24th International Meeting“Cardiology Today”

5-6 April 2014Hilton Park Hotel

Nicosia, Cyprus

Final Program & Abstracts BookOrganized by:

Cyprus Society of Cardiology

www.cycardio.com

CME points will be accredited to all participants

Πριν τη συνταγογράφηση συµβουλευτείτε την ΠΧΠ

στην ιστοσελίδα του ΕΜΑ www.ema.europa.eu

GR.C

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ΓΙΑ ΠΕΡΙΣΣΟΤΕΡΕΣ ΠΛΗΡΟΦΟΡΙΕΣ ΑΠΕΥΘΥΝΘΕΙΤΕ ΣΤΟ ΕΠΙΣΤΗΜΟΝΙΚΟ ΤΜΗΜΑ ΤΗΣ SANOFI.Sanofi-aventis Κύπρου, Χαράλαµπου Μούσκου 14, Γραφείο 104, 2015 Στρόβολος, Λευκωσία, Κύπρος, Τηλ.: 22871600 - Fax: 22871601

Dear Collegues and Friends,

On behalf of the Organizing Committee of the 24th International Meeting "Cardiology Today," it is with great pleasure that I welcome you to this important event at Hilton Park Hotel in Nicosia. The Meeting will provide the opportunity for a comprehensive overview of the latest developments in Cardiovascular Medicine.

During the Meeting, the participants will have the opportunity to enhance and exchange ideas in an interactive manner on emerging subjects such as the prevention diagnosis, novel treatment, application and adaptation of Guidelines on a national level for the quality of Cardiovascular Care. During the Meeting, delegates will be able to attend sessions with distinguished Cardiologists, world class experts in the �eld of cardiology, including lectures, round table discussions, interactive sessions and satellite symposia.

The Organizing Committee and Faculty have tried to formulate a superb Scienti�c Programme that will o�er both state of the art knowledge as well as innovative approaches in the rapidly evolving �eld in Contemporary Cardiovascular Medicine.

We welcome each and every one of you in Cyprus, to learn more of the history of the island and at the same time to enjoy the sunny weather and the famous Cypriot hospitality.

Petros AgathangelouPresidentCyprus Society of Cardiology

Organizing Committee:President: P. Agathangelou

MembersL. AntoniadesG.M. GeorgiouI. StephanouM. IoannidesK. MakridesCh. ChristouJ. MoutirisP. Avraamides

L. AnastasiadesA. KazantzisM. AgathangelouE. NicolaidesK. AvraamidesE. Papadopoulos P. Nicolaides

P. KourtellarisG.P. GeorghiouP. GeorgiouK. GiangouE. KleanthousTh. KomodromosP. Zarvos

S. Constantinides Ch. EftyhciouPh. Stylianou

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GENERAL INFORMATION

Duration: The scienti�c program of the meeting will commence on Saturday morning, the 5th of April 2014 and will end on Sunday, 6th of April 2014.

Venue: The meeting will be held at the Hilton Park Hotel in Nicosia. Located in a peaceful neighbor-hood, the hotel is close to many museums, entertainment areas and the Horse Race Club, and is a ten-minute drive from the city center of Nicosia, Cyprus. Larnaca International Airport is a 45-minute drive from the hotel.

Exhibition: The exhibition will be running throughout the duration of the meeting. The exhibition is open to pharmaceutical companies and manufacturers of medical and surgical equipment.

Language: The o�cial language of the meeting is English with the exception of a few presentations which will be conducted in Greek.

Currency: The currency of the Republic of Cyprus is Euro (€).

Climate: Cyprus is the hottest, driest island in the Mediterranean and enjoys more sunshine than any other Mediterranean resort. Hot dry summers from mid-May to mid-September and rainy, rather changeable, winters from November to mid-March are separated by short autumn and spring seasons of rapid change in weather conditions. The average maximum temperature in March reaches about 19°C-20°C on the plains and 10°C on the mountain ranges.

Information and Registration Desk: All participants must register. A Registration Desk will be operating throughout the duration of the meeting. The Registration Desk will also be operating as an Information Desk for any information or assistance participants may require during the meeting. The badge of each participant gives access to all sessions, exhibition and co�ee breaks.

