The effect of hand fine motor skills on peritoneal dialysis-related peritonitis

INTRODUCTION

We aimed to evaluate the relationship between the hand fine motor skills of peritoneal dialysis (PD) practitioners and PD-related peritonitis.

METHODS

This multicenter prospective observational study was conducted with 120 incident PD patients. Patients were divided into two groups who had PD-related peritonitis within the first year as Group 1, and those who did not as Group 2. Hand fine motor skills were evaluated by Nine-Hole Peg Test (NHPT) and Nut Screwing Test (NST).

RESULTS

Initial NHPT (28.5 ± 6.0 s vs. 25.8 ± 5.0 s, p = 0.011) and NST (82.3 (61.5-102.8) s versus 65.3 (52.3-88.5) s p = 0.023) scores were significantly higher in Group 1 than Group 2. In multivariate logistic regression analysis, NHPT, Body Mass Index, Mini-Mental Test, self PD practitioner, and catheter complications were found to be independent variables in predicting PD-related peritonitis.

CONCLUSION

Decreased hand fine motor skills of PD patients is a risk factor for peritonitis.

P667 Protein supplementation improves left ventricular systolic functions in athletes by 2D speckle tracking echocardiography

Funding Acknowledgements

none

Background

Exercise induced left ventricular remodelling is known for many years. Left ventricular enlargement, hypertrophy, left atrial dilatation are adaptive responsive mechanisms of myocardial tissue to increased physiological demand by exercise. In recent years, strain and strain rate have been used for the assessment of myocardial adaptation in athletes’. In literature, left ventricular and right ventricular deformation is decreased in athletes’, compared to normal healthy individuals. Also left atrial reservoir and contractile functions, which can be measured by speckle tracking echocardiography, decrease in endurance athletes with atrial fibrillation. Athletes have been using protein supplementation frequently in recent years however cardiac effects are largely unknown. There is limited data in the literature about cardiac effects of protein supplementation.

Purpose

In our study, we aim to evaluate the effects of protein supplementation on cardiac functions in athletes with 2D speckle tracking echocardiography. This is the first study in the literature evaluating the effects of protein supplements on echocardiographic parameters.

Methods

Eighty-three athletes (mean age = 29.7 ± 7.9) without history of cardiac disease or other chronic diseases such as hypertension, diabetes mellitus, kidney failure were prospectively included in our study. 73.5% (n = 61) of them were male. Participants were divided into two groups; participants who use protein supplementation regularly was defined as group 1 (n = 33); did not use protein supplementation was defined as group 2 (n = 50). In addition to Standard 2D echocardiographic measurements, left ventricle global longitidunal strain (LvGLS), right ventricle global longitidunal strain (RvGLS), right ventricle free wall strain (RvFWS), left atrium strain and strain rate were analyzed with Vivid E9, offline using a customized software package (Echo Pac for PC, GE Vingmed) (Figure 1).

Results

Diameter of interventricular wall was higher in group 1 (10.1 ± 1.0 vs 9.5 ± 1.2, p = 0.022). Systolic peak ejection velocity of the mitral valve medial annulus is higher in group 1 than group 2 (0.09 ± 0.1 vs 0.08 ± 0.1, p < 0.001). Late diastolic velocity of the mitral valve medial annulus is higher in the group 1 (0.09 ± 0.02 vs 0.08 ± 0.02, p = 0.015). LvGLS which was the indicator of left ventricular deformation was significantly higher in the group 1 (-19.49 ± 1.9 vs -18.45 ± 2.2, p = 0.030). Although RvGLS was higher in the group 1, there was no statistically significant difference (-22.93 ± 4.52 vs -21.07 ± 5.02, p = 0.083).

Conclusion

In recent years protein supplementation usage increases in young adults and athletes. In our study, although there was no statistically significant difference with left ventricular ejection fraction, LvGLS which is the early indicator of LV systolic functions better in the athletes who used protein supplementation. Further studies are needed to evaluate the long term effects of protein supplements on the heart.

P777 Effects of chronic cigarette smoking on left ventricle, left atrium and right ventricle strain parameters with 2D speckle tracking echocardiography

Funding Acknowledgements

None

Background

Cigarette smoking effects myocardium with several mechanisms such as sympathetic nervous system activation, oxidative stress and endothelial dysfunction. Chronic smokers have an increased risk of morbidity and mortality associated with adverse cardiac events. Echocardiography is the well-established non-invasive diagnostic tool for the assessment of cardiac systolic and diastolic functions. 2D speckle tracking echocardiography (STE) has been widely used for this purpose in recent years.

Purpose

The aim of this study is to compare the left ventricle, left atrium and right ventricle systolic functions with 2D speckle tracking echocardiography in chronic smokers and non-smoker healthy population.

Method

40 healthy participant (mean age 33.4 ± 10.0) without smoking history, 42 healthy participant (mean age 33.9 ± 9.2) who had smoking history at least 3 years without history of cardiac disease or any other chronic diseases such as hypertension, diabetes mellitus, kidney failure were prospectively included. In addition to Standard 2D echocardiographic measurements, left ventricular global longitidunal strain (LvGLS), right ventricular global longitidunal strain (RvGLS), left atrial strain and strain rate were analyzed with Vivid E9, offline using a customized software package.

Results

Smokers had lower peak early diastolic velocity (E) and E/A (late diastolic velocity) ratio in mitral inflow (0.70 ± 0.13 vs 0.77 ± 0.13, p = 0.023; 1.47 ± 0.44 vs 1.73 ± 0.44, p = 0.011; respectively). Peak early diastolic velocity of mitral valve medial annulus and E’/A’ ratio (0.11 ± 0.02 vs 0.12 ± 0.02, p = 0.023; 1.20 ± 0.37 vs 1.40 ± 0.46, p = 0.039; respectively) was lower in smokers. LvGLS and RvGLS were significantly impaired in smokers (-17.65 ± 3.01 vs -19.21 ± 2.52, p = 0.013; -18.96 ± 4.47 vs -21.06 ± 4.58, p = 0.039; respectively). Although εs, reservoir phase strain of left atrium; εe, conduit phase strain of left atrium; εa, contractile phase strain of left atrium were similar between two groups, εe/εa was significantly lower in smokers than non-smokers (1.32 ± 0.59, 1.63 ± 0.63, p = 0.026).

Conclusion

Impaired RV deformation was found in chronic cigarette smokers. Besides standardized diastolic dysfunction parameters εe/εa might be used for the early indicator of diastolic dysfunction. Although there was no statistically significant difference with left ventricular ejection fraction between smokers and non-smokers, LvGLS which is the early indicator of LV systolic dysfunction in chronic smokers might be used for the early assesment of LV systolic impairment.

Abstract P777 figure 1