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GLOBAL ATRIAL PERFORMANCE WITH TYROSINE KINASE INHIBITORS IN METASTATIC RENAL CELL CARCINOMA
Abstracts
complications occured in 1 in every 475 tests (0.21%). In our analysis, life-threatening complications occurred in 1 in every 772 studies (0.13%). Dobutamine stress ECHO can be performed in a non-hospital based outpatient facility with an acceptably low incidence of major life threatening complications. Close proximity to an interventional centre enabling quick transfer for life threatening complications is recommended.
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and deformation indices. No significant effects were noted on dynamic LA function (Table). CONCLUSION: The influence of TKIs on cardiac chambers in mRCC patients, treated in the short to intermediate term, uncovers that the RA exhibited greater change in strain after TKI treatment when compared to the LA. The implication of these findings and their potential significance would warrant further study to assess the longer term effects.
297 GLOBAL ATRIAL PERFORMANCE WITH TYROSINE KINASE INHIBITORS IN METASTATIC RENAL CELL CARCINOMA S Moustafa, TH Ho, P Shah, K Murphy, BK Nelluri, H Lee, S Wilansky, F Mookadam Scottsdale, Arizona BACKGROUND:
We investigated the hypothesis that early subclinical atrial dysfunction, secondary to tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC), could be signaled by abnormal cardiac mechanics utilizing velocity vector imaging (VVI). METHODS/RESULTS: Echocardiographic images were acquired from the apical views in 23 mRCC patients. All patients had baseline and at least a 3 month follow up echocardiogram after receiving TKI therapy. Computer-generated left and right atrial (LA/RA) curves were produced by continuous tracing of the atrial endocardium. Subsequently, the ensuing ejection fraction and volumetric indices were calculated. In addition, strain (ε) and strain rate (SR) as well as peak positive ε (εPos), peak negative ε (εNeg), peak early negative SR (SREarlyNeg), peak late negative SR (SRLateNeg), and peak positive SR (SRPos) values were extracted. Accordingly, εNeg (matching the atrial booster function) and εPos (matching the conduit function) were calculated. The SR values (SRLateNeg, SRPos, and SREarlyNeg), representing atrial contraction, beginning of ventricular systole, and beginning of ventricular diastole, were appraised. Mean age was 679 years with 92% men. 18% developed new onset hypertension and 9% had worsening of pre-existing hypertension while on therapy. Left and right ventricular conventional function indices did not change significantly with TKIs. Nonetheless, the reservoir and conduit functions of the RA were reduced using volumetric
298 REPAIR-ORIENTED TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF THE REGURGITANT BICUSPID AORTIC VALVE M Pagé, M Laflamme, O Nawaytou, C De Meester, L De Kerchove, G EL-Khoury, J Vanoverschelde Montréal, Québec
complications occured in 1 in every 475 tests (0.21%). In our analysis, life-threatening complications occurred in 1 in every 772 studies (0.13%). Dobutamine stress ECHO can be performed in a non-hospital based outpatient facility with an acceptably low incidence of major life threatening complications. Close proximity to an interventional centre enabling quick transfer for life threatening complications is recommended.
S157
and deformation indices. No significant effects were noted on dynamic LA function (Table). CONCLUSION: The influence of TKIs on cardiac chambers in mRCC patients, treated in the short to intermediate term, uncovers that the RA exhibited greater change in strain after TKI treatment when compared to the LA. The implication of these findings and their potential significance would warrant further study to assess the longer term effects.
297 GLOBAL ATRIAL PERFORMANCE WITH TYROSINE KINASE INHIBITORS IN METASTATIC RENAL CELL CARCINOMA S Moustafa, TH Ho, P Shah, K Murphy, BK Nelluri, H Lee, S Wilansky, F Mookadam Scottsdale, Arizona BACKGROUND:
We investigated the hypothesis that early subclinical atrial dysfunction, secondary to tyrosine kinase inhibitors (TKIs) in patients with metastatic renal cell carcinoma (mRCC), could be signaled by abnormal cardiac mechanics utilizing velocity vector imaging (VVI). METHODS/RESULTS: Echocardiographic images were acquired from the apical views in 23 mRCC patients. All patients had baseline and at least a 3 month follow up echocardiogram after receiving TKI therapy. Computer-generated left and right atrial (LA/RA) curves were produced by continuous tracing of the atrial endocardium. Subsequently, the ensuing ejection fraction and volumetric indices were calculated. In addition, strain (ε) and strain rate (SR) as well as peak positive ε (εPos), peak negative ε (εNeg), peak early negative SR (SREarlyNeg), peak late negative SR (SRLateNeg), and peak positive SR (SRPos) values were extracted. Accordingly, εNeg (matching the atrial booster function) and εPos (matching the conduit function) were calculated. The SR values (SRLateNeg, SRPos, and SREarlyNeg), representing atrial contraction, beginning of ventricular systole, and beginning of ventricular diastole, were appraised. Mean age was 679 years with 92% men. 18% developed new onset hypertension and 9% had worsening of pre-existing hypertension while on therapy. Left and right ventricular conventional function indices did not change significantly with TKIs. Nonetheless, the reservoir and conduit functions of the RA were reduced using volumetric
298 REPAIR-ORIENTED TRANSESOPHAGEAL ECHOCARDIOGRAPHIC ASSESSMENT OF THE REGURGITANT BICUSPID AORTIC VALVE M Pagé, M Laflamme, O Nawaytou, C De Meester, L De Kerchove, G EL-Khoury, J Vanoverschelde Montréal, Québec