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P038 The Reversed Mitral Annular Motion Velocity Wave at the Beginning of the Mitral Valve Closure
Poster Sessions / International Journal of Cardiology 147S1 (2011) S9–S32
index admission was significantly higher in the T2DM HF cohort (42.5% vs 25.6%, p = 0.025). For the T2DM HF cohort, the oneyear mortality rate was 24.7% (n = 20), the one-year death or cardiovascular readmission rate was 60.5% (n = 49), and the oneyear death or any readmission rate was 72.0% (n = 59). These values were not significantly differently from the non-T2DM HF cohort. Conclusion: Our study showed that one-year outcomes between both cohorts are not statistically significant. That may, in part, be due to the fact that the follow-up period for our study is one year, whereas studies by Kamalesh et al and de Groote et al that have reported a positive association between T2DM and mortality in HF contain longer follow-up durations. P036 The Application of Tissue Doppler in Analysis of LV Function of Noncompaction Cardiomyopathy J. Xu, F.C. Lu, J. Yao, S.L. Chen. Nanjing First Hospital affiliated to Nanjing Medical University, #68 Chang Le Road, Nanjing 210007, China Objective: To study the left ventricular function of noncompaction of ventricular myocardium (NVM) by using Doppler tissue imaging (DTI), which may provide a new way for diagnosis. Methods: Routine echocardiography and color Doppler were used in finding the NVM patients. The apical four chamber view and apical two chamber view of 9 NVM patients and 18 healthy subjects were stored by using QTVI. The left ventricle septum, anterior wall, lateral wall, posterior wall and inferior wall were analyzed, which were divided to basal, middle and apex segments respectively. The velocity, strain rate and the Peak systolic stain values on every segment were measured respectively. The stain rate curves were collected and compared in two groups. Results: Compare with the control group, in the septum, anterior and posterior wall of left ventricle, the velocity, strain rate and the Peak systolic stain values of NVM group was significantly lower than which of the control group. The stain rate curves in NVM group were twisted, which showed the mis-match of the wall motion during myocardium contraction. Conclusion: DTI, combined with Two-dimensional echocardiography and color Doppler, is a new quantitative parameter which can find the regional systolic dysfunction more accurately in NVM patients. P037 Nursing Experience in Helping a Primipara Adapt to an Infant with Congenital Heart Disease – Case Report M.C. Hsiung, Y.T. Li, H.C. Shih. Cheng-Hsin General Hospital, No 45, Cheng-Hsin Street, 112, Shipai, Taipei, Taiwan; Department of Nursing, Kaohsiung Armed Forces General Hospital, Taiwan Objective: Congenital heart disease is one of the common congenital diseases in children. It is not only a great blow to have a baby with the congenital heart disease to primipara of expectant the beginning, but also must face a succession of totally unknown medical treatment. It is all a section of hard process of the pressure and psychological adaption. This case report describes nursing experience for helping a primipara adapt to an infant with congenital heart disease. Methods: The duration of nursing care was between July 12, 2006 and August 7, 2006. The methods of data collection included observation and face-to-face interview. The total nursing evaluation was based on the physiological, psychological, social, and spirituality levels. Results: The case’s health problems included 1. fear. 2. lack of knowledge. 3. potential risk parents. 4. The nerve of the care giver. While performing nursing interventions, the author established the interrelationship to the case, listened to the case’s feeling, cared the demand, offered medical information, and then increased the
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knowledge of the disease and care ability and reduced the negative emotion. Conclusion: This case report was expected to share nursing experience and provide reference to clinical nursing specialists for further caring of similar cases. P038 The Reversed Mitral Annular Motion Velocity Wave at the Beginning of the Mitral Valve Closure F.Q. Huang, R.S. Tan. Cardiology Department, National Heart Centre Singapore Objective: Pulsed tissue Doppler imaging is widely used to record mitral annular motion and evaluate the left ventricular function. A reversed mitral annular motion (MAM) velocity wave (Cm) is commonly seen at the beginning of the mitral valve closure in timing, whereas the underlying mechanism and clinical significance have not been very clearly. Some studies found that Cm reflects the deviation of MAM toward the left atrium at the beginning of the mitral valve closure. Methods: Total of 125 patients (with normal LVEF, age: 44 y±13 y; male: 71, female: 54) with various heart diseases