- Email: [email protected]
GW27-e1144 Clinical value of rest gated myocardial perfusion SPECT imaging in the prognostic assessment of male patients with STEMI
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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
single-vessel coronary stenosis group, whereas only GLS and GAS had statistically significantly decreased (p<0.05). ③ An optimal GLS cutoff value of magnitude -11% with 84.2% sensitivity and GAS cutoff value of magnitude -20% with 80% specificity detected severe multivessel coronary stenosis. CONCLUSIONS Global strain by 3D-STE is useful to detect severe multi-vessel coronary stenosis, wherein GLS and GAS are more valuable indicators. GW27-e0955 Quantification of coronary flow using dynamic angiography with 320detector row CT and motion coherence image processing: Detection of ischemia for intermediate coronary stenosis Jie Qin,1 Songwang Cai,2 Li Quan,1 Wenjie Tang1 1 Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University; 2Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-sen University OBJECTIVES The purpose of this study is to propose a new method for quantifying coronary flow using dynamic CT angiography for the whole heart (heart-DCT) and investigate its ability for detecting ischemia from intermediate coronary stenosis. METHODS Participants comprised 36 patients with coronary artery disease who underwent heart-DCT using 320-detector CT with tube voltage of 80kV and myocardial perfusion scintigraphy (MPS). HeartDCT was continuously performed at mid-diastole throughout 15-25 cardiac cycles with prospective ECG-gating after bolus injection of contrast media (12-24ml). Dynamic datasets were computed into 90100 data sets by motion coherence image processing (MCIP). Next, time-density curves (TDCs) for coronary arteries with a diameter >3mm were automatically calculated for all phases using MCIP. On the basis of the maximum slope method, coronary flow index (CFI) was defined as the ratio of the maximum upslope of coronary artery attenuation to the upslope of ascending aorta attenuation on the TDC, and was used to quantify coronary flow. CFIs for the proximal and distal sites of coronary arteries with mild-to-moderate stenosis were calculated. Coronary territories were categorized as non-ischemic or ischemic by MPS. Receiver-operating-characteristic (ROC) analysis was performed to determine the optimal cutoff for CFI to detect ischemia. RESULTS Distal CFI was significantly lower for ischemia (0.260.08) than for non-ischemia (0.500.17, p<0.0001). No significant difference in proximal CFI was seen between ischemia (0.550.23) and nonischemia (0.620.24). ROC analysis revealed 0.39 as the optimal cutoff for distal CFI to detect ischemia, with C-statistics of 0.91, 100% sensitivity, and 75% specificity. CONCLUSIONS This novel imaging technique allows coronary flow quantification using heart-DCT. Distal CFI can detect myocardial ischemia derived from intermediate coronary stenosis. GW27-e0976 Preliminary study on gender differences of non-physiologic tricuspid regurgitation in healthy old people Zhang Hui, Yangling Zhang, Yongjiang Mao, Guanghui Guo, Rongqin Zheng Department of Ultrasound, the 3rd Affiliated Hospital of Sun Yat-sen University OBJECTIVES Use echocardiography to study gender differences of relevant parameters of non-physiologic tricuspid regurgitation in healthy old people. METHODS Study subjects included 873 healthy people (392 men, mean age 596 years, 481 women, mean age 568 years) examed in the Third Affiliated Hospital of Sun Yat-sen University from May 2014 to May 2015. They were all nonsmokers. All subjects had no history of heart diseases, normal blood tests and normal resting 12-lead ECGs. We used an ultrasound apparatus (A10 and F75, Hitachi-Aloka Company, Tokyo, Japan) with a UST-52105 cardiac probe (Hitachi-Aloka). Before examination, every person had a rest for 10 minutes. After a conventional echocardiographic examination, the largest area view of tricuspid regurgitation was selected. Color doppler sampling volume includes all right atrium, tricuspid valve and part of the right ventricle. The area of tricuspid regurgitation was measured, and regurgitation area >1.5 cm2 was defined as the non-physiologic regurgitation. Use continuous-wave Doppler to measure maximum pressure gradient of tricuspid regurgitation. Data were processed
