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GW27-e0067 Neutrophil-to-lymphocyte Ratio and Lymphocyte-to-monocyte Ratio are Associated with Fibrous Cap Thickness Assessed by Optical Coherence Tomography in Patients with Coronary Artery Disease
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
NONINVASIVE CARDIAC ELECTRICAL INSPECTION GW27-e0067 Neutrophil-to-lymphocyte Ratio and Lymphocyte-to-monocyte Ratio are Associated with Fibrous Cap Thickness Assessed by Optical Coherence Tomography in Patients with Coronary Artery Disease Sun Rong,1,2 Bo Yu1,2 1 Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Province Heilongjiang, China; 2Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Province Heilongjiang, China OBJECTIVES Recent studies have shown that neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) and lymphocyteto-monocyte ratio(LMR), are new inflammatory markers and predictors for cardiovascular outcomes, being more accurate and stable than absolute blood cell counts. The aim of this study was to investigate whether NLR, PLR and LMR are related to thin-cap fibroatheroma(TCFA) identified by optical coherence tomography(OCT) in patients with coronary artery disease(CAD). METHODS A total of 204 patients (158 with acute coronary syndrome and 46 with stable angina pectoris) who had undergone pre-intervention OCT imaging were enrolled. Patients were divided into a TCFA group (n¼81) and a non-TCFA group (n¼123). TCFA was defined as a plaque with lipid content in 2 quadrants and the thinnest part of the fibrous cap measuring < 65 mm. NLR, PLR and LMR, derived from complete blood count(CBC) on admission, were compared between the two groups. RESULTS The NLR and PLR levels in the TCFA group were significantly higher than those in the non-TCFA group. (2.43 [IQR,1.77 to 3.77] vs. 1.81 [IQR,1.39 to 2.42]; P¼0.000, 131.87 39.46 vs. 113.43 37.74; P¼0.001, respectively). The LMR levels in the TCFA group were significantly lower than those in the non-TCFA group. (3.62 [IQR, 2.66 to 4.70] vs. 4.06 [IQR, 3.30 to 5.36]; P¼0.004). Moreover, the NLR and LMR were significantly correlated with fibrous cap thickness (r¼ 0.267, P¼0.000 and r¼ 0.21, P¼0.004, respectively). CONCLUSIONS This study showed that the levels of NLR,PLR and LMR are associated with TCFAs, as detected by OCT. Moreover, NLR and LMR are correlated to fibrous cap thickness. GW27-e0099 Correlation of Left Atrial Appendage strain rate with D-dimmer and Brain natriuretic peptide in patients with atrial fibrillation and its predictive value of thrombotic events Pan Lu,1 Wang Qin2 1 Ningxia medical university, Ning Xia Yin Chuan, China; 2Department of echocardiography in heart center, General hospital of Ningxia medical university, Ning Xia Yin Chuan, China OBJECTIVES To assess the predictive value of the strain rate of left atrial appendage (LAA), brain natriuretic peptide (BNP), D-dimer for thedetection of LAA thrombus in patients with nonvalvular atrial fibrillation(NVAF). METHODS 44 patients with NVAF were evaluated by transthoracic and transesophageal echocardiography(TEE). Each segment systolic strain rate (SRS) was measured by strain rate imaging. The parameters of SRI are performed with offline analysis in 5 segments of LAA wall. And all patients immediately underwent fluorescence immunoassay to detect the plasma D-D and BNP. According to with or without thrombotic events, the patients were divided into thrombotic events positive group (n¼20) and thrombotic events negative group (n¼24). The comparison of strain rate and the levels of D-D and BNP between thrombotic events positive group and thrombotic events negative group. The evaluation of diagnostic value for the independent risk factors of thrombotic events in patients with AF. RESULTS Ssr taken from the tip of the LAA were negatively correlated with left atrium dimension (r¼-0.547, P<0.01). Patients with LAA thrombus showed a significantly lower the tip strain rate values (0.84 0.49 vs 2.42 1.68, P < 0.01, respectively) than those without LAA thrombi. The Person product-moment correlation coefficient was used to evaluate the associations of the tip Ssr with the plasma D-dimer level and BNP level. The SSr was negatively associated with the Ddimer level (R2¼0.30, P<0.05) and BNP level (R2¼0.25, P<0.05). ROC curve analysts showed that, the top SSr curve had certain diagnostic accuracy for LAA thrombotic. The best diagnostic cut-off point of it
