Abstract P024: Pharmacological Treatment of Hypertension and Lv Dysfunction Predictors in ESRD Patients With AV Fistula

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Sayed Tariq ◽  
James Anderson ◽  
Rohit Dhingra ◽  
Mikhail Torosoff
Keyword(s):  
Systolic Function ◽  
Beta Blockers ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Channel Blockers ◽  
Ca Channel ◽  
Av Fistula ◽  
Fistula Surgery ◽  
Lv Dysfunction ◽  
Ca Channel Blockers

Background: Effects of anti-hypertensive medications on left ventricular dimensions and systolic function in patients with arterio-venous (AV) fistulas have not been well investigated. Material and Methods: Medical charts and echocardiograms of 346 patients with AV fistula were reviewed. Of 346, 149 patients had TTE prior to the AV fistula surgery, 197 had TTE after the AV fistula surgery, and 76 patients had TTE before and after the AV fistula surgery. Data on medication use was available in 314 patients. ANOVA, chi-square, and logistic regression tests were employed. Results: In patients scheduled for AV fistula placement, 20% (31/149) patients had systolic dysfunction and 15% (22/142) had increased LV end-diastolic dimensions (LVEDD). Moderate systolic LV dysfunction was observed in 6% (9/149) and additional 8% (12/149) had severe LV dysfunction. Increased LVEDD with some LV dysfunction was noted in 27% (38/142).Following the AV fistula placement, 18% (36/197) of patients had systolic dysfunction and 12% (22/187) had increased LV end-diastolic dimensions (LVEDD). Moderate or severe systolic LV dysfunction was observed in 6% (5/197). LV systolic dysfunction or dilatation was noted in 23% (43/187). Of 314 patients, 63% were on beta-blockers (BB), 25% were on ACE inhibitor or an ARB , 43% on calcium-channel blocker , and 15% on alpha-antagonist . BB, ACEi-ARB, or AA were not associated with increased LVEDD or systolic dysfunction before or after the AV fistula placement. Prior to AV fistula, CCB treatment was not related to LV dilatation (36% in each group, p=0.981) Post AV fistula, CCB treatment was associated with increased LV dimensions (71% vs. 46%, p=0.029) but not LV systolic dysfunction (49% in LV dysfunction vs. 38% in the rest, p=0.446) . This association persisted after adjustment for co-morbidities and demographic parameters. Conclusions: LV systolic dysfunction and/or dilatation are common in patients undergoing AV fistula surgery. Despite decreased use of Ca-channel blockers in patients with LV dysfunction prior to AV fistula, Ca-channel blockers are associated with increased LV dimensions post AV fistula, and probably should be avoided in this vulnerable patient population.

P1812Speckle tracking echocardiography for early detection of left ventricular systolic dysfunction in patients with Chagas disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M C P Nunes ◽  
A L P Ribeiro ◽  
O R S Junior ◽  
C D L Olivera ◽  
C S Cardoso ◽  
...  
Keyword(s):  
Early Detection ◽  
Chagas Disease ◽  
Longitudinal Strain ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Lv Dysfunction

