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PP-080 SERUM IGF-I LEVELS ARE CORRELATED WITH MITRAL VALVE CALCIFICATION SCORE IN PATIENTS WITH RHEUMATIC MITRAL STENOSIS
Poster Discussions / International Journal of Cardiology 155S1 (2012) S99–S127
PP-078 RELATIONSHIP BETWEEN SEVERITY OF STENOSIS AND LEFT ATRIAL FUNCTIONS IN PATIENT WITH MITRAL STENOSIS A. Kaya, I.H. Tanboga, M. Kurt, T. Isık, ¸ M. EkincI. Erzurum Education and Research Hospital, Department of Cardiology, Erzurum, Turkey Objective: In this study we aimed to investigate, in isolated mitral stenosis (MS) patients, the relation between the severity of stenosis and left atrial (LA) mechanical functions in three phases (pump, conduit and reservoir phases). Methods: Study population consisted of 28 patients with MS (13 mild and 15 moderate-severe) and age-sex matched 14 healthy subjects. The study population underwent a comprehensive echocardiographic examination and LA volumetric measurements were obtained and from these phasic LA mechanical functions (reservoir, conduit and pump) were calculated. Results: While moderate to severe MS patients had significantly decreased reservoir and pump functions when compared to both the control group and mild MS patients, there were no significant differences between mild MS patients and control group. Besides, conduit function was comparable between the control group and mild MS patients and it was significantly decreased in moderate to severe MS patients when compared to both mild MS patients and control group (22.5±6.0, 46.0±6.6;22.5±6.045.3±8; p: 0.001 respectively). Correlation analysis revealed that as the severity of stenosis increases, reservoir and conduit functions were more significantly impaired than pump function. Conclusions: Left atrial reservoir and conduit functions more markedly impaired than pump function as the severity of stenosis increases in patients with MS. PP-079 COPEPTIN LEVEL AND COPEPTIN RESPONSE TO PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN MITRAL STENOSIS O. Gunebakmaz1 , A. Celik2 , M.T. Inanc3 , M. Duran4 , E. Karakaya5 , M. Tulmac6 , M. Akpek3 , B. Sarli3 , A. Ergin3 , R. Topsakai3 . 1 Department of Cardiology, Kastamonu Munif Islamoglu State Hospital, Turkey; 2 Department of Cardiology, Elazig Education and Research Hospital, Elazig, Turkey; 3 Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey; 4 Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey; 5 Department of Cardiology, Kırsehir State Hospital, Kırsehir, ¸ Turkey; 6 Department of Cardiology, Kırıkkale University School of Medicine, Kırıkkale, Turkey Objective: Arginine vasopressin (AVP) has well-established effects on cardiovascular homeostasis. Copeptin, which is more stable and can be measured more easily than AVP, is co-secreted with AVP. We aimed to investigate copeptin levels in mitral stenosis (MS) and the behavior of copeptin after percutaneous balloon mitral valvuloplasty (PBMV). Methods: The study involved 29 symptomatic consecutive patients with moderate to severe rheumatic MS who underwent PMBW. Twenty-eight age and gender matched healthy volunteers composed the control group. Results: The copeptin level of the patient group was statistically different from that of the control group (61.8±34.4; 36.8±15.2, respectively, p = 0.001). PBMV resulted in significant increase of mitral valve area measured by both planimetric and pressure halftime method at the 24th hour after valvuloplasty (from 1.12±0.17 to 1.76±0.41, p = 0.001, and from 1.11±0.19 to 1.82±0.32, p = 0.001, respectively) (Figure 1, Table 1). On Doppler echocardiographic study, transmitral gradient as well as systolic pulmonary artery pressure (SPAB) decreased significantly at the 24th hour after valvuloplasty (from 11.4±3.2 to 5.9±2.3, p = 0.001, and from 46.3±9.4 to 35.7±9.1, p = 0.001, respectively). The same parameters measured by catheterization showed sudden decrease immediately after the procedure (transmitral gradient from 14.9±5.6 to 3.7±2.1, p = 0.001; SPAB from 51.4±11.9 to 38.5±7.5, p = 0.001). We detected
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statistically significant decline in copeptin levels at the 24th hour after PBMV compared to the baseline levels (from 61.8±34.4 to 44.1±18.2, p = 0.004) (Figure 1, Table 1). Conclusions: Rheumatic mitral stenosis patients have significantly higher copeptin level compared to the healthy control subjects. PBMV results in dramatic decrease in copeptin level which runs parallel with hemodynamic improvements.