using commercial software (SPSS 19.0, IBM, Armonk NY, USA). Numerical data are presented as mean standard deviation (SD). Differences between two groups of men and women using t test, with a P<0.05 considered statistically. RESULTS Compared male group with female group, the incidence of non-physiologic tricuspid regurgitation was higher in female group (3413% vs 167%, P<0.05). The non-physiologic tricuspid regurgitation area was larger in female group (2.711.04 cm2 vs 4.221.64 cm2, P<0.05). But the pressure gradient of the tricuspid regurgitation has no statistical differences in two groups (2711 mmHg vs 2410 mmHg, P>0.05). CONCLUSIONS Gender may influence incidence and flow area of nonphysiologic tricuspid regurgitation in healthy old people. GW27-e1101 Analysis of heart remodeling and function in patients with myeloproliferative neoplasms Wang Chunjian, Xue Han, Fang Wang, Beibei Bai, Ye Chen Department of Hematology, Beijing Anzhen Hospital, Capital Medical University OBJECTIVES Myeloproliferative neoplasms are chronic hematopoietic malignancies characterized by a high frequency of cardiovascular events. Its effect on cardiac remodeling and function is still not clear. METHODS Patients with MPN were enrolled in Beijing Anzhen Hospital from Apr 2004 to Apr 2016. The clinic data including age, gender, cardiovascular risk factors, blood counts, blood lipids, echocardiaographic parameters were collected and analyzed. Control group were non-MPN patients, gender and age were matched with MPN patients. No differences of previous history of coronary artery diseases, hypertension or diabetes were found between the two groups. The cardiac parameters of echocardiography assessment were analyzed and compared in patients with MPN or non-MPN. RESULTS A total of 86 patients with MPN and without MPN were enrolled respectively, the average age was 6112.9 years old in MPN patients, 61.512.7 in non-MPN patients. There were 57 cases with ET, 26 with PV and 3 with PMF among MPNs. There were no differences in age, gender and medical history including coronary heart disease, dyslipidemia, hypertension, diabetes and smokers between the two groups. The white blood cell, neutrophil, lymphocyte, basophil and platelet counts in MPN group were significantly higher than those in control group (8.94.8109/L vs 6.21.9109/L, P¼0.000; 6.23.5109/L vs 3.91.3109/L, P¼0.000; 2.01 109/L vs 1.80.7109/L, P¼ 0.017; 0.050.02109/L vs 0.0260.019109/L, P¼0.000; 488.20261.5109/L vs 213.449.6 109/L, P¼0.000). Left ventricular diastolic dimension, left atria diameter and right ventricular anterior-posterior diameter in MPN group were significantly higher than that in control group (48.95.4mm vs 46.95.5mm, P¼0.048; 37.86.5mm vs 35.34.8mm, P¼0.006; 21.96.0mm vs 20.42.6mm, P¼0.021). MPN patients with aortic valve thickening was 22 cases (27.9%), with pulmonary artery hypertension (PAH) 10 cases (11.6%). Both patients with aortic valve thickening and PAH were higher than control group [11cases (12.8%), P¼0.022; 0 case (0%), P¼0.001]. The left ventricular ejection fraction (LVEF) in MPN patients was significantly lower than that in control group (60.010.4% vs 63.47.2%, p¼0.014). CONCLUSIONS MPN patients are prone to develop cardiac remodeling and dysfunction, especially left atria and ventricular enlargement and decreased ejection fraction, degenerative aortic valve changes as well as PAH. Our results show MPN patients not only associated with high incidence of thrombus events, but also with remodeling and dysfunction of heart. GW27-e1144 Clinical value of rest gated myocardial perfusion SPECT imaging in the prognostic assessment of male patients with STEMI Zhenhua WU,1 Jin Han,1 Jing Huang,1 Huanzhen Chen2 Shanxi Medical University; 2Department of Cardiovascular Medicine, First Hospital of Shanxi Medical University
1
OBJECTIVES This study aims to investigate the clinical value of rest GMPI in the prognostic evaluation of male patients with acute STsegment elevation myocardial infarction. METHODS Seventy male patients with acute STEMI were collected from July 2014 to December 2014 of cardiovascular dept in the First Hospital of Shanxi Medical University hospital. General information