MEETING SECRETARIAT

2 Leonidou & Acropoleos Ave., 2007 Strovolos, Nicosia - CyprusTel.: +357 22713721 - Fax: +357 22869735

E-mail: cycardio@topkinisis.comwww.cycardio.com

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SPEAKERS

CHRISTOS CHRISTOUCardiologist, American Medical Center, Cyprus

COKKINOS V.DENNIS Director Cardiovascular Research at Biomedical Research Foundation of the Academy of Athens, Greece

DEANFIELD JOHNProfessor of Cardiology, Director, National Centre for Cardiovascular Prevention and OutcomesUniversity College London, UK

ELLIOTT PERRYInherited Cardiac Disease Unit, The Heart Hospital, UK

FILIPPATOS GERASIMOSUniversity of Athens, Department of Cardiology, Heart Failure Unit , Greece

FOUSSAS STEFANOSDepartment of Cardiology, Tzanio Hospital, Piraeus, Greece

FRASER ALANProfessor of Cardiology, Wales Heart Research Institute, Cardi� University, UK

HADJIANASTASSIOU G.VASSILISConsultant Vascular & General Surgeon, Director of Transplantation, Nicosia General HospitalProfessor (Hon), St. George’s Hospital Uni. of London Medical School at the University of Nicosia, Cyprus

HINDRICKS GERHARDDirector of the Department of Electrophysiology Leipzig University Heart Center, Germany

HOBBS RICHARDProfessor of Primary Health Services, Director NIHR English School of Primary Care Research, UK

KARAMFILOFF KIRILBoard of Trustees, Bulgarian Society of Cardiology, National coordinator for the Stent for life program, Bulgaria

KOURTELLARIS PANTELISCardiologist / Electrophysiologist, American Medical Center, Cyprus

LINHART ALESChair of Complex Cardiovascular Center, Head of 2nd Department of Internal Cardiovascular Medicine, General Universal Hospital in Prague, Czech Republic

NEDOSHIVIN ALEXANDRSecretary General of the Russian Society of Cardiology, Russia

PAPADEMETRIOU VASILISProfessor of Cardiology Georgetown University , U.S.A.

PAPADOPOULOS DEMETRISCardiologist, Cyprus

VARDAS PANOSPresident of the European Society of Cardiology, Greece

VASILEIADIS IOANNISAthens Euroclinic, Greece

ZAMORANO JOSE Head of Cardiology, University Hospital Ramon y Cajal, Spain

MEETING PROGRAM

Saturday, 5 April

8:00-9:00 – Registrations

8:30 -10:00 – ORAL PRESENTATIONS

(1) Προοπτική μελέτη καταγραφής περιστατικών δια-καθετηριακής εμφύτευσης αορτικής βαλβίδας (CYPRUS TAVI Registry): άμεση έκβαση και βραχυπρόθεσμα αποτελέσματα 30 ημερώνΓιώργος Μ. Γεωργίου1, Χρήστος Ευτυχίου1, Χριστίνα Χ’Λουκά2, Σαβέριος Χουρρης3, Άρης Χ’Γρηγορίου, Μιχάλης Μυριανθεύς1, Γρηγόριος Σιμαμονιάν1, Μάριος Ιωαννίδης1, Μιχάλης Μαϊμάρης4, Χρυσόστομος Κόκκινος4, Ευαγόρας Νικολαϊδης1

¹Καρδιολογική Κλινική, ²Μονάδα Εντατικής Θεραπείας, ³Αναισθησιολοκή Κλινική, 4Καρδιοχειρουργική Κλινική, Γενικό Νοσοκομείο Λευκωσίας

(2) Long-term outcome after coronary angiography and intervention in patients with kidney dysfunctionKalani M1, 2, Ka�an S, Henriksson P, Jacobson SH, Lundman P, Lagerqvist B, Spaak J1Clinical Sciences, Karolinska Institute, Stockholm, Sweden2Cardiology Dept, Cardiac Cath Lab, Ygia Polyclinic, Limassol, Cyprus

(3) Anomalous origin of left coronary artery from right sinus of valsalva. An unusual cause of Sudden Cardiac Death in young peopleMoustra E1, Daniel G1, Nicolaides E2, Basso C3, Antoniades L1,4

1Unit Inherited Cardiovascular Diseases, 2Department of Cardiology Nicosia General Hospital Cyprus, 3Department of Cardiac Thoracic and Vascular Sciences Pathological Anatomy-Cardiovascular Pathology University of Padua Medical School Italy, 1,4Department of Cardi-ology Larnaca General Hospital Cyprus.

(4) Sudden Cardiac Death in two young family members due to Long QT SyndromeDaniel G1, Moustra E1, Nicolaides E2, Charalampous N3, Antoniades L1,4

1Unit Inherited Cardiovascular Diseases, 2Department of Cardiology Nicosia General Hospital Cyprus, 3Forensic Service Cyprus, 4Department of Cardiology Larnaca General Hospital Cyprus.

(5) Cor triatriatum: two cases diagnosed in adolescent.Kontos C, Karvounaris S, Rotos C, Karampetsos V, Stylianou A, Theocharous, Lanara S, Mavrommatis P.Department of Cardiology, Paphos General Hospital.

