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70 Paravalvular aortic regurgitation after autoexpandibles aortic protheses. Comparison between Edwards-Sapien protheses and Perceval sutureless aortic valve. {#article-title-2} Purpose: The transcatheter aortic valve implantation (TAVI) has proved to be an alternative treatment for severe aortic stenosis in high risk patients. New surgical techniques with autoexpandibles suturless aortic valve protheses have shown good results with a less invasive surgical approach and a reduction in surgical time. The purpose of the study was to compare initial echocardiographic results after aortic valve implantation by both techniques. Methods: We studied 142 consecutive patients submitted to TAVI and 33 patients submitted to aortic valve replacement (AVR) with autoexpandibles sutureless Perceval valves. Clinical and demographic variables were registered and a transthoracic echocardiography study was performed before the implantation and after the procedure or surgery. Maximum and mean aortic gradients were registered as well as the paravalvular aortic regurgitation (AR). The latter was classified in two grades: I= null o mild; II= moderate or severe. Results: The 142 patients submitted to TAVI were diagnosed of symptomatic severe aortic stenosis with a high surgical risk (Logistic EuroSCORE 10,4 ± 7,8), and higher age than the ones submitted to surgery (81,8 vs. 79,8; p=0,005). From the 33 patients submitted to AVR with Perceval protheses, 5 of them (15%) were also performed a coronary artery bypass graft. The incidence of paravalvular AR was grade I (null o mild) in 25 patients (86%), and grade II (moderate or severe) in 4 (14%). In patients with TAVI, 94 of them (69,1%) presented null or minimum paravalvular AR, while in the 42 remaining patients (30,9%) it was grade II, with statistically significant differences between the 2 types of protheses ( p=0,046). Both protheses presented similar aortic gradients in the study after the implantation, without statistically significant differences between TAVI and Perceval protheses in maximum Doppler gradient (20,98 vs. 23,87 mmHg; p= 0.152) and mean gradient (11,16 vs. 13,31 mmHg; p=0.063). The relation between time-velocity integral of the LV outflow tract and aortic valve after the implantation was also similar between both groups (median 0,55 vs. 0,53; p= 0,228). Conclusions: The early echocardiographic study after the implantation of autoexpandible aortic protheses shows comparable results between both types of protheses in terms of gradients, with a higher incidence of paravalvular aortic regurgitation in the group of TAVI. # 71 Exercise echocardiographic determinants of BNP changes during follow-up in asymptomatic patients with aortic stenosis and preserved left ventricular function {#article-title-3} Purpose: B-type natriuretic peptide (BNP) level may be a useful prognostic marker in asymptomatic patients with severe aortic stenosis (AS). Recently updated European Society of Cardiology guidelines recommend its measurement and the use of exercise stress echocardiography to optimize risk stratification in these patients. The goal of this study was to correlate exercise echocardiographic data and BNP changes during follow-up in asymptomatic patients with AS and preserved left ventricular (LV) function. Methods: We studied 61 asymptomatic patients (age: 70±13 years; 64% of males) with ≥ moderate AS (aortic valve area: 0.98±0.25cm2) and preserved LV ejection fraction (69±6%) who underwent resting and exercise Doppler echocardiography with concomitant BNP level measurement at baseline. None of the patients developed symptoms during test. BNP measurement was repeated after at least 6-months follow-up (22±12.5 months; median: 20; range: 7-47 months) and then each 6- or 12-month, according to the individual management. Results: From baseline to the last BNP measurement during follow-up, the distribution of BNP changes was: 65.5±129.5pg/mL; median: 29; range: -104-+675pg/mL. Patients were divided into 2 groups according to the median of serial BNP changes. There were no significant differences regarding clinical characteristics (all p

Background: Resting pulmonary hypertension (PH) is a powerful determinant of poor outcome in patients with systemic scleroderma (SSc). In various cardiac diseases, exercise-induced PH (EIPH) is considered as an early stage of resting PH, and may predict the occurrence of adverse events. We hypothesized that the presence of EIPH is a predictor of the onset of resting PH in patients with SSC. Methods: 33 patients with diagnosis of SSc disease were prospectively submitted to comprehensive both resting and exercise stress echocardiography between January 2009 and November 2012. Resting PH was defined as a transtricuspid pressure gradient (TTG) ≥ 30mmHg, and EIPH as TTG ≥ 40 mmHg Patients were prospectively follow-up and regularly performed resting echocardiography. Results: There was a significant increase in TTG from rest to exercise (21.5±7.7 vs. 37.5±15.2, p