I IP
Medical Research Society
Gender does not appear to be' independently associated
with aortic root diameter except insofar as women
patients have a tendency to be less tall than men. A
computer system has been developed that can display the
history of a patient's measured aortic root diameters
and where each lies in relation to a reference range
corrected for age and height.
Conclusion. Echocardiographic assessment of a patients'
aortic diameter in order to evaluate their r i s k o f
aortic dissection should take into account age and
for
height. Computer systems have the potenlial
assisting in decision making by highlighting major
departures from normal ranges.
the SL measurement was compared with the nearest of the adjacent
two HgS measurements providing 3 interdevice BP differences for
each position. Results Mean (+ standard deviation) systolic blood
pressure (SBP) and diastolic blood pressure (DBP) for each device in
Supine
Sitting
Erect
SBP (mmHa)
.
-_
SL
HgS
Diff
168+27 175+30 -8+12*
166327 170f29 -5+10*
166329 169+30 -3+12*
DBP (. m H -,
d
HgS
Diff
SL
93f15 89f14 3+8*
93+14 91+15 2+7*
93216 91216 2+8*
M35 Q T INTERVAL AND Q T DISPERSION FAIL TO
CORRELATE WITH CHANGES IN REGIONAL WALL
MOTION
DURING
DOBUTAMINE
STRESS
ECHOCARDIOGRAPHY
R S MORE, H GRIFFITHS and D J SHERIDAN
Academic Department of Cardiology, St Mary's Hospital, London,
England
Changes in QTc interval and QTc dispersion occur in conditions as
diverse as left ventricular hypertrophy and myocardial infarction.
However there is very limited information on whether abnormalities
of left ventricular wall motion affect these parameters. We thus
measured 12 lead QTc and QTc dispersion both at rest and at peak
heart rate (PHR) during standard dobutamine stress
echocardiography in 3 age and sex matched patient groups. Group 1 individuals with normal wall motion at rest and during dobutamine
infusion, Group 2 - normal wall motion at rest but wall motion
abnormalities induced with dobutamine and G o u p 3 - resting wall
motion abnormalities present which worsen with dobutamine
infusion.
Group 2
Group 1
491 (56)
QT/ms
444 (18)
89 (38)
QT dispersiodms
76 (17)
PHR QT/ms
517 (53)*
516 (37)
119 (42)
QT dispersiodms
127 (54)*
Values are mean (SD). * p<0.05 for PHR v Rest values-
Rest
Group 3
512 (73)
107 (52)
502 (44)
107(37)
No significant difference in QTc or QTc dispersion was observed
between the 3 groups either at rest or at PHR. Group 1 patients only
however did show a significant prolongation of the QTc interval and
QTc dispersion at PHR compared to rest values.
In conclusion. it would appear that alterations in QTc and QTc
dispersion during dobutamine stress echocardiography do not
correlate with any changes in left ventricular regional wall motion.
M36 EFFECT O F POSTURE ON BLOOD PRESSURE
MEASURED BY A NON-INVASIVE BLOOD PRESSURE
MONITOR AND A MERCURY SPHYGMOMANOMETER
M37
INCREASED SOLUBLE P-SELECTIN : A NEW MARKER
FOR THE PROGRESSION OF VASCULAR DISEASE
AD BLANN and CN MCCOLLUM
Dept. Surgery, Univ Hosp South Manchester,
Nell Lane, Didsbury, Manchester M20 8LR, UK
Introduction Adhesion molecule P-selectin
(CD62P) is involved in leukocyte - platelet endothelium adhesion and is present in platelets and on endothelial cells. Raised soluble
levels have been described in atherosclerosis
(Blann et a1 Thrombosis Haemostasis
1995:74;626-30).
To determine whether these raised plasma
levels could predict new cardiovascular
events in non-diabetic patients surviving a
myocardial infarction.
Method Blood was obtained from 36 (mean age
60, 5 women, 8 smokers) patients at least 7
weeks after hospital discharge for myocardial
infarction. Citrated plasma P-selectin was
measured by ELISA (R&D Systems).
Results After a mean of 48 months (range 3855), 14 patients had experienced an end point
of a second fatal or non-fatal myocartiial
infarction, arterial surgery, positive angiography or new symptomatic atherosclerosis.
P-selectin
was 360+49 ng/mL (meankSD) in
those with an end point compared to 272+74 in
patients free of an end point (p=O.O006, t
test). The conventional risk factors for
atherosclerosis (lipids, smoking, hypertension etc) could not predict this outcome.
Conclusion Increased soluble P-selectin,
probably the product of activated platelets,
is a new risk factor for the progression of
coronary or peripheral atherosclerosis.
P IQBAL and MD FOTHERBY
University Department of Medicine for the Elderly, The
Glenfield Hospital, Groby Road, Leiccstcr LE3 9QP
Automatic ambulatory blood pressure (BP) monitors using the
oscillometric princple are increasingly being used, particularly in
elderly subjects where the prevalence of hypertension is greatest.
Aim To determine differences in BP recorded by the SpaceLabs
90207 BP monitor (SL) and a mercury sphygmomanometer (HgS) in
elderly persons according to posture. Methods 85 subjects aged 6090 years had 3 sets of BP measurements taken in the order HgS-SLHgS repeated 3 times giving a total of 9 BP readings in each of the
supine, standing and sitting positions. For each set of BP readings
M38
LIPOPROTEIN (a) IN THE INTERSTITIAL FLUID AND SERUM OF
PATIENTS WITH CHRONIC RENAL FAILURE AND MATCHED CONTROLS
G.N LWOOD. DBHATNAGAR. M.I.MACKNESS, W A HERD, C.D.SHORT and
P.N.DURRINGTON
University Departments of Medicine and Nephrolcgy. Manchester Royal Infirmary,
Oxford Road, Manchester, M13 9WL, U K
Raised serum lipoprotein (a) (Lp(a)) concentrations, especially in the
presence of elevated LDL cholesterol are associated with an increased