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PS160 Inflammatory Thoracic Aortic Aneurysms and Dissections
POSTER ABSTRACTS
PS157 The Relationship Between Heart Rate Recovery and the Levels of Catestatin After Acute Myocardial Infarction W. Zhao*1, Y. Liu1, L. Zu1, W. Gao1 1 Cardiology, Peking University Third Hospital, Beijing, China Introduction: Autonomic nervous dysfunctions are closely related to the occurrence, development and prognosis of acute myocardial infarction (AMI). Heart rate recovery after exercise (HRR)is a common clinical evaluated index of autonomic nervous function, which reflects autonomic balance under treadmill exercise. Our preliminary study showed that plasma levels of catestatin (CST) were increased gradually, and inversely associated with norepinephrine during the early phase of AMI, which indicated that CST might play an important role in regulation of autonomic nervous system after AMI. However there are few studies about the relationship between HRR and CST after AMI. Objectives: To investigate the relationship between HRR and CST in patients with acute ST segment elevation myocardial infarction (STEMI) treated with primary PCI. Methods: A total of 80 STEMI patients with blood sample were retrospectively investigated. All the patients were conducted cardiopulmonary exercise testing(CPET)within 30 days after STEMI, and heart rate recovery at 1 minute and 2 minute (HRR1,HRR2) were calculated. Levels of plasma CST in patients with blood samples before primary PCI were detected by ELISA, and the correlation between CST and HRR were investigated. Results: Mean plasma concentration of CST in those patients before PCI was 4.300.61 ng/ml. The plasma levels of CST were positively associated with HRR1(r¼0.234,p¼0.037) and HRR2(r¼0.238, p¼0.033). Multiple linear regression analysis demonstrated CST was independently positively correlated to HRR1 and HRR2. Conclusion: Lower Catestain level is an independently predicting factor of autonomic nervous dysfunction in STEMI. Disclosure of Interest: None Declared PS158 Determinants of Heart Rate Recovery for Patients With Primary PCI After ST-Elevation Myocardial Infarction W. Zhao*1, Y. Liu1, L. Zu1, W. Gao1 1 Cardiology, Peking University Third Hospital, Beijing, China Introduction: The majority of patients with acute myocardial infarction (AMI) are associated with autonomic nervous dysfunctions, which are closely related to the prognosis of AMI. Heart rate recovery after exercise (HRR) is a common clinical evaluated index of autonomic nervous function. However there are few studies about the determinants of HRR. Objectives: To investigate the determinants of HRR in patients with acute ST segment elevation myocardial infarction (STEMI) treated with primary PCI. Methods: A total of 260 patients were retrospectively investigated from July 2011 to December 2014. All the patients were conducted cardiopulmonary exercise testing(CPET)within 30 days after STEMI, and heart rate recovery at 1 minute and 2 minute (HRR1, HRR2) were calculated. The correlation among HRR with clinical characteristics, biochemical measurements,echocardiographic parameters and exercise tolerance was analysed. Results: The mean HRR1 was 25.9712.17 bpm and mean HRR2 was 43.7613.32 bpm in the whole study population. HRR1 was positively correlated to peak oxygen uptake(VO2peak) (r¼0.129, p<0.001¼,while negatively associated with age (r¼-0.140,p¼-0.026), the value of the ratio of early transmitral flow velocity to early diastolic velocity of mitral annulus (E/Em) (r¼-0.172, p¼0.003), and left atrial pressure( LAP) (r¼-0.186,p¼0.003). Multiple linear regression analysis demonstrated that VO2peak was independently positively associated with HRR1, while LAP, heart rate during recovery phase of STEMI and age was negatively correlated to HRR1. HRR2 was positively correlated to VO2peak (r¼0.288, p<0.001¼, while negatively associated with age (r¼ -0.242, p<0.001¼, E/Em (r¼-0.255, p<0.001¼, and LAP (r¼-0.279, p<0.001). Multiple linear regression analysis demonstrated that VO2peak was positively associated with HRR2, while LAP, E/Em and age were negatively correlated to HRR2. Conclusion: Lower exercise tolerance in STEMI patients is associated with abnormal HRR. Disclosure of Interest: None Declared PS160 Inflammatory Thoracic Aortic Aneurysms and Dissections T. Strecker*1, A. Agaimy2, M. Weyand1 Center of Cardiac Surgery, 2Institute of Pathology, University of Erlangen-Nuremberg, Erlangen, Germany
1
Introduction: Aortic aneurysms represent one of the major causes of cardiovascular surgery. Their etiology varies greatly based on patient’s age and other clinicopathologic determinants. In addition to common atherosclerotic vascular diseases, an inflammatory etiology, in particular IgG4-related disease (IgG4-RD) has increasingly emerged as a cause of dissecting inflammatory aortic aneurysms (IAA). Objectives: Aortic aneurysms represent one of the major causes of cardiovascular surgery. Their etiology varies greatly based on patient’s age and other clinicopathologic determinants. In addition to common atherosclerotic vascular diseases, an inflammatory etiology, in particular IgG4-related disease (IgG4-RD) has increasingly emerged as a cause of dissecting inflammatory aortic aneurysms (IAA).