(6) An unusual case of non-compaction cardiomyopathy associated with coronary artery disease.Karvounaris Stylianos, Rotos Christis, Karampetsos Vasilis, Kontos Christos, Stylianou Ariadni, Theocharous Eroula, Lanara Stavroula, Mavrommatis PetrosDepartment of Cardiology, Paphos General Hospital

(7) Χρήση αμφοτερόπλευρων ΄Εσω Μαστικών αρτηριών στην Επαναιμάτωση του Μυοκαρδίου - Το πρόγραμμα του Γεν. Νοσ. Λευκωσίας.Τάνος, Ε.Ευαγγελάκης, Χρ.Κόκκινος, Μ.Μα'ι'μάρης, Α. Χ”Γρηγορίου, Σλ. Κορνιώτου, Χλ. Γιαπανά, Σ. Χούρης.Χειρ/κη Κλινική Καρδιάς-Θώρακος-Αγγείων, Γ.Ν.Λευκωσίας

(8) Use of the Occlutech Device as a salvage maneuver for the treatment of aortic rupture as a bridge for Surgical aortic arch de-branching before the supra-aortic vessels covered by an endovascular stent graft.Georgios P. Georghiou1, MD, Marinos C. Soteriou1, MD, Savvas Constantinides2, MD, Christos P. Christou2, MD, Christos Georghiades3, MDDepartments of 1 Cardiothoracic Surgery,2 Cardiology and 3Interventional Radiology, American Medical Center, Nicosia, Cyprus

(9) The prevalence of Ischemic heart disease and vascular cerebral disease in the Cypriot population.The frequency of the main risk factors, arterial hypertension, diabetes mellitus, smoking and hypercholesterolemia, and the relationship of each factor with coronary heart disease and strokes in CyprusHeracleous-Moustra H1, Zannetos S2, Pavlakis A.1Cardiologist, 2Cyprus Open University.

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Room: DionysosChairs: Pieros Georgiou, Christos Eftychiou

Room: Ledra A

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Saturday, 5 April

8:00 - 09:00

9:00-10:30

09:00 - 09:30

09:30 - 10:00

10:00 - 10:30

10:30 - 11:00

11:00 - 12:30

11:00 - 11:20

11:20 - 11:40

11:40 - 12:00

12:00 - 12:30

12:30 - 13:30

13:30 - 14:30

14:30 - 16:00

14:30 - 14:50

14:50 - 15:10

15:10 - 15:30

15:30 - 16:00

Registrations

CORONARY ARTERY DISEASE CYPRUS HELLENIC RUSSIAN SOCIETY OF CARDIOLOGY JOINT SESSION Chairs: Georgios M. Georgiou, Savvas Constantinides

Modern treatment of STEMI, Kiril Karam­lo�

Stable angina, pharmacological management: from guidelines to everyday clinical practice, Alexandr Nedoshivin

Acute Coronary Syndrome with co-morbidities, Stefanos Foussas

Co�ee Break

HEART FAILUREChairs: Eleni Kleanthous, Ioannis Stephanou

Recent insights into the pathophysiology and diagnosis of heart failure with normal ejection fraction, Alan Fraser

Advances in device therapy in heart failure patients: an overview, Kiril Karam­lo�

Heart Failure: new perspectives to improve health related quality of life, Alexandr Nedoshivin

The Heart and Renal failure-chicken and the egg, Gerasimos Filippatos

Satellite Symposium

Chair: Petros Agathangelou, Georgios P. Georghiou Stroke Prevention in patients with Non Valvular Atrial Fibrillation: The added value of Novel Oral Anticoagulants, Richard Hobbs

Lunch

ARRHYTHMIASChairs: Pambis Nicolaides, Panayiotis Avraamides, Joseph Moutiris

Atrial �brillation: novel insights into the pathophysiology and new treatment strategies, Gerhard Hindricks Sudden arrhythmic death syndrome: Diagnosis and management of Families,Perry Elliott Ventricular arrhythmias in the young patients: How Benign or how malignant,Pantelis Kourtellaris

Co�ee Break

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16:00 - 17:30

16:00 - 16:30

16:30 - 17:00

17:00 - 17:30

17:30 - 18:30

18:30 - 19:30

19:30 - 20:00

20:00

MEETING THE EXPERTSChairs: Ioannis Kallikazaros, Evagoras Nicolaides, Philippos Stylianou

Catheter-based sympathetic Renal denervation in cardiovascular disease: Drugs Resistance Hypertension, Vassilis Papademetriou

Heart Failure: Update in 2014, Gerasimos Filippatos

Imaging inside the cath lab. Why Aortic Regurgitation is so crucial after TAVI,Jose Zamorano

Satellite Symposium

Chair: Petros Agathangelou, Lakis AnastasiadesAnticoagulation for non - Valvular Atrial Fibrillation: Are the new OACS for everybody?Vasileios Papadimitriou, Demetris Papadopoulos

Opening Ceremony Welcome Speeches:Dr. Petros Agathangelou President of the Cyprus Society of CardiologyDr. Andreas Demetriou, President of the Pancyprian Medical AssociationMr. Constantinos Yiorkadjis, Mayor of NicosiaDr. Gerasimos Filippatos, European Society of CardiologyDr. Philippos C. Patsalis, Minister of HealthH. B. Archbishop of Nova Justiniana and all Cyprus Chrysostomos

