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CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
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K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
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0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Impact of left ventricular diastolic function on the outcomes of patients with atrial fibrillation
Session:
Posters 2 - Écran 6 - Arritmologia
Speaker:
Rita Ventura Gomes
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.2 Atrial Fibrillation - Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Rita Ventura Gomes; Antonio; Gonçalo Lopes Da Cunha; Dra. Inês Cruz; Ana Rita F. Pereira; Daniel Sebaiti; Ana I. Marques; Marco Quadrado; Ana Almeida; Paula Fazendas; Isabel João; Helder Pereira
Abstract
<p><strong>Introduction</strong></p> <p>Atrial fibrillation (AF) is associated with an increased risk of stroke, all-cause mortality and heart failure (HF).</p> <p>Left ventricular (LV) diastolic impairment is associated with a poor prognosis and in patients (pts) with AF, may also contribute to the formation of left atrial appendage thrombus (LAAT), the usual source of embolic events.</p> <p><strong>Purpose</strong></p> <p>To investigate the impact of transthoracic echocardiographic parameters of LV diastolic function (DF) on the prognosis of patients with AF.</p> <p><strong>Methods</strong></p> <p>Retrospective case-control study of pts with permanent AF and no more than mild valvular heart disease, who were examined in our echo lab between January 2015 and December 2016 and had an evaluation of diastolic function (mitral inflow E velocity and tissue Doppler septal and lateral mitral annulus velocities (e’) and E/e’ ratios). Follow-up (FU) was 2,7±0,8 years.</p> <p>The outcome was a composite of thromboembolic events (TE), presence of a left atrial appendage thrombus (LAAT) or spontaneous echo contrast (SEC) in transoesophageal echocardiography (TEE) and/or all-cause mortality.</p> <p><strong>Results</strong></p> <p>120 pts were included (mean age 73,4±9,4years; 60,0% male; CHA<sub>2</sub>DS<sub>2</sub>-VASc 4,0±1,5).</p> <p>During FU, 65 pts had at least one event corresponding to outcome. Twenty-two (14,7%) had LAAT or SEC in a TEE, 29 (24,2%) had at least one TE and 34 (28,3%) died. Pts were older (75,3±9,3vs 71,1±9,2, p=0,015), had higher CHA<sub>2</sub>DS<sub>2</sub>-VASc score (4,4±1,2vs3,5±1,6, p=0,001), more HF (70,8%vs45,5%, p=0,005) and more coronary disease (29,2%vs9,1%, p=0,006), bigger left atrium (70,0±26,5vs62,1±22,5mL/m<sup>2</sup>, p=0,08), lower LVEF (47,9±15,7% vs 50,5±13,2%, p=0,476), lateral e’ velocity (8,1±2,8vs10,4±3,1cm/s, p<0,0001) and average e’ velocity (7,6±2,1vs9,1±2,5cm/s, p=0,010) and higher lateral E/e’ ratio (13,5±6,3vs10,7±4,4cm/s, p=0,033) and average E/e’ ratio (15,1±6,5vs12,3±4,7cm/s<strong>, </strong>p=0,032).</p> <p>In the multivariate analysis, only the lateral e’ velocity was an independent predictor of adverse events (OR 0,749, CI 0,568-0,989 p=0,041). ROC curve showed an acceptable discriminative capacity for lateral e’ velocity (AUC 0,699, p=0,001).</p> <p><strong>Conclusion</strong></p> <p>Lateral e’ velocity is a predictor of adverse events in patients with AF, independent of other clinical and echocardiographic data.</p> <p>Echocardiographic assessment of LV DF is a simple step of the routine evaluation of any patient. If prospectively validated, this finding may help physicians in the risk stratification of pts with AF, alone or integrated in a model of risk prediction.</p>
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