52 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0027 Cardiology
“Elite Child Athletes are Our Future” Cardiac Adapta- tion to Swim Training in Prepubertal Egyptian Athletes
Magdy ABOUZEID1 Alexandria University, Egypt1
Background: The elite child athletes are one who has superior athletic talent. Monofi n (a single surface swim fi n) swimming already proved to be the most effi cient method of swimming for human being. This is a novel descriptive study examining myocardial function indices in prepubertal monofi n children.
Methods: 14 elite monofi n children aged 11.95 years (± 1.09 yr) took part for (LTMT).
All subjects underwent two-dimension, M-mode, and Doppler echocardiography before and after training to evaluate cardiac dimensions and function; septal and pos- terior wall thickness. Statistical methods of SPSS, means ± SD and paired t test, % of improvement were used
Results: There was signifi cant difference (p<0.01) and % improvement for all echo- cardiography parameter after (LTMT). Inter ventricular septal thickness in diastole and in systole increased by 27.9 % and 42.75 %. Left ventricular end systolic dimension and diastole increased by 16.81 % and 42.7 % respectively. Posterior wall thickness in systole very highly increased by 283.3 % and in diastole increased by 51.78 %. Left ventricular mass in diastole and in systole increased by 44.8 % and 40.1 % respective- ly. Stroke volume (SV) and resting heart rate (HR) signifi cant changed (sv) 25 %, (HR) 14.7 %.
Conclusions: Monofi n training is an effective sport to enhance “Heart athlete’s” for children, because the unique swim fi n tool and create propulsion and overcome resist- ance. Further researches are needed to determine the effects of monofi n training on right ventricular in child athletes
PS 0028 Cardiology
Blood Pressure Variability: A Motive for Discussion
Elena Vitalyevna PELLO1, Sofia Konstantinovna MALYUTINA1, Evgeni Georgievich VEREVKIN1, Galina Ilinichna SIMONOVA1, Yuri Petrovich NIKITIN1
FSBI Institute of Internal Medicine and Preventive Medicine SB RAMS, Russia1
Background: The economic loading of cardiovascular disease detection and treatment is expensive and is encumbered by co-morbidities and devastating consequences.
Hypertension, as one of the major shareholders of health disruption, facilitates devel- opment of grim cardiovascular incidence. Although blood pressure level (BPL) is the linchpin of outcomes, the enlightened views suggest that an increased BP variability (BPVar) is integrated with greater degree of target-organ damage and higher rate of cardiovascular events. With these concerns in mind, we have delved into the realm of possible ties of BPL and BPVar in patients at highest risk, with combined pathologies, and with complications.
Methods: We performed EPOGH follow-up (5 years, n=194), applied clock-time-de- pendent method narrow approach, and assessed BPL (average value) and BPVar (SD) for day (D) and night (N) systolic (S)/ diastolic (Di) BP.
Results: Generally, it is necessary commitment to look for scientifi c revenues: BPVar is related with BPL, short-term BPVar frequently is rampant during day and night, dignity of nighttime BPVar includes feedforward interaction with higher rate of cardiovascular events, carotid atherosclerosis, and stroke formation, etc. Therefore, the fi ndings dis- pelled scruples, ascertaining the following positive correlations: between DSBPVar and DSBPL (r=0.380, p<0.001), DDiBPL (r=0.157, p=0.028), DDiBPVar (r=0.706, p<0.001), NSBPL (r=0.258, p<0.001), NSBPVar (r=0.433, p<0.001), NDiBPVar (r=0.321, p<0.001);
between DDiBPVar and DSBPL (r=0.162, p=0.024), NSBPVar (r=0.231, p=0.001), NDiB- PVar (r=0.267, p<0.001); between NSBPVar and DSBPL (r=0.487, p<0.001), DDiBPL (r=0.322, p<0.001), NSBPL (r=0.301, p<0.001), NDiBPVar (r=0.760, p<0.001); between NDiBPVar and DSBPL (r=0.330, p<0.001), DDiBPL (r=0.298, p<0.001), NSBPL (r=0.145, p=0.044). Promoting the frontiers of knowledge ahead, we shouldn’t neglect by the root causes of abnormal BPVar encompassing responsibility of barorefl ex and nervous system effects, intrinsic and environmental infl uences in regulation of BP changes.
Conclusions: Even so, our data may optimize an awareness of BPVar steady-state importance in cardiovascular outcomes construction.
