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Predictors of mortality amongst recipients of implantable cardioverter defibrillators for secondary prevention of cardiac arrest
POSTER PRESENTATIONS
Poster Presentations Correlation between morphological and functional changes, life quality and ventricular dysrhythmias in patients with dilated cardiomyopathy
Predictors of mortality amongst recipients of implantable cardioverter defibrillators for secondary prevention of cardiac arrest
Timur Abdullaev ∗ , Ilkham Ikramov, Nurali Kurbanov, Bakhodir Mardanov
Sunil Agarwal a,b,∗ , Ish Singla a,b , Haitham Hreybe a,b , Samir Saba a,b
Republican Specialized Center of Cardiology Aim: To study association between the prevalence and nature of ventricular arrhythmia (VA) and clinical and functional characteristics in DC patients. Methods: Clinical examination, Holter’s ECG monitoring (HECGM), echocardiography with ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), ESP/ESV (where ESP is end-diastolic pressure) measuring, life quality (LQ) by LWHF-questionnaire. Results: A total of 106 DC patients aged 16–61 (mean age 41.9 ± 0.5) years were evaluated. Patients were assigned to two groups: group I was composed of 63 patient with grade II VE and group 2 was composed of 43 patients with grade IVA and IVB VE. The disease duration as assessed on examination ranged from 1 month to 6 years. Ventricular extrasystoles (VE) as form of HRD were detected in 102 (96%) patients. Frequency of VE ranged from 1 to 1850 (mean 157.01 ± 34.24) VE per hour. High-grade VE were observed in 41 (40.2%) patients. Analysis of correlation between the prevalence and severity of HF symptoms showed that clinical manifestations, such as syncopes (100 and 0%), dizziness (39 and 18%), dyspnoea (83 and 47%) at rest and weight loss (38 and 68%), are significantly more common when concomitant high-grade VA are present. Markedly compromised haemodynamics in both systemic and pulmonary circulation, which correspond with NYHA HF grades III and IV (÷2 = 6.004, p < 0.05) were significantly more frequent in patient with high-grade VA. Evident differences, revealed by LQ analysis, showed, that total LQ point in patients with complex VE was substantially and significantly higher than in control group (80.33 ± 1.74 vs. 64.71 ± 3.85 respectively, p < 0.01). Conclusions: DC patients with complex forms of arrhythmia have significantly increased myocardial dimensions, associated with severity clinical and functional characteristics (syncopes, dizziness, dyspnoea at rest and weight loss), which determine lower LQ in these patients. doi:10.1016/j.hlc.2007.11.009
a University b University
of North Carolina at Chapel Hill, NC, USA of Pittsburgh Medical Center, PA, USA
Background: Implantable cardioverter-defibrillators (ICD) reduce mortality in survivors of cardiac arrest (CA). We investigated the predictors of mortality after ICD implantation in survivors of CA. Methods: Retrospective review of electronic clinical records and social security death index of all patients who received ICD implant subsequent to acute myocardial infarction and CA and a random sample of patients with CA only, matched by age, gender, and myocardial function. Univariate analyses followed by multivariate Cox proportional hazard model, with backward elimination were used to identify predictors, and Kaplan–Meier curves were plotted. Results: 80 patients (64 males) with a mean (±S.D.) age of 64.4 ± 12.5 years were followed for 4.7 ± 2.3 years after ICD implantation. Survival rates were 93.8%, 65% and 50% at 1, 5, and 10 years, respectively. Independent predictors of time to death were determined to include age (hazard ratio (HR) = 1.91 per year increase, p = 0.003), serum creatinine, d 1.3 mg/dL (HR = 2.56, p = 0.004), and QRS complex > 120 ms (HR = 5.14, p = 0.012). Conclusions: In this sample of ICD recipients secondary to CA, age, serum creatinine and QRS duration were independent predictors of mortality. The coexistence of two or more of these risk factors confers a higher mortality risk. Whether interventions such as biventricular pacing can offset this increase risk of death warrants research. doi:10.1016/j.hlc.2007.11.010 The protective effect of a purified extract of Withania somnifera against doxorubicin-induced cardiac toxicity in rats Amr Amin ∗ , Alaa Hamza UAE University The therapeutic value of doxorubicin as an effective antineoplastic agent is limited by its cardiotoxic side effects. The administration of doxorubicin (10 mg/kg) to male Wistar rats induced necrosis and apoptosis in heart tissues. It also caused oxidative stress damage as evidenced 1443-9506/04/$30.00
