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PT241 “Atrial Bite”: A Marker of Elevated Left Ventricular End-Diastolic Pressure in Aortic Regurgitation
PT242 The Useful of Myocardial Deformation Imaging to Predict the New Onset Heart Failure During Pregnancy K. Hristova*1, R. Marinov2, G. Stamenov3, K. Chaceva3, M. Michova3 1 Noninvasive Functional Diagnostic and Imaging, 2National Heart Hospital, Sofia, 3Wonem Health Hospital, Sofia, Bulgaria
Conclusion: The reduction of the aortic complex volume among the patients with calcific aortic valve stenosis shows a “negative remodeling” in this group of patients. This is the only work of this kind conducted in Mexico that has analyzed the dimensions of the aortic complex by 3D-TEE. Disclosure of Interest: None Declared PT241 “Atrial Bite”: A Marker of Elevated Left Ventricular End-Diastolic Pressure in Aortic Regurgitation M. A. Cobos*1, P. Martínez Losas1, L. Pérez de Isla1 1 Instituto Cardiovascular, Hospital Clinico San Carlos, Madrid, Spain Introduction: Continuous wave Doppler provides a noninvasive assessment of the diastolic gradient between the aorta and the left ventricle in patients with aortic regurgitation (AR). Thus, it can provide us with information regarding left ventricular diastolic pressure. We have found a telediastolic notch, the so called “atrial bite” in the CW Doppler signal of AR in some patients in sinus rhythm. Objectives: We hipotesize that the atrial bite is caused by the A wave of the LV pressure in patients with a non compliant ventricle. Methods: We reviewed the echo studies of 15 pts with atrial bite, and compare the data with a group of 20 pts without atrial bite.
Introduction: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics,consistent with an increase in preload and decrease in afterload and systemic vascular resistance. Objectives: The aim of the study is to evaluate left ventricular cardiac mechanics via speckle tracking echocardiography in a population of healthy pregnant women and women after invitro fertilisation (IVF)during different stages of pregnancy. Methods: The study population included 22 normal pregnant women, 40 after IVF, 10 of them with multiple pregnancy (46.53years) and 20 healthy non pregnant women (334years).2D images were acquired (657frames/s)during the first, second and third trimester of the pregnancy, as well as up to two months post partum.The curves of longitudinal(GLS), circumferential(GCS),radial strain(GRS) and LVT /LVUR were extracted using a commercial software. Results: Peak LVT and LVUR increased significantly in the 3rd trimester in both pregnancy groups (13.482.90 ,13.123.30 ,16.833.61 ,P<0.001;and-111.5223.54 /sec,107.4026.58 /sec,-144.3045.14 /sec,P< 0.001;in the 1st, 2nd,and 3rd trimester,respectively).The pregnants with twins have highest value for LVT and LVUR(p<0.01),but in the last trimester, the time to peak LVUR is prolonged.A corelation was found between the change in LVT and LVend-systolic volume in 1st and 3rd trimester (r¼0,56). Peak LVUR at the 3rd trimester correlated significantly with LV end-diastolic volume. Multiple regression analysis indicate that only systolic blood pressure (r ¼ 0.394, P ¼ 0.005) was an independent predictor for increased LV torsion. Arterial hypertension (AH) and prevalence of preeclampsia (PE) is more often in IVF gruop. GLS decreased significantly (p<0.001) during 3th trimester in women with AH and PE. GLS were non significantly different between the different groups in first and second trimester (GLS-20.6 3,14 vs.19,29 2,17).There are not found significant differences for GCS and GRS during pregnancy. Conclusion: During pregnancy LV twist and peak untwisting rate increase in the 3rd trimester and correlate with end-systolic and end-diastolic volume, respectively. Blood pressure and condition of multiple pregnancy are independently associated with increased torsion and may predict the new onset heart failure and perinatal cardiomyopathy. Global longitudinal