Opening of the Exhibition

STATE OF THE ART LECTUREChairs: Petros Agathangelou

Translational cardiovascular research: where we are now, Dennis V. Cokkinos

Dinner

9:00 - 10:00

09:00 - 09:20

09:20 - 09:40

09:40 - 10:00

10:00 - 11:30

10:00 - 10:30

10:30 - 11:00

11:00 - 11:30

11:30 - 12:00

12:00 - 14:00

12:00 - 12:20

12:20 - 12:40

12:40 - 13:00

13:00 - 13:20

13:20 - 13:40

CARDIOMYOPATHIESChairs: Loizos Antoniades, Michalis Myrianthefs

FABRY’s Disease: Diagnostic challenge for the cardiologist, Ales Linhart

Hypertropic Cardiomyopathy in 2014, Perry Elliott

Common Cardiac Issues in Athletes, Ales Linhart

CARDIOVASCULAR IMAGINGChairs: Marios Ioannides, Constantinos Makrides

Targeting the vulnerable CAD Patient: The evolving role of nuclear cardiology and cardiac computed Tomography, Ioannis Vasileiades

New concepts for advanced diagnostic imaging, Alan Fraser

What is the relation between function and anatomy: a new era of multimodality imaging, Ioannis Vasileiades

Co�ee Break

ESC-CSC JOINT SESSIONChairs: Petros Agathangelou, Panos Vardas

Diagnostic evaluation of patients with stable CAD. What do the guidelines say?,Jose Zamorano

New insights in the management of venous thromboembolism, Panos Vardas

Lifetime management of atheroclerosis- investing in your arteries, John Dean­eld

Management of Carotid Artery Stenosis – what is the latest evidence? - The vascular surgeons approach, Vassilis G. Hadjianastassiou

Management of Carotid Artery Stenosis – what is the latest evidence? - The cardiologist’s perspective, Christos Christou

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Sunday, 6 April 2014 Room: Ledra A

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Προοπτική μελέτη καταγραφής περιστατικών δια-καθετηριακής εμφύτευσης αορτικής βαλβίδας (CYPRUS TAVI Registry): άμεση έκβαση και βραχυπρόθεσμα αποτελέσματα 30 ημερών

Γιώργος Μ. Γεωργίου1, Χρήστος Ευτυχίου1, Χριστίνα Χ’Λουκά2, Σαβέριος Χουρρης3, Άρης Χ’Γρηγορίου, Μιχάλης Μυριανθεύς1, Γρηγόριος Σιμαμονιάν1, Μάριος Ιωαννίδης1, Μιχάλης Μαϊμάρης4, Χρυσόστομος Κόκκινος4, Ευαγόρας Νικολαϊδης1

¹Καρδιολογική Κλινική, ²Μονάδα Εντατικής Θεραπείας, ³Αναισθησιολοκή Κλινική, 4Καρδιοχειρουργική Κλινική, Γενικό Νοσοκομείο Λευκωσίας

Εισαγωγή: Η διαδερμική αντικατάσταση αορτικής βαλβίδας (TAVI) αποτελεί θεραπεία εκλογής για ασθενείς με συμπτωματική σοβαρή στένωση αορτικής βαλβίδας που χαρακτηρίζονται ανεγχείρητοι ή υψηλού χειρουργικού κινδύνου.Παρουσιάζουμε τα πρώτα αποτελέσματα της δια-καθετηριακής εμφύτευσης αορτικών βαλβίδων στο Γενικό Νοσοκομείο Λευκωσίας (Cyprus TAVI registry).

Μέθοδος: Το Cyprus TAVI registry συμπεριέλαβε όλους τους ασθενείς που υποβλήθηκαν σε δια-μηριαία, δια-κορυφαία και δια-αορτική αντικατάσταση αορτικής βαλβίδας στο Γενικό Νοσοκομείο Λευκωσίας από το Μάρτιο 2012 μέχρι και τον Ιανουάριο του 2014. Παρουσιάζουμε τα περιεπεμβατικά και τα βραχοπρόθεσμα κλινικά και υπερηχογραφικά αποτελέσματα 30 ημερών.

