AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 18 Submission ID: 1064 A DECREASED LA RESERVOIR FUNCTION IS ASSOCIATED WITH HIGH TRANS MITRAL GRADIENT IN MITRAL STENOSIS (MS) PATIENTS Kallala M.Y., Bouchahda N., Slimene W., Bouchnag S., Bouallagui S., Ibn El Mechri N., Lamine S., Ben Messaoud M., Boussaada M., Hassine M., Gamra H. Cardiology A department, Fattouma Bourguiba University Hospital, Monastir, Tunisia Background: Measurement of mean trans-mitral gradient (MTMG)to assess the severity of rheumatic MS is widely accepted. However, gradient is highly dependent on flow conditions and heart rate. The role of LA in generating trans-mitral gradient has been poorly investigated. Objective: To assess the correlation between LA reservoir function (LASr) determined by 2D Speckle Tracking Echocardiography(STE) derived from global LA strain and MTMG. Methods: We prospectively performed trans-thoracic echocardiography (TTE) in a cohort of patients with rheumatic MS. Basic 2D and doppler EKG gated echocardiographic parameters were recorded such as mitral valve area (MVA) with planimetry and pressure half time (PHT), MTMG, maximal Tricuspid Regurgitation Velocity (TRVmax). Studied parameters represent the mean of 3 consecutive cardiac cycles. LA global strain curve and peak reservoir strain data were obtained on a dedicated 4C view with STE technique. Results: 195 patients with rheumatic MS were enrolled between February 2018 and October 2021. The mean age was 50.7±12 yrs. We divided our cohort into two groups: group 1 with MTMG <=10 mmHg and group 2 with MTMG >10 mmHg. There was not a significant difference between the two groups in age (52±11vs49.12yrs, p=0.09), severity of symptoms (43.2vs45.8%, p=0.7 had NYHA class III or IV symptoms) nor in the incidence of atrial fibrillation (62.5vs59.5%, p=0.6). MVA was significantly lower in group 2(1.07±0.3vs1.54±0.4cm², p<0.001). Group 2 patients had significantly higher Wilkins score (11.2±2vs12.7±2,p<0.001), LAindexedvolume (88.7±47vs75.9±36ml/ m², p=0.03) and TRVmax (3.5±0.7vs2.8±0.4m/s, p<0.001). LASr was significantly higher among patients in group 1 (12.3±8 vs 8.2±5%, p<0.001). Conclusion: LA reservoir function is strongly associated with the level of mean trans-mitral gradient in patients with rheumatic mitral stenosis. MODERATED POSTER SESSION 1 Submission ID: 1038 ASSOCIATION BETWEEN GRACE RISK SCORE AND CORONARY DISEASE COMPLEXITY IN PATIENTS WITH ACUTE CORONARY SYNDROME Sabrine Soudani, SARRA CHENIK, Aymen Noomen, Taha yassine Jabloun, Wafa Fehri Cardiology Department, Military Hospital of Tunis, Tunisia Introduction: The GRACE score is a useful tool for risk stratification in patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate the accuracy of the GRACE score in predicting the extent of coronary artery disease. Method: A total of 90 patients hospitalized in the cardiology department of the main military, presenting with ACS and undergoing coronary angiography were included in this analysis. Patients were classified into two categories: those with coronary status with monotruncular involvement and those with bi-truncular or tri-truncular status. Results: The mean age of our patients was 64.8 years with a male predominance (sex ratio =1.9). According to the Grace score 23.3% of the patients had a low risk, 18.9% had a medium risk, and 16.7% had a high risk of mortality. Spearman correlation and receiver characteristic analysis were performed to investigate the role of the GRACE score as a predictor of the severity of coronary status. There was a significant positive correlation between coronary status and GRACE (r= 0.31, p < 0.023). The GRACE score predicted severe CAD (bi-truncular and tri-truncular status) moderately well. Therefore, our study reports a significantly positive correlation between the GRACE score and coronary status in patients with ACS. Conclusion: A multidisciplinary approach by a cardiac team could potentially change the therapeutic approach and management of patients with ACS and a high calculated GRACE score. anemia (100 % vs 0%, p<0.001), thrombocytopenia < 100 000 (100% vs 0%, p<0.001), active malignancy (100 % vs 0%, p<0,001) and had more frequently a high PRECISE DAPT SCORE (>25) (67.7 % vs 4.9 %, p<0.001 ). Conclusion: Our study demonstrated that high bleeding risk patients are patients with high ischemic risk. Thismakes the decision of double anti-platelet aggregation duration more challenging in our everyday practice. Submission ID: 1066 ASSOCIATION OF LEFT ATRIAL RESERVOIR FUNCTION WITH PULMONARY HYPERTENSION (PH) IN PATIENTS WITH RHEUMATIC MITRAL STENOSIS Kallala M.Y., Bouchahda N., Bouchnag S., Ibn El Mechri N., Slimene W., Sassi G., Bouallagui S. Ben Messaoud M., Boussaada M., Hassine M., Mahjoub M., Gamra H. Cardiology A department, Fattouma Bourguiba University Hospital, Monastir, Tunisia Background: The pathophysiology triggering dyspnea in rheumatic MS patients remains not fully understood. Studies attributing the severity of symptoms to the degree of PH were deceptive as a non-negligible group of patients relatively tolerated MS despite disproportionate levels of PH. Recently introduced echocardiographic techniques allowed the study of left atrial reservoir function (LASr) notably in patients with PH. Objective: To assess the correlation between LASr determined by 2D Speckle Tracking Echocardiography (STE) derived from global LA strain and PH. Methods: We performed prospective 2D TTE in patients with rheumatic MS. 2D and doppler TTE parameters, including indexed LA volume, maximal trans tricuspid velocity (TRVmax), mean trans-mitral gradient (MTMG), valve area (MVA) using pressure half time (PHT),
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