Figure 1. Changes in echocardiographic parameters and copeptin level after percutaneous balloon mitral valvuloplasty.
Table 1. Echocardiograhic, hemodynamic characteristics and copeptin levels before and after percutaneous balloon mitral valvuloplasty in mitral stenosis patients
MVA (planimetry) MVA (pressure half-time) Transmitral MG (Doppler) Transmitral MG (hemodynamic) SPAP (Doppler) SPAP (hemodynamic) Copeptin (pg/mL)
Baseline
At 1-day after procedure
p
1.12±0.17 1.11±0.19 11.4±3.2 14.9±5.6 46.3±9.4 51.4±11.9 61.8±34.4
1.76±0.41 1.82±0.32 5.9±2.3 3.7±2.1* 35.7±9.1 38.5±7.5* 44.1±18.2
0.001 0.001 0.001 0.001 0.001 0.001 0.004
Data are presented as the mean value±S.D. p < 0.05 considered statistically significant. *Measured immediately at the end of the procedure. MVA, mitral valve area; Transmitral MG, transmitral mean gradient; SPAP, systolic pulmonary artery pressure.
PP-080 SERUM IGF-I LEVELS ARE CORRELATED WITH MITRAL VALVE CALCIFICATION SCORE IN PATIENTS WITH RHEUMATIC MITRAL STENOSIS ¨ Sen O.S. Deveci1 , B. Yavuz2 , O. ¸ 2 , K.O. Akın4 , K. Dal3 , N. Ata3 , 3 1 1 D.T. Ertu˘grul , A. Tokatlı . Department of Cardiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey; 2 Department of Cardiology, Kecioren Research and Training Hospital, Ankara, Turkey; 3 Department of Internal Medicine, Kecioren Research and Training Hospital, Ankara, Turkey; 4 Department of Biochemistry, Kecioren Research and Training Hospital, Ankara, Turkey Objective: Although the prevalence of rheumatic fever has greatly decreased in developed countries, rheumatic mitral stenosis (RMS) still causes significant morbidity and mortality. Relatively recent awareness that IGF-I regulate immune function has cast this pathway in an unexpected light; it may represent an important switch governing the quality and amplitude of immune responses. IGF-I/IGF-IR signaling may also participate in the pathogenesis of autoimmune diseases, although its relationship with these processes seems complex and relatively unexplored. At present, there have been no controlled clinical trial on the levels of IGF-1 in the patients with RMS. The aim of this study was to assess the levels of insulin like growth factor-I (IGF-I) and its correlation with Wilkins score in patients with RMS.
S124
Poster Discussions / International Journal of Cardiology 155S1 (2012) S99–S127
Methods: SIxty-two patients with RMS and fifty-eight healthy age and sex matched control subjects were enrolled in this study. All subjects underwent transthoracic echocardiography after a complete medical evaluation and laboratory examination. Planimetric mitral valve area and Wilkins score were evaluated for all patients. BIochemical parameters, serum IGF-I levels were measured. IGF-I levels are compared both in the patients with RMS and control groups and in the the group of patients with lower Wilkins score (≤8, n:35) and higher Wilkins score (>8, n:27). Results: Mean age was similar in RMS and control groups (50±10 vs 52±10 years, p= NS). Level of IGF-I was significantly higher in RMS than in controls (111.7±48.3 ng/ml vs 91.3±44.9 ng/ml, p = 0.018). Similarly mean IGF-I levels were significantly higher in the group of patients with higher Wilkins score than in the patients with lower Wilkins score 121.3±37.2 ng/ml vs 101.8±34.5 ng/ml, p < 0.05). A moderate correlation between IGF-I and Wilkins score was determined (r: 0.554). There was no correlation between IGF-I level and other echocardiographic parameters of mitral stenosis. Conclusions: The present study demonstrated that serum IGF-I levels were significantly higher both in patients with RMS compared to control subjects and in the group of patients with higher Wilkins score than in the patients with lower Wilkins score. IGF-I levels were also correlated with Wilkins score. It can be suggested that there may be a link between serum IGF-I levels and inflammation process of RMS. PP-081 LATE CHANGES OF PULMONARY FUNCTIONS OCCURRED AFTER MITRAL VALVE REPLACEMENT H. Parlar, S. Yavuz, E. Ozbudak, M. Kanko, K.T. Berki. Department of Cardiovascular Surgery, Kocaeli University, Kocaeli, Turkey Objective: In patients with mitral valve disease, reversible or irreversible changes occur in the lungs. At the end of the process of secondary pulmonary hypertension develops. In early stage after MVR, the pulmonary functions can not improve because of CPB and its complications. In our study, we examined the late changes in the pulmonary functions of patients who underwent mitral valve replacement. Methods: In our clinic between January 2008 and June 2011, mitral valve replacement performed in 26 patients, were included in the study. The patients with aortic regurgitation, CAD and COLD were excluded. Respiratory function of patients were evaluated with spirometry. We performed the preoperative assesment in 3 day before surgery and the postoperative examination performed in 6 months after surgery. In respiratory function tests, we measured FEV1, FVC, FEF 25–75 and PEF values, respectively. The statistical analysis were performed by using SPSS for Windows 10.0. We used the Shapiro-Wilk test and the Wilcoxon test to measure the statistical analysis. Results: The range of ages of the patients included in the study was 24 to 74. 18 of the patients were female and 8 male. Mean age was 55.88±14.52. Mean value of preoperative mitral valve area was 1.03±0.19 cm2 . Mean value of mitral gradient was 10.06±7.18 mmHg. Mean EF value was 54.38±11.52 %. Mean value of PAP was 57.12±18.98. preoperative values of FEV1, FVC, FEF 25–75 and PEF values were compared with postoperative values, respectively. All data on the comparison, were statistically significant. Preoperative and postoperative values of spirometry Preoperative
FVC (L) FEV1 (L) FEV1/FVC (%) FEF 25–75 (L/s) PEF (L/s)
Postoperative
Expected
Measured
%
Measured
%
2.98±0.87 2.47±0.72 78.12±2.70 3.17±0.68 6.52±1.37
2.17±0.75 1.64±0.61 75.31±10.21 1.90±0.75 3.83±1.46
72.65±18.67 66.31±15.96
2.58±0.80 2.09±0.68 81.58±9.47 2.48±0.88 4.82±1.39
86.73±10.99 84.73±12.03
60.85±23.39 58.65±18.60
78.42±24.18 74.04±16.67
Conclusions: We observed in our study, the pulmonary hypertension due to mitral valve disease, a significant improvement in pulmonary functions occurs long period after mitral valve replacement in patients with pulmonary hypertension due to mitral valve disease. PP-082 ANTERIOR MITRAL VALVE PROLAPSE CONTRIBUTES TO MITRAL REGURGITATION AND PANIC DISORDER U. Ku¨ c¸ uk ¨ 1 , H.O. Ku¨ c¸ uk ¨ 2 . 1 G¨ ulhane Military Medical Academy Department of Cardiology, Ankara Turkey; 2 GAZI University Department of Cardiology, Ankara, Turkey; 3 Gulhane Military Medical Academy Haydarpasa Training Hospital Department of Cardiology, Ankara, Turkey Objective: The aim of this prospective study is to investigate the contribution of the anterior mitral leaflet prolapse to mitral regurgitation and panic disorder. Methods: Mitral valve prolapse is affecting 2.4 % of general population which shows similar prevalence, age and gender distribution and share common nonspecific symptoms with panic disorder. Ninety-six patients, who were finally diagnosed as having noncardiac chest pain with anterior mitral valve prolapse during the evaluation of chest pain, palpitation and fatigue were assessed for panic disorder. Results: From 96 patients with mitral valve prolapse (mean age 40±8 years), 46 (48%) had panic disorder and 32 (33%) had mitral regurgitation. Majority of the patients were female (53%). 48 % of the patients with panic disorder had mitral regurgitation. Among 32 patients with mitral regurgitation, 22 (69%) had panic disorder. The incidence of panic disorder in patients with mitral regurgitation was 69%. Among those with panic disorder, 48% had mitral regurgitation. There was a significant correlation between mitral regurgitation and panic disorder (p = 0.004). Conclusions: This study has demonstrated the possible contribution of the anterior mitral leaflet prolapse to mitral regurgitation and panic disorder. Panic disorder and mitral valve prolapse presents a co-morbidity, which deserves further clinical investigations. PP-083 THE ASSOSIATION OF VENTRICULER SEPTAL DEFECT AND AORTIC INSUFFIENCY IN OUR CASES ¨ un ¨ ur ¨ Ceylan1 , S. ¸ Kayalı1 , V. Do˘gan1 , M. Koc¸ 2 , U.A. Or ¨ 1 , S. Ozg ¨ 1 , O. M. Keskin1 , S. Karademir1 , A. Kutsal2 . 1 Department of Pediatric Cardiology, Dr Sami Ulus Maternity, Children Health and Diseases Training and Education Hospital, Ankara, Turkey; 2 Department of Cardiovascular Surgery, Dr Sami Ulus Maternity, Children Health and Diseases Training and Education Hospital, Ankara, Turkey Objective: Aortic insufficiency (AI) associated with ventricular septal defect (VSD), a well-known anatomical disorder. Pezzi Laubry defined for the first time in 1921 and the incidence varies between 2.5–8% of all VSD. It is more common seen in Asia and Far East. In these patients VSD shows subpulmoner or subcristal (perimembranous) placement. As AI is progressive, it is important to recognise the defect early and to make a right decision for surgical time. While some researchers are defending that only closure of VSD would be sufficient, the others defend valvuloplasty is also necessary. Between 2006–2011, 14 patients with VSD and AI were eveluated in our study. Mean age was 5.5 years (range 1.5 to 13 years). Nine of the patients were male, and 6 were female. The VSD was perimembranous in 13 patients and subpulmonary in 1. Aortic insufficiency was mild in 11 patient, moderate in 3. Eleven patients were operated in our hospital, 2 patient were clinically followed up because the aortic insuffiency was mild and one admitted other hospital for operation after diagnosis. Only closure of ventricular septal defect were performed in 6 patients and in 5 patients aortic
PP-078 RELATIONSHIP BETWEEN SEVERITY OF STENOSIS AND LEFT ATRIAL FUNCTIONS IN PATIENT WITH MITRAL STENOSIS A. Kaya, I.H. Tanboga, M. Kurt, T. Isık, ¸ M. EkincI. Erzurum Education and Research Hospital, Department of Cardiology, Erzurum, Turkey Objective: In this study we aimed to investigate, in isolated mitral stenosis (MS) patients, the relation between the severity of stenosis and left atrial (LA) mechanical functions in three phases (pump, conduit and reservoir phases). Methods: Study population consisted of 28 patients with MS (13 mild and 15 moderate-severe) and age-sex matched 14 healthy subjects. The study population underwent a comprehensive echocardiographic examination and LA volumetric measurements were obtained and from these phasic LA mechanical functions (reservoir, conduit and pump) were calculated. Results: While moderate to severe MS patients had significantly decreased reservoir and pump functions when compared to both the control group and mild MS patients, there were no significant differences between mild MS patients and control group. Besides, conduit function was comparable between the control group and mild MS patients and it was significantly decreased in moderate to severe MS patients when compared to both mild MS patients and control group (22.5±6.0, 46.0±6.6;22.5±6.045.3±8; p: 0.001 respectively). Correlation analysis revealed that as the severity of stenosis increases, reservoir and conduit functions were more significantly impaired than pump function. Conclusions: Left atrial reservoir and conduit functions more markedly impaired than pump function as the severity of stenosis increases in patients with MS. PP-079 COPEPTIN LEVEL AND COPEPTIN RESPONSE TO PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN MITRAL STENOSIS O. Gunebakmaz1 , A. Celik2 , M.T. Inanc3 , M. Duran4 , E. Karakaya5 , M. Tulmac6 , M. Akpek3 , B. Sarli3 , A. Ergin3 , R. Topsakai3 . 1 Department of Cardiology, Kastamonu Munif Islamoglu State Hospital, Turkey; 2 Department of Cardiology, Elazig Education and Research Hospital, Elazig, Turkey; 3 Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey; 4 Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey; 5 Department of Cardiology, Kırsehir State Hospital, Kırsehir, ¸ Turkey; 6 Department of Cardiology, Kırıkkale University School of Medicine, Kırıkkale, Turkey Objective: Arginine vasopressin (AVP) has well-established effects on cardiovascular homeostasis. Copeptin, which is more stable and can be measured more easily than AVP, is co-secreted with AVP. We aimed to investigate copeptin levels in mitral stenosis (MS) and the behavior of copeptin after percutaneous balloon mitral valvuloplasty (PBMV). Methods: The study involved 29 symptomatic consecutive patients with moderate to severe rheumatic MS who underwent PMBW. Twenty-eight age and gender matched healthy volunteers composed the control group. Results: The copeptin level of the patient group was statistically different from that of the control group (61.8±34.4; 36.8±15.2, respectively, p = 0.001). PBMV resulted in significant increase of mitral valve area measured by both planimetric and pressure halftime method at the 24th hour after valvuloplasty (from 1.12±0.17 to 1.76±0.41, p = 0.001, and from 1.11±0.19 to 1.82±0.32, p = 0.001, respectively) (Figure 1, Table 1). On Doppler echocardiographic study, transmitral gradient as well as systolic pulmonary artery pressure (SPAB) decreased significantly at the 24th hour after valvuloplasty (from 11.4±3.2 to 5.9±2.3, p = 0.001, and from 46.3±9.4 to 35.7±9.1, p = 0.001, respectively). The same parameters measured by catheterization showed sudden decrease immediately after the procedure (transmitral gradient from 14.9±5.6 to 3.7±2.1, p = 0.001; SPAB from 51.4±11.9 to 38.5±7.5, p = 0.001). We detected
S123
statistically significant decline in copeptin levels at the 24th hour after PBMV compared to the baseline levels (from 61.8±34.4 to 44.1±18.2, p = 0.004) (Figure 1, Table 1). Conclusions: Rheumatic mitral stenosis patients have significantly higher copeptin level compared to the healthy control subjects. PBMV results in dramatic decrease in copeptin level which runs parallel with hemodynamic improvements.
Figure 1. Changes in echocardiographic parameters and copeptin level after percutaneous balloon mitral valvuloplasty.
Table 1. Echocardiograhic, hemodynamic characteristics and copeptin levels before and after percutaneous balloon mitral valvuloplasty in mitral stenosis patients
MVA (planimetry) MVA (pressure half-time) Transmitral MG (Doppler) Transmitral MG (hemodynamic) SPAP (Doppler) SPAP (hemodynamic) Copeptin (pg/mL)
Baseline
At 1-day after procedure
p
1.12±0.17 1.11±0.19 11.4±3.2 14.9±5.6 46.3±9.4 51.4±11.9 61.8±34.4
1.76±0.41 1.82±0.32 5.9±2.3 3.7±2.1* 35.7±9.1 38.5±7.5* 44.1±18.2
0.001 0.001 0.001 0.001 0.001 0.001 0.004
Data are presented as the mean value±S.D. p < 0.05 considered statistically significant. *Measured immediately at the end of the procedure. MVA, mitral valve area; Transmitral MG, transmitral mean gradient; SPAP, systolic pulmonary artery pressure.
PP-080 SERUM IGF-I LEVELS ARE CORRELATED WITH MITRAL VALVE CALCIFICATION SCORE IN PATIENTS WITH RHEUMATIC MITRAL STENOSIS ¨ Sen O.S. Deveci1 , B. Yavuz2 , O. ¸ 2 , K.O. Akın4 , K. Dal3 , N. Ata3 , 3 1 1 D.T. Ertu˘grul , A. Tokatlı . Department of Cardiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey; 2 Department of Cardiology, Kecioren Research and Training Hospital, Ankara, Turkey; 3 Department of Internal Medicine, Kecioren Research and Training Hospital, Ankara, Turkey; 4 Department of Biochemistry, Kecioren Research and Training Hospital, Ankara, Turkey Objective: Although the prevalence of rheumatic fever has greatly decreased in developed countries, rheumatic mitral stenosis (RMS) still causes significant morbidity and mortality. Relatively recent awareness that IGF-I regulate immune function has cast this pathway in an unexpected light; it may represent an important switch governing the quality and amplitude of immune responses. IGF-I/IGF-IR signaling may also participate in the pathogenesis of autoimmune diseases, although its relationship with these processes seems complex and relatively unexplored. At present, there have been no controlled clinical trial on the levels of IGF-1 in the patients with RMS. The aim of this study was to assess the levels of insulin like growth factor-I (IGF-I) and its correlation with Wilkins score in patients with RMS.
