- Email: [email protected]
P34 Multilocalized vascular disease in women and ischaemic heart disease
P33
P31 WITH PATIENTS INDICATORS IN COAGULATION PAROXYSMAL ATRIAL FIBRILLATION: EFFECT OF ELECTRICAL AND PHARMACOLOGICAL CARDIOVERSION. Carlo Giansante, Nicola Fiotti, Maddalena Miccio l , Salvatore Calabrese, Rosamarla Salvi *, Annamaria Borri, Gianfranco Guamieri. Institute of Clinical Medicine, University of Trieste;‘: Emergency Unit, Ospedale Maggiore, Trieste, Italy
DIRECT RELATIONSHIPBETWEEN RESTENOSIS AND OXIDATIVE STRES5AFTER ANGIOPLAZTY
F. Clpollone’, F. Costontini’,5.0. Pierdomanico*,1 Paloscla”, G Moterarzo”, E. D’Annunzio*, D. De Cesare’, M. Di Riii*,T. Butciarellin, F. Cuccurullo’, A. Mezzetti*. Deptr. of Medicine 8 Aging* and Biomedical Science**, University of thieti D’hnnunrio” Hospital, The
OXIDATIVE STRESSAND MONOCYTEACIIVATION AFTERTREATMENT
FCipollone’,F Cortontint*,
5.0. Pierdomenitc?, 1. Polortio*,
M. Fana*, C. Ciompoli*, I. Buctiarelli”,
G. Moterarzo#,
E. D’Annunzioff, M.
F. Cucrurullo*, A. Mezzetti’.
Deptr of Medicine & Aging* and Biomedical Science *, Untverrity
of Chieti “G D’Anmmzio” School
of Medione, Chieti; the Division of Cardiology *, ‘IS. Annunxioto” Hospital, Perroro.
lnterleukin
(lltlp
is an rmportont determinant
of intrmd hyperplorio.
Recent studier KI V//M
hove shown that oxidized lipoproteins (0x101) moy induce gene expression of It-l)3. We set out to investigate rertenorls
whether
oxrdotrve srress and It-lp
secretion IS altered and contribute
to
after PICA. We rtudred 4h (30M;16F; aged 62&S yr) potientr who underwent PICA
ond who had repeal onglogromr at 6.month follow-up. Rertenorir occurred in 12 (26%) potientr. Blood romp/es were rolletted at baseline and 24 hours, 48 hours ond 15 days after PICA. We meorured plormo level of fluorertenl manocyter to produce It-I(3 in
products of lipid peroxidation (FPLPr) ond the topotity of
vttroqn the
presence or ohrente of 5 rig/ml lipapolyrotthoride
(LPS]. There were no differences ot boreline. However, FPLPs ond It-lp in the rertenorrr
were higher (P
group through the I’h, 2” ond 15th doyr after PICA. Multivoriote
regression
onalyr~r showed that 11-l[3 and FPlPr ot 24 hours, ond FPLPr of IS days offer PICA were independent predictors for luminol renorrowing was found between fPLPr ond It-lp
after PICA. linally, o strong correlation (f~O.3)
throughout all the period of study. lhrr study suggest that:
a) oxidant sensitive It-I(3 broryntherrs rertenorrr
“G
’ “5s. Annunrlota”
Transient burden
whether
release of lipid peroxides in this
oxidotive
setting
remains
has been reported;
controversial.
stress is altered and contribute
however
the role of
We set out to investigate
to restenasis
after PTCA. We studied
46(3DM;16F;aged62+5 yr) patientswhounderwentPTCAof onecoronaryortery and who had repeat potiants.
ongiogromr
ot 6.month
follow-up.
Blood samples were collected at baseline
Restenosir
occurred
in 12 (26%)
ond 24 hours, 48 hours and I5 days
ofter PTtA. We determined the susceptibility of LDL to 111v&oaxidation (lag phase), the in viva oxidotion status of LDL (thiobarbituric acid-reattiva subrtoncer (TBARS]), LDL vitamin
E, the plasma levels
boseline restenoris
(59?3
YS 61f4
group 24 hours (43+2
(32+_2 YS 54+4) ~tmol/L);
after
however,
27.525; KD.DZ), K0.0001).
