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2 YIA Abstract FA YOUNG INVESTIGATOR AWARD NHAM CONGRESS 2019 YOUNG INVESTIGATOR AWARD ABSTRACTS Imaging YIA 1 Time: 1040-1055 Global Longitudinal Strain Predicts Adverse Left Ventricular Remodeling After ST-segment Elevation Myocardial Infarction Y.Y. Oon1, K.T. Koh1, K.H. Ho1, C.T. Tan1, F.E.P. Shu1, A. Said1,2, Y.L. Cham1, N.Z. Khiew1, N.H. Mohd Amin1, A.Y.Y. Fong1,3 , T.K. Ong1 1Department of Cardiology, Sarawak Heart Centre 2Faculty of Medicine and Health Sciences, University Malaysia Sarawak 3Clinical Research Centre, Sarawak General Hospital Arrhythmias YIA 2 Time: 1055-1110 Preliminary Results of Smartphone Electrocardiogram for Detecting Atrial Fibrillation After A Cerebral Ischemic Event: A Multi-center Randomised Controlled Trial KT Koh1, Law WC2, Zaw WM2, DHP Foo3, CT Tan1, D Samuel4, TL Fam4, CH Chai4, ZS Wong4, DB Chandan1,5, JSH Tan5, FEP Shu1, KH Ho1, YY Oon1, NZ Khiew1, YL Cham1, A Said1,6, NH Mohd Amin1, AYY Fong1,3, TK Ong1 1Department of Cardiology, Sarawak Heart Centre, Kota Samarahan, Malaysia 2Neurology Unit, Department of Medicine, Sarawak General Hospital, Kuching, Malaysia 3Clinical Research Centre, Sarawak General Hospital, Kuching, Malaysia 4Department of Medicine, Miri Hospital, Malaysia 5Department of Medicine, Bintulu Hospital, Malaysia 6Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia Arrhythmias YIA 3 Time: 1110-1125 Prevalence of Atrial Fibrillation Detected by Single-Lead ECG among Senior Citizens at Northern Regions of West Malaysia in 2018 J.G. Ang1, H. Mohamed Hasnan1, K.R. Narasamuloo1, D. Karthikesan1, A.S. Mustafa1, S.S Gian Singh1, J.N. Lim2, A.S. Saad1, 1 1 YOUNG1 1 1 1 1 1 A.F. Mohd Ezanee , Y.Z. Cheng , G.J. Mathews , S.F. TAN , R.H. TAN , H.A. Keya Nordin , A.S. Abdullah ,S. Krishinan 1Department of Cardiology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia 2Department of Medical, Hospital Pulau Pinang, Malaysia Imaging INVESTIGATOR YIA 4 Time: 1125-1140 Utility of 2-Dimensional Speckle-Tracking Echocardiography to Predict Severity of Coronary Artery Disease in Patients With Non ST-Elevation Acute Coronary Syndrome and Apparent Normal Global and SegmentalAWARD Systolic Function K.H.Ho1, Y.Y.Oon1, F.E.P.Shu1, C.T.Tan1, DB.Chandan1, N.Z.Khiew1, Y.L.Cham1, S.Asri2, A.Y.Y.Fong3, T.K. Ong1 1Cardiology department, Sarawak Heart Centre, Sarawak 2Faculty of Medicine and Health Sciences, University Malaysia Sarawak (UNIMAS) 3Sarawak Clinical Research Centre, Sarawak General Hospital Basic Science / Translational Medicine YIA 5 Time: 1140-1155 Stingless Bee Propolis Alleviates Diabetic Cardiomyopathy: Antioxidative Modulation Through esRAGE-AGE Interaction O.Z. Lim1, B.S. Yeoh1, N. Omar*1, M. Mohamed1, A. A. M. Zin2, R. Ahmad1. 1Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia. 2Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia. *corresponding author: [email protected] Imaging YIA 6 Time: 1155-1210 Left Ventricle Function Recovery After Revascularisation in Patients With Acute Myocardial Infarction (Single Vessel Disease): Comparison of 2D Strain Imaging With Standard Echocardiography K.H.Ho1, Y.Y.Oon1, F.E.P.Shu1, C.T.Tan1, DB.Chandan1, N.Z.Khiew1, Y.L.Cham1, S.Asri2, A.Y.Y.Fong3, T.K. Ong1 1Cardiology department, Sarawak Heart Centre, Sarawak 2Faculty of Medicine and Health Sciences, University Malaysia Sarawak (UNIMAS) 3Sarawak Clinical Research Centre, Sarawak General Hospital 27 Date: 13th April 2019 NHAM CONGRESS 2019 Time: 1040-1055 Venue: Ballroom 1 Imaging YIA 1 Global Longitudinal Strain Predicts Adverse Left Ventricular Remodeling After ST-segment Elevation Myocardial Infarction Y.Y. Oon1, K.T. Koh1, K.H. Ho1, C.T. Tan1, F.E.P. Shu1, A. Said1,2, Y.L. Cham1, N.Z. Khiew1, N.H. Mohd Amin1, A.Y.Y. Fong1,3 , T.K. Ong1 1Department of Cardiology, Sarawak Heart Centre 2Faculty of Medicine and Health Sciences, University Malaysia Sarawak 3Clinical Research Centre, Sarawak General Hospital Background Global Longitudinal Strain (GLS), assessed using 2-dimensional speckle-tracking echocardiography, is a sensitive marker of left ventricular (LV) systolic dysfunction. In ST-segment elevation myocardial infarction (STEMI), GLS has been shown to predict adverse LV remodeling. However, its added predictive value over other echocardiographic variables remains uncertain. Objective To determine whether GLS provides additional prognostic value over other echocardiographic variables in patients with STEMI, using adverse LV remodeling as a surrogate endpoint for post-MI mortality. Methods This was a single center, prospective observational study. Patients aged > 21 years who were admitted for STEMI were screened. Recruited patients underwent echocardiography within 48-72 hours of STEMI and at 6 months follow-up. Echocardiography analysis was done offline using TOMTEC system. GLS were measured using TOMTEC AutoSTRAIN©analysis. Adverse LV remodeling was defined as an increase in LV end-diastolic volume (EDV) ≥ 15% over 6 months. Results 94 patients (mean age 53 ±11 years ,93.6% male, BMI 25.8 ±4.0 kg/m2, 45.7% anterior STEMI,37.6% hypertension, 20.4% diabetes, 23.7% dyslipidaemia, 64.5% current smoker) were recruited. 75.3% of patients received thrombolysis, 8.6% underwent primary percutaneous coronary intervention (PCI), and 16.1% had late PCI due to either late presentation or spontaneous ST-segment resolution. Adverse LV remodeling occurred in 32 patients (34.0%). The baseline LV ejection fraction and GLS for patients without versus those with adverse LV remodeling were 51.4 ±9.2% vs. 47.5 ±10.2% (p=0.064), and -13.2 ±4.6 vs. -10.9 ±4.1 (p=0.023) respectively. Univariate analysis showed that septal and lateral e’ velocity, septal a’ velocity and GLS were associated with adverse LV remodeling. In multivariate analysis, only GLS was independently predictive of adverse LV remodeling (HR 1.20, 95% CI 1.06 – 1,35, p=0.004). Using a cut-off of <-12.6, GLS had sensitivity of 71.9%, specificity of 54.8%, negative predictive value of 79.1%, positive predictive value of 45.1% and accuracy of 60.6% in predicting adverse LV remodeling. Conclusions In our study, GLS was the sole echocardiographic parameter that predicted adverse LV remodeling in patients with STEMI. 28 Date: 13th April 2019 NHAM CONGRESS 2019 Time: 1055-1110 Venue: Ballroom 1 Arrhythmias YIA 2 Preliminary Results of Smartphone Electrocardiogram for Detecting Atrial Fibrillation After A Cerebral Ischemic Event: A Multi-center Randomised Controlled Trial KT Koh1, Law WC2, Zaw WM2, DHP Foo3, CT Tan1, D Samuel4, TL Fam4, CH Chai4, ZS Wong4, DB Chandan1,5, JSH Tan5, FEP Shu1, KH Ho1, YY Oon1, NZ Khiew1, YL Cham1, A Said1,6, NH Mohd Amin1, AYY Fong1,3, TK Ong1 1Department of Cardiology, Sarawak Heart Centre, Kota