- Email: [email protected]
LEFT VENTRICULAR MYOCARDIAL SYSTOLIC VELOCITY, BUT NOT EJECTION FRACTION, IS REDUCED IN PATIENTS WITH PERIPHERAL ARTERY DISEASE
Publication Only 67
DECREASED KIDNEY FUNCTION AS A RISK FACTOR FOR ATHEROSCLEROTIC CARDIOVASCULAR EVENTS IN SUBJECTS WITH METABOLIC SYNDROME AND HIGH CARDIOVASCULAR RISK
M. Barylski 1 , L. Pawlicki 1 , M. Banach 2 , R. Irzma´nski 1 , J. Błaszczyk 3 , E. Kowalczyk 3 , A. Lewi´nski 4 , J. Kowalski 1 . 1 Department of Internal Medicine and Cardiological Rehabilitation, Medical University in Lodz/Clinical Hospital No 5, Lodz, Poland; 2 Department of Cardiology, Ist Chair of Cardiology and Cardiosurgery, Medical University in Lodz/Clinical Hospital No 3, Lodz, Poland; 3 Department of Human Physiology and Biophysics, Medical University of Lodz, Poland; 4 Department of Endocrinology and Metabolic Diseases, Medical University of Lodz/Polish Mother’s Memorial Hospital - Research Institute, Lodz, Poland Background and aims: A lot of data confirm that chronic kidney disease is an independent risk factor for the development of cardiovascular events. The aim of the study was to estimate the level of kidney function in subjects with metabolic syndrome (MS) and high cardiovascular risk. Methods: The study included 75 subjects: 50 subjects with MS (diagnosed on the basis of NCEP ATP III criteria), aged 55,94±11,82 years and 25 healthy subjects, aged 54,24±12,84 years. Basing on SCORE index, a 10-year death risk due to cardiovascular complications was estimated. Glomerular filtration rates (GFR) were measured with Cockroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas. The value of GFR <60 ml/min/1.73 m2 was accepted as a risk factor for cardiovascular events. Results: All the subjects with MS had high death risk due to cardiovascular complications (SCORE index ≥5%). The value of GFR <60 ml/min/1.73 m2 in the group with MS was observed in 5 subjects (10%) (measured with CG formula) and in 15 subjects (30%) (measured with MDRD formula). In the group of healthy subjects, GFR <60 ml/min/1.73 m2 was observed in 2 subjects (8%) (measured with both CG and MDRD formulas). Conclusions: Because of the presence of obesity in patients with MS, the estimation of glomerular filtration rate using MDRD formula seems to be more accurate and precise. Decreased level of kidney function is much more common in patients with MS and high cardiovascular risk than in the rest of the population. LEFT VENTRICULAR MYOCARDIAL SYSTOLIC VELOCITY, BUT NOT EJECTION FRACTION, IS REDUCED IN PATIENTS WITH PERIPHERAL ARTERY DISEASE
C. Hammar 1 , J. Viklund 1 , J. Leppert 2 , E. Henriksen 3 , A. Hellberg 4 , I. Lönnberg 1 , P. Hedberg 3 . 1 Department of Internal Medicine- Cardiology, Central Hospital, Vasteras, Sweden; 2 Centre of Clinical Research, University of Uppsala, Central Hospital, Vasteras, Sweden; 3 Department of Clinical Physiology, Central Hospital, Vasteras, Sweden; 4 Department of Vascular Surgery, Central Hospital, Vasteras, Sweden Background and aims: Left ventricular (LV) systolic dysfunction is often a consequence of coronary heart disease (CHD). CHD is prevalent among patients with peripheral artery disease (PAD). However, there is limited data regarding LV function in those patients. We evaluated LV systolic function in patients with PAD. Methods: In an ongoing observational study we analysed LV systolic function in 100 consecutive patients (mean age 67.0, SD 8.5; 45% women) referred to the Department of Vascular Surgery and fulfilling the following inclusion criteria: ankle/brachial index ≤ 0.9 or >30% carotid artery stenosis. LV function was evaluated by echocardiography as 1) ejection fraction (LVEF) and 2) myocardial longitudinal maximum systolic velocity measured by tissue Doppler (TV-S). A gender and age (±3 years) matched control group was selected randomly from the general population. A control subject was excluded only if fulfilling any of the patient group inclusion criteria. Results: There were no differences between patients and controls regarding mean LVEF (58.4%, SD 9.0, vs 59.4%, SD 9.0; p=0.51) or prevalence of LVEF < 45% (6.0% vs 5.7%; p=1.00). However, TV-S was significantly lower in the patients (4,7 cm/s, SD 1.1, vs 5.1 cm/s, SD 1.1; p=0,017). Prevalence of hypokinesia in one or more LV segments was also more common in patients (18.0% vs 6.9%; p=0.028). Conclusions: Patients with PAD had lower left ventricular systolic velocity, but they did not differ in ejection fraction from controls.
