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Prediction of Heart Failure and Atrial Fibrillation Using the CHARGE-AF and ARIC Risk Scores
Abstracts
225 Pluripotent Stem Cell-Derived Mesenchymal Stem Cells Improve Cardiac Function and Reduce Scar Size Post MI S. Thavapalachandran 1,2,∗ , T. Le 2 , E. Kizana 1,2 , J. Chong 1,2 1 Westmead
Hospital, Sydney, Australia Institute for Medical Research, Sydney, Australia
2 Westmead
Introduction/Aim: Mesenchymal stem cells (MSCs) have been shown to improve cardiac function after injury and are already being tested in clinical trials. The aim of this study is to test the cardiac regenerative potential of pluripotent stem cell (PSC)-derived MSC population to structurally and functionally repair the rat heart after myocardial infarction (MI) and to benchmark this efficacy to bone marrow (BM) derived MSCs that are already in the clinical trials stages. Methods: MI of athymic male rats was induced by 60 min of ischaemia-reperfusion (I/R) injury. Four days after I/R, animals were randomly assigned to one of the three treatment groups: (i) PSC-derived MSCs group (n = 4; (ii) BM-derived MSCs group (n = 3); (iii) Control group–media alone (n = 4). A total of 5 × 106 cells were injected at three sites within the left ventricular wall. TTE was performed at baseline on Day 4 (prior to cell injection) and Day 28. Animals were euthanised on Day 28, and hearts were harvested to assess for engraftment and extent of scar. Results: There was no evidence of cell engraftment using immunostaining at Day 28 in the BM MSCs and PSC-derived MSCs groups. TTE assessments of the infarcted rats at baseline and 1 month after cell injection showed a significant global increase of fractional shortening (FS) in the PSCderived MSCs group (+5.5% of FS; p < 0.05). FS remained steady in the vehicle-injected hearts and decreased in the BM MSCs group (p = NS). There was also a reduction in scar size using PicroSirius Red staining in the PSC-derived MSCs treated group compared to the vehicle and BM-MSCs groups. Conclusion: PSC-derived MSCs show superiority over BM MSCs and vehicle in improving cardiac function 28 days after transplantation with reduction in scar size. http://dx.doi.org/10.1016/j.hlc.2017.06.226
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226 Prediction of Heart Failure and Atrial Fibrillation Using the CHARGE-AF and ARIC Risk Scores S. Ramkumar 1,3,∗ , H. Yang 2 , Y. Wang 2 , M. Nolan 2 , K. Negishi 2 , T. Marwick 1,2,3 1 Baker Heart And Diabetes Institute, Melbourne, Australia 2 Menzies Institute for Medical Research, Hobart, Australia 3 School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
Introduction: The CHARGE-AF score gives a 5-year atrial fibrillation(AF) risk assessment. Heart Failure(HF) risk can be assessed using the ARIC score. We aimed to compare the CHARGE-AF score to the ARIC score in prediction of HF and AF. Methods: A community based study of 503 participants(mean ± SD age 70.8 ± 4.7yrs,male 48% with median follow up 12 months) ≥ 65 years were recruited if they had presence of 1 or more risk factor. HF and AF risk was assessed using the CHARGE-AF and ARIC scores. ECG/echocardiography was performed and HF was diagnosed as per ESC guidelines. AF was diagnosed by local doctors, by 12 lead ECG during outpatient clinics or using a portable ECG monitoring device(5 × 1 min daily recordings over 1 week). ROC curves were compared between both scores using the Hanley and McNeil method. Results: During the follow-up period 55 patients developed HF. 173/503 participants completed follow-up for AF of which 43(25%) were newly diagnosed. Patients with HF were older with higher rates of diabetes and hypertension(p < 0.05). Patients with AF were older and had higher CHARGE-AF score(p < 0.05). In patients with HF and AF, echocardiography showed impaired global longitudinal strain and increased LA volume(p < 0.05). For HF and AF, there was only modest discriminative ability with no significant difference in the AUC between both scores(Table). Conclusion: The CHARGE-AF score is a useful clinical tool in predicting both HF and AF in patients with risk factors. Table 1. AUC CHARGEAF
95% C.I p Value
HF
0.65
0.58-0.73, p < 0.001
AF
0.61
0.51-0.71, p = 0.04
AUC ARIC
95% C.I p Value
Comparison of AUC (p)
0.65
0.58-0.73, p < 0.001
0.89
0.59
0.48-0.69, p = 0.11
0.77
......................