Αποτελέσματα: Συνολικά 45 ασθενείς υποβλήθηκαν σε TAVI στο πιο πάνω χρονικό διάστημα: 38 δια της μηριαίας προσπέλασης, 5 δια της κορυφαίας, ενώ για 2 ασθενείς επιλέγηκε η δια-αορτική οδός. Η μέση ηλικία και το μέσο λογιστικό-EuroSCORE ήταν 79±8 έτη και 21±13%, αντίστοιχα. Το ποσοστό επιτυχίας της επέμβασης ήταν 100% και της συσκευής 97.8%. Η περι-επεμβατική θνητότητα ήταν 6.5% (n=3), ενώ η συνολική θνητότητα 30 ημερών ήταν 11% (n=5). Στις 30 μέρες από την επέμβαση δεν παρατηρήθηκαν μείζονα αγγειακά εγκεφαλικά επεισόδια, ενώ τα μείζονα εγγειακά συμβάντα ήταν 9% (n=4) και αντιμετωπίστηκαν διαδερμικά, μέσα στο αιμοδυναμικό εργαστηρίο. Η ανάγκη εμφύτευσης μόνιμου βηματοδότη στις 30 ημέρες ήταν 4.5% (n=2). Μετά την αντικατάσταση το μέσο δραστικό στόμιο της αορτικής βαλβίδας αυξήθηκε από 0,66±0,15 cm2 σε 1,61±0,43 cm2 και η μέση διαβαλβιδκή κλίση πίεσης μειώθηκε από 51±14 mm Hg σε 10±3 mm Hg, αντίστοιχα. Μέτρια παραβαλβιδική,μετά και από μετα-διαστολή με μπαλόνι, παρέμεινε σε ποσοστό 2.2% (n=1).

Συμπέρασμα: Τα πρώτα αποτελέσματα διακαθετηριακής εμφύτευσης αορτικών βαλβίδων κρίνονται ικανοποιητικά, λαμβάνοντας υπόψη την καμπύλη εκμάθησης της νέας τεχνικής, το προφίλ εξαιρετικά υψηλού κινδυνου των ασθενών, τη προχωρημένη ηλικία, καθώς και την συνύπαρξη σοβαρών συν-νοσηροτήτων. Η διαπίστωση πως τα αποτελέσματα αυτά δεν διαφέρουν ουσιαστικά από εκείνα μεγάλων registries ευρωπαϊκών και άλλων χωρών, αποτελεί εχέγγυο για την ευρύτερη εφαρμογή της.

ORAL PRESENTATIONS – ABSTRACTS

Long-term outcome after coronary angiography and intervention in patients with kidney dysfunction

Kalani M1, 2, Ka�an S, Henriksson P, Jacobson SH, Lundman P, Lagerqvist B, Spaak J1 Clinical Sciences, Karolinska Institute, Stockholm, Sweden2 Cardiology Dept, Cardiac Cath Lab, Ygia Polyclinic, Limassol, Cyprus Aims: Kidney dysfunction remains one of the strongest predictors of outcome after myocardial infarction. We studied long-term prognosis after coronary angiography and percutaneous coronary intervention (PCI) in patients with kidney dysfunction.Methods and Results: We performed a retrospective study using part of the SWEDEHEART registry on 6830 patients performing coronary angiography and PCI at Danderyd University Hospital in Stockholm during 2005-2008. We found 4968 patients (65.9 years, 68% male) with complete records on creatinine. Patients were strati�ed according to glomerular �ltration rate (GFR) using the MDRD formula. Long-term mortality (up to 5 years) was studied using Cox regression. Compared to patients with GFR ≥60, the group with GFR 30-59 ml/min had a survival of 0.33 (unadjusted; con�dence interval 0.27-0.42; p<0.0001). 168 patients with GFR 30-59 ml/min received a bare metal stent (BMS), and 109 received a drug eluted stent (DES). After adjusting for age and diabetes mellitus, DES was associated with a reduced risk of death (hazard ratio 0.43; con�dence interval 0.19-0.97; p<0.05).Conclusion: Moderate kidney dysfunction is a strong risk factor for long term mortality after PCI. The use of DES in patients with stage III kidney dysfunction is associated with a signi�cant reduction in long term mortality.

Anomalous origin of left coronary artery from right sinus of valsalva. An unusual cause of Sudden Cardiac Death in young people

Moustra E1, Daniel G1, Nicolaides E2, Basso C3, Antoniades L1,4

1Unit Inherited Cardiovascular Diseases, 2Department of Cardiology Nicosia General Hospital Cyprus, 3Department of Cardiac Thoracic and Vascular Sciences Pathological Anatomy-Cardiovascular Pathology University of Padua Medical School Italy, 1,4Department of Cardiology Larnaca General Hospital Cyprus. Introduction: Coronary artery anomalies are reported in 1.3% of patients undergoing coronary angiography and may be associated with sudden death, myocardial ischemia, arrhythmia and syncope. Some anatomic presentations of coronary anomalies are considered to be high-risk group. However, many patients were asymptomatic before their presentation of sudden cardiac death (SCD).Case Report: We present a case of SCD in a young boy age 13. At age 12, he presented an episode of syncope during preheat time before exercise with head injury. He was fully investigated that time including ECG, Echo, Stress test, Holter and EEG without abnormal �ndings. Since that time he was follow up without any other episodes. He continue his sport activities without any complains. The following year, while waiting to start a Taekwondo game he collapsed on the �our without pulse and respiration. At the hospital where he was transferred he was found dead. From family history he has two twin brothers age 20 and a sister age 14. One of his twin brothers was investigated in the past because of fainting episodes probably “vasovagal”.At post mordent examination the heart was 200 gr without any histological abnormal �ndings. An anomalous origin of the left coronary artery from the right sinus of valsalva was observed with an interarterial course between the aorta and the pulmonary artery. Conclusions: Congenital coronary artery abnormalities with origin from the wrong sinus are not uncommonly associated with sudden cardiac death in young and young athletes. The catastrophic event probably provoked by myocardial ischemia. The acute angle take-o� and kinking of the coronary artery as it arises from the aorta, compression of the anomalous coronary artery between the aorta and pulmonary trunk during exercise and spasm of the anomalous coronary artery are the potential mechanism to explain the myocardial ischemia and SCD.

