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S16 Heart, Lung and CirculationPoster Presentations 2008;17S:S4–S53

measured the value of E-wave tissue Doppler velocity inbase of septum and colour M-mode propagation velocitysimultaneously.

Results: We studied 151 patients mean age 50.78 ± 2.86years (53% men 47% women). The one-way analysis ofvariance (ANOVA) procedure showed that there is sig-nificant differences at the 95% confidence level betweenthe normal and grade 1–3 diastolic dysfunction groupsin TDI diastolic E-wave and mitral propagation veloci-ties (p < 0.001). Once ANOVA analysis determined thatdifferences exist among the means, the Bonferroni posthoc multiple comparisons test showed that there is sig-nificant decrease in TDI diastolic E-wave and mitralpropagation velocities between the all evaluated groupsseparately.

Normal Grade 1 Grade 2 Grade 3

TDI E-wave (cm/s) 10.14 ± 2.63* 6.27 ± 1.81 4.78 ± 1.76 2.65 ± 0.85

MPV (cm/s) 60.32 ± 9.04* 42.79 ± 9.06 35.91 ± 7.23 26.16 ± 1.57

∗ Significant.

Conclusion: Application of load independent criteria(tissue Doppler imaging and colour M-mode propa-gation velocity) could classify quantitatively diastolicdysfunction.

doi:10.1016/j.hlc.2007.11.038

not related to cardiac pathology. The objective measure-ments of obesity seemed to correlate reasonably well withheart weight but not with severity of coronary artery dis-ease.

The detailed conclusions will be discussed.

doi:10.1016/j.hlc.2007.11.039

Point of care international normalised ratio testing inacute cardiac wards

Michelle Giles a,∗, Heather Bevan a,∗, Jodie Walters a, JulieHeads a, Ian Wright b, Vicki Parker a

a Hunter New England Area Health Serviceb Hunter Medical Research Institute

Currently there may be considerable delay before inter-national normalised ratio (INR) results are available. Manypatients wait for results to undergo cardiac catheterisation,cardio-version or discharge. Point of care (POC) INR tech-nology may offer benefits to patients, health care staff andfacilities. There are few studies reporting its efficacy andimpact on cardiovascular disease inpatients on warfarintherapy, and none that report POC INR use in patients con-verting from heparin. The aim of this study was to comparethe accuracy of INR results from POC testing with INR lab-oratory testing for patients receiving warfarin in an acutecare setting and included patients being converted from

Autopsy objective measures of obesity: A pilot study ofthe correlation of adipose stores to sudden cardiac death

John Fernandes a,∗, Sara Tam b, Brandy Cochrane a,Imtiaz Samjoo a

a Hamilton Health Sciences Centreb McMaster University

The epidemic of obesity affecting the westernised worldis fast becoming a primary health problem for most indus-trialised nations. There has been some work examiningobjective measures of obesity as a guide to clinical man-agement. The purpose of this study was to correlateobjective measurements of adipose stores with assess-ments of cardiovascular pathology and cause of deathamongst individuals who die suddenly. Data were col-lected prospectively upon registration in a forensic unit ofdecedents who died suddenly and unexpectedly. Exclu-sion criteria were applied to ensure a population in whomall of the measures of obesity could be determined safelyand then careful assessment of cardiovascular findingswas examined. Correlation with histological findings andthe final cause of death will be offered. There were 37cases who met the inclusion and exclusion criteria, result-ing in a distribution of 25 males and 12 females (2:1).The average age was 52.8 years (15–87), average weight83.8 kg (39–147), average height 171 cm (147–191), averageabdominal circumference (AC) 93.7 cm (66–138), averagehip circumference (HC) 100.3 cm (69–134), average thighcircumference (TC) 50.3 cm (35.5–65), and average heartweight 471.9 g (213–837). Thirteen of the deaths had a car-diac cause of death. The remainder had causes of death

intravenous heparin.POC INR testing was done by the bedside nurse, using

CoaguChek XS, for 50 cardiovascular patients receiv-ing warfarin. Formal INR laboratory testing was plannedwithin one hour of the POC testing being performed, 38%of paired tests were performed on patients also receiv-ing heparin. Results were compared using Spearman rankcorrelation and Bland–Altman plots.

Fifty patients were enrolled in the study. A total of 117paired INR results were collected, 44 from patients alsoon heparin. Results were highly significantly correlated(r = 0.953, p < 0.0001). Bland–Altman plots demonstratea close agreement between POC INR and laboratoryINR results for patients receiving warfarin regardlessof whether they were receiving heparin. The differencebetween the paired results showed a median bias of +0.2.The presence of diabetes significantly reduced the dif-ference between paired tests. Bias significantly increasedabove an INR of 4.5. 97% of all values fell between 20%limits of agreement after accounting for a fixed bias of +0.2.

Results indicate the potential use of POC INR testingfor clinical decision making for patients receiving war-farin within an acute care setting. Clinical guidelines, to betested within a larger population group, are being devel-oped.

doi:10.1016/j.hlc.2007.11.040