C. Pneumoniae antibodies between 7 months and 8 years of age in a prospective child cohort

232

Vogt

IN TWO PATIENTS I764 LONG TERM LIPID-APHFRFSIS WITH MASSIVE ELEVATION OF LIPOPROTEIN(A) AND PROGRESSIVE CORONARY HEART DISEASE

A. Vort, U. Kassner, H.-F! Thomas, C. Schliesser, E. Steinhagen-Thiessen. Chari&, Virchow-Klinikum, Humboldt-Uniuersify Berlin, Germany Lipoprotein(a) levels (LP(a), >30 mg/dl) are accepted as an independent risk factor for premature development of coronary heart disease (CHD) but the metabolic properties of this lipoprotein are not yet entirely clear. Until now there is no effective drug therapy to lower levels of LP(a). If patients with elevated LP(a) levels and no other or optimized cardiovascular risk factors suffer from progressive CHD lipid-apheresis (LA) is the only therapeutic option to lower LP(a) levels significantly in order to stop progression of atherosclerosis. We are showing the data of two of our patients with elevated LP(a) levels recieving LA on a weekly basis. Prior to LA CHD was progressive in both patients despite maximal conservative therapy and optimal control1 of all treatable cardiovascular risk factors. Patient 1: CHD was diagnosed at the age of 36, brother and father died of premature CHD, initial LP(a) was 139 mg/dl. Patient 2: CHD was diagnosed at the age of 42, father died of premature CHD, initial LP(a) was 180 mg/dl. LA is now running for 4, respectively 7.5 years without any side effects. Each LA causes a reduction of more than 60% of LP(a). Compared to the baseline value a significant reduction of pretherapeutic LP(a) levels is achieved. After LA was initiated no further cardiac intervention was necessary and both patients are physically active. This demonstrates the feasibility and the excellent effectiveness of longterm LA in patients with isolated elevation of LP(a) and CHD. I765 C. PNEUMONIAE 8 YEARS

ANTIBODIES BETWEEN 7 MONTHS AND OF AGE IN A PROSPECTIVE CHILD COHORT

I.K. Volanen, R.M. Vainionpti, .I. Ilonen, P.I. Markula, 0. Simell. Uniuersify of Turku, Finland

H.Y. Helenius,

Objectives:

C. pneumoniae infection has been associated with atherosclerosis. The aim of our study was to follow C. pneumoniae-specific antibodies in a cohort of young healthy children, particularly to detect recurrent or suspected persisting C. pneumoniae infections during the follow-up. Methods: C. pneumoniae IgG, IgA and IgM antibodies were measured in 199 healthy children, followed from age 7 months to 8 years. The children were participants in a coronary heart disease prevention trial. The prospectively collected serum samples (n=1225) were analysed with a commercial enzyme immunoassay kit (IgG-, IgA- and IgM-EIA, ThermoLabsystems, Helsinki, Finland) according to the instructions of the manufacturer. Results: IgA antibodies to C. pneumoniae were scarce before age 13 months, but IgG antibodies were common at all ages. The antibody titers showed no gender difference. IgM antibodies were detected in 28% of the samples studied. Of the 128 identified seroconversions, 94 were primary infections and 34 reinfections. Twenty-six children had 2 infections and 4 children had 3 infections during the follow-up. IgG antibodies declined rapidly after early primary infections, whereas 10% of the children had high IgG and IgA antibody titers at the ages of 7 and 8 years. Conclusions: Our study shows that C. pneumoniae infections are common also at a very early age. Consecutive high IgG and IgA antibody titers at the ages of 7 and 8 years suggest that chronic C. pneumoniae infections may occur already in young children.