Abstract Introduction Longitudinal strain by speckle tracking echocardiography (STE) imaging is a reliable tool for quantitative measurement of myocardial contractility. Assessment of left ventricular (LV) systolic function has a central role in the evaluation of patients with Chagas disease, particularly for identification of subtle changes that could predict disease progression. Purpose We aimed to detect early LV dysfunction using LV global longitudinal strain (GLS) in patients with Chagas disease and its relationship to other echocardiographic and laboratory parameters. Methods Eight-hundred and fifty patients with Chagas disease (mean age of 60±12 years, 70% female) who live in remote areas in Brazil were enrolled. Clinical evaluation, ECG, N-terminal pro-brain natriuretic peptide (NT-ProBNP), and echocardiogram were performed. LV GLS was assessed offline on the four-, three- and two-chamber views. Patients were divided into tertiles according to the LV strain. Data were analyzed using One-way ANOVA. Results The ECG was normal in 19%, whereas typical ECG abnormalities related to Chagas cardiomyopathy were found in 58% of the patients. Overall mean LV ejection fraction (LVEF) was 59±11%, and LV GLS was - 14.1±4.4%. Apical aneurysm was detected in 34 patients (4%).The prevalence of LV systolic dysfunction, defined as LVEF <54% and GLS ≤ |16|%, was 19% and 66%, respectively. Abnormal GLS was observed in 408 (48%) patients despite a normal LVEF. Stratified according to tertiles of LV GLS, patients in the first tertile (strain <|10.7|%), had a significantly decreased in LVEF (Fig 1, A), increased E/e' ratio (Fig 2,B), left atrial volume (Fig 1,C), and NT-proBNP levels (Fig 1,D), indicating severity of LV dysfunction (n=215). Similarly, the patients in the third tertile (strain >|17|%), had normal standard echo parameters and NT-proBNP levels (n=210). However, patients in the second tertile (|10.7|% to |17|%; n=425), the strain was abnormal while other parameters were normal, showing LV impairment that was not evidenced by conventional exams. Conclusions LV longitudinal strain assessed by STE in a general population of Chagas disease provided diagnostic information beyond conventionally measured LVEF. Early detection of ventricular impairment may help to identify Chagas disease patients at risk for development of heart failure.

P6 Characterisation of right heart dysfunction in left ventricular systolic failure

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
H H L Chen ◽  
C H Gan ◽  
D Makarious ◽  
C H Ng ◽  
A Bhat ◽  
...  
Keyword(s):  
Systolic Function ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Disease Process ◽  
Left Ventricular ◽  
Pulmonary Artery Systolic Pressure ◽  
P Value ◽  
Basal Diameter ◽  
Lv Dysfunction ◽  
Rv Function

Abstract Funding Acknowledgements Nil Background Left and right ventricular (RV) function is proposed to be intimately linked. Reduced systolic ventricular interaction in patients with reduced global left ventricular (LV) performance is hypothesised to result in a reduction in RV contractile performance, even if the RV is not directly involved in the disease process. Concurrent RV and LV dysfunction is known to carry a poorer prognosis. However, the incidence of RV structural change and systolic dysfunction in patients with LV dysfunction in patients in a clinical setting is not well characterised. Purpose To determine the prevalence of RV systolic impairment in patients with LV systolic impairment from non-ischaemic cardiomyopathy (NICM); and to characterise the relationship between LV and RV systolic function using echocardiographic parameters. Methods 86 consecutive patients with stable heart failure with reduced ejection fraction secondary to NICM without valvular, congenital, and pulmonary disease were recruited. All patients underwent a comprehensive transthoracic echocardiogram and were stratified into tertiles based on LVEF (mild: 40-49%, moderate: 30-39%, severe: &lt;30%). RV function was characterised using standard and novel measures. 2D RV free wall peak systolic strain (RV FWS) was measured using vendor independent software (TomTec Image Arena, Germany v4.6).  Results Of the mild, moderate and severe groups (mean age 58 ± 34, 36% men): mean LVEF (%) was 46 ± 6, 35 ± 6, 22 ± 10 ; mean pulmonary artery systolic pressure (mmHg) was 28 ± 24, 34 ± 31, 38 ± 24; 26%, 79%, 74% had mild or moderate pulmonary hypertension respectively. 33% had RV impairment based on TAPSE of &lt;1.6cm; 48% had RV impairment based on RVS’ of &lt;10cm/s; and 65% had RV impairment based on a FAC of &lt;35%.  Conclusion Whilst there is a concurrent increase in the prevalence of RV impairment with severity of LV systolic impairment, interestingly not all patients with LV dysfunction had RV dysfunction. The presence of RV dysfunction is greatest when measured using FAC and RV FWS. Routine screening of RV dysfunction in patients with HFrEF secondary to NICM may help identify patients with poorer prognosis, who could benefit with more intensive follow up and treatment. LVEF 40-49% (n = 31) LVEF 30-39% (n = 28) LVEF &lt; 30% (n = 27) ONE WAY ANOVA Significance (P value) Mean RV Basal Diameter (cm) 4.1 ± 1.3 3.7 ± 1.6 3.6 ± 1.5 0.51 Mean TAPSE (cm) 2.1 ± 0.8 1.9 ± 1.0 1.7 ± 1.1 0.49 Mean RVS" (cm/s) 11 ± 5 11 ± 6 9 ± 6 0.24 Mean FAC (%) 44 ± 20 29 ± 21 17 ± 13 0.000 Mean RV FWS (%) -27.4 ± 14.4 -17.2 ± 11.6 -7.9 ± 6 0.000

scholarly journals Exercise Contractile Reserve for Predicting Mortality in Non-Ischemic Ventricular Dysfunction

