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GW27-e0347 Clinical significance of Rheumatic Heart Disease in patients with Ankylosing Spondylitis
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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
show correlation with gender, age and case history, but remarkably correlated with cardiac functional gradings (r ¼ 0.563; 0.425; 0.332, P<0.05). CONCLUSIONS CTGF may play a significant role in myocardial fibrosis of RHD, and take part in the occurrence of atrial fibrillation. GW27-e0347 Clinical significance of Rheumatic Heart Disease in patients with Ankylosing Spondylitis Yina Wang,1 Tang Li,1 Jieruo Gu,2 Shangyan Liang,1 Qiongli Yin,1 Benrong Zheng,1 Buyun Yu2 1 Special Medical Treatment Center, The Third Affiliated Hospital of Sun Yat-sen University; 2Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University OBJECTIVES To study the clinical significance of Rheumatic Heart Disease (RHD) in patients with Ankylosing spondylitis (AS). METHODS 40 healthy controls and 60 patients with AS who visited the Third Affiliated Hospital of Sun Yet-sen University between 2012 to 2016 were included. According to history of RHD, patients were divided into AS group (group 1, n¼42) and AS with RHD group (group 2, n¼28). Anti-streptolysin O (ASO) and anti-DNA enzyme B in serum were examined by latex agglutination and enzyme-linked immunosorbent assay (ELISA), C-reaction protein (CRP) and erythrocyte sedimentation rate (ESR) were examined by means of standard clinical chemistry methods. Clinical symptoms and physical signs were observed. Radiographic grade were analysed. RESULTS Positive rates of ASO (40.48%) and anti-DNA enzyme B (52.38%) in group 1 were significantly higher than those in the control group (5%;10%;P<0.05), meanwhile they were observably lower than those in the group 2 (82.14%;89.28%;P<0.05). Compared with group 1, patients in group 2 experienced higher incidences of swelling and pain over knee and ankle, positive sign Schober Test, increased level of CRP and ESR, and cacroiliac joint X ray above phase II (P<0.05). CONCLUSIONS Streptococcal infection may contribute to the pathogenesis and the progression of AS. A history of RHD in AS patients might be a potential predictor of the severity and activity of AS. GW27-e0509 Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis Mattia Cattaneo,1 Daniel Staub,2 Alessandra P. Porretta,1 Jeanne Marie Gallino,1 Paolo Santini,3 Magdalena M. Pawelec,1 Costanzo Limoni,4 Rolf Wyttenbach,3 Augusto Gallino1 1 Hospital of San Giovanni, Department of Cardiology, Bellinzona, Switzerland; 2University Hospital Basel, Department of Angiology, Basel, Switzerland; 3Hospital of San Giovanni, Department of Radiology, Bellinzona, Switzerland; 4University of Applied Sciences and Arts of Southern Switzerland OBJECTIVES Currently, the most widely accepted predictor of stroke risk in patients with carotid atherosclerosis is the degree of stenosis. Plaque echogenicity on ultrasound imaging (US) and intraplaque neovascularization (IPNV)are becoming recognized as factors of plaque vulnerability. The aim of the study was to investigate the correlation between the echogenicity of the carotid atherosclerots by standard US and the degreee of IPNV by contrast enchanced US (CEUS). METHODS We recruited 45 consecutive subjects with an asymptomatic > or ¼ 50% carotid artery stenosis. Carotid plaque echogenicity on standard US was visually graded according to Gray-Weale classification (GW) and measured by the greyscale median method (GSM, a semi-automated measurment performed by Adobe Photoshop. On CEUS imaging IPNV was graded by different point scales according to the visual appearence of contrast within the plaque as follows: CEUS_A (1¼ absent; 2¼present); CEUS_B (increasing from 1 to 3); CEUS_C (increasing from 0 to 3). RESULTS The correlation between echogenicity by GW and IPNV was as follows: CEUS_B (-0.130 p.423), CEUS_C (-0.108 p.509, CEUS_A (0.021 p.897. The correlation between echogenicity by GSM measurment and IPNV was as follows: using CAUS_A (-0.125 p.444); CEUS_B (0.005, p.997), CEUS_C (-0.021, p.897). No correlation was found statistically significant. Agreement between repeated