strain is the main predictor of new onset peripartum cardiomyopathy. Disclosure of Interest: None Declared PT243 The Prognostic Value of Coronary Flow Reserve in Patients With Angiographically-Assessed Intermediate Left Anterior Descending Artery Diameter Stenosis in A Country With Low Gross Domestic Product T. Kovacevic-Preradovic*1, B. Stanetic2, A. Djordjevic-Dikic3, M. Ostojic1 1 Clinic for Cardiovascular Diseases, 2University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina, 3Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia Introduction: The coronary flow reserve (CFR) measured by transthoracic Doppler echocardiography has been proposed as an useful tool for functional lesion severity assessment. Objectives: The aim of our study was to investigate the prognostic value of CFR in patients with angiographically-assessed intermediate LAD (50-70%) diameter stenosis. Methods: We evaluated 61 patients (49 men; mean age 62.97.9) who underwent CFR assessment (intravenous adenosine at a dose of 140mg/kg/min) after elective coronary angiography in University hospital Banja Luka between January 2012 and October 2014. Patients were stratified according to the CFR value (2.0 vs. >2.0). The occurrence of cardiovascular events - a composite of target vessel revascularization (TVR), hospitalizations for cardiovascular reason (HOSP), non-fatal myocardial infarction (MI) and cardiac death was ascertained from the hospital information system and/or telephone contacts. Results: All patients were followed-up for a median of 830 71 days. Among 24 patients with CFR 2.0 (mean CFR 1.610.27) 8 events occurred: 4 TVR, 3 HOSP, and 1 cardiac death. Thirty-seven patients had CFR >2.0 (mean CFR 2.570.48) who developed 6 events: 3 TVR, 2 HOSP and 1 non-fatal MI. Overall event rate in the entire cohort of 61 patients was 22.9%. Significantly higher event rate was shown in patients with CFR value 2.0 when compared with patients in whom CFR value was >2.0 (33.3% vs. 16.2%, respectively, log-rank P¼0.028).
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
e165
POSTER ABSTRACTS
Results: There were 11 men and 4 women with a mean age of 75.18.2. The LVEF was 43.310.4. The main degree of severity of the aortic regurgitation was 2.21.0. The E/A index was 1.81.0, and E/é was 21.36.5. The atrial bite disappeared in 4 patients in which the study was repeated after a significant clinical improvement. Compared to the group of pts with AR, sinus rhythm and no atrial bite, the atrial bite patients show a significant difference (p <0,01) in LVEF (43.3 vs 60.4, A/E (1.8 vs 0,70) and E/é (21.3 vs 10.0). Conclusion: We report a new echocardiographic sign in the Doppler signal of the AR in patients with elevated LVEDP. Disclosure of Interest: None Declared
Conclusion: The reduction of the aortic complex volume among the patients with calcific aortic valve stenosis shows a “negative remodeling” in this group of patients. This is the only work of this kind conducted in Mexico that has analyzed the dimensions of the aortic complex by 3D-TEE. Disclosure of Interest: None Declared PT241 “Atrial Bite”: A Marker of Elevated Left Ventricular End-Diastolic Pressure in Aortic Regurgitation M. A. Cobos*1, P. Martínez Losas1, L. Pérez de Isla1 1 Instituto Cardiovascular, Hospital Clinico San Carlos, Madrid, Spain Introduction: Continuous wave Doppler provides a noninvasive assessment of the diastolic gradient between the aorta and the left ventricle in patients with aortic regurgitation (AR). Thus, it can provide us with information regarding left ventricular diastolic pressure. We have found a telediastolic notch, the so called “atrial bite” in the CW Doppler signal of AR in some patients in sinus rhythm. Objectives: We hipotesize that the atrial bite is caused by the A wave of the LV pressure in patients with a non compliant ventricle. Methods: We reviewed the echo studies of 15 pts with atrial bite, and compare the data with a group of 20 pts without atrial bite.
Introduction: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics,consistent with an increase in preload and decrease in afterload and systemic vascular resistance. Objectives: The aim of the study is to evaluate left ventricular cardiac mechanics via speckle tracking echocardiography in a population of healthy pregnant women and women after invitro fertilisation (IVF)during different stages of pregnancy. Methods: The study population included 22 normal pregnant women, 40 after IVF, 10 of them with multiple pregnancy (46.53years) and 20 healthy non pregnant women (334years).2D images were acquired (657frames/s)during the first, second and third trimester of the pregnancy, as well as up to two months post partum.The curves of longitudinal(GLS), circumferential(GCS),radial strain(GRS) and LVT /LVUR were extracted using a commercial software. Results: Peak LVT and LVUR increased significantly in the 3rd trimester in both pregnancy groups (13.482.90 ,13.123.30 ,16.833.61 ,P<0.001;and-111.5223.54 /sec,107.4026.58 /sec,-144.3045.14 /sec,P< 0.001;in the 1st, 2nd,and 3rd trimester,respectively).The pregnants with twins have highest value for LVT and LVUR(p<0.01),but in the last trimester, the time to peak LVUR is prolonged.A corelation was found between the change in LVT and LVend-systolic volume in 1st and 3rd trimester (r¼0,56). Peak LVUR at the 3rd trimester correlated significantly with LV end-diastolic volume. Multiple regression analysis indicate that only systolic blood pressure (r ¼ 0.394, P ¼ 0.005) was an independent predictor for increased LV torsion. Arterial hypertension (AH) and prevalence of preeclampsia (PE) is more often in IVF gruop. GLS decreased significantly (p<0.001) during 3th trimester in women with AH and PE. GLS were non significantly different between the different groups in first and second trimester (GLS-20.6 3,14 vs.19,29 2,17).There are not found significant differences for GCS and GRS during pregnancy. Conclusion: During pregnancy LV twist and peak untwisting rate increase in the 3rd trimester and correlate with end-systolic and end-diastolic volume, respectively. Blood pressure and condition of multiple pregnancy are independently associated with increased torsion and may predict the new onset heart failure and perinatal cardiomyopathy. Global longitudinal strain is the main predictor of new onset peripartum cardiomyopathy. Disclosure of Interest: None Declared PT243 The Prognostic Value of Coronary Flow Reserve in Patients With Angiographically-Assessed Intermediate Left Anterior Descending Artery Diameter Stenosis in A Country With Low Gross Domestic Product T. Kovacevic-Preradovic*1, B. Stanetic2, A. Djordjevic-Dikic3, M. Ostojic1 1 Clinic for Cardiovascular Diseases, 2University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina, 3Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia Introduction: The coronary flow reserve (CFR) measured by transthoracic Doppler echocardiography has been proposed as an useful tool for functional lesion severity assessment. Objectives: The aim of our study was to investigate the prognostic value of CFR in patients with angiographically-assessed intermediate LAD (50-70%) diameter stenosis. Methods: We evaluated 61 patients (49 men; mean age 62.97.9) who underwent CFR assessment (intravenous adenosine at a dose of 140mg/kg/min) after elective coronary angiography in University hospital Banja Luka between January 2012 and October 2014. Patients were stratified according to the CFR value (2.0 vs. >2.0). The occurrence of cardiovascular events - a composite of target vessel revascularization (TVR), hospitalizations for cardiovascular reason (HOSP), non-fatal myocardial infarction (MI) and cardiac death was ascertained from the hospital information system and/or telephone contacts. Results: All patients were followed-up for a median of 830 71 days. Among 24 patients with CFR 2.0 (mean CFR 1.610.27) 8 events occurred: 4 TVR, 3 HOSP, and 1 cardiac death. Thirty-seven patients had CFR >2.0 (mean CFR 2.570.48) who developed 6 events: 3 TVR, 2 HOSP and 1 non-fatal MI. Overall event rate in the entire cohort of 61 patients was 22.9%. Significantly higher event rate was shown in patients with CFR value 2.0 when compared with patients in whom CFR value was >2.0 (33.3% vs. 16.2%, respectively, log-rank P¼0.028).
GHEART Vol 11/2S/2016
j
June, 2016
j
POSTER/WCC_2016-POSTERS
e165
POSTER ABSTRACTS
Results: There were 11 men and 4 women with a mean age of 75.18.2. The LVEF was 43.310.4. The main degree of severity of the aortic regurgitation was 2.21.0. The E/A index was 1.81.0, and E/é was 21.36.5. The atrial bite disappeared in 4 patients in which the study was repeated after a significant clinical improvement. Compared to the group of pts with AR, sinus rhythm and no atrial bite, the atrial bite patients show a significant difference (p <0,01) in LVEF (43.3 vs 60.4, A/E (1.8 vs 0,70) and E/é (21.3 vs 10.0). Conclusion: We report a new echocardiographic sign in the Doppler signal of the AR in patients with elevated LVEDP. Disclosure of Interest: None Declared