AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 30 Submission ID: 1060 FACTORS ASSOCIATED WITH LOW-FLOW IN RHEUMATIC MITRAL STENOSIS (MS) PATIENTS Kallala M.Y., Bouchahda N., Slimene W., Bouchnag S., Ibn Mechri N., Bouallagui S., Sassi G., Boussaada M., Ben Messaoud M., Hassine M., Mahjoub M., Gamra H. Cardiology A department, Fattouma Bourguiba University Hospital, Monastir, Tunisia Background: Stroke volume(SV) raised enthusiasm in the early investigations of rheumatic MS pathophysiology and was considered as a key component triggering dyspnea. Given the discrepancies uncovered in later studies, its importance was later downgraded. Yet low-flow is present in a non-negligible number of MS patients and new entities were introduced such as low-flow lowgradient MS. Novel echocardiographic techniques allowing subclinical study of left atrial (LA) and ventricular contractility represent a promising tool in the study of the determinants of SV. Objective: To assess correlations between LA reservoir function (LASr) and global left ventricular longitudinal strain (LVS) determined by 2D Speckle Tracking Echocardiography (STE) and stroke volume index (SVI). Methods: We performed trans-thoracic echocardiography (TTE) in a cohort of patients with rheumatic MS. Basic 2D and doppler parameters were recorded such as mean trans-mitral gradient (MTMG), mitral valve area (MVA) with 2D planimetry and pressure half time (PHT), maximal Tricuspid Regurgitation Velocity (TRVmax). Studied parameters represent the mean of three consecutive cardiac cycles. LASr data was obtained on a dedicated 4C view with STE technique. LVS was generated based on the 3 basic apical views. A low-flow state was defined as an SVI <=35ml/m². Results: 195 patients were included between February 2018 and October 2021. We divided our cohort into two groups: group I with SVI <=35 ml/m² and group II with SVI >35ml/m². There was not a significant difference in terms of age (49.8 ±12vs51.6 ±10yrs, p=0.3), sex (70.7vs72.2% were female, p=0.8) and history of atrial fibrillation (67.4vs55.7%, p=0.09). 2D MVA was significantly lower in group I (1.22 ±0.4vs1.43 ±0.5cm², p=0.003). Surprisingly, MVA determined with PHT did not significantly differ (1.43 ±0.6vs1.39 ±0.4cm², p=0.5). The incidence of severe dyspnea was (44.3vs44.4% p=0.9). TRVmax levels (3.23 ±0.6vs3.07±0.6m/s, p=0.14) were comparable. Group I had significantly higher MTMG (12.1±7vs9.8±4mmHg, p=0.01). LVS and LVEF were significantly lower in low-flow patients: (-15±4vs-18±2%, p<0.001) and (61.1±8%vs64.2±5%, p=0.04) respectively. LASr was higher in normal flow patients but did not reach statistical significance. (9.5±7vs11.5±6%, p=0.062). Conclusions: MVA, LVS, and LVEF were significant associates of low-flow state in MS patients. LA reservoir function was not significantly correlated to SVI. Submission ID: 1065 IMPACT OF ACUTE HYPERGLYCEMIA AFTER ANGIOPLASTY FOR ACUTE MYOCARDIAL INFARCTION SKANDER BOUCHNAG, majed hassine, sana bouallegue, nidhal bouchahda, mahdi boussaada, MEJDI BEN MESSAOUD, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA Cardiology A departement, Fattouma bourguiba university hospital, Monastir, Tunisia Introduction: Hyperglycemia (HG) has been shown to be a powerful predictor of worse outcome after ST segment-elevation myocardial infarction (STEMI). Aim: Investigate the relationship between acute HG and patient outcome after primary or rescue angioplasty for STEMI. Methods: We retrospectively included 399 patients who underwent revascularization for STEMI. We compared intrahospital outcomes of the groups of patients with HG (HG+) with those without HG (HG-) and outcomes of diabetic with non-diabetic in the HG+ group. Plasma glucose was measured at hospital admission. HG was defined as plasma glucose > 11 mmol/L (198 mg/dL). Results: Among the overall population, 37.6% patients had HG . They were more frequently women with a more frequent history of diabetes and dyslipidemia.. Procedural success was significantly lower in the HG group (86% vs 92%, p=0.05) with lower rates of ST segment resolution at 24 hours (47.3% vs 61.4%, p=0.006). Intrahospital outcomes were worse in the HG group as attested by a higher mortality (20% vs 10.4%, p=0.008), higher late heart failure (32% vs 18.1%, p=0.001), more frequent ventricular arrhythmias (16% vs 6.8%, p=0.01) and atrial fibrillation (9.3% vs 4.4%, p=0.05). Those outcomes were similar in the HG group regardless of the diabetic status. In non-diabetic patients (n = 260), HG was associated with larger infarct size (p=0.001), more adverse outcome (p=0.009) and the HbA1c was associated with one year mortality (p=0.02). Predictive factors for intrahospital mortality in the overall cohort were : procedural failure (OR : 4.76 ; 95% CI [1.65 - 13.7] ; p=0.004), heart failure at presentation (OR : 9.75 ; 95% CI [4.14 - 22.87] ; p<0.001), non ST regression at 24 hours (OR : 2.19 ; 95% CI [1.08 - 4.445] ; p=0.029), anemia (OR : 4.22 ; 95% CI [2.06 - 8.63] ; p<0.001), high creatinine levels (OR :1.09 ; 95% CI [1.03 - 1.14] ; p=0.001), high glycemia (OR : 2.66 ; 95% CI [1.2, 5.9] ; p=0.016). Diabetes did not predict intrahospital mortality (p=0.64). Conclusion: In patients with STEMI, HG is an important predictor of worse outcomes with an increasing mortality risk even beyond 11 mmol/L. In non-diabetic patients, both elevated admission glucose and HbA1c levels were associated with adverse outcomes. These results suggest the usefulness of glycemia assessment in the setting of STEMI even in non-diabetic and the beneficial effect of strict glycemic control. Submission ID: 1073 CONTRIBUTION OF BIOMARKERS (TROPONIN AND NTPRO BNP) IN THE EARLY DETECTION OF CARDIOTOXICITY INDUCED BY CHEMOTHERAPY dardouri safa, bouhlel imen, emna hijri, samia ernez, mahdhaoui abdallah, jeridi Farhat Hached Hospital cardiology department, Tunisia Background: The seriousness of the cancerous disease has led to the acceptance of side effects that would be considered prohibitive for other pathologies.Cardiotoxicity remains the most disabling complication. MODERATED POSTER SESSION 2
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