YZ 49.7+4),
PTCA. Vitamin
7Fd (21&4
In like manner, but was rlgoificantly
pmol/L;
FO.OOS),
E and vitamin
C was similar FO.002)
shorter
vs 40f5)
at baseline potientr
(33.5&4
during
the I”
YS 26?4;
group 24 hours (24+3
FO.002) differences
YI 35.5?4 (24+4
YS
“I 33.3+4;
E did not differ before the PTlA (27.6+4
no significant
in the
and I5 days
ond 15’” days (22?4
lower in the restenosis
48 hours (21&3
after PTIA. Finally,
(KD.DDOl)
48 hours (34?2
in rertenosir
YI 26.4i2; vitamin
C. lag phase did not differ at
but was significantly
was decreased
pmol/l),
KO.0001)
of vitamin
minutes),
and 15 days (19*3
vs29.6+5 vs27.5+4 YS 30+4;
rn TBARI and vrtomm E content
of LDL were found. Thus study provide clear evrdence for o prolonged
oxidotrve
PTCA. Moreover,
the strong relationship
the severity
restertorts
offer
theropres
may
a noninvosive
between approach
to test
stress m the days following of lipid peroxtdation
the efftracy
and
of antioxIdant
in the tare of tordiac reperfusron.
P34
LATE LUMEN LOSS AFTER CORONARY ANGIOPLASTY IS ASSOCIATEDWITH THE
Marini’,
of Cardiology
pathophysiolagy of restanosisafter coronaryanqiaplasty(PTCA) hasnot yet been
oxrdatlve
P32
Chieti; the Division
Pescara.
elucidated.
OBJECTIVES. The aim of this study was to determine whether electrical or pharmacological cardioversion affects the coagulation system of patients with paroxysmal atrial fibrillation (PAF). Design. 35 Pati&nts with PAF undergoing either electrical or pharmacological cardioversion (CV) to sinus rhythm were studied. INTERVENTION. All patients underwent either electrical or pharmacological CV; the sinus rhythm was restored in all of them, and maintained throughout the observation period. MAIN OUTCOME. Fibrinopeptide A (F.p.A) and dDimer blood samples were taken immediately before cardioversion, and also within 5 minutes, at 6 and 12 hours post cardioversion. Blood samples were taken again at day 7. 14 and 28. RESULTS. When compared to the Control Group, the pre-cardioversion F.p.A plasma values were significantly elevated (11.8 vs. 2.5 ng/mL). F.p.A plasma values were significantly reduced 5 minutes after cardioversion (11.8 vs. 5.3 ng/mL), and remained stable at all the following sequential measurements. D-dimer plasma values were significantly increased only in patients who underwent electrical cardioversion. A positive correlation was found (R*=0.76) between the energy delivered for cardioversion to sinus rhythm and day-7 D-dimer plasma values. CONCLUS/OiVS. This study demonstrates that in patients with PAF the haemostatic system is activated; cardioversion to sinus rhythm rapidly normalises the haemostatic system. Electrical, but not pharmacological, cardioversion induces an early activation of the fibrinolytic system. The intensity of such activation depends upon the energy required to restore the sinus rhythm.
School of Medicine,
might provide o mechonirm possibly tontributing
ofter PICA; b) may offer o rotronol borer for evoluonng ontioxidontr
odiuvont to reperfurron rtrafegrer,
rurh OSPTCAand thrombolytic drugs.
to
OS therapy
MULTl.IBCALaIZJtD ISCHAEMIC HEART
VASCULAR DISEASE.
