S164 Abstracts Eur J Echocardiography Abstracts Supplement, December 2006 (LVEF) is often preserved in patients with end stage renal disease (ESRD) at the onset of renal replacement therapy. The aim of this study was to deter- mine whether tissue Doppler velocities and strain/strain rate imaging detect LV dysfunction in asymptomatic patients with ESRD and normal LVEF. Methods: Eighty patients with ESRD (mean age 54±11 years, 67 male, mean creatinine 610 ±198 µmol/L) were enrolled immediately prior to the initiation of dialysis therapy. All had LVEF >50% with no prior history of cardiac dis- ease. Sixty-five age and sex matched controls were also studied. All under- went a standard cross sectional transthoracic echocardiogram with tissue Doppler imaging (TDI). Peak long axis velocity (Sm) was determined by aver- aging the values from the septal and lateral sites of the mitral annulus. Strain and strain rate data were collected from the basal, mid and apical segments of the anterior and inferior walls. Results: Mean LVEF and LV end systolic diameter (LVESD) were similar in the 2 groups. Mean Sm was significantly lower in patients with ESRD com- pared to controls (7.4 cm/sec vs 9.8 cm/sec, p=0.02). Averaged mean myo- cardial deformation indices were significantly lower in patients with ESRD compared to controls (Strain: 39±18 vs 54±20, p=0.03; Strain rate: -1.1 vs - 1.9, p=0.02). Longitudinal strain and strain rate were significantly lower in all LV segments of the inferior and anterior walls for patients with ESRD com- pared to controls. Myocardial strain rate correlated with LV mass (r=0.49, p=0.03) but not LVESD in patients with ESRD. Conclusions: Subclinical changes in LV function can be detected in pa- tients with ESRD and normal LVEF at the onset of dialysis therapy. TDI may be useful in the future for predicting LV function in this patient group before the ventricle starts to fail irreversibly. MYOCARDIAL VELOCITY IMAGING (DMI) – OTHER 955 Echo-TDI evaluation of left atrial function in patiens with major thalassemia I. Monte 1 ; D. Capodanno 1 ; E. Nicolosi 1 ; S. Licciardi 2 1 Lab. Echo, Policlinic University, Cardiology Unit, Catania, Italy; 2 MIMS, University, Catania, Italy Hemosiderosis is the main cause of cardiac dysfunction, which is revealed by heart failure and arrhythmias, in patients (pts) with thalassemia major (TM). Heart disease conditions the prognosis, so it’s very important to identify early markers for a specific therapy. New echocardiographyc techniques, as Tissue Doppler Imaging (Echo-TDI), concur to study the regional ventricular and atrial systo- diastolic function. Recent studies exalt the interest of E/Em and Strain Rate: the first represents the ratio between the protodiastolic velocity of the transmitral flow (E) and the velocity of the protodiastolic movement of the mitral annulus (Em) and is considered as well related with the left ventricular (LV) telediastolic pres- sure. Aim of the study was to identify, with TDI, some differences of the atrial function in pts with TM and previous episodes of supraventricular arrhythmias. We examined 24 pts (14 M and 10 F, TAL group), divided on the basis of the presence (TAL1, 11 pts) or absence (TAL2, 13 pts) of supraventricular arrhythmias and 12 healthy people (NORM, 9 M and 3 F). All pts underwent Echo-TDI with evaluation of morphological (LVIDd, LVIDs, LADs, LAarea), systolic (LVEF) and diastolic function (PVE, PVA, E/A) and derived from TDI parameters, as the veloc- ity at the mitral annulus (Sm, Em, Am, E/Em), the maximal strain rate (SR peak) during systole (S), early filling (E) and atrial contraction and their relative time of peak (SR time) for the LV at the basal septum (SIV) and free cardiac wall (PLV) and for the atria at the distal interatrial septum (SIA) and free atrial wall (PAL). We executed a statistic analysis among the groups using Student’s t-test for impaired data, Pearson’s coefficient calculation and multiple regression. Results: TAL vs NORM showed a minor BSA, major LAarea and PVE, minor Sm, major E/Em, shorter SR-A time at all the interrogated points (SIV, PLV, SIA, PAL). TAL1 vs TAL2 showed older age, minor Sm and minor SR-S, SR- E, SR-A peak at PAL. The multiple regression evidenced a negative correla- tion between E/Em and SIA-SR peak E and between E/Em and Sm and Am annulus velocities (squared multiple R: 0,410)  Conclusions: TDI derived parameters identified a different behaviour be- tween the two groups of TM pts: the group with arrhythmias showed minor values of atrial SR in relation to an higher E/Em value. This can be referred to the early LV involvement in absence of an evident systolic dysfunction. This analysis, checked on a bigger group, could be considered suitable to find a bigger probability of supraventricular arrhythmic events in the TM population. 