e40
Methods: To assess the frequency and types of IAA, we reviewed all cases of aortic aneurysms resected at our Erlangen Heart Center during 2000-2013. 376 patients underwent resection of aortic aneurysms in the study period. These are further categorized as ascending aortic aneurysms (45%), aortic arch aneurysm (2%), descending aortic aneurysm (3%), type A dissection (46%) and type B dissection (4%). Results: Fifteen cases (4%) showed variable lymphoplasmacytic inflammation thus qualifying as IAA. Affected were 9 females and 6 males (female to male ratio ¼ 1.5: 1). None was known to have IgG4-RD and serum IgG4 and/ or IgG levels (known in 6 cases) were normal. Variable sclerosing lymphoplasmacytic inflammation was seen either confined to the adventitia (periaortitis; mainly in males) or extending through all layers (mainly in females). A wide range of IgG4 plasma cells were detected. Lymphoid follicle and variable fibrosis were common but obliterative phlebitis was not seen. Conclusion: IgG4-rich sclerosing lymphoplasmacytic thoracic aortitis is a constant histological feature of thoracic IAA. Normal serum IgG4 in most patients, predilection for women and absence of other features of IgG4-RD all suggest a tissue-specific localized autoimmunological process and argue against a systemic disorder. The relationship of IgG4-rich lymphoplasmacytic thoracic aortitis in those patients with IAA lacking other organ manifestations or an elevated serum IgG4 level to systemic IgG4-RD remains unclear and merit further studies. Disclosure of Interest: None Declared PS162 Integrating Pro-Bnp and Pedometer to the 6MWT in Patients With PH in Public Hospital Center of Argentina V. Gregorietti*1, S. Perrone1, A. Machain1, R. Gamboa1, C. Tajer1, A. Estevez1, D. Aimone1, R. Sarmiento1, on behalf of Grupo de estudio y Tratamiento de Hipertension Pulmonar Hospital El Cruce 1 29819, Buenos Aires, Argentina Introduction: The walk test six minutes, as we all know, is a prognostic marker, both at the time of diagnosis, and monitoring and adjusting the treatment, which is why the goal of our work is to search an index into this test that allows us definer of more accurate manner, in accordance with not only the parameters measured in a standardized way but add a count steps (pedometer) and proBNP levels at the time when performing the test. Objectives: To evaluate the association between basal level pro-BNP and the number of footsteps measured by a digital pedometer during the 6MWT, and ohter parameters of clinical and prognostic relevance. Methods: To evaluate the association between basal level pro-BNP, the number of footsteps measured by a digital pedometer during the 6MWT and ohter parameters of clinical and prognostic relevance. We prospectively analized 118 consecutive 6MW tests from 118 patients with pulmonary hypertension(PH) with different etiologies according to ESC 2015 classification, in outpatient monitoring in our center. The statistical method was used SPSS. Results: Mean age was 49 years (SD 6.4 years), and 73 % of the population was female. Mean 6MWD was 323 mts (18-520), mean number of footsteps was 586 (42-1290). Mean pro-BNP levels were 270 pg/ml (14- 1110). The correlation between pro-BNP levels, the number of footsteps, the 6MWD and WHO functional class was analyzed. We found a significant association between pro-BNP levels and the number of footsteps (p¼0.001) and WHO functional class (p¼0.009). Conclusion: The number of footsteps during the 6MWT correlates inversely with clinical and laboratory parameters of prognostic relevance in