WCIM 2014 SEOUL KOREA 79
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0126 Cardiology
Comparison of Blood Pressure at the Beginning and at the End of Visits in a HIV Clinic
Manuel ROCA1, M. Daniela DIAZ2, M. Alexandra MENDOZA3, Bernardino ROCA1 Medicine, Hospital Provincial, Spain1, Medicine, Hospital General, Spain2, Physical Therapy and Rehabili- tation, Hospital General, Spain3
Objectives: Stress and other causes can infl uence blood pressure levels and may limit the usefulness of its measurement in the offi ce, but knowledge in this fi eld is limited.
We aim to determine the impact on and blood pressure of the state of anxiety that HIV-infected patients experience when they are about to be informed of immunologic and virologic tests and other blood analysis results in clinical visits.
Methods: In a cohort of HIV-infected patients, we measured blood pressure of every subject twice: at the beginning of visits just before we reported them lymphocyte CD4 cell count, HIV-viral load and other blood analysis results, and about ten minutes afterwards at the end of visits. We compared results of both determinations, and searched for factors associated with differences between both determinations, when present.
Results: We included 152 patients, the median of age was 45 years (interquartile range: 39-50), 101 (66 %) were male, 24 (16 %) had been diagnosed of hypertension previously, 28 (18 %) had been diagnosed of diabetes, 25 (16 %) had been diagnosed of dyslipidemia, and 120 (79 %) were smokers; 142 (93 %) were taking antiretroviral medication. Table shows results at the beginning and at the end of visits (sBP and dBP = systolic and diastolic blood pressure, measured in mmHg). An association was found between lower sBP at the end of the visit compared to blood pressure at the beginning of the visit and the following variables: younger age (P = 0.018) and female gender (P = 0.008).
Conclusion: sBP at the end of the visit is commonly lower than sBP at the beginning of the visit, especially in young women.
PS 0128 Cardiology
Case Report - An Unusual Association of Mitral Steno- sis with Diffuse Systemic Sclerosis
Girish RAMTEKE1, Sanjay DUBEY1, Neeraj DAYANI1, Mridulata PRAJAPATI1, Paridhi SHIVDE1
MGM Medical College and MY Hospital, India1
Introduction: Disorders of collagen tissue are caused by humoral and cellular mediat- ed immune responses mediated by cytokines like TGF ß, TNF a etc. The various disease manifestations include mixed connective tissue diseases, rheumatoid arthritis, sjogren’s syndrome, systemic sclerosis etc. One of the associations is that of cardiac valves- stenotic lesion-though extremely rare. We report one such rare case.
Case presentation: 60 year old female presented with a history of tightness of skin, contractures of fingers, inability to open mouth and pitting scars over the tip of digits. There was no history of breathlessness. There is a history of rheumatic heart disease-mitral stenosis-open mitral valvulotomy 7 years ago. On evaluation she had features suggestive of Mauskopf’s facies, microstomia and other features of systemic sclerosis and the ACR criteria suggested systemic sclerosis. Modified Rodnan skin thickness score was 43 out of 51. Her Antiscl-70 antibody was positive and skin biopsy showed dermal sclerosis. HRCT chest showed- septal thickening with ground glass ap- pearance. Though the patient was asymptomatic her echo revealed chordal shortening, cuspal retraction which was an additional feature compared to earlier echo 7 years ago. This association of valvular involvement in systemic sclerosis is an extremely rare association with only 5 cases reported in literature.
Conclusion: Association of valve- stenotic has been very rarely associated with col- lagen disease like systemic sclerosis; though other collagenous tissues of the body are involved cardiac valves are generally spared. With only 5 cases reported in the liter- ature we report one such case of this rare association where in an initially affected and treated mitral valve due to rheumatic heart disease has been now involved due to systemic sclerosis.
PS 0130 Cardiology
Serum Leptin Level and the Main Components of the Metabolic Syndrome
Suleyman MAMMAEV1, Aminat KARIMOVA1 Dagestan State Medical Academy, Russia1
Background: The adipocytokine/hormone leptin produced by adipose tissue plays the key role in pathogenesis of metabolic syndrome (MS) and its main components: insulin resistance (IR), arterial hypertension and dyslipidemia.
