ISSN: 1583-2996Preedinte:Dan DeleanuPreedinte care urmeaz:Ioan Mircea ComanFost preedinte:Radu CplneanuVicepreedini:Doina DimulescuGabriel Tatu-ChioiuSecretar:Adriana IlieiuTrezorier:Drago VinereanuMembri:Eduard Apetreierban BlnescuMircea CintezOvidiu ChioncelAlexandru Grigore DimitriuMaria DorobanuDan DobreanuCarmen GinghinCtlina Arsenescu GeorgescuDaniel LighezanFlorin MituAntoniu PetriBogdan A. PopescuLucian ZarmaCONSILIUL DE CONDUCERE ALSOCIETII ROMNE DE CARDIOLOGIEColectivul de redacieRedactor efEduard ApetreiRedactor ef adjunctCarmen GinghinRedactoriRadu CplneanuCezar MacarieRedactor fondatorCostin CarpRedactori asociaiMihaela RuginRuxandra JurcuBogdan A. PopescuCostel MateiColegiul de redacieIon V. Bruckner - BucuretiAlexandru Cmpeanu - BucuretiG. Cerin - ItaliaMircea Cintez - BucuretiRadu Ciudin - BucuretiD. V. Cokkinos - GreciaIoan Mircea Coman - BucuretiG. Andrei Dan - BucuretiDan Deleanu - BucuretiGenevieve Derumeaux - FranaDoina Dimulescu - BucuretiMaria Dorobanu - Bucuretitefan Iosif Drgulescu - TimioaraGuy Fontaine - FranaBradu Fotiade - BucuretiAlan Fraser - AngliaCtlina Arsenescu-Georgescu - IaiMihai Gheorghiade - USALeonida Gherasim - BucuretiE. Grosu - Chiinu, R. MoldovaAssen R. Goudev - Bulgaria Alexandru Ioan - BucuretiDan Dominic Ionescu -CraiovaGabriel Kamensky - SlovaciaAndre Keren - IsraelIoan Maniiu - SibiuMartin S. Martin - SUAGerald A. Maurer - Austriaerban Mihileanu - FranaNour Olinic - Cluj-NapocaFausto Pinto - PortugaliaGian Luigi Nicolosi - ItaliaMariana Rdoi - BraovWillem J. Remme - OlandaDoina Rogozea - BucuretiMichal Tendera - PoloniaIon intoiu - BucuretiPanagiotis Vardas - GreciaDrago Vinereanu - BucuretiMarius Vintil - BucuretiDumitru Zdrenghea -Cluj-NapocaSecretar de redacieMihaela SlgeanEditura: Media Med PublicisPublicitate: of ce@mediamed.roDistribuie: Revista Romn deCardiologie se distribuie membrilor Societii Romne de CardiologieAbonamente: of ce@mediamed.roCaseta tehnicRspundereapentruconinutularticolelorpublicaterevinenntregimeautorilor.Opi-niile, ideile, rezultatele studiilor publicate n Revista Romn de Cardiologie sunt cele ale autorilor i nu refect poziia i politica Societii Romne de Cardiologie. Nicio parte a acestei publicaii nu poate f reprodus, stocat, transmis sub nicio form sau mijloc (elec-tronic, mecanic, fotocopie, nregistrare) fr permisiunea scris a edito rului. Toate drepturile rezervate Societii Romne de Cardiologie.Contact:Societatea Romn de CardiologieStr. Avrig nr. 63, Sector 2, BucuretiTel./Fax: +40.21.250 01 00, +40.21.250 50 86, +40.21.250 50 87;E-mail: rscardio@rscardio.ro1-4Insufciena cardiacA15-8Cardiopatie ischemicA69-15Poster Forum IA1216-65Poster IA2166-71 Sesiunea tnrului investigatorA7472-75AritmiiA8276-79 Varia 1A8680-83EcocardiografeA9184-90 Poster Forum IIA9691-139Poster IIA104 140-143HTAA154 144-147Varia 2A159 148-151CardiomiopatiiA163 152-159Varia 3A168 160-166Poster Forum IIIA176 167-214Poster IIIA184Index autoriA238Index subiecteA244 Smbt 9 oct ombr i e 2010 Dumi ni c 10 oct ombr i e 2010 Joi 7 oct ombr i e 2010 Vi ner i 8 oct ombr i e 2010Vol. XXV,Suplimentul A, 2010Vol. XXII, Nr. 1, 20081-4Heart FailureA15-8Coronary Heart DiseaseA69-15Poster Forum IA1216-65Poster IA2166-71 Young investigators award sessionA7472-75ArrhytmiasA8276-79Varia 1A8680-83EchocardiographyA9184-90Poster Forum IIA9691-139Poster IIA104 140-143HypertensionA154 