DISEASE
IN
WOMEN
AND
R CIMINO, S. GIANCOITI. G. MUCCARI. S. MAZZLJCA. II DIVISI~MEDICLVA OSP. “A. PugIiese ” - Catanzuro. Cardiovascular disease remesents the most t?euumt cause of mortalitv and morbidity in females. Aim of he study WBEto evaluate, nrm invasively, by echo-Doppler, the prevalence of carotid artery disease (CAD) and obliterating arthaial di(OAD) of the lower limbs in pts (females in ore and east mcnopauaal age) with ischacmic heert disease (Iin>); the relet&s with djor cardicwasculcurisk Ewtc~, tho incidence of awdii complicaths comparatively with a group of men. IMicmts and owthda 200 exmuxtivo ptients (130 M and 70 F, mean age 68ilO. range 30-92 yews) admitted in our iaetitution with prior myocardiil hrfretion wera included in the study. Our pta were divided in two groups of age (c end > 55 years), bewee for woman, 55 yw=s old could be oonsideral8 hypataic passage ksn the fertile ags into post mmcpausal age. The pawxndas eaeaninai in mds pte wau: Hypaiasa&m; BM1; Diabaes Msllitus; Dialipidanic disorders, Fibrinogat; Smoka To each pts wera required infmmatim for TIA, Stroke and ciaudicatio intumitteas. All tie patients UndQwont au Echo-Doppler examinnth of -id art&a (si@ficant Stanoses > SO%)and Doppler CW examfnarion (ankidarm p-0 index) of artaial lavcr limb. in our study the inci&os of cardiac wmpbetionr wac highsPmglg~withOADandorCADthsnin~~~nocoexi~g lesions. Risk l?s&m ware si@fiwttly hi&her amoq ps with muiti-localized athaosolaosis than in the oihom Iho red&s sueoQarsdthat tb prrsenw of multi-localized athwceclsrosis, in pts with myocudial in-ion, WB(Iassociated with high risk of late c&iac and nm cerdiac compliution, and deueas& life erpoetancy. ‘Tlmdm, the reduction of athawclarotio risk f&tom is primarily important to prcvant the devolopmeot of atbrrc6cIaosis. The resnb of the pw6nt (dudy ahcwi a hiah - asvalslce of multilocalizad atheroscl&c disease in wtnnmn in ga%ttic 01 post-maqnwal age. @A 63: 445% vs F 26: 37,1°m;P = NS). In those patients the ratio of cardiac ovmt (an&a pcctorie or acute myawdkd roinfprdion) vwm t3ipifiumtly higha in fanale group (reinfhrctim M 14.2% P 20% angtne hi 23,70/s.F 34~5%). Sigoifimnt diffareplcs about the prevalancc of knowo atJwrosclerotic risk factors was obsawd in the ratio of diabetes mellhus, hypertatsion, obasity and fibrinogen amongthe female @oop.
P31 WITH PATIENTS INDICATORS IN COAGULATION PAROXYSMAL ATRIAL FIBRILLATION: EFFECT OF ELECTRICAL AND PHARMACOLOGICAL CARDIOVERSION. Carlo Giansante, Nicola Fiotti, Maddalena Miccio l , Salvatore Calabrese, Rosamarla Salvi *, Annamaria Borri, Gianfranco Guamieri. Institute of Clinical Medicine, University of Trieste;‘: Emergency Unit, Ospedale Maggiore, Trieste, Italy
DIRECT RELATIONSHIPBETWEEN RESTENOSIS AND OXIDATIVE STRES5AFTER ANGIOPLAZTY
F. Clpollone’, F. Costontini’,5.0. Pierdomanico*,1 Paloscla”, G Moterarzo”, E. D’Annunzio*, D. De Cesare’, M. Di Riii*,T. Butciarellin, F. Cuccurullo’, A. Mezzetti*. Deptr. of Medicine 8 Aging* and Biomedical Science**, University of thieti D’hnnunrio” Hospital, The
OXIDATIVE STRESSAND MONOCYTEACIIVATION AFTERTREATMENT
FCipollone’,F Cortontint*,
5.0. Pierdomenitc?, 1. Polortio*,
M. Fana*, C. Ciompoli*, I. Buctiarelli”,
G. Moterarzo#,
E. D’Annunzioff, M.
F. Cucrurullo*, A. Mezzetti’.
Deptr of Medicine & Aging* and Biomedical Science *, Untverrity
of Chieti “G D’Anmmzio” School
of Medione, Chieti; the Division of Cardiology *, ‘IS. Annunxioto” Hospital, Perroro.
lnterleukin
(lltlp
is an rmportont determinant
of intrmd hyperplorio.
