e342 [5] Bitam A, Benakmoum A, Ammouche A. Incidences nutritionnelles de l’ingestion de l’huile de tournesol thermooxydée sur les fractions lipidiques sériques et sur l’␣-tocophérol chez le rat en croissance. Sciences des Aliments 2004;24:323—35. [6] Aïnouz L, Omari N, Ammar Aouchiche MA, Benmohand C, Giaimis J, Baz A.33ème Congrès de la Société Franc ¸aise d’Endocrinologie, Bordeaux. 2016. [7] Namazi F, Shomali T, Taghikhani P, Nazifi S. Protective effect of Urticadioica leaf hydro alcoholic extract against experimentally-induced atherosclerosis in rats. Avicenna J. Phytomed 2018;8:254—62. https://doi.org/10.1016/j.acvdsp.2019.05.024
Correlation of serum uric acid levels with traditional risk factors and cardiovascular disease in the area of Blida (Algeria) A. Bachir Cherif ∗,a , S. Bennouar a , A. Bouamra a , M. Temmar b , M. Bouafia a a Clinic of Internal Medicine and Cardiology, University Hospital Center of Blida, Blida 09000, Algeria b Cardiology and Angiology Center, Ghardaia 47000, Algeria ∗ Corresponding author. E-mail address:
[email protected] (A. Bachir Cherif) Purpose To investigate the relationship of Serum Uric Acid (SUA) levels with the traditional risk factors and fatal cardiovascular disease (CVD) in the area of Blida (Algeria). Methods We prospectively enrolled 1954 hypertensive patients: 912 men (57.4 ± 8.5 years old) and 1042 women (56.3 ± 8.7 years old) consulting for evaluation in our hypertension clinic. In all subjects; routine blood chemistry, including SUA determination, echocardiographic examination, office and 24 h ambulatory blood pressure (BP) monitoring were obtained along with data regarding lifestyle habits. The risk of fatal cardiovascular disease was evaluated by using the SCORE risk chart for countries with low CVD risk based on the following risk factors: age, sex, smoking, systolic BP and total cholesterol. Results Spearman analysis showed that the SUA levels were significantly and positively associated with the average 24 hours systolic BP levels (RS = 0.088, P < 0.02 for SBP) but not with diastolic BP levels (RS = 0.051, P > 0.05). Furthermore, the Kruskal Wallis analysis revealed that SUA levels were significantly associated with fatal CVD risk (P < 0.01). Specifically, patients with SCORE risk < 1%, between 1—5%, risk > 5% had SUA levels of 5.3 ± 1.1 mg/dl, 5.9 ± 1.3 mg/dl and 6.7 ± 1.7 mg/dl respectively (Z:- 6.9 P< 0.001). SUA levels were significantly associated with almost all major risk factors. Specifically SUA levels were significantly higher in males (Mann-Whitney U = 17384.70, P < 0.01), in elder patients (RS = 0.12, P < 0.01), in patients with increased body mass index (RS = 0.381, P < 0.01), with diabetes (U = 17745.70, P < 0.05) and with increased systolic BP levels (RS = 0.087, P < 0.04). In contrast, smoking status was not related with SUA levels (P = NS). Regarding lipoproteins, only serum HDL levels were significantly associated with SUA levels (RS= — 0.327, P < 0.01) but not total cholesterol and LDL plasma levels (NS). Conclusions Subjects with lower SUA levels presented lower BP levels as well as SCORE risk for fatal cardiovascular disease. SUA levels were significantly associated with SBP levels. The relative importance of these associations has made it possible to specify the possible role of uric acid in the cardiovascular continuum. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.05.025
High blood pressure and Systemic Lupus Erythematosus
02 - Heart and Ships Jihed Anoun , Wafa Baya ∗ , Imen Ben Hassine , Emna Ben Hadj Ali , Anis Mzabi , Amel Rezgui , Monia Karmani , Fatma Ben Fredj Ismail , Chedia Laouani Kechrid Sahloul University Hospital, Internal medicine department, Sousse, Tunisia ∗ Corresponding author. E-mail address:
[email protected] (W. Baya) Introduction Systemic lupus erythematosus (SLE) is an autoimmune systemic disease affecting young women and associated with high cardiovascular risk. Hypertension during SLE is more frequent than in the general population and occurs earlier. Its pathophysiology remains unclear. The purpose of our study is to report the clinical data of hypertensive patients with SLE. Patients and methods Our retrospective study included 24 patients with lupus and hypertension among 67 lupus patients hospitalized in the internal medicine department between 2011 and 2017. Results Our patients were 22 women and 2 men (mean age 46 years old). SLE had been evolving for an average of 12 years. Lupus nephropathy was present in 15 cases and 8 patients had renal failure. The treatment was based on steroids for all