INCREASED HEART RATE AS A PREDICTOR OF CARDIOVASCULAR COMPLICATIONS IN SUBJECTS WITH METABOLIC SYNDROME AND HIGH CARDIOVASCULAR RISK
M. Barylski 1 , J. Kowalski 1 , M. Banach 2 , J. Błaszczyk 3 , E. Kowalczyk 3 , R. Irzma´nski 1 , A. Lewi´nski 4 , L. Pawlicki 1 . 1 Department of Internal Medicine and Cardiological Rehabilitation, Medical University in Lodz, Clinical Hospital No 5 in Lodz, Poland; 2 Department of Cardiology, Ist Chair of Cardiology and Cardiosurgery, Medical University in Lodz, Clinical Hospital No 3 in Lodz, Poland; 3 Department of Human Physiology and Biophysics, Medical University in Lodz, Poland; 4 Department of Endocrinology and Metabolic Diseases, Medical University in Lodz, Polish Mother’s Memorial Hospital - Research Institute, Lodz, Poland Background and aims: Mounting evidence shows that increased Heart Rate (HR) is associated with greater risk of developing atherosclerosis and is a potent predictor of cardiovascular morbidity and mortality. The aim of the study was to estimate the occurrence of high HR in subjects with metabolic syndrome (MS) and high cardiovascular risk. Methods: The study included 75 subjects: 50 subjects with MS (diagnosed on the basis of NCEP ATP III criteria) and 25 healthy subjects. Basing on SCORE index, a 10-year death risk due to cardiovascular complications was estimated. Heart rate was measured three times, after 10 minutes of rest, and the mean value was estimated. Results: All the subjects with MS had high death risk (SCORE index ≥5%). The mean value of HR in subjects with MS was significantly higher than in the healthy subjects (78,20±10,53/min. vs 69,80± 9,18/min.). In the group with MS, HR of 60-70 bpm was found in 6 subjects (12%), 70-80 bpm in 18 subjects (36%), 80-90 bpm in 16 subjects (32%) and HR >90 bpm in 10 subjects (20%). In the group of healthy subjects HR <60 bpm was found in 1 subject (4%), HR of 60-70 bpm was found in 10 subjects (40%), 70-80 bpm in 8 subjects (32%), 80-90 bpm in 5 subjects (20%) and HR >90 bpm in 1 subject (4%). Conclusions: Increased heart rate in subjects with MS and high cardiovascular risk is an independent risk factor of cardiovascular morbidity and mortality in this group of patients. 70
ESTIMATION OF CARDIOVASCULAR COMPLICATIONS IN SUBJECTS WITH METABOLIC SYNDROME AND HIGH CARDIOVASCULAR RISK
M. Barylski 1 , J. Błaszczyk 3 , M. Banach 2 , R. Irzma´nski 1 , E. Kowalczyk 3 , L. Pawlicki 1 , A. Lewi´nski 4 , J. Kowalski 1 . 1 Department of Internal Medicine and Cardiological Rehabilitation, Medical University in Lodz/Clinical Hospital No. 5 in Lodz, Poland; 2 Department of Cardiology, Ist Chair of Cardiology and Cardiosurgery, Medical University in Lodz/Clinical Hospital No. 3 in Lodz, Poland; 3 Department of Human Physiology and Biophysics, Medical University in Lodz, Poland; 4 Department of Endocrinology and Metabolic Diseases, Medical University in Lodz/Polish Mother’s Memorial Hospital - Research Institute, Lodz, Poland Background and aims: Numerous studies have shown that pulse pressure (PP), may be the best predictor of cardiac events for all the blood pressure values. PP has become of clinical interest as an independent marker of risk for the development of cardiovascular disease, including stroke and heart failure. It has also been observed to be a significant and independent indicator of myocardial infarction. The aim of the study was to estimate cardiovascular complications in subjects with metabolic syndrome (MS) and high cardiovascular risk. Methods: The study included 75 subjects: 50 subjects with MS (diagnosed on the basis of NCEP ATP III criteria), aged 55,94±11,82 years and 25 healthy subjects, aged 54,24±12,84 years. Basing on SCORE index, a 10-year death risk due to cardiovascular complications was estimated. The value ≥5% was accepted as high risk of death within 10 years. Increased risk of cardiovascular complications was determined for the pulse pressure >63 mmHg. Results: All the subjects with MS had high death risk due to cardiovascular complications (SCORE index ≥5%). The mean value of PP in subjects with MS was significantly higher than in the group of healthy subjects (66,14±17,33 mmHg vs 41,40±8,60 mmHg). Increased risk of cardiovascular complications (PP>63 mmHg) was found in 26 subjects (52%) with MS. In the group of healthy subjects PP>63 mmHg was not found. Conclusions: High risk of cardiovascular complications occurs statis-
