Twenty Second PanAfrican Course on Interventional Cardiology PAFCIC 2021

CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 33 AFRICA MODERATED POSTER SESSION 2 volume index (SVI), indexed LA volume, maximal trans-tricuspid velocity (TRVmax), mean trans-mitral gradient (MTMG) and valve area (MVA) using pressure half time (PHT), 2D and 3D planimetry were recorded. Global longitudinal LA strain value was studied on a dedicated 4C view and peak reservoir strain (LASr) was calculated. LVS was generated based on the 3 basic apical views. A 6-minutes walking test was also performed before and 4 weeks after PTMC. The variation of negative strain was calculated as the difference between the value before and after PTMC. The variation of other 2D, 3D, doppler and positive strain values were calculated as the difference between the value after and before PTMC. Results: 12 consecutive candidates to PTMC were enrolled. The mean age was 41±5yrs. 25% (n=3) had permanent AF. 76%(n=8) had mild dyspnea (NYHA I or II). There was a significant improvement in MVA calculated using 2D (0.9±0.2vs1.5±0.3 cm², p<0.001), 3D( p=0.03) and PHT (p<0.001) and in MTMG (p=0.019). The increase of mitral flow (MF) was significant (59.8±8±20vs97.7±28, p=0.007). The SVI did not significantly change (p=0.9) The amelioration of LASr (p=0.1) and LVS ( p=0.6) did not reach statistical significance. Besides, there was a significant increase in 6MWD (p=0.038). Interestingly, ∆MVA was correlated with ∆LVS (r=0.8, p=0.05) and ∆MF (p=0.005) ∆LVS (p=0.05) and ∆MF were also correlated (p=0.03) ∆LASr was correlated with ∆MTMG (p=0.01). The correlation between ∆LASr and ∆MVA was not significant (p=0.1). ∆6mwd was not correlated to any TTE, Doppler or strain parameter. Conclusions: The improvement of MS tolerance was not attributable to any TTE parameter. The increase of MF allowed by the increase of MVA is highly associated with the improvement of LVS. Submission ID: 1126 FINDINGS IN THE MAIN CAUSES OF HEART FAILURE(HF) IN YOUNG PATIENTS Meriem Drissa, Asma Brahim, Oumayma Taher, Refka Oueslati, Asma Bouslimi LA RABTA, Tunisia Introduction: HF affects patients differently depending on their age, young patients with HF face lower risk of death but poorer quality of life than the elderly. Aim: Is to assess specific findings in main causes of HF in younger adults. Methods: Our study is prospective and descriptive. We have tracked 40 patients who were hospitalized in ‘Adults’ cardiology Department in Rabta hospital for management of acute HF from september 2019 to september 2020. Results: The mean age was 33 +/- 6. 65% men and (35%) women. Patients were active smokers in (35%), (22,5%) had hypertension, (20%) diabetes mellitus, (12,5%) Chronic kidney disease. Obesity and history of coronary artery disease CAD were both found in (5%) of cases. The mean left ventricular ejection fraction LVEF was 34.6+/- 9. The principal cause of HF was valvular herat disease VHD in 25% followed by CAD 17.5%. Other etiologies were alcoholism (2.5%), peripartum cardiomyopathy (12.5%), arrhythmia (2.5%), hypertension (5%), hemochromatosis (2.5%), chemotherapy induced (2.5%), hypertrophic cardiomyopathy(7.5%) and idiopatihc (22.5%). The tracking at one year showed 8 deaths, 4 lost of sight, 11 (27.5%) deterioration of the LVEF and 9 (22.7%) improvement. In VHD patients with atrial fibrillation p=0.042, severe mitral regurgitation p=0.006 and severe tricuspid regurgitation p=0.042 are more likely to devolep dilated cardiomyopathy. Whereas in CAD, active smokers,p=0.024, hypertension p= 0.047, history of anterior STEMI p=0.028, Akinesia in more than 7 segments in TTE p=0.027, and critical stenosis of left anterior decending artery P=0.01 are associated to higher rate of ulterior dilated cardiomyopathy. Conclusion: Dilated cardiomyopathy is a progressive disease which has various ethiologies. Despite the progress of medicin nowadays, the idiopathic cause remains significant. Submission ID: 1129 EVOLUTION OF RIGHT VENTRICULAR (RV) STRAIN AFTER PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY (PTMC): A PROSPECTIVE CASE SERIES STUDY Kallala M.Y., Slimene W., Bouchahda N., Bouchnag S., Bouallagui S., Ibn El Mechri N., Hmidi M., Boussaada M., Ben Messaoud M., Mahjoub M., Hassine M., Gamra H. Cardiology A department, Monastir, Tunisia Background: RV function is strongly associated with the prognosis of Rheumatic mitral stenosis (MS) patients. Thus, the evaluation of RV response to PTMC is crucial for patients’ outcome. A quantitative echocardiographic evaluation of RV global and regional functions remains difficult due to its complex anatomy. Two-dimensional Speckle Tracking Echocardiography (STE) has recently been validated for the study of RV contractility allowing a new insight into the subclinical response of the RV to PTMC. Objective: To compare longitudinal RV free-wall and 4-chamber strain assessed by 2D STE before and after transvenous mitral commissurotomy (PTMC). Methods: This interventional case-control study was performed on consecutive patients admitted to Cardiology A department for PTMC from April to September 2021. 3 patients were excluded afterwards due to the presence of left appendage thrombus. We prospectively performed comprehensive 2D trans-thoracic echocardiography (TTE) before proceeding to PTMC. A second TTE was done after one to four months. Standard 2D and doppler TTE parameters including stroke volume index (SVI) were recorded. RV free wall longitudinal strain (RVFWSL) and RV four-chamber strain (RV4CSL) were measured using a dedicated RV-focused fourchamber view. The variation of RV strains (∆RVFWSL and ∆RV4CSL) was calculated as the difference between its value before and after PTMC. The variation of SVI (∆SVI) was calculated as the difference between its values after and before PTMC. A 6-minutes walking test was performed right before every TTE examination. The variation of the 6-minutes walking distance (6MWD) was calculated as the difference between its values after and before PTMC. Results: We enrolled 12 patients with severe rheumatic MS and candidates to PTMC. The mean age was 41±5yrs.

RkJQdWJsaXNoZXIy NDIzNzc=