patients, 20 of them received synthetic antimalarial drugs, 18 patients had immune suppressors and 2 patients received a biotherapy. The average age of onset of hypertension was 37 years; 5 years after SLE diagnosis. Hypertension was essential in 8 cases, attributable to SLE in 14 cases, corticoid-induced in 17 cases and secondary to renal failure in 7 cases. A multiple origin was retained in half of the cases. Each patient had an average of 5 cardiovascular risk factors in addition to hypertension and SLE. Treatment relied primarily on angiotensin converting enzyme inhibitors, calcium channel blockers and beta-blockers. Monotherapy was used in 8 cases. A blood pressure control was obtained in 17 patients. Seven developed complications such as hypertensive heart disease (n = 6) and retinopathy (n = 3). Ten patients had atherosclerosis, 6 of whom had a cardiovascular complication. The average age of the latter group was 46 years. Conclusion Hypertension during SLE is frequent and multifactorial. It is associated with accelerated atherosclerosis and a high risk of cardiovascular disease. A better understanding of the pathophysiology of hypertension during SLE would improve the prognosis. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.05.026
Simplified pulse wave velocity measurement in children: A validation study of the pOpmètre® Saïd Bichali 1,∗ , Alexandra Bruel 2 , Marion Boivin 3 , Gwénaëlle Roussey 2 , Bénédicte Romefort 1 , Jean-Christophe Rozé 4 , Emma Allain-Launay 2 1 CHU - Nantes University Hospital, Pediatric Cardiology Unit, 44000, Nantes, France 2 CHU - Nantes University Hospital, Pediatric Nephrology Unit, 44000, Nantes, France 3 CHU - Nantes University Hospital - Clinical Investigation Center CIC 004, Inserm-Nantes, 44000, Nantes, France 4 CHU, Nantes University Hospital, Department of Neonatal Intensive Care, 44000 Nantes, France ∗ Corresponding author. E-mail address: said
[email protected] (S. Bichali) Background In populations exposed to cardiovascular risk, aortic stiffness is an important marker assessed by the gold standard carotid-to-femoral pulse wave velocity (PWV). In childhood, the aplanation tonometer SphygmoCor® is a validated method, however, it is limited in routine practice by the child’s cooperation
02 - Heart and Ships and operator’s experience. The pOpmètre® is a device validated in adults which rapidly measures finger-to-toe PWV using 2 oxymeterlike sensors. Purpose Our objective was to demonstrate the value of the pOpmètre® in children by comparing pOpmètre® to SphygmoCor® PWV measurements. Methods This prospective study enrolled 60 children aged between 4 and 8 years old with a 1 sex ratio from the Nantes University Hospital. Bland and Altman method was used to compare pOpmètre® and SphygmoCor® PWV in a training group and in a validation group. The primary endpoint was reached if the 95% confidence interval (95%CI) of the mean PWV difference was between − 0.450 and + 0.450. Results The mean pOpmètre® PWV (PWVpop) was 3.919 ± 0.587 m/sec and the mean SphygmoCor® PWV was 4.280 ± 0.383 m/sec in the training group (n = 26), with a difference of − 0.362 (95%CI: − 0.546— − 0.178). A new algorithm was defined using transit time (TTpop): corrected PWVpop (m/sec) = 0.150/TTpop (sec) + 1.381 * Height (m) + 1.148. It was tested in the validation group (n = 24): the mean corrected PWVpop was 4.231 ± 0.189 m/sec and the mean SphygmoCor® PWV was 4.208 ± 0.296 m/sec with a corrected difference of 0.023 (95%CI: −0.086—0.131). Conclusion After algorithm correction, we found a good agreement between PWV measured by the SphygmoCor® and the pOpmètre® which seems more appropriate in young children. Disclosure of interest The authors declare that they have no competing of interest. https://doi.org/10.1016/j.acvdsp.2019.05.027
Cardiovascular Risk Factors in Renal Transplant Patient L. Kara-Hadj Safi ∗ , S. Derrouiche , M. Benmansour Nephrology Department, University Hospital Tlemcen, Tlemcen, Algeria ∗ Corresponding author. E-mail address: kara