Recent studier KI V//M
hove shown that oxidized lipoproteins (0x101) moy induce gene expression of It-l)3. We set out to investigate rertenorls
whether
oxrdotrve srress and It-lp
secretion IS altered and contribute
to
after PICA. We rtudred 4h (30M;16F; aged 62&S yr) potientr who underwent PICA
ond who had repeal onglogromr at 6.month follow-up. Rertenorir occurred in 12 (26%) potientr. Blood romp/es were rolletted at baseline and 24 hours, 48 hours ond 15 days after PICA. We meorured plormo level of fluorertenl manocyter to produce It-I(3 in
products of lipid peroxidation (FPLPr) ond the topotity of
vttroqn the
presence or ohrente of 5 rig/ml lipapolyrotthoride
(LPS]. There were no differences ot boreline. However, FPLPs ond It-lp in the rertenorrr
were higher (P
group through the I’h, 2” ond 15th doyr after PICA. Multivoriote
regression
onalyr~r showed that 11-l[3 and FPlPr ot 24 hours, ond FPLPr of IS days offer PICA were independent predictors for luminol renorrowing was found between fPLPr ond It-lp
after PICA. linally, o strong correlation (f~O.3)
throughout all the period of study. lhrr study suggest that:
a) oxidant sensitive It-I(3 broryntherrs rertenorrr
“G
’ “5s. Annunrlota”
Transient burden
whether
release of lipid peroxides in this
oxidotive
setting
remains
has been reported;
controversial.
stress is altered and contribute
however
the role of
We set out to investigate
to restenasis
after PTCA. We studied
46(3DM;16F;aged62+5 yr) patientswhounderwentPTCAof onecoronaryortery and who had repeat potiants.
ongiogromr
ot 6.month
follow-up.
Blood samples were collected at baseline
Restenosir
occurred
in 12 (26%)
ond 24 hours, 48 hours and I5 days
ofter PTtA. We determined the susceptibility of LDL to 111v&oaxidation (lag phase), the in viva oxidotion status of LDL (thiobarbituric acid-reattiva subrtoncer (TBARS]), LDL vitamin
E, the plasma levels
boseline restenoris
(59?3
YS 61f4
group 24 hours (43+2
(32+_2 YS 54+4) ~tmol/L);
after
however,
27.525; KD.DZ), K0.0001).
YZ 49.7+4),
PTCA. Vitamin
7Fd (21&4
In like manner, but was rlgoificantly
pmol/L;
FO.OOS),
E and vitamin
C was similar FO.002)
shorter
vs 40f5)
at baseline potientr
(33.5&4
during
the I”
YS 26?4;
group 24 hours (24+3
FO.002) differences
YI 35.5?4 (24+4
YS
“I 33.3+4;
E did not differ before the PTlA (27.6+4
no significant
in the
and I5 days
ond 15’” days (22?4
lower in the restenosis
48 hours (21&3
after PTIA. Finally,
(KD.DDOl)
48 hours (34?2
in rertenosir
YI 26.4i2; vitamin
C. lag phase did not differ at
but was significantly
was decreased
pmol/l),
KO.0001)
of vitamin
minutes),
and 15 days (19*3
vs29.6+5 vs27.5+4 YS 30+4;
rn TBARI and vrtomm E content
of LDL were found. Thus study provide clear evrdence for o prolonged
oxidotrve
PTCA. Moreover,
the strong relationship
the severity
restertorts
offer
theropres
may
a noninvosive
between approach
to test
stress m the days following of lipid peroxtdation
the efftracy
and
of antioxIdant
in the tare of tordiac reperfusron.
P34
LATE LUMEN LOSS AFTER CORONARY ANGIOPLASTY IS ASSOCIATEDWITH THE
Marini’,
of Cardiology
pathophysiolagy of restanosisafter coronaryanqiaplasty(PTCA) hasnot yet been
oxrdatlve
P32
Chieti; the Division
Pescara.
elucidated.