2019 ◽  
pp. 1-6
Author(s):  
Alberto Bouzas-Mosquera ◽  
Fernando Rebollal ◽  
Javier Broullon ◽  
Jesus Peteiro ◽  
Jose M. Vazquez-Rodriguez ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Lv Function ◽  
Contractile Reserve ◽  
Lv Dysfunction ◽  
History Of ◽  
Artery Disease ◽  
Lv Systolic Function

Objectives: A preserved contractile reserve is a marker of favorable outcome in different cardiac diseases. In some studies, using drugs, an increase in left ventricular (LV) systolic function was associated to better prognosis in patients with dilated cardiomyopathy. We aimed to assess whether a positive contractile reserve (CR) to physical exercise is a marker of good outcome in patients with LV systolic dysfunction not related to coronary artery disease (CAD). Design: From our exercise echocardiography database we extracted patients with LV systolic dysfunction (LVEF ≤45), negative coronary angiography, and absence of a history of CAD. A positive CR was considered when peak LVEF was higher that resting LVEF. The endpoint was overall mortality. Results and Conclusions: Among the 225 patients included, 105 had a positive CR and 120 a negative CR. Resting LV function was similar in patients with positive and negative CR (LVEF 35±8 vs. 34±9; wall motion score index 1.81±0.34 vs. 1.80±0.29; both p=NS). During a follow up of 6.2+4.7 years (25-75th percentiles 2.2-9.5), there were 71 deaths. Ten-year mortality rates were 34% for patients with CR and 67% for patients without CR (p=0.003). After multivariate adjustment that included clinical variables, medications, resting LV function, and exercise testing variables the only predictors of death were age (hazard ratio (HR) 1.07, 95% Confidence Interval (CI) 1.04-1.10, p<0.001), and absence of CR (HR 1.80, 95% CI 1.09-2.98, p=0.02). In conclusion, in patients with non- ischemic LV dysfunction, a positive CR to physical exercise is a marker of better outcome.

scholarly journals Functional adaptation of the right ventricle to different degrees of the left ventricular systolic dysfunction in patients with left-sided heart disease: a three-dimensional echocardiography study

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
E Surkova ◽  
A Kovacs ◽  
M Tokodi ◽  
BK Lakatos ◽  
D Muraru ◽  
...  
Keyword(s):  
Heart Disease ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Radial Component ◽  
Left Ventricular ◽  
Functional Adaptation ◽  
Contraction Pattern ◽  
Relative Contribution ◽  
Lv Dysfunction