956 Is color Doppler myocardial imaging superior to conventional echocardiography in early detection of myocardial dysfunction in acromegaly? J. Separovic Hanzevacki 1 ; M. Cikes 1 ; M. Lovric Bencic 1 ; A. Ernst 1 1 University Hospital Centre Zagreb, Cardiovascular Diseases Dept., Zagreb, Croatia Purpose: The most common feature of myocardial involvement in acrome- galy is left ventricular hypertrophy (LVH) which is often accompanied by diastolic dysfunction (DD). By measuring myocardial velocities with Color Doppler Myocardial Imaging (CDMI) we can detect changes in myocardial function more accurately than by conventional echocardiography (PWE). We sought to analyze myocardial relaxation using CDMI in acromegalic pa- tients (pts.) without LVH or diastolic dysfunction according to PWE and in pts.with innitial changes in these parameters. Material nd methods: 32 pts. with acromegaly (49.5±10.5 years) with nor- mal systolic function were distributed in 2 groups according to disease ac- tivity. Group A: 12 pts. in remission after pituitary adenectomy; group B: 20 pts. with active disease. All pts. and 26 healthy sex and age matched normals underwent CDMI (E’, A’, E’/A’) at the lateral mitral annulus and PWE (IVRT, PFVE, PFVA, DtE, Adur, PVA, PVAdur). Kruskal Wallis and Mann-Whitney tests were used for statistical analysis. Results: Group A: Parameters measured by PWE revealed diastolic dys- function in 17% and innitial LVH in 33% of pts. while CDMI revealed diastolic dysfunction (E’/A’<1) in 25% of pts. Group B: PWE parameters showed di- astolic dysfunction in 40% of pts. while LVH was present in 35%. CDMI val- ues indicated diastolic dysfunction in majority of pts. (85%). Conclusion: Parameters measured by CDMI in pts. with active disease re- vealed DD in majority of pts. while LVH was present in only 35% of pts., still at an innitial phase. DD was recognized by PWE parameters in 40% of pts. In pts. in remission, DD was noticed by CDMI in a smaller number of pts., but still greater than according to PWE parameters. The occurence of DD measured by CDMI was more associated with disease activity than LVH. Therefore, it seems that data obtained by CDMI are the earliest evidence of acromegalic heart disease and might have significant clinical value in diag- nosis of subclinical myocardial disease and follow up of treatment. Table 1. Results age LV mass E/A PVAdur/ E’ E’/A’ index (g/m²) /MVAdur (cm/s) control group 39.41 94.91 1.33 0.66 -11.92 1.79 remission 45.25 99.46 1.13 0.88 -7.94* 1.16# active disease 52.10# 110.19# 1.02* 0.68 -6.42* 0.80*¤ Values expressed as mean value. * p<0.03 vs control group, # p=0.03 vs control group, ¤ p=0.21 vs group A LV FUNCTION – OTHER 957 Relationship of left ventricular dysfunction and inflammation in acute coronary syndromes I. Burazor 1 ; M. Burazor 1 ; A. Vojdani 2 ; G. Cvetanovic 3 ; S. Nagorni 2 ;  N. Krstic 2 ; J. Glasnovic 2 1 Clinical Center, Cardiology Dept., Nis, Serbia and Montenegro; 2 Immunosciences Lab. Inc., Los Angeles, United States of America; 3 Clinical Center, Leskovac, Serbia and Montenegro Background and aim: Inflammatory markers are widely investigated as prog- nostic factors in acute coronary syndromes (ACS). The aim of the study was to assess the relationship of initial levels of interleukin (IL) 6, high sensitivity C - reactive protein (Hs CRP) and fibrinogen as well as monocytes and white blood cells (WBC) count with echocardiographic variables in patients with ACS. Material and methods: The prospective study was conducted among 115 patients (42% females, mean age 59.86 years) admitted to Coronary Care Unit due to ACS. Blood samples were taken on admission before application of therapy and frozen on -40C. Sera were sent on dry ice to Immunosciences Lab. Inc, Beverly Hills for analyses. IL-6, Hs CRP, WBC, monocytes and fibrinogen were determined. Echocardiogram was done on day 2. Left ventricular ejection fraction (LVEF), fractional shortening, end diastolic volume and left atrial size were measured and analyzed for relationships with biochemical markers. Results: IL - 6 (p=0.01), HsCRP (p=0.01), monocytes (p=0.05), WBC (p=0.05) and fibrinogen (p=0.05) significantly correlated with decreasing LVEF. IL - 6 (p=0.05) and monocytes (p=0.05) were related with end-dias- tolic volume while fractional shortening was significantly correlated with IL - 6 (p=0.01) and fibrinogen (p=0.05). Patients were divided into two groups regarding LVEF (group 1: LVEF <40% and group 2: LVEF >40% for multiple regression model. HsCRP (p=0.01), monocytes (p=0.021) and WBC (p=0.002) were independent predictors of decreasing LVEF. Correlation between biochemical markers and left atrial size was not significant. Conclusion: Inflammatory markers measured on admission correlate with early post-ACS LV function, especially with LVEF. MYOCARDIAL VELOCITY IMAGING – FUNCTION 958 Assessment of left ventricular diastolic velocities of the mitral annulus by tissue doppler imaging to differentiate physiological from pathological left ventricular hypertrophy T. Butz 1 ; F. Van Buuren 1 ; K.P. Mellwig 1 ; Y.Z. Kim 1 ; C. Langer 1 ;  O. Oldenburg 1 ; D. Horstkotte 1 ; L. Faber 1 1 Heart Center North Rhine-Westphalia, Cardiology Dept., Bad Oeynhausen, Germany Introduction: Tissue Doppler Imaging (TDI) has been proposed for the dif- ferentiation between physiological and pathological left ventricular hypertro- phy (LVH). Normal or even supernormal diastolic TDI velocities have been by guest on May 14, 2011 ejechocard.oxfordjournals.org Downloaded from