http://dx.doi.org/10.1016/j.hlc.2017.06.227
225 Pluripotent Stem Cell-Derived Mesenchymal Stem Cells Improve Cardiac Function and Reduce Scar Size Post MI S. Thavapalachandran 1,2,∗ , T. Le 2 , E. Kizana 1,2 , J. Chong 1,2 1 Westmead
Hospital, Sydney, Australia Institute for Medical Research, Sydney, Australia
2 Westmead
Introduction/Aim: Mesenchymal stem cells (MSCs) have been shown to improve cardiac function after injury and are already being tested in clinical trials. The aim of this study is to test the cardiac regenerative potential of pluripotent stem cell (PSC)-derived MSC population to structurally and functionally repair the rat heart after myocardial infarction (MI) and to benchmark this efficacy to bone marrow (BM) derived MSCs that are already in the clinical trials stages. Methods: MI of athymic male rats was induced by 60 min of ischaemia-reperfusion (I/R) injury. Four days after I/R, animals were randomly assigned to one of the three treatment groups: (i) PSC-derived MSCs group (n = 4; (ii) BM-derived MSCs group (n = 3); (iii) Control group–media alone (n = 4). A total of 5 × 106 cells were injected at three sites within the left ventricular wall. TTE was performed at baseline on Day 4 (prior to cell injection) and Day 28. Animals were euthanised on Day 28, and hearts were harvested to assess for engraftment and extent of scar. Results: There was no evidence of cell engraftment using immunostaining at Day 28 in the BM MSCs and PSC-derived MSCs groups. TTE assessments of the infarcted rats at baseline and 1 month after cell injection showed a significant global increase of fractional shortening (FS) in the PSCderived MSCs group (+5.5% of FS; p < 0.05). FS remained steady in the vehicle-injected hearts and decreased in the BM MSCs group (p = NS). There was also a reduction in scar size using PicroSirius Red staining in the PSC-derived MSCs treated group compared to the vehicle and BM-MSCs groups. Conclusion: PSC-derived MSCs show superiority over BM MSCs and vehicle in improving cardiac function 28 days after transplantation with reduction in scar size. http://dx.doi.org/10.1016/j.hlc.2017.06.226
S143
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226 Prediction of Heart Failure and Atrial Fibrillation Using the CHARGE-AF and ARIC Risk Scores S. Ramkumar 1,3,∗ , H. Yang 2 , Y. Wang 2 , M. Nolan 2 , K. Negishi 2 , T. Marwick 1,2,3 1 Baker Heart And Diabetes Institute, Melbourne, Australia 2 Menzies Institute for Medical Research, Hobart, Australia 3 School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
Introduction: The CHARGE-AF score gives a 5-year atrial fibrillation(AF) risk assessment. Heart Failure(HF) risk can be assessed using the ARIC score. We aimed to compare the CHARGE-AF score to the ARIC score in prediction of HF and AF. Methods: A community based study of 503 participants(mean ± SD age 70.8 ± 4.7yrs,male 48% with median follow up 12 months) ≥ 65 years were recruited if they had presence of 1 or more risk factor. HF and AF risk was assessed using the CHARGE-AF and ARIC scores. ECG/echocardiography was performed and HF was diagnosed as per ESC guidelines. AF was diagnosed by local doctors, by 12 lead ECG during outpatient clinics or using a portable ECG monitoring device(5 × 1 min daily recordings over 1 week). ROC curves were compared between both scores using the Hanley and McNeil method. Results: During the follow-up period 55 patients developed HF. 173/503 participants completed follow-up for AF of which 43(25%) were newly diagnosed. Patients with HF were older with higher rates of diabetes and hypertension(p < 0.05). Patients with AF were older and had higher CHARGE-AF score(p < 0.05). In patients with HF and AF, echocardiography showed impaired global longitudinal strain and increased LA volume(p < 0.05). For HF and AF, there was only modest discriminative ability with no significant difference in the AUC between both scores(Table). Conclusion: The CHARGE-AF score is a useful clinical tool in predicting both HF and AF in patients with risk factors. Table 1. AUC CHARGEAF
95% C.I p Value
HF
0.65
0.58-0.73, p < 0.001
AF
0.61
0.51-0.71, p = 0.04
AUC ARIC
95% C.I p Value
Comparison of AUC (p)
0.65
0.58-0.73, p < 0.001
0.89
0.59
0.48-0.69, p = 0.11
0.77
......................
http://dx.doi.org/10.1016/j.hlc.2017.06.227