－ S 441 －
― S-171 ―
Clinical features of severe left ventricular systolic dysfunction of unknown etiology
Gangneung Asan Hospital, Ulsan university
*Hyuk Ko, Sang-yong Ryu, Sang-Sik Cheong
Background : Many causes can induce severe left ventricular systolic dysfunction, as like ischemia, tachycardia, stress, postpartum, valvular heart disease, metabolic cause, drugs, etc. However, the outcome and influential factor of severe left ventricular systolic dysfunction of unknown etiology is not well known. Methods : From January 1997 to June 2007, 116 consecutive patients with severe left ventricular systolic dysfunction of unknown etiology were enrolled. Severe left ventricular systolic dysfunction was defined as less than 35% of left ventricular ejection fraction(LVEF) and nearly normalized LVEF as more than 50%. Results : 116 patients were followed for an average 39 months. 49 patients (24 males, mean age ; 55.6±13.2 years) recovered to nearly normal LVEF (24.0±4.5% at admission, 59.1±5.8% at follow up) and 67 patients ( 47 males, mean age ; 58.9±16.3 years) showed persistent LV systolic dysfunction (LVEF of 22.3±4.7 % at admission, 30.4±8.5% at follow up).
Patients who recovered LVEF had higher blood pressure and less frequently LBBB pattern of ECG at admission. Another baseline characteristics were not different between two groups. At follow up, patients who recovered LVEF were more frequently administered with Beta blocker and Ca channel blocker. There was no significant difference in the incidence of all cause of death, non-fetal MI, and readmission due to heart failure and no definite influential factor. However, Cardiac death ( 2.0% vs 13.4% p = 0.031 ) occurred less frequently in patients who recovered LVEF . Interestingly, there was a lower incidence of all cause of death, cardiac death in patients who were followed up regularly. Conclusion : Severe LV systolic dysfunction of unknown etiology could recover to nearly normal LV systolic function. Further study is needed for long-term follow up to define influential factor for recovery of LVEF.
― S-172 ―
Estimating the Risk of Cardiovascular Events with Measuring the Thickness of Pericardial Fat
Sungkyunkwan University School of Medicine, Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center
*Soo Jin Cho, Sang Yeob Lee, Sung Won Cho, Jin-Oh Choi, Jidong Sung, Sang-Chol Lee, Seung Woo ParkvJeong Euy Park Background : Framingham risk score (FRS) is a famous multivariate risk model which has been developed for estimating the risk of cardiovascular events. Pericardial fat (PF) is recognized as an indicator of visceral fat, which plays a key role in metabolic syndrome and cardiovascular risk evaluation. Transthoracic echocardiography (TTE) is an easy and reliable imaging method for measuring PF. Arterial stiffness is also associated with elevated risk for cardiovascular disease. The aim of this study was (1) to investigate the relationship between PF thickness and arterial stiffness and (2) to demonstrate the correlation between PF thickness and FRS. Methods and Results : We calculated FRS of each ninety one patients (M:F=61:30, mean age=60.4±12.6 years) who underwent TTE and arterial stiffness measurement and their association was analyzed. The PF thickness was defined as the average value of the maximal thickness of PF measured in front of the free wall of the right ventricle from both parasternal long-axis and short axis view. The mean value of the PF thickness evaluated by two independent observers was selected. The brachial-ankle pulse wave velocity (baPWV) was measured by oscilometric method to evaluate the arterial stiffness. The baPWV was positively correlated with PF thickness, age, systolic blood pressure (BP) and diastolic BP (r=0.632 and p<0.001, r=0.428 and p<0.001, r=0.643 and p<0.001, r=0.321 and p=0.002, respectively) in univariate analysis. Multiple regression analysis showed that the baPWV was associated with PF thickness, age, systolic BP and diabetes independently (p<0.001, p=0.007, p=0.003 and p=0.021, respectively). The logarithm of the thickness of PF and baPWV are significantly correlated with FRS (r=0.428 and p<0.001, r=0.423 and p<0.001, respectively). Conclusions : Pericardial fat thickness was significantly correlated with the arterial stiffness and FRS. Therefore, its measurement with TTE could be useful to predict the arteriosclerotic changes and the risk of cardiovascular events in routine clinical practice.