was enrolled. All patients underwent full echocardiogram. Patients with valve replacement were excluded. We measured the mitral flow velocity E using pulsed Doppler, the mitral annulus motion velocity Em and the peak Cm velocity at the septal mitral annulus using tissue Doppler imaging. All subjects divided into two groups: 60 patients with E/Em <8 and 65 patients with E/Em ranging from 8–15. Results: The peak Cm of the MAM velocity significantly reduced in patients with E/Em ranging from 8–15 compared to those with E/Em <8 (0.035±0.009 m/s vs 0.044±0.021 m/s, respectively. P < 0.05). Conclusion: The Cm velocity measurement may be easy and useful to evaluate the left ventricular diastolic dysfunction. P039 Low Dose CCTA Protocol: An Evaluation on Radiation Dose of Coronary CTA with a 320-Detector-Row Scanner C.W. Wong, Y.C. Chu, S.H. Chiu, S.K. Ng, P.Y. Fung, S. Lau, H.S. Lam. Department of Radiology, Kwong Wah Hospital, Kowloon, Hong Kong, China Objective: To evaluate the effective dose of coronary CTA performed with a 320-detector-row scanner in Low Dose CCTA Protocol. Methods: Consecutive patients for coronary CTA between April and September 2010 were included. Dose reduction measures included heart rate control with beta-blocker, BMI-adjusted exposure and individualized z-axis range. Low Dose CCTA Protocol was used as single beat mode and prospective gating targeted at 75% with limited padding (70–80%). Prospective gating with larger padding was required when heart rate control was suboptimal or when there was arrhythmia, and the scanner automatically continued into next heartbeat when it detected changes in rhythm during the scan. The effective dose was derived from dose length product with the following equation: effective dose = 0.017*dose length product. Results: Totally 598 patients underwent coronary CTA, and were performed with prospective gating. Among them, 410 cases were scanned with Low Dose CCTA Protocol using single beat mode prospective gating targeting at 75% R-R interval with limited padding (70–80%). Mean effective dose was 2.489 mSv when scanned with Low Dose CCTA Protocol, or only 1.849 mSv for patients with BMI less than 25. The lowest effective dose achieved was just 0.737 mSv. Mean heart rate was also significantly lower when using Low Dose CCTA Protocol (54 vs. 63 bpm, p < 0.001). Mean effective dose was significantly higher for patients with single beat mode padding more than 70–80% R-R interval (4.939 vs. 2.489 mSv, p < 0.001), prospective gating with more than one beat (12.936 vs. 2.489 mSv, p < 0.001), heart rate more than 60 bpm
index admission was significantly higher in the T2DM HF cohort (42.5% vs 25.6%, p = 0.025). For the T2DM HF cohort, the oneyear mortality rate was 24.7% (n = 20), the one-year death or cardiovascular readmission rate was 60.5% (n = 49), and the oneyear death or any readmission rate was 72.0% (n = 59). These values were not significantly differently from the non-T2DM HF cohort. Conclusion: Our study showed that one-year outcomes between both cohorts are not statistically significant. That may, in part, be due to the fact that the follow-up period for our study is one year, whereas studies by Kamalesh et al and de Groote et al that have reported a positive association between T2DM and mortality in HF contain longer follow-up durations. P036 The Application of Tissue Doppler in Analysis of LV Function of Noncompaction Cardiomyopathy J. Xu, F.C. Lu, J. Yao, S.L. Chen. Nanjing First Hospital affiliated to Nanjing Medical University, #68 Chang Le Road, Nanjing 210007, China Objective: To study the left ventricular function of noncompaction of ventricular myocardium (NVM) by using Doppler tissue imaging (DTI), which may provide a new way for diagnosis. Methods: Routine echocardiography and color Doppler were used in finding the NVM patients. The apical four chamber view and apical two chamber view of 9 NVM patients and 18 healthy subjects were stored by using QTVI. The left ventricle septum, anterior wall, lateral wall, posterior wall and inferior wall were analyzed, which were divided to basal, middle and apex segments respectively. The velocity, strain rate and the Peak systolic stain values on every segment were measured respectively. The stain rate curves were collected and compared in two groups. Results: Compare with the control group, in the septum, anterior and posterior wall of left ventricle, the velocity, strain rate and the Peak systolic stain values of NVM group was significantly lower than which of the control group. The stain rate curves in NVM group were twisted, which showed the mis-match of the wall motion during myocardium contraction. Conclusion: DTI, combined with Two-dimensional echocardiography and color Doppler, is a new quantitative parameter which can find the regional systolic dysfunction more accurately in NVM patients. P037 Nursing Experience in Helping a Primipara Adapt