protective effects in various models of hypertension. A single bolus of 3.0x108 transfection units of lenti-Ang-(1-7) was injected into the left ventricle chamber of the heart in 5-day-old male Sprague-Dawley rats. At six weeks, MI was induced by ligating the left anterior descending coronary artery. After four weeks, echocardiography and hemodynamic parameters were measured to assess the cardiac function. Heart tissues were collected for histological assessment and subsequent mRNA determination. An in vitro hypoxia experiment was also carried out to test the effects of Ang-(1-7) on rat neonatal cardiac myocytes (RNCM). Results: Lenti-viral vector efficiently transduced the rat heart and significantly increased Ang-(1-7) levels. MI rats showed a significant decrease in ejection fraction and dp/dt, and an increase in left ventricular end diastolic pressure (LVEDP) and ventricular hypertrophy. Overexpression of Ang-(1-7) attenu- ated these impairments to non-significant values, and also prevented myo- cardial wall thinning and tended to decrease the infarction area. Furthermore, MI caused an up-regulation of ACE mRNA expression but tended to down- regulate ACE2 mRNA expression, whereas, overexpression of Ang-(1-7) prevented these changes and also up-regulated ACE2 and Bradykinin B2 receptor (BKR2). In the in vitro study, Ang-(1-7) protected RNCM from hypoxia induced cell death and mediated up-regulation of ACE2, BKR2 and IL-10 and decreased levels of inflammatory cytokines (TNF-a ´ and IL-6). Conclusions: Cardiac overexpression of Ang-(1-7) exerts protective influence on heart function following cardiac injury, and attenuates the cardiac remodel- ing process. The effects of Ang-(1-7) may be mediated through restoring the ACE/ACE2 balance, which directly or indirectly increases BKR2 and IL10. PP.1.11 EFFECT OF AN INTEGRATED APPROACH TO CARE ON HEART FAILURE PATIENTS WITH HYPERTENSION E. Cosentino, E. Rinaldi, D. Degli Esposti, S. Bacchelli, M. Pombeni, E. Bianchi, C. Cavallari, M. Kolletztek, F. Santi, C. Borghi. S.Orsola-Malpighi Hospital, Bologna, Italy Background: Heart Failure(HF) might represents the conclusive clinical event of hypertensive disease(HBP) and its complications.Considering its increasing prevalence, HF is an important clinical and economic challenge often needing integrated and specialistic management programs. Purpose: Aim of the present study was to assess the effect of 1 year dedicated and integrated program care,comprehensive of systematic assessment and management,counselling,educational,on progression of NYHA class and rate of hospital admissions in patients with hypertension-related HF. Methods: Patients with history of hypertension and clinical,radiological or echocardiographic evidence of HF have been enrolled in the study.At entry and after 12 months we evaluated: physical signs,NYHA class,LV func- tion(LVEF%),neuro-humoral profile,on-going therapy. Main objective was the number of and hospital admissions after 6–12 months of intensive approach compared with those in the previous 12 months. Results: In a 5 year period we evaluated 438 consecutive HF patients, of which 170(75%) had at least 1 year control (108 M and 62 F,mean age 76 years,range 40–90). At entry, 103 pts(32%) had at least 1 hospital admission for HF,and 53 patients(17%) had > =3 admissions,whereas after 1 year 17 patients(5%) were admitted once and 30 patients(9.1%) had >=3 readmissions (p < .0001);15 patients died. At baseline visit, 57% patients were in NYHA class I,30% in NYHA class II,12,5% in NYHA class III and 0,5% patients were in NYHA class IV.At 12 month of follow up,12 % worsened NYHA class pts,40% unchanged pts and 48% ameliorated pts(p < .001 for improving trend). At entry and after 1 year respectively 44 and 46% of patients received ACE- inhibitors, 32,4 and 60 % Angio II-inhibitors, 51 and 73% B-blockers, 65 and 71% diuretics, 11 and 8% digoxin, 24 and 22% calcium channel blockers, 15 and 21% nitrates and 17 and 21% aldosterone receptor antagonists. Conclusions: The specific care and educational/support intervention program was effective in reducing readmission and ameliorating NYHA class of HF and HBP patients without any significant variation in pharmacological therapy. PP.1.12 COMPARISON BETWEEN INTERVAL TRAINING AND ENDURAND TRAINING ON 24-H BLOOD PRESSURE AND GLUCOSE METABOLISM IN HYPERTENSIVE PATIENTS WITH HEART FAILURE: A PILOT STUDY G. Caminmiti, M. Volterrani, A. Cerrito, G. Marazzi, A. Carluccio, S. Bovone, R. Massaro, G. Rosano. Cardiology Rehabilitation, S. Raffaele IRCCS, Rome, Italy Aim: To evaluate if interval training (IT) is more effective than endurance training blood pressure (BP) and heart rate recovery (HRR) of hypertensive subjects with chronic heart failure (CHF). Methods: We enrolled 36 (M/F 22/14) CHF patients (NYHA class II) median age 62 Æ 7 ys. They were divided into 2 groups according to the exercise protocol. Group IT (20 patients): interval training (exercise between 50% and 80% of VO2 peak); group ET (16 patients) endurance training (exercise at 60% VO2 peak). The follow up period was 12 weeks. At baseline and 12 weeks patients underwent blood sample collection, cardiopulmonary test and 24hour ambulatory BP monitoring. Results: At baseline there were not significant between groups differences on daytime and nighttime systolic BP and diastolic BP. After 12 weeks of training VO2 peak increased in both groups in a similar manner (IT +13; ET +11%; p 0.18). IT group had a greater no significant increase of time of exercise (+133 sec vs +112 sec; p 0.09) than ET group. ET had a lower reduction of rest heart rate (-4 bpm vs –9 bpm, p 0.03) and a lower improvement of heart rate recovery al I minute (-6.2 bpm vs -11.3 bpm; p0.01) After t12 weeks IT group had a greater reduction of daytime (-16% vs – 7; p 0.02) and nighttime (-19% vs – 8; p 0.006) diastolic blood pressure, and lower daytime (-12% vs – 9; p 0.07) and nighttime (-13% vs – 6; p 0.002) heart rate than ET group. HOMA IR was significantly reduced in the IT group (-18%, p 0.02) while was unchanged in the ET group (-4%, p 0.32). Conclusions: Despite similar effectiveness on exercise tolerance IT seems to determine greater effects on blood pressure control and insulin resistance than ET in hypertensive patients with CHF. PP.1.13 EFFECT OF FOLIC ACID SUPPLEMENTATION IN PATIENTS WITH CHRONIC HEART FAILURE I. Sudano, A.J. Flammer, D. Periat, F. Enseleit, M. Wolfrum, M. Hermann, T.F. Luscher, F. Ruschitzka, R. Corti, G. Noll. Cardiovascular Center Cardiology University Hospital Zurich, Zurich, Switzerland Background: Patients with chronic heart failure (CHF) are characterized by endothelial dysfunction, partly due to increased oxidative stress. Since folic acid exerts potential antioxidant activity, the present study was designed to evaluate the impact of folic acid supplementation on endothelial function, as well as on markers of chronic inflammation and oxidative-stress. Methods and Results: 20 patients with CHF were included in this random- ized, double blind, placebo-controlled study to receive folic acid (5 mg/day) or placebo for 1 month, on top of standard optimal therapy. Despite a significant increase in plasma folate levels (from 6.9 Æ 3.2 to 163.2 Æ 147.7 ng/ ml, p < 0.01) and a significant reduction in homocystein plasma concen- tration (from 14.8 Æ 3.5 to 12.0 Æ 2.0 mmol/L p = 0.011) in the folate-group, endothelial function, as assessed non-invasively by flow mediated vasodi- latation, was not significantly affected (from 3.8 Æ 1.7% to 4.1 Æ 2.1%, p = 0.64). Oxidative stress and inflammation parameters did not change significantly after folate substitution. However, 4 weeks of treatment with 5 mg folic acid significantly decreased diastolic blood pressure (DBP) as compared to baseline from 76.1 Æ 12.2 to 69.5 Æ 7.2mmHg; p = 0.03). A not- significant decrease in systolic blood pressure (SBP) was also observed (from 115 Æ 10.5 to 111 Æ 12.8mmHg; p = 0.06). There was no change in blood pressure after placebo (SBP from 113.8 Æ 8.9 to 116 Æ 5.1mmHg, p = 0.36 DBP from 68.9 Æ 7.2 to 71.0 Æ 6.9mmHg p = 0.13). Conclusion: Chronic treatment with folic acid (5 mg/day) over one month did not improve endothelial function and oxidative as well as inflammatory parameters in patients with CHF. However a significant reduction in arterial blood pressure has been observed. PP.1.14 ECHOCARDIOGRAPHY IN PATIENTS WITH HEART FAILURE: REDUCED AND PRESERVED LEFT VENTRICULAR FUNCTION F. Santi, E.R. Cosentino, D. Degli Esposti, E.R. Rinaldi, S. Bacchelli, M. Pombeni, E. Bianchi, C. Cavallari, M. Kolletzek, C. Borghi. Internal Medicine Dpt, S. Orsola Malpighi Hospital, University of Bologna, Bologna, Italy Introduction: Patients (pts) with heart failure (HF) can show reduced (r) or preserved (p) left ventricular ejection fraction (EF) and both these groups share the same morbility and mortality, even if there’s still a tendency to consider more at stake pts with reduce EF. Objective: Our aim was to observe if pts with pEF or rEF show different echocardiographic geometric pattern and if there was any difference among E/ A ratio, left ventricular isovolumetric time relaxation (IVRT) and deceleration time (DT) of early Doppler mitral valve flow velocity between the two groups. Methods and Results: We evaluated 205 consecutive pts with HF, defined by ACC/AHA guidelines, admitted to our Out-patients Clinic for the Management of Heart Failure after discharge from hospital where they had been admitted for acute HF. Each pts underwent echocardiography e50 Journal of Hypertension Vol 28, e-Supplement A, June 2010