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ÖKG-Jahrestagung – Abstracts

J KARDIOL 2008; 15 (5–6)

179

tung der CT-NA erfolgte über axiale Bilder sowie mittels multi-

planarer und gekurvter planarer Reformation, die der K-NA mittels

semiautomatischer quantitativer Analyse. Überprüft wurden Sensi-

tivität, Spezitivität, sowie positiv und negativ prädiktiver Wert

(PPW, NPW) der Detektion von signifikanten (> 70 %) Instent-

Restenosen (ISR) mittels CT-NA im Vergleich zur K-NA.

Ergebnisse Es wurden 63 NAS bei 48 P (25 männlich) mit

einem mittleren Alter von 71 ± 9 Jahren untersucht. Die Bildqualität

der CT-NA erlaubte eine Evaluierung von 60 NAS (95 %), wohin-

gegen 3 NAS (bei 2 P) wegen Aufhärtungsartefakten infolge hoch-

gradiger Verkalkungen der gestenteten Abschnitte nicht beurteilt

werden konnten. Die K-NA am Tag nach der CT-NA fand ins-

gesamt 5 ISR (8 %), von denen alle zuvor mittels CT-NA korrekt

erkannt worden waren (Sensitivität und NPW jeweils 100 %). Eine

einzige in der K-NA nicht signifikante ISR wurde in der CT-NA

überschätzt und als signifikant eingestuft (Spezifität 98 %, PPW

83 %). Bei 6 NAS (10 %) war mittels CT-NA eine geringe Intima-

hyperplasie darstellbar, welche in der K-NA nicht nachgewiesen

werden konnte.

Schlussfolgerung Die Evaluierung von NAS mittels hochauf-

lösender CT-NA ermöglicht die Identifizierung von signifikanten

ISR mit einer Sensitivität von 100 % bei einer Spezifität von 98 %

und kann daher als nicht invasive Kontrollmethode empfohlen wer-

den.

In- and Outpatients with Noncompaction: Differences

in Cardiac and Neuromuscular Co-Morbidity 056

C. Stöllberger, G. Blazek, M. Winkler-Dworak, J. Finsterer

Rudolfstiftung Hospital, Vienna; Hanusch Hospital, Vienna; Vienna Institute of

Demography of the Austrian Academy of Sciences

Background and Methods The prognosis of patients with left

ventricular hypertrabeculation/noncompaction (LVHT) is contro-

versial. LVHT is associated with neuromuscular disorders (NMD)

and diagnosed echocardiographically in in- as well as outpatients.

We compared cardiologic and neurologic findings and mortality in

LVHT-patients according to their diagnosis established as in- or

outpatients.

Results Among 113 patients (33 females, mean-age 53 years), 91

were investigated neurologically. Fifty-nine inpatients were older

(55 vs 50 years, p < 0.05), more frequently referred because of heart

failure (73 vs 37 %; p < 0.001), had more often diabetes (24 vs 7 %;

p < 0.05), heart failure (81 vs 57 %; p < 0.01), a lower left-ventricu-

lar fractional-shortening (21 vs 26 %; p < 0.05) and more extensive

LVHT (1.7 vs 1.5 affected walls, p < 0.05). Fifty-four outpatients

were referred more often because of chest-pain (33 vs 12 %;

p < 0.01), myopathy (13 vs 2 %; p < 0.05), were more often neuro-

logically normal (20 vs 7 %; p < 0.05) or had a specific NMD (28 vs

12 %; p < 0.05). During a mean follow-up of 3.8 years, mortality

was 5.8 %/year. Inpatients had a higher mortality (12.1 vs 2.1 %/

year; p = 0002) and a shorter time between LVHT-diagnosis and

death (1.7 vs 4.6 years; p = 0.0197) than outpatients.

Conclusions Outpatients with LVHT have a better prognosis than

inpatients. Inpatients with LVHT should be closely monitored.

Atrial Fibrillation in Left Ventricular Noncompaction

is Associated With a Poor Prognosis – With and With-

out Neuromuscular Disorders 057

C. Stöllberger, G. Blazek, M. Winkler-Dworak, J. Finsterer

Rudolfstiftung Hospital, Vienna; Hanusch Hospital, Vienna; Vienna Institute of

Demography of the Austrian Academy of Sciences

Aims The study in patients with left ventricular hypertrabecula-

tion/noncompaction (LVHT) aimed to compare patients with and

without atrial fibrillation (AF) regarding prevalence of neuromus-

cular disorders (NMD), cardiac symptoms, electrocardiographic

(ECG) findings, left ventricular function, location and extension of

LVHT and mortality.

