P6199Predictive value of ve/vco2 slope in discovering hfpef during combined cardiopulmonary/stress-echocardiography testing in patients with hypertension and normal systolic and diastolic function at rest

M. Banovic, I. Nedeljkovic, V. Brkovic, S. Aleksandric, J. Stepanovic, M. Jaukovic, V. Giga, B. Beleslin, M. Petrovic
2017 European Heart Journal  
flammatory adipocytokine chemerin, that has been extensively associated with inflammation and cardiovascular diseases, in patients with heart failure in order to study the possible correlations between this hormone and body composition in those patients. Methods: We made a selection of 60 patients from the Cardiology Service in the Clinical Hospital of Santiago de Compostela which had depressed ejection fraction, a Gallagher Nutricional Index of 3 and an average age of 68 years old (81,7%
more » ... . Patient's body composition was measured using dual energy X-ray absorptiometry (DEXA). These patients were classified in four groups according to their lean mass (low <18.7 kg/m 2 in men and <14.9 kg/m 2 in women; medium 18.7 to 21 kg/m 2 in men and 14.9 to 17.2 kg/m 2 in women and high >21 kg/m 2 in men and >17.2 kg/m 2 in women) and fat mass (low fat mass ≤25% in men and ≤35% in women; high fat mass >25% in men and >35% in women): low lean mass/ low body fat; low lean mass/ high body fat; high lean mass/ low body fat and high lean mass / high body fat (Lavie et al., 2012). Each variable was analysed using the statistics program SPSS and the Mann-Whitney U test. Results: We have found a statistically significant reduction of the chemerin plasma levels in high lean mass patients (p=0.044) compared with those with low lean mass. To note, those high lean mass patients showed also increased BMI (p=0.000), fat mass amount (p=0.008) and visceral fat amount (p=0.049) than low lean mass patients. No other statistically significant differences were found between those two groups. Conclusion: The proinflammatory adipocytokine chemerin is negatively correlated with the lean mass amount in patients with heart failure. Our results suggest that the amount of lean mass could be determinant of the inflammatory status in heart failure patients, independently of the fat mass amount. amount in patients with heart failure. Our results suggest that the amount of lean mass could be determinant of the inflammatory status in heart failure patients, independently of the fat mass amount. P6201 | BEDSIDE Left ventricular assist devices as a bridge to candidacy in severe heart failure with secondary pulmonary hypertension Purpose: Elevated pulmonary artery pressure (PAP), transpulmonary gradient (TPG) and pulmonary vascular resistance (PVR) are risk factors for poor outcomes after heart transplantation in patients with secondary pulmonary hypertension (PH) and may contraindicate transplantation. Unloading of the left ventricle with an implantable left ventricular assist device (LVAD) may reverse these pulmonary vascular changes. We studied the effect of implanting LVADs in a cohort of patients with secondary PH as a bridge to candidacy. Methods: Pulmonary haemodynamics on patients implanted with LVADs at a single unit between December 2003 and April 2015 were retrospectively reviewed. Results: Thirty -five patients were implanted with LVADs. Seven were ineligible for transplant by virtue of high TPG/PVR. All the patients were optimized with inotropes/balloon pump followed by LVAD insertion. Four required temporary right VAD support. Thirty-day mortality post-LVAD was 3.4% with a 1-year survival of 85.7%. Twenty patients have been transplanted to date: 30-day mortality was 7.7% (1 of 13) and 1-year survival was 91% (10 of 11). Baseline and post-VAD pulmonary haemodynamics were significantly improved: systolic PAP (mmHg), mean PAP, TPG (mmHg) of 57±9.5, 42±4.4 and 14±3.9 reduced to 32±7.5, 18±5.5 and 9±3.3, respectively. PVR reduced from 5±1.5 to 2.1±0.5 Wood units (P<0.05). Conclusion: In selected heart failure patients with secondary PH, use of LVAD results in significant reductions in PAP, TPG and PVR, which are observed within 1 month, reaching a nadir by 3 months. Such patients bridged to candidacy have post-transplant survival comparable with those having a heart transplant as primary treatment. Background: There are few data examining the factors identified as contributing to heart failure (HF) hospitalization. We evaluated the frequency of clinical factors leading to admission for heart failure and the association between precipitating factors and subsequent outcomes. Downloaded from https://academic.oup.com/eurheartj/article-abstract/38/suppl_1/ehx493.P6199/4087215 by guest on 28 July 2018
doi:10.1093/eurheartj/ehx493.p6199 fatcat:t6dru4jejrgytipghueg3m5bdy