to an Infant with Congenital Heart Disease – Case Report M.C. Hsiung, Y.T. Li, H.C. Shih. Cheng-Hsin General Hospital, No 45, Cheng-Hsin Street, 112, Shipai, Taipei, Taiwan; Department of Nursing, Kaohsiung Armed Forces General Hospital, Taiwan Objective: Congenital heart disease is one of the common congenital diseases in children. It is not only a great blow to have a baby with the congenital heart disease to primipara of expectant the beginning, but also must face a succession of totally unknown medical treatment. It is all a section of hard process of the pressure and psychological adaption. This case report describes nursing experience for helping a primipara adapt to an infant with congenital heart disease. Methods: The duration of nursing care was between July 12, 2006 and August 7, 2006. The methods of data collection included observation and face-to-face interview. The total nursing evaluation was based on the physiological, psychological, social, and spirituality levels. Results: The case’s health problems included 1. fear. 2. lack of knowledge. 3. potential risk parents. 4. The nerve of the care giver. While performing nursing interventions, the author established the interrelationship to the case, listened to the case’s feeling, cared the demand, offered medical information, and then increased the
S19
knowledge of the disease and care ability and reduced the negative emotion. Conclusion: This case report was expected to share nursing experience and provide reference to clinical nursing specialists for further caring of similar cases. P038 The Reversed Mitral Annular Motion Velocity Wave at the Beginning of the Mitral Valve Closure F.Q. Huang, R.S. Tan. Cardiology Department, National Heart Centre Singapore Objective: Pulsed tissue Doppler imaging is widely used to record mitral annular motion and evaluate the left ventricular function. A reversed mitral annular motion (MAM) velocity wave (Cm) is commonly seen at the beginning of the mitral valve closure in timing, whereas the underlying mechanism and clinical significance have not been very clearly. Some studies found that Cm reflects the deviation of MAM toward the left atrium at the beginning of the mitral valve closure. Methods: Total of 125 patients (with normal LVEF, age: 44 y±13 y; male: 71, female: 54) with various heart diseases was enrolled. All patients underwent full echocardiogram. Patients with valve replacement were excluded. We measured the mitral flow velocity E using pulsed Doppler, the mitral annulus motion velocity Em and the peak Cm velocity at the septal mitral annulus using tissue Doppler imaging. All subjects divided into two groups: 60 patients with E/Em <8 and 65 patients with E/Em ranging from 8–15. Results: The peak Cm of the MAM velocity significantly reduced in patients with E/Em ranging from 8–15 compared to those with E/Em <8 (0.035±0.009 m/s vs 0.044±0.021 m/s, respectively. P < 0.05). Conclusion: The Cm velocity measurement may be easy and useful to evaluate the left ventricular diastolic dysfunction. P039 Low Dose CCTA Protocol: An Evaluation on Radiation Dose of Coronary CTA with a 320-Detector-Row Scanner C.W. Wong, Y.C. Chu, S.H. Chiu, S.K. Ng, P.Y. Fung, S. Lau, H.S. Lam. Department of Radiology, Kwong Wah Hospital, Kowloon, Hong Kong, China Objective: To evaluate the effective dose of coronary CTA performed with a 320-detector-row scanner in Low Dose CCTA Protocol. Methods: Consecutive patients for coronary CTA between April and September 2010 were included. Dose reduction measures included heart rate control with beta-blocker, BMI-adjusted exposure and individualized z-axis range. Low Dose CCTA Protocol was used as single beat mode and prospective gating targeted at 75% with limited padding (70–80%). Prospective gating with larger padding was required when heart rate control was suboptimal or when there was arrhythmia, and the scanner automatically continued into next heartbeat when it detected changes in rhythm during the scan. The effective dose was derived from dose length product with the following equation: effective dose = 0.017*dose length product. Results: Totally 598 patients underwent coronary CTA, and were performed with prospective gating. Among them, 410 cases were scanned with Low Dose CCTA Protocol using single beat mode prospective gating targeting at 75% R-R interval with limited padding (70–80%). Mean effective dose was 2.489 mSv when scanned with Low Dose CCTA Protocol, or only 1.849 mSv for patients with BMI less than 25. The lowest effective dose achieved was just 0.737 mSv. Mean heart rate was also significantly lower when using Low Dose CCTA Protocol (54 vs. 63 bpm, p < 0.001). Mean effective dose was significantly higher for patients with single beat mode padding more than 70–80% R-R interval (4.939 vs. 2.489 mSv, p < 0.001), prospective gating with more than one beat (12.936 vs. 2.489 mSv, p < 0.001), heart rate more than 60 bpm