S157ABSTRACTS / Journal of Molecular and Cellular Cardiology 42 (2007) S145–S161

Results: In 218 patients [(m=64%) (age=60±16.5)], T cor-related directly with BMI (r=0.313; p<0.001) and inverselywith BNP (r=−0.235; p<0.001), BUN (r=−0.252; p<0.001)and creatinine (r=−0.264; p<0.001). All other correlationswere not significant. Out of the total, 112 (51.4%) patientsbelonged to the NBT population. Patients with NBT hadsignificantly higher (p<0.001) mean BMI (32.5±7.21) thanpatients with LBT (BMI=27.7±6.2) and were thus more obese.Plasma BUN levels were higher in LBT vs. NBT patients (26±12.5 mg/dl 22.36±13.1) (p<0.05). Other factors were similarin the 2 groups.

Conclusion: Low T in HF correlates with low BMI, andelevated BNP, BUN and Creatinine. Patients with normal tem-perature are more obese and have lower average BUN. Based oncommon prognostic factors, patients with T more than 97 °Fmay fair better than patients with lower temperatures.

Keywords: Cardiology; Heart failure

doi:10.1016/j.yjmcc.2007.03.507

Atrial fibrillation (AF) and heart failure (HF): Effect onexercise toleranceMassimo F Piepoli, Alessandro Capucci. Heart Failure Unit,Department of Cardiology, G da Saliceto PolichirurgicoHospital, Piacenza

Aim: To study the effect of the development of AF in HFpatients.

Methods: In our database of HF clinic, we assessed allconsecutive patients who underwent elective electrical cardio-version (CV) because of persistent (>1 month) AF. Fifty-fourpatients, 65.7±7.2 years, all on optimal stable (>6 months)therapy and warfarin (INR 2–3). Cardiopulmonary exercisetesting, clinical evaluation and 2D-Echo, before and 3 monthafter elective biphasic CV were performed.

Results: Baseline mean NYHA class was 2.7±0.6, LVEF29.4±8.6%, peak VO2 14.0±3.2 ml/kg/min, Ve/VCO2 46.2±8.7. At 3months, persistence of sinus rhythmwas observed in 37patients (67%): in the overall population no significantimprovements in Echo-2D, Ventilatory variables and NYHAclass. When total population was differentiated according to theexercise tolerance (peak VO2 <14 [26 patients] vs. >14 [24patients] ml/kg/min), we observed persistence of sinus rhythm in84% in the fitter vs. 62% in the weaker group (p<0.05).Younger was the former (59.3±4.5 y) vs. the latter (71.4±5.6 y,p<0.001) group. Improvement in exercise tolerance was ob-served among the fitter: exercise duration (from 9.5±3.4 min to13.7±3.2 min, p<0.05), peak VO2 (from 19.85±3.5 ml/min/kg to 32.2±3.6 ml/min/kg, p<0.05), with improvements inNYHA class and Ve/VCO2 slope.

Conclusion: Sinus rhythm restoration improved exercisetolerance in selected CHF patients with basal peak VO2>14 ml/kg/min. Rhythm control strategy may be important inCHF patients younger with preserved exercise capacity, while it

may be irrelevant in older CHF patients with more impairedexercise tolerance.

Keywords: Heart failure; Atrial fibrillation

doi:10.1016/j.yjmcc.2007.03.508

Cardiopulmonary exercise testing (CPET) in theidentification of candidate for cardiac resynchronisationtherapy (CRT)Massimo F Piepoli, Alessandro Capucci. Heart Failure Unit,Department of Cardiology, G da Saliceto PolichirurgicoHospital, Piacenza

Aim: To assess in patients with heart failure the effect ofCRT over 12 months' follow up on functional class, cardiacfunction, CPETand neurohormonal indices, the time course andto identify responders to CRT.

Methods: Eighty-nine patients with a left ventricular (LV)ejection fraction <35% and a left bundle branch block (QRSduration of>150 ms) were prospectively evaluated either in thecontrol (n=45) or CRT group (n=44). All patients (74.1±1 years) were in stable NYHA class III or IV after receivingoptimal medical treatment.

Results: In the CRT group vs. control group, improvementof cardiac indices (LVEF, LVEDD, Mitral DT), CPET indices(peak VO2, Ve/VCO2, duration) NYHA class were evident amedium term (over 6 months) follow up, which persisted on along term (12 month) (all p<0.05). An inhibitory medium tolong-term effect of CRT on neuro-hormonal activation with aincrease in HRVafter 6 month and decrease of plasma BNP (allp<0.05). We identified 26 responders to CRT vs. 18 non-responders according to changes in cardiac ejection fraction anddiameters. Responders presented more preserved clinical(NYHA class 2.1±0.1 vs. 3.2±0.2), haemodynamic (LVEF27±1 vs. 21±0.1%) and functional indices (peak VO2 10±0.3vs. 6±0.4 ml/kg/min) (all p<0.05). In the multivariate analysis,CPET indices were the strongest predictors of responders.

Conclusion: Less depressed hemodynamic and functionalstatus were the strongest predictors of responders to CRT.

Keywords: Heart failure; Cardiac function

doi:10.1016/j.yjmcc.2007.03.509

Asynchronous right ventricular DDD stimulation incomparison to VVI stimulation in a pig modelSandra Voss, Helge Moellmann, Holger Nef, AlbrechtElsaesser, et al. Kerckhoff-Klinik, Department of Cardiology,Bad Nauheim, Germany

Background: Previous rapid pacing models to induceheart failure show inhomogeneous results and require a