European Heart Journal

Rus, H; Bobescu, E; Poinareanu, I

doi: 10.1093/eurheartj/ehab849.008pmid: N/A

Funding AcknowledgementsType of funding sources: None.IntroductionLeft atrial (LA) systolic dysfunction is present in early stages of atrial fibrillation (AFib) prior to left anatomical changes and is influenced by left ventricular systolic function. We evaluate weather left atrial function index (LAFI), left atrial strain parameters (LASP) and glycemic control can be a predictor of AFib recurrence after medical or electrical conversion patients with paroxysmal AFib.Material and methodWe evaluate 150 patients who underwent medical or electrical conversion for paroxysmal AFIb, for a period of 2 years. LA systolic function was appreciated with the echocardiography determined LA emptying volume = Maximum LA volume (LAV max)-minimum LA volume (LAV min), LA emptying fraction= {[LAV max-LAV min]/LAV max]x100}, and LAFI = LA emptying fraction x LVOT-VTILA max index. Left atrial strain (LAS) was assessed as reservoir strain[normal value(NV) 39%], conduit strain(NV 23%) and contractile strain(NV 17%). Flow mediated vasodilation was recorded at the level of brachial artery. Recurrent AFib was recorded in 75 patients (50%), time11,5 ± 10 month.ResultsUnivariate analysis revealed as markers for arrhythmia recurrence low LAFI, reduced LA ejection force, altered LASP, high BMI, poor glycemic control (cut-off value for hemoglobin HbA1C 7%), high BMI, decreased index of flow mediated vasodilatation (FMD). On multivariate analysis poor glycemic control, reduced LAFI, altered LASP and larger LA diameter had a higher risk of AFib than patients with higher LAFI and good glycemic control (p < 0,004).ConclusionIn patients with paroxysmal atrial fibrillation, reduced left atrial function index, altered left atrial strain parameters, larger left atrium, altered endothelial dysfunction appreciated by flow mediated vasodilatation, and poor glycemic control can be predictors of arial fibrillation recurrence.

Inamdar, Aniket

doi: 10.1093/eurheartj/ehab849.139pmid: N/A

Funding AcknowledgementsType of funding sources: None.BackgroundBody mass index (BMI) is positively and independently associated with morbidity and mortality from hypertension, cardiovascular disease, type II diabetes mellitus, and other chronic diseases. In Caucasian and Asian populations, a strong association has been depicted between BMI and mortality. Globally, high blood pressure is estimated to cause 7.1 million deaths, about 13% of the total. About 62% of cerebrovascular disease and 49% of ischemic heart disease are attributable to suboptimal BP (systolic > 115 mm Hg). Overweight and obesity increase the risks of high BP, coronary heart disease, ischemic stroke, type II diabetes mellitus, and certain cancers. Worldwide, about 58% of diabetes mellitus and 21% of ischemic heart disease are attributable to BMI above 21 kg/m2. The combination of blood pressure and Body Mass Index (BMI) contribute more than 60% cases of cardiovascular disease.PurposeThe main objective was to determine the correlation between BMI and systolic and diastolic blood pressure of rural Indian patients.Materials and Methods310 patients who visited our hospital in rural India from January 15,2021 to February 15,2021 were included in this study and their systolic and diastolic blood pressure, weight and height were measured. BMI was calculated by weight in kilograms divided by square of height in meters. Using this, the patients were categorized as underweight (<18.5 kg/m2), normal or lean BMI (18.5–22.9 kg/m2), overweight (23.0 –24.9 kg/m2) and obese (≥25 kg/m2) based on the revised consensus guidelines for India. Descriptive analysis and Spearman correlation test were used to analyze the data.ResultsThe results of the bivariate analysis using Spearman correlation test showed that there is significant relationship between BMI and systolic blood pressure (p < 0.001, r = 0.375) as well as BMI and diastolic blood pressure (p <0.001, r = 0.432). This study shows that as BMI increases both systolic and diastolic blood pressure increases.ConclusionThis study shows statistically significant relationship between Body Mass Index (BMI) and systolic and diastolic blood pressure in rural Indian patients. Weight gain seems to be an important risk factor for development of hypertension. Weight loss has been recommended for obese hypertensive patients and has been shown to be most effective non pharmacological treatment approach. Physical activity and caloric restriction should be promoted to control the obesity epidemic which will significantly reduce global cardiovascular disease burden.

Barakat, A; Amar, A; Alsaadi, A,R

doi: 10.1093/eurheartj/ehab849.069pmid: N/A

Funding AcknowledgementsType of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and Uneversity Heart Surgery Center, Damascus, Syrian Arab Republic.BackgroundCoronary artery disease (CAD) affects left ventricular (LV) systolic and diastolic function. This  results in high filling pressure which expressed by different waves and may be assessed by invasive and noninvasive methods. Validation and comparing the correlation between CAD and different LV filling pressure waves may add a step forward in CAD diagnosis, prognosis and treatment.PurposeThis study invasively validates the correlation between coronary artery disease (CAD) and left ventricular end-diastolic pressure (LVEDP) as well as left ventricular pre-A wave (LV pre-A wave) and compare the results.Methods124 patients who accepted to participate for this study underwent left heart catheterization for medical indications. This study obtained the results of LV filling pressures (LVEDP and LV pre-A wave), as well as, coronary angiography results with assessing the severity and extents (if CAD presents) by vessels number and Gensini Score (GS). Spearman r correlation were used for continuous/continuous or continuous/ordinal variables and Chi square test for nominal/nominal variables. Then we compared the results.ResultsCAD presence with elevated LVEDP incidence (OR = 4.29, relative risk = 1.85 P = 0.0123). Vessel number, plaque number and Gensini score correlations with LVEDP were (P = 0.0038 r = 0.34, P = 0.0002 r = 0.44, p = 0.0002 r = 0.43 and p = 0.0622 r = 0.22) respectively. In the same way, CAD presence with LV pre-a wave (OR = 2.75, relative risk = 1.5, P = 0.0447). Vessels number, plaque numbers and Gensini score relations with LV pre-A wave were (P = 0.0379 r = 0.23, P = 0.0004 r = 0.39, p = 0.0002 r = 0.40 and p = 0.0568 r = 0.21) respectively. All the results are summarized in Tables (1 + 2+3).ConclusionsLV filling pressure had a significant correlation with CAD presence, vessel number and plaque number but it did not have a correlation with Gensini score. LVEDP had a stronger correlation with CAD presence, severity, sensitivity and extent but lower specificity than LV pre-A wave.Abstract Tables of results (1 + 2) Abstract Table of result 3