patients with PH such as pro-BNP levels and WHO functional class. The number of footsteps measured with a digital pedometer during the 6MWT might provide valuable data for evaluation and follow up of patients with PH. Disclosure of Interest: None Declared PS163 Tenascin-C Levels and Clinical Importance in Pulmonary Arterial Hypertension Associated With Congenital Heart Disease O. Vuran*1, M. Kayikcioglu2, S. Nalbantgil2, O. Musayev3, H. S. Kemal4, N. Mogulkoc5, L. C. Hurkan2, H. Kultursay2 1 Cardiology, Alasehir State Hospital, Manisa, 2Cardiology, Ege University Medical Faculty, Izmir, Turkey, 3Cardiology, Central Clinic, Baku, Azerbaijan, 4Cardiology, Near East University, Nicosia, Cyprus, 5Pulmonology, Ege University Medical Faculty, Izmir, Turkey Introduction: In Pulmonary arterial hypertension (PAH), prognostic value of some biomarkers like BNP/NT-proBNP has been shown and used in the routine course of the disease. Tenascin-C (TNC) is an extracellular matrix glycoprotein and has a great importance in the pathophysiology of PAH, but clinical relevance is unknown. Objectives: In this study, the relationship of TNC levels measured in patients with PAH associated with congenital heart disease (PAH-CHD), disease prognostic markers and adverse events in short-term follow-up (1 year) were investigated. Methods: Thirty-four PAH-CHD patients (age: 31 8.3, 20 females) followed in our centre were age and sex matched with 21 healthy volunteers and plasma TNC levels were measured using ELISA. Also, 6-minute walk test (6-MWT), transthoracic echocardiography performed and baseline NT-proBNP levels were measured simultaneously. Clinical monitoring of patients for the development of adverse events (right heart failure, syncope, hospitalization and death) took place. Results: TNC levels in patients with PAH-CHD were significantly higher compared to healthy group (respectively 61.520.4 ng/ml, 13.36.4 ng/ml, p<0.0001). There was a significant
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
PS157 The Relationship Between Heart Rate Recovery and the Levels of Catestatin After Acute Myocardial Infarction W. Zhao*1, Y. Liu1, L. Zu1, W. Gao1 1 Cardiology, Peking University Third Hospital, Beijing, China Introduction: Autonomic nervous dysfunctions are closely related to the occurrence, development and prognosis of acute myocardial infarction (AMI). Heart rate recovery after exercise (HRR)is a common clinical evaluated index of autonomic nervous function, which reflects autonomic balance under treadmill exercise. Our preliminary study showed that plasma levels of catestatin (CST) were increased gradually, and inversely associated with norepinephrine during the early phase of AMI, which indicated that CST might play an important role in regulation of autonomic nervous system after AMI. However there are few studies about the relationship between HRR and CST after AMI. Objectives: To investigate the relationship between HRR and CST in patients with acute ST segment elevation myocardial infarction (STEMI) treated with primary PCI. Methods: A total of 80 STEMI patients with blood sample were retrospectively investigated. All the patients were conducted cardiopulmonary exercise testing(CPET)within 30 days after STEMI, and heart rate recovery at 1 minute and 2 minute (HRR1,HRR2) were calculated. Levels of plasma CST in patients with blood samples before primary PCI were detected by ELISA, and the correlation between CST and HRR were investigated. Results: Mean plasma concentration of CST in those patients before PCI was 4.300.61 ng/ml. The plasma levels