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Prognostic value of NT-proBNP in Algerian patients with asymptomatic aortic stenosis
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Prognostic value of NT-proBNP in Algerian patients with asymptomatic aortic stenosis H. Foudad ∗ , I. Bouaguel , A. Trichine Service de cardiologie, hôpital militaire universitaire, Constantine, Algeria ∗ Corresponding author. E-mail address: [email protected] (H. Foudad) Introduction and objectives Aortic stenosis (AS) is the most common valve disease. Aortic valve replacement (AVR) is the treatment of choice in symptomatic patients with severe AS. Our objective was to assess the prognostic value of NT-proBNP in Algerian patients with asymptomatic moderate/severe aortic. Methods Prospective study of 305 patients with degenerative asymptomatic moderate/severe aortic stenosis. NT-proBNP was determined in all patients, who were then followed up clinically. A clinical event was defined as surgery, hospital admission due to angina, heart failure or syncope, or death. Results A total of 51% were women, and the mean age was 73 years. Mean (SD) echocardiographic values were as follows: peak velocity 4.14 (0.87) m/s; mean gradient, 43.2 (16.0) mmHg; aortic valve area, 0.87 (0.72) cm2 , and aortic valve area index, 0.49 (0.14) cm2 /m2 . The median NT-pro-BNP value was 490.0 [198.0—1312.0] pg/mL. There were 182 events during followup (median 12 months). The optimum NT-proBNP cut-point was 515 pg/mL, giving event-free survival rates at 6 months and 1 years of 93% and 57%, respectively, in patients with NT-proBNP < 515 pg/mL compared with 50% and 31% in those with NT-proBNP > 515 pg/mL. Conclusions NT-proBNP determination provides prognostic information in patients with asymptomatic moderate/severe aortic stenosis. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.270 393
What are the clinical and angiographic features of the coronary artery disease in postmenopausal women K. Kharbouche ∗ , S. Khaddi , L. Azouzi , R. Habbal Service de cardiologie, hôpital Ibn Roche Casablanca, Casablanca, Morocco ∗ Corresponding author. E-mail address: [email protected] (K. Kharbouche) Background The menopause marks an evolutionary turning point in women’s health. It is widely accepted that the risk for coronary artery disease (CAD) of premenopausal women is low because of hormone protection. CAD is the leading cause of morbidity and mortality in women after the age of 50 years. The aim of our study is to analyze the clinical and angiographic characteristics of postmenopausal women with CAD. Materiels and methods A total of 87 postmenopausal women (over 50 years) and 68 premenopausal women who underwent coronary angiography in Ibn Roche Center of Cardiology from June to December 2014 were enrolled. The clinical data and coronary angiographic characteristics (presence, localization, length and severity) were compared between the premenopausal and postmenopausal CAD groups. Results Postmenopausal CAD patients presented more frequently with hypertension, diabetes mellitus and dyslipidemia compared with premenopausal CAD patients (66.0% vs. 55.0%, 31.5% vs. 15.0%, 37.4% vs. 23.9%, respectively; all P < 0.05). Although we found more frequent involvement of single vessel in premenopausal CAD (43.2%
04-Valvular heart disease and general cardiology vs. 26.9%, P = 0), and triple vessels in postmenopausal CAD patients (33.8% vs. 20.4%, P = 0), much more severe lesions (> or = 90%) at left main (2.9% vs. 1.1%, P = 0.048) and proximal left anterior descending artery (LAD) (28.2% vs. 16.6%, P = 0) in the postmenopausal CAD group were found. Conclusion Postmenopausal patients frequently combine many risk factors, and comorbidities that impact the prognosis, also their angiographic status was characterized by the spread and complexity of the coronary disease. The estrogen deficiency could be a physiopathological explanation for these results. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.271 092
