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Heart, Lung and Circulation S412008;17S:S4–S53 Poster Presentations

The aim of the present study was evaluation of the mass,size and LV function in athletes and hypertensive patients.

Methods: We studied 52 soccer players (I group), 30hypertensive patients (II group) and 15 healthy volun-teers (III group). LV mass and function was evaluated byDoppler echocardiography.

Results: In all groups LV-mass, End systolic–diastolicdiameters, septum and posterior wall thickness, ejec-tion fraction, LV diastolic filling velocities: VE, VAwas measured. Pulmonary vein flow was assessed. LVmass index was 188 ± 14.5 g/m2 (95% CI 165–121) in Igroup, 168 ± 6.5 g/m2 (95% CI 138–182) in II group and106 ± 5.3 g/m2 (95% CI 96.4–115.6) in III group.

VE/VA in I group 1.1 ± 0.9 (95% CI 0.5–2.58), 0.85 ± 0.33(95% CI 0.43–1.161) and 1.12 ± 0.3 (95% CI 0.72–1.52) in IIand III groups. Comparison showed, that group of athletesis more heterogeneous depending on standard deviationand wide variation of 95% CI of study parameters. From megroup 15 subjects were separated. In all of them variationof indices significantly exceeded the variations in controlgroup. This 15 athletes formed group IA After separation Igroup became more homogeneous (group IB). In IA groupLV mass index was 188 ± 3.2 g/m2 (95% CI 182–193.6) and172 ± 4.1 g/m2 (95% CI 163.9–180) in IB group. VE/VA inIA group was 1.0 ± 0.25 (95% CI 0.56–1.44) and 2.2 ± 0.28(95% CI 1.1–2.7). In IB group LV mass growth was associ-ated with heart function enhancement, while in IA grouplf

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Table 1.

Parameters E/E′ < 10 (n = 71) E/E′ ≥ 10 (n = 17) p-Value

LVPpre-A (mmHg) 13 ± 5 20 ± 5 <0.001EF (%) 49 ± 9 40 ± 6 <0.001LA volume (ml) 52 ± 19 63 ± 18 0.039E/A 0.69 ± 0.16 0.69 ± 0.12 0.994DT (ms) 230 ± 52 230 ± 53 0.995IVRT (ms) 144 ± 34 145 ± 23 0.932PVs/PVd 1.58 ± 0.38 1.62 ± 0.40 0.726

echocardiographic measurement. Patients were dividedinto subjects with E/E’ < 10 (n = 71) and E/E′ ≥ 10 (n = 17).

Results: LVPpre-A was well correlated with echocar-diographic Doppler and hemodynamic parameters (E/E′,r = 0.536, p < 0.001; LA volume, r = 0.295, p = 0.008; EF,r = −0.234, p = 0.028). Forty (45% of total) patients hadhigh LVFP, defined as LVPpre-A ≥ 15 mmHg. Patients withE/E’ ≥ 10 had a significantly higher incidence of high LVFP,when compared to patients with E/E’ < 10 (88% vs. 35%,p < 0.001). LA volume and LVPpre-A were significantlyincreased and EF was decreased in patients with E/E′ ≥ 10(Table 1). However, there were no significant differences ofparameters derived from transmitral inflow and transpul-monary venous flow between two groups.

Conclusions: In patients with impaired relaxation pat-tern, elevated E/E′ has related to elevation of LVFP,regardless of transmitral inflow and transpulmonaryindices. Therefore, impaired relaxation pattern with ele-vated ratio of early diastolic transmitral flow velocity tomitral annular velocity (E/E′) may have been consideredas another grade of diastolic dysfunction.

doi:10.1016/j.hlc.2007.11.105

Impact of stage III and IV diabetic nephropathy on car-diovascular disease

Ana Paula Silva ∗, Alexandre Baptista, Pedro Leao Neves

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arge LV mass and signs of impaired diastolic function wasound, like in patient’s group.

Conclusions: We suggested that LV hypertrophy in ath-etes is not always pure physiologic adaptation andndividuals with impaired LV function may be at higherisk of cardiovascular events, than athletes with preservedeart function.

oi:10.1016/j.hlc.2007.11.104

ow can we grade impaired relaxation pattern withlevated E/E′ as grade 1 diastolic dysfunction by echocar-iography?

oon-Han Shin ∗, Un-Jung Choi, Hong-Seok Lim, Soo-in Kang, Jung-Won Hwang, Byoung-Joo Choi, So-Yeonhoi, Myeong-Ho Yoon, Gyo-Seung Hwang, Seung-Jeaahk

Ajou University School of Medicine, Republic of Korea

Purpose: Impaired relaxation pattern (grade 1 diastolicysfunction) by Doppler echocardiography is known toeflect preserved left ventricular filling pressure (LVFP),hile increased ratio of early diastolic transmitral flow

elocity to mitral annular velocity (E/E′) indicated ele-ated LVFP. We evaluated the characteristics of impairedelaxation pattern with elevated E/E’ ratio.

Methods: Eighty-eight patients (mean age 63 ± 11, 59ales) who had coronary artery disease with impaired

elaxation pattern (E/A < 1) were enrolled. Echocardiog-aphy including tissue Doppler imaging (TDI) was per-ormed. All patients underwent cardiac catheterization tonvestigate LV pre-A pressure (LVPpre-A) within 6 h after

Hospital Distrital Faro

Background and aims: Cardiovascular disease (CVD) isommon in the general population, affecting the majorityf adults past the age of 60 years. Patients with dia-etes mellitus (DM) have a significantly higher risk and aigher mortality from cardiovascular disease. The diabeticatient has a 2–4-fold increase in the risk for developmentVD.The aim of our study was to evaluate the impact of stage

II and IV the diabetic nephropathy (DN) on cardiovascu-ar and cerebrovascular (CV) disease.