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Sudden Cardiac Death in two young family members due to Long QT Syndrome

Daniel G1, Moustra E1, Nicolaides E2, Charalampous N3, Antoniades L14

1Unit Inherited Cardiovascular Diseases, 2Department of Cardiology Nicosia General Hospital Cyprus,3Forensic Service Cyprus, 4Department of Cardiology Larnaca General Hospital Cyprus. Introduction: Long QT syndrome is one of the leading cause of sudden cardiac death in young otherwise healthy individuals. Congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by a prolongation of the QT interval at basal ECG and by a high risk of life-threatening arrhythmias. The two cardinal manifestations of LQTS are syncopal episodes, that may lead to cardiac arrest and sudden cardiac death and electrocardiographic abnormalities, including prolongation of the QT interval and T wave abnormalities. Case Report: We present two cases of SCD in two young family members, age 11 and 12. A young boy age 12 died suddenly at home while was playing Play Station. Past medical history was negative. Routine medical examination two years ago including ECG was reported without abnormal �ndings. From family history his niece age 11, died suddenly two years ago. Post mordent examination and histopathological examination did not show any abnormal �ndings. From family screening a borderline QT interval was observed on his mother ECG. For that reason genetic testing was performed for Long QT syndrome. A mutation V16671/g983006>a of SCN5A gene was found in her mother DNA sample. The same mutation was detected from para�n blocks histological tissue in both SCD young victims. This mutation has been associate with Long QT Syndrome.Conclusions: Long QT Syndrome is a major cause of SCD in children and young adults. According to HRS/EHRA Expert Consensus Statement on the State of Genetic Testing for the Channelopathies and Cardiomyopathies, if postmortem genetic testing were performed routinely, it is estimated that 25% to 35% of SCD cases from age 1 to 35 years and up to 15% of SIDS cases may be due to mutation(s) in one of the known channelopathy-associated genes. Intense cardiac testing of the SCD decedent’s living �rst-degree

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Cor triatriatum: two cases diagnosed in adolescent.

Kontos C, Karvounaris S, Rotos C, Karampetsos V, Stylianou A, Theocharous E, Lanara S, Mavrommatis P.Department of Cardiology, Paphos General Hospital. Introduction: Cor triatriatum (CT) is an extremely rare congenital cardiac anomaly (0.1% of congenital heart diseases) characterized by a �bromuscular membrane with an ori�ce of varying diameter, separating the left atrium –sinister- (CTS) or right atrium –dexter- (CTD) into two chambers. The clinical manifestations depend on the size and number of the defects within the separating membrane and the presence of other cardiac anomalies. We report two cases of incomplete CT diagnosed during adolescent.

Case1: A 18 year old male was referred for chest pain. Cardiovascular exam revealed a mild diastolic murmur. Echocardiographic evaluation (2-D, 3-D, TOE) revealed the presence of a membranous band in the left atrium without obvious obstruction by Doppler �ow measurements (Figure 1). Based on these �ndings the diagnosis of CTS was con�rmed.

Case 2: A 13 year old boy was referred for evaluation due to pectus excavatus. Physical examination was unremarkable. Echocardiography (2-D, 3-D, TOE) showed an incomplete membrane divided the right atrium into two chambers (Figure 2). Colour and pulsed Doppler showed a turbulence �ow across the two portions of the right atrium, without a signi�cant gradient, expressing an incomplete CTD. Moreover, a bicuspid aortic valve (BAV) was noted (Figure3). Diagnosis was con�rmed by cardiac MRI.

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Fig1: Cor triatriatum sinister Fig2: Cor triatriatum dexter Fig3: Bicuspid aortic valve

Conclusion: We present two cases of CT, a very rare congenital anomaly. The second one described here is unique, because of the combination of CTD and BAV. Despite our e�orts, we failed to �nd a similar case in the available literature.

An unusual case of non-compaction cardiomyopathy associated with coronary artery disease.

Karvounaris Stylianos, Rotos Christis, Karampetsos Vasilis, Kontos Christos, Stylianou Ariadni, Theocharous Eroula, Lanara Stavroula, Mavrommatis PetrosDepartment of Cardiology, Paphos General Hospital Introduction: Non-compaction cardiomyopathy (NCC) is a rare disease characterized by the presence of extensive myocardial trabeculation and deep intertrabecular recesses. It is accompanied by heart failure, systemic embolism and ventricular arrhythmia. Although, its association with coronary artery disease is very rare.

