overlaps might be expected among high-confidence disease signa- tures that are reproducibly identified across all mouse replicate experiments. Instead, we found that the three analyzed types of omics data each nominated a distinct set of disease signatures with modest overlaps (12-18%), and each data type indicated perturba- tions in separate cardiac pathways. The integration of transcript abundance, protein abundance, and protein turnover data led to 75% gain in reproducibly identified disease gene candidates, including 70 out of 273 disease signatures that were nominated only when protein turnover data were included (e.g., USP47, HADHA, PPIF). In total, 36 nonredundant Reactome pathways were implicated in cardiac remodeling, representing a 57% gain over using only tran- script and protein abundance data. Moreover, up to 38% of examined genes (e.g., CLU, MYH6, APOA1) were found to exhibit con- tradirectional changes in transcript abundance, protein abundance, and protein turnover ratios in the remodelling heart, suggesting the nonoverlap of nominated signatures was not due to arbitrarily chosen cut-offs in data filtering. Conclusion: Transcriptomics and proteomics inquiries nominate distinct disease signature candidates and are enriched in different cardiac pathways. Our results suggest that there may well be value in performing integrated “multi-omics” analyses to provide more comprehensive insights into the patho- genesis of various cardiovascular diseases. doi:10.1016/j.yjmcc.2017.07.073 062 Readmission rates after Acute Decompensated Heart Failure Waqas Siddiqui, Andrew Kohut, Syed Hasni, Jesse Goldman, Benjamin Silverman, Ellie Kelepouris, Howard Eisen, Sandeep Aggarwal Drexel University College of Medicine, Philadelphia, PA, USA Hahnemann University Hospital, Philadelphia, PA, USA Introduction: Acute Decompensated Heart Failure (ADHF) is a major health concern worldwide. Ultrafiltration (UF) versus Conven- tional Diuretics (CD) in ADHF treatment has been studied in several trials with variable outcomes. Objective: To determine if UF is superior to CD in reducing readmissions after ADHF. Methods: MEDLINE was searched using PUBMED for potential studies. Total studies found = 590, Total trials=34, Randomized control trials (RCT) = 9 were included (n=820, UF=403, CD =417). RevMan Version 5.3 Copenhagen was used for statistical analysis. Sensitivity analysis was done for heteroge- neity. Results: Baseline characteristics were similar in both groups. Mean age was 66 years and 74% were males. Mean EF was 32.9%. Total of 188 patients were readmitted secondary to ADHF with 77 in UF group vs 111 in CD group; RR was 0.71 (95% CI, 0.49-1.02, p = 0.07, I 2 = 47%) . There was significantly reduced number of readmissions at 90 days 43 vs 67 in favor of UF; RR was 0.65 (95% CI, 0.47-0.90, P=0.01, I 2 = 0%). Fluid removal and weight change were significantly higher in UF compared to CD. Change in creatinine pre and post intervention and the number of acute kidney injury were similar in both groups. There was also no difference in the length of hospital stay. Hypotension was more common in UF group compared to CD group (24 vs 13, OR = 2.06, 95%CI = 0.98- 4.32, P=0.06, I 2 =0%) but it was statistically insignificant. Major Adverse Cardiovascular Events (MACE) and mortality was also similar in both groups. Sensitivity analysis was done for heterogeneity and is reported using I 2 . Conclusions: In this meta-analysis, UF was associated with significantly reduced heart failure readmissions at 90 days and there was trend towards reduced cumulative hospital readmissions. There was no difference in renal outcomes, fluid removal, weight loss, MACE and length of hospital stay in either intervention group. doi:10.1016/j.yjmcc.2017.07.074 063 Pacemaker syndrome; an often overlooked diagnosis in patients with pacemakers Awais Arif, Rizwan Khan, Nicole Tran University Of Oklahoma, Oklahoma, USA The use of cardiac pacemakers has expanded rapidly in recent times. The complicated technology of cardiac pacemakers often discourages clinicians other than electrophysiology specialists from approaching and evaluating for a pacemaker malfunction. As a result, these malfunctions may be missed or confused with other medical etiologies. We present a case of pacemaker syndrome that was initially thought to be an acute exacerbation of heart failure. Case: 88-year-old female with newly diagnosed heart failure with preserved ejection fraction (HF-pEF) and sick sinus syndrome status post pacemaker placement 8 years prior (DC-PPM Medtronic), who presented with acute decompensation of her underlying heart failure. History, exam, labs and chest x-ray findings were classic for heart failure exacerbation so she was treated with IV diuretics. No other triggers for her acute decom- pensation of heart failure could be identified including dietary indiscretion, medication noncompliance, cardiac ischemia, sub- stance abuse or possible drug interactions. EKG showed that a right ventricular paced rhythm had replaced atrial pacing. In light of these EKG changes device interrogation of her pacemaker was performed which showed that the pacemaker battery was at end of life (EOL) and as a result, the pacing mode had automatically switched to VVI (right ventricle being paced irrespective of native atrial contraction, resulting in AV dyssynchrony) to conserve energy. Her symptoms were attributed to pacemaker syndrome. She underwent generator change of her pacemaker and following that her symptoms markedly improved and remained asymptom- atic at 3 month follow up. Conclusion: Pacemaker syndrome is a common problem faced by physicians who take care of patients with cardiac pacemakers. Patients often present with clinical signs and symptoms of other common cardiac conditions. Clinicians should always have a high index of suspicion for a commonly missed diagnosis of pacemaker syndrome. doi:10.1016/j.yjmcc.2017.07.075 064 Tuberculous aortitis, an unusual presentation of tuberculosis Rizwan Khan, Awais Arif, Nicole Tran University Of Oklahoma, Oklahoma, USA 51-year-old female who recently emigrated from Mexico with past history of coronary artery disease (CAD) status post coronary artery bypass grafting (CABG) two years prior who presented with chest pain. She reported diffuse anterior chest pain that radiated to the back. She also reported a 4 kg weight loss, night sweats, chills and fevers over the same time period. In the emergency department her EKG was normal, cardiac enzymes were negative and prelimi- nary CTA report was concerning for possible aortitis vs aortic hematoma. Her ESR and CRP were elevated but autoimmune work- up including ANCA and ANA was negative, raising suspicion for an underlying infectious etiology. The patient had a positive PPD skin test with 17 mm induration, a positive quantiferon test and chest X-ray showed numerous lung nodules bilaterally, consistent with a diagnosis of tuberculosis. Transesophageal echocardiogram showed regional thickening of ascending aorta with the major differential Abstracts 155