Complications of repeat percutaneous mitral valvuloplasty S. Fennira , S. Hannachi , M. Tekaya ∗ , S. Antit , S. Kamoun , S. Kraiem Department of cardiology, Habib thameur hospital, Tunis, Tunisia ∗ Corresponding author. E-mail address: [email protected] (M. Tekaya) Background Percutaneous mitral valvuloplasty (PMV) has emerged as the procedure of choice in treatment of mitral stenosis and has proved effectiveness in cases of mitral restenosis after surgical commissurotomy Compared with surgery, PMV is associated with shorter hospital stays, reduced patient discomfort, and significantly lower costs. However, it is unknown whether patients who developed symptomatic mitral restenosis after PMV may benefit from repeat PMV (re-PMV) with safety. Objectives This study was designed to evaluate the occurrence rate and the predictive factors for severe complications following re-PMV. Methods Retrospective study from a series of 40 procedures of re-PMV with the Inoue balloon at 8 ± 4 years after prior procedure. A clinical and ultrasound follow-up was achieved in 31 patients with a mean follow-up period of 43 ± 26 months. Results The mean age of patients was 43 ± 11 years [23; 63], 87,5% of the population being female (5 men and 35 women). The immediate procedural success was achieved in 31 patients (77.5%). A severe mitral regurgitation (MR) was observed in 3 patients (7.5%). A cerebrovascular stroke occurred in 1 patient (2.5%). No procedurerelated death or cardiac tamponade were noted. Only a left atrial area ≤ 25 cm2 was linked to high risk of severe MR. At long-term, mitral restenosis was observed in 13 patients (42%) at 53 ± 30 months [9; 128] after re-PMV, 2 patients presented thromboembolic events (6%) and no death. Only the male had been identified as a predictor of restenosis. Conclusion The feasibility of re-PMV with a relatively high procedural success rate and an acceptable complication profile makes it an appealing therapeutic strategy for patients with recurrent valve stenosis. The improved experience of our medical teams, and the systematic use of transoesophageal echocardiography to detect thrombi explain the low incidence of the complications of re-PMV in our study. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.272
Prognostic value of NT-proBNP in Algerian patients with asymptomatic aortic stenosis H. Foudad ∗ , I. Bouaguel , A. Trichine Service de cardiologie, hôpital militaire universitaire, Constantine, Algeria ∗ Corresponding author. E-mail address: [email protected] (H. Foudad) Introduction and objectives Aortic stenosis (AS) is the most common valve disease. Aortic valve replacement (AVR) is the treatment of choice in symptomatic patients with severe AS. Our objective was to assess the prognostic value of NT-proBNP in Algerian patients with asymptomatic moderate/severe aortic. Methods Prospective study of 305 patients with degenerative asymptomatic moderate/severe aortic stenosis. NT-proBNP was determined in all patients, who were then followed up clinically. A clinical event was defined as surgery, hospital admission due to angina, heart failure or syncope, or death. Results A total of 51% were women, and the mean age was 73 years. Mean (SD) echocardiographic values were as follows: peak velocity 4.14 (0.87) m/s; mean gradient, 43.2 (16.0) mmHg; aortic valve area, 0.87 (0.72) cm2 , and aortic valve area index, 0.49 (0.14) cm2 /m2 . The median NT-pro-BNP value was 490.0 [198.0—1312.0] pg/mL. There were 182 events during followup (median 12 months). The optimum NT-proBNP cut-point was 515 pg/mL, giving event-free survival rates at 6 months and 1 years of 93% and 57%, respectively, in patients with NT-proBNP < 515 pg/mL compared with 50% and 31% in those with NT-proBNP > 515 pg/mL. Conclusions NT-proBNP determination provides prognostic information in patients with asymptomatic moderate/severe aortic stenosis. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.270 393