S124
Poster Discussions / International Journal of Cardiology 155S1 (2012) S99–S127
Methods: SIxty-two patients with RMS and fifty-eight healthy age and sex matched control subjects were enrolled in this study. All subjects underwent transthoracic echocardiography after a complete medical evaluation and laboratory examination. Planimetric mitral valve area and Wilkins score were evaluated for all patients. BIochemical parameters, serum IGF-I levels were measured. IGF-I levels are compared both in the patients with RMS and control groups and in the the group of patients with lower Wilkins score (≤8, n:35) and higher Wilkins score (>8, n:27). Results: Mean age was similar in RMS and control groups (50±10 vs 52±10 years, p= NS). Level of IGF-I was significantly higher in RMS than in controls (111.7±48.3 ng/ml vs 91.3±44.9 ng/ml, p = 0.018). Similarly mean IGF-I levels were significantly higher in the group of patients with higher Wilkins score than in the patients with lower Wilkins score 121.3±37.2 ng/ml vs 101.8±34.5 ng/ml, p < 0.05). A moderate correlation between IGF-I and Wilkins score was determined (r: 0.554). There was no correlation between IGF-I level and other echocardiographic parameters of mitral stenosis. Conclusions: The present study demonstrated that serum IGF-I levels were significantly higher both in patients with RMS compared to control subjects and in the group of patients with higher Wilkins score than in the patients with lower Wilkins score. IGF-I levels were also correlated with Wilkins score. It can be suggested that there may be a link between serum IGF-I levels and inflammation process of RMS. PP-081 LATE CHANGES OF PULMONARY FUNCTIONS OCCURRED AFTER MITRAL VALVE REPLACEMENT H. Parlar, S. Yavuz, E. Ozbudak, M. Kanko, K.T. Berki. Department of Cardiovascular Surgery, Kocaeli University, Kocaeli, Turkey Objective: In patients with mitral valve disease, reversible or irreversible changes occur in the lungs. At the end of the process of secondary pulmonary hypertension develops. In early stage after MVR, the pulmonary functions can not improve because of CPB and its complications. In our study, we examined the late changes in the pulmonary functions of patients who underwent mitral valve replacement. Methods: In our clinic between January 2008 and June 2011, mitral valve replacement performed in 26 patients, were included in the study. The patients with aortic regurgitation, CAD and COLD were excluded. Respiratory function of patients were evaluated with spirometry. We performed the preoperative assesment in 3 day before surgery and the postoperative examination performed in 6 months after surgery. In respiratory function tests, we measured FEV1, FVC, FEF 25–75 and PEF values, respectively. The statistical analysis were performed by using SPSS for Windows 10.0. We used the Shapiro-Wilk test and the Wilcoxon test to measure the statistical analysis. Results: The range of ages of the patients included in the study was 24 to 74. 18 of the patients were female and 8 male. Mean age was 55.88±14.52. Mean value of preoperative mitral valve area was 1.03±0.19 cm2 . Mean value of mitral gradient was 10.06±7.18 mmHg. Mean EF value was 54.38±11.52 %. Mean value of PAP was 57.12±18.98. preoperative values of FEV1, FVC, FEF 25–75 and PEF values were compared with postoperative values, respectively. All data on the comparison, were statistically significant. Preoperative and postoperative values of spirometry Preoperative
FVC (L) FEV1 (L) FEV1/FVC (%) FEF 25–75 (L/s) PEF (L/s)
Postoperative
Expected
Measured
%
Measured
%
2.98±0.87 2.47±0.72 78.12±2.70 3.17±0.68 6.52±1.37
2.17±0.75 1.64±0.61 75.31±10.21 1.90±0.75 3.83±1.46
72.65±18.67 66.31±15.96
2.58±0.80 2.09±0.68 81.58±9.47 2.48±0.88 4.82±1.39