Abstract Funding Acknowledgements Type of funding sources: None. Background. Right ventricular (RV) systolic dysfunction in patients with left-sided heart disease is known adverse factor. However, the RV adaptation at the different degrees of left ventricular (LV) dysfunction remains to be clarified. Purpose  to assess the change in RV contraction pattern in relation to LV ejection fraction (EF) in patients with left-sided heart disease. Methods. LV and RV volumes and EF were measured by 3D-echocardiography in 295 patients with left-sided heart disease (59 ± 17years, 69% male). The 3D meshmodel of the RV was postprocessed by the ReVISION software and its contraction pattern was decomposed along the longitudinal, radial and anteroposterior directions (Fig. A) providing longitudinal, radial and anteroposterior EF (LEF, REF, AEF). Relative contribution of each component to the RV systolic function was measured as the ratio between LEF, REF and AEF and global RVEF (LEFi, REFi, AEFi). Results. Patients with LV systolic dysfunction also had reduced RVEF. Relative contribution of the longitudinal and anteroposterior components decreased, while radial component increased in patients with reduced LVEF (Table). RV LEF and AEF significantly correlated with the LVEF (Rho 0.50 and 0.51, p &lt; 0.0001), while the correlation between REF and LVEF was weak (Rho 0.22, p = 0.0002). There was a significant drop in LEF and AEF (Fig. B) and their relative contribution to the total RVEF (Fig. C) starting from the earlier stages of LV dysfunction. However, it was effectively compensated by significant increase in the radial RV component resulting in preservation of total RVEF in those with normal, mildly and moderately reduced LVEF (50 [46;54] vs 47 [44;52] vs 46 [42;49]%), whereas total RVEF dropped significantly only in severe LV dysfunction (30 [25;39]%; p &lt; 0.0001) (Fig. D). Conclusions. The longitudinal and anteroposterior RV contraction was related to the LVEF and decreased from early stages of the LV systolic dysfunction. Increase in the radial component compensated for the loss of longitudinal and anteroposterior RV components in mild and moderate LV dysfunction to maintain total RVEF. Drop in all three components resulted in significant reduction of total RVEF in severe LV dysfunction. Characteristics of study population Overall (N = 295) LVEF≥50% (N = 166) LVEF &lt; 50% (N = 129) LV EF, % 49.6 ± 14.3 59.9 ± 5.6 36.4 ± 10.9* RV EF, % 46.5 ± 9.2 49.8 ± 6.9 42.3 ± 10.0* RV LEFi 0.42 ± 0.09 0.45 ± 0.09 0.38 ± 0.09* RV REFi 0.47 ± 0.1 0.45 ± 0.1 0.50 ± 0.09* RV AEFi 0.39 ± 0.08 0.41 ± 0.08 0.37 ± 0.07* *p &lt; 0.0001 Abstract Figure.

Abstract 14850: Independent Role of the Priming and Triggering of the NLRP3 Inflammasome in the Heart

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Stefano Toldo ◽  
Eleonora Mezzaroma ◽  
Matthew D McGeough ◽  
Carla A Pena ◽  
Carlo Marchetti ◽  
...  
Keyword(s):  
Nlrp3 Inflammasome ◽  
Cardiac Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Ischemic Injury ◽  
Premature Death ◽  
Left Ventricular ◽  
Caspase 1 ◽  
Lv Dysfunction ◽  
Lv Systolic Function

Introduction: The NLRP3 inflammasome is activated in the heart following ischemic injury, and it promotes cardiac dysfunction. Ischemic injury establishes both a priming signal (leading to transcription of inflammasome components) and a trigger (NLRP3 activation). Whether activation of NLRP3 (in absence of priming) represents the limiting step in the formation of the inflammasome in the heart is unknown. Hypothesis: Both priming and the triggering signals in the heart are necessary for the formation of the inflammasome and ensuing cardiac dysfunction. Methods: We induced systemic expression of a floxed mutant NLRP3-A350V, that is constitutively active, in 10 mice using a tamoxifen-inducible Cre recombinase, to create a condition in which NLRP3 is activated, in absence or presence of priming with low dose LPS (2 mg/kg). Molecular analyses were performed on the heart and the spleen (myeloid organ not dependent on priming) to measure caspase-1 activity using a fluorogenic assay, mRNA expression of the component of the inflammasome (caspase-1 and IL-1β), and echocardiography to measure left ventricular (LV) dimension and systolic function. Results: NLRP3-A350V mutant mice had increased caspase-1 activity in the spleen but not in the heart and had normal LV systolic function (Figure), showing that in NLRP3 activation without priming is insufficient to induce inflammasome formation in the heart nor LV systolic dysfunction. Priming with LPS induced the expression of the inflammasome components in the heart which in absence of NLRP3 activation (control mouse) had no effects on LV systolic function, whereas in the presence of NLRP3 activation (mutant mouse) led to reduced LV systolic function and premature death (Figure). Conclusions: The inflammasome formation in the heart requires a priming signal to be coupled with activation of NLRP3 in order to induce LV dysfunction.

scholarly journals Are premature ventricular contractions in patients without apparent structural heart disease really safe?

