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￭ S-271 ￭
Clinical implications of combined glucose intolerance in treatment-naive hypertensive patients
가톨릭의대 대전성모병원 심장내과
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성예규, 김대원
Background: This study is the first study to evaluate clinical significances of combined glucose intolerance (CGI) in treatment-naive hypertensive patients. Methods: We compared the results of demographic, anthropometric, clinical, laboratory examinations, echocardiography, arterial stiffness, central blood pressure (BP) and ambulatory BP monitoring (ABPM) between the groups according to fasting blood sugar (FBS), postprandial 2 hour blood glucose (PP2) and gender in treatment-naive hypertensive patients. A total of 376 concecutively-eligible patients were categorized as follows: (1) normal glucose tolerance (NGT); FBS＜100 mg/dL and PP2＜140 (2) isolated glucose intolerance (IGI); 100≤FBS＜126 or 140≤PP2＜200, but not both 100≤FBS＜126 and 140≤PP2＜200 (3) CGI; both 100≤FBS＜126 and 140≤PP2＜200. Results: Males were divided into NGT (n＝58, 33.1%), IGI (n＝88, 50.3%), CGI (n＝29, 16.6%) and females were divided into NGT (n＝59, 43.1%), IGI (n＝48, 35%), CGI (n＝30, 21.9%). Multivariate analyses revealed that mitral average E/Ea (IGI vs CGI, p＝0.022), brachial-ankle pulse wave velocity baPWV(Rt.) (IGI vs CGI, p＝0.026), baPWV(Lt.) (IGI vs CGI, p＝0.018), office systolic BP (SBP) (NGT vs. CGI , p＝0.005; IGI vs. CGI, p＝0.001), office diastolic BP (DBP) (NGT vs.
CGI , p＝0.034; IGI vs. CGI, p＝0.019), night-time SBP (NGT vs. CGI , p＝0.049; IGI vs. CGI, p＝0.018) were significantly higher in the CGI group than in the NGT or IGI group . However, there were no significant differences between the female groups. Conclusions: Treatment-naive hypertensive males with CGI showed increased subclinical diastolic dysfunction, arterial stiffness and BPs, compared to those of the male NGT or IGI group but not females.
￭ S-272 ￭
Peak Atrial Systolic Mitral Annular Velocity: Predictive Values for Development of Atrial Arrhythmia
제주대학교병원 내과
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남궁연, 부기영, 김형윤, 최준혁, 김송이, 김기석, 주승재, 이재근
Background: Atrial arrhythmia (AA) is a frequent comorbidity in patients with device-based therapy of cardiac rhythm abnormalities and is a recog- nized cause of mortality, morbidity, and quality-of-life impairment. The aim of this study was to investigate the correlation between left atrial dysfunc- tion assessed by Tissue Doppler Imaging (TDI) and development of AA after the implantation of devices. Method: Patients with sinus node dysfunc- tion (including sick sinus syndrome, tachycardia-bradycardia syndrome and high grade atrio-ventricular (AV) block), complete AV block and car- diomyopathies (ischemic and dilated cardiomyopathy) that were indicated devices were selected. Results: A total of 72 patients (age 72.1±10.1 years, 41 male and 31 female) were treated with devices, and 22 of those patients were excluded from the study. During a follow up, 25 patients (50.0%) de- veloped AA. Mean peak atrial systolic mitral annular velocity (A’ velocity) was 6.50±1.93 cm/s in AA patients, while it was 8.71±2.85 cm/s in the pa- tients without development of AA. The optimal A’ velocity cut-off to predict development of AA was 8.10 cm/s (sensitivity 82.6 %, specificity 64.0 %, AUC 0.76). At the logistic regression analysis, lower A’ velocity was an independent predictor for development of AA (OR＝0.392, 95% confidence in- terval＝0.23-0.68, p＝0.001). Conclusion: In patients with pacing devices for sinus node dysfunction, complete AV block and cardiomyopathy, A’ ve- locity seems to be a good predictor for development of AA.