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
including age, history of hypertension and diabetes, therapies were recorded. Venous blood was drawn from all patients and NT-proBNP, cTnI, hs-CRP concentration were measured. CAG and rest G-MPI were performed in all patients to measured the LVEDV, LVESV and LVEF, and the myocardial perfusion defect area was calculated. All patients were followed within 180 days after discharge to record the major adverse cardiovascular events(MACE). According to the follow-up results, patients were assigned to MACE group and non-MACE group, the value of prognostic evaluation between myocardial perfusion defect area and NT-proBNP was analyzed by ROC curve. According to the best cut-off value of myocardial perfusion defect area which determined by ROC curve analysis, patients were divided into tow groups, then drawn the Kaplam-Meier survival curve. RESULTS 1. The myocardial perfusion defect area in STEMI patients is uncorrelated with cTnI and hs-CRP concentration (P>0.05), and positive correlation with NT-proBNP concentration (r¼0.793, P<0.05). The myocardial perfusion defect area in STEMI patients is uncorrelated with LVEDV and LVESV (P>0.05), and negative correlation with LVEF (r¼-0.609, P<0.05). 2. The level of age, history of hypertension and diabetes, HDL-C, LDL-C, hs-CRP, cTnI, LVEDV, LVESV and LVEF among the MACE group and non-MACE group, had no statistically significant differences (P>0.05). There were apparent differences between the MACE group and non-MACE group, which in the myocardial perfusion defect area, NT-proBNP concentration and vascular lesion, the differences were statistically significant (P<0.05 or 0.01). 3.ROC curve analysis showed that the area under the curve of myocardial perfusion defect area was 0.700 (cut-off value¼14.06%, sensitive¼84.2%, specificity¼62.5%, Youden index¼0.467, P<0.05). And the area under the curve of NT-proBNP concentration was 0.644 (cut-off value¼1609 ng/L, sensitive¼44.7%, specificity¼87.5%, Youden index¼0.322, P<0.05). The difference of the area under the ROC curve among two predictors had statistically significant (P<0.05). Combined testing (sensitive¼94.7%, specificity¼50.0%, Youden index¼0.447, P<0.05). 4. There were obvious differences in MACE incidence between the two group, the differences were statistically significant (P<0.05). CONCLUSIONS 1. The value of myocardial perfusion defect area in the prognostic evaluation of MACE with male STEMI patients was better than NT-proBNP concentration. 2. Myocardial perfusion defect area can be a predictor of risk stratification in male STEMI patients, predict the risk of MACE, and the best cut-off value of myocardial perfusion defect area was 14.06%. GW27-e1161 Effects of garlic on a Rabbit Model of In-Stent Neoatherosclerosis: An Optical Coherence Tomography Study Chen Shuyuan,1,2 Hou Jingbo1,2 Department of Cardiology, the 2nd Affiliated Hospital of Harbin MedicalUniversity; 2The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education,Harbin
1
OBJECTIVES In this study we analyse the effect of per oral administration of the time-released garlic herbal preparation on a rabbit model of in-stent neoatherosclerosis (ISNA) using optical coherence tomography (OCT). METHODS Sirolimus-eluting stents were implanted in the right common carotid arteries of the male New Zealand white rabbits with surgical procedure and then received chow containing 1% cholesterol during the whole animal experiment. Animals were randomly divided into 2 groups (group 1 rabbits were received cholesterol-rich diet with per oral administration of the time-released garlic herbal preparation containing 300 mg garlic powder; group 2 were received just cholesterol-rich diet as control). Stented arterial segments were harvested at 12 weeks after stenting and then processed for optical coherence tomographic analysis and histology. Meanwhile, rabbits were phlebotomized and blood collected for the determination of cytokines levels. RESULTS Compared with control subjects, the garlic-treated animals showed lower rate of lipid-rich intima and per-strut low-signal intensity layer, smaller neointimal area and neointimal thickness, larger fibrous cap thickness and minimum lumen area. The serum IL-6, IL-12, MCP-1 and TNF-a decreased and IL-10 increased in the garlic -treated groups. CONCLUSIONS Garlic prevents the development of cholesterolinduced experimental in-stent neoatherosclerosis compared with control. Targeting of inflammatory pathways after percutaneous