I766 EZETIMlBE STEROLS

EFFECTIVELY REDUCES SERUM PLANT IN PATIENTS WITH SITOSTEROLEMlA

K. van Bergmann’, G. Salen’, D. Lutjohann’ , T. Musliner3, B. Musser3. ’ Uniuersify of Bonn, Germany: ‘University ofMedicine and Dentistry of New Jersey, Newark, NJ: ‘Merck Research Laboratories, Rahway, NJ, USA Sitosterolemia is an inherited disorder, resulting from a gene defect in either the ABCGS or G8 transporter protein, with hyperabsorption and decreased biliary excretion leading to markedly elevated plant sterol levels (e.g., sitosterol and campesterol), and premature atherosclerosis. We examined whether treatment with ezetimibe, an inhibitor of cholesterol absorption, reduces plant sterol levels in patients with phytosterolemia. Thirty-seven patients with sitosterolemia participated in this multicenter, double-blind, placebo-controlled study. Treatment lasted 8 weeks after a 3-week runin period. Seven patients received placebo and 30 received ezetimibe 10 mg/day. Sitosterol comcentrations decreased from baseline by a mean

(SE) of 21% (2.8) in ezetimibe-treated patients (p
OF INTRAPERITONEAL RETROPERITONEAL FAT MEASUREMENT COMPUTED TOMOGRAPHY

AND BY

F! Von Hafe’ , A-M. Ptrez’,

P. Pinto’, T. Jorge’, F! Froufe’, M. Tavares3. ‘Department ofMedicine, 2Department ofRadiology, Hospital S. Jo&, Faculdade de Medicina do Porte: ‘Department of Epidemiology, Faculdade de Medicina do Porte, Portugal Intra-abdominal fat is related to increased disease risk and includes intraperitoneal (PF) and retroperitoneal (RF) adipose tissue compartments that are heterogenous in its metabolism and blood drainage. The purpose of this study is to examine the reproducibility of computed tomography (CT) quantification of PF and RF areas. Abdominal fat was quantified by CT in 27 healthy individuals of both sexes at the level of the 4th lumbar vertebra. Intra-abdominal fat was defined as the area inside the abdominal muscles, including all the pixels with attenuation coefficients between -50 and -250 Hounsfield units. Intra-abdominal adipose tissue is distinguished and separated into intraperitoneal and retroperitoneal adipose tissue compartments using anatomical markers. Four observers (2 experienced with the method and 2 without experience) made the determinations. Assessment of variability and limits of agreement (=standard deviation of the differences/standard deviation of the means) of image analysis for fat area measurements was made between and within observers. There was a high degree of reproducibility in measurements of overall intra-abdominal fat, PF and RF, demonstrated by high correlations in duplicate measurements between and within observers with coefficients ranging from 0,97 to l,OO. Coefficients of variation within observer was 5,0% and between observers ranged from 12% to 15%. The limits of agreement ranged from 0,20&0,28 for RF and from 0,07-O, 13 for PF. In conclusion, the accuracy and precision of the CT method in the quantification of PF an RF is excellent. I768 EFFECTS

OF MODERATE PHYSICAL TRAINING ON ENDOTHELIUM-DEPENDENT DILATATION IN PATIENTS WITH RECENT MYOCARDIAL INFARCTION

M. Vona A. Rossi, S. Rizzo, G. Pinna, F. Cobelli. Cardiac Rehabilitation, Aosta,ItaZy We evaluated prospectively, the effect of the moderate exercise training on endothelial function (EnF) in pts with first recent myocardial infarction (AMI). 18 pts (57&6 years, LDL-cholesterol = 92&8 mg%) were submitted 1 month after the AM1 to the evaluation of the endothelial function by flowmediated dilation (FMD%) with the non invasive method. We considered: basal diameter (BasD), after hyperemia (HyD), FMD%, after cold (COD) and sublingual nitroglycerin (TNTD).We repeated the testings after three months of controlled training at 70% of the exercise testing maximal heart rate in 11 pts (Group 1) and in the other 7 pts (Group 2) did not submit a regular exercise training. The results on EnF are shown in the table.

GI

G2

Baseline

3 Mmth

Baselhc

3 Mmths

BasD mm

4.750.74

4.6ZSO.68

4.85&0.78

4.850.78

HyD

4.850.77

5.05&.86(e)

4.9&0.99

4.9850.84

FMD%

1.6453%

7.37&2.9%(a)

0.81&4.9%

454.2%

CoD

4.5&0.86(e)

4.6450.67

4.6651.05

4.6950.91

5.4&0.75(e)

5.5*/-0.7(e)

5.4H.O(e)

5.5&0.9(e)

mm

mm

TNT Dlnm (e)=p

hf

73rd EAS Congress

0.05 vs BasD;

a=p hf

0.05 vs baseline.