[email protected] (L. Kara-Hadj Safi) Introduction and aim Cardiovascular mortality among renal transplant patients remains significantly higher than that of the general population. The aim of our study was to evaluate the frequency and characteristics of cardiovascular risk factors in renal transplant patients at the Tlemcen University Hospital. Patients and Methods We performed a descriptive retrospective study of 100 renal transplant patients from living donors from 2007 to 2017. Hypertension was defined as systolic blood pressure > 130 mmHg and/or diastolic blood pressure > 80 mmHg and/or taking an antihypertensive treatment. Overweight was defined as BMI > 25 kg/m2, diabetes by two fasting blood glucose > 1.26 g/L, dyslipidemia as LDL cholesterol level > 1,3 g/L. Results The mean patients’ age was 34.1 years old, [range: 6—54], sex ratio: 1.76. The mean creatinine clearance was 144.65 mol. The prevalence of hypertension post-transplantation was 31.8%. A strong correlation was found between cyclosporine and hypertension; 38.4% of patients had a BMI > 25Kg/m2 . Dyslipidemia and hyperuricemia were found in 28% and 18.6% of patients respectively. Fifteen percent developed diabetes after a mean posttransplant period of 7.2 months; 54.1% of diabetics had a metabolic syndrome before transplantation and 57% had a family history of diabetes. A strong correlation was found between diabetes and Tacrolimus. Four patients died with a functional graft. Discussion The prevalence of hypertension (31.8%), dyslipidemia (28%) and hyperuricemia (18.6%) in our series were significantly lower than those previously reported in kidney transplant patients. The reason could be a lower patients’ age in our study, a better graft function (grafts from living donors), or perhaps the choice of immunosuppressive drugs: 76% of our patients received Tacrolimus;
e343 actually, it is currently accepted that Tacrolimus causes less hypertension and dyslipidemia than cyclosporine. The prevalence of post-graft hypertension was higher in patients having hypertension before transplantation, indeed pre-existing hypertension is an independent risk factor for the occurrence of post-transplant hypertension, hence underlining the importance of ensuring optimal dialysis for patients who are candidates for transplantation. More than 1/3 of patients had overweight. Indeed, dietary management is recommended in the grafted patient, in order to maintain the BMI below 25 kg/m2 . About 1/3 of our recipients have metabolic complications (diabetes, dyslipidemia) associated with hypertension increasing the cardiovascular risk in these patients, knowing that the annual rate of death or cardiovascular events is 50 times higher in transplant recipients compared to the general population. Conclusion The transplant population has multiple cardiovascular risk factors. Early detection and correction of these factors must be a priority in order to improve the survival of these patients. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.05.028
Use of biomarkers for prognosis cardiovascular risks Berik Koichubekov ∗ , Marina Sorokina , Ludmila Turgunova , Anara Turmuhambetova , Yelena Laryushina , Ilia Korshukov Karaganda State Medical University, 100024 Karaganda, Kazakhstan ∗ Corresponding author. E-mail address:
[email protected] (B. Koichubekov) Background and aim The major risk factors for cardiovascular disease (CVD) are: age, male gender, hypertension, diabetes mellitus, dyslipidemia and smoking. Strong evidence also exists for lack of physical activity, obesity and alcohol intake. However, over 35% of CVD occurs among those without any known risk factors. The ongoing search for novel markers is inspired by this discrepancy and the need to better portray future cardiovascular risk, such that preventive and therapeutic interventions can be more effectively and also by the opportunity to discover new targets for intervention. The aim of this research was to study some biomarkers to the future development of CVD. Methods Our study was performed among 481 people aged 40—65 years (347 with high risk of CVD, SCORE = 5—10% and 134 control subjects). Some biochemical markers: CK- MB, FABP4, NT Pro BNP, VEGF were tested. Evaluation of differences was performed using nonparametric tests. For each marker, ROC-curve was plotted and the area under the ROC curve (AUC) was calculated. Results The plasma levels of markers in both groups were compared, they all showed statistically significant differences (P < 0.05). The AUC can be used as a criterion to measure the test’s discriminative ability. According to our results the greatest diagnostic significance belongs to the SK-MB marker. However, the AUC value for this marker was 0.615 (95%CI: 0.564—0.666) and its diagnostic abilities was poor. In this case, the optimum sensitivity value is 53.7%, and specificity 66.4%. Conclusion The creatinine kinase marker (CK-MB), found in the serum during inflammatory and degenerative muscular diseases, was the most informative studied biochemical markers for predicting the CVD. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.05.029