PS 0029 Cardiology
Long-Term Effects of Dual-Antiplatelet Therapy in Patients with 1st Generation DES Implantation
Yong Cheol KIM1, Seok Kyu OH1, Sang Jae RHEE1, Kyeong Ho YUN1, Nam-Ho KIM1, Jin-Won JEONG1
Wonkwang University of Medicine & Hospital, Korea1
Background: Dual-antiplatelet therapy was used to minimize the risk of stent throm- bosis after implantation of DES. We evaluated the long-term effects of dual-antiplate- let therapy in the patients with 1st generation DES implantation
Methods: We retrospectively analyzed 820 consecutive patients who underwent fi rst generation DES implantation at de novo lesion from September 2003 to August 2006. After 1 year of aspirin and clopidogrel combination therapy, we excluded 235 patients and a total of 585 patients were included in this analysis. The patients were randomized to aspirin and clopidogrel (Clopidogrel group, n=272) vs aspirin and ci- lostazol (Cilostazol group, n=313). A total of 435 patients who treated completely the dual-antiplatelet therapy for 5 years were enrolled.
Results: The primary end points were the incidence of stent thrombosis and bleeding between 1 year and 5 years. Secondary end point were the major adverse cardiovas- cular and cerebrovascular events (MACCE), including stent thrombosis, all-cause mor- tality, non-fatal myocardial infarction, non-fatal stroke, target lesion revascularization and target vessel revascularization. The Incidence of stent thrombosis was 2 cases only in cilostzaol group. But another one, the risk of bleeding, was increased in clopi- dogrel group than cilostazol group, 8.2% versus 4.0%. Secondary endpoint, MACCE was increased in clopidogrel groups, 12.0% versus 6.6%. But there was no signifi cant between group differences in stent thrombosis, bleeding and MACCE. However, major bleeding including intracranial hemorrhage and more than decrease hemoglobin 5.0 g/dL was signifi cant reduced in cilostazol group, as compared with clopidogrel group, 8.2% versus 3.1% (P=0.020).
Conclusions: Cilostazol was not inferior to clopidogrel for prolonged DAPT, preferably was good for major bleeding
PS 0030 Cardiology
Clinical Characteristics and Outcomes of Acute Myo- cardial Infarction in Young Korean Adults
Seunghun LEE1, Ju Han KIM1, Myung Ho JEONG1, Hyukjin PARK1, Ji Eun KIM1, Youngkeun AHN1, Jong Hyun KIM2, Shung Chull CHAE3, Young Jo KIM4, Seung Ho HUR5, In Whan SEONG6, Take Jong HONG7, Donghoon CHOI8, Myeong Chan CHO9, Chong Jin KIM10, Ki Bae SEUNG11, Wook Sung CHUNG11, Yang Soo JANG8, Jeong Gwan CHO1, Jong Chun PARK1, Seung Jung PARK12
Chonnam National University Hospital, Korea1, Hanseo Hospital, Korea2, Kyungpook National University Hospital, Korea3, Yeungnam University Hospital, Korea4, Keimyung University Dongsan Medical Center, Korea5, Chungnam National University Hospital, Korea6, Pusan National University Hospital, Korea7, Yonsei University Severans Hospital, Korea8, Chungbuk National University Hospital, Korea9, Kyunghee University College of Medicine, Korea10, The Catholic University of Korea Hospital, Korea11, Asan Medi- cal Center, University of Ulsan College of Medicine, Korea12
Background: This study aims to investigate clinical features, angiographic fi ndings, and outcomes of young AMI patients.
Methods: We analyzed major adverse cardiac events (MACE) in the Korea Acute Myocar- dial Infarction Registry from November 2005 to October 2010. Registered patients were divided into two groups, young age group (<45 years) and old age group (=65 years).
Results: Young age group was composed of 1,248 patients (39.6±4.3 years) and old age group 9,759 patients (74.5±6.5 years). Male, smoking, family history and dyslipi- demia were more frequent in young age group than those in old age group (96.6% vs.
57.5%, P<0.001; 86.9% vs. 45.7%, P<0.001; 15.5% vs. 4.8%, P<0.001; 13.4% vs. 9.5%, P<0.001). Young Korean adults with AMI had a shorter symptom-to-door (17.4±72.6 min vs. 24.2±77.7 min, P=0.002), but a longer door-to-balloon time (111.1±106.8 min vs. 101.8±92 min, P=0.043). The young age group had shown a favorable prognosis compared with old age group by Kaplan-Meier survival analysis (long-rank, P<0.001).
However, there was no signifi cant difference in the adjusted MACE rate at one-year (HR 1.10, 95% CI 0.79-1.53, P=0.585), even after propensity-matched analysis (HR 0.80, 95% CI 0.52-1.23, P=0.307).
Conclusions: Young Korean adults with AMI have similar clinical outcomes with old age patients, and therefore they should be treated aggressively like elderly patients.