What are the clinical and angiographic features of the coronary artery disease in postmenopausal women K. Kharbouche ∗ , S. Khaddi , L. Azouzi , R. Habbal Service de cardiologie, hôpital Ibn Roche Casablanca, Casablanca, Morocco ∗ Corresponding author. E-mail address: [email protected] (K. Kharbouche) Background The menopause marks an evolutionary turning point in women’s health. It is widely accepted that the risk for coronary artery disease (CAD) of premenopausal women is low because of hormone protection. CAD is the leading cause of morbidity and mortality in women after the age of 50 years. The aim of our study is to analyze the clinical and angiographic characteristics of postmenopausal women with CAD. Materiels and methods A total of 87 postmenopausal women (over 50 years) and 68 premenopausal women who underwent coronary angiography in Ibn Roche Center of Cardiology from June to December 2014 were enrolled. The clinical data and coronary angiographic characteristics (presence, localization, length and severity) were compared between the premenopausal and postmenopausal CAD groups. Results Postmenopausal CAD patients presented more frequently with hypertension, diabetes mellitus and dyslipidemia compared with premenopausal CAD patients (66.0% vs. 55.0%, 31.5% vs. 15.0%, 37.4% vs. 23.9%, respectively; all P < 0.05). Although we found more frequent involvement of single vessel in premenopausal CAD (43.2%
04-Valvular heart disease and general cardiology vs. 26.9%, P = 0), and triple vessels in postmenopausal CAD patients (33.8% vs. 20.4%, P = 0), much more severe lesions (> or = 90%) at left main (2.9% vs. 1.1%, P = 0.048) and proximal left anterior descending artery (LAD) (28.2% vs. 16.6%, P = 0) in the postmenopausal CAD group were found. Conclusion Postmenopausal patients frequently combine many risk factors, and comorbidities that impact the prognosis, also their angiographic status was characterized by the spread and complexity of the coronary disease. The estrogen deficiency could be a physiopathological explanation for these results. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.271 092
Complications of repeat percutaneous mitral valvuloplasty S. Fennira , S. Hannachi , M. Tekaya ∗ , S. Antit , S. Kamoun , S. Kraiem Department of cardiology, Habib thameur hospital, Tunis, Tunisia ∗ Corresponding author. E-mail address: [email protected] (M. Tekaya) Background Percutaneous mitral valvuloplasty (PMV) has emerged as the procedure of choice in treatment of mitral stenosis and has proved effectiveness in cases of mitral restenosis after surgical commissurotomy Compared with surgery, PMV is associated with shorter hospital stays, reduced patient discomfort, and significantly lower costs. However, it is unknown whether patients who developed symptomatic mitral restenosis after PMV may benefit from repeat PMV (re-PMV) with safety. Objectives This study was designed to evaluate the occurrence rate and the predictive factors for severe complications following re-PMV. Methods Retrospective study from a series of 40 procedures of re-PMV with the Inoue balloon at 8 ± 4 years after prior procedure. A clinical and ultrasound follow-up was achieved in 31 patients with a mean follow-up period of 43 ± 26 months. Results The mean age of patients was 43 ± 11 years [23; 63], 87,5% of the population being female (5 men and 35 women). The immediate procedural success was achieved in 31 patients (77.5%). A severe mitral regurgitation (MR) was observed in 3 patients (7.5%). A cerebrovascular stroke occurred in 1 patient (2.5%). No procedurerelated death or cardiac tamponade were noted. Only a left atrial area ≤ 25 cm2 was linked to high risk of severe MR. At long-term, mitral restenosis was observed in 13 patients (42%) at 53 ± 30 months [9; 128] after re-PMV, 2 patients presented thromboembolic events (6%) and no death. Only the male had been identified as a predictor of restenosis. Conclusion The feasibility of re-PMV with a relatively high procedural success rate and an acceptable complication profile makes it an appealing therapeutic strategy for patients with recurrent valve stenosis. The improved experience of our medical teams, and the systematic use of transoesophageal echocardiography to detect thrombi explain the low incidence of the complications of re-PMV in our study. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.272