Monday, 1 September 2008 - European Heart Journal

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$Heart failure with preserved ejection fraction - European Heart Journal$

272 Confonding factors influencing outcome after stenting able on the independent role of chronic and acute post procedural renal failure in predicting mortality in patients with ST-elevation myocardial infarction (STEMI) treated with primary coronary angioplasty (PCI). Methods:We studied 453 consecutive patients with STEMI without cardiogenic shock treated at our institution with primary angioplasty and stent between January 2002 and December 2006. Demographic, clinical, angiographic and hemodynamic variables were collected prospectively by independent clinicians. Creatinine concentration and glomerular filtration rate (GFR, estimated by MDRD equation) were determined at hospital admission (baseline) and 6h, 24h, 48h and 72 h after the procedure. Contrast-induced nephropathy (CIN) was defined as the increase of creatinine of more than 25% from baseline value within 48h after the procedure. The mortality rate at 1 and 12 months was obtained by clinical interview or review of death certificates. Results:22 (4.8%) patients died within the first month after the procedure, 44 (10.2%) within 1 year. Both 1 month and 1 year mortality were significantly associated with age, baseline creatinine and GFR, CIN and pre-procedural ejection fraction (EF) (all p
Confonding factors influencing outcome after stenting / New vessels and changed vessels: angiogenesis and vascular remodelling 273 Interval late luminal loss. procedure may be observed following DES therapy. There appears to exist a device-specificity in this late reduction in anti-restenotic efficacy in favour of a platform devoid of permanent polymer. 1795 Comparison of 18 month clinical outcome of endothelial progenitor cell capture stent versus drug eluting and bare metal stents in patients undergoing primary percutaneous coronary intervention E. Chong, Liang Shen, K.K. Poh, S.G. Teo, A. Low, C.H. Lee, H.C. Tan. National University Hospital, The <strong>Heart</strong> Institute, Singapore, Singapore Purpose: Endothelial progenitor cell (EPC) capture stent (Genous stent), is designed to promote rapid endothelization and is potentially most useful in patients undergoing primary percutaneous coronary intervention (PPCI) for acute ST-segment elevation myocardial infarction (STEMI). We compare its long-term clinical efficacy and safety with a sirolimus-eluting (SES) bioabsorbable polymercoated stent (Cura stent) and a bare metal stent (BMS) (Liberte stent) in patients with STEMI. Methods: All patients who presented to our center with STEMI and received PPCI with either EPC, SES or BMS stents between Jan 2004 and June 2006 were enrolled in this cohort study. The study endpoints were cumulative major adverse cardiac events (MACE) defined as a composite end point of death, myocardial infarction (MI) and target vessel revascularization (TVR) at 18 months. Results: A total of 365 patients (EPC=95, SES=53, BMS 218) were enrolled. Baseline demographics in terms of age, gender, diabetes mellitus, baseline renal impairment, pre-discharge left ventricular ejection fraction, cardiogenic shock were comparable between the 3 groups. Procedural success rate was high at a mean of 99.5%. Post-procedural TIMI 3 flow was achieved in EPC 91.6%, SES 96.2% and BMS 88.5%. The MACE results and stent thrombosis rate at 18-months are shown in table. Table 1. 18 month clinical outcome Events EPC (n=95) SES (n=53) BMS (n=218) p value MACE (%) 13(13.7%) 8(15.1%) 35(16.1%) 0.865 Death (%) 9(9.5%) 2(3.8%) 25(11.5%) 0.208 Non-fatal MI (%) 1(1.1%) 1(1.9%) 4(1.8%) 0.916 TVR 3(3.2%) 5(9.4%) 6(2.8%) 0.070 Acute stent thrombosis 1 (1%) 0 (0%) 0 (0%) ns Subacute stent thrombosis (SAT) 0 (0%) 0 (0%) 0 (0%) ns Late stent thrombosis (LST) 0 (0%) 0 (0%) 2 (0.9%) ns Conclusion: The MACE rates among patients who underwent PPCI were similar in all 3 stent groups at 18 months follow-up. There was no difference in TVR rate and stent thrombosis remains a low event occurrence. NEW VESSELS AND CHANGED VESSELS: ANGIOGENESIS AND VASCULAR REMODELLING 1814 Neuropilin-1 expressing mononuclear cells (NEMs) deriving from the bone marrow promote vessel maturation during therapeutic angiogenesis S. Zacchigna1 , L. Pattarini1 , L. Zentilin1 , A. Carrer1 ,S.Moimas1 , S. Tafuro 1 , M. Sinigaglia1 , G.F. Sinagra 2 , M. Giacca1 . 