S62 Posters / International Journal of Cardiology 125 Suppl. 1 (2008) S51–S73 P337 Combined use of fenoﬁbrate and statins in the patients with unstable angina pectoris A.B. Shek*, R.D. Kurbanov, M.B. Mavlaynova, S.A. Aminov. Republican Center of Cardiology, Tashkent, Uzbekistan Aim: To study hypolipidemic efﬁcacy of combined use of fenoﬁbrate and statins in patients with unstable angina pectoris with mixed dislipidemia. The study was performed on 19 patients with progressing angina pectoris with mixed dislipidemia: levels of LDL cholesterol >100 mg/dL, TG > 250 mg/dL at the age 60 years. The subjects with initial increased levels of ALT, AST as well as KFK were excluded from the study. Fenoﬁbrate was prescribed in daily dose 200mg/day, statins (simvastatin, atorvastatin) in doses 10-20 mg/day. After onset of study 3 patients were excluded (15.8%), one patient due to appearance of muscular pains and two patients due to dyspepsia signs. The rest 16 patients received combined therapy during 6 months. Combined therapy during 6 months was accompanied with strong tendency to reduction of total cholesterol level from 230.2 to 203.0mg/dL, however LDL cholesterol had less marked character, that, possibly, was related to relative small dose of statins, that was not titrated during investigation to prevent of adverse effects. The levels of TG (P < 0.001) and VLDL cholesterol (P < 0.001) reliably reduced to the 6 month of therapy that was accompanied by decrease of atherogenecity coefﬁcient (P < 0.05). The level C-RP had tendency towards reduction from 5.1 to 4.4mg/L. The achieved positive dynamics of lipid spectrum was accompanied with good clinical effect, stabilization of the state in all the patients, repeated destabilization during 6 months required hospitalization was observed only in one patient (6.3%). Among three patients, at whom therapy was interrupted at the early period due to adverse effects, also one repeated hospitalization (33.3%) was observed. P338 Effect of statin therapy different regimens on C-reactive protein level in the patients with unstable angina pectoris A.B. Shek*, R.D. Kurbanov, M.B. Mavlanova, A.V. Zyyaeva. Republic Center of Cardiology, Tashkent, Uzbekistan Effect of aggressive hypolipidemic therapy during 3 months was studied in 18 patients with unstable angina of effort, group I (atorvastatin, 10-40 mg, HLDL < 70–100 mg/dl), against group II, receiving common non-controlled lipid reducing therapy (simvastatin 10-20, n = 20). Group of control included 12 patients with intolerance to statins (n = 8) as well as patients stopping their use after discharge from hospital (n = 4). Basis therapy included beta-blockers, nitrates, heparin or low molecular heparins in the acute period with further switch-over to aspirin. The study groups had no differences in relation to severity of clinical course, main indications of lipid metabolism as well as concentration C-RP – 11.2±5.4 mg/l, 9.7±4.6 mg/l and 8.9±4.1 mg/l in groups I, II and control, respectively. During 1.3.6-month therapy there was noted moderate reduction of total cholesterol, LDL cholesterol concentrations in group of non-aggressive therapy, however, there were no revealed reliable changes in the blood C-RP level. Aggressive statin therapy additionally to high reliable effect of the level of total cholesterol (P < 0.001), LDL cholesterol (P < 0.001) (P < 0.001) induced reliable reduction in C-RP concentration in comparison with initial value – 7.8±3.9 (P < 0.05), 6.7±2.9 (P < 0.01) and 6.0±2.6 (P < 0.01) after 1, 3, and 6 months, respectively. Results obtained showed that although hypolipidemic therapy in common regime enables reduction of blood total cholesterol and LDL cholesterol concentrations only aggressive reduction of blood lipid levels with statins resulted in stable pathogenic effect expressing as decrease in C-RP level during 6-month therapy. P339 Study of the optimal pacemaker parameters in cardiac resynchronization therapy M. Shen*, B. Liu, H.C. Wang, W.J. Li, W.Y. Guo, L.W. Liu, J. Zhang. Department of Cardiology, Xijng Hospital, Xi’an, Shaanxi 710032, China 0bjective: To observe the clinical effect of biventricular pacing in patients with chronic heart failure, to approach of how to optimize of the pacemaker parameters in order to enhance the efﬁcacy of CRT. Methods: Twenty-six patients with chronic heart failure received biventricular resynchronous pacing, and left ventricle leads were implanted into one of cardiac veins. The location of left ventricle lead was equal pace to the position that was the most delayed contraction symptomed by ultrasound as far as possible. Results: The heart function of 25 patients was signiﬁcantly improved after the treatment. The NYHA class of the patients was improved from class III–IV to class II–III. Left ventricular end diastolic diameter (LVEDD) was decreased from 77.0±9.4 mm to 68.7±10.2 mm, P < 0.05. Left ventricular end systolic diameter (LVESD) was decreased from 67.6±8.2 mm to 60.7±9.6 mm, P < 0.05. Left ventricular ejection fraction (LVEF) was increased from 21.2±4.5% to 34.7±5.1%, P < 0.05. Standard deviation of time to regional peak systolic velocity (Ts-Sd-12) was decreased from 48.4±17.9 ms to 30.2±18.6 ms, P < 0.05. About 1/3 patients accepted optimization of AV delay and VV delay. Optimal PAV and SAV was 130–180 and 110–160 ms, VV delay was 8-40 ms. Conclusions: The biventricular resynchronous pacing is an effective treatment for chronic heart failure. Optimization of the pacemaker parameters is needed in order to enhance the efﬁcacy of CRT. P340 Postoperative echocardiographic evaluation of modiﬁed Blalock–Taussig shunts Y.S. Shi*. Department of Echocardiography, Fu Wai Hospital, China Objective: Modiﬁed Blalock–Taussig (BT) shunts is widely applied as a staging procedure to provide controlled pulmonary blood ﬂow for the patients with complex congenital heart disease. The purpose of present study is to summarize the experience of postoperative and mid-term echocardiographic evaluation of modiﬁed BT shunts. Methods: 35 consecutive patients received modiﬁed BT shunts and survived 6 postoperative 6 months during 2003–2006 were enrolled in this study. Transthoracic echocardiography was utilized to evaluate the patency of shunts and the change of pulmonary arteries (PA) and left ventricle (LV). Results: 3 patients received the emergence surgery for the intervention for the BT shunts. The follow-up was 20.7±11.6 months. During the follow-up, the obstruction of shunts occurred in 5 cases. After the placement of shunts, the mean size of PA increased by 30.6%, meanwhile, the size of LV increased by 25.2%. 12 patients received the followed deﬁnitive repair or palliative operations. Compared with the patients still waiting for the growth of PA, the patients who receiving the second staged procedure achieved the more appropriate PA growth. Furthermore, for the above patients, there was no signiﬁcant difference between the angiographic and echocardiographic evaluation for the PA size. Conclusion: Echocardiography could accurately diagnose the patency of shunts and record the growth of PA and LV following BT shunts. Echocardiography is a highly reliable noninvasive approach for the perioperative evaluation and mid-term follow-up for the modiﬁed BT shunts.