P1452Endogenous selenoprotein P mediates pressure overload-induced cardiac hypertrophy

Abstract

Introduction: Parasternal short-axis (SAX) assessment of circumferential extent of paravalvular leakage (PVL) in patients who had undergone transcatheter aortic valve implantation (TAVI) potentially underestimates PVL. I-Rotate echocardiography from an apical recording may be a new method to assess the circumferential extent of PVL. Methods: The study included 41 consecutive outpatient patients (21 men, mean age 80±10 years) who had undergone TAVI with a self-expandable device. All patients underwent assessment of PVL circumferential extent by SAX analysis and I-Rotate echocardiography. From the standard 5-chamber view the probe was held in the same position and images were recorded at 15 degrees intervals to cover the whole circumference of the TAVI prosthesis. Results: I-Rotate echocardiography was feasible in all patients and induced no loss in spatial or temporal resolution. Circumferential extent correlated well with SAX (r=0.84, p<0.001) although a bias of 6.0% (limits of agreement: ±19.7%) with a significant larger circumferential extent with I-Rotate (13.7%±17.0% vs. 7.7%±10.1%, p<0.001) was observed. Individual case analyses revealed, apart from suspected underestimation due to acoustic shadowing, impaired SAX quality and jets separated by echo-dense areas as causes for PVL underestimation by SAX analysis and non-central alignment in the stent by I-Rotate echocardiography as a possible cause for (relative) overestimation by I-Rotate echocardiography. PVL assessment with I-RotateConclusions: I-Rotate echocardiography from an apical view is a feasible method to study the circumferential extent of PVL after TAVI. Future studies should provide more insight whether I-Rotate overestimates or SAX analysis underestimates circumferential extent of PVL. Purpose: To analyze the influence of overweight and obesity on multi-layer longitudinal strain in a healthy population free of cardiovascular risk factors by speckle tracking derived two-dimensional echocardiography. Methods: One-hundred sixty-six consecutive subjects (age = 41±15 years, range = 12-78 years, F/M = 95/71) free of any kind of cardiovascular disease (including heart failure, coronary artery and valve heart disease) were enrolled after excluding hypertensive, diabetic and dyslipidemic patients as well as smokers. According to body mass index (BMI) subjects were divided into 2 groups: 114 normoweight (N) and 52 overweight/obese (O) (BMI >25.1 kg/m 2 in men and >23.9 kg/m 2 in women). All subjects underwent a complete echo Doppler exam including quantitation of 2D global longitudinal strain (GLS), considered as "positive" (sign +). Post-hoc analysis by a multi-layer strain software allowed also to obtain subendocardial and subepicardial GLS (EndoLS and EpiLS respectively). Intramyocardial longitudinal gradient (LSgrad) was calculated as the difference between EndoLS and EpiLS. Results: The two groups were comparable for sex prevalence, blood pressure (BP) and heart rate whereas O were older than N (p<0.002). At standard echo-Doppler O had higher LV mass...