1ICGEB, Molecular Medicine, Trieste, Italy; 2Unita di Cardiologia Ospedali Riuniti TS, Trieste, Italy Purpose: The possibility that bone marrow (BM)-derived cells promote new blood vessel formation through transdifferentiation has recently aroused much excitement. Recent evidence however indicates that these cells have less plasticity than predicted and that their effect is essentially paracrine. To exactly define the role of BM cells during neovascularization, here we exploited a gene transfer approach and characterized the in vivo effect of various factors, differing in their capacity to recruit BM cells and to promote angiogenesis. Methods: Adeno-Associated Virus (AAV) vectors were used to sustain the longterm expression of VEGF121, VEGF165 and Sema3A in the mouse skeletal muscle. Treated muscles were harvested at different times after transduction and the angiogenic effect was assessed by histological and functional examinations. BM transplantation, immunoFISH, siRNA-mediated silencing and clodronate depletion were used to explore the in vivo role of BM cells. Results: The injection of a vector expressing VEGF165 determined the formation of an impressive number of new arterioles, paralleled by a massive infiltration of CD11b+ BM cells. In contrast, VEGF121 induced a potent capillary sprouting, but neither cellular infiltrates nor arterial vessels were evident. Leading from the consideration that the main difference between these two VEGF isoforms is their ability to bind the receptor neuropilin-1 (NP-1), we examined the effect of semaphorin-3A (Sema3A), another ligand for NP-1. Strikingly, an AAV vector expressing Sema3A, although not angiogenic, was able to recruit CD11b+ BM cells similar to VEGF165. Consistent with these findings, we found that CD11b+ cells migrated in vitro in response to both VEGF and Sema3A, and that their migration was impaired after NP- 1 silencing both in vitro and in vivo. These CD11b+,NP-1expressing mononuclear cells (NEMs) were in no case directly incorporated in the newly formed vasculature nor they were arteriogenic per se, but contributed to arterial formation through a paracrine effect ensuing in the activation and proliferation of tissue-resident mural cells in order to promote the maturation of VEGF121induced capillaries to acquire an arterial phenotype. Consistently, NEM depletion by clodronate significantly impaired the formationof new arterial vessels. Conclusions: These findings show that the different isoforms of VEGF are not redundant, and that BM-derived NEMs, although not directly incorporated into the newly formed vasculature, are essential for proper arterial formation, thus playing a key role during therapeutic angiogenesis. 1815 Interferon-beta attenuates collateral artery growth by inducing monocyte apoptosis and inhibiting smooth muscle cell proliferation S.H. Schirmer 1 , P.T.G. Bot 2 , J.O. Fledderus 3 , A.J.G. Horrevoets 4 , J.J. Piek 2 , I.E. Hoefer 3 ,N.VanRoyen 2 . 1 Universitaetsklinikum des Saarlandes, Klinik fuer Innere Medizin III, Homburg/Saar, Germany; 2 Academic Medical Center, Department of Cardiology, Amsterdam, Netherlands; 3 University Medical Center, Department of Vascular Medicine, Utrecht, Netherlands; 4 VU University Medical Center, Department of Molecular Cell Biology and Immu, Amsterdam, Netherlands Purpose: Circulating monocytes orchestrate collateral artery growth (arteriogenesis). In a recent study we demonstrated that monocytes from patients with insufficient coronary collateral artery growth show increased expression of the interferon (IFN)-beta pathway compared to patients with well developed collateral arteries, pointing to an inhibitory role of the IFNbeta-pathway in arteriogenesis (EHJ suppl. 2007). Here, we investigated the underlying mechanisms of the putative inhibitory effect of IFNbeta on arteriogenesis and hypothesized that we could stimulate arteriogenesis by blocking IFNbeta-signaling. Methods: Three groups of mice (control (129Sv/Ev, n=25), IFNalpha/betareceptor knockout mice (IFNAR /-, n=25) and IFNbeta treated mice (105 IU/kg s.c, n=25) underwent unilateral femoral artery ligation. Collateral dependent hindlimb perfusion was assessed after one week by infusing fluorescent microspheres under conditions of maximal vasodilation. Hindlimb tissue was analyzed immunohistochemically for the presence of IFNAR. Both hindlimb tissue and stimulated peripheral blood monocytes were subjected to gene expression analysis using RT-PCR. Smooth muscle cells (SMCs) and THP1 monocytes were treated with interferon-beta to assess the effects of IFNbeta on apoptosis and proliferation in-vitro. Results: IFN-beta treatment significantly reduced perfusion restoration compared to control mice, expressed as percentage ligated/non-ligated hindlimb (31.46±4.12% vs. 41.88±8.2%, p=0.01), while mice lacking the IFNbeta-receptor showed significantly increased hindlimb perfusion (54.29±6.55%, p
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Page 3 and 4: CAN WE PREDICT ATRIAL FIBRILLATION?
Page 5 and 6: Thromboembolic risks and therapeuti
Page 7 and 8: Healthy bone marrow for a healthy h
Page 9 and 10: NEW PROGNOSTIC MARKERS IN ACUTE CAR
Page 11 and 12: CI 0.2-1.6, p=0.32) after epinephri
Page 13 and 14: Risk assessment: strengths and weak
Page 15 and 16: Prognosis in heart failure: surveys
Page 17: Restenosis: is there an alternative
Page 21 and 22: New vessels and changed vessels: an
Page 23 and 24: (n=574) served as the cohort where
Page 25 and 26: Using Cox’s proportional hazards
Page 27 and 28: hibitory response, or in pts with p
Page 29 and 30: Multimodality imaging of coronary h
Page 31 and 32: Conclusions: EVH is a strong indepe
Page 33 and 34: any antiarrhythmic drug (AAD), Grou
Page 35 and 36: oxidases decreased O2- by 16±3.1%
Page 37 and 38: Fig. 1. Five types of merge errors.
