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PP-158 A Case of Infective Endocarditis Resulting from Brucella Melitensis
MARCH 26e29, 2015 Table Inflammatory parameters between groups Group I (mild& moderate OSAS) n:103 Red blood cell count, 10000/mm3 Leukocyte count, 10000/mm3 Neutrophil count, 10000/mm3 Lymphocyte count, 10000/mm3 Neutrophil to lymphocyte ratio (NLR) C-reactive protein, mg/L
5.20 7.74 4.44 2.63 1.75
0.45 2.25 1.45 0.62 0.67
4.90
Group II (severe OSAS) n:89 5.28 8.41 5.03 2.68 2.02
0.45 2.29 1.85 0.77 0.89
9.31
p
- PP-158 0.24 0.045 0.015 0.63 0.021 0.001
(CRP)(p:0.002), leukocyte (p:0.045), neutrophil count (p:0.015), and NLR (p:0.021)(Table). Higher CRP levels significantly correlated with AHI, body mass index (BMI), and NLR. Multivariate regression analysis demonstrated higher NLR (p¼0.001) and BMI (p¼0.004) were independent predictors of increased inflammation. Conclusion: NLR may become a simple determinant of increased inflammation in patients having OSAS.
- PP-157
P O S T E R A B S T R A C T S
commonly used parameters for the evaluation of the patients receiving chemotherapy but diastolic functions are effected earlier than the systolic functions. As a results diastolic parameters should also be evaluated for these patients who had or have anthracycline therapy.
Anthracycline-induced Cardiomyopathy in Children: A Report of Five Cases. Özkan Kaya1, Ilker Ertugrul1, S¸eyma Kayalı1, Tamer Yoldas¸1, Vehbi Dogan1, Senem Özgür1, Onur Çandır2, Utku Arman Örün1, Selmin Karademir1. 1Dr. Sami Ulus Obstetrics and Pediatrics Research and Education Hospital, Pediatric Cardiology; 2Dr. Sami Ulus Obstetrics and Pediatrics Research and Education Hospital, Pediatric Oncology. Cardiomyopathies are the primary diseases of the myocardium. The most common type of them is dilated cardiomyopathy (DCM) characterized by diminished systolic functions associated with dilatation of ventricles most commonly left ventricle. Etiologies responsible for the DCM can be listed as idiopathic, genetic, viral, immune, toxins, drugs, and ischemia. Anthracyclines used for treatment of the leukemia and lymphoma have cardio toxic side effects. They are responsible from mortality and morbidity during acute, subacute, and chronic phase of the disease. Here in we want to emphasize the importance of anthracycline toxicity that may lead to mortality and morbidity during adolescence or adult life after survival of these malignancies during childhood period. This was a report of 5 pediatric patients who DCM detected during or after the anthracycline therapy. The ages of patients were between 8-14 years. The diagnosis of primary malignancies was lymphoma in two cases, osteosarcoma, neuroendocrine tumor, Ewing’s sarcoma in the other cases. Cumulative anthracycline dosage was between 210-480 mg/m2 (median 420 mg/m2). Time between diagnosis of DCM and administration of chemotherapy ranging between 11-34 months (median 24 months). These patients were medically stable but one patient who is referred for transplantation. All patients were receiving ACEI and diuretic treatments. Digoxin was prescribed for two patients and carvedilol for one. The mean duration of follow up was 5,5 years (2,5-9 years). One patient who diagnosed after 210 mg/m2 of anthracycline was also reviewing cyclosporine that increase toxicity of anthracycline. Left ventricular functions and dilatation was reversible in that patient. Congestive heart failure and cardiomyopathy has been reported in patients receiving anthracycline as 4-36% and 1-30% respectively depending on treatment protocol, diagnosis, age of the patients. Systolic and diastolic functions and dimensions of the heart can be evaluated by echocardiography. Left ventricular ejection fraction and shortening fraction is the most