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coronary intervention may be an efficacious way to prevent restenosis without the long-term risk of late thrombosis. GW27-e1180 Semi-automatic Assessment of Normal Human Aortic Roots by Three-dimensional Transesophageal Echocardiography: Results from the SMARTER Registry Minghui Zhang,1 Linyuan Wan,1 Weichun Wu,1 Kun Liu,2 Li Zhang,1 Zhilan Zheng,3 Hui Li,1 Yan Sun,1 Yisheng Shi,1 Zhenhui Zhu,1 Bin Lyu,2 Hao Wang1 1 Department of Ultrasound, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; 2Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; 3Division of Ultrasonography, Siemens Healthineers China OBJECTIVES The progress in surgery of the aortic root and the evolution of transcatheter aortic valve replacement (TAVR) as an alternative to surgical treatment in selected patients have refocused the need for quantitative imaging of the aortic root during TAVR and valve-sparing aortic root surgery. A specialized three-dimensional transesophageal echocardiography (3D-TEE) reconstruction tool has recently been introduced, which can semi-automatically configure a geometric model of the aortic root from the images obtained by 3D-TEE and performs quantitative analysis of these structures. We aimed to compare the measurements of the aortic annulus (AA) obtained by mannual 3D-TEE, 3D-TEE with the specialized reconstruction tool, and multidetector computed tomography (MDCT), and the ability of the semi-automatic 3D TEE modeling software was tested. METHODS This is a registered single-center clinical trial (ClinicalTrials.gov Identifier: NCT02724709). Patients with clinical normal aortic valve and root, who were indicated for both 3D-TEE and MDCT due to atrial fibrillation or patent foramen ovale, were prospectively enrolled. The AA diameters and area were evaluated by the conventional 3D-TEE, then analyzed by the semi-automated quantitative software (eSie Valves, Autovalve prototype version, Siemens Medical Solutions, USA). Electrocardiographic gating MDCT images were evaluated by TAVR-planning workstations (Syngo.Via v4.8, Siemens Healthineers, Germany). All parameters were measured independently with blinding methods. RESULTS We included 68 patients, 32% female (22/68), median age 55 years old (range 22-77). We showed an excellent correlation between the measurements obtained by both manual and quantitative 3D-TEE. Methods: intra-class correlation coefficient (ICC): 0.701 (0.518-0.862), r: 0.742 for AA diameter and ICC: 0.723 (0.662-0.923), r: 0.723 for the AA area, with no significant differences regardless of the method used. The interobserver variability was superior for the quantitative measurements than for the manual ones. In a subgroup of 58 patients, we also found an excellent correlation between the quantitative 3DTEE measurements and those obtained by MDCT, ICC: 0.941 (0.7610.985), r: 0.901 for AA diameter and ICC: 0.853 (0.409-0.964), r: 0.744 for the AA area. CONCLUSIONS The new semi-automatic 3D-TEE software allows modelling and quantifying the aortic root from 3D-TEE data with high reproducibility. There is good correlation between the semi-automatic measurements and other 3D validated techniques. Given the workflow advantages of automation, this 3D-TEE approach may enhance the clinical adoption of routine 3-dimensional imaging beyond MDCT previous to TAVR. RELATED PHARMACEUTICAL CLINICAL RESEARCH GW27-e0074 Use of Thymosin Beta4 and Troponin I to Predict Trastuzumab-induced Cardiotoxicity in Early Breast Cancer Patients Xue Jian, Zhang Xiaozhong Affiliated Hospital of Academy of Military Medical Sciences OBJECTIVES Current methods to identify patients at risk for cancer therapy cardiotoxicity are inadequate. METHODS All consecutive women with HER2-positive breast cancer and scheduled to receive adjuvant chemotherapy including anthracyclines, taxanes and trastuzumab. The biomarkers assessed in this study were high-sensitivity troponin I(hs-TnI) and thymosin b4 (Tb4). Blood samples were obtained at baseline, three and six months.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