Objectives: to reveal the correlations between the leptin level and the most important MS components parameters.
Methods: 115 persons included in the study were divided into two groups: the main group - 90 patients (36 men and 54 women) with MS, mean age 50,6±7,3 years, and the control group - 25 healthy people (11 men and 14 women), mean age - 37,1±7,2 years. The anthropometrical measurements, biochemical blood analyses, heart and liver ultrasonography and fasting serum insulin and leptin levels estimation (by ELISA) were carried out in both groups. IR index was evaluated by Homeostasis Model Assessment 2 (HOMA2) calculator (version 2.2.).
Results: The mean leptin level in patient with MS was 56,9±27,5 that was signifi cantly higher than in control group (p<0,001). Reliable positive correlations between the BMI, the waist circumference (WC) and leptin level, and negative correlation of a hormone rate with waist-to-hip ratio (WHR) were revealed in the study (R (Spirmen correlation coeffi cient) = 0,36, p<0,001; R=0,29, p=0,006 and R = - 0,6, p<0,001 for BMI, WC and WHR, respectively). Reliable positive correlations between leptin level and systolic and diastolic BP were also revealed (R=0,5, p<0,001 and R=0,34, p=0,001 for SBP and DBP, respectively). More over, leptin level showed strong reliable positive correlation with fasting serum insulin level, IR-NOMA2 and cholesterol level (R=0,59, p<0,001; R=0,65, p<0,001; R=0,23, p=0,04 for insulin, IR-NOMA2 and cholesterol, respectively,).
Conclusions: There was revealed the raised serum leptin level in patients with MS compared to healthy people. Leptin level signifi cantly correlated with the parameters that characterize the most important components of MS.
PS 0127 Cardiology
Risk Management of Cardiovascular Disease Through Milk Enriched with Sterols in a Young-Adult Population
Yurrita Collado LUIS1, San Mauro ISMAEL1, Cuadrado MARRIA ANGELES2, Hernandez MARTA3, Ciudad MARIA JOSE1
Complutense University of Madrid, Spain1, Hospital Clinico San Carlos, Spain2, CAPSA UCM/CLAS, Spain3
Backgournd: Hypercholesterolemia is one of the most relevant risk factors of car- diovascular diseasein spain, where. Aim to determine the effectiveness of a rich in phytosterols for reducing markers of cardiovascular disease
Methods: A randomized, clinical controlled trial, double-blind crossover study. The sample was recruited from the University Hospital Clinico San Carlos in Madrid. The sterols were ingested through commercial milk, with two phases and three weeks respectively separated by a washout period of 2 weeks. At the beginning and end of each phase blood draws were performed. Taking 2 glasses of milk daily in adminis- tering them an amount of 2.7 g of plant sterols per day, for those subjects during the
“milk of study “, and the same amount of skim milk, sterols, for placebo. Lipid profi le, hematology, was collected
Results: Nineteen people completed the study of 34.68 years (± 6.91). The difference between baseline and fi nal scores were 19.47 (± 29.10) mg / dl, 24.47 ( ± 30.68 ) mg / dl, 14.36 (± 44.16) mg / dl for LDL cholesterol, the TC and TG, respectively, represent- ing a decrease of 12.21 (± 18.70) %, 10.44 (± 12.88) % and 7.04 (± 35.77) % decrease for LDL-C, TC and TG, respectively. Without considerable changes in HDLc. There are signifi cant differences between placebo and milk with sterols for LDL (p=0.009) and Ct (p=0.003). Similar data have been reported by many groups in other matrices, and to a lesser extent milk, with similar decreases in lipid markers.
Conclusions: As is evident, sterols supplied in a functional food, such as milk, can be a strategy for non- pharmacological treatment of hypercholesterolemia and therefore a tool for cardiovascular risk reduction globally.
