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OP-123 Can Galectin-3 Be A New Biomarker to Detect Diastolic Dysfunction in HD Patients?
MARCH 13e16, 2014
O R A L A B S T R A C T S
Table
Figure 1. Correlation between Ca125 and LVEF
valve by 2D guided M-mode. Aort diameters calculated from internal borders of anterior and posterior walls of aorta in systole and diastole. Systolic diameter of aorta (AoS) was calculated when aortic valve was totally open. Diastolic diameter of aorta (AoD) was calculated synchronously with peak point of QRS from ECG records. Measurements were performed in consecutive 5 beats and average values were determined. Doppler echocardiography was used to obtain diastolic functions. Results: There was not a significant difference in aortic strain and dystensibility measurements between asymptomatic patients and patients with diastolic dysfunctions. However patients with diastolic dysfunction had more lower E’and more higher E/E’values (p < 0.001). Conclusion: Aortic stiffness has no affect on progression of diastolic dysfunction to diastolic heartfailure. This made us to think importance of another parameters on progression of diastolic dysfunction to diastolic heartfailure. Assesment and follow up values of E/E’ by Doppler echocardiography can be the precursor of heartfailure in patients with diastolic dysfunctions and also treatment of these patients in aysmptomatic period can delay and maybe prevent progression to heart failure.
Heart Failure: New Therapeutic Modalities
Objectives: The aim of the study was to analyze associations between serum Cancer Antigen 125 (Ca-125) levels and LV function in patients with ESRD treated with maintance hemodialysis(HD) patients. Patients and Method: The study group included 110 patients {(54 women and 56 men) aged 62.83 13.66 years, treated with HD for 38.4 36.3 months} and 47 healthy age and sex matched volunteer controls were enrolled in the study. Ca-125 and biochemical parameters were measured and echocardiography was performed. Hemodialysis patients were divided into different groups based on Ca125 levels, heart function. Results: Mean Ca-125 levels in patients were 38.7835.48 U/ml and were significantly higher compared with controls (9.20 4.55 U/ml; P ¼0.003). Patients with elevated Ca125 (n¼40) had significantly lower albumin, RWT, LVEF, FS while B-type natriuretic peptide levels, LVEDd, LVESd were significantly higher. Correlation analysis showed that CA 125 was positively related proBNP (r¼0.596, P<0.05), Crp (r¼0.439, P<0.05), LVEDd(r¼0.599, P<0.001), LVESd ( r¼0.750, P<0.001), LVMI( r¼0.378, P<0.05). However, serum Ca 125 levels were negatively correlated with albumin ( r¼-0.513, P<0.05), hemoglobin ( r¼-0.475, P<0.05), HDL ( r¼-0.336, P<0.05), EF ( r¼-0.878, P<0.0001)( Figüre 1). Presence of depressed ejection fraction (ß¼-1.121, p<0.0001) and increased CRP levels (ß¼0.247, p¼0.035) were independent predictors of high CA-125 levels in the whole group in the multivariate-model. Conclusion: Our study demonstrated first time that there was an association between Ca125 and LV systolic dysfunction via inflammation in patients on maintanence HD.
Friday, March 14, 2014 5:00 PM w 6:30 PM, Hall 6 (Abstract nos. OP-122 w OP-128) - OP-122 Ca 125 Levels and LV Function in Patients with ESRD Treated with Maintenance Hemodialysis Patients. H. Yılmaz1, M.A. Bilgic1, O. Malcok Gurel2, E. Sahiner3, H.T. Celik4, N. Bavbek1, A. Akcay1. 1 Department of Internal Medicine, Section of Nephrology, Turgut Ozal University, Ankara, Turkey; 2Department of Cardiology, Turgut Ozal University, Ankara, Turkey; 3Department of Internal Medicine, Turgut Ozal University, Ankara, Turkey; 4Department of Biochemistry, Turgut Ozal University, Ankara, Turkey.