144-147Varia 2A159 148-151CardiomyopathiesA163 152-159Varia 3A168 160-166Poster Forum IIIA176 167-214Poster IIIA184Authors indexA238Topics indexA244 Sat ur day, 9t h Oct ober2010 Sunday, 10t h Oct ober2010 Thur sday, 7t h Oct ober2010 Fr i day, 8t h Oct ober2010Vol. XXV,Suplimentul A, 2010Revista Romn de Cardiologie | Vol. XXV | Suplimentul A, 2010ratura (0.81). Totusi, adaugarea EPA la acest model de predictienuaamelioratsubstantialputereadediscri-minare a SAR.Concluzii.Studiianterioareauanalizatrelatiadintre SARsiEPAindeosebilapacientiicudisfunctierena-lasiinSARbilateralesauperinichiunicfunctional. Rezultatele studiului nostru pledeaza pentru o asociere semnifcativastatisticaEPAcuSARchiarinabsenta azotemiei si pentru orice varianta topografca de SAR, inclusiv cea unilaterala. Sunt necesare analize ulterioa-re pentru determinarea impactului EPA asupra mode-lelor de predictie a SAR. Association of acutepulmonary edema with renal artery stenosis in hypertensive patients. Purpose:Caseserieshavereportedthatrenalrevas-cularizationpreventstherecurrenceofacutepulmo-nary edema (APE). Terefore, APE might be included amongstthepredictivefactorsofrenalarterystenosis (RAS). However, few studies have done so. For this re-ason,weaimedatevaluatingtheAPEprevalenceand the predictive power for RAS in hypertensive patients.Method:189hypertensivepatientswereinvestigated forRASbyduplexultrasonography(92%negative predictivevalueforthediagnosisofastenosis50% formerly confrmed by angiography in our laboratory). RASscreeningwasindicatedbecauseofinsuf cient blood pressure control, unexplained azotemia, or azo-temia while on ACE-inhibitors (increase of serum cre-atinine more than 0.25 mg/dL). Age (a), female gender (f),abdominalbruit(b),vasculardisease(v),serum creatinine(c),azotemiawhileonACE-inhibitors(z), aswellashistoryofAPEwererecorded,andalinear discriminantanalysis(LDA)forRASpredictionwas performed.Results:RASwasidentifedin29%ofthecases (55/189). APE prevalence in RAS was 22% (23% in uni-lateral stenosis and 20% in bilateral stenosis or on so-litaryfunctionalkidney),whereasinpatientswithout 1. Asocierea dintre edemulpulmonar acut cardiogen sistenoza de artere renale lapacientii cu hipertensiunearterialaRoxana Darabont, A. Corlan, M. Cinteza,D. VinereanuUniversitatea de Medicina si Farmacie Carol Davila, BucurestiObiectiv. Serii de cazuri au raportat faptul ca revascu-larizarea renala previne recurenta edemului pulmonar acut(EPA).Acesteobservatiiauconduslaincluderea EPA printre factorii de predictie ai stenozelor de artere renale(SAR),desiputinestudiiauanalizatsistematic aceasta asoicere. In acest context ne-am propus sa eva-luamprevalentaEPAsiputereasapredictivapentru SAR, la pacienti cu hipertensiune arteriala.Metoda.SARafostinvestigataprinultrasonografe duplexdeartererenalela189pacientihipertensivi (92%valoarepredictivanegativapentrudiagnosticul unei SAR 50%, confrmata angiografc in laboratorul nostru). Screening-ul de SAR a fost indicat pentru con-trolinsufcientaltensiuniiarteriale,pentruazotemie de cauza inexplicabila sau azotemie sub IEC mai mare de 0.25 mg/dL. Varsta (a), sexul feminin (f), suful ab-dominal(b),boalavasculara(v),creatininaserica(c), azotemia sub IEC (z), ca si istoricul de EPA au fost inre-gistrate si s-a efectuat o analiza de discriminare lineara (ADL) pentru predictia de SAR.Rezultate.SARafostidentifcatala29%dincazuri (55/189). Prevalenta EPA a fost de 22% (23% in steno-zele unilaterale si 20% in stenozele bilaterale sau pe ri-nichi unic functional), in timp ce la pacientii fara SAR a fost de numai 8%. Asocierea dintre EPA si SAR a fost semnifcativa pentru orice topografe de SAR (unilate-rala, bilaterala sau pe rinichi unic functional ) (p=0.01) si a fost independenta de prezenta azotemiei. ADL a ge-nerat formula 0.22f - 0.0044a + 1.22b + 1.61v + 0.037c +1.28zdreptpredictivapentruSAR.Acuratetea(aria de sub curba) a acestui model predictiv a fost de 0.78, comparabila cu cea mai buna valoare raportata in lite-I NSUFI CI ENA CARDI AC |HEART FAI LUREI NSUFI CI ENA CARDI ACHEART FAI LURERevista Romn de Cardiologie, Vol. XXVSuplimentul A, 2010RAS it was only 8%. Te association between APE and the presence of RAS was signifcant for any RAS topo-graphy (unilateral, bilateral or on solitary kidney steno-sis)(p=0.01),andwasindependentofthepresenceof azotemia.LDAgeneratedtheformula0.22f-0.0044a + 1.22b + 1.61v + 0.037c + 1.28z as predictive for RAS. Te accuracy (area under the curve) of this prediction model was 0.78, comparable to the best predictive value in the literature (0.81). Still, adding APE to this model did not substantially improve the discriminative power for RAS prediction.Conclusions: In this vascular ultrasound study of RAS evaluation, we found that APE has a statistically signi-fcant association with RAS. While most of the studies on this issue have focused exclusively on the relations-hip between APE and RAS for patients with azotemia, we found that this association holds for both categories ofpatientswithrenaldysfunction,aswellasthose without it and for any topography, including the unila-teral one. Further studies are needed to investigate the impact power of EPA on the prediction models of RAS. 2. Rolul prognostic al raportu-lui E/(ES) la pacientii cu dis-functie ventriculara stanga C. Mornos, D. Cozma, Adina Ionac, Irina Popescu, L. Petrescu, S. Pescariu, ST. I. DragulescuInstitutul de Boli Cardiovasculare, Timisoara Studii prealabile au aratat ca o valoare de peste 1.6 pen-truraportulE/(ES)estimeazacuobunaacuratete unnivelcrescutalpresiuniitelediastoliceintraventri-culare stangi (E=velocitatea precoce maxima transmi-trala, E=velocitatea precoce diastolica a inelului mitral, S=velocitatea sistolica maxima a inelului mitral).Scop:EvaluarearolulprognosticalunuiraportE/(ES)>1.6 in ceea ce priveste moartea de cauza cardi-aca la pacientii cu disfunctie ventriculara stanga (VS).Metoda: Raportul E/(ES) a fost determinat dupa sta-bilireaunuitratamentoptimla110pacienticonsecu-tivi, spitalizati, cu disfunctie VS, in ritm sinusal. A fost utilizata media velocitatilor de la nivelul extremitatilor septala si respectiv laterala ale inelului mitral. Pacientii cufereastraecocardiografcainadecvata,valvulopatii mitrale semnifcative, sindrom coronarian acut sau by-pass aorto-coronarian in ultimele 72 de ore nu au fost inclusi in acest lot de studiu. A fost urmarita incidenta deceselor de cauza cardiaca la pacientii analizati.Rezultate:Peparcursulcelor3612lunideurmari-reaufostinregistrate22dedecesedecauzacardiaca (20%).ValoaremediearaportuluiE/(ES)afostde 3.681.48lapacientiiprezentanddecesdecauzacar-diaca, in timp ce la ceilalti bolnavi a fost indentifcata o medie de 1.780.91 (p=0.017). Un raport E/(ES)>1.6 aavutosensibilitatede86%siospecifcitatede54% privind estimarea mortii de cauza cardiaca. La pacienti curaportE/(ES)1.6(n=60),ratadesupravietuire afostsemnifcativmaimarecomparativcubolnavii prezentandE/(ES)>1.6(94%versus32%,p=0.001, log-rank).IncluzandraportulE/(ES)>1.6,E,S,E, raportuldintrevelocitateatransmitralaprecocesicea tardiva, timpul de decelerare al undei E, fractia de ejec-tieaVS,volumulindexatalatriuluistang,presiunea sistolica in artera pulmonara, fractiunea N-terminala a peptidului natriuretic cerebral, varsta si sexul pacienti-lor, in regresia Cox multivariata, raportul E/(ES)>1.6 areprezentatcelmaibunpredictorindependentpen-tru moartea de cauza cardiaca (hazard ratio=4.76, 95% interval de confdenta=1.50-15.13, p=0.008).Concluzie:OvaloarearaportuluiE/(ES)>1.6poa-te reprezenta un predictor prognostic puternic pentru moartea de cauza cardiaca la pacientii prezentand dis-functie VS afati in ritm sinusal.Prognostic value of the E/(ES) ratio in patients with left ventricular dysfunction It has been shown that a cut-of value of 1.6 for a novel TissueDopplerindex,E/(EaSa),isabletopredicta high levels of lef ventricular (LV) end-diastolic pressu-re (E = early diastolic transmitral velocity, Ea = early di-astolic mitral annular velocity and Sa = systolic mitral annular velocity).Tepurposeofourstudywastoinvestigatewhether E/(EaSa)>1.6 could be a predictor of cardiac death in patients with LV dysfunction.Methods: We determined E/(EaSa) in 110 consecuti-vehospitalizedpatientswithLVdysfunction,insinus rhythm, afer appropriate medical treatment. Te ave-rage of the velocities from the septal and lateral mitral annular sites was used. Patients with inadequate echo-Revista Romn de Cardiologie, Vol. XXVSuplimentul A, 2010I NSUFI CI ENA CARDI ACHEART FAI LUREcardiographicimages,signifcantmitralvalvulopathy, acutecoronarysyndromeorcoronaryarteryby-pass within 72 hours were not included. Te primary study end-point was defnited as cardiac death.Results:Terewere22cardiacdeaths(20%)during 3612monthsoffollow-up.MeanE/(EaSa)was 3.681.48inthosepatients,whileitwas1.780.91in the rest (p=0.017). Te E/(EaSa)>1.6 had 86% sensi-tivityand54%specifcitytopredictcardiacdeath.In patientswithE/(EaSa)1.6(n=60),cardiacsurvi-valratewasmarkedlyhigherthanintherestwithE/(EaSa)>1.6 (94% versus 32%, p=0.001, log-rank) (Fi-gure 1). On multivariate Cox regression analysis inclu-ding E/(EaSa), Ea, Sa, E, early/late diastolic transmi-tral velocity, E deceleration time, LV ejection fraction, indexedlefatrialvolume,pulmonaryarterysystolic pressure,N-terminalpro-brainnatriureticpeptide, age, sex, E/(EaSa)>1.6 was the best independent pro-gnosticpredictor(hazardratio=4.76,95%confdence interval =1.50-15.13, p=0.008).Conclusions: E/(EaSa)>1.6 could be a powerful pre-dictor of cardiac death in patients with LV dysfunction. 3. Gradul depresiei se coreleaza cu evolutia pacientilor cuinsuficienta cardiaca cronica congestiva Anca Daniela Farcas,N. OlinicUniversitatea de Medicina si Farmacie Iuliu Hatie-ganu, Cluj NapocaReactiilepsihicedeadaptarelaboalapotaveaunrol important in evolutia pacientilor cu insufcienta cardi-aca.Obiectivul acestui studiu a fost de a evalua modul cum depresia infuenteaza calitatea vietii si evolutia pacien-tiilorcuinsufcientacardiacacronicaagravata,inra-port cu evolutia insufcientei cardiace sub tratament.Materialsimetoda:Aufostexaminati150depa-cienti(p) internati