measures of plaque echogenicity was as follows: GW grading (k 0.188), high for all of the GSM-derived measures, CEUS_A (k 0.754), CEUS_B (k 0.705), CEUS_C (k 0.594). Agreement between reader was as follows: GW grading (k 0.051), high for all of the GSM-derived variables,CEUS_A (k 0.688), CEUS_B (k 0.705), moderate for CEUS_C (k 0.313). CONCLUSIONS Our results display no significant correlation between echogenicity and IPNV, despite good reproducibility and repeatbility for most of the methods. The samll sample number and the multifaceted pathophysiology of the atherosclerotic plaque may explain the absence of statistically significant correlation. Curtailing vulnerability explanation to either IPNV or echolugency may be misleading. GW27-e0982 Can left ventricular strain analysis detect significant residual mitral regurgitation post mitral clip implantation? James Shue Min Yeh,1 Jian Chen,1,2 Madhu Mary Minz,1 Lucia Venneri,1 Rajdeep Khattar,1 Ali Vazir,1 Alison Duncan,1 Anan Daqa,1 Francesca Calicchio,1 Mao Liu,1,2,3 Cesare Quarto,1 Rob Smith,4 Neil Moat,1 Roxy Senior,1 Carlo Di Mario1 1 Royal Brompton Hospital, London, United Kingdom; 2Department of Cardiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China; 3Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; 4Harefield Hospital, London, United Kingdom OBJECTIVES The assessment of residual mitral regurgitation (MR) post MitraClip implantation using echo remains a challenge due to jet eccentricity and multiplicity. We examined the potential role of left ventricular (LV) strain analysis as a novel technique for assessing residual MR post MitraClip implantation in a cohort of patients with primary MR. METHODS Clinical and echocardiographic evaluation, 2D speckletracking LV strain analysis was performed on serial echos of 10 patients who had previously undergone MitraClip implantation for primary MR. The time points analysed were: (1) before clip implantation; (2) early post clip implantation (before discharge); and (3) at 6-12 months follow-up. The time point series analysis allows each patient to be its own internal control. RESULTS In the 10 patients, the age was 7513 years and 40% was male. All patients had moderate-severe (3þ) or severe (4þ) MR and was in New York Heart Association (NYHA) class III/IV. Successful MitraClip implantation without significant complications resulted in significantly reduced MR severity (20% in 3þ/4þ) and improved in NYHA functional class (30% in III/IV). Echocardiography revealed no improvement in LV size and systolic function during 6-12 months follow-up. The relationship between MR severity and LV strain was further analysed one by one. Six patients with worsening of the LV strain early post-clip (before discharge) had residual MR that remained stable at 6-12 months follow-up. Four patients with improvement in the LV strain early post-clip had residual MR that either remained stable or became worse at 6-12 months. The former (n¼2) appeared to be associated with poor LV strain before clip implantation, the latter (n¼2) with normal LV strain. CONCLUSIONS In the high-risk patients, MitraClip implantation is a feasible and safe option resulting in improvement of MR severity and clinical symptoms. This preliminary study suggests that LV strain before and early post MitraClip implantation for primary MR may potentially be used to identify significant residual MR, i.e. that which progresses within 6-12 months. GW27-e1119 Resheathable self-expanding transcatheter aortic valve system: 1-year high volume centre experience James Shue Min Yeh,1 Mao Liu,1,2,3 Shufang Wang,1 Tito Kabir,1 Alison Duncan,1 Anan Daqa,1 Francesca Calicchio,1 Cesare Quarto,1 Rashmi Yadav,1 Jian Chen,1,3 Eleanor Dunnett,1 Carlo Di Mario,1 Miles Dalby,1 Simon William Davies,1 Neil Moat1 1 Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom; 2Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; 3Department of Cardiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China OBJECTIVES The CoreValve Evolut R (Medtronic) is a new secondgeneration resheathable self-expanding transcatheter aortic valve
