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artery ISR and planned for a ostial LMCA stenting on a later date if angina
persists.
Conclusion: This a rare case of subclavian stent restenosis causing coronary
steal syndrome causing exertional angina in a post coronary artery bypass
graft patient. Definitive diagnosis has to be established before planning
any intervention. First line of treatment for coronary steal syndrome is
percutaneous transluminal angioplasty than surgery since its minimally
invasive shorter hospital stay and avoidance of general anaesthesia.
KeyWords: Coronary steal, takayasu arteritis, post CABG.
ABN10072
CORRELATION OF CLINICAL RISK SCORES WITH ANGIOGRAPHIC
EXTENT AND SEVERIT Y OF CORONARY ARTERY DISEASE IN PATIENTS
WITH ST ELEVATION ACUTE CORONARY SYNDROME
A.R. Munde, I. Syed. Osmania Medical College, Hyderabad, India
Purpose: The Global Registry for Acute Coronary Events (GRACE) and the
Thrombolysis in Myocardial Infarction (TIMI) risk scores predict adverse
clinical outcomes in patients with ST elevation acute coronary syn-
dromes (STEACS). In the present study, we sought to determine whether
GRACE and TIMI risk scores correlate with angiographic extent and
severity of coronary artery disease (CAD) according to SYNTAX score
(SXscore) and Gensini Score in patients with STEACS undergoing
catheterization.
Methods: We performed a prospective analysis of 100 consecutive STEACS
patients who underwent coronary angiography and had at least one sig-
nificant vessel disease (>50% stenosis in a vessel >1.5 mm). SXscore and
Gensini score a marker of CAD severity, was assessed from angiograms
using the SXscore and Gensini score algorithms. In order to investigate
predictive ability of clinical risk scores in determination of CAD severity,
patients were divided into 3 groups according to their GRACE risk scores:
GRACE scores 0 to 108 (low), 109 to 140 (intermediate), and >140 (high).
Similarly, patients were classified into 3 categories according to TIMI risk
scores: TIMI scores 0 to 2 (low), 3 to 4 (intermediate), and 5 to 7 (high).
Then these scores were correlated with SXscore and Gensini score by using
appropriate statistical methods
Results: There were significant correlations between risk scores and
angiographic profile of the patients
Conclusion: In patients with STEACS, both GRACE and TIMI risk scores are
correlated with the extent and severity of CAD. Therefore, in patients with
higher GRACE and TIMI risk scores, CAD can be predicted to be more
diffuse and severe.
ABN5008
MITRAL VALVE SEPARATION INDEX- A SIMPLER AND MORE
REPRODUCIBLE METHOD OF CALCULATING MITRAL VALVE AREA AND
GRADIENT ACROSS MITRAL VALVE
S. Anbarasan, N. Swaminathan, G. Ravishankar, G.J. Paul, S.
Venkatesan. Madras Medical College and Rajiv Gandhi Government
General Hospital, Chennai, India
Background: Severity of mitral stenosis is assessed by multiple echocar-
diographic techniques including the measurement of mitral valve area by
planimetry, pressure half time (PHT), measurement of mean gradient
across the valve, usage of continuity equation etc. Each of these methods
are influenced by various factors including the hemodynamic conditions,
LV function, coexistence of Mitral regurgitation, presence of atrial fibril-
lation etc. Mitral valve separation index (MVSI) is a simple, reliable, rapid,
reproducible method of assessing the degree of valve stenosis. The cor-
relation of MVSI and MVA by planimetry, PHT and mean gradient is
evaluated in this study. Materials and
Methods: It is a cross sectional analytical study carried out in 100
consecutive patients of Rheumatic MS visiting our OPD. Mitral valve sep-
aration index is measured in parasternal long axis view and apical 4
chamber view from inner edge to inner edge in end diastole. The mea-
surement was done in 3 cycles and the mean was taken. MVA by
planimetry was obtained in short axis view by standard protocol, the mean
gradient across the valve and valve area by pressure half time was
measured in apical 4 chamber view. The results are tabulated and
evaluated.
Results: The mean age of the study population was 38 ±10. 2 years. 70% of
the study population were females and the remaining 30% were males.
Correlation between MVSI and MVA by planimetry showed a linear posi-
tive correlation, with correlation (Pearson’s) coefficient “r”equalling 0.97
(P <0.001). On applying linear regression analysis, the regression equation
obtained was “Y¼0.21405 X - 0.12255”, where y (dependent variable) is
MVA measured by planimetry and x (Independent variable) is MVSI. This
gives a simple and easy formula for calculating MVA from measurement
for MVSI. [MVA¼(0.21) x MVSI e0.12]. The correlation of MVSI with the
measured mean gradient across the mitral valve was studied. It showed a
moderate negative correlation with “r”¼-0. 71 (P<0.001). On applying
linear regression analysis, between MVSI and mean gradients, the
regression equation was “Y¼- 0.96 X + 15.3”, Y is Mean gradient and X is
MVSI. The formula derived for calculating Mean gradient across the mitral
valve from MVSI is, Mean gradient¼(-0.96) x MVSI + 15.3. Valve separation
index also correlated linearly with measured valve area by pressure half
time.
Conclusion: Mitral valve area measurement by planimetry in short axis
view is considered as the reference standard. But multiple variations in the
values obtained by planimetry are frequently observed even between
experienced operators. MVSI more than 7.6 identifies patients with severe
Mitral stenosis from the equation we obtained in the study. MVSI serves as
an easy tool with which both the mital valve area and mean pressure
gradient across the valve can be easily calculated from the formula derived
from this study. MVA¼(0.21) x MVSI e0.12 Mean gradient¼(-0.96) x
MVSI + 15.3
ABN150013
ELECTROCARDIOGRAPHIC CHANGES IN OSTIUM SECUNDUM ATRIAL
SEPTAL DEFECT- BEFORE AND AFTER SHUNT CLOSURE- A
RETROSPECTIVE COHORT ANALYSIS
S. Anbarasan, N. Swaminathan, G. Ravishankar, G.J. Paul, S.
Venkatesan, C.M. Majella. Madras Medical College and Rajiv Gandhi
Government General Hospital, Chennai, India
Background: Atrial Septal Defect is a common congenital heart disease that
is seen in adult life and various ECG changes are described in it. In our
current study we intend to analyze the ECG features of Ostium Secundum
ASD at baseline and after closure of the defect. Materials and
Methods: This is a retrospective cohort study. Total of 60 patients who
underwent closure of ASD either by percutaneous device closure or sur-
gical patch closure were included. The baseline ECG before the closure of
the defect was obtained from the available records. The ECGs of the pa-
tients after the closure was compared with the baseline ECG and devel-
opment of any new changes were analyzed.
Results: Of the 60 cases included in the study, 30 underwent surgical
closure and the remaining 30 underwent percutaneous devic e closure. 66%
of the study population were females. Mean age was 28.4 ±09 years. At
baseline 59 patients were in sinus rhythm and one patient had atrial
fibrillation (1.6%). P wave amplitude was more than 2.5mV in 3 patients
(5%). PR interval prolongation was seen 4 (6.66%) patients. Mean QRS axis
was 108 ±10 degrees. Right axis deviation was seen in 48 (80%) patients.
rSR’(Right Ventricular outflow tract volume and pressure overload
pattern) in Right pre-cordial leads was seen in 58.33% of patients, rR’or qR
pattern was present in 12 (20%) patients. Notching of R wave in Inferior
Abstracts / Indian Heart Journal 71 (2019) S30eS97S34