single-vessel coronary stenosis group, whereas only GLS and GAS had statistically significantly decreased (p<0.05). ③ An optimal GLS cutoff value of magnitude -11% with 84.2% sensitivity and GAS cutoff value of magnitude -20% with 80% specificity detected severe multivessel coronary stenosis. CONCLUSIONS Global strain by 3D-STE is useful to detect severe multi-vessel coronary stenosis, wherein GLS and GAS are more valuable indicators. GW27-e0955 Quantification of coronary flow using dynamic angiography with 320detector row CT and motion coherence image processing: Detection of ischemia for intermediate coronary stenosis Jie Qin,1 Songwang Cai,2 Li Quan,1 Wenjie Tang1 1 Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University; 2Department of Cardiothoracic Surgery, the Third Affiliated Hospital of Sun Yat-sen University OBJECTIVES The purpose of this study is to propose a new method for quantifying coronary flow using dynamic CT angiography for the whole heart (heart-DCT) and investigate its ability for detecting ischemia from intermediate coronary stenosis. METHODS Participants comprised 36 patients with coronary artery disease who underwent heart-DCT using 320-detector CT with tube voltage of 80kV and myocardial perfusion scintigraphy (MPS). HeartDCT was continuously performed at mid-diastole throughout 15-25 cardiac cycles with prospective ECG-gating after bolus injection of contrast media (12-24ml). Dynamic datasets were computed into 90100 data sets by motion coherence image processing (MCIP). Next, time-density curves (TDCs) for coronary arteries with a diameter >3mm were automatically calculated for all phases using MCIP. On the basis of the maximum slope method, coronary flow index (CFI) was defined as the ratio of the maximum upslope of coronary artery attenuation to the upslope of ascending aorta attenuation on the TDC, and was used to quantify coronary flow. CFIs for the proximal and distal sites of coronary arteries with mild-to-moderate stenosis were calculated. Coronary territories were categorized as non-ischemic or ischemic by MPS. Receiver-operating-characteristic (ROC) analysis was performed to determine the optimal cutoff for CFI to detect ischemia. RESULTS Distal CFI was significantly lower for ischemia (0.260.08) than for non-ischemia (0.500.17, p<0.0001). No significant difference in proximal CFI was seen between ischemia (0.550.23) and nonischemia (0.620.24). ROC analysis revealed 0.39 as the optimal cutoff for distal CFI to detect ischemia, with C-statistics of 0.91, 100% sensitivity, and 75% specificity. CONCLUSIONS This novel imaging technique allows coronary flow quantification using heart-DCT. Distal CFI can detect myocardial ischemia derived from intermediate coronary stenosis. GW27-e0976 Preliminary study on gender differences of non-physiologic tricuspid regurgitation in healthy old people Zhang Hui, Yangling Zhang, Yongjiang Mao, Guanghui Guo, Rongqin Zheng Department of Ultrasound, the 3rd Affiliated Hospital of Sun Yat-sen University OBJECTIVES Use echocardiography to study gender differences of relevant parameters of non-physiologic tricuspid regurgitation in healthy old people. METHODS Study subjects included 873 healthy people (392 men, mean age 596 years, 481 women, mean age 568 years) examed in the Third Affiliated Hospital of Sun Yat-sen University from May 2014 to May 2015. They were all nonsmokers. All subjects had no history of heart diseases, normal blood tests and normal resting 12-lead ECGs. We used an ultrasound apparatus (A10 and F75, Hitachi-Aloka Company, Tokyo, Japan) with a UST-52105 cardiac probe (Hitachi-Aloka). Before examination, every person had a rest for 10 minutes. After a conventional echocardiographic examination, the largest area view of tricuspid regurgitation was selected. Color doppler sampling volume includes all right atrium, tricuspid valve and part of the right ventricle. The area of tricuspid regurgitation was measured, and regurgitation area >1.5 cm2 was defined as the non-physiologic regurgitation. Use continuous-wave Doppler to measure maximum pressure gradient of tricuspid regurgitation. Data were processed
