CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 23 AFRICA Submission ID: 1159 CARDIOVASCULAR RISK IN HEART FAILURE WITH MIDRANGE EJECTION FRACTION Mariem Drissa, Cyrine Aouji, Marouen Sta, Essia Chahnez Mousli, Habiba Drissa Tunisia Introduction Heart failure with mid-range ejection fraction (HFmrEF) is considered a new clinical entity that’s still not well understood. HFmrEF patients represent a group with different clinical characteristics and heterogeneous outcomes. The purpose of the study was to establish the clinical, therapeutic and prognostic profile of patients presenting HFmrEF and identify the predictive factors of mortality and rehospitalization. Methods This was a prospective, longitudinal and analytical study including 100 patients presenting new onset of HFmrEF, hospitalized in the adult cardiology department of La Rabta hospital from June 2018 to June 2019 with a 6 months follow-up. Results The mean age was 65 ± 12 years with a sex ratio of 1.3. Hypertension (56%) was the most common cardiovascular risk factor. Dyspnea was present in (96%) of patients and chest pain in (45%) of patients. Atrial fibrillation was found in (39%) of patients. The etiologies of HF were: ischemic (48%), hypertensive (15%), valvular (14%), dilated cardiomyopathy (14%) and rhythmic (9%). Angiotensin converting enzyme inhibitors (ACEi) were prescribed for (86%) of patients, beta blockers (BB) for (82%). Myocardial revascularization and valve surgery were performed on (48%) and (10%) of patients respectively. In-hospital and 6-months mortality were respectively 5% and 15%. The 6-months rehospitalization rate was 11% with an average rehospitalization time of 50 ± 40 days. The 6-months MACE rate was 26%. During follow-up, surviving patients (n=85) have presented a dynamic evolution of the LVEF marked by stability (n=60), improvement (n=10) or impairment (n=15). In multivariate analysis: age> 70 years, arterial hypertension, ischemic etiology and anemia were independent predictors of mortality. NYHA stage III-IV dyspnea, history of chronic obstructive pulmonary disease and echocardiographic parameters of right ventricular impairment were associated with an increased risk of readmission. Conclusion HFmrEF is considered a distinct entity with specific characteristics, a dynamic evolution with possible transition from one type of HF to another and an unpredictable prognosis which needs a well characterized and individualized therapy. MODERATED POSTER SESSION 1 which occurred in 8 patients. For the group who underwent surgery, the average size of the defect was 32,5 mm which is much higher than the first group(P<0.001). Complications occurred in 8.5%. After surgery, the average of peak systolic pulmonary pressure significantly decreased from 38.6 mmHg to 28.1 mmHg(P<0.001). Residual shunt was non-significant in both groups. Conclusion: Both treatment modalities are safe and effective, with excellent outcomes. However, the percutaneous treatment has lower morbidity. These results support the fact that percutaneous treatment of atrial septal defects should be considered as the method of choice for treatment of ASD. Submission ID: 1169 CLINICAL CHARACTERISTICS OF PATIENTS WITH INFECTIVE ENDOCARDITIS Kacem Marwen, Gribaa Rym, Meddeb Ayoub, Zarouali Imane, Ouannes Sami, hela kaddour, Ben Saad Saeb, Ben Farhat Sameh, Elheraiche Aymen, Slim Mehdi, Neffati Elies Cardiology Department, University Sahloul Hospital, Tunisia Background Infective endocarditis (IE) is a condition where the fields of cardiology and infectious diseases overlapmaking the initial presentation amix of signs of infection, signs of cardiac involvement, and in a considerable number of cases signs of embolic events. Few recent papers studied the clinical characteristics of patients with confirmed IE. Aim The aim of our study is to determine clinical characteristics of patients with IE in sahloul department of cardiology during a period of 10 years. Methods Between January 2010 and December 2020, 74 patients were admitted to the sahloul cardiology department for EI using the modified duke criteria. Data was collected retrospectively from patient medical records. Follow-up evaluations were done with clinical and lab tests assessment at a yearly rate. Results Of the 74 studied patients 95.94% had low grade fever during 2 days prior to first medical contact; 29.72% of patients had grade III to IV dyspnea. Neurological loss of function was present in 13.51% secondary to embolic ischemic stroke while 16.21% of patients had chest pain. Patients with anorexia and weight loss made up of nearly 30% of the total studied pool. Physical exam data showed cardiac murmur in 78.37% of patients, signs of heart failure on the other hand were reported in 19% of cases for left heart failure, 19% for right heart failure and 14.86% for global heat failure. On the electrocardiogram 13.5% of patients had atrial fibrillation one patient had complete heart block, 5.4% had left bundle branch block and 2.7% had right bundle branch block Conclusion The initial clinical presentation of patients with IE varies in the studied population with fever being the most frequent sign. Overall no real changes compared to prior studies have been found in the general clinical profile of patients with IE. Submission ID: 1221 A CORONARY PERFOARATION : ALWAYS A NIGHTMARE ben ouanes sami, MEKKI NOUHA, BEN SAAD SAEB, AYOUB MEDDEB, KADDOUR HELA, GRIBAA RYM, SLIM MEHDI, HRAYECH AYMEN, BEN FARHAT SAMEH, NEFFATI ELYES Department ôf Cardiology Sahloul Hospital Tunisia Background Coronary perforation is an uncommon but potentially life-threatening complication of percutaneous coronary intervention.In this case, we share our latest experience in the management of coronary perforation. A 70-year-old man, smoker, presenting with a NSTEMI. The EKG showed inversed T waves in the anterior leads.TTE showed a reduced ejection fraction estimated at 40%. The coronary angiogram revealed a significant calcified thrombotic lesions of the left main artery and the LAD with a slow flow and a critical lesion of the marginal. After anticoagulation with 5,000 Units of intravenous
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