- OP-123 Can Galectin-3 Be A New Biomarker to Detect Diastolic Dysfunction in HD Patients?. O. Malcok Gurel1, H. Yılmaz2, H.T. Celik3, M. Namuslu3, M.A. Bilgic2, N. Bavbek2, A. Akcay2, B. Eryonucu1. 1Department of Cardiology, Turgut Ozal University, Ankara, Turkey; 2Department of Internal Medicine, Section of Nephrology Turgut Ozal University, Ankara, Turkey; 3Department of Biochemistry, Turgut Ozal University, Ankara, Turkey. Background: Gal-3 is an emerging prognostic biomarker in HF, and clinical and experimental studies suggest that Gal-3 is an important mediator of cardiac fibrosis. The aim of this study was to examine the relation of galectin-3 (Gal-3), a marker of cardiac fibrosis, with diastolic and systolic heart dysfunction in patients on maintenance HD. Methods: We examined the relation between plasma galectin-3 levels and left ventricular of systolic and diastolic heart function. We measured serum galectin-3 in 83 subjects with ESRD and 45 with Healthy controls using biochemical evaluations. Echocardiographic assessment was
S36 The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
MARCH 13e16, 2014 performed in all patients. Pulsed tissue Doppler imaging was performed at the mitral annulus and was characterized by the diastolic early relaxation velocity Em. Conventional transmitral flow was measured with pw-doppler. Early (E) transmitral flow velocity was measured. LVDD was defined as E/Em ratio >or¼ 15 and/or Em < 8 cm⁄ second. Results: Median value of BNP in healthy controls was 3105.62 pg/ml, 3428.46pg/ml in HD patients with normal diastolic function, 5637.29 pg/ml in HD patients with diastolic dysfunction. There was no correlation between serum galectin-3 levels and systolic dysfunction indexes (EF, FS, LVEDd, LVESd). Serum galectin-3 levels correlated with mitral E/A wave ratio (Spearman r¼0.35, p<0.001), mitral deceleration time (r¼-0.25, p¼0.002), and mitral E wave/tissue Doppler lateral E’ wave ratio (r¼0.38, p<0.001). Conclusion: The level of serum galectin-3 is related to the changes of left ventricular diastolic function, indicating that galectin-3 may have been involved in the process of left ventricular remodeling in CHF. In HD patients with preserved left ventricular systolic function a highly significant increase in Galectin-3 serum level related to the deterioration of diastolic dysfunction was found.
- OP-124 Effect of Levosimendan on Left Ventricular Diastolic Function in Patients with Ischemic Heart Failure. Ö. Öztürk1, Ü. Öztürk2. 1 Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey; 2Department of Neurology, Dicle University Medicine Faculty, Diyarbakir, Turkey. Objective: Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on the left ventricular diastolic function was evaluated by Doppler echocardiography in patients with ischemic heart failure. Methods: The study population consisted of 42 patients having an acute decompensated heart failure with ischemic cardiomyopathy. Patients who have left ventricular ejection fraction <40% were included in the study. Echocardiographic examinations were performed before and 24-h after levosimendan treatment. Left ventricular diastolic function by Doppler echocardiography were measured. Results: Left ventricular diastolic function between first and second echocardiographic results were significantly different. Left ventricular diastolic function were significantly improved after the levosimendan treatment (p<0.05). Conclusion: In patients with chronic ischemic heart failure, levosimendan acutely improved left ventricular diastolic function.
ventricular myocardial performance index before levosimendan treatment was 0.53. LV MPI after 24-h levosimendan treatment was 0.43 Left ventricular myocardial performance index were significantly decreased after the levosimendan treatment (p<0.05). Conclusion: In patients with chronic ischemic heart failure, levosimendan acutely improved left ventricular myocardial performance index.
- OP-126 The Effect of Levosimendan Treatment on QT Dispersion in Patients with Dilated Cardiomyopathy. Ö. Öztürk1, Ü. Öztürk2. 1 Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey; 2Department of Neurology, Dicle University Medicine Faculty, Diyarbakir, Turkey. Objective: Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on QT dispersion in patients with dilated cardiomyopathy. Methods: The study population consisted of 37 patients having an acute decompensated heart failure with dilated cardiomyopathy. Patients who have left ventricular ejection fraction <40% were included in the study. QT dispersion were measured before and 24-h after levosimendan treatment. Results: QT dispersion measurements before and after levosimendan treatment were not significantly different (Table 1) (p>0.05). Conclusion: In patients with dilated cardiomyopathy, levosimendan treatment do not have a significant effect on QT parameters. Electrocardiographic findings before and after Levosimendan treatment.