Case presentation: A 71-year-old man, who travelled a week earlier, hospitalised due to pneumonia. Ten days later he developed acute dyspnoea, tachypnea and hypotension. Clinical examination was unremarkable. ECG showed sinus tachycardia and new RBBB suggesting severe pulmonary embolism. Initial ECG had QS in precordial leads compatible with «old» myocardial infarction. Urgent CT-scan con�rmed clinical diagnosis of pulmonary embolism. In addition, a de�cit in left ventricular apex was noted. Echocardiography revealed dilated left ventricle, severely reduced ejection fraction, two large thrombus and near normal right cavities (Figure 1). Thrombolysis was avoided and patient treated with LMWH, oxygen and inotropes. After stabilization a more detailed echocardiogram (contrast, 3D) showed typical �ndings of NCC (Figure 2). Coronary angiogram showed extensive obstructions, despite the absence of risk factors, and he underwent CABG. ICD implantation was also suggested.

Conclusion: We described a case of NCC associated with complex three-vessel coronary artery disease. To the best of our knowledge, this combination is extremely rare. The coincidence of massive pulmonary embolism and clots in left ventricle made management more challenging.

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Χρήση αμφοτερόπλευρων ΄Εσω Μαστικών αρτηριών στην Επαναιμάτωση του Μυοκαρδίου - Το πρόγραμμα του Γεν. Νος. Λευκωσίας.

Τάνος, Ε.Ευαγγελάκης, Χρ.Κόκκινος, Μ.Μα'ι'μάρης, Α. Χ”Γρηγορίου, Σλ. Κορνιώτου, Χλ. Γιαπανά, Σ. Χούρης.Χειρ/κη Κλινική Καρδιάς-Θώρακος-Αγγείων, Γ.Ν.Λευκωσίας

Σκοπός της ανακοίνωσης, είναι η παρουσίαση στην καρδιολογική κοινότητα του σύγχρονου προγράμματος στον τομέα της επαναιμάτωσης του μυοκαρδίου με την χρήση και των δυο ΄Εσω Μαστικών Αρτηριών(IMA).Με τον αυξανόμενο αριθμό στεφανιαίων περιστατικών που αντιμετωπίζονται στην κλινική μας τα τελευταία χρόνια, ξεκίνησε και το πρόγραμμα χρήσης των δυο IMA, σαν ποιοτική αναβάθμιση στην αντιμετώπιση της στεφανιαίας νόσου.Η μέθοδος αυτή της επαναιμάτωσης, χρησιμοποιείται παγκοσμίως από 15ετιας με συνεχή εξάπλωση και αδιαμφισβήτητη καθιέρωση της ως η καταλληλότερη επιλογή στην επαναιμάτωση του μυοκαρδίου, ιδίως την αρ. κοιλία.Από την 1/7/2012 έως 31/12/2013 διενεργήθηκαν 567 κρχ επεμβάσεις εκ των οποίων τα 441 ήταν μόνο CABG και 39 ήταν CABG+AVR/MVR.Από τα ανωτέρω, σε 146 ασθενείς (περίπου ένας στους τρεις ασθενείς) χρησιμοποιήθηκαν και οι δυο IMA, με συνήθη περιοχή επαναιμάτωσης την αρ. κοιλία (ένας μόνο ασθενής έλαβε την RIMA-->RCA).Στο μεγαλύτερο ποσοστό αφορούσε νεαρής ηλικίας ασθενείς (μ.ο.59χρ) με max ηλικία 76χρ.Δεν αποκλείστηκαν από το πρόγραμμα ασθενείς με ΣΔ, παχυσαρκία, πολυαγγειοπάθεια ή χρόνια πνευμονοπάθεια.Δίνεται ιδιαίτερη σημασία στην ενημέρωση και προετοιμασία των ασθενών για την μετεγχειρητική τους πορεία, την εκπαίδευση για αποτελεσματική φυσιοθεραπεία αναπνευστικού και στήριξη του στέρνου, καθώς και την επιμελή ρύθμιση του ΣΔ τους.Καθοριστικός όμως παράγοντας αποτελεί ο τρόπος παρασκευής των IMA με απόλυτο σεβασμό στους ιστούς και η επιμελής σύγκλειση της στερνοτομής.Σαν αποτέλεσμα αυτών, από τους 146 ασθενείς που έλαβαν BIMA για CABG, δυο(2) εξ αυτών παρουσίασαν επιφανειακή επιμόλυνση στέρνου, ένας(1) με διάσταση στέρνου, κανένας όμως με μεσοθωρακίτιδα.Καθ’ όλη αυτή την περίοδο της παρακολούθησης τους, μόνο δυο (2) ασθενείς εμφανιστήκαν με στεφανιαίο σύμβαμα που τους οδήγησε σε αγγειογραφία στεφανιαίων. Και στους δυο βρέθηκαν βάτες οι BIMA με αποφραγμένο κάποιο φλεβικό μόσχευμα.Τα αποτελέσματα μας, αν και σε περιορισμένο αριθμό περιστατικών, είναι απόλυτα συμβατά με τις διεθνείς αναφορές και στατιστικές, ενθαρρύνοντας μας στην συνέχιση και ανάπτυξη του προγράμματος της χρήσης των δυο ΄Εσω Μαστικών Αρτηριών στην επαναιμάτωση του μυοκαρδίου.

