Poster Session 5

Background: Despite recent approaches, a profound understanding of pathophysio- logical abnormalities in heart failure with preserved ejection fraction (HFpEF) is still lacking. Purpose: Echocardiography provides the method of choice for diagnosis as well as progression assessment in patients with suspected HFpEF. Thus, the purpose of this exploratory study is to investigate long-term outcomes regarding echocardiographic and clinical parameters aiming to further characterize this barely described condition. Methods: A total number of 115 HFpEF patients (mean age 70.6 6 8.9 years, 66.1% females) were consecutively enrolled: medical history, physical examination, New York Heart Association (NYHA) functional class, 6-minute walking distance and rou- tine blood tests including serum NT-proBNP measurement were evaluated at baseline and follow-up visits. Furthermore, comprehensive transthoracic echocardiography (TTE) was performed at baseline and at mean 23.9 6 15.5 months of follow-up. Results: The present analysis suggests that HFpEF patients featured significant improvement in NYHA functional class ( (cid:2) III: 72.2% vs. 55.7%, p < 0.001) as well as a minor increase in 6-minute walking distance (mean 325.4 6 120.6 vs. 355.1 6 123.5 meters, p ¼ 0.756) at follow-up, whereas serum NT-proBNP levels (mean 2026.7 6 3301.5 vs. 2242.0 6 3976.9 pg/mL, p ¼ 0.265) remained consistent. Notably, TTE revealed global, yet not significant, enlargement of atrial and ventricular size over time (left Conclusions: Our work demonstrates deterioration of right ventricular function and worsening of tricuspid regurgitation over time. Although HFpEF is generally regarded as disease of the left ventricle, recent investigations provide strong evidence of right ventricular contribution to the overall impairment and mortality of these patients. can on of ablation may in and effects on may remodeling paroxysms of AF than in patients without paroxysms of AF (4,5 6 1,5 and 2,8 6 1,5 mm, h ¼ 0,001). The multivariate regression analysis demonstrated that EFT is an independent predictor of non-effective of radiofrequency ablation therapy of AF (OR ¼ 1,47, 95% CI 1,02-2,04, p ¼ 0,014). Conclusions: Epicardial fat in patients with non effectiveness of radiofrequency abla- tion is thicker than in patients with effect of this therapy. Greater thickness of epicardial fat is associated with higher risk of non effectiveness of radiofrequency ablation. Epicardial fat can influence on remodeling of the heart, that’s why in patients with metabolic syndrome recurrent paroxysms of atrial fibrillation were detected more often than in patients with atrial fibrillation and without metabolic syndrome. AIM:Tocompare left atrial (LA) mechanical function, assessed by two-dimensional echo- cardiography, in patients with essential hypertension with healthy controls. Methods: LA volumes were measured echocardiographically in 50 hypertensive patients and 50 age-matched healthy controls using biplane Simpson method. LA volume measurements were done at the time of mitral valve opening (Vmax), at the onset of atrial systole (p wave at the electrocardiogram ¼ Vp) and at mitral valve closure (Vmin). All volumes were indexed for body surface area, and the follow- ing left atrial emptying functions were calculated: LA passive emptying volume ¼ Vmax-Vp, LA passive emptying fraction ¼ LA passive emptying volume/Vmax, conduit volume ¼ left ventricular stroke volume-(Vmax-Vmin), LA active emptying volume ¼ Vp-Vmin, LA active emptying fraction ¼ LA active emptying volume/Vp, LA total emptying volume ¼ (Vmax-Vmin), LA total emptying fraction ¼ LA total emptying volume/Vmax. Results: Hypertension was associated with an increase of all LA volumes: Vmax (p < 0.001), Vp (p < 0.001) and Vmin (p < 0.004). LA booster pump function was significantly greater in hypertensive patients than in controls with an increase of LA active emptying fraction (35 6 12% versus 30 6 12%respectively; p ¼ 0.032). The increase of LA booster pump function was found to be greater in hypertensive patients with impaired diastolic function compared to those with normal diastolic function (p ¼ 0.029). LA conduct function assessed by LA passive emptying fraction was found to be significantly greater in control group than in hypertensives (32 6 11% versus 22 6 12% respectively; p < 0.001). There was a negative correlation between left ventricular mass index and LA passive emptying fraction (r ¼ -0.37; p ¼ 0.007). LA reservoir function evaluated by LA total emptying fraction was similar in both groups while LA total emptying volume was greater in hypertensives than in control group (p ¼ 0.03). Conclusion: Hypertension was associated with a decrease in left atrial passive emp- tying function, and an increase of systolic pump function. Left ventricular hypertrophy and diastolic dysfunction probably played a major role in these modifications. Consecutive 77 patients undergoing clinically indicated is an accu- rate, easy