AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 36 Submission ID: 1527 CLINICAL, ANATOMICAL AND PROGNOSTIC CHARACTERISTICS OF CORONARY ARTERY DISEASE IN TUNISIAN DIABETICS FATMA SGHAIER, HICHEM DENGUIR, MOHAMED AOUINA, SAHAR GMIHA, AHMED ALBATRAOUI, HASSEN EZZAIN TUNISIA Introduction: Diabetes mellitus is considered a major cardiovascular risk factor, particularly type 2 diabetes. The prevalence of diabetes is between 15 and 30% depending on the respective low or high risk at admission for ACS according to the international GRACE registry. The study of the clinical, anatomical, and prognostic particularities of coronary artery disease in diabetics will help improve the management of coronary artery disease in this population. Materials and methods: This is a cross-sectional, descriptive and analytical study that took place over a 12-month period from February 2019 to February 2020. It includes all patients referred to the cardiac catheterization unit of the university hospital of Gabes for coronary angiography exam. Results: Of the 286 patients included, 55.4% were diabetic. The mean age was 62.75 years (35-82) versus 60.62 years (24-90) in non-diabetics (p=0.104). Two-thirds of the diabetics (66%) were men compared to 85.2% of the non-diabetics (p=00001). Diabetics were less likely to smoke (40.3% vs. 60.3% p=0.001), were more hypertensive (64.8% vs. 38% p=0), more dyslipidemic (25.5% vs. 16.4% p=0.71) and more obese (16.8% vs. 12% p=0.268). The clinical presentation was dominated by chronic coronary syndrome followed by ST+ ACS and ST- ACS in diabetics and non-diabetics respectively in 53.5%, 25.8% and 20.1 vs 44.3%, 31.1% and 23% without significant difference (p= 0.567, p=0.322, p=0.126). Non-significant coronary lesions and single vessel disease were lower in diabetics (19.5% vs 32.8% p=0.01), (27% vs 33.6% p=0.234). On the other hand, double vessel disease and triple vessel disease were more frequent in diabetics (30.2% vs 18.9% p=0.03) and (23.3%vs 14.8%p=0.075). Concerning revascularization 45.3% of diabetics vs 38.5% had coronary angioplasty and coronary artery bypass grafting was indicated in 18.9% of diabetics vs 10.2% of non-diabetics (p=0.023). At 1 year, 6.2% of diabetics died compared to 1.8% of nondiabetics (p=0.12), 15.3% of diabetics had a recurrence of angina compared to 9.9% of non-diabetics (p=0.205). 17.4% of diabetics had a major cardiovascular event versus 10.8% of non-diabetics (p=0.141). Conclusion: Coronary artery disease remains frequent in Tunisian diabetics. The clinical presentation is more severe because of the extensive and complex anatomical lesions wish are factors of bad prognosis compared to non-diabetics. Submission ID: 1530 ECHOCARDIOGRAPHIC FINDINGS IN PATIENTS WITH IMPROVED HEART FAILURE ALI KHORCHANI, HOCINE BEN ABDELHAFIDH, TAHA LASSOUED, ZINELABIDINE BEN ALI, SAMI MILOUCHI, RIDHA FEKIH, DERBEL EMNA, MTIRI IMEN TUNISIA Introduction: Heart failure (HF) is a common and devastating disease, it represents a major public health issue due to its high morbidity and morbidity rate. A new subset of heart failure class has been recently identified, representing patients with reduced left ventricular ejection fraction (LVEF) who have demonstrated an improvement in ejection fraction (EF). Aim: We sought by this study to describe echocardiographic characteristics of patients with HF with improved EF (HFiEF). Patients and methods: We conducted a monocentric survey including out patients aged 18 years and older diagnosed with HF with reduced LVEF (<40%). After a 1-year follow-up involving at least one trans thoracic echocardiography (TTE) re-examination, we identified patients who had shown an improvement of the LVEF to reach a LVEF > 50%. Results: In all, 87 patients were enrolled in the study. The time period between enrolment and the control TTE was on average 8 months. Patients had shown an improvement of LVEF were 13.8% (12 patients) and 86.2% (75 patients) had a persistent HF with reduced ejection fraction (HFrEF). In our serie, the average LVEF in first TTE was 31.2% ± 6.5 The group with HFiEF had features of higher baseline LVEF (36.2% ± 3.7 vs 30.5% ± 4.7; p=0.03) and lower baseline left ventricular enddiastolic diameter (63 mm ± 24 vs 59 mm ± 32 , p= 0.05). Change of LVEF from first to follow-up TTE was 12.7% ±13.1 in all, 3.8% ±9.6 in persistent HFrEF, and 25.7% ±11.6 in HFiEF. Severe mitral regurgitation was significantly more common among patients with persistent HFrEF (8.3% vs 16%; p=0.02). Conclusion: HFiEF is a relatively recent description of a subset of HF patients, it is characterised by a less echocardiographic parameters deteriorations and a better prognosis. More researches on these patients are needed to better understand the mechanism that led to improvement in EF. Submission ID: 1531 PULMONARY VALVE REPLACEMENT AFTER TETRALOGY OF FALLOT REPAIR BENOTHMAN RIHAB, HAKIM KAOUTHAR, SOULA MOHAMED AMINE, TALHAOUI AMIRA, SOUDANI SABRINE, HMAYER ELLA, GHORBEL CHAYMA, BEN JEDDOU SYRINE, MEKKI NOUHA, ZEREI KARAM, IDRISSI BASSEM, MSAAD HELA, OUARDA FATMA TUNISIA Background: The improved survival of patients after tetralogy of Fallot (TOF) repair is coupled with a high rate of morbidity and re-operation during long term follow-up. Objective: The aim of this study was to evaluate the long-term outcome and freedom from pulmonary valve replacement (PVR) after initial repair of tetralogy of Fallot (TOF). Patients and methods: 66 patients with repaired TOF before 2016, regularly followed up in our pediatric cardiology department were enrolled in our study between June 2021 and March 2022. Patients were treated with transannular patch (TAP), valve sparing repair (VSR), or conduits from the right ventricle to the pulmonary arteries (RVPA conduits). Results: Fifteen patients (23%) received surgical PVR after a median of 12.4 ± 7.2 years with no late mortality. A significant difference in MODERATED POSTER SESSION
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