- OP-125 Effect of Levosimendan on Left Ventricular Myocardial Performance Index in Patients with Ischemic Heart Failure. Ö. Öztürk1, Ü. Öztürk2. 1Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey; 2Department of Neurology, Dicle University Medicine Faculty, Diyarbakir, Turkey. Objective: Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on the left ventricular myocardial performance index was evaluated by Doppler echocardiography in patients with ischemic heart failure. Methods: The study population consisted of 42 patients having an acute decompensated heart failure with ischemic cardiomyopathy. Patients who have left ventricular ejection fraction <40% were included in the study. Echocardiographic examinations were performed before and 24-h after levosimendan treatment. Left ventricular myocardial performance index by Doppler echocardiography were measured. Results: Left ventricular myocardial performance index between first and second echocardiographic results were significantly different. Left
O R A L
- OP-127 Ivabradine Improves Heart Rate Variability in Patients with Advanced Nonischemic Dilated Cardiomyopathy. E. Kurtoglu1, S. Balta2, Y. Karakus1, E. Yasar1, B. Cuglan1, O. Kaplan1, G. Gozubuyuk1. 1Department of Cardiology, Malatya State Hospital, Malatya, Turkey; 2Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey. Objective: Ivabradine is a novel specific heart rate (HR) lowering agent that improves event-free survival in heart failure (HF) patients. We evaluated the effect of ivabradine on time domain indices of heart rate variability (HRV) in patients with advanced HF. Methods: Thirty-six patients with nonischemic origin of compansated HF were included. Ivabradine treatment was initiated according to latest HF guidelines. Twenty-four hour Holter recording for HRV
The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S37
A B S T R A C T S
O R A L A B S T R A C T S
Table
Figure 1. Correlation between Ca125 and LVEF
valve by 2D guided M-mode. Aort diameters calculated from internal borders of anterior and posterior walls of aorta in systole and diastole. Systolic diameter of aorta (AoS) was calculated when aortic valve was totally open. Diastolic diameter of aorta (AoD) was calculated synchronously with peak point of QRS from ECG records. Measurements were performed in consecutive 5 beats and average values were determined. Doppler echocardiography was used to obtain diastolic functions. Results: There was not a significant difference in aortic strain and dystensibility measurements between asymptomatic patients and patients with diastolic dysfunctions. However patients with diastolic dysfunction had more lower E’and more higher E/E’values (p < 0.001). Conclusion: Aortic stiffness has no affect on progression of diastolic dysfunction to diastolic heartfailure. This made us to think importance of another parameters on progression of diastolic dysfunction to diastolic heartfailure. Assesment and follow up values of E/E’ by Doppler echocardiography can be the precursor of heartfailure in patients with diastolic dysfunctions and also treatment of these patients in aysmptomatic period can delay and maybe prevent progression to heart failure.
