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S28 Heart, Lung and CirculationAbstracts 2008;17S:S1–S34

63COMPREHENSIVE ASSESSMENT OF CORONARYARTERY STENOSES: CT CORONARY ANGIOGRAPHYVERSUS CONVENTIONAL CORONARY ANGIOGRA-PHY AND CORRELATION WITH FFR

N van Pelt 1,2,∗, WB Meijboom 1, C van Miegham 1, NMollet 1, PJ de Feyter 1

1 Middlemore Hospital, Auckland, New Zealand2 Erasmus MC, Rotterdam, The Netherlands

Background: The clinical significance of intermediatecoronary stenosis may be difficult to determine. We eval-uated whether invasive coronary angiography (ICA) andCT coronary angiography (CTCA) can determine the clin-ical significance of intermediate coronary artery stenosis,using invasive fractional flow reserve (FFR) as the goldstandard.

Methods: 70 patients (83 segments, 13 excluded dueto calcification or image artefact) with intermediate coro-nary stenosis who had both FFR measurement and CTCAwere retrospectively identified. FFR of <0.75 measuredafter maximal hyperemia using intravenous adenosinewas defined as a clinically significant stenosis. CTCA wasperformed with a 64 slice CT scanner. Coronary stenosiswere graded both visually (>50% stenosis) and quanti-tatively (Q-CTCA) and compared with invasive coronaryangiography (visual and quantitative assessment (QCA)).

prevalence of anaemia and raised inflammatory markersamong IE patients and to determine whether these simpleand widely available investigations are of additional valuein the initial clinical suspicion of IE in the primary caresetting.

Method: Retrospective chart review of all consecutivepatients diagnosed with IE at Waikato hospital between 1January 2002 and 31 December 2007. Patients who did notmeet Dukes clinical criteria for definite IE were excluded.Anaemia was defined as Haemoglobin < 120 g/L (mild:100–<120 g/L; moderate: 80–<100 g/L; severe: <80 g/L).

Results: A total of 93 patients (73% males), over theage of 16 years, were identified. New-onset anaemiawas found in 72 (77.4%) [Mild: 26.8%; moderate: 31%;severe 19.3%] patients at presentation. At least one raisedinflammatory marker was found in 68 (73%) [C-reactiveprotein > 50 mg/L (56%) or erythrocyte sedimentation rate(ESR) > 50 mm/h (55%) or white cell count > 14 × 109/L(21%)] patients at presentation. Both anaemia and a raisedinflammatory marker were found in 52 (56%) patients.

Conclusion: Anaemia and raised inflammatory markersare common features of IE at presentation. IE should beconsidered if new-onset anaemia and raised inflammatorymarkers are found during the initial assessment of patientswith unexplained febrile or systemic illness.

doi:10.1016/j.hlc.2008.03.065

Results: In 70 segments, mean FFR was 0.84 (S.D. = 0.08)and degree of stenosis 39.6% (S.D. = 13.9) as determined byQCA. Eleven segments had a clinically significant stenosis(FFR < 0.75). The sensitivity, specificity, positive predictivevalue (PPV) and negative predictive value (NPV) for visualCTCA and Q-CTCA to detect clinically significant coro-nary stenosis as determined by FFR was 91%, 46%, 27%and 96% and 56%, 85%, 38% and 92%, respectively. In com-parison, these values for ICA (visual and QCA) to detect aclinically significant coronary stenosis was 50%, 64%, 20%and 88% and 22%, 80%, 15% and 86%, respectively.

Conclusions: In intermediate severity lesions, CTCAand invasive coronary angiography are not able to reliablypredict the clinical significance of a coronary stenosis. Inthis situation functional assessment such as FFR should beused to determine whether revascularization is indicated.

doi:10.1016/j.hlc.2008.03.064

64THE CONTRIBUTION OF NEW-ONSET ANAEMIAAND RAISED INFLAMMATORY MARKERS IN THEDIAGNOSIS OF INFECTIVE ENDOCARDITIS

S Perera ∗, N Wijesinghe, V Mathavan, A Robin, GPDevlin

Department of Cardiology, Waikato Hospital, Hamilton, NewZealand

Background: High level of clinical suspicion is importantfor early diagnosis of infective endocarditis (IE). Diagnosisis often difficult, particularly when IE is not consideredas a possible cause of illness. Our aim was to study the

65INCIDENCE AND AETIOLOGY OF PERICAR-DIAL DISEASE ASSOCIATED WITH PULMONARYEMBOLISM

N Wijesinghe ∗, LW Chan, C Sebastian, HF McAlister, GPDevlin

Department of Cardiology, Waikato Hospital, New Zealand

Background: Pulmonary embolism (PE) and pericardialeffusion (PEF) usually present in isolation. Whilst PE andPEF may occur simultaneously, the frequency is unknown.Our aim was to study the incidence and aetiology of PEFin PE patients.

Methods: All patients who diagnosed with PE by Com-puter Tomographic Pulmonary Angiography (CTPA) from1 January 2000 to 31 December 2007 at Waikato Hospitalwere included in this analysis. Their CTPA reports andechocardiography reports, if performed during the sameadmission, were reviewed for evidence of pericardial dis-ease.

Results: A total of 560 consecutive patients (mean age65.6 ± 8.6 years, 51% men) were diagnosed with PE dur-ing this period—340 were bilateral, 163 right-sided onlyand 57 left-sided only. PEF was detected in 12 (2.1%) ofthese patients while another patient was found to have apericardial mass. Two patients had presented with cardiactamponade and bilateral PE. The aetiology of this com-bination of medical conditions was malignant in 8 (67%),cardiac surgery in 3 (25%) and sympathetic effusion from alarge PE in 1 (8%) patient. The incidence of PEF was higherin patients with bilateral PE [10/340 (2.9%)], and those with