OBJECTIVES. The aim of this study was to determine whether electrical or pharmacological cardioversion affects the coagulation system of patients with paroxysmal atrial fibrillation (PAF). Design. 35 Pati&nts with PAF undergoing either electrical or pharmacological cardioversion (CV) to sinus rhythm were studied. INTERVENTION. All patients underwent either electrical or pharmacological CV; the sinus rhythm was restored in all of them, and maintained throughout the observation period. MAIN OUTCOME. Fibrinopeptide A (F.p.A) and dDimer blood samples were taken immediately before cardioversion, and also within 5 minutes, at 6 and 12 hours post cardioversion. Blood samples were taken again at day 7. 14 and 28. RESULTS. When compared to the Control Group, the pre-cardioversion F.p.A plasma values were significantly elevated (11.8 vs. 2.5 ng/mL). F.p.A plasma values were significantly reduced 5 minutes after cardioversion (11.8 vs. 5.3 ng/mL), and remained stable at all the following sequential measurements. D-dimer plasma values were significantly increased only in patients who underwent electrical cardioversion. A positive correlation was found (R*=0.76) between the energy delivered for cardioversion to sinus rhythm and day-7 D-dimer plasma values. CONCLUS/OiVS. This study demonstrates that in patients with PAF the haemostatic system is activated; cardioversion to sinus rhythm rapidly normalises the haemostatic system. Electrical, but not pharmacological, cardioversion induces an early activation of the fibrinolytic system. The intensity of such activation depends upon the energy required to restore the sinus rhythm.
School of Medicine,
might provide o mechonirm possibly tontributing
ofter PICA; b) may offer o rotronol borer for evoluonng ontioxidontr
odiuvont to reperfurron rtrafegrer,
rurh OSPTCAand thrombolytic drugs.
to
OS therapy
MULTl.IBCALaIZJtD ISCHAEMIC HEART
VASCULAR DISEASE.
DISEASE
IN
WOMEN
AND
R CIMINO, S. GIANCOITI. G. MUCCARI. S. MAZZLJCA. II DIVISI~MEDICLVA OSP. “A. PugIiese ” - Catanzuro. Cardiovascular disease remesents the most t?euumt cause of mortalitv and morbidity in females. Aim of he study WBEto evaluate, nrm invasively, by echo-Doppler, the prevalence of carotid artery disease (CAD) and obliterating arthaial di(OAD) of the lower limbs in pts (females in ore and east mcnopauaal age) with ischacmic heert disease (Iin>); the relet&s with djor cardicwasculcurisk Ewtc~, tho incidence of awdii complicaths comparatively with a group of men. IMicmts and owthda 200 exmuxtivo ptients (130 M and 70 F, mean age 68ilO. range 30-92 yews) admitted in our iaetitution with prior myocardiil hrfretion wera included in the study. Our pta were divided in two groups of age (c end > 55 years), bewee for woman, 55 yw=s old could be oonsideral8 hypataic passage ksn the fertile ags into post mmcpausal age. The pawxndas eaeaninai in mds pte wau: Hypaiasa&m; BM1; Diabaes Msllitus; Dialipidanic disorders, Fibrinogat; Smoka To each pts wera required infmmatim for TIA, Stroke and ciaudicatio intumitteas. All tie patients UndQwont au Echo-Doppler examinnth of -id art&a (si@ficant Stanoses > SO%)and Doppler CW examfnarion (ankidarm p-0 index) of artaial lavcr limb. in our study the inci&os of cardiac wmpbetionr wac highsPmglg~withOADandorCADthsnin~~~nocoexi~g lesions. Risk l?s&m ware si@fiwttly hi&her amoq ps with muiti-localized athaosolaosis than in the oihom Iho red&s sueoQarsdthat tb prrsenw of multi-localized athwceclsrosis, in pts with myocudial in-ion, WB(Iassociated with high risk of late c&iac and nm cerdiac compliution, and deueas& life erpoetancy. ‘Tlmdm, the reduction of athawclarotio risk f&tom is primarily important to prcvant the devolopmeot of atbrrc6cIaosis. The resnb of the pw6nt (dudy ahcwi a hiah - asvalslce of multilocalizad atheroscl&c disease in wtnnmn in ga%ttic 01 post-maqnwal age. @A 63: 445% vs F 26: 37,1°m;P = NS). In those patients the ratio of cardiac ovmt (an&a pcctorie or acute myawdkd roinfprdion) vwm t3ipifiumtly higha in fanale group (reinfhrctim M 14.2% P 20% angtne hi 23,70/s.F 34~5%). Sigoifimnt diffareplcs about the prevalancc of knowo atJwrosclerotic risk factors was obsawd in the ratio of diabetes mellhus, hypertatsion, obasity and fibrinogen amongthe female @oop.