Heart Failure: New Therapeutic Modalities
Objectives: The aim of the study was to analyze associations between serum Cancer Antigen 125 (Ca-125) levels and LV function in patients with ESRD treated with maintance hemodialysis(HD) patients. Patients and Method: The study group included 110 patients {(54 women and 56 men) aged 62.83 13.66 years, treated with HD for 38.4 36.3 months} and 47 healthy age and sex matched volunteer controls were enrolled in the study. Ca-125 and biochemical parameters were measured and echocardiography was performed. Hemodialysis patients were divided into different groups based on Ca125 levels, heart function. Results: Mean Ca-125 levels in patients were 38.7835.48 U/ml and were significantly higher compared with controls (9.20 4.55 U/ml; P ¼0.003). Patients with elevated Ca125 (n¼40) had significantly lower albumin, RWT, LVEF, FS while B-type natriuretic peptide levels, LVEDd, LVESd were significantly higher. Correlation analysis showed that CA 125 was positively related proBNP (r¼0.596, P<0.05), Crp (r¼0.439, P<0.05), LVEDd(r¼0.599, P<0.001), LVESd ( r¼0.750, P<0.001), LVMI( r¼0.378, P<0.05). However, serum Ca 125 levels were negatively correlated with albumin ( r¼-0.513, P<0.05), hemoglobin ( r¼-0.475, P<0.05), HDL ( r¼-0.336, P<0.05), EF ( r¼-0.878, P<0.0001)( Figüre 1). Presence of depressed ejection fraction (ß¼-1.121, p<0.0001) and increased CRP levels (ß¼0.247, p¼0.035) were independent predictors of high CA-125 levels in the whole group in the multivariate-model. Conclusion: Our study demonstrated first time that there was an association between Ca125 and LV systolic dysfunction via inflammation in patients on maintanence HD.
Friday, March 14, 2014 5:00 PM w 6:30 PM, Hall 6 (Abstract nos. OP-122 w OP-128) - OP-122 Ca 125 Levels and LV Function in Patients with ESRD Treated with Maintenance Hemodialysis Patients. H. Yılmaz1, M.A. Bilgic1, O. Malcok Gurel2, E. Sahiner3, H.T. Celik4, N. Bavbek1, A. Akcay1. 1 Department of Internal Medicine, Section of Nephrology, Turgut Ozal University, Ankara, Turkey; 2Department of Cardiology, Turgut Ozal University, Ankara, Turkey; 3Department of Internal Medicine, Turgut Ozal University, Ankara, Turkey; 4Department of Biochemistry, Turgut Ozal University, Ankara, Turkey.
- OP-123 Can Galectin-3 Be A New Biomarker to Detect Diastolic Dysfunction in HD Patients?. O. Malcok Gurel1, H. Yılmaz2, H.T. Celik3, M. Namuslu3, M.A. Bilgic2, N. Bavbek2, A. Akcay2, B. Eryonucu1. 1Department of Cardiology, Turgut Ozal University, Ankara, Turkey; 2Department of Internal Medicine, Section of Nephrology Turgut Ozal University, Ankara, Turkey; 3Department of Biochemistry, Turgut Ozal University, Ankara, Turkey. Background: Gal-3 is an emerging prognostic biomarker in HF, and clinical and experimental studies suggest that Gal-3 is an important mediator of cardiac fibrosis. The aim of this study was to examine the relation of galectin-3 (Gal-3), a marker of cardiac fibrosis, with diastolic and systolic heart dysfunction in patients on maintenance HD. Methods: We examined the relation between plasma galectin-3 levels and left ventricular of systolic and diastolic heart function. We measured serum galectin-3 in 83 subjects with ESRD and 45 with Healthy controls using biochemical evaluations. Echocardiographic assessment was
S36 The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
MARCH 13e16, 2014 performed in all patients. Pulsed tissue Doppler imaging was performed at the mitral annulus and was characterized by the diastolic early relaxation velocity Em. Conventional transmitral flow was measured with pw-doppler. Early (E) transmitral flow velocity was measured. LVDD was defined as E/Em ratio >or¼ 15 and/or Em < 8 cm⁄ second. Results: Median value of BNP in healthy controls was 3105.62 pg/ml, 3428.46pg/ml in HD patients with normal diastolic function, 5637.29 pg/ml in HD patients with diastolic dysfunction. There was no correlation between serum galectin-3 levels and systolic dysfunction indexes (EF, FS, LVEDd, LVESd). Serum galectin-3 levels correlated with mitral E/A wave ratio (Spearman r¼0.35, p<0.001), mitral deceleration time (r¼-0.25, p¼0.002), and mitral E wave/tissue Doppler lateral E’ wave ratio (r¼0.38, p<0.001). Conclusion: The level of serum galectin-3 is related to the changes of left ventricular diastolic function, indicating that galectin-3 may have been involved in the process of left ventricular remodeling in CHF. In HD patients with preserved left ventricular systolic function a highly significant increase in Galectin-3 serum level related to the deterioration of diastolic dysfunction was found.
- OP-124 Effect of Levosimendan on Left Ventricular Diastolic Function in Patients with Ischemic Heart Failure. Ö. Öztürk1, Ü. Öztürk2. 1 Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey; 2Department of Neurology, Dicle University Medicine Faculty, Diyarbakir, Turkey. Objective: Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on the left ventricular diastolic function was evaluated by Doppler echocardiography in patients with ischemic heart failure. Methods: The study population consisted of 42 patients having an acute decompensated heart failure with ischemic cardiomyopathy. Patients who have left ventricular ejection fraction <40% were included in the study. Echocardiographic examinations were performed before and 24-h after levosimendan treatment. Left ventricular diastolic function by Doppler echocardiography were measured. Results: Left ventricular diastolic function between first and second echocardiographic results were significantly different. Left ventricular diastolic function were significantly improved after the levosimendan treatment (p<0.05). Conclusion: In patients with chronic ischemic heart failure, levosimendan acutely improved left ventricular diastolic function.
ventricular myocardial performance index before levosimendan treatment was 0.53. LV MPI after 24-h levosimendan treatment was 0.43 Left ventricular myocardial performance index were significantly decreased after the levosimendan treatment (p<0.05). Conclusion: In patients with chronic ischemic heart failure, levosimendan acutely improved left ventricular myocardial performance index.
- OP-126 The Effect of Levosimendan Treatment on QT Dispersion in Patients with Dilated Cardiomyopathy. Ö. Öztürk1, Ü. Öztürk2. 1 Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey; 2Department of Neurology, Dicle University Medicine Faculty, Diyarbakir, Turkey. Objective: Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on QT dispersion in patients with dilated cardiomyopathy. Methods: The study population consisted of 37 patients having an acute decompensated heart failure with dilated cardiomyopathy. Patients who have left ventricular ejection fraction <40% were included in the study. QT dispersion were measured before and 24-h after levosimendan treatment. Results: QT dispersion measurements before and after levosimendan treatment were not significantly different (Table 1) (p>0.05). Conclusion: In patients with dilated cardiomyopathy, levosimendan treatment do not have a significant effect on QT parameters. Electrocardiographic findings before and after Levosimendan treatment.
- OP-125 Effect of Levosimendan on Left Ventricular Myocardial Performance Index in Patients with Ischemic Heart Failure. Ö. Öztürk1, Ü. Öztürk2. 1Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey; 2Department of Neurology, Dicle University Medicine Faculty, Diyarbakir, Turkey. Objective: Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on the left ventricular myocardial performance index was evaluated by Doppler echocardiography in patients with ischemic heart failure. Methods: The study population consisted of 42 patients having an acute decompensated heart failure with ischemic cardiomyopathy. Patients who have left ventricular ejection fraction <40% were included in the study. Echocardiographic examinations were performed before and 24-h after levosimendan treatment. Left ventricular myocardial performance index by Doppler echocardiography were measured. Results: Left ventricular myocardial performance index between first and second echocardiographic results were significantly different. Left
O R A L
- OP-127 Ivabradine Improves Heart Rate Variability in Patients with Advanced Nonischemic Dilated Cardiomyopathy. E. Kurtoglu1, S. Balta2, Y. Karakus1, E. Yasar1, B. Cuglan1, O. Kaplan1, G. Gozubuyuk1. 1Department of Cardiology, Malatya State Hospital, Malatya, Turkey; 2Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey. Objective: Ivabradine is a novel specific heart rate (HR) lowering agent that improves event-free survival in heart failure (HF) patients. We evaluated the effect of ivabradine on time domain indices of heart rate variability (HRV) in patients with advanced HF. Methods: Thirty-six patients with nonischemic origin of compansated HF were included. Ivabradine treatment was initiated according to latest HF guidelines. Twenty-four hour Holter recording for HRV
The American Journal of Cardiologyâ MARCH 13e16, 2014 10th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S37
A B S T R A C T S