S40 JACC: CARDIOVASCULAR INTERVENTIONS, VOL. 7, NO.

2, Suppl S, 2014

agreement (6.3
5.8 vs. 6.0
4.8, kappa 0.74 (p<0.001). Calcied lesions were Purpose: To assess the ability of tissue Doppler imaging (TDI) - as a noninvasive
identied to a similar extent (28 vs. 26 cases) with fair degree of agreement (kappa0.40). method- to predict pulmonary artery pressure and to determine the possibility of
Both Bifurcation lesions and total occlusions were identied to a similar degree by assessment of severity of pulmonary hypertension.
MSCTA and ICA, (kappa0.38 for bifurcation lesions and 0.64 for total occlusion). Patients and Methods: The study population comprised three parallel groups of
For lesions identied with both techniques the degree of agreement was higher than total consecutive patients. The study groups were: Group I (31 control subjects) in which
score (6.5
4.8 for ICA vs. 6.9
6.3 for MSCTA, p<0.05), kappa 0.76). conventional Doppler and TDI-derived echocardiographic variables were measured
Conclusion: We found a good degree of agreement between 64 MSCTA and ICA in from lateral tricuspid annulus and compared with Group II (30 pts with pulmonary
syntax score calculation. Larger studies with new scanners of MSCT are needed to hypertension and normal left side structure and function) and group III (30 pts with
conrm our results. pulmonary hypertension and dilated cardiomyopathy).
Results: In group I the median age of the pts was 40.4 years, 68% of them were males,
in group II the median age of the pts was 35.5 years, 76.7% of them were females
while in group III the median age of the pts was 33.5 years, 80% of them were
CRT-303 males. The estimation of PASP was derived from tricuspid regurgitation velocity
according to the Bernoulli equation. The measurement of IVRT was calculated using
pulsed tissue Doppler. In group II and in group I (p, 0.0001), the average IVRT
was 81.00
6.3 ms [95% condence interval (CI):6596] and 32.3
7.05 ms (95% CI:
2050), respectively. We found a strong correlation between IVRT and systolic
NonInvasive Assessment of Plaque Characteristics with Dual Source Multislice pulmonary pressure in group II (r0.57, p, 0.0001) and a cut-off of 57.5 ms showed a
Computed Tomography Coronary Angiography in Symptomatic Controlled Diabetic sensitivity and specicity of 100% and 97%, respectively, for the prediction of
Patients elevated PASP. In group II and in the group I (p, 0.0001), the average IVCT was
34.2
4.8 ms [95% condence interval (CI):2545] and 61.5
9.7 ms (95% CI:
Mohamed Ali Mohamed Abdel Mageed, Mohamed Salem El Baz, Islam Shawky, 4575), respectively. We found a strong inverse correlation between IVCT and systolic
Abdel Aziz, Moustafa Ibrahim Mokarrab, Kamal Ahmed Meghany, Wael Mohamed Atteia pulmonary pressure in the PH group (r -0.38, p, 0.0001) and a cut-off of 35.5ms
Al Azhar Univ., Cairo, Egypt showed a sensitivity and specicity of 60% and 63%, respectively, for the prediction of
Objective: Cardiovascular events are high in patients with type II diabetes, whereas their elevated PASP.
risk stratication is more difcult. The higher risk may be related to differences in cor- Conclusions: The measurement of IVRT and IVCT by TDI is a simple and
onary plaque burden and composition. The purpose of this study was to evaluate whether reproducible method that correlates well with PASP. It is, therefore, parameters to
differences in the extent and composition of coronary plaques in patients with and consider in the echocardiographic assessment of pts with PH, and may be particularly
without diabetes can be observed using multi slice computed tomography (MSCT). important when the tricuspid Doppler signal is poor.
Research design and methods: MSCT was performed in 100 patients (56 [56%] with
type II diabetes) we also use HA1c as a predictor to differentiate between controlled and
uncontrolled diabetic patients. The number of diseased coronary segments was determined
per patient; each diseased segment was classied as showing obstructive (50% luminal
narrowing) disease or not. In addition, plaque type (non calcied, mixed, and calcied) was CRT-305
determined. Plaque characteristics were compared in patients with and without diabetes
and also between controlled and uncontrolled diabetic patients. Regression analysis was
performed to assess the correlation between plaque characteristics and diabetes.
Results: Patients with diabetes showed signicantly more diseased coronary segments
than non diabetic patients (4.870
2.488 vs. 2.130
1.558, P < 0.001*) with more ST Elevation Morphology and Site of Early Repolarization Pattern in Patients with
non obstructive (3.833
2.847 vs. 0.567
1.558, P < 0.001*) plaques. Relatively more False Tendons
non calcied (0.833
0.841 vs. 0.348
0.640) and calcied (3.278
2.528 vs.
Ahmed Mohamed Ragab, Amir AbdelWahab, Yasser Yazeed, Wael El Naggar
0.565
0.935) and less mixed (0.741
0.894 vs. 1.217
1.191) plaques were observed
Cardiovascular Department, Cairo University, Cairo, Egypt
in patients with diabetes (P < 0.02). Also patients with uncontrolled diabetes showed
signicantly more non calcied plaques than patients with controlled diabetes (1.50
Background: Although early repolarization pattern (ERP) have been considered for
0.67 vs 0.375
0.609, P< 0.001*). Diabetes correlated with the number of diseased long time to be a normal electrocardiographic nding, it was proved in recent studies
segments and non obstructive, non-calcied, and calcied plaques. to cause sudden cardiac death. Exact mechanism underling this electrocardiographic
Conclusions: Differences in coronary plaque characteristics on MSCT were observed phenomenon is not well established. False tendons are (FT) bromuscular bands that
between patients with and without diabetes and patients with controlled and uncon- transverse the left ventricular cavity and often contain conduction tissue which proved
trolled diabetes. Diabetes was associated with higher coronary plaque burden. More in some case reports to cause ventricular tachycardia.
non calcied and calcied plaques and less mixed plaques were observed in diabetic Objectives: To investigate the electrocardiographic characteristics of patients with
IMAGING