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
show correlation with gender, age and case history, but remarkably correlated with cardiac functional gradings (r ¼ 0.563; 0.425; 0.332, P<0.05). CONCLUSIONS CTGF may play a significant role in myocardial fibrosis of RHD, and take part in the occurrence of atrial fibrillation. GW27-e0347 Clinical significance of Rheumatic Heart Disease in patients with Ankylosing Spondylitis Yina Wang,1 Tang Li,1 Jieruo Gu,2 Shangyan Liang,1 Qiongli Yin,1 Benrong Zheng,1 Buyun Yu2 1 Special Medical Treatment Center, The Third Affiliated Hospital of Sun Yat-sen University; 2Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University OBJECTIVES To study the clinical significance of Rheumatic Heart Disease (RHD) in patients with Ankylosing spondylitis (AS). METHODS 40 healthy controls and 60 patients with AS who visited the Third Affiliated Hospital of Sun Yet-sen University between 2012 to 2016 were included. According to history of RHD, patients were divided into AS group (group 1, n¼42) and AS with RHD group (group 2, n¼28). Anti-streptolysin O (ASO) and anti-DNA enzyme B in serum were examined by latex agglutination and enzyme-linked immunosorbent assay (ELISA), C-reaction protein (CRP) and erythrocyte sedimentation rate (ESR) were examined by means of standard clinical chemistry methods. Clinical symptoms and physical signs were observed. Radiographic grade were analysed. RESULTS Positive rates of ASO (40.48%) and anti-DNA enzyme B (52.38%) in group 1 were significantly higher than those in the control group (5%;10%;P<0.05), meanwhile they were observably lower than those in the group 2 (82.14%;89.28%;P<0.05). Compared with group 1, patients in group 2 experienced higher incidences of swelling and pain over knee and ankle, positive sign Schober Test, increased level of CRP and ESR, and cacroiliac joint X ray above phase II (P<0.05). CONCLUSIONS Streptococcal infection may contribute to the pathogenesis and the progression of AS. A history of RHD in AS patients might be a potential predictor of the severity and activity of AS. GW27-e0509 Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis Mattia Cattaneo,1 Daniel Staub,2 Alessandra P. Porretta,1 Jeanne Marie Gallino,1 Paolo Santini,3 Magdalena M. Pawelec,1 Costanzo Limoni,4 Rolf Wyttenbach,3 Augusto Gallino1 1 Hospital of San Giovanni, Department of Cardiology, Bellinzona, Switzerland; 2University Hospital Basel, Department of Angiology, Basel, Switzerland; 3Hospital of San Giovanni, Department of Radiology, Bellinzona, Switzerland; 4University of Applied Sciences and Arts of Southern Switzerland OBJECTIVES Currently, the most widely accepted predictor of stroke risk in patients with carotid atherosclerosis is the degree of stenosis. Plaque echogenicity on ultrasound imaging (US) and intraplaque neovascularization (IPNV)are becoming recognized as factors of plaque vulnerability. The aim of the study was to investigate the correlation between the echogenicity of the carotid atherosclerots by standard US and the degreee of IPNV by contrast enchanced US (CEUS). METHODS We recruited 45 consecutive subjects with an asymptomatic > or ¼ 50% carotid artery stenosis. Carotid plaque echogenicity on standard US was visually graded according to Gray-Weale classification (GW) and measured by the greyscale median method (GSM, a semi-automated measurment performed by Adobe Photoshop. On CEUS imaging IPNV was graded by different point scales according to the visual appearence of contrast within the plaque as follows: CEUS_A (1¼ absent; 2¼present); CEUS_B (increasing from 1 to 3); CEUS_C (increasing from 0 to 3). RESULTS The correlation between echogenicity by GW and IPNV was as follows: CEUS_B (-0.130 p.423), CEUS_C (-0.108 p.509, CEUS_A (0.021 p.897. The correlation between echogenicity by GSM measurment and IPNV was as follows: using CAUS_A (-0.125 p.444); CEUS_B (0.005, p.997), CEUS_C (-0.021, p.897). No correlation was found statistically significant. Agreement between repeated
