, gender, body mass index, baseline value of LDL-C and HDL-C. Multiple logistic analysis demonstrated that lower CD34 positive cell number (<0.84/ml) (Odds ratio: 2.70, 95%confidential interval: 1.26e5.81, p ¼ 0.01) was an independent predictors of the CCS progression, even after adjustment of age, gender, hypertension, diabetes, and current smoking. Conclusions: The substudy demonstrated the lower number of circulating CD34 positive cell is a novel predictor of CCS progression in patients with hypercholesterolemia under statin therapy.
EAS16-0403, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. A GIANT LEFT ATRIUM Y. Saleh, A. Almaghraby, B. Hammad, M. Elbahey, A. Samoka, A. Ghoneem, M. Seleem. Faculty of Medicine, Cardiology, Alexandria, Egypt Objectives: We are reporting a case presenting with GLA measuring about 160 mm in diameter with an estimated volume of 2.5 liters using Echocardiography and a maximum diameter of 200 mm using computed tomography. Methods: A 65-year-old female patient with history of rheumatic heart disease and mitral valve replacement via a tilting disk 25 years ago. The patient started complaining of progression of her dyspnea in the past 3 weeks. Upon presentation, her blood pressure was 100/70 mmHg, heart rate was 90 bpm showing irregular irregularity. Chest and heart auscultation revealed a well heard mechanical click, a pansystolic murmur heard over the tricuspid area, accentuated pulmonary component of the second heart sound and diminished air entry over the right lung base. Electrocardiography revealed atrial fibrillation, chest X-ray showed significant cardiomegaly. Results: Echocardiography showed well-functioning mitral valve prosthesis, severe tricuspid regurgitation and a giant left atrium measuring about 160 mm with an estimated volume of 2.5 liters. Subsequently, Computed tomography revealed that the left atrium is hugely dilated occupying a considerable amount of the hemithorax measuring 200 155 182 mm and causing subtotal collapse of the right lower lobe. The patient was managed conservatively, and she reported improvement of her symptoms after uptitrating the furosemide. Conclusions: GLA is a rare disorder that results from mitral valve disease, most commonly secondary to rheumatic heart affection, however due to better screening in the developing countries its incidence is declining. To our knowledge, this case is one of the largest left atria reported in the literature up to date.
EAS16-0416, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. ARTERIAL STIFFNESS AS A PREDICTOR OF RECOVERY OF LEFT VENTRICULAR SYSTOLIC FUNCTION AFTER ACUTE MYOCARDIAL INFARCTION TREATED WITH PRIMARY PERCUTANEOUS CORONARY INTERVENTION G. Mandraffino 1, C.O. Aragona 1, S. Quartuccio 1, G. Trapani 1, A. Saitta 1, M. Vatrano 2, E. Imbalzano 1. 1 University of Messina, Department of Clinical and Experimental Medicine, Messina, Italy; 2 Hospital "Pugliese-Ciaccio", UTIC and Cardiology, Catanzaro, Italy Objectives: Left ventricular ejection fraction (LVEF) and pulse wave velocity (PWV) are to date acknowledged as independent risk factors in different high-risk populations. We investigated the predictive power of PWV as arterial stiffness index on LV function changes at 3 and 6 months after acute myocardial infarction. Methods: Changes in LVEF have been evaluated in 136 consecutive patients who were diagnosed with ST-segment elevation coronary syndrome
e189
and treated with primary percutaneous coronary intervention. Doppler guided by 2D ultrasound was used to measure carotid-femoral PWV. Results: According to tertiles of arterial stiffness, a significant correlation between higher PWV and worse recovery in LVEF was found (3 months EF change: 9.9 ± 5.0% vs 5.9 ± 3.4 vs 3.8 ± 1.6; p < 0.001 and 6 months EF change: 18.5 ± 7.0% vs 11.5 ± 5.2 vs 7.3 ± 3.0; p ¼0.002). By the multivariate analysis PWV showed the ability to predict the outcome in terms of EF recovery at 3 and 6 months also after any correction for age and other potential confounding variables (b¼ 0.566, p < 0.001). Conclusions: Arterial stiffening may result in a less effective recovery of LV function after acute myocardial infarction, moreover to evaluate PWV within 48 hours following acute myocardial infarction may provide additional information about recovery potential of LVEF.
EAS16-0424, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. EVALUATION OF CHANGES OF GLOBAL LONGITUDINAL STRAIN IN PATIENTS WITH STEMI AFTER MYOCARDIAL REVASCULARIZATION V. Oleynikov, V. Galimskaya, E. Romanovskaya. Penza State University, Therapy, Penza, Russia Objectives: To determine the change in parameters of global longitudinal strain (GLS) in patients with STEMI by dimensional Strain techniques depending on the effectiveness of revascularization. Methods: The study included 49 patients with STEMI (one infarct-related coronary artery), 51,3 ± 9,1 years, and control group consisting of 21 healthy volunteers 44,9 ± 6,8 years. Echocardiography was performed by MyLab 90 ultrasound scanner with X-Strain™ software (Esaote, Italy) at 7e8 days after the onset of the disease, and at 3 months follow-up. Results: Based on the TIMI scale the patients of group 1 were divided into two subgroups. Subgroup 1a included 34 patients with good angiographic result (TIMI 2e3), in 1be15 patients of unsatisfactory result (TIMI 0e1). In the subgroup 1a a decrease of GLS (20,2 ± 4,1) by 11% (p < 0,01) was found, in subgroup1b GLS were reduced by 50% (11,5 ± 4,8; p < 0,001) compared to control (22,8 ± 2,5). In 6 patients of 1a subgroup a reduction in GLS (15,2 ± 1,6) was revealed. Repeated examination in group TIMI 2e3 has shown a reduction of GLS (20,7 ± 3,4) by 9% of control values, while in the above mentioned 6 patients an increase of parameter (19,4 ± 4,3) by 28% from the baseline was revealed. In group TIMI 0e1 GLS (13,6 ± 3,6) was lower compared to control by 40% (p < 0,01) and increased by 18% compared to baseline. Conclusions: In the group TIMI 2e3 a decline in GLS may reflect a partial endocardial damage. In the group TIMI 0e1 a significant reduction in the data value confirms the ineffectiveness of conducted PCI and more severe LV myocardial ischemic injury.
EAS16-0430, VASCULAR BIOLOGY: MYOCARDIAL INFARCTION, STROKE, PERIPHERAL VASCULAR DISEASE. ASSESSMENT OF EFFICIENT REVASCULARIZATION ON DYNAMICS OF VELOCITY PARAMETERS IN PATIENTS WITH STEMI V. Oleynikov, V. Galimskaya, E. Romanovskaya, I. Avdeeva. Penza State University, Therapy, Penza, Russia Objectives: To evaluate the impact of revascularization on dynamic of velocity parameters in patients with STEMI. Methods: The study included 49 patients with STEMI (one infarct-related coronary artery), 51,3 ± 9,1 years, and control group consisting of 21 healthy volunteers 44,9 ± 6,8 years. Echocardiography was performed by MyLab 90 ultrasound scanner with X-Strain™ software (Esaote, Italy) at 7e8 days after the onset of the disease, and at 3 months follow-up with evaluation of global longitudinal, circular and radial strain (GLSR, GCSR, GRSR). Results: Based on the TIMI scale the patients with STEMI were divided into two subgroups. Subgroup 1a included 34 patients with good angiographic result (TIMI 2e3), in 1be15 patients of unsatisfactory result (TIMI 0e1). In