using commercial software (SPSS 19.0, IBM, Armonk NY, USA). Numerical data are presented as mean standard deviation (SD). Differences between two groups of men and women using t test, with a P<0.05 considered statistically. RESULTS Compared male group with female group, the incidence of non-physiologic tricuspid regurgitation was higher in female group (3413% vs 167%, P<0.05). The non-physiologic tricuspid regurgitation area was larger in female group (2.711.04 cm2 vs 4.221.64 cm2, P<0.05). But the pressure gradient of the tricuspid regurgitation has no statistical differences in two groups (2711 mmHg vs 2410 mmHg, P>0.05). CONCLUSIONS Gender may influence incidence and flow area of nonphysiologic tricuspid regurgitation in healthy old people. GW27-e1101 Analysis of heart remodeling and function in patients with myeloproliferative neoplasms Wang Chunjian, Xue Han, Fang Wang, Beibei Bai, Ye Chen Department of Hematology, Beijing Anzhen Hospital, Capital Medical University OBJECTIVES Myeloproliferative neoplasms are chronic hematopoietic malignancies characterized by a high frequency of cardiovascular events. Its effect on cardiac remodeling and function is still not clear. METHODS Patients with MPN were enrolled in Beijing Anzhen Hospital from Apr 2004 to Apr 2016. The clinic data including age, gender, cardiovascular risk factors, blood counts, blood lipids, echocardiaographic parameters were collected and analyzed. Control group were non-MPN patients, gender and age were matched with MPN patients. No differences of previous history of coronary artery diseases, hypertension or diabetes were found between the two groups. The cardiac parameters of echocardiography assessment were analyzed and compared in patients with MPN or non-MPN. RESULTS A total of 86 patients with MPN and without MPN were enrolled respectively, the average age was 6112.9 years old in MPN patients, 61.512.7 in non-MPN patients. There were 57 cases with ET, 26 with PV and 3 with PMF among MPNs. There were no differences in age, gender and medical history including coronary heart disease, dyslipidemia, hypertension, diabetes and smokers between the two groups. The white blood cell, neutrophil, lymphocyte, basophil and platelet counts in MPN group were significantly higher than those in control group (8.94.8109/L vs 6.21.9109/L, P¼0.000; 6.23.5109/L vs 3.91.3109/L, P¼0.000; 2.01 109/L vs 1.80.7109/L, P¼ 0.017; 0.050.02109/L vs 0.0260.019109/L, P¼0.000; 488.20261.5109/L vs 213.449.6 109/L, P¼0.000). Left ventricular diastolic dimension, left atria diameter and right ventricular anterior-posterior diameter in MPN group were significantly higher than that in control group (48.95.4mm vs 46.95.5mm, P¼0.048; 37.86.5mm vs 35.34.8mm, P¼0.006; 21.96.0mm vs 20.42.6mm, P¼0.021). MPN patients with aortic valve thickening was 22 cases (27.9%), with pulmonary artery hypertension (PAH) 10 cases (11.6%). Both patients with aortic valve thickening and PAH were higher than control group [11cases (12.8%), P¼0.022; 0 case (0%), P¼0.001]. The left ventricular ejection fraction (LVEF) in MPN patients was significantly lower than that in control group (60.010.4% vs 63.47.2%, p¼0.014). CONCLUSIONS MPN patients are prone to develop cardiac remodeling and dysfunction, especially left atria and ventricular enlargement and decreased ejection fraction, degenerative aortic valve changes as well as PAH. Our results show MPN patients not only associated with high incidence of thrombus events, but also with remodeling and dysfunction of heart. GW27-e1144 Clinical value of rest gated myocardial perfusion SPECT imaging in the prognostic assessment of male patients with STEMI Zhenhua WU,1 Jin Han,1 Jing Huang,1 Huanzhen Chen2 Shanxi Medical University; 2Department of Cardiovascular Medicine, First Hospital of Shanxi Medical University
1
OBJECTIVES This study aims to investigate the clinical value of rest GMPI in the prognostic evaluation of male patients with acute STsegment elevation myocardial infarction. METHODS Seventy male patients with acute STEMI were collected from July 2014 to December 2014 of cardiovascular dept in the First Hospital of Shanxi Medical University hospital. General information
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 68, NO. 16, SUPPL S, 2016
