Conclusion: Renal insufficiency is a risk factors for HF in AF pts without underlying

heart disease.

1086

Important Factors for the Prevention of Renal Function Under the Inhibition of

Rennin-Angiotensin-Aldosterone System in Acute Heart FailureNAOKI SATO1, YAMAMOTO TAKESHI1, IWASAKI YUKI1, KATO KOJI1,YOSHIKAWA MASATOMO1, HIRASAWA YASUHIRO1, KAMIYAMASATAKA1, MURAI KOJI2, TAKANO TERUO2, TANAKA KEIJI1

1Intensive & Cardiac Care Unit, Nippon Medical School, Tokyo, Japan, 2FirstDepartment of Internal Medicine, Nippon Medical School, Tokyo, Japan

Background/Goal: Prevention of renal function (RF) is very important in acute heart

failure (AHF). Although the inhibition of rennin-angiotensin-aldosterone system

(RAAS) is important, it is not always protect RF. Therefore, our goal was to clarify

what were important factors.

Methods: Sixty three AHF were treated with carperitide (C) with and without furo-

semide (F). Blood pressure (BP), urine volume, doses of F, left ventricular ejection

fraction, cardiothoracic ratio, serum creatinine and hemodynamics were evaluated

on 1st and 3rd hospital day. We determined independent factors for the prevention

of RF using the logistic regression analysis.

Results: Independent factors for the prevention of RF are shown in table.

Conclusion: BP and the interaction of concomitant agent are important for the pre-

vention of RF in AHF.

1087

Intravenous Iron Sucrose in Anemic and Non-anemic Iron Deficient Patients

with CHF: A Randomized, Controlled, Observer-blinded Intervention Study

(FERRIC-HF)STEFAN D. ANKER1,3, DARLINGTON O. OKONKO3, AGNIESZKA GRZESLO2,TOMASZ WITKOWSKI2, CONSTANTINOS G. MISSOURIS4, WALDEMARBANASIAK2, PHILIP A. POOLE-WILSON3, PIOTR PONIKOWSKI2

1Department of Cardiology, Charite Campus Virchow-Klinikum, Berlin, Germany,2Cardiac Department, Military Hospital, Wroclaw, Poland, 3Clinical Cardiology,NHLI, Imperial College London, London, UK, 4Department of Cardiology,Wexham Park Hospital, Slough, UK

In chronic heart failure (CHF), iron deficiency is common and associated with exer-

cise intolerance. We tested whether iron repletion with intravenous (IV) iron sucrose

would safely improve exercise capacity in these patients.

Methods: We randomly assigned 35 CHF patients (age 64613y, NYHA II/III, LVEF

3067%) with iron deficiency to 16 weeks of IV-iron or no treatment (2:1 ratio; ob-

server blinded). Treatment: 200 mg IV-iron sucrose weekly until iron repletion (iron

repletion dose 5 weight (kg)�2.4�[15 - hemoglobin (g/dL)] þ 500 mg) and 200 mg

monthly thereafter.

Results: The difference (95% confidence interval) in the mean changes from baseline

to end of study between IV-iron and control groups was 96 mL/min (-12, 205) for

absolute pVO2 (P50.08), 2.2 mL/kg/min (0.5, 4.0) for pVO2/kg (P50.01), 60 sec

(-6, 126) for treadmill exercise duration (P 5 0.08), -0.8 (-1.3, -0.3) for NYHA class

(P50.003), and 1.7 (0.7,2.6) for patient global assessment (P50.002).

In anaemic patients (Hb!12.5g/dL), IV-iron improved absolute pVO2 (P50.02) and

pVO2/kg (P50.01). In non-anaemics, IV-iron improved exercise duration (P50.06)

and NYHA class (P50.06). The incidence of serious and non-serious adverse events

did not differ between groups.

Conclusions: Iron repletion with intravenous iron sucrose was safe and associated

with improvements in exercise capacity and symptom status in CHF patients with

iron deficiency. Benefits were more evident in anaemic patients.