C123
was 1.66.BNP, D-dimmer have predictive value as therisk assessment of thrombotic events in patients with atrial fibrillation; the best critical points of BNP and D-D were 312pg/ml, 0.9mg/l. CONCLUSIONS The application of strain rate imaging can detect LAA function dysfunction. The LAA Ssr may be helpful for predicting the incidence of LAA thrombus. Ssr is clinically useful for the risk stratification of systemic thromboembolism in patients with unanticoagulated NVAF. LAA strain rate, D- dimer and BNP have a high diagnostic value. GW27-e0166 False lumen status in patients with acute aortic dissection: a systematic review and meta-analysis Li Dongze,1 Yu Cao1 1 Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China OBJECTIVES The long-term association between the status of the false lumen and poor patient outcomes in acute aortic dissection (AAD) remains unclear. This systematic review and meta-analysis investigated whether the status of the false lumen was a predictor of poor long-term survival in AAD. METHODS The PubMed, Embase and Cochrane electronic databases were searched to identify relative studies exploring the association between status of false lumen and long-term outcomes (> 1year) in AAD, published up to December 2015. Studies were included if they reported multivariate-adjusted hazard ratio (HRs) with 95% CIs of long-term outcomes from different status of false lumen. Pooled HRs for mortality and aortic events were computed and weighted using generic inverse-variance and random-effect modeling. RESULTS Eleven cohort studies (2924 participants) exploring the association between the false lumen status and long-term outcomes (> 1 year) in AAD were included. Residual patent false lumen was an independent predictor of long-term mortality in AAD type A (HR, 1.71; 95% CI, 1.16-2.52; P ¼ 0.007) and type B (HR, 2.79; 95% CI, 1.80-4.32; P < 0.001). AAD patients with residual patent false lumen exhibited an increased risk of aortic events (HR, 5.43; 95% CI, 2.95-9.99; P < 0.001). Partial false lumen thrombosis was independently associated with long-term mortality in type B AAD (HR, 2.24, 95% CI, 1.37-3.65; P ¼ 0.001). This association was not observed in AAD type A patients (HR, 1.75; 95% CI, 0.88-3.45; P ¼ 0.211). CONCLUSIONS The false lumen status influences late outcomes in AAD. Residual patent false lumen is independently associated with poor long-term survival in AAD. However, only type B AAD patients with partial false lumen thrombosis had an increased late mortality risk. GW27-e0319 Study about myocardial contrast stress echocardiography evaluating myocardial blood flow Zhou Cuicui, Zhongqun Wang Affiliated Hospital of Jiangsu University OBJECTIVES To evaluate the clinical application value of myocardial contrast stress echocardiography(MCSE) in detecting myocardial blood flow(MBF). METHODS 50 patients hospitalized in the Department of Cardiology, Affiliated Hospital of Jiangsu University were recruited from September 2014 to September 2015. According to the medical history inquiry, physical examination and coronary angiography, all patients were divided into acute myocardial infarction group (n¼15), moderate stenosis group (n¼9) and control group (n¼31). All patients were detected by real-time myocardial contrast echocardiography(MCE), myocardial contrast stress echocardiography(MCSE) and global acoustic densitometry(GAD) before and after dobutamine stress test in order to evaluate the clinical application value of MCSE in detecting MBF. After running GAD software, myocardial visualization peak density (PI) and time to peak density (TP) were calculated, and then MBF[MBF¼(PI/TP)oPI] was detected. RESULTS After the treatment with dobutamine in control group, PI appeared an increasing trend, TP was reduced and MBF was significantly increased (P < 0.01). After the treatment with dobutamine in X syndrome group, PI appeared an increasing trend, TP was reduced and MBF was significantly increased. However, there was no significant difference between before and after the treatment (P >0.05).
