The Prognostic Power of Mitral Filling Pattern: Is it the same in all Patients? Results From an Individual Patient Meta-Analysis (MeRGE)

The Prognostic Power of Mitral Filling Pattern: Is it the same in all Patients? Results From an Individual Patient Meta-Analysis (MeRGE)

S86 Abstracts ABSTRACTS doi:10.1016/j.hlc.2008.05.203 Heart, Lung and Circulation 2008;17S:S1–S209 Doppler, Valsalva and colour m-mode). Pts were...

176KB Sizes 0 Downloads 2 Views

S86

Abstracts

ABSTRACTS

doi:10.1016/j.hlc.2008.05.203

Heart, Lung and Circulation 2008;17S:S1–S209

Doppler, Valsalva and colour m-mode). Pts were grouped by diastolic grade and survival (Kaplan Meier) was compared. Results: HF pts (n = 841): mean age 68 years, 70% male, mean EF33%; no pts exhibited grade 0 filling; 47% (n = 394) exhibited grade 1; 28% (n = 236) grade 2 and 25% (n = 211) grade 3. Four-year survival was highest in pts with grade 1 (90%), and worse in both the grade 2 (80%) and grade 3 (73%) pts (log rank p < 0.001). Post-AMI pts (n = 543): mean age 64 years, 68% male, mean EF 48%; 43 (8%) pts exhibited grade 0 filling, 276 (51%) pts exhibited grade 1; 123 (23%) grade 2 and 101 (19%) grade 3. Incremental deterioration in survival was seen through the grades of DD: grade 0 (98%), grade 1 (86%), grade 2 (80%), and grade 3 (51%). Conclusion: The four grades of DD were associated with incremental deterioration in survival following AMI, but in HF pts less separation between Grades 2 and 3 was seen. Suggesting the clinical context may be important when considering the prognostic implications of differing grades of DD.

203 The Prognostic Power of Mitral Filling Pattern: Is it the same in all Patients? Results From an Individual Patient Meta-Analysis (MeRGE)

doi:10.1016/j.hlc.2008.05.204

Gillian Whalley 1,∗ , Frank Dini 2 , Graham Hillis 3 , Katrina Poppe 1 , Kanchana Perera 1 , David Prior 4 , Cheuk-Man Yu 5 , Miguel Quintana 6 , Allan Klein 7 , Pier Temporelli 8 , Jacob Moller 9 , Greg Gamble 1 , Robert Doughty 1

Martin Brown ∗ , William O’Brien, Tommy Wong, Maged Willaim, Scott Whyte, Jonathon Sturm, Dennis Crimmins

1 The

Atrial Fibrillation (AF) occurs post Acute Ischaemic Stroke (AIS) in 3% patients. To determine if 24 h versus 48 h of Holter monitoring detects a higher incidence of new onset or paroxysmal AF and if this is related to stroke severity or location, we conducted a prospective study of 41 patients with AIS admitted to Gosford Hospital Stroke Unit. Patients were excluded if they had current or prior AF. Stroke severity and location was classified using the NIHSS and Oxfordshire systems. MRI determined stroke location. A Transient Ischaemic Attack (TIA) was a neurological deficit less than 24 h duration. Atrial fibrillation of greater than 30 s was deemed significant. Holter monitor analysis was blinded to stroke type and severity. Our results found only 2/41 (4.9%) patients developed AF in the first 24 h but 3/41 (7.3%) developed AF in the second 24 h (total 12.2%). 4/5 (80%) were strokes and 1/5 (20%) TIA. Stroke was partial anterior circulation in 2/4 (50%) and lacunar in 2/4 (50%). Mean age of patients developing AF was 85.2 years (mean study age 75.4 years). 3/5 (60%) AIS

University of Auckland, Auckland, New Zealand; Chiara Hospital, Pisa, Italy; 3 Aberdeen Royal Infirmary, Aberdeen, United Kingdom; 4 St. Vincent’s Hospital, Melbourne, Australia; 5 The Chinese University of Hong Kong, Hong Kong, China; 6 The Karolinska Institute, Stockholm, Sweden; 7 The Cleveland Clinic Foundation, Ohio, United States; 8 Salvatore Maugeri Foundation, Veruno, Italy; 9 Rigshospitalet, Copenhagen, Denmark 2 Santa

Using Doppler-echocardiography, diastolic dysfunction (DD) can be differentiated: normal (grade 0), abnormal relaxation (grade 1), pseudonormal (grade 2) and restrictive filling (grade 3). Although grade 3 DD is associated with worse survival, limited prognostic data exist regarding other grades. MeRGE is an individual patient meta-analysis evaluating DD and mortality in patients (pts) with heart failure (HF) and post-AMI. This analysis compares outcome by grade of DD. Methods: Nine studies (1384 pts) are included. Diastolic filling was assessed using standard criteria (pulsed wave

204 Acute Ischaemic Stroke and Atrial Fibrillation—Does Time, Location and Severity Matter?

Gosford Hospital, Gosford, Australia