1088

Effect of Left Ventricular Reconstruction Surgery on Mitral Regurgitation as

Assessed with EchocardiographyTAKASHI KIHARA1, TAKAHIRO SHIOTA2, CHUWA TEI1

1Department of Cardiovascular, Respiratory and Metabolic Medicine, GraduateSchool of Medicine, Kagoshima University, Kagoshima, Japan, 2Department ofCardiovascular Medicine, Cleveland Clinic Foundation, Ohio, USA

Background: Left ventricular (LV) reconstruction surgery (LVR) was applied to treat

end-stage ischemic cardiomyopathy (ICM). The existence of post-operative severe mi-

tral regurgitation (MR) is well known to be a strong predictor of poor prognosis. There-

fore, we evaluated the severity of MR in patients with ICM who underwent LVR.

Methods: Of the 197 patients with ICM who underwent LVR, 32 patients (62610

years) without mitral valve repair or atrial fibrillation were studied before and 6

days and 10 months after LVR. Using echocardiology, we observed the severity of

MR, mitral annular area, mitral leaflet tenting area, and transmitral inflow.

Results: Severity of MR significantly increased from 4.966.5 pre-operatively to

7.669.6 at the early post-surgery, and to 11.669.7% during follow-up. Mitral annular

area significantly increased from 5.861.6 to 6.461.8, and to 6.861.7 cm2. However,

mitral leaflet tenting area did not change during the follow-up. E/A ratio significantly

increased from 1.060.6 to 1.761.4 at the early post-operative stage, which gradually

recovered to 1.260.8 during follow up. Stepwise multiple linear regression analysis

demonstrated that increase of mitral annular area was the only predictor of increase

of MR (r250.45, p!0.01).

Conclusions: The early appearance of MR after LVR was found in ICM patients with

mild MR pre-operatively. The dilation of mitral annular area is suspected to be a cause

of mild MR after LVR.

1089

Detection of Diastolic Dysfunction Using Color Kinesis in the Absence of Systolic

Dysfunction: Experimental and Clinical StudiesTAKEDA YASUHARU1, SAKATA YASUSHI1, MANO TOSHIAKI1, NISHIOMAYU1, OHTANI TOMOHITO1, UMEKAWA SEIKO2, KOBAYASHI YUMIKO1,YAMAMOTO KAZUHIRO1, HORI MASATSUGU1

1Department of Cardiovascular Medicine, Osaka University Graduate Scool ofMesicine, Tokyo, Japan, 2Clinical Laboratory Medicine, National HospitalOrganization Osaka Minami Medical Center

Objectives: Color-encoded images enable the quantitative assessment of LV diastolic

wall motion abnormality. In the experimental study we aimed to clarify factors that affect

LV wall motion during diastole using hypertensive rats. Next, the clinical study was con-

ducted to evaluate LV wall motion during diastole in normal volunteers and diabetics.

Method: In the experimental, study echocardiographic and hemodynamic data were

collected in 25 hypertensive rats fed on high-salt diet with normal EF and 16 normoten-

sive rats fed on normal chow. In the clinical study, data were collected in consecutive 19

diabetics (DM) and age-matched 9 normal volunteers (N). A diastolic index of color

kinesis (CK-DI) was calculated as a ratio of LV segmental cavity area expansion during

the first 30% of diastole to that during whole diastole using color-encoded images.

Result: In the experimental study CK-DI was inversely correlated with Tau (p!0.05,

R50.44), but E/A or DT of the E wave was not. In the clinical study there was no

significant difference in blood pressure (N: 124615mmHg vs DM: 123615mmHg)

and EF (N: 6967 % vs DM 6966%) between the two groups. CK-DI was significantly

smaller in DM than in N(N: 60613% vs DM 46616%, p!0.05).

Conclusion: CK-DI was lowered in association with LV relaxation abnormality, and

the diabetic patients showed low CK-DI without changes in systolic function or blood

pressure.

The 10th Annual Scientific Meeting � JHFS S179