and fast alternative to conventional manual methodology. This technique may contribute towards full integration of 3DE quantification into clinical routine. associated Methods: 3D transthoracic echocardiography per- formed on a non-dialysis day. Unpaired T tests and Chi-squared tests were utilised to identify differences between baseline characteristics of patients with and without LV mechanical dyssynchrony, defined as a standard deviation (SD) of time to minimum systolic volume corrected to heart rate (Tmsv-16 SD) of > 3%. Cox regression analy- sis was applied to assess the predictive value of LV dyssynchrony to all-cause mortality, cardiac events, and heart failure hospitalizations. Results: Ninety-seven patients had adequate images for analysis (67% male, median age 63 [25th-75th centile, 50-72] years). 94% had preserved LV ejection fraction (LVEF) > 50%. Mean Tmsv-16 SD was 3.35 (3.30)%, and 39 patients (40%) had LV mechanical dyssynchrony. There was no difference between patients with and without LV dyssynchrony in any clinical parameter; LVEF (59.6% vs 63.3%, p ¼ LVMI/ used three-dimensional echocardiography full-volume mul-tibeat data sets temporal of the Using available software pack-age a 3D beutel model of the Using in to (EDV) ejection factors of PE of and divided into 2 with course of PE days and On admission ECHO-signs of right ventricle (RV) dysfunction (RV and right atrium (RA)diameters, RV/LV index, systolic blood pressure in PA, shift of intraventricular septum (IVS), hypokinesis of RV free wall) and LV ejection long-term complications of thrombolysis, obstructive shock\hypotension, subclinical a predictor of future heart failure (HF) a EPIFAT not EPIFAT HF. 86 echocardiograms of patients with a normal ventricle ejection BMI Methods: In 24 patients with electrical LV dyssynchrony (6 with left bundle branch block, 4 with right ventricular pacing and 14 with biventricular pacing) we performed simultaneous echocardiography and measurement of pulmonary capillary wedge pressure (PCWP) as an indirect measure of LV filling pressure. Septal and lateral e’ were measured and E/e’ calculated using both septal (n ¼ 24) and average (n ¼ 23) e’. Using a cutoff for average E/e’ of 14 and septal E/e’ of 15, patients were classified as having either normal ( (cid:4) 12 mmHg) or elevated ( > 12 mmHg) LV filling pressure. Results: Mean PCWP in the population was 24 6 9 ( 6 SD) mmHg. Average E/e’ above 14 detected elevated LV filling pressure with a sensitivity of 70% (95% CI: 46- 88), whereas septal E/e’ above 15 detected elevated filling pressure with a sensitivity of 91% (70-99). Conclusions: E/e’ seems to be a sensitive marker of elevated LV filling pressure in patients with electrical dyssynchrony. If confirmed in a larger population, this finding indicates that E/e’ can be used the same way in this population as in patients with narrow QRS. Background Left ventricular (LV) diastolic dysfunction is seen on patients with acute myocardial infarction (MI) even after successful percutaneous coronary intervention. Previous studies showed the majority of diastolic function post MI recovered slowly than systolic function after revascularization. In this study, we prospectively observed the LV diastolic function change in patients with ST-elevation MI and determined if early reopening of the occluded coronary artery made a better recovery of diastolic function than late reopening during the acute phase of MI. Methods 45 consecutive patients(61.20 6 11.37years, 8Females) presenting with acute STEMI and treated with coronary intervention were prospectively enrolled in this study. The important inclu- sion criteria were first acute coronary syndrome episode and LV ejection fraction exceeded 45% on echocardiography. The patients were divided to two different groups by total ischemia time according to the newest ESC guideline on myocardial revascularization. Total ischemic time consisted of prehospital patient delay time and first medical contact (FMC) to balloon time. Transthoracic echocardiography were performed within the first week after coronary intervention and data were compared between early reperfusion (total ischemia time < 6hours) and late reperfusion group (total ischemia time (cid:2) 6h). The mitral inflow velocity was obtained from spectral pulse- wave Doppler and mitral annulus propagation velocity (MVp) was measured by color M-mode. The mean of the septal, lateral, anterior, posterior e’ velocity from tissue Doppler was used for calculation of E/ e’. Blood samples were collected to test the cardiac enzymes, pro BNP, lipid cholesterols ect. Results A normal diastolic filling pattern on Doppler echocardiography is seen in only 9 patients in the acute phase of MI. The other 80% patients had abnormal filling patterns: 16 impaired relaxation, 14 pseudonormal, 6 restrictive filling patterns. The baseline age, systolic and diastolic blood pressure, heart rate, body mass index and serum creatinine were not signifi- cantly differe