86.73±10.99 84.73±12.03
60.85±23.39 58.65±18.60
78.42±24.18 74.04±16.67
Conclusions: We observed in our study, the pulmonary hypertension due to mitral valve disease, a significant improvement in pulmonary functions occurs long period after mitral valve replacement in patients with pulmonary hypertension due to mitral valve disease. PP-082 ANTERIOR MITRAL VALVE PROLAPSE CONTRIBUTES TO MITRAL REGURGITATION AND PANIC DISORDER U. Ku¨ c¸ uk ¨ 1 , H.O. Ku¨ c¸ uk ¨ 2 . 1 G¨ ulhane Military Medical Academy Department of Cardiology, Ankara Turkey; 2 GAZI University Department of Cardiology, Ankara, Turkey; 3 Gulhane Military Medical Academy Haydarpasa Training Hospital Department of Cardiology, Ankara, Turkey Objective: The aim of this prospective study is to investigate the contribution of the anterior mitral leaflet prolapse to mitral regurgitation and panic disorder. Methods: Mitral valve prolapse is affecting 2.4 % of general population which shows similar prevalence, age and gender distribution and share common nonspecific symptoms with panic disorder. Ninety-six patients, who were finally diagnosed as having noncardiac chest pain with anterior mitral valve prolapse during the evaluation of chest pain, palpitation and fatigue were assessed for panic disorder. Results: From 96 patients with mitral valve prolapse (mean age 40±8 years), 46 (48%) had panic disorder and 32 (33%) had mitral regurgitation. Majority of the patients were female (53%). 48 % of the patients with panic disorder had mitral regurgitation. Among 32 patients with mitral regurgitation, 22 (69%) had panic disorder. The incidence of panic disorder in patients with mitral regurgitation was 69%. Among those with panic disorder, 48% had mitral regurgitation. There was a significant correlation between mitral regurgitation and panic disorder (p = 0.004). Conclusions: This study has demonstrated the possible contribution of the anterior mitral leaflet prolapse to mitral regurgitation and panic disorder. Panic disorder and mitral valve prolapse presents a co-morbidity, which deserves further clinical investigations. PP-083 THE ASSOSIATION OF VENTRICULER SEPTAL DEFECT AND AORTIC INSUFFIENCY IN OUR CASES ¨ un ¨ ur ¨ Ceylan1 , S. ¸ Kayalı1 , V. Do˘gan1 , M. Koc¸ 2 , U.A. Or ¨ 1 , S. Ozg ¨ 1 , O. M. Keskin1 , S. Karademir1 , A. Kutsal2 . 1 Department of Pediatric Cardiology, Dr Sami Ulus Maternity, Children Health and Diseases Training and Education Hospital, Ankara, Turkey; 2 Department of Cardiovascular Surgery, Dr Sami Ulus Maternity, Children Health and Diseases Training and Education Hospital, Ankara, Turkey Objective: Aortic insufficiency (AI) associated with ventricular septal defect (VSD), a well-known anatomical disorder. Pezzi Laubry defined for the first time in 1921 and the incidence varies between 2.5–8% of all VSD. It is more common seen in Asia and Far East. In these patients VSD shows subpulmoner or subcristal (perimembranous) placement. As AI is progressive, it is important to recognise the defect early and to make a right decision for surgical time. While some researchers are defending that only closure of VSD would be sufficient, the others defend valvuloplasty is also necessary. Between 2006–2011, 14 patients with VSD and AI were eveluated in our study. Mean age was 5.5 years (range 1.5 to 13 years). Nine of the patients were male, and 6 were female. The VSD was perimembranous in 13 patients and subpulmonary in 1. Aortic insufficiency was mild in 11 patient, moderate in 3. Eleven patients were operated in our hospital, 2 patient were clinically followed up because the aortic insuffiency was mild and one admitted other hospital for operation after diagnosis. Only closure of ventricular septal defect were performed in 6 patients and in 5 patients aortic