Methods: The retrospective study, comparative from Jan-ary 2000 to September 2007. We analysed patients withephropathy diabetic and divided in two groups: A (stage

II DN) and group B (Stage IV DN). We have studied theistribution by age, laboratorial parameters, cardiovascu-

ar (manifested by myocardial infarction, angina pectoris,eart failure) and cerebrovascular (manifested by strokend transient ischemic attack) disease.

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S42 Heart, Lung and CirculationPoster Presentations 2008;17S:S4–S53

Statistical analysis was performed with Student’s t-test,χ2 test.

Results: Group B, had lower haemoglobin level(12.6 g/dl vs. 13.6 g/dl, p = 0.006), lower creatinine clearance(50 ml/min vs. 80 ml/min, p = 0.0001) and elderly patients(60.5 years vs. 49.7 years, p = 0.006). There was also theincidence of CVD (p = 0.001) and CV (p = 0.002) was sig-nificantly higher.

Conclusion: In our study the stage IV of diabeticnephropathy were greater the high rates of cardiovascularand cerebrovascular disease.

doi:10.1016/j.hlc.2007.11.106

Inflammatory markers and progression of end-stage renaland cardiovascular disease in patients with diabeticnephropathy

Ana Paula Silva ∗, Alexandre Baptista, Pedro Leao Neves

Hospital Distrital de Faro

Introduction and aims: Chronic inflammation is increas-ingly recognized as an important issue due to its role invarious pathological states. Diabetes is a risk factor foratherosclerosis and low-degree inflammation may play acentral role in both diseases.

Various reports have indicated a significant associa-tion between increase serum of inflammatory biomarkers,

Interleukin-6 (IL-6): Is a marker for cardiovascular diseasein patients with diabetic nephropathy

Ana Paula Silva ∗, Alexandre Baptista, Ana Cabrita, PedroLeao Neves

Hospital Distrital de Faro

Interleukin-6 (IL-6) is synthesized in response to diverseinflammatory stimuli and causes cellular damage and pro-motes atherosclerotic process.

Elevated concentrations of IL-6 are associated with thedevelopment and severity of coronary heart and renal dis-ease.

The aim of the present study was to assess the relation-ship between increased plasma IL-6 levels and outcomein patients with diabetic nephropathy (DN).

We included 30 patients, mean age 80 years, followedin on low clearance outpatient clinic for more than12 months. The presence of inflammation parametersobtained from blood samples collected monthly since thefirst day of consultation and the criterion of hospitalization(cardiovascular disease) is defined by medical history andclinical symptoms.

The patients were divided in two groups: Group A = 12patients beginning dialysis and Group B = 18 patients thatnot evolution of ESRF. The two groups were compared inrelation of IL-6 and outcome (number and day of hospital-ization from cardiovascular disease) in patients with DN.

such as interleukin-6 (IL-6) and high sensitivity C reac-tive protein (hs CRP) and cardiovascular disease (CVD),mortality, morbidity and progression of end-stage renaldisease (ESRD) in diabetic patients group.

The aim of the present study was to assess theassociation between inflammatory biomarkers and fastprogression of ESRD and cardiovascular disease inpatients with diabetic nephropathy stage IV.

Methods: We included 30 patients, type 2, and stage IVDN, mean age 68.2 years, followed in outpatient clinicfor more than 24 months. The presence of inflamma-tion parameters obtained from blood sample collectedmonthly since the first day of consultation. The CVDis manifested by myocardial infarction, angina pectoris,heart failure.

The patients were divided in two groups: group A = 12patients develop ESRD and beginning dialysis and groupB = 18 patients not develop ESRD. The two groups werecompared relation of IL-6, hs CPR and fast progression ofESRD and the cardiovascular disease.

Results: The patients group A showed elevated IL-6 andhs CRP levels (6.7 vs. 4.0, p = 0.08) and (1.3 vs. 0.46, p = 0.015)and develop ESRD 20 months later and increase the car-diovascular disease.

Conclusions: The present study elevated levels of IL-6 andhs CPR contribute to the development and the fast pro-gression of ESRD and cardiovascular disease in patientswith DN stage IV.

doi:10.1016/j.hlc.2007.11.107

The IL-6 is measured by means IMMULITE 2000 analyser.The presence of clinical cardiovascular disease (CVD) wasdefined by medical history and clinical symptoms.

For comparisons between groups, Student’s t-test andthe χ2 test were used.

The patients in the A group showed elevated IL-6 levels(6.7 vs. 4.0, p = 0.08) and the number and the duration ofhospitalization in this group is significantly higher (1.42vs. 0.1, p = 0.002 and 12 vs. 0.6 day, p = 0.004.

The present study the elevated IL-6 plasma level hasa major effect on cardiovascular disease in patients withdiabetic nephropathy

doi:10.1016/j.hlc.2007.11.108

Donor heart procurement experience in Singapore

David Kheng Leng Sim ∗, R.N. Ka Lee Kerk, R.N. ChiaLee Neo, Chong-Hee Lim, C. Sivathasan, Teing Ee Tan,Bernard Wing Kuin Kwok

National Heart Centre, Singapore

Background: Heart transplantation began in Singaporeat our centre in 1990. Although the incidence of heart fail-ure is increasing, the number of heart transplant beingdone remains low, mainly due to low organ donation rateand limited population. To alleviate the demand for moreorgan donors, Human Organ Transplant Act (HOTA) wasamended in 2004 to allow removal of organ upon deathunless the individual registered an objection. We reviewour organ procurement experience before after HOTAamendment.