A Case of Infective Endocarditis Resulting from Brucella Melitensis. Serkan Akdag1, Koray Celal Demirel1, Aytac Akyol1, Müntecep Asker1, Ali Kemal Gör2, Hasan Ali Gümrükçüoglu1, Musa Sahin1, Hakkı Simsek1, Naci Babat1, Mustafa Tuncer1. 1Department of Cardiology, Yüzüncü Yıl University, Van, Turkey; 2Department of Cardiovascular Surgery, Yüzüncü Yıl University, Van, Turkey. Brucellosis is a zoonotic disease endemically seen in Turkey, which occurs with various clinical findings. Brucella endocarditis is associated with high morbidity and mortality. It can lead to complications affecting many systems. Endocarditis is an infrequent, but serious complication of brucellosis. 32- years- old famale patient was admitted to our emergency department complaining with ongoing fever 8 days, dyspnea, and fatigue. There wasn’t diseases known his history. She had recently consumed fresh cheese. On his physical examination, 38.8 C fever was noted and blood pressure 110/60 mmHg, heart rate 92 beats/min, were rhythmic. The number of white blood cell count (WBC) and C-reaktive protein (CRP) level were found 18,000/mm3 and 152 mg/dl, respectively. Brucella agglutination titer was positive at 1/320. B. Melitensis was isolated from _ her transthoracic echocardiography blood cultures in the eighth day. In showed rheumatic mitral valve, severe mitral regurgitation, and a 24x16 mm in diameter on the movable cover vegetation on the mitral valve. The patient was consulted with infectious diseases and cardiovascular surgery, medical treatment was started and surgical operation was planned.
Figure. Vegetation on the mitral valve.
- PP-159 Assessment of Copeptin Levels in Hypertrophic Cardiomyopathy. Irfan Sahin1, Berk Ozkaynak2, Baris Gungor3, Fatih Uzun4, Suat Hayri Küçük5, Burak Ayca1, Ilhan Ilker Avci1, Ertugrul Okuyan1, Sukru Cetın Cetin1, Mustafa Hakan Dinckal1. 1Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey; 2Department of Cardiolovascular Surgery, Bagcılar Research and Education Hospital, Istanbul, Turkey; 3 Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey; 4 Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 5Department of Biochemistry, Bagcılar Research and Education Hospital, Istanbul, Turkey. Objective: Correlation of increased copeptin levels with various cardiovascular diseases has been described. The correlation of copeptin
S166 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster
5.20 7.74 4.44 2.63 1.75
0.45 2.25 1.45 0.62 0.67
4.90
Group II (severe OSAS) n:89 5.28 8.41 5.03 2.68 2.02
0.45 2.29 1.85 0.77 0.89
9.31
p
- PP-158 0.24 0.045 0.015 0.63 0.021 0.001
(CRP)(p:0.002), leukocyte (p:0.045), neutrophil count (p:0.015), and NLR (p:0.021)(Table). Higher CRP levels significantly correlated with AHI, body mass index (BMI), and NLR. Multivariate regression analysis demonstrated higher NLR (p¼0.001) and BMI (p¼0.004) were independent predictors of increased inflammation. Conclusion: NLR may become a simple determinant of increased inflammation in patients having OSAS.
- PP-157
P O S T E R A B S T R A C T S
commonly used parameters for the evaluation of the patients receiving chemotherapy but diastolic functions are effected earlier than the systolic functions. As a results diastolic parameters should also be evaluated for these patients who had or have anthracycline therapy.