Page 39 and 40: manent AF were studied. The number
Page 41 and 42: P1933 Left atrial appendage dominan
Page 43 and 44: hydrolysable, it would dissipate be
Page 45 and 46: P1949 A first-in-human clinical tri
Page 47 and 48: P1957 Electrophysiological effects
Page 49 and 50: for the population of Tayside, Scot
Page 51 and 52: P1973 Effect of ursodeoxycholic aci
Page 53 and 54: =0.31, p=0.0003) and QUICKI (r=0.29
Page 55 and 56: P1989 Hormonal mechanisms of cachex
Page 57 and 58: or more of the following ECG change
Page 59 and 60: P2004 Association between cardiovas
Page 61 and 62: P2012 Correlations between the degr
Page 63 and 64: disease. Familial study was recomen
Page 65 and 66: P2027 MRI for the detection of rest
Page 67 and 68: P2035 Oxidized low density lipoprot
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P2042 Persistent under representati
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P2049 Addition of B-type natriureti
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P2058 Genetic variation in CYP2C19
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p=0.003). Minor bleeding was also l
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Avidin, a protein found in hen eggs
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flow, and
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(PCWP) were recorded. In 16 patient
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Methods: A prospective, consecutive
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over paclitaxel-eluting stent (PES)
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which proved to be safe and effecti
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Comparison of neointimal growth amo
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patients between October 2006 and J
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P2139 Inverse relation of baseline
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tive. We sought to determine the ef
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P2155 A very high prevalence of low
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P2163 The influence of estradiol on
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2nd year of follow-up, respectively
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P2179 Symptoms of atrial fibrillati
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P2187 The relationships of ambulato
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tension (WCHT) to vascular damage i
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in the postero- and midseptal regio
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elevation myocardial infarction (AM
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assigned to receive either unselect
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was injected. Left ventricular func
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of MACE in patients with LGE and de
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P2243 Blood oxygenation level-depen
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P2250 Prognostic value of revascula
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needed to achieve 90% of age-predic
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presence/absence of VIVC assessed u
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2341 Telemonitoring in an elderly,
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Heart failure with preserved systol
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the most dilated, LA mostly influen
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Conclusion: In patients with stable
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2388 Magnitude of glycaemia variati
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patients with RV > 30 ml this corre
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BIOMARKERS: NEW KIDS ON THE BLOCK 2
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the importance of calling the emerg
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Sudden death, devices and public aw
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Bone marrow progenitors: filling th
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2566 Esophageal capsule endoscopy i
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(7.0%) patients receiving aliskiren
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P2600 Final aggregation response is
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Results: Female patients (27.7%) we
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with atrial fibrillation (AF) under
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e feasible and safe. This approach
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coagulant therapy (P=0.038; OR=2.42
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ison between responders and nonresp
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Table 1. Systolic, diastolic and dy
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Syncope and cardiac pacing: miscell
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their downstream effector, myosin h
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Understanding determinants of hemod
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the abundance of profibrotic CCN2 p
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parison with IL-8 as well as the ex
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and EF (-0.5%) which significantly
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of effects on systemic BP and cardi
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Conclusion: Compared to previously
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P2723 Differential virus-associated
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Methods: During 2007, 10 patients (
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cardiomyocyte apoptosis was highest
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higher for NT-proBNP (area under th
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or higher) in 85 patients (4.2%). M
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teria as a final Thrombolysis In My
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cantly correlated to in-hospital de
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nosis in patients with myocardial i
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lesion classification, stent type u
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Prognosis in ST-elevation myocardia
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P2802 In-hospital and long-term mor
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P2810 Long-term clinical results fo
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Percutaneous coronary intervention;
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vessels (DES 16.7%, BMS 6.7%, p=0.0
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patients receiving a DES and the ra
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Results: The two groups had similar
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among their non-DM counterparts (HR
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tigated the long-term consequences
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culogenesis. Reduction of VPC and E
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y echo-tracking technique calibrate
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P2885 Statins are effective in redu
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Conclusions: The patient-centred he
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P2900 Should left ventricular hyper
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P2908 Telmisartan up-regulates the
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important sex-based differences in
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Hypertension: regional and ethnic p
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whether the selective mineralocorti
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THE ENDOTHELIUM: AT THE HEART OF VA
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P2951 Reproducibility of endothelia
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P2959 Brachial flow-mediated dilati
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P2966 Detection of late enhancement
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tissue as an enhanced area. On the
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dial dysfunction is critical for th
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for testing the load dependence. Th
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diastolic velocity (-12.3±4.9 vs -
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Monday, 1 September 2008 - European Heart Journal

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