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S50 Heart, Lung and CirculationPoster Presentations 2008;17S:S4–S53

Conclusion: Beta blocker use did not worsen glycaemiccontrol in our cohort of diabetic patient with systolicheart failure. Carvedilol may improve glycaemic controlin diabetic heart failure patients when compared to B1selective antagonists. Further studies are required toinvestigate this.

doi:10.1016/j.hlc.2007.11.125

Identifying high risk patients with heart failure inintensive care unit with N-terminal pro-brain natriureticpeptide—Apollo study

Nitin Yadav ∗, Neelam Yadav, G. Ravindra, G.V. Somaya-julu

Apollo Hospitals, Anantapur, India

Purpose: The purpose of this study was to establish therelationship between elevated N-terminal pro-brain natri-uretic peptide (NT-proBNP) levels and high risk heartfailure patients in our intensive coronary care unit (ICCU),during hospital stay and/or short term follow-up.

Methods: We prospectively evaluated 60 consecutivepatients with heart failure, admitted in our ICCU. Allpatients were evaluated clinically and underwent echocar-diography and NT-proBNP estimation on admission. Wealso evaluated short-term follow-up of these patients.

Results: This study included 60 patients—39 (65%) males

Diastolic dysfunction in asymptomatic hypertensives—Apollo study

Nitin Yadav ∗, Neelam Yadav, G. Ravindra, G.V. Somaya-julu

Apollo Hospitals, Anantapur, India

Purpose of this study: In hypertension, even before leftventricular hypertrophy develops, changes in both systolicand diastolic function may be seen. Diastolic dysfunctionis the earliest and most common manifestation of effect ofhypertension on cardiac function and can lead to conges-tive heart failure from increased filling pressures, leadingto increased morbidity and mortality. The purpose of thisstudy was to evaluate asymptomatic hypertensive patientsby Doppler Echocardiography for evidence of diastolicdysfunction.

Methods: Eighty asymptomatic hypertensive patientswithout evidence of coronary artery disease and a normalelectrocardiogram were screened for diastolic dysfunc-tion by Doppler Echocardiography. Twenty age-matchedpatients served as controls.

Results: E:A reversal was seen in 66 patients with hyper-tension; as against four controls (p < 0.01). Isovolumicrelaxation time (IVRT) more than 100 ms was seen in 68patients of hypertension as against two controls (p < 0.01).

Conclusions: E:A reversal with prolonged IVRT as evi-dence of diastolic dysfunction with normal left ventricular

and 21 (35%) females. Mean age of patients was 58.2 ± 15.6years. Mean follow-up period was 6.5 ± 2.1 months. Nine-teen (31.5%) patients were in NYHA Class IV, while 25(41.5%) patients were in Class III and 16 (26.5%) were inClass II. NT-proBNP levels were significantly higher inpatients in higher NYHA Classes (p = 0.0084).

Left ventricular (LV) systolic dysfunction (LV ejectionfraction-LVEf < 45%, mean 32.6 ± 7%) was present in 37(61.5%) patients. Isolated diastolic dysfunction was seenin 14 patients. Those with higher grades of diastolic dys-function had significantly elevated levels of NT-proBNP(impaired relaxation: n = 11; pseudonormal: n = 6; restric-tive: n = 23; p = 0.021).

Patients with higher transmitral early diastolic veloc-ity/tissue Doppler early diastolic mitral annular velocity(E/Ea) ratio had higher NT-proBNP levels (E/Ea > or = 14,n = 22, v.E/Ea < 14, n = 34, p = 0.033). Patients who devel-oped ventricular tachycardia (n = 14) had higher NT-proBNP levels compared to other patients (n = 46).Similarly, patients who needed ventilatory support (n = 16)had higher NT-proBNP levels. Patients with higher NT-proBNP levels needed longer stay in the ICCU (>2days).Patients who had adverse events (worsening heart failure,readmission or death) on follow-up (n = 18) had signifi-cantly higher NT-proBNP levels than other patients.

Conclusions: Elevated NT-proBNP levels on admissionin heart failure patients are useful to identify the higherrisk subset with higher in-hospital and follow-up mortalityand morbidity; and hence have prognostic value.

doi:10.1016/j.hlc.2007.11.126

systolic function, is commonly seen in asymptomaticpatients with hypertension. It can contribute to complica-tions like congestive heart failure and increased morbidityand mortality, even in patients with good left ventricularsystolic function.

doi:10.1016/j.hlc.2007.11.127

Incremental value of combined left ventricular volumeand matrix metalloproteinase-2 for risk stratification ofpatients with non-ischemic dilated cardiomyopathy

Dong Heon Yang ∗, Sung Chull Chae

Kyungpook National University Hospital, Republic of Korea

Background: Extracellular matrix remodeling and apop-tosis are known to play important roles in the progressionof heart failure (HF). Matrix metalloproteinase (MMP) hasbeen associated with ventricular remodeling and failure.The aim of this study was to evaluate the prognostic valueof serum levels of MMP-2, MMP-3, soluble Fas (sFas) andsoluble Fas ligand (sFasL) in patients with non-ischemicdilated cardiomyopathy (DCM).

Subjects and methods: Serum samples were obtained from70 patients with DCM and analyzed for MMP-2, MMP-3,sFas and sFasL. We also measured left ventricular (LV) vol-ume and variable echocardiographic parameters. Patientswere followed up for the occurrence of either mortality orhospitalizations due to HF.

Results: Cardiac events were occurred at 21 patients(30%, death: 10, hospitalization due to HF: 11). LVend-diastolic volume (LVEDV) and end-systolic volume