Samarahan, Malaysia 2Neurology Unit, Department of Medicine, Sarawak General Hospital, Kuching, Malaysia 3Clinical Research Centre, Sarawak General Hospital, Kuching, Malaysia 4Department of Medicine, Miri Hospital, Malaysia 5Department of Medicine, Bintulu Hospital, Malaysia 6Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia Background Atrial Fibrillation (AF) is a common and preventable cause of recurrent stroke but it is often undiagnosed and undertreated. Smartphone Electrocardiogram detection of AF has been demonstrated to be accurate and feasible in community screening for AF. However, the utility of this technology for detection of AF after ischemic stroke is unknown. Objective (1) To determine the diagnostic yield of 30-day smartphone electrocardiogram recording compared to 24-hour Holter monitoring for detecting AF≥30 seconds. (2) To determine if a strategy of 30-day smartphone electrocardiogram monitoring results in a change in clinical practice. Methods In this investigator initiated, multi-center, open-label study, we randomly assigned 85 participants in a 1:1 ratio to undergo one additional 24-Hour Holter monitoring (control group) versus 30-day smartphone electrocardiogram monitoring (intervention group) using Kardia Mobile Cardiac Monitor (AlivCor®, Mountain View, CA). Major inclusion criteria included age≥55 years old, without known AF, and ischemic stroke or transient ischemic attack (TIA) within the preceeding 12 months. Seven (8.2%) patients were excluded for various reasons and the final preliminary analysis consisted of 40 patients in the control group and 38 patients in the intervention group. Results Baseline characteristics were similar between the two groups except for more hypertensive patients in the intervention group (94.7% vs 70.0%, p=0.004). The index event was ischemic stroke in 86.5% and 80% in each group respectively (p=0.852). AF lasting ≥30 seconds was detected in 5 out of 38 patients in the intervention group and 0 out of 40 patients in the control group (13.2% vs 0%; absolute difference 13.2%; p=0.024). Number needed to screen to detect one AF was 8. After the 30-day monitoring, oral anticoagulant therapy had been prescribed in 4 out of 38 patients in the intervention group and 2 out of 40 patients in the control group (10.5% vs 5.0%, p=0.425). Conclusions Our preliminary results showed that among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone electrocardiogram recording significantly improved the detection of AF as compared with the standard repeat 24-hour Holter monitoring. However, there was no change in clinical practice in response to detection of AF. 29 Date: 13th April 2019 NHAM CONGRESS 2019 Time: 1110-1125 Venue: Ballroom 1 Arrhythmias YIA 3 Prevalence of Atrial Fibrillation Detected by Single-Lead ECG among Senior Citizens at Northern Regions of West Malaysia in 2018 J.G. Ang1, H. Mohamed Hasnan1, K.R. Narasamuloo1, D. Karthikesan1, A.S. Mustafa1, S.S Gian Singh1, J.N. Lim2, A.S. Saad1, A.F. Mohd Ezanee1, Y.Z. Cheng1, G.J. Mathews1, S.F. TAN1, R.H. TAN1, H.A. Keya Nordin1, A.S. Abdullah1,S. Krishinan1 1Department of Cardiology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia 2Department of Medical, Hospital Pulau Pinang, Malaysia Background Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia encountered in clinical practice.
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