Poster Presentations Correlation between morphological and functional changes, life quality and ventricular dysrhythmias in patients with dilated cardiomyopathy
Predictors of mortality amongst recipients of implantable cardioverter defibrillators for secondary prevention of cardiac arrest
Timur Abdullaev ∗ , Ilkham Ikramov, Nurali Kurbanov, Bakhodir Mardanov
Sunil Agarwal a,b,∗ , Ish Singla a,b , Haitham Hreybe a,b , Samir Saba a,b
Republican Specialized Center of Cardiology Aim: To study association between the prevalence and nature of ventricular arrhythmia (VA) and clinical and functional characteristics in DC patients. Methods: Clinical examination, Holter’s ECG monitoring (HECGM), echocardiography with ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), ESP/ESV (where ESP is end-diastolic pressure) measuring, life quality (LQ) by LWHF-questionnaire. Results: A total of 106 DC patients aged 16–61 (mean age 41.9 ± 0.5) years were evaluated. Patients were assigned to two groups: group I was composed of 63 patient with grade II VE and group 2 was composed of 43 patients with grade IVA and IVB VE. The disease duration as assessed on examination ranged from 1 month to 6 years. Ventricular extrasystoles (VE) as form of HRD were detected in 102 (96%) patients. Frequency of VE ranged from 1 to 1850 (mean 157.01 ± 34.24) VE per hour. High-grade VE were observed in 41 (40.2%) patients. Analysis of correlation between the prevalence and severity of HF symptoms showed that clinical manifestations, such as syncopes (100 and 0%), dizziness (39 and 18%), dyspnoea (83 and 47%) at rest and weight loss (38 and 68%), are significantly more common when concomitant high-grade VA are present. Markedly compromised haemodynamics in both systemic and pulmonary circulation, which correspond with NYHA HF grades III and IV (÷2 = 6.004, p < 0.05) were significantly more frequent in patient with high-grade VA. Evident differences, revealed by LQ analysis, showed, that total LQ point in patients with complex VE was substantially and significantly higher than in control group (80.33 ± 1.74 vs. 64.71 ± 3.85 respectively, p < 0.01). Conclusions: DC patients with complex forms of arrhythmia have significantly increased myocardial dimensions, associated with severity clinical and functional characteristics (syncopes, dizziness, dyspnoea at rest and weight loss), which determine lower LQ in these patients. doi:10.1016/j.hlc.2007.11.009
a University b University
of North Carolina at Chapel Hill, NC, USA of Pittsburgh Medical Center, PA, USA
Background: Implantable cardioverter-defibrillators (ICD) reduce mortality in survivors of cardiac arrest (CA). We investigated the predictors of mortality after ICD implantation in survivors of CA. Methods: Retrospective review of electronic clinical records and social security death index of all patients who received ICD implant subsequent to acute myocardial infarction and CA and a random sample of patients with CA only, matched by age, gender, and myocardial function. Univariate analyses followed by multivariate Cox proportional hazard model, with backward elimination were used to identify predictors, and Kaplan–Meier curves were plotted. Results: 80 patients (64 males) with a mean (±S.D.) age of 64.4 ± 12.5 years were followed for 4.7 ± 2.3 years after ICD implantation. Survival rates were 93.8%, 65% and 50% at 1, 5, and 10 years, respectively. Independent predictors of time to death were determined to include age (hazard ratio (HR) = 1.91 per year increase, p = 0.003), serum creatinine, d 1.3 mg/dL (HR = 2.56, p = 0.004), and QRS complex > 120 ms (HR = 5.14, p = 0.012). Conclusions: In this sample of ICD recipients secondary to CA, age, serum creatinine and QRS duration were independent predictors of mortality. The coexistence of two or more of these risk factors confers a higher mortality risk. Whether interventions such as biventricular pacing can offset this increase risk of death warrants research. doi:10.1016/j.hlc.2007.11.010 The protective effect of a purified extract of Withania somnifera against doxorubicin-induced cardiac toxicity in rats Amr Amin ∗ , Alaa Hamza UAE University The therapeutic value of doxorubicin as an effective antineoplastic agent is limited by its cardiotoxic side effects. The administration of doxorubicin (10 mg/kg) to male Wistar rats induced necrosis and apoptosis in heart tissues. It also caused oxidative stress damage as evidenced 1443-9506/04/$30.00