PP-177 Oxidative Preconditioning with Hyperbaric Oxygen Therapy Protects the Heart Against Drug Induced Cardiomyotoxicity

MARCH 10e13, 2016 exact prognostic value of the TG/HDL-C ratio, a marker for cardiovascular events, is currently unknown among Iranians so this study sought to determine the optimal cut-off point for the TG/HDL-C ratio in predicting CVD events in the Iranian population. Methods: The Isfahan Cohort Study (ICS) is an ongoing, longitudinal, population-based study that was originally conducted on adults aged 35 years or older, living in urban and rural areas of three districts in central Iran. After 10 years of follow-up, 5,431 participants were reevaluated using a standard protocol similar to the one used for baseline. At both measurements, participants underwent medical interviews, physical examinations, and fasting blood measurements. “High-risk” subjects were defined by the discrimination power of indices, which were assessed using receiver operating characteristic (ROC) analysis; the optimal cut-off point value for each index was then derived. Results: The mean age of the participants was 50.7
11.6 years. The TG/HDL-C ratio, at a threshold of 3.68, was used to screen for cardiovascular events among the study population. Subjects were divided into two groups (“low” and “high” risk) according to the TG/HDL-C concentration ratio at baseline. A slightly higher number of high-risk individuals were identified using the European cut-off points of 63.7% in comparison with the ICS cut-off points of 49.5%. The unadjusted hazard ratio (HR) was greatest in high-risk individuals identified by the ICS cut-off points (HR ¼ 1.54, 95% CI [1.33-1.79]) vs. European cut-off points (HR ¼ 1.38, 95% [1.17-1.63]). There were no remarkable changes after adjusting for differences in sex and age (HR ¼ 1.58, 95% CI [1.36-1.84] vs. HR ¼ 1.44, 95% CI [1.22-1.71]) for the ICS and European cut-off points, respectively. Conclusions: The threshold of TG/HDL  3.68 is the optimal cutoff point for predicting cardiovascular events in Iranian individuals.

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The Role of Thiol Disulphide Homeostasis in the Presence of Slow Coronary Flow. Harun Kundi1, Murat Gok1, Mustafa Cetin1, Emrullah Kiziltunc1, Canan Topcuoglu1, Salim Neselioglu2, Ozcan Erel2, Feridun Vasfi Ulusoy1, Ender Ornek1. 1Ankara Numune Education and Research Hospital; 2Yıldırım Beyazıt University, Biochemistry Department, Ankara, Turkey. Objective: The aim of this study was to investigate the role of thiol disulphide homeostasis in the presence of SCF. Material-Methods: In this cross-sectional study, a total of 110 patients, who admitted to our hospital between March 2014 and December 2015, were included in the study. Of these, 65 patients were the slow coronary flow and 45 patients were the normal coronary flow. Results: We found significant differences between slow coronary flow and the control groups for thiol disulphide homeostasis, and the results of our study indicated that hsCRP, and thiol disulphide ratio were independently associated with slow coronary flow. For predicting slow coronary flow, the cut-off value of thiol disulphide ratio was 18.5, with a sensitivity of 80.4% and a specificity of 76%.

Conclusion: Our study showed that thiol disulphide homeostasis was significantly and independently related to the presence of SCF.

- PP-176 Reliability and Validity of Timed Up and Go in Coronary Heart Disease and Heart Failure. Mohammed Khalaf Alanazi1, Basel Ahmad Alenazy1, Rakan Nazer2, Ali Albarrati2. 1College of medicine, King Saud University, Riyadh, Saudi Arabia; 2King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia. Introduction: Physical inactivity is associated with increased risk of morbidity and rate of mortality in patients with coronary heart disease (CHD) and Heart failure (HF). Various assessment method tools have been used to document the level of physical activity; however, they are not implemented in clinical practice due to limited resources. Timed Up and Go (TUG) test is a simple and reproducible measure of physical activity and has been validated in several populations. We hypothesised that the TUG test would be a reproducible and valid measure in patients with CHD and HF. Method: A group of patients with CHD and HF performed the TUG test as they were asked to get up from an unarmed chair, walk 3 meters and return back to the chair at their normal pace and time recorded in second. After familiarisation, patients were asked to perform the test on two separate occasions within the same day. Other outcome measures including six minute walking distance (6MWD) and body composition were also determined. Results: Twenty patients (10 with CHD and 10 with HF) with mean age (SD) 56 (11) had a TUG time of 14.6 (4.9) s on the first occasion and 14.5 s (4.7) on the second occasion. The 6MWD was 333 (108). Repeated measure analysis of variance showed no difference between patients measurement, p>0.05. Intraclass correlation was 0.98 (95%CI: 0.96-0.98) between the two tests. Mean error of measurement was 0.8 s. There was a high correlation between the TUG test and 6MWD, r¼-0.68, p<0.001. Conclusion: The TUG test demonstrated to be a reproducible and valid measure in patients with CHD and HF. The TUG test is an integrated measure of gait, balance and muscle strength and owing to its simplicity; it may serve as a screening tool for physical activity inside a cardiologist’s clinic. Comparing the TUG time recorded to the normal limit for such age category indicates that the patients with CHD or HF had reduced physical activity. Table 1 Characteristics of the patients. Variable

Mean

SD

Age (years) Height (m) Weight (Kg) BMI (kg/m2) 1st TUG (sec) 2nd TUG (sec) 6MWD (m)

56 1.70 76.2 26.4 14.6 14.5 333

11 6 17.7 5.8 4.9 4.7 108

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Figure. Graph shows a significantly negative correlation between thiol disulphide ratio values and corrected Timi Frame Count Graph showing a significant difference for thiol disulphide ratio values between the groups

Oxidative Preconditioning with Hyperbaric Oxygen Therapy Protects the Heart Against Drug Induced Cardiomyotoxicity. Orhan Tezcan1, Ahmet Çalıs¸kan1, Oguz Karahan1, Cenap Ekinci2, Celal Yavuz1, Sinan Demirtas¸1, Aysun Ekinci3. 1Department of Cardiovascular Surgery, Medical School of Dicle University, Diyarbakır, Turkey; 2Department of Histology, Medical School of Dicle University, Diyarbakır, Turkey; 3Department of Biochemistry, Medical School of Dicle University, Diyarbakır, Turkey.

S104 The American Journal of Cardiologyâ MARCH 10e13, 2016 12th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster

MARCH 10e13, 2016 Table 1 The levels of serum and cardiac oxidative markers in groups Groups I II III p

Serum TOS

Serum TAC

Serum OSI

Cardiac TOS

Cardiac TAC

Cardiac OSI

Cardiac MDA

65.81
20.88 382.07
67.82 183.95
29.75 .028

0.92
0.34 1.40
0.08 1.22
0.17 .048

0.71
0.05 2.55
0.68 1.49
0.026 .032

70.11
23.71 164.48
16.52 205.49
6.65 .034

0.64
0.20 0.88
0.12 0.82
0.09 .289

1.09
0.20 1.87
0.09 2.35
0.11 .034

5.04
0.87 6.65
1.22 11.92
1.37 .052

Group I: Control group; Group II:Doxorubicin group; Group III:HBO2þDoxorubicin group; TOS: Total oxidant status; TAC: Total antioxidant capacity; OSI: Oxidative stress index; MDA: malondialdehyde; p<0.05 is significant

Introduction: Drugs can lead to cardiomytoxic adverse effects. Doxorubicin can an important example such these drugs. Preventive methods are also investigated for protecting cardiomyocytes in patients who need to use cardiotoxic drugs. Therefore, we investigated the effects of hyperbaric oxygen (HBO2) therapy in experimental model with drug induced cardiotoxicity. Method: Four equal rat groups were created with 6 rats in each group. Control group is created for obtaining the basic serum oxidant levels and nature cardiac tissue of rat genus. Sham group was created for evaluating the HBO2 therapy effects alone (2.5 atmospheric 100% oxygen therapy, 90min/day for one week). Cardiotoxicity groups were created as group I (30 mg/kg single dose doxorubicin application), group II (2.5 atmospheric 100% oxygen therapy, 90min/day for one week before 30 mg/kg single dose doxorubicin application and 2.5 atmospheric 100% oxygen therapy, 90min/day for one week after drug application). After completion of protocols,

rats were venous blood samples and hearts were obtained from each groups. Findings: Despite the slightly increment found in sham group there is not any difference between control and sham group in regards of serum oxidative stress markers. The highest serum oxidative marker levels obtained in Group II. Nevertheless partially healthy myocardial tissue detected microscopically in this group. Although moderate oxidative stress marker increment determined in group I, the most obvious myocardial destruction was found in this group (p¼0.005). Conclusions: HBO2 can provide adoption in myocardial tissue by provocation of oxidative stress gradually. This scenario might be helpful the protection of myocardial tissue against doxorubicin induced cardiotoxicity.

Picture 1. Histopathology of normal rat myocardium, doxorubicin exposed myocardium and HBO2 preconditioning in doxorubicin exposed myocardium

- PP-178 Figure 1. a. Comparison of Serum Oxidative Stress Index Levels; b. Comparison of Cardiac Oxidative Stress Index Levels; OSI: Oxidative Stress Index Levels

Figure 2. Comparison of Cardiac Malondialdehyde Levels; MDA: Malondialdehyde

Total Bilirubin Levels Predict Subclinical Atherosclerosis in Patients with Prediabetes. Hikmet Hamur1, Hakan Duman2, Levent Demirtas3, Eftal Murat Bakirci1, Murtaza Emre Durakoglugil2, Husnu Degirmenci1, Kamuran Kalkan4, Erkan Yildirim4, Ertan Vuruskan5. 1 Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey; 2Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey; 3Department of Internal Medicine, Faculty of Medicine, Erzincan University, Erzincan, Turkey; 4 Department of Cardiology, Training and Research Hospital, Erzurum, Turkey; 5Department of Cardiology, Dr. Ersin Arslan State Hospital, Gaziantep, Turkey. Objective: Bilirubin has important anti-atherosclerotic effects. Prediabetes (PD), the intermediate stage before diabetes mellitus (DM), has increased cardiovascular morbidity and mortality similar to that of DM. We planned to evaluate the relationship between serum bilirubin levels and carotid intima-media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with PD. Methods: We enrolled 170 consecutive patients with PD. The patients underwent ultrasonography to evaluate cIMT. The patients were divided into groups according to cIMT values (<0.9 vs. 0.9 mm).

The American Journal of Cardiologyâ MARCH 10e13, 2016 12th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster S105

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