NONINVASIVE CARDIAC ELECTRICAL INSPECTION GW27-e0067 Neutrophil-to-lymphocyte Ratio and Lymphocyte-to-monocyte Ratio are Associated with Fibrous Cap Thickness Assessed by Optical Coherence Tomography in Patients with Coronary Artery Disease Sun Rong,1,2 Bo Yu1,2 1 Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Province Heilongjiang, China; 2Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, Province Heilongjiang, China OBJECTIVES Recent studies have shown that neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) and lymphocyteto-monocyte ratio(LMR), are new inflammatory markers and predictors for cardiovascular outcomes, being more accurate and stable than absolute blood cell counts. The aim of this study was to investigate whether NLR, PLR and LMR are related to thin-cap fibroatheroma(TCFA) identified by optical coherence tomography(OCT) in patients with coronary artery disease(CAD). METHODS A total of 204 patients (158 with acute coronary syndrome and 46 with stable angina pectoris) who had undergone pre-intervention OCT imaging were enrolled. Patients were divided into a TCFA group (n¼81) and a non-TCFA group (n¼123). TCFA was defined as a plaque with lipid content in 2 quadrants and the thinnest part of the fibrous cap measuring < 65 mm. NLR, PLR and LMR, derived from complete blood count(CBC) on admission, were compared between the two groups. RESULTS The NLR and PLR levels in the TCFA group were significantly higher than those in the non-TCFA group. (2.43 [IQR,1.77 to 3.77] vs. 1.81 [IQR,1.39 to 2.42]; P¼0.000, 131.87 39.46 vs. 113.43 37.74; P¼0.001, respectively). The LMR levels in the TCFA group were significantly lower than those in the non-TCFA group. (3.62 [IQR, 2.66 to 4.70] vs. 4.06 [IQR, 3.30 to 5.36]; P¼0.004). Moreover, the NLR and LMR were significantly correlated with fibrous cap thickness (r¼ 0.267, P¼0.000 and r¼ 0.21, P¼0.004, respectively). CONCLUSIONS This study showed that the levels of NLR,PLR and LMR are associated with TCFAs, as detected by OCT. Moreover, NLR and LMR are correlated to fibrous cap thickness. GW27-e0099 Correlation of Left Atrial Appendage strain rate with D-dimmer and Brain natriuretic peptide in patients with atrial fibrillation and its predictive value of thrombotic events Pan Lu,1 Wang Qin2 1 Ningxia medical university, Ning Xia Yin Chuan, China; 2Department of echocardiography in heart center, General hospital of Ningxia medical university, Ning Xia Yin Chuan, China OBJECTIVES To assess the predictive value of the strain rate of left atrial appendage (LAA), brain natriuretic peptide (BNP), D-dimer for thedetection of LAA thrombus in patients with nonvalvular atrial fibrillation(NVAF). METHODS 44 patients with NVAF were evaluated by transthoracic and transesophageal echocardiography(TEE). Each segment systolic strain rate (SRS) was measured by strain rate imaging. The parameters of SRI are performed with offline analysis in 5 segments of LAA wall. And all patients immediately underwent fluorescence immunoassay to detect the plasma D-D and BNP. According to with or without thrombotic events, the patients were divided into thrombotic events positive group (n¼20) and thrombotic events negative group (n¼24). The comparison of strain rate and the levels of D-D and BNP between thrombotic events positive group and thrombotic events negative group. The evaluation of diagnostic value for the independent risk factors of thrombotic events in patients with AF. RESULTS Ssr taken from the tip of the LAA were negatively correlated with left atrium dimension (r¼-0.547, P<0.01). Patients with LAA thrombus showed a significantly lower the tip strain rate values (0.84 0.49 vs 2.42 1.68, P < 0.01, respectively) than those without LAA thrombi. The Person product-moment correlation coefficient was used to evaluate the associations of the tip Ssr with the plasma D-dimer level and BNP level. The SSr was negatively associated with the Ddimer level (R2¼0.30, P<0.05) and BNP level (R2¼0.25, P<0.05). ROC curve analysts showed that, the top SSr curve had certain diagnostic accuracy for LAA thrombotic. The best diagnostic cut-off point of it
C123
was 1.66.BNP, D-dimmer have predictive value as therisk assessment of thrombotic events in patients with atrial fibrillation; the best critical points of BNP and D-D were 312pg/ml, 0.9mg/l. CONCLUSIONS The application of strain rate imaging can detect LAA function dysfunction. The LAA Ssr may be helpful for predicting the incidence of LAA thrombus. Ssr is clinically useful for the risk stratification of systemic thromboembolism in patients with unanticoagulated NVAF. LAA strain rate, D- dimer and BNP have a high diagnostic value. GW27-e0166 False lumen status in patients with acute aortic dissection: a systematic review and meta-analysis Li Dongze,1 Yu Cao1 1 Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China OBJECTIVES The long-term association between the status of the false lumen and poor patient outcomes in acute aortic dissection (AAD) remains unclear. This systematic review and meta-analysis investigated whether the status of the false lumen was a predictor of poor long-term survival in AAD. METHODS The PubMed, Embase and Cochrane electronic databases were searched to identify relative studies exploring the association between status of false lumen and long-term outcomes (> 1year) in AAD, published up to December 2015. Studies were included if they reported multivariate-adjusted hazard ratio (HRs) with 95% CIs of long-term outcomes from different status of false lumen. Pooled HRs for mortality and aortic events were computed and weighted using generic inverse-variance and random-effect modeling. RESULTS Eleven cohort studies (2924 participants) exploring the association between the false lumen status and long-term outcomes (> 1 year) in AAD were included. Residual patent false lumen was an independent predictor of long-term mortality in AAD type A (HR, 1.71; 95% CI, 1.16-2.52; P ¼ 0.007) and type B (HR, 2.79; 95% CI, 1.80-4.32; P < 0.001). AAD patients with residual patent false lumen exhibited an increased risk of aortic events (HR, 5.43; 95% CI, 2.95-9.99; P < 0.001). Partial false lumen thrombosis was independently associated with long-term mortality in type B AAD (HR, 2.24, 95% CI, 1.37-3.65; P ¼ 0.001). This association was not observed in AAD type A patients (HR, 1.75; 95% CI, 0.88-3.45; P ¼ 0.211). CONCLUSIONS The false lumen status influences late outcomes in AAD. Residual patent false lumen is independently associated with poor long-term survival in AAD. However, only type B AAD patients with partial false lumen thrombosis had an increased late mortality risk. GW27-e0319 Study about myocardial contrast stress echocardiography evaluating myocardial blood flow Zhou Cuicui, Zhongqun Wang Affiliated Hospital of Jiangsu University OBJECTIVES To evaluate the clinical application value of myocardial contrast stress echocardiography(MCSE) in detecting myocardial blood flow(MBF). METHODS 50 patients hospitalized in the Department of Cardiology, Affiliated Hospital of Jiangsu University were recruited from September 2014 to September 2015. According to the medical history inquiry, physical examination and coronary angiography, all patients were divided into acute myocardial infarction group (n¼15), moderate stenosis group (n¼9) and control group (n¼31). All patients were detected by real-time myocardial contrast echocardiography(MCE), myocardial contrast stress echocardiography(MCSE) and global acoustic densitometry(GAD) before and after dobutamine stress test in order to evaluate the clinical application value of MCSE in detecting MBF. After running GAD software, myocardial visualization peak density (PI) and time to peak density (TP) were calculated, and then MBF[MBF¼(PI/TP)oPI] was detected. RESULTS After the treatment with dobutamine in control group, PI appeared an increasing trend, TP was reduced and MBF was significantly increased (P < 0.01). After the treatment with dobutamine in X syndrome group, PI appeared an increasing trend, TP was reduced and MBF was significantly increased. However, there was no significant difference between before and after the treatment (P >0.05).