including age, history of hypertension and diabetes, therapies were recorded. Venous blood was drawn from all patients and NT-proBNP, cTnI, hs-CRP concentration were measured. CAG and rest G-MPI were performed in all patients to measured the LVEDV, LVESV and LVEF, and the myocardial perfusion defect area was calculated. All patients were followed within 180 days after discharge to record the major adverse cardiovascular events(MACE). According to the follow-up results, patients were assigned to MACE group and non-MACE group, the value of prognostic evaluation between myocardial perfusion defect area and NT-proBNP was analyzed by ROC curve. According to the best cut-off value of myocardial perfusion defect area which determined by ROC curve analysis, patients were divided into tow groups, then drawn the Kaplam-Meier survival curve. RESULTS 1. The myocardial perfusion defect area in STEMI patients is uncorrelated with cTnI and hs-CRP concentration (P>0.05), and positive correlation with NT-proBNP concentration (r¼0.793, P<0.05). The myocardial perfusion defect area in STEMI patients is uncorrelated with LVEDV and LVESV (P>0.05), and negative correlation with LVEF (r¼-0.609, P<0.05). 2. The level of age, history of hypertension and diabetes, HDL-C, LDL-C, hs-CRP, cTnI, LVEDV, LVESV and LVEF among the MACE group and non-MACE group, had no statistically significant differences (P>0.05). There were apparent differences between the MACE group and non-MACE group, which in the myocardial perfusion defect area, NT-proBNP concentration and vascular lesion, the differences were statistically significant (P<0.05 or 0.01). 3.ROC curve analysis showed that the area under the curve of myocardial perfusion defect area was 0.700 (cut-off value¼14.06%, sensitive¼84.2%, specificity¼62.5%, Youden index¼0.467, P<0.05). And the area under the curve of NT-proBNP concentration was 0.644 (cut-off value¼1609 ng/L, sensitive¼44.7%, specificity¼87.5%, Youden index¼0.322, P<0.05). The difference of the area under the ROC curve among two predictors had statistically significant (P<0.05). Combined testing (sensitive¼94.7%, specificity¼50.0%, Youden index¼0.447, P<0.05). 4. There were obvious differences in MACE incidence between the two group, the differences were statistically significant (P<0.05). CONCLUSIONS 1. The value of myocardial perfusion defect area in the prognostic evaluation of MACE with male STEMI patients was better than NT-proBNP concentration. 2. Myocardial perfusion defect area can be a predictor of risk stratification in male STEMI patients, predict the risk of MACE, and the best cut-off value of myocardial perfusion defect area was 14.06%. GW27-e1161 Effects of garlic on a Rabbit Model of In-Stent Neoatherosclerosis: An Optical Coherence Tomography Study Chen Shuyuan,1,2 Hou Jingbo1,2 Department of Cardiology, the 2nd Affiliated Hospital of Harbin MedicalUniversity; 2The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education,Harbin
1
OBJECTIVES In this study we analyse the effect of per oral administration of the time-released garlic herbal preparation on a rabbit model of in-stent neoatherosclerosis (ISNA) using optical coherence tomography (OCT). METHODS Sirolimus-eluting stents were implanted in the right common carotid arteries of the male New Zealand white rabbits with surgical procedure and then received chow containing 1% cholesterol during the whole animal experiment. Animals were randomly divided into 2 groups (group 1 rabbits were received cholesterol-rich diet with per oral administration of the time-released garlic herbal preparation containing 300 mg garlic powder; group 2 were received just cholesterol-rich diet as control). Stented arterial segments were harvested at 12 weeks after stenting and then processed for optical coherence tomographic analysis and histology. Meanwhile, rabbits were phlebotomized and blood collected for the determination of cytokines levels. RESULTS Compared with control subjects, the garlic-treated animals showed lower rate of lipid-rich intima and per-strut low-signal intensity layer, smaller neointimal area and neointimal thickness, larger fibrous cap thickness and minimum lumen area. The serum IL-6, IL-12, MCP-1 and TNF-a decreased and IL-10 increased in the garlic -treated groups. CONCLUSIONS Garlic prevents the development of cholesterolinduced experimental in-stent neoatherosclerosis compared with control. Targeting of inflammatory pathways after percutaneous