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Charles Jazra ◽  
Oussma Wazni ◽  
Wael Jaroudi
Keyword(s):  
Heart Disease ◽  
Catheter Ablation ◽  
Beta Blockers ◽  
Structural Heart Disease ◽  
Arrhythmogenic Right Ventricular Dysplasia ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Channel Blockers ◽  
Premature Ventricular Contractions ◽  
Lv Dysfunction

<p>Premature ventricular complexes (PVC) are considered benign when they occur in patients without apparent structural heart disease. They usually originate from the right, or less commonly, left ventricular outflow tract. Their suppression was not beneficial in patients with heart disease like myocardial infarction and cardiomyopathies. Recently it has been shown that their suppression medically or by ablation, improved the left ventricular (LV) dysfunction. This led to the hypothesis that they may contribute to this LV dysfunction especially when they are particularly frequent (&gt; 20000 per day). Because of some overlap with arrhythmogenic right ventricular dysplasia, the evaluation in patients without apparent heart disease should consider an magnetic resonance imaging if the echocardiography was not able to help in diagnosis especially when there is a suspicion.</p><p>Patients without structural heart disease and low-to modest PVC burdens do not always require treatment.</p><p>When necessary, treatment for PVCs involves beta-blockers, calcium channel blockers, or other antiarrhythmic</p><p>drugs and catheter ablation in selected cases. Catheter ablation can be curative, but it is typically reserved</p><p>for drug-intolerant or medically refractory patients with a high PVC burden.</p>

scholarly journals Peripartum Cardiomyopathy

1970 ◽  
Vol 24 (2) ◽  
pp. 67-70
Author(s):  
Shirin Akter Begum ◽  
SB Chowdhury ◽  
Begum Nasrin ◽  
Jannatul Ferdous ◽  
Zillur Rahman Bhuiyan
Keyword(s):  
African American Women ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Systolic Dysfunction ◽  
The United States ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Objective Evidence

Peripartum cardiomyopathy (PPCM) is a rare but potentially lethal complication of pregnancy occurring in approximately 1in 3000 live births in the United States although some series report a much higher incidence. African-American women are particularly at risk. Diagnosis requires symptoms of heart failure in the last month of pregnancy or within five months of delivery in the absence of recognized cardiac disease prior to pregnancy as well as objective evidence of left ventricular systolic dysfunction. Obstetricians should suspect the diagnosis, particularly if the patient has risk factors. Evaluation should include an echocardiogram to assess the LV systolic function. Treatment includes ACE inhibitors or angiotensin receptor blockers, beta-blockers, and diuretics. Consideration should be given to anticoagulation. A number of causes are being investigated, including nutritional, infectious, and genetic, which, hopefully, lead to more targeted treatments. This paper provides an updated, comprehensive review of PPCM, including emerging insights into the etiology of this disorder as well as current treatment options. Bangladesh J Obstet Gynaecol, 2009; Vol. 24(2) : 67-70   DOI: http://dx.doi.org/10.3329/bjog.v24i2.8531

scholarly journals Dynamic Left Intraventricular Obstruction Phenotype in Takotsubo Syndrome

2021 ◽  
Vol 10 (15) ◽  
pp. 3235
Author(s):  
Davide Di Vece ◽  
Angelo Silverio ◽  
Michele Bellino ◽  
Gennaro Galasso ◽  
Carmine Vecchione ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Systolic Function ◽  
Hemodynamic Instability ◽  
Left Ventricular ◽  
Takotsubo Syndrome ◽  
Benign Condition ◽  
Coronary Syndrome ◽  
Lv Dysfunction ◽  
Appropriate Therapy ◽  
Selection Of

Takotsubo syndrome (TTS) is characterized by acute, generally transient left ventricular (LV) dysfunction. Although TTS has been long regarded as a benign condition, recent evidence showed that rate of acute complications and in-hospital mortality is comparable to that of patients with acute coronary syndrome. In particular, the prevalence of cardiogenic shock ranges between 6% and 20%. In this setting, detection of mechanisms leading to cardiogenic shock can be challenging. Besides a severely impaired systolic function, onset of LV outflow tract obstruction (LVOTO) together with mitral regurgitation related to systolic anterior motion of mitral valve leaflets can lead to hemodynamic instability. Early identification of LVOTO with echocardiography is crucial and has important implications on selection of the appropriate therapy. Application of short-acting b1-selective betablockers and prudent administration of fluids might help to resolve LVOTO. Conversely, inotrope agents may increase basal hypercontractility and worsen the intraventricular pressure gradient. To date, outcomes and management of patients with TTS complicated by LVOTO as yet has not been comprehensively investigated.