of CST were positively associated with HRR1(r¼0.234,p¼0.037) and HRR2(r¼0.238, p¼0.033). Multiple linear regression analysis demonstrated CST was independently positively correlated to HRR1 and HRR2. Conclusion: Lower Catestain level is an independently predicting factor of autonomic nervous dysfunction in STEMI. Disclosure of Interest: None Declared PS158 Determinants of Heart Rate Recovery for Patients With Primary PCI After ST-Elevation Myocardial Infarction W. Zhao*1, Y. Liu1, L. Zu1, W. Gao1 1 Cardiology, Peking University Third Hospital, Beijing, China Introduction: The majority of patients with acute myocardial infarction (AMI) are associated with autonomic nervous dysfunctions, which are closely related to the prognosis of AMI. Heart rate recovery after exercise (HRR) is a common clinical evaluated index of autonomic nervous function. However there are few studies about the determinants of HRR. Objectives: To investigate the determinants of HRR in patients with acute ST segment elevation myocardial infarction (STEMI) treated with primary PCI. Methods: A total of 260 patients were retrospectively investigated from July 2011 to December 2014. All the patients were conducted cardiopulmonary exercise testing(CPET)within 30 days after STEMI, and heart rate recovery at 1 minute and 2 minute (HRR1, HRR2) were calculated. The correlation among HRR with clinical characteristics, biochemical measurements,echocardiographic parameters and exercise tolerance was analysed. Results: The mean HRR1 was 25.9712.17 bpm and mean HRR2 was 43.7613.32 bpm in the whole study population. HRR1 was positively correlated to peak oxygen uptake(VO2peak) (r¼0.129, p<0.001¼,while negatively associated with age (r¼-0.140,p¼-0.026), the value of the ratio of early transmitral flow velocity to early diastolic velocity of mitral annulus (E/Em) (r¼-0.172, p¼0.003), and left atrial pressure( LAP) (r¼-0.186,p¼0.003). Multiple linear regression analysis demonstrated that VO2peak was independently positively associated with HRR1, while LAP, heart rate during recovery phase of STEMI and age was negatively correlated to HRR1. HRR2 was positively correlated to VO2peak (r¼0.288, p<0.001¼, while negatively associated with age (r¼ -0.242, p<0.001¼, E/Em (r¼-0.255, p<0.001¼, and LAP (r¼-0.279, p<0.001). Multiple linear regression analysis demonstrated that VO2peak was positively associated with HRR2, while LAP, E/Em and age were negatively correlated to HRR2. Conclusion: Lower exercise tolerance in STEMI patients is associated with abnormal HRR. Disclosure of Interest: None Declared PS160 Inflammatory Thoracic Aortic Aneurysms and Dissections T. Strecker*1, A. Agaimy2, M. Weyand1 Center of Cardiac Surgery, 2Institute of Pathology, University of Erlangen-Nuremberg, Erlangen, Germany
1
Introduction: Aortic aneurysms represent one of the major causes of cardiovascular surgery. Their etiology varies greatly based on patient’s age and other clinicopathologic determinants. In addition to common atherosclerotic vascular diseases, an inflammatory etiology, in particular IgG4-related disease (IgG4-RD) has increasingly emerged as a cause of dissecting inflammatory aortic aneurysms (IAA). Objectives: Aortic aneurysms represent one of the major causes of cardiovascular surgery. Their etiology varies greatly based on patient’s age and other clinicopathologic determinants. In addition to common atherosclerotic vascular diseases, an inflammatory etiology, in particular IgG4-related disease (IgG4-RD) has increasingly emerged as a cause of dissecting inflammatory aortic aneurysms (IAA).