pentru insufcienta cardiaca cronica congestivaagravata.Comportareaclaseifunctionale NYHA,afractieideejectie(FE)determinataecogra-fc, a testului de mers timp de 6 minute, a scorului de depresie si a scorului de calitate a vietii, la internare, la externare, la trei, sase si douasprezece luni de la exter-nare, au fost analizate, atat individual, cat si comparativ intre pacientii cu grade diferite de depresie.Rezultate: Cei 150p, la internare au avut o FE de 30,8 9,2. La 6 luni, aceasta a crescut in medie cu 5 % (32,3 9,6), valoare afata la limita semnifcatiei statistice (p =0,052).La12lunidelaexternare,la118p(78,7%), FEacrescutinmediecu10%(35,59,4,p35mmHg, E/E>15, E/vp>1,5, ar-A>25ms. FEVS masurata prin metoda Simpson a fost in toate cazurile maimicade45%.Pacientiiaufostimpartitiin4gru-puri: 1. HVS+ si reperfuzie efcienta 2. HVS- care nu au prmit terapie de reperfuzie sau cu reperfuzie inefcienta 3.HVS-sireperfuzieefcienta4.HVS-farareperfuzie sau cu reperfuzie inefcienta.Rezultate: 1. 67 pacienti (68,36%) au prezentat criterii deHVS.2.Valorilemediialeparametrilorecocardio-grafci de crestere a presiunii de umplere la pacientii cu HVS si fara reperfuzie au fost: IVAS: 35,04, p=0,00007, PAPs: 45,57, p= 0,00122, E/E: 14,81, p=0,03992, E/vp: 1,99,p=0,00197,ar-A:28,79,p=0,00726.3.Celmai mare procent de pacienti cu valori medii ale parametri-lor de umplere ce au depasit valorile limita a fost gasit in grupul cu HVS care nu a primit terapie de reperfuzie sau care desi au primit trombolitic nu au prezentata cri-teriidereperfuzie:IVAS:26,53%,PAPs:26,53%,E/E: 15,31%, E/vp:22,45%, ar-A: 16,33%.Concluzii:1.Lapacientiihipertensivifaracriteriide reperfuzietotiparametriiecocardiografciasociaticu cresterea presiunii de umplere au avut valori medii mai maridecatvalorilelimita,comparativcupacientiihi-pertensivi fara HVS si cu criterii de reperfuzie prezen-te. 2.Cele mai mari valori au fost intalnite in grupul cu HVS fara reperfuzie, pacienti care teoretic au cele mai mari presiuni de umplere. POSTER FORUM IPOSTER FORUM IRevista Romn de Cardiologie, Vol. XXVSuplimentul A, 201011Echocardiographic parameters of filling presure in hypertensive patients with acute myocardial infarction Background:Beforeacutemyocardialinfarction (AMI),hypertensivepatientshavehighfllingpressu-re in lef ventricle which is supplementary rised during the infarction by the areas of necrosis and ischemia.Aims of the study: was to evaluate echocardiographic parameters of diastolic dysfunction in hypertensive pa-tients during the frst week afer AMI.Methods:Anumberof98hypertensivepatients(56 malesand43females),admittedwithacutemyocar-dialinfarctionwithST-segmentelevationwereeva-luatedinthefrstweekby:clinicalexamination,12 leadstandardECG,echocardiographicmeasurements of:lefatriumvolumeindex(LAVi)andlefventricle mass index (LVMi) using transthoracic echocardiogra-phy,pulmonaryarterysystolicpressure(PAPs)using Doppler echocardiography for tricuspid infow, E/E, E/vp and ar-A, using Doppler echocardiography for mi-tralinfow(Ewavevelocity,Awaveduration),tissue Doppler echocardiography at lateral and medial corner ofmitralannulus(Ewavevelocity),colourMmode (fowpropagationvelocityvp)andpulmonaryveno-us fow (ar wave duration): cut of levels: LAVi>32ml/m2, LVMi>131g/m2 in males and>125g/m2 in females (lefventricularhypertrophy,LVH),PAPs>35mmHg, E/E>13,E/vp>1,5,ar-A>25ms.LVEFmeasuredby Simpson method was less than 45%. Patients were di-videdin4groups:1.LVH+andreperfusion2.LVH+ withoutreperfusion3.LVH-andreperfusion4.LVH- without reperfusion.Results:1.LVHwasfoundin67patients(68,36%). 