Methods and Results LVHT was diagnosed in 102 patients (30

female, age 53 ± 16 years) between June 1995 and November 2006.

A specific NMD was diagnosed in 21, a NMD of unknown etiology

in 47, the neurologic investigation was normal in 14, and 20 patients

refused. The 15 patients with AF were older (65 versus 51 years;

p < 0.01), suffered more often from exertional dyspnoea (100 vs

62 %; p < 0.01), diabetes mellitus (33 vs 12 %; p < 0.05) and heart

failure (100 vs 57 %; p < 0.01) than patients without AF. The preva-

lence of NMD was slightly higher in patients with than without AF

(87 vs 82 %; p = n. s.). AF patients had more frequent ECG abnor-

malities (2.3 vs 1.4; p < 0.01), valvular abnormalities (93 vs 48 %;

p < 0.01), lateral wall LVHT (87 vs 37 %; p < 0.01), more extensive

LVHT (2.1 vs 1.5 ventricular parts; p < 0.05), a worse left-ventricu-

lar fractional-shortening (14 vs 25 %; p < 0.01) and higher mortal-

ity during 3.8 years.

Conclusion LVHT-patients with AF deserve special care because

they have a worse prognosis than LVHT-patients without AF.

Cardiac and Neurologic Implications of Left Ventricu-

lar Hypertrabeculation/Noncompaction Affecting the

Septum 058

C. Stöllberger, J. Finsterer

Rudolfstiftung Hospital, Vienna

Left ventricular hypertrabeculation/noncompaction is mainly de-

tected by echocardiography. Left ventricular hypertrabeculation/

noncompaction is commonly associated with cardiac and extra-car-

diac disorders, preferentially neuromuscular disorders. Left ven-

tricular hypertrabeculation/noncompaction is mainly located within

the left ventricular apex, lateral, posterior and anterior wall but only

rarely in the medial and basal portions of the interventricular

septum.

Aim of the present review is to summarize the knowledge about sep-

tal affection in left ventricular hypertrabeculation/noncompaction.

Septal affection in left ventricular hypertrabeculation/noncompac-

tion is a finding in predominantly children and adolescents. Septal

left ventricular hypertrabeculation/noncompaction occurs more in

females than in males. Patients with septal left ventricular hyper-

trabeculation/noncompaction have a poor prognosis. Septal left

ventricular hypertrabeculation/noncompaction is most likely con-

genital. The association of septal left ventricular hypertrabecula-

tion/noncompaction with extracardiac abnormalities and neuro-

muscular disorders remains unclear. Presumably left ventricular

hypertrabeculation/noncompaction does not represent a cardiac

manifestation of a neuromuscular disorder.

Significant Reduction of Radiation Exposure Using

a Protection Cabin for Electrophysiological Proce-

dures 041

B. Strohmer, F. Danmayr, C. Schernthaner, V. Schett, M. Pichler

Department of Medicine and Cardiology, Salzburger Landeskliniken, Paracelsus

Private Medical University, Salzburg

Background Fluoroscopy is the main visualization technique for

intracardiac catheter positioning in electrophysiology. This may

result in high cumulative operator radiation exposure with potential

stochastic and deterministic sequels. Traditional radiation protec-

tion is frequently associated with discomfort and leaves unprotected

body parts. Thus a radiation protection cabin (RPC) shielded with

2 mm lead-equivalent walls was tested as an alternative protection

tool (Cathpax, Lemer Pax). The main objective was to compare

radiation doses inside the RPC vs. outside the RPC.

Methods The X-ray system used was either a biplane or a mono-

plane Philips Allura Xper FD10 system. Significant air kerma re-

duction was achieved with pulsed fluoroscopy at 3 to 7 frames/s and

entrance dose limitation. Cumulative dose-area product (DAP) and

total fluoroscopy times were measured. To assess the scattered ra-

diation to the operator inside the RPC an electronic personal dosi-

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