scholarly journals AB0422 LEFT VENTRICULAR ABNORMALITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS FOLLOWED BY SEQUENTIAL ECHOCARDIOGRAPHY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1510.1-1511
Author(s):  
T. Kuga ◽  
M. Matsushita ◽  
K. Tada ◽  
K. Yamaji ◽  
N. Tamura
Keyword(s):  
Lupus Erythematosus ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Monocyte Count ◽  
Lv Dysfunction ◽  
Group A ◽  
Group B ◽  
Lv Diastolic Dysfunction ◽  
Group D

Background:Cardiovascular disease (CVD) is detected in up to 50% of systemic lupus erythematosus (SLE) patients1and major cause of death2. Even clinically silent SLE patients can develop left ventricular (LV) diastolic dysfunction3. Proper echocardiographic follow up of SLE patients is required.Objectives:To clarify how the prevalence of LV abnormalities changes over follow-up period and identify the associated clinical factors, useful in suspecting LV abnormalities.Methods:29 SLE patients (24 females and 5 men, mean age 52.8±16.3 years, mean disease duration 17.6±14.5 years) were enrolled. All of them underwent echocardiography as the baseline examination and reexamined over more than a year of follow-up period(mean 1075±480 days) from Jan 2014 to Sep 2019. Patients complicated with pulmonary artery hypertension, deep venous thrombosis or pulmonary embolism and underwent cardiac surgery during the follow-up period were excluded. Left ventricular(LV) systolic dysfunction was defined as ejection fraction (EF) < 50%. LV diastolic dysfunction was defined according to ASE/EACVI guideline4. LV dysfunction (LVD) includes one or both of LV systolic dysfunction and LV diastolic function. Monocyte to HDL ratio (MHR) was calculated by dividing monocyte count with HDL-C level.Prevalence of left ventricular abnormalities was analysed at baseline and follow-up examination. Clinical characteristics and laboratory data were compared among patient groups as follows; patients with LV dysfunction (Group A) and without LV dysfunction (Group B) at the follow-up echocardiography, patients with LV asynergy at any point of examination (Group C) and patients free of LV abnormalities during the follow-up period (Group D).Results:At the baseline examination, LV dysfunction (5/29 cases, 13.8%), LV asynergy (6/29 cases, 21.7%) were detected. Pericarditis was detected in 7 patients (24.1%, LVD in 3 patients, LV asynergy in 2 patients) and 2 of them with subacute onset had progressive LV dysfunction, while 5 patients were normal in echocardiography after remission induction therapy for SLE. At the follow-up examination, LV dysfunction (9/29 cases, 31.0%, 5 new-onset and 1 improved case), LV asynergy (6/29 cases, 21.7%, 2 new-onset and 2 improved cases) were detected. Though any significant differences were observed between Group A and Group B at the baseline, platelet count (156.0 vs 207.0, p=0.049) were significantly lower in LV dysfunction group (Group A) at the follow-up examination. Group C patients had significantly higher uric acid (p=0.004), monocyte count (p=0.009), and MHR (p=0.003) than Group D(results in table).Conclusion:LV dysfunction is progressive in most of patients and requires regular follow-up once they developed. Uric acid, monocyte count and MHR are elevated in SLE patients with LV asynergy. Since MHR elevation was reported as useful marker of endothelial dysfunction5, our future goal is to analyse involvement of monocyte activation and endothelial dysfunction in LV asynergy of SLE patients.References:[1]Doria A et al. Lupus. 2005;14(9):683-6.[2]Manger K et al. Ann Rheum Dis. 2002 Dec;61(12):1065-70.[3]Leone P et al. Clin Exp Med. 2019 Dec 17.[4]Nagueh SF et al. J Am Soc Echocardiogr. 2016 Apr;29(4):277-314.[5]Acikgoz N et al. Angiology. 2018 Jan;69(1):65-70.Numbers are median (interquartile range), Mann-Whitney u test were performed, p value less than 0.05 was considered statistically significant.Disclosure of Interests: :None declared

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