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Use of the Occlutech Device as a salvage maneuver for the treatment of aortic rupture as a bridge for Surgical aortic arch de-branching before the supra-aortic vessels covered by an endovascular stent graft.

Georgios P. Georghiou1, MD, Marinos C. Soteriou1, MD, Savvas Constantinides2, MD, Christos P. Christou2, MD, Christos Georghiades3, MDDepartments of 1Cardiothoracic Surgery,2 Cardiology and 3 Interventional Radiology, American Medical Center, Nicosia, Cyprus

Aortic rupture after surgical repair for mycotic aneurysm is rare complication, but one with very high mortality. Comorbid conditions and anatomical considerations may preclude surgical re-intervention and endovascular graft repair, respectively. One such patient presented at out institution. The aortic leak was ‘plugged’ using the Occludech devise as a salvage maneuver. The pseudoaneurysm thrombosed, the leak ceased and the patients back pain and hemoptysis resolved. This case demonstrates the feasibility of using PFO/ASD closure devices as an o�-label but life-saving option. It argues for the customization of such devises for the speci�c purpose of ‘plugging’ aortic leaks and in situations where no conventional surgical therapy is an option, they could potentially provide a temporary solution, a bridge until standard treatment does become available.

The prevalence of Ischemic heart disease and vascular cerebral disease in the Cypriot population. The frequency of the main risk factors, arterial hypertension, diabetes mellitus, smoking and hypercholesterolemia, and the relationship of each factor with coronary heart disease and strokes in Cyprus

Heracleous-Moustra H1, Zannetos S2, Pavlakis A3.1Cardiologist, 2 Statistician, Cyprus Open University,3. Assistant prof. Cyprus Open University

Introduction: In the developed and developing countries, as well as in Cyprus, the transition of the health pro�le from infectious diseases to Non Communicable diseases is changing the orientation of health policy. That requires the adoption of policies and actions that will focus on prevention of habits and medical conditions that promote and increase the impact of cardiovascular diseases. Methodology: Statistical analysis of the data collected for the population health research for 2008, released by the statistical service of Cyprus. The selection of the sample was made by means of a random strati�ed sampling. Research data have been analyzed with the method of descriptive statistics and the statistical test of Chi Square test. Results: The prevalence of coronary heart disease found 3,9% in the general population of Cyprus, while the prevalence of Strokes found 1,2% in population. The arterial hypertension found in 16,7% of the population, diabetes mellitus at 5,5%, hypercholesterolemia at 14%, tobacco use showed that 25,2% of the population were daily smokers and 3,4% occasional smokers.In people who had medical history of stroke the prevalence of Arterial Hypertension was found to be 73,5% (P value = 0,000), hypercholesterolemia 49.0% (P value = 0,000), diabetes mellitus 32.0% (P value = 0,000) and 20,2% were daily and occasional smokers (P value = 0,195), 38% P value = 0,604 and only 4,3% of women with Stroke were smokers (P value = 0,088).In people with IHD the �ndings on the prevalence of risk factors were 62,0% for hypertension (P value = 0,000), 25,8% for Diabetes (P value = 0,000), 56.5% for hypercholesterolemia (P value = 0,000) and the preva-lence of smokers were 21,8% daily and occasional smokers (P value = 0,019), 31.9% in men (P value = 0.007) and 5.6% in females (P value = 0.004). Conclusions: The analysis of the �ndings and the information processing de�ne the scope and indicate directions that the therapeutic and preventive health campaigns should based on, in order to reduce the prevalence, and incidence of CHD and Strokes in the population of Cyprus as a large proportion of these diseases are predictable and therefore preventable.

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ACKNOWLEDGEMENTSThe Organizing Committee wishes to thank all the following Organizations for their supportand contribution to the 24th International Meeting “Cardiology Today”:

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O πρώτος από του στόματος άμεσος αναστολέας του παράγοντα Xa

Απλή προστασία για τους ασθενείς σας

ΝΕΟXarelto® ένα δισκίο των 20mg (ή των 15mg για τους ασθενείς με μέτρια νεφρική δυσλειτουργία), άπαξ ημερησίως για την πρόληψη των Αγγειακών Εγκεφαλικών Επεισοδίων στην Κολπική Μαρμαρυγή1

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