patients and also more non calcied plaques were observed in uncontrolled diabetic false tendons.
patients. Thus, MSCT may be used to identify differences in coronary plaque burden, Methods: We studied 60 non cardiac patients with FTs and 60 non cardiac patients
which may be useful for risk stratication. with ERP. Patients were classied according to presence of ERP and FTs to:
ERPFT (group 1, n52) and ERP or FT (group 2, n68). ERP was dened
as J point elevation manifested either as QRS slurring (transition from the QRS
segment to the ST segment) or notching (positive deection on terminal S wave),
Imaging upper concavity ST segment elevation for more than 0.1mV and prominent T waves in
at least 2 contiguous leads. False tendons were dened (by 2D TTE) as bands
stretching across the left ventricle (LV) from the ventricular septum to the papillary
muscle or LV free wall but not connecting, like the chordae tendinae, to the mitral
leaet. PRd, QRSd, QT, QTc, JT and JTc were calculated, site morphology of ST
elevation was identied and amplitude of ERP and number of leads with ST elevation
were calculated. Site and number of FTs were identied and length & thickness &
CRT-304 volume of FT were measured. FTs were classied according to their points of
attachment as type 1 (longitudinal), type 2 (diagonal), type 3 (transverse) and type 4
(weblike).
Results: ERP was present in 29 patients (48.3%) of patients with FTs and FTs were
present in 23 patients (38.3%) of patients with false tendons. Horizontal ST segment
Validity of Tissue Doppler Markers in the Assessment of Pulmonary Hypertension elevation was found in (61.4%) patients of those with ER and FT which is much more
Abdo M. Nasr, II common than patients with ER alone (27.8%) and this was statistically signicant (P
Kasr El Eini, Cairo, Egypt 0.007). We found that 80% of patients with ER pattern in the inferior leads have
oblique FTs (P 0.043) and 72% of patients with ER pattern in the inferolateral leads
Background: The accuracy of tissue Doppler parameters of right ventricular function have transverse FTs (P 0.05).
including Isovolumic relaxation time (IVRT) and Isovolumic contraction time (IVCT) Conclusion: Our results suggest that FTs may play a role in genesis and determi-
have not been validated sufciently in pulmonary hypertensive patients (pts). nation of site and morphology of ERP.