e40
Methods: To assess the frequency and types of IAA, we reviewed all cases of aortic aneurysms resected at our Erlangen Heart Center during 2000-2013. 376 patients underwent resection of aortic aneurysms in the study period. These are further categorized as ascending aortic aneurysms (45%), aortic arch aneurysm (2%), descending aortic aneurysm (3%), type A dissection (46%) and type B dissection (4%). Results: Fifteen cases (4%) showed variable lymphoplasmacytic inflammation thus qualifying as IAA. Affected were 9 females and 6 males (female to male ratio ¼ 1.5: 1). None was known to have IgG4-RD and serum IgG4 and/ or IgG levels (known in 6 cases) were normal. Variable sclerosing lymphoplasmacytic inflammation was seen either confined to the adventitia (periaortitis; mainly in males) or extending through all layers (mainly in females). A wide range of IgG4 plasma cells were detected. Lymphoid follicle and variable fibrosis were common but obliterative phlebitis was not seen. Conclusion: IgG4-rich sclerosing lymphoplasmacytic thoracic aortitis is a constant histological feature of thoracic IAA. Normal serum IgG4 in most patients, predilection for women and absence of other features of IgG4-RD all suggest a tissue-specific localized autoimmunological process and argue against a systemic disorder. The relationship of IgG4-rich lymphoplasmacytic thoracic aortitis in those patients with IAA lacking other organ manifestations or an elevated serum IgG4 level to systemic IgG4-RD remains unclear and merit further studies. Disclosure of Interest: None Declared PS162 Integrating Pro-Bnp and Pedometer to the 6MWT in Patients With PH in Public Hospital Center of Argentina V. Gregorietti*1, S. Perrone1, A. Machain1, R. Gamboa1, C. Tajer1, A. Estevez1, D. Aimone1, R. Sarmiento1, on behalf of Grupo de estudio y Tratamiento de Hipertension Pulmonar Hospital El Cruce 1 29819, Buenos Aires, Argentina Introduction: The walk test six minutes, as we all know, is a prognostic marker, both at the time of diagnosis, and monitoring and adjusting the treatment, which is why the goal of our work is to search an index into this test that allows us definer of more accurate manner, in accordance with not only the parameters measured in a standardized way but add a count steps (pedometer) and proBNP levels at the time when performing the test. Objectives: To evaluate the association between basal level pro-BNP and the number of footsteps measured by a digital pedometer during the 6MWT, and ohter parameters of clinical and prognostic relevance. Methods: To evaluate the association between basal level pro-BNP, the number of footsteps measured by a digital pedometer during the 6MWT and ohter parameters of clinical and prognostic relevance. We prospectively analized 118 consecutive 6MW tests from 118 patients with pulmonary hypertension(PH) with different etiologies according to ESC 2015 classification, in outpatient monitoring in our center. The statistical method was used SPSS. Results: Mean age was 49 years (SD 6.4 years), and 73 % of the population was female. Mean 6MWD was 323 mts (18-520), mean number of footsteps was 586 (42-1290). Mean pro-BNP levels were 270 pg/ml (14- 1110). The correlation between pro-BNP levels, the number of footsteps, the 6MWD and WHO functional class was analyzed. We found a significant association between pro-BNP levels and the number of footsteps (p¼0.001) and WHO functional class (p¼0.009). Conclusion: The number of footsteps during the 6MWT correlates inversely with clinical and laboratory parameters of prognostic relevance in patients with PH such as pro-BNP levels and WHO functional class. The number of footsteps measured with a digital pedometer during the 6MWT might provide valuable data for evaluation and follow up of patients with PH. Disclosure of Interest: None Declared PS163 Tenascin-C Levels and Clinical Importance in Pulmonary Arterial Hypertension Associated With Congenital Heart Disease O. Vuran*1, M. Kayikcioglu2, S. Nalbantgil2, O. Musayev3, H. S. Kemal4, N. Mogulkoc5, L. C. Hurkan2, H. Kultursay2 1 Cardiology, Alasehir State Hospital, Manisa, 2Cardiology, Ege University Medical Faculty, Izmir, Turkey, 3Cardiology, Central Clinic, Baku, Azerbaijan, 4Cardiology, Near East University, Nicosia, Cyprus, 5Pulmonology, Ege University Medical Faculty, Izmir, Turkey Introduction: In Pulmonary arterial hypertension (PAH), prognostic value of some biomarkers like BNP/NT-proBNP has been shown and used in the routine course of the disease. Tenascin-C (TNC) is an extracellular matrix glycoprotein and has a great importance in the pathophysiology of PAH, but clinical relevance is unknown. Objectives: In this study, the relationship of TNC levels measured in patients with PAH associated with congenital heart disease (PAH-CHD), disease prognostic markers and adverse events in short-term follow-up (1 year) were investigated. Methods: Thirty-four PAH-CHD patients (age: 31 8.3, 20 females) followed in our centre were age and sex matched with 21 healthy volunteers and plasma TNC levels were measured using ELISA. Also, 6-minute walk test (6-MWT), transthoracic echocardiography performed and baseline NT-proBNP levels were measured simultaneously. Clinical monitoring of patients for the development of adverse events (right heart failure, syncope, hospitalization and death) took place. Results: TNC levels in patients with PAH-CHD were significantly higher compared to healthy group (respectively 61.520.4 ng/ml, 13.36.4 ng/ml, p<0.0001). There was a significant
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS