CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 47 AFRICA Results: On the orthostatic test, heart rate has increased of 40±18.05 bpm before the tenth minute without orthostatic hypotension. At mental stress, the central sympathetic beta response was at 25.5 ± 13.6% and the central sympathetic Alpha response was at 13.41 ± 8.54%. At the deep breathing test, vagal activity was at 67.68 ± 27.9%. And on the hand grip test, the vagal response was at 39.4 ± 21.8% while the peripheral sympathetic response was at 14.45 ± 8.29%. Discussion: POTS is a frequent dysautonomia, defined by the association of chronic symptoms of intolerance to orthostatism (for more than 6 months) with an increase in heart rate ≥ 30 within 10 first minutes of moving to the upright position and in the absence orthostatic hypotension [1]. Symptoms include both of cardiac symptoms (palpitations, chest pain, dyspnoea, fainting, or syncope) and non-cardiac symptoms (headache, nausea, tremors, blurred vision, poor sleep, exercise intolerance, asthenia), leading to a significant limitation of functional capacity. POTS can be due to a neuropathic origin, a central hyperadrenergic activity, a deficiency on norepinephrine transporter or a mast cells activation. In our study, 75% of the subjects were women. All patients had a high central and peripheral sympathetic B response with a normal central and peripheral alpha response. 7/8 patients had associated vagal hyperactivity. In the literature, there is a predominance in young people with a peak between 15 and 25 years old, and with a great female predominance (sex ratio: 1/5). There is a familial predisposition in a quarter of cases [2]. Patients were put on hygieno-dietary measures and betablockers. With a clear improvement in their symptoms Conclusion: POTS is frequent, disabling, often neglected with central hyperadrenergia as the main etiology. It has a good prognosis if it’s well treated. Submission ID: 1623 INFECTIVE ENDOCARDITIS WITH LOW C-REACTIVE PROTEIN: IS IT WORTH CONSIDERING? HAYAR SALAH EDDINE, MAAROUFI ANASS, CHAWKI KHAWLA MOROCCO Background and purpose: Bacterial infective endocarditis (IE) is rarely suspected in patients with a low C-reactive protein (CRP) concentration. To address the incidence, characteristics and outcome of leftsided valvular IE with low CRP concentration. Methodology: This was a retrospective analysis of cases of IE discharged from a tertiary hospital between December 2013 and june 2022. The 10% lowest CRP concentration (<25mg/L) was used to define low CRP concentration. Right-sided cardiac device-related IE, nonbacterial IE, sequellar IE and IE previously treated by antibiotics were excluded. Results and discussion: Of the 122 patients, 17 (14%; median age 40 [15–65] years) had definite (n=13) or possible (n=4) left-sided valvular IE with CRP<25mg/L (median 12 [1.5–24.8] mg/L). The median white blood cell count was 8 (3–15.6) G/L. The main presentations were heart failure (n=14; 82%) and stroke (n=1; 6%). Transthoracic echocardiography (TTE) showed vegetations (n=13) or isolated valvular regurgitation (n=2). Overall, nine patients (53%) had severe valvular regurgitation on transoesophageal echocardiography (TOE), and two patients (12%) underwent cardiac surgery. 82% of patients survived at 1-year follow-up. Bacterial pathogens were documented only in four patients (streptococci, coagulasenegative Staphylococcus, gamella morbillorum) using blood cultures solely , due to lack of disponibility of specific serology / valve culture and/or polymerase chain reaction analysis Conclusions: Left-sided valvular IE with limited or no biological syndrome is rare, but is often associated with severe valvular and paravalvular lesions. TOE should be performed in presence of unexplained heart failure, new valvular regurgitation or cardioembolic stroke when TTE is insufficient to rule out endocarditis, even in patients with a low CRP concentration. Submission ID: 1626 IMPACT OF DIPPER PROFILE ON TARGET ORGAN DAMAGE AND CARDIOVASCULAR RISK IN HYPERTENSIVE PATIENTS. A PROSPECTIVE STUDY AMINE BOUFARES, ANTIT SAOUSSEN, CYRINE ANTIT, RIDHA FEKIH, BEN KAAAB BADREDDINE, BOUSSABAH ELHEM, ZAKHAMA LILIA TUNISIA Background: Unlike other methods of blood pressure measurement, ABPM offers the possibility of studying BP at night. The aim of our work was to study the correlation between the dipper profile, the target organ damage and the occurrence of cardiovascular events. Methods: Our study included 240 consecutive treated hypertensive patients followed at the outpatient clinic of the Internal Security Forces Hospital in La Marsa, who had an ABPM and were followed for a period of five years. Results: Analyzing the ABPM results, 52% of patients had a “non dipper” profile, 21% “normal dipper,” 13% “extreme dipper,” and 14% “reverse dipper. “Twenty-four patients were lost to follow-up. No deaths were noted. Microalbuminuria was observed in 31.5% of our patients, 73% of whom were non-dippers. Electrical LVH was described in 7.2% of patients, also mostly of non-dipper status. Forty-three cardiovascular events occurred at 5 years of follow-up: Coronary syndrome was the most frequent event (35%), followed by atrial fibrillation (30%), heart failure (4%) and stroke (2%) Nondipper was the profile most correlated with events (5.9%), followed by riser (4.2%), normo-dipper (3.5%), and extreme dipper (2.1%). Conclusion: We conclude that the non-dipper profile is associated with an increased cardiovascular risk and significantly increases target organ damage. Thus, ABPM is an interesting long-term prognostic tool in hypertensive patients that should be made more accessible and available. MODERATED POSTER SESSION
RkJQdWJsaXNoZXIy NDIzNzc=