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
PUBLICATION ONLY
68
69
231
DECREASED KIDNEY FUNCTION AS A RISK FACTOR FOR ATHEROSCLEROTIC CARDIOVASCULAR EVENTS IN SUBJECTS WITH METABOLIC SYNDROME AND HIGH CARDIOVASCULAR RISK
M. Barylski 1 , L. Pawlicki 1 , M. Banach 2 , R. Irzma´nski 1 , J. Błaszczyk 3 , E. Kowalczyk 3 , A. Lewi´nski 4 , J. Kowalski 1 . 1 Department of Internal Medicine and Cardiological Rehabilitation, Medical University in Lodz/Clinical Hospital No 5, Lodz, Poland; 2 Department of Cardiology, Ist Chair of Cardiology and Cardiosurgery, Medical University in Lodz/Clinical Hospital No 3, Lodz, Poland; 3 Department of Human Physiology and Biophysics, Medical University of Lodz, Poland; 4 Department of Endocrinology and Metabolic Diseases, Medical University of Lodz/Polish Mother’s Memorial Hospital - Research Institute, Lodz, Poland Background and aims: A lot of data confirm that chronic kidney disease is an independent risk factor for the development of cardiovascular events. The aim of the study was to estimate the level of kidney function in subjects with metabolic syndrome (MS) and high cardiovascular risk. Methods: The study included 75 subjects: 50 subjects with MS (diagnosed on the basis of NCEP ATP III criteria), aged 55,94±11,82 years and 25 healthy subjects, aged 54,24±12,84 years. Basing on SCORE index, a 10-year death risk due to cardiovascular complications was estimated. Glomerular filtration rates (GFR) were measured with Cockroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas. The value of GFR <60 ml/min/1.73 m2 was accepted as a risk factor for cardiovascular events. Results: All the subjects with MS had high death risk due to cardiovascular complications (SCORE index ≥5%). The value of GFR <60 ml/min/1.73 m2 in the group with MS was observed in 5 subjects (10%) (measured with CG formula) and in 15 subjects (30%) (measured with MDRD formula). In the group of healthy subjects, GFR <60 ml/min/1.73 m2 was observed in 2 subjects (8%) (measured with both CG and MDRD formulas). Conclusions: Because of the presence of obesity in patients with MS, the estimation of glomerular filtration rate using MDRD formula seems to be more accurate and precise. Decreased level of kidney function is much more common in patients with MS and high cardiovascular risk than in the rest of the population. LEFT VENTRICULAR MYOCARDIAL SYSTOLIC VELOCITY, BUT NOT EJECTION FRACTION, IS REDUCED IN PATIENTS WITH PERIPHERAL ARTERY DISEASE
C. Hammar 1 , J. Viklund 1 , J. Leppert 2 , E. Henriksen 3 , A. Hellberg 4 , I. Lönnberg 1 , P. Hedberg 3 . 1 Department of Internal Medicine- Cardiology, Central Hospital, Vasteras, Sweden; 2 Centre of Clinical Research, University of Uppsala, Central Hospital, Vasteras, Sweden; 3 Department of Clinical Physiology, Central Hospital, Vasteras, Sweden; 4 Department of Vascular Surgery, Central Hospital, Vasteras, Sweden Background and aims: Left ventricular (LV) systolic dysfunction is often a consequence of coronary heart disease (CHD). CHD is prevalent among patients with peripheral artery disease (PAD). However, there is limited data regarding LV function in those patients. We evaluated LV systolic function in patients with PAD. Methods: In an ongoing observational study we analysed LV systolic function in 100 consecutive patients (mean age 67.0, SD 8.5; 45% women) referred to the Department of Vascular Surgery and fulfilling the following inclusion criteria: ankle/brachial index ≤ 0.9 or >30% carotid artery stenosis. LV function was evaluated by echocardiography as 1) ejection fraction (LVEF) and 2) myocardial longitudinal maximum systolic velocity measured by tissue Doppler (TV-S). A gender and age (±3 years) matched control group was selected randomly from the general population. A control subject was excluded only if fulfilling any of the patient group inclusion criteria. Results: There were no differences between patients and controls regarding mean LVEF (58.4%, SD 9.0, vs 59.4%, SD 9.0; p=0.51) or prevalence of LVEF < 45% (6.0% vs 5.7%; p=1.00). However, TV-S was significantly lower in the patients (4,7 cm/s, SD 1.1, vs 5.1 cm/s, SD 1.1; p=0,017). Prevalence of hypokinesia in one or more LV segments was also more common in patients (18.0% vs 6.9%; p=0.028). Conclusions: Patients with PAD had lower left ventricular systolic velocity, but they did not differ in ejection fraction from controls.
INCREASED HEART RATE AS A PREDICTOR OF CARDIOVASCULAR COMPLICATIONS IN SUBJECTS WITH METABOLIC SYNDROME AND HIGH CARDIOVASCULAR RISK
M. Barylski 1 , J. Kowalski 1 , M. Banach 2 , J. Błaszczyk 3 , E. Kowalczyk 3 , R. Irzma´nski 1 , A. Lewi´nski 4 , L. Pawlicki 1 . 1 Department of Internal Medicine and Cardiological Rehabilitation, Medical University in Lodz, Clinical Hospital No 5 in Lodz, Poland; 2 Department of Cardiology, Ist Chair of Cardiology and Cardiosurgery, Medical University in Lodz, Clinical Hospital No 3 in Lodz, Poland; 3 Department of Human Physiology and Biophysics, Medical University in Lodz, Poland; 4 Department of Endocrinology and Metabolic Diseases, Medical University in Lodz, Polish Mother’s Memorial Hospital - Research Institute, Lodz, Poland Background and aims: Mounting evidence shows that increased Heart Rate (HR) is associated with greater risk of developing atherosclerosis and is a potent predictor of cardiovascular morbidity and mortality. The aim of the study was to estimate the occurrence of high HR in subjects with metabolic syndrome (MS) and high cardiovascular risk. Methods: The study included 75 subjects: 50 subjects with MS (diagnosed on the basis of NCEP ATP III criteria) and 25 healthy subjects. Basing on SCORE index, a 10-year death risk due to cardiovascular complications was estimated. Heart rate was measured three times, after 10 minutes of rest, and the mean value was estimated. Results: All the subjects with MS had high death risk (SCORE index ≥5%). The mean value of HR in subjects with MS was significantly higher than in the healthy subjects (78,20±10,53/min. vs 69,80± 9,18/min.). In the group with MS, HR of 60-70 bpm was found in 6 subjects (12%), 70-80 bpm in 18 subjects (36%), 80-90 bpm in 16 subjects (32%) and HR >90 bpm in 10 subjects (20%). In the group of healthy subjects HR <60 bpm was found in 1 subject (4%), HR of 60-70 bpm was found in 10 subjects (40%), 70-80 bpm in 8 subjects (32%), 80-90 bpm in 5 subjects (20%) and HR >90 bpm in 1 subject (4%). Conclusions: Increased heart rate in subjects with MS and high cardiovascular risk is an independent risk factor of cardiovascular morbidity and mortality in this group of patients. 70
ESTIMATION OF CARDIOVASCULAR COMPLICATIONS IN SUBJECTS WITH METABOLIC SYNDROME AND HIGH CARDIOVASCULAR RISK
M. Barylski 1 , J. Błaszczyk 3 , M. Banach 2 , R. Irzma´nski 1 , E. Kowalczyk 3 , L. Pawlicki 1 , A. Lewi´nski 4 , J. Kowalski 1 . 1 Department of Internal Medicine and Cardiological Rehabilitation, Medical University in Lodz/Clinical Hospital No. 5 in Lodz, Poland; 2 Department of Cardiology, Ist Chair of Cardiology and Cardiosurgery, Medical University in Lodz/Clinical Hospital No. 3 in Lodz, Poland; 3 Department of Human Physiology and Biophysics, Medical University in Lodz, Poland; 4 Department of Endocrinology and Metabolic Diseases, Medical University in Lodz/Polish Mother’s Memorial Hospital - Research Institute, Lodz, Poland Background and aims: Numerous studies have shown that pulse pressure (PP), may be the best predictor of cardiac events for all the blood pressure values. PP has become of clinical interest as an independent marker of risk for the development of cardiovascular disease, including stroke and heart failure. It has also been observed to be a significant and independent indicator of myocardial infarction. The aim of the study was to estimate cardiovascular complications in subjects with metabolic syndrome (MS) and high cardiovascular risk. Methods: The study included 75 subjects: 50 subjects with MS (diagnosed on the basis of NCEP ATP III criteria), aged 55,94±11,82 years and 25 healthy subjects, aged 54,24±12,84 years. Basing on SCORE index, a 10-year death risk due to cardiovascular complications was estimated. The value ≥5% was accepted as high risk of death within 10 years. Increased risk of cardiovascular complications was determined for the pulse pressure >63 mmHg. Results: All the subjects with MS had high death risk due to cardiovascular complications (SCORE index ≥5%). The mean value of PP in subjects with MS was significantly higher than in the group of healthy subjects (66,14±17,33 mmHg vs 41,40±8,60 mmHg). Increased risk of cardiovascular complications (PP>63 mmHg) was found in 26 subjects (52%) with MS. In the group of healthy subjects PP>63 mmHg was not found. Conclusions: High risk of cardiovascular complications occurs statis-
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
PUBLICATION ONLY
68
69
231