Jaime Ferreira

182 Increased thickness of dyssynergic segments in the acute phase of myocardial infarction: a presage of left ventricular remodeling?

Introduction: In the acute phase el myocardial inlarction (AMI), echocardiography apreciales the location, extent and severity el dyssynergy, which correlate wilh the infarct-related vessel and the occluded segment. Initially, wall thickness of the aflected segments is usually normal, but systolic thickening is decreased or absent, often with an increase in echogenicity. In a small group of patients (pts) 6 in a series el 50 with ST-segment elevation anterior AMI, we observed a significant increase el myocardial thickness in dyssynergic segments. The aim el our study was to evaluate these pts in order Io clarify the meaning el lhis finding. Methods: The study group consists of 6 men (mean age 45 years) who received reperfusion therapy within 6 hrs alter symptom onset. The 2 pls who underwent primary angioplasty presented TIMI grade 3 flow al the end of the procedure. All 4 pls who received fibrinolysis underwent urgenl coronary angiography because el apparently unsuccesslul repedusion: rescue angioplasly was performed in 3 el lhese pts, bul TIMI grade 3 flow was reslored in only one; the remaining pl presenled a non-significant residual stenesis but TIMI grade 2 flow in the distal LAD. All 10Is had single-vessel (LAD) disease, except one (this pl had coronary angioplasty el the LCx on day 5 post AMI). All pts evolved in Killip class I, except one (worst KiUip II). Peak CK-MB averaged 404 IU,,1. We compared the echocardiographic findings at 2 time points: acute (Echo-I), in the first 48 hrs alter admission, and chronic (Echo-II), at 12±3 months. Results: On Echo-I, wall thickness of the involved septal segments was increased (14-17mm), but normal in all the remaining uninvolved segments. Loll venlricular (LV) ejection lraclion was _20% and wall thickness of lhe infarct segmenls decreased by >_50% in all but l p t . Conclusion: In pls wilh large anlerior ST-segment elevation AMI, a markedly increased parietal thickness of the inlarct-related segments observed alter repedusion therapy seems to relate with LV remodeling. Failure of repedusion therapy may be the underlying mechanism of this finding.

AB0315 Is the efficacy of biologic therapeutic in rheumatoid arthritis is affected by body mass index

Background Weight could be expected to affect the response to biological therapies by simply reducing the mg/Kg dose in fixed dose regimens. Furthermore, adipose tissue produces a variety of pro-inflammatory cytokines (as TNFa, IL-6, IL- 1) whose role in Rheumatoid Arthritis (RA) activity, remains unclear. Objectives The purpose of this study was to determine whether body mass index (BMI) is related with response to the biologic therapy adjusted to the weight (tocilizumab, infliximab) in RA patients. Methods Patients with RA followed in our day-hospital and registered in BioReportAR who had complete information of baseline and 12th week visit were included. Only patients with intravenously weight-adjusted therapy were considered. The body mass index (BMI) at baseline was calculated. Sociodemoraphic and clinical data were collected using data from the BioReportAR. Spearman correlation coefficient was used to analyse correlation between BMI and disease activity at baseline and its change after 12 weeks. Comparison between BMI categories was performed using Kruskal-Wallis test. p-values <0,05 were considered as statistically significant. Results 45 patients were included (86,7% women, mean disease duration 12,93±10,69 years, mean age 57,11±11,0 years), 20 receiving tocilizumab and 25 infliximab. The BMI mean was 25,55±3,92 kg/m2, and at baseline the mean DAS28 was 3,06±1,33. No correlation between BMI and baseline DAS28 (r= -0,158; p=0,519), change DAS28 (r= -0,207; p= 0,177) and individual parameters of DAS calculation were observed. When we compared change in DAS 28 between BMI categories (BMI£25 kg/m2 and >25 kg/m2) it didn’t show difference (p=0.607). Conclusions This study is the first that correlates tocilizumab and BMI. In this study, BMI was not associated with disease activity or response to tocilizumab or infliximab therapy. These negative results might be at least partially explained by the low number of patients with BMI 330 kg/m2 (only 6) or by using BMI as unique marker of adipose tissue. Disclosure of Interest None Declared