Anthracycline-induced Cardiomyopathy in Children: A Report of Five Cases. Özkan Kaya1, Ilker Ertugrul1, S¸eyma Kayalı1, Tamer Yoldas¸1, Vehbi Dogan1, Senem Özgür1, Onur Çandır2, Utku Arman Örün1, Selmin Karademir1. 1Dr. Sami Ulus Obstetrics and Pediatrics Research and Education Hospital, Pediatric Cardiology; 2Dr. Sami Ulus Obstetrics and Pediatrics Research and Education Hospital, Pediatric Oncology. Cardiomyopathies are the primary diseases of the myocardium. The most common type of them is dilated cardiomyopathy (DCM) characterized by diminished systolic functions associated with dilatation of ventricles most commonly left ventricle. Etiologies responsible for the DCM can be listed as idiopathic, genetic, viral, immune, toxins, drugs, and ischemia. Anthracyclines used for treatment of the leukemia and lymphoma have cardio toxic side effects. They are responsible from mortality and morbidity during acute, subacute, and chronic phase of the disease. Here in we want to emphasize the importance of anthracycline toxicity that may lead to mortality and morbidity during adolescence or adult life after survival of these malignancies during childhood period. This was a report of 5 pediatric patients who DCM detected during or after the anthracycline therapy. The ages of patients were between 8-14 years. The diagnosis of primary malignancies was lymphoma in two cases, osteosarcoma, neuroendocrine tumor, Ewing’s sarcoma in the other cases. Cumulative anthracycline dosage was between 210-480 mg/m2 (median 420 mg/m2). Time between diagnosis of DCM and administration of chemotherapy ranging between 11-34 months (median 24 months). These patients were medically stable but one patient who is referred for transplantation. All patients were receiving ACEI and diuretic treatments. Digoxin was prescribed for two patients and carvedilol for one. The mean duration of follow up was 5,5 years (2,5-9 years). One patient who diagnosed after 210 mg/m2 of anthracycline was also reviewing cyclosporine that increase toxicity of anthracycline. Left ventricular functions and dilatation was reversible in that patient. Congestive heart failure and cardiomyopathy has been reported in patients receiving anthracycline as 4-36% and 1-30% respectively depending on treatment protocol, diagnosis, age of the patients. Systolic and diastolic functions and dimensions of the heart can be evaluated by echocardiography. Left ventricular ejection fraction and shortening fraction is the most
A Case of Infective Endocarditis Resulting from Brucella Melitensis. Serkan Akdag1, Koray Celal Demirel1, Aytac Akyol1, Müntecep Asker1, Ali Kemal Gör2, Hasan Ali Gümrükçüoglu1, Musa Sahin1, Hakkı Simsek1, Naci Babat1, Mustafa Tuncer1. 1Department of Cardiology, Yüzüncü Yıl University, Van, Turkey; 2Department of Cardiovascular Surgery, Yüzüncü Yıl University, Van, Turkey. Brucellosis is a zoonotic disease endemically seen in Turkey, which occurs with various clinical findings. Brucella endocarditis is associated with high morbidity and mortality. It can lead to complications affecting many systems. Endocarditis is an infrequent, but serious complication of brucellosis. 32- years- old famale patient was admitted to our emergency department complaining with ongoing fever 8 days, dyspnea, and fatigue. There wasn’t diseases known his history. She had recently consumed fresh cheese. On his physical examination, 38.8 C fever was noted and blood pressure 110/60 mmHg, heart rate 92 beats/min, were rhythmic. The number of white blood cell count (WBC) and C-reaktive protein (CRP) level were found 18,000/mm3 and 152 mg/dl, respectively. Brucella agglutination titer was positive at 1/320. B. Melitensis was isolated from _ her transthoracic echocardiography blood cultures in the eighth day. In showed rheumatic mitral valve, severe mitral regurgitation, and a 24x16 mm in diameter on the movable cover vegetation on the mitral valve. The patient was consulted with infectious diseases and cardiovascular surgery, medical treatment was started and surgical operation was planned.
Figure. Vegetation on the mitral valve.
- PP-159 Assessment of Copeptin Levels in Hypertrophic Cardiomyopathy. Irfan Sahin1, Berk Ozkaynak2, Baris Gungor3, Fatih Uzun4, Suat Hayri Küçük5, Burak Ayca1, Ilhan Ilker Avci1, Ertugrul Okuyan1, Sukru Cetın Cetin1, Mustafa Hakan Dinckal1. 1Department of Cardiology, Bagcılar Research and Education Hospital, Istanbul, Turkey; 2Department of Cardiolovascular Surgery, Bagcılar Research and Education Hospital, Istanbul, Turkey; 3 Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey; 4 Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 5Department of Biochemistry, Bagcılar Research and Education Hospital, Istanbul, Turkey. Objective: Correlation of increased copeptin levels with various cardiovascular diseases has been described. The correlation of copeptin
S166 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster