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Mild Overweight is Associated with Progressive Increase in Left Ventricular Wall Thickness in a Normal Population
Abstracts CSANZ 2012 Abstracts
519 Mild Overweight is Associated with Progressive Increase in Left Ventricular Wall Thickness in a Normal Population E. Robertson ∗ , R. Jeremy Royal Prince Alfred Hospital, Australia Obesity is associated with hypertension and left ventricular (LV) hypertrophy but the impact of lesser degrees of overweight on LV geometry in normal people is unknown. LV geometry was measured by echocardiography in two triennia cohorts: 1988–1990 (n = 715) and 2007–2009 (n = 1026). All patients with normal echocardiograms in each cohort were included and body mass index (BMI, kg m−2 ) was recorded at time of study. Diastolic and systolic LV cavity dimensions (LVD, LVS); septal and posterior wall thickness (IVS, PW), and systolic shortening (FS) were measured (American Society Echocardiography criteria) and compared between cohorts and age groups by factorial ANOVA (SPSS v.19). 1988–1990
2007–2009
Age yrs
10–20
21–40
41–60
10–20
21–40
41–60
n Weight kg BMI LVD mm LVS mm IVS mm PW mm FS %
124 63 ± 15 22 ± 4 48 ± 5 30 ± 4 8.2 ± 1.2 8.1 ± 1.3 37 ± 5
353 67 ± 14 24 ± 5 49 ± 5 31 ± 4 8.5 ± 1.2 8.3 ± 1.2 37 ± 6
238 70 ± 14* 25 ± 5* 49 ± 5 31 ± 5 9.0 ± 1.3* 8.8 ± 1.3* 38 ± 5
172 67 ± 19 23 ± 6 47 ± 5 30 ± 4 8.7 ± 1.4 8.5 ± 1.4 36 ± 6
539 77 ± 20␣ 26 ± 6β 48 ± 5 30 ± 4 9.2 ± 1.3β 9.0 ± 1.3β 37 ± 6
315 76 ± 19*,α 27 ± 6*,α 47 ± 6β 29 ± 4 9.9 ± 1.4*,β 9.7 ± 1.5*,β 39 ± 7
Mean ± SD. ∗
p < 0.001 vs age 10–120
␣
p < 0.01.

p < 0.001 vs 1988–1990 cohort.
Mean body weight in young and middle aged adults has increased during last 20 years and is associated with increased LV wall thickness. Even mild overweight is associated with wall thickening in the normal population, with progressive worsening of LV geometry by age 60. http://dx.doi.org/10.1016/j.hlc.2012.05.530 520 Myocardial Grid-Tagging is a Superior Predictor of Myocardial Viability Than Late Gadolinium-Enhanced Magnetic Resonance Imaging Post STEMI D. Wong 1,3,∗ , D. Leong 2 , M. Weightman 1 , M. Leung 1 , J. Richardson 1 , A. Bertaso 1 , K. Teo 1 , I. Meredith 3,4 , M. Worthley 1 , S. Worthley 1 1 Royal Adelaide Hospital and University of Adelaide, Australia 2 University
of Adelaide, Australia Australia 4 Monash University, Australia 3 MonashHeart,
Background: Assessment of transmurality extent on late-gadolinium-enhancement (LGE) cardiac MRI (CMR) have limited accuracy in predicting viability in segments with intermediate (25–75%) transmurality. Functional assessment derived from myocardial-grid-tagging may provide a better predictor of viability than LGE-CMR.
S215
Methods: Patients treated with primary-PCI for STEMI underwent CMR at day 3 (baseline) and day 90 (follow-up). LGE infarct transmurality (categorised as <50% or >50% transmurality) was assessed at baseline. The circumferential strain (CS), circumferential-strain-rate (CSR) and circumferential-diastolic-strain-rate (CDR) for each segment was calculated from grid-tagged images at baseline and at follow-up. We defined viability as improvement of CS to <−10% at follow-up, as previously described. Results: Thirty-seven patients (aged 58 ± 12 years, 92% males) with 132 infarct segments were analysed. Non-viable segments had lower magnitude baseline-CS compared to viable segments (−4.9 ± 6.2 vs −7.7 ± 7.2, P = 0.01). A baseline-CS cut-off of −3.16% was associated with sensitivity of 82% and specificity of 44% for detection of segmental viability. On ROC analysis for predicting viability, the area-under-curve (AUC) for baseline-CS was (0.67, P = 0.025) compared to LGE transmurality (0.58, P = 0.068), baseline-CSR (0.63, P = 0.066) and baseline-CDR (0.5, P = 0.729). On comparison of AUCs, baseline-CS was superior to LGE transmurality >50% in predicting viability (P = 0.007). On multivariate analysis, baseline-CS was the sole independent predictor of viability (P = 0.025). Conclusion: Myocardial-grid-tagging derived baselineCS is a superior predictor of segmental viability than segmental LGE transmurality. Patients with contraindications to gadolinium contrast would particularly benefit from this superior alternative methodology of viability assessment. http://dx.doi.org/10.1016/j.hlc.2012.05.531 521 Non-invasive Assessment of Interstitial Myocardial Fibrosis in Pressure-Overload Left Ventricular Hypertrophy A. Jabbour 1,2,∗ , T. Ismail 1,2 , A. Krishnamoorthy 1,2 , S. Zaman 1,2 , S. Zaman 1,2 , O. Sotubo 1,2 , B. Hewins 1,2 , M. Abdel-Malek 1,2 , A. Gulati 1,2 , R. Wage 1,2 , P. Croisille 3 , Y. Feng 1,2 , K. Norita 1,2 , T. He 1,2 , J. Pepper 1,2 , C. Shakespeare 1,2 , D. Firmin 1,2 , S. Prasad 1,2 1 Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom 2 Imperial College, London, United Kingdom 3 INSERM, Lyon, France
Background: Aortic stenosis (AS) and systemic hypertension (HT) are associated with increased interstitial myocardial fibrosis (IMF). We hypothesised that interstitial expansion could be detected by CMR after bolus gadolinium administration in patients with HT or severe AS. Methods: A MOLLI sequence was used to generate 11 T1-weighted images in healthy volunteers, patients with severe AS, and patients with hypertension. Myocardial and blood pool T1 values were derived by fitting a signal intensity-time curve using CMR42® . The Ve was determined by plotting (1/T1myo vs. 1/T1blood pool ) after contrast equilibrium. Myocardial tagging was acquired
ABSTRACTS
Heart, Lung and Circulation 2012;21:S143–S316
519 Mild Overweight is Associated with Progressive Increase in Left Ventricular Wall Thickness in a Normal Population E. Robertson ∗ , R. Jeremy Royal Prince Alfred Hospital, Australia Obesity is associated with hypertension and left ventricular (LV) hypertrophy but the impact of lesser degrees of overweight on LV geometry in normal people is unknown. LV geometry was measured by echocardiography in two triennia cohorts: 1988–1990 (n = 715) and 2007–2009 (n = 1026). All patients with normal echocardiograms in each cohort were included and body mass index (BMI, kg m−2 ) was recorded at time of study. Diastolic and systolic LV cavity dimensions (LVD, LVS); septal and posterior wall thickness (IVS, PW), and systolic shortening (FS) were measured (American Society Echocardiography criteria) and compared between cohorts and age groups by factorial ANOVA (SPSS v.19). 1988–1990
2007–2009
Age yrs
10–20
21–40
41–60
10–20
21–40
41–60
n Weight kg BMI LVD mm LVS mm IVS mm PW mm FS %
124 63 ± 15 22 ± 4 48 ± 5 30 ± 4 8.2 ± 1.2 8.1 ± 1.3 37 ± 5
353 67 ± 14 24 ± 5 49 ± 5 31 ± 4 8.5 ± 1.2 8.3 ± 1.2 37 ± 6
238 70 ± 14* 25 ± 5* 49 ± 5 31 ± 5 9.0 ± 1.3* 8.8 ± 1.3* 38 ± 5
172 67 ± 19 23 ± 6 47 ± 5 30 ± 4 8.7 ± 1.4 8.5 ± 1.4 36 ± 6
539 77 ± 20␣ 26 ± 6β 48 ± 5 30 ± 4 9.2 ± 1.3β 9.0 ± 1.3β 37 ± 6
315 76 ± 19*,α 27 ± 6*,α 47 ± 6β 29 ± 4 9.9 ± 1.4*,β 9.7 ± 1.5*,β 39 ± 7
Mean ± SD. ∗
p < 0.001 vs age 10–120
␣
p < 0.01.

p < 0.001 vs 1988–1990 cohort.
Mean body weight in young and middle aged adults has increased during last 20 years and is associated with increased LV wall thickness. Even mild overweight is associated with wall thickening in the normal population, with progressive worsening of LV geometry by age 60. http://dx.doi.org/10.1016/j.hlc.2012.05.530 520 Myocardial Grid-Tagging is a Superior Predictor of Myocardial Viability Than Late Gadolinium-Enhanced Magnetic Resonance Imaging Post STEMI D. Wong 1,3,∗ , D. Leong 2 , M. Weightman 1 , M. Leung 1 , J. Richardson 1 , A. Bertaso 1 , K. Teo 1 , I. Meredith 3,4 , M. Worthley 1 , S. Worthley 1 1 Royal Adelaide Hospital and University of Adelaide, Australia 2 University
of Adelaide, Australia Australia 4 Monash University, Australia 3 MonashHeart,
Background: Assessment of transmurality extent on late-gadolinium-enhancement (LGE) cardiac MRI (CMR) have limited accuracy in predicting viability in segments with intermediate (25–75%) transmurality. Functional assessment derived from myocardial-grid-tagging may provide a better predictor of viability than LGE-CMR.
S215
Methods: Patients treated with primary-PCI for STEMI underwent CMR at day 3 (baseline) and day 90 (follow-up). LGE infarct transmurality (categorised as <50% or >50% transmurality) was assessed at baseline. The circumferential strain (CS), circumferential-strain-rate (CSR) and circumferential-diastolic-strain-rate (CDR) for each segment was calculated from grid-tagged images at baseline and at follow-up. We defined viability as improvement of CS to <−10% at follow-up, as previously described. Results: Thirty-seven patients (aged 58 ± 12 years, 92% males) with 132 infarct segments were analysed. Non-viable segments had lower magnitude baseline-CS compared to viable segments (−4.9 ± 6.2 vs −7.7 ± 7.2, P = 0.01). A baseline-CS cut-off of −3.16% was associated with sensitivity of 82% and specificity of 44% for detection of segmental viability. On ROC analysis for predicting viability, the area-under-curve (AUC) for baseline-CS was (0.67, P = 0.025) compared to LGE transmurality (0.58, P = 0.068), baseline-CSR (0.63, P = 0.066) and baseline-CDR (0.5, P = 0.729). On comparison of AUCs, baseline-CS was superior to LGE transmurality >50% in predicting viability (P = 0.007). On multivariate analysis, baseline-CS was the sole independent predictor of viability (P = 0.025). Conclusion: Myocardial-grid-tagging derived baselineCS is a superior predictor of segmental viability than segmental LGE transmurality. Patients with contraindications to gadolinium contrast would particularly benefit from this superior alternative methodology of viability assessment. http://dx.doi.org/10.1016/j.hlc.2012.05.531 521 Non-invasive Assessment of Interstitial Myocardial Fibrosis in Pressure-Overload Left Ventricular Hypertrophy A. Jabbour 1,2,∗ , T. Ismail 1,2 , A. Krishnamoorthy 1,2 , S. Zaman 1,2 , S. Zaman 1,2 , O. Sotubo 1,2 , B. Hewins 1,2 , M. Abdel-Malek 1,2 , A. Gulati 1,2 , R. Wage 1,2 , P. Croisille 3 , Y. Feng 1,2 , K. Norita 1,2 , T. He 1,2 , J. Pepper 1,2 , C. Shakespeare 1,2 , D. Firmin 1,2 , S. Prasad 1,2 1 Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom 2 Imperial College, London, United Kingdom 3 INSERM, Lyon, France
Background: Aortic stenosis (AS) and systemic hypertension (HT) are associated with increased interstitial myocardial fibrosis (IMF). We hypothesised that interstitial expansion could be detected by CMR after bolus gadolinium administration in patients with HT or severe AS. Methods: A MOLLI sequence was used to generate 11 T1-weighted images in healthy volunteers, patients with severe AS, and patients with hypertension. Myocardial and blood pool T1 values were derived by fitting a signal intensity-time curve using CMR42® . The Ve was determined by plotting (1/T1myo vs. 1/T1blood pool ) after contrast equilibrium. Myocardial tagging was acquired
ABSTRACTS
Heart, Lung and Circulation 2012;21:S143–S316