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coronary intervention may be an efficacious way to prevent restenosis without the long-term risk of late thrombosis. GW27-e1180 Semi-automatic Assessment of Normal Human Aortic Roots by Three-dimensional Transesophageal Echocardiography: Results from the SMARTER Registry Minghui Zhang,1 Linyuan Wan,1 Weichun Wu,1 Kun Liu,2 Li Zhang,1 Zhilan Zheng,3 Hui Li,1 Yan Sun,1 Yisheng Shi,1 Zhenhui Zhu,1 Bin Lyu,2 Hao Wang1 1 Department of Ultrasound, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; 2Department of Radiologic Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; 3Division of Ultrasonography, Siemens Healthineers China OBJECTIVES The progress in surgery of the aortic root and the evolution of transcatheter aortic valve replacement (TAVR) as an alternative to surgical treatment in selected patients have refocused the need for quantitative imaging of the aortic root during TAVR and valve-sparing aortic root surgery. A specialized three-dimensional transesophageal echocardiography (3D-TEE) reconstruction tool has recently been introduced, which can semi-automatically configure a geometric model of the aortic root from the images obtained by 3D-TEE and performs quantitative analysis of these structures. We aimed to compare the measurements of the aortic annulus (AA) obtained by mannual 3D-TEE, 3D-TEE with the specialized reconstruction tool, and multidetector computed tomography (MDCT), and the ability of the semi-automatic 3D TEE modeling software was tested. METHODS This is a registered single-center clinical trial (ClinicalTrials.gov Identifier: NCT02724709). Patients with clinical normal aortic valve and root, who were indicated for both 3D-TEE and MDCT due to atrial fibrillation or patent foramen ovale, were prospectively enrolled. The AA diameters and area were evaluated by the conventional 3D-TEE, then analyzed by the semi-automated quantitative software (eSie Valves, Autovalve prototype version, Siemens Medical Solutions, USA). Electrocardiographic gating MDCT images were evaluated by TAVR-planning workstations (Syngo.Via v4.8, Siemens Healthineers, Germany). All parameters were measured independently with blinding methods. RESULTS We included 68 patients, 32% female (22/68), median age 55 years old (range 22-77). We showed an excellent correlation between the measurements obtained by both manual and quantitative 3D-TEE. Methods: intra-class correlation coefficient (ICC): 0.701 (0.518-0.862), r: 0.742 for AA diameter and ICC: 0.723 (0.662-0.923), r: 0.723 for the AA area, with no significant differences regardless of the method used. The interobserver variability was superior for the quantitative measurements than for the manual ones. In a subgroup of 58 patients, we also found an excellent correlation between the quantitative 3DTEE measurements and those obtained by MDCT, ICC: 0.941 (0.7610.985), r: 0.901 for AA diameter and ICC: 0.853 (0.409-0.964), r: 0.744 for the AA area. CONCLUSIONS The new semi-automatic 3D-TEE software allows modelling and quantifying the aortic root from 3D-TEE data with high reproducibility. There is good correlation between the semi-automatic measurements and other 3D validated techniques. Given the workflow advantages of automation, this 3D-TEE approach may enhance the clinical adoption of routine 3-dimensional imaging beyond MDCT previous to TAVR. RELATED PHARMACEUTICAL CLINICAL RESEARCH GW27-e0074 Use of Thymosin Beta4 and Troponin I to Predict Trastuzumab-induced Cardiotoxicity in Early Breast Cancer Patients Xue Jian, Zhang Xiaozhong Affiliated Hospital of Academy of Military Medical Sciences OBJECTIVES Current methods to identify patients at risk for cancer therapy cardiotoxicity are inadequate. METHODS All consecutive women with HER2-positive breast cancer and scheduled to receive adjuvant chemotherapy including anthracyclines, taxanes and trastuzumab. The biomarkers assessed in this study were high-sensitivity troponin I(hs-TnI) and thymosin b4 (Tb4). Blood samples were obtained at baseline, three and six months.