measures of plaque echogenicity was as follows: GW grading (k 0.188), high for all of the GSM-derived measures, CEUS_A (k 0.754), CEUS_B (k 0.705), CEUS_C (k 0.594). Agreement between reader was as follows: GW grading (k 0.051), high for all of the GSM-derived variables,CEUS_A (k 0.688), CEUS_B (k 0.705), moderate for CEUS_C (k 0.313). CONCLUSIONS Our results display no significant correlation between echogenicity and IPNV, despite good reproducibility and repeatbility for most of the methods. The samll sample number and the multifaceted pathophysiology of the atherosclerotic plaque may explain the absence of statistically significant correlation. Curtailing vulnerability explanation to either IPNV or echolugency may be misleading. GW27-e0982 Can left ventricular strain analysis detect significant residual mitral regurgitation post mitral clip implantation? James Shue Min Yeh,1 Jian Chen,1,2 Madhu Mary Minz,1 Lucia Venneri,1 Rajdeep Khattar,1 Ali Vazir,1 Alison Duncan,1 Anan Daqa,1 Francesca Calicchio,1 Mao Liu,1,2,3 Cesare Quarto,1 Rob Smith,4 Neil Moat,1 Roxy Senior,1 Carlo Di Mario1 1 Royal Brompton Hospital, London, United Kingdom; 2Department of Cardiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China; 3Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; 4Harefield Hospital, London, United Kingdom OBJECTIVES The assessment of residual mitral regurgitation (MR) post MitraClip implantation using echo remains a challenge due to jet eccentricity and multiplicity. We examined the potential role of left ventricular (LV) strain analysis as a novel technique for assessing residual MR post MitraClip implantation in a cohort of patients with primary MR. METHODS Clinical and echocardiographic evaluation, 2D speckletracking LV strain analysis was performed on serial echos of 10 patients who had previously undergone MitraClip implantation for primary MR. The time points analysed were: (1) before clip implantation; (2) early post clip implantation (before discharge); and (3) at 6-12 months follow-up. The time point series analysis allows each patient to be its own internal control. RESULTS In the 10 patients, the age was 7513 years and 40% was male. All patients had moderate-severe (3þ) or severe (4þ) MR and was in New York Heart Association (NYHA) class III/IV. Successful MitraClip implantation without significant complications resulted in significantly reduced MR severity (20% in 3þ/4þ) and improved in NYHA functional class (30% in III/IV). Echocardiography revealed no improvement in LV size and systolic function during 6-12 months follow-up. The relationship between MR severity and LV strain was further analysed one by one. Six patients with worsening of the LV strain early post-clip (before discharge) had residual MR that remained stable at 6-12 months follow-up. Four patients with improvement in the LV strain early post-clip had residual MR that either remained stable or became worse at 6-12 months. The former (n¼2) appeared to be associated with poor LV strain before clip implantation, the latter (n¼2) with normal LV strain. CONCLUSIONS In the high-risk patients, MitraClip implantation is a feasible and safe option resulting in improvement of MR severity and clinical symptoms. This preliminary study suggests that LV strain before and early post MitraClip implantation for primary MR may potentially be used to identify significant residual MR, i.e. that which progresses within 6-12 months. GW27-e1119 Resheathable self-expanding transcatheter aortic valve system: 1-year high volume centre experience James Shue Min Yeh,1 Mao Liu,1,2,3 Shufang Wang,1 Tito Kabir,1 Alison Duncan,1 Anan Daqa,1 Francesca Calicchio,1 Cesare Quarto,1 Rashmi Yadav,1 Jian Chen,1,3 Eleanor Dunnett,1 Carlo Di Mario,1 Miles Dalby,1 Simon William Davies,1 Neil Moat1 1 Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom; 2Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; 3Department of Cardiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China OBJECTIVES The CoreValve Evolut R (Medtronic) is a new secondgeneration resheathable self-expanding transcatheter aortic valve