Massive Audio PAT50 User Manual download pdf (Page 25)

166 J KARDIOL 2008; 15 (5–6)

ÖKG-Jahrestagung – Abstracts

NT-proBNP in this study, but both markers appear to be closely re-

lated.

Predictive Value of Repetitive Measurement of Co-

peptin in Patients with Chronic Heart Failure 046

M. Elhenicky, S. Neuhold, G. Gouya, A. Hammer, R. Berger, J. Struck,

N. Morgenthaler, A. Bergmann, D. Mörtl, R. Pacher, M. Huelsmann

Division of Cardiology, Department of Internal Medicine II, Medical University of

Vienna; Vienna University of Economics and Business Administration; BRAHMS

AG Hennigdorf

Purpose Vasopressin and Copeptin – a fragment of pre-pro-vaso-

pressin – has demonstrated to be increasing with the severity of

chronic heart failure. The predictive value of Copeptin has been

shown in heart failure. Our aim was to investigate the predictive

value of repetitive measurements of Copeptin.

Methods Long-term observational study in chronic heart failure

patients that were admitted for an episode of cardiac decompen-

sation. Copeptin was measured at time of discharge and after 3

months.

Results Copeptin was measured in 181 consecutive patients.

Mean age was 70 ± 12 years, body mass index 27.4 ± 4.9 kg/m

LVEF 29 ± 8 %, NYHA class I/II/III/IV was 0/2/52/46 %. Copeptin

at index time was 23.5 ± 24.7 pmol/l and after 3 months 15.4 ±

16.4 pmol/l on average. Copeptin decreased by 8.1 ± 19.4 pmol/l on

average. Building a stepwise Cox-regression analysis – corrected

for age and gender – Copeptin values at follow-up (Exp [B] 1.031;

p < 0.007) was the best predictor of death and neither baseline

Copeptin nor changes over time contributed additional independent

information. In a similar model regarding hospitalization due to

heart failure, Copeptin measured at follow-up was again the most

potent single predictor (Exp [B] 1.042; p < 0.001). Only age could

provide additional independent information. The combined end-

point death and hospitalization based on heart failure was best pre-

dicted by age (Exp [B] 1.051; p < 0.0001) in a Cox regression

model, but Copeptin at follow- up revealed additional independent

information (Exp [B] 1.032; p < 0.016).

Conclusion Increased Copeptin levels measured at follow-up

after an episode of cardiac decompensation is a better predictor of

outcome than baseline Copeptin levels. Interestingly, changes in

Copeptin over time did not reveal additional independent informa-

tion.

Comparison of Two Cardiac Imaging Modalities:

Contrast Enhanced Magnetic Resonance and Echo-

cardiography 049

M. Nowosielski, G. Klug, K. Pedarnig, A. Mayr, M. Schocke, T. Trieb, A. Köhler,

O. Pachinger, B. Metzler

Department of Cardiology, Medical University of Innsbruck

Background The purpose of this study is to compare two cardiac

imaging modalities, cardiovascular magnetic resonance (CMR) and

echocardiography, by using the AHA 17-segments model and to

assess the improvement of left ventricular function in patients

treated with primary angiography (p-PTCA) for acute myocardial

infarction.

Methods We performed CMR and echocardiographic investiga-

tions in 64 patients with first AMI shortly after p-PTCA and four

months thereafter. Global (EF, %) and regional (systolic wall thick-

ening, %) left ventricular function was determined from Cine-MR

images. In echocardiography the global (EF, %) left ventricular

function and regional wall motion abnormalities were determined.

A segment was scored as infarcted if it was > 50 % hypokinetic.

Results EF in echocardiography correlates with EF MRI at base-

line (r: 0.357; p < 0.004) and at follow-up (r: 0.553; p < 0.001). The

total number of infarcted segments in echocardiography correlates

with the total number of segments which show a systolic wall thick-

ening (SWT) < 30 % (r: 0.503; p < 0.001) at baseline and (r: 0.541;

p < 0.001) at follow-up. The number of infarcted segments in echo-

cardiography correlates with the number of LE segments and the

infarcted mass in grams at baseline (r: 0.468; p < 0.001 and r: 0.467;

p < 0.001) and at follow-up (r: 0.383; p < 0.002, and r: 0.561;

p < 0.001). Out of 1024 evaluated segments the following para-

meters improvement was highly significant (p < 0.001) after a four

month period. The total number of infarcted segments in echo-

cardiography decreased from 141 to 78. At baseline the mean EF

Echo was 50.67 ± 8.33 % and at follow-up 53.84 ± 8.33 %

(p < 0.01). The mean EF MRI increased from 43.61 ± 11.09 % to

48.05 ± 11.19 %.