2.Meanvaluesofparametersoffllingpressurein hypertensivepatientswithLVHandwithoutreper-fusionwere:VASi:35,04,p=0,00007,PAPs:45,57,p= 0,00122, E/E: 14,81, p=0,03992, E/vp: 1,99, p=0,00197, ar-A: 28,79, p=0,00726. 3. Percentages of patients with LVHandwithoutreperfusionwhichpresentedflling pressureparametersvalueshigerthancutoflevel were:VASi:26,53%,PAPs:26,53%,E/E:15,31%,E/vp:22,45%, ar-A: 16,33%.Conclusions: 1.In hypertensive patients without or fa-iledthrombolitictherapyallechocardiographicpara-meters of flling pressure mean values were higher than cut of levels and than in hypertensive patients without LVHandwithsuccessfulmedicalreperfusion.2.Te highestmeanvalueswerefoundinhypertensivepa-tientswithLVHandwithoutreperfusion,whichthe-oreticalhadthehighestvaluesoflefventricleflling pressure. 11. Alterarea vasodilatatiei mediate de flux la nivelul arterei brahiale la pacienti hipertensivi cu sindrom metabolic Simona Dragan, Corina Serban, Ruxandra Christo-dorescu, Maria Rada, Dana Velimirovici,Spitalul Clinic Municipal de Urgenta, Clinica de Cardio logie ASCAR, TimisoaraPremize:Sindromulmetabolicesteoaglomerarede factorideriscinterconectaticareindicapacientiicu risc crescut de diabet zaharat de tip 2 si boala corona-riana.Obiective. Scopul acestui studiu a fost compararea va-lorilor parametrilor antropometrici si ale vasodilatatiei mediate de fux la nivelul arterei brahiale la pacienti hi-pertensivi cu sindrom metabolic in functie de numarul de criterii ale NCEP ATP III prezente.Materialsimetoda:Aufoststudiati48depacienti cusindrommetabolic3.67ani).Sindromulmetabo-lic(varstamedie57afostdefnitconformcriterii-lorNCEPATPIII.Pacientii,cucaracteristicisimilare in ceea ce privete distributia pe sexe i varsta, au fost apoiimpartitiinpatrugrupuriinfunctiedenumarul de criterii ale NCEP ATP III indeplinite: 12 pacienti cu 2, 11 pacienti cu 3, 13 pacienti cu 4 si 12 pacienti cu 5 criterii NCEP ATP III indeplinite. Au fost determinate la toti participantii parametrii antropometrici: indicele demasacorporala(IMC),circumferintaabdominala (CA)siraportultalie-sold(WHR).Aufostefectua-testudiiultrasonografcedeinaltarezolutiepentrua masura raspunsurile endotelial-dependente [exprimate cavasodilatatie-mediatadefux%(FMD)]alearterei brahiale.Rezultate: A fost observata o relatie directa, semnifca-tiva, gradata intre valorile parametrilor antropometrici si numarul de criterii NCEP ATP III prezente. Valori-le medii ale IMC pentru cei cu 2, 3, 4, si 5 0.44,0.52, 32.55 0.62, 30.75 0.34, 27.85 criterii au fost: 25.66 kg/m2, p < 0.001. Valorile medii ale CA pentru cei cu 2, Revista Romn de Cardiologie, Vol. XXVSuplimentul A, 201015POSTER FORUM IPOSTER FORUM IMean BMI values for those with 2, 3, 4, and 5 criteria were:0.44,kg/m2,p0.52,32.550.62,30.750.34, 27.8525.66150mg/dlortreatmentwith hypolipidemic drugs). Arterial stifness was measured using TensioMedTMArteriograph. Cut of values, opti-mum sensitivity, specifcity and area under the receiver operatingcharacteristic(ROC)curvewereevaluated. ClassifcationoftheMetSwasbasedontheIDFgui-delines.Results:Nosignifcantdiferenceswereregistered betweenpatientswithvswithoutMetSregardingthe