Conclusion CMR and echocardiography correlate well in the

assessment of regional wall motion abnormalities and left ven-

tricular function. Systolic wall motion thickening at less than 30 %

can be used as a cut-off value to define a pathologic, infarcted seg-

ment.

Keine Auswirkungen von altersabhängiger Zunahme

der viszeralen Adipositas bei adipösen Frauen auf die

Prävalenz kardiometabolischer Risikofaktoren 047

I. Ohnutek, E. Schrattenholzer, R. Martys, T. Stefenelli

I. Medizinische Abteilung, Kaiserin-Elisabeth-Spital, Wien

Einleitung Für die Diagnose der Adipositas werden in der tägli-

chen Praxis BMI und Bauchumfang (BU) herangezogen. Studien

zeigen, dass steigender BU (gleichbedeutend mit Zunahme der vis-

zeralen Adipositas) eine höhere prädiktive Aussagekraft für die

Entwicklung des Metabolischen Syndroms (MS) hat als der BMI.

Die Zunahme des BU bei Frauen mit steigenden Lebensalter ist be-

kannt (z. B. [Zefalu, Wang 1995]).

Fragestellung Gibt es altersabhängige Unterschiede bei BMI

und BU adipöser Frauen? Entstehen dadurch Auswirkungen auf die

Prävalenz des MS und/oder seiner Teilfaktoren?

Patienten und Methode Bei 122 konsekutiven adipösen Frauen

(BMI > 28 kg/m

; BU > 88 cm) kaukasischer Abstammung unserer

Adipositasambulanz wurden in Abhängigkeit vom Alter, Größe,

Gewicht, BU, BMI, syst. und diast. Blutdruck, ges. Chol, HDL-C,

Serum TG und Nüchtern-BZ sowie die Prävalenz eines MS (ATP-

III-Kriterien) verglichen. Es wurden Mittelwerte, Standardabwei-

chung, Median, Quartile, Minimum und Maximum oder Häufigkei-

ten errechnet. Die Su/jointfilesconvert/272007/bgruppenanalysen erfolgten mittels U- und

Chi-Quadrat Tests.

Ergebnisse Die Frauen zwischen 22 und 76 Jahren (~ 49,25 Jah-

re) wurden für die Auswertung 2 Su/jointfilesconvert/272007/bgruppen zugeordnet: unter 50

Jahre: nc (~ 37,92 Jahre; S.D. 8,18) und über 50 Jahre: nY (~ 61,34

Jahre; S.D. 6,83). Obwohl das ~-Gewicht und der ~-BMI der < 50-

jährigen Frauen signifikant höher war als bei den > 50-jährigen

(~ 109,96 vs. 100,49; p = 0,003; ~ 39,65 kg/m

, S.D. 5,99 vs.

~ 37,21 kg/m

, S.D. 6,46; p = 0,008), war der BU in beiden Gruppen

nahezu gleich (~ 114 cm S.D. 0,11 vs. ~ 116 cm; S.D. 0,17; p =

0,923). Beide Altersgruppen hatten eine gleich hohe Prävalenz des

MS (60,3 vs. 57,6 %; p = 0,763). Bei den Teilfaktoren des MS

waren nur die mit dem Alter korrelierbaren syst. RR-Werte der älte-

ren Frauen signifikant höher (~ 146,67 mmHg; S.D. 21,76 vs.

~ 133,69; S.D. 19,56), die übrigen Teilfaktoren wiesen keine signi-

fikanten Unterschiede auf.

Schlussfolgerungen Adipöse Frauen in unserer Adipositas-

ambulanz haben zu ca. 60 % ein MS (nach ATP-III-Kriterien). Die

> 50-Jährigen haben bei geringerem BMI eine signifikante Zunah-

me der viszeralen Adipositas. Dieses veränderter Fettverteilungs-

muster hat keinen signifikanten Einfluss auf der Prävalenz des MS

und/ oder seiner Teilfaktoren.

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