presenceofsmoking(16.2%vs28.1%),dyslipidaemia (73.5%vs71.9%),butwerefoundoutinrelationship withhypertension(73.5%vs37.5%,p=0.001),dia-betes(26.5%vs0%,p=0.001)andobesity(44.1%vs 18.8%, p=0.015). Tere were no signifcant diferences registeredregardingarterialstifnessparametersva-luesbetweenpatientswithandwithoutMetS:AixAo (38.0314.07vs40.4713.79),PWVAo(11.8414.34 vs 9.662.12), SAI (49.825.38 vs 48.748.49) for DAI (50.35.49 vs 51.248.49). Determined areas under the ROCcurvewereasfollows:0.55forAixAo,0.591for PwVao,0.607forSAIand0.598forDAI.Diagnostic cutoflevelswiththeoptimumsensitivityandspeci-fcityderivedfromtheROCcurvewerefoundtobe forAixAo20.5(sensitivity19.7%,specifcity96.9%), PWVAo8.1(sensitivity89.4%,specifcity31.2%),SAI 49.1 (sensitivity 53.8%, specifcity 74.2%) and DAI 50.8 (sensitivity 52.3%, specifcity 74.2%).Conclusion: Although, arterial stifness parameters are undertheinfuenceofsomefactorsthatarenotfully explained, AixAo seems to have the best specifcity and PWVAothebestsensibilityinidentifyingMetSpati-ents. Funding NURC ID_2246/2009 Revista Romn de Cardiologie | Vol. XXV | Suplimentul A, 201021Perugia (4 vs 14 vs 14). La pct cu SA si CMH prevalenta HVS estimata prin indicii Sokolow-Lyon, Cornell pro-dus, Romhilt-Estes si Perugia, a fost similara (p>0.6). S septal, S lateral si SGL au fost similare intre pct cu SA si CMH (p>0.05) si reduse comparativ cu pct hipertensivi (p50%) and a similar extent of LVH asassessedbyechocardiography:20ptswithisolated HTN (609 yr, 7 men), 20 pts with severe AS (659 yr, 16. Electrocardiografia versus ecocardiografie in diagnosticul hipertrofiei ventriculare stangi: expresia gradului sau a tipului hipertrofiei?F.Matei, Cristiana Carmen Beladan, Andreea Calin, Monica Rosca, B.A.Popescu, Denisa Muraru, Roxana Enache, Fabiana Curea, C.Sandu, Carmen GinghinaInstitutul de Urgenta pentru Boli Cardiovasculare Prof. Dr. C. C. Iliescu, Bucuresti Premise. Hipertrofa ventriculara stanga (HVS) este un factorindependentderisccardiovascular.Electrocar-diografa(ECG)siecocardiografasuntrecomandate in practica pentru diagnosticul HVS. Cu toate acestea, existaadeseadiscrepanteintremasaVSestimataeco-cardiografc si expresia ECG a HVS.Obiectiv. Evaluarea capacitatii ECG de detectare a HVS comparativcudateleobtinuteprinecocardiografela pacienti (pct) cu hipertensiune arteriala (HTA), steno-za aortica (SA) si cardiomiopatie hipertrofca (CMH).Metoda:S-auinrolatpctcufractiedeejectieVSpre-zervata (>50%) si masa VS comparabila, evaluata eco-cardiografc: 20 de pct cu HTA izolata (609 ani, 7 bar-bati),20depctcuSAsevera(659ani,12barbati)si 20depctcuCMHsimetrica(5712ani,11barbati). TotipctaufostinvestigatiprinECGstandardin12 derivatiisiecocardiografe.S-auurmariturmatoarele criteriiECGpentruHVS:indiciiSokolow-Lyon,Cor-nell produs si voltaj, scorurile Romhilt-Estes si Perugia. Aufostmasurateecocardiografcvelocitatileanulare mitralelongitudinale(SseptalsiSlateral)sistrain-ul global longitudinal (SGL) VS (cuantifcat prin tehnica speckle tracking).Rezultate:Nus-auobservatdiferentesemnifcative intreloturilestudiateinceeaceprivestevarsta,sexul, indiceledesuprafatacorporalasauindiceledemasa VS(14756g/m2,15721g/m2,17646g/m2,p=0.09). NumarulpctcucriteriiECGdeHVS(HTAvsSAvs CMH) a fost: indice Sokolow-Lyon (4 vs 12 vs 11), in-dice Cornell voltaj (1 vs 4 vs 9), indice Cornell produs (2vs6vs8),scorRomhilt-Estes(1vs10vs11),scor POSTER I|POSTER IPOSTER IPOSTER IRevista Romn de Cardiologie, Vol. XXVSuplimentul A, 20102212men)and20ptswithsymmetricHCM(5712yr, 11 men). Standard 12-lead ECG and a comprehensive 2Dechocardiographywereperformedinall.Wetes-ted the following ECG criteria for LVH: Sokolow-Lyon index,Cornellvoltageandproductindexes,Romhilt-EstesandPerugiascores.Mitralannularlongitudinal velocities (Sseptal and Slateral) and global longitudinal LV strain (GLS) were assessed from apical views by tis-sue Doppler and by speckle tracking echocardiography respectively.Results:Terewerenosignifcantdiferencesbetwe-en HTN, SA and HCM pts regarding age, gender, body surface area or LVM index (14756g/m2, 15721g/m2, 17646g/m2,p=0.089).PresenceofLVHcriteriaon ECG in HTN vs AS vs HCM pts was as follows: Soko-low-Lyon index (4 vs 12 vs 11), Cornell voltage (1 vs 4 vs9),Cornellproduct(2vs6vs8),Romhilt-Estes(1 vs 10 vs 11), Perugia score (4 vs 14 vs 14). Sseptal, Sla-teral and GLS were similar between AS and HCM pts (p>0.05)andlowerascomparedtoHTNpts(p1, aplatizarea septului interventricular, gradient de presiune VD-AD > 50 mmHg, timpul de accelerare al velocitatii fuxului pulmonar,diametrulexpiratoralveneicaveinferioa-re 500 ng/mL are sensibilitate inalta dar specifcitate scazuta. Scintigrafa pulmonara de perfuze, CT torace, RMN si angiografa pulmonara maresc acuratetea diagnosticuluiConcluzii:Coroborareadatelorclinice,ecocardiogra-fcesidopplervenosaprezisdiagnosticulpozitivde TEPA la un procent de 84,4%. Revista Romn de Cardiologie, Vol. XXVSuplimentul A, 20102IPOSTER IPOSTER I22. Reducerea mortalitatii prin infarct miocardic acut in cadrul registrului regional de sindroame coronariene acute rezultate la 5 ani I.Benedek, Monica Chitu, I.Kovacs, P.A.Sarbu, Clau-dia Matei, Diana Horga, Zsuzsanna Suciu, Teodora BenedekUniversitatea de Medicina si Farmacie, Targu MuresScop: S-a urmarit pe parcursul a 5 ani evolutia mortali-tatii prin infarct miocardic acut (IMA) intr-un teritoriu cu aderenta scazuta la ghidurile europene, aferent unei populatiide1milionlocuitori,perioadaincaretoa-tecazuriledesindromcoronarianacutinregistratein acest teritoriu au fost incluse intr-un Registru Regional de Sindroame Coronariene Acute.Material si metoda: Registrul a inclus 13 spitale, avand cel mai apropiat centru interventional la o distanta de maxim200km.Aufostcolectatesiprocesatedatelea 3,990 pacienti, din care 1.841 cu IMA cu supradenive-lare ST si 2.149 cu angina instabila / IMA nonST. Loturi de bolnavi: gr. 1 1411 pacienti cu IMA cu supradeni-velare ST tratati in spitalele teritoriale, fara posibilitati de PCI, gr. 2 430 pacienti cu IMA trimisi direct cen-trului interventional.Rezultate: La grupa 1 procentul terapiei de reperfuzie (PTCA per primam + tromboliza) a fost de 11.28% in 2004 crescand pana la 27.43% in 2009. In gr. 2 terapia dereperfuzieafostposibilain99.39%dintrecazuri, constandinPTCAprimarain76.96%cazuri,PTCA facilitatain15.75%cazurisitrombolizasistemicain 6.6% cazuri. Ratele mortalitatii au scazut progresiv, de la 20.77% in 2004 la 11.9% in 2009, corelate cu creste-rea numarului de cazuri care au benefciat de terapie de reperfuzie (p=0.001). In gr. 2 mortalitatea globala a fost de 6.6% pentru pacientii ajunsi in timp util pentru re-permeabilizare, comparativ cu 17.65% pentru pacientii cu prezentare tardiva (>12 ore) (p