World Heart Congress May 22- 24, 2017 Osaka, Japan

Biography:

Tomasz M Kameczura is an Interventional Cardiologist, Clinician, Inventor, Researcher and University Lecturer. He is also the Founder and CEO of NewTechMed LLC, New York.

Abstract:

Background: The reduction of heart damage and improvement of patient outcome are the main goals in the treatment of myocardial infarction. For both, shortening of time to reperfusion and use of appropriate pharmacological treatment is crucial. Two commonly recognized milestones in this area are the techniques of mechanical reperfusion and new generations of antiplatelet drugs. Restrain of myocardial metabolic activity seems to be possible third way, which may have an impact on myocardial damage especially during the critical ischemia. The use of direct heart hypothermia to reduce myocardial metabolic activity is a very promising tool for reducing left ventricle damage and improve patients prognosis.

Methods: The study is conducted using an animal model. We compared 20 domestic swines (Polish Landrace Pig), 10 in the study group (SG) and 10 in the control group (CG). The animals in both groups were randomly paired by age, sex and body mass. Animals in the CG were sequentially given analgesia, sedation and respiratory therapy. After that we got an arterial access (femoral artery), performed coronarography and by using balloon catheters (BC), we performed inflation in proximal part of  LAD (POBA) (target prox /mid LAD with a diameter of 2.5-4.0 mm behind DG1). After 45 minutes, the balloon was deflated and removed from the LAD. The animal was observed, monitored (if necessary, appropriate medication was given). After 48 hours since POBA, the MRI was performed with assessment of  EF of LV and quantitative assessment of microvascular obstruction (MO). Similarly, in SG the coronary angiography was performed with POBA LAD. After removal of BC from the LAD, a dry puncture of pericardium (pericardial catheter inserted to the pericardial sac) was performed, with subsequent 12 hrs procedure of direct hypothermia of heart (saline 30°C). 48 hours since POBA, there was MRI evaluation made in CG (MRI CG2) with estimation of  EF and MO.

Conclusion: Direct heart hypothermia (DHH) method by METcooler in acute experimental heart ischemia is a viable and safe method in an animal model. Dry pericardial puncture and lowering the temperature in the pericardial sac by applying a closed refrigerant circuit are relatively simple procedures that can be performed if necessary in a regular ER or cardiology department. Preliminary results demonstrate that the DHH may be considered in the future as an additional method to reduce cardiac damage in the course of myocardial infarction. In the future we plan to carry out further researches that will strengthen the position of the DHH as a strategic element of the proceedings in myocardial infarction, TAVI and BAV surgeries, as well as bridging therapy in advanced coronary artery disease before the heart transplant (HTX) and unstable ventricular arrhythmias.

Biography:

Galya Atanasova has completed her PhD training in Cardiology from Department of Cardiology, Pulmonology and Endocrinology at Pleven Medical University, Bulgaria. She is a General Practitioner and Cardiologist in Trainee at Pleven Medical University, Bulgaria. She specialized in General Medicine from Pleven Medical University, Bulgaria during 1993. She has attended many international events and presented her research work. She did many researches on metabolic syndrome and myocardial infarction of heart.

Abstract:

Objectives of this study is to evaluate influence of the metabolic syndrome (MS) and its components on pulse pressure (PP) and apolipoprotein B/apolipoprotein A1 (Apo B/Apo A1). A total of 107 persons without any apparent disease were selected. Among these subjects MS was found in 36. One way ANOVA test, multiple comparison test of means and multiple logistic regression analyses are used. The four groups used in ANOVA are men and women with and without MS. The ANOVA F-statisticis showed 3.683 with p-value 0.0145. The multiple comparison tests showed differences between subjects with and without MS. The first logistic regression includes gender, PP and Apo B/Apo A1. The results showed that the pulse pressure was the more significant factor that contributes to metabolic syndrome for women than for men. The results showed that PP and Apo B/Apo A1 ratio could be used as complex marker for MS, Fig.1. When the pulse pressure was wide and wriest was greater than 102/88 cm (men/women) the odds ratio was above 1. These two factors could be used to diagnose metabolic syndrome. The same conclusion could be made for wide pulse pressure and triglycerides level greater than 1.7 mmol/l. The results showed that PP and wriest or triglycerides level could be used as indicator of MS. In conclusion, wide pulse pressure with some of the considered clinical and biochemical markers could be used to diagnose MS. The results showed that for simultaneously increase of PP with 5 mm Hg and increase of Apo B/Apo A1 with 0.05045 it was expected about 1.5787 times increase in the odds ratio (OR) of MS. The results indicated relation between PP and increase of OR of MS. The increase of OR of MS with increase of PP and Apo B/Apo A1 is obtained. Increase of PP and Apo B/Apo A1 influences cardiometabolic risk.

Biography:

Ashish K Saxena is a Clinical Cardiologist, an alumnus of Christian Medical College, Ludhiana. He has special interest in heart failure, diabetes and thyroid disorder, and is passionate about learning, clinical research and improving the health and well-being of the society. With the aim to attain best knowledge and explore newer frontiers in the treatment of various disorders he drives a passion to teach and make awareness about quality of health and life. This approach is responsive for his easy accessibility and confidence attained by his fellow co-workers and patients associated with him.

Abstract:

Thyroid diseases, both hyperthyroid and hypothyroid have significant profound and clinically relevant findings on the heart that gives rise to various signs and symptoms of cardiovascular disease. There needs to be an understanding of the action of this hormone on the cardiovascular system and it is possible to explain the changes in the cardiac output, contractility, rhythm changes, blood pressure and vascular resistance. Echocardiography is an emerging scientific application that gives a better assay of the cardiovascular haemodynamics and its reversibility on subsequent follow up of patients. Pericardial effusion, heart failure, dyslipidaemia and the complex interrelationship between hypothyroidism and ischemic heart disease can be well established on echocardiography.  Primary pulmonary hypertension a progressive disease leading to right heart failure and premature death is often of unknown origin. Recently, a link to the thyroid disease has been identified and this disease can be kept among one of the differential diagnosis. Diastolic dysfunction and mitral valve prolapse, enlargement of left atrium and atrial fibrillation leading to congestive heart failure can be easily demonstrated by echocardiography. The clinical correlation of the thyroid hormone with the EKG and echocardiography helps to attain a better level of understanding the prognosis of the disease as well as a guide to the morbidity and mortality associated with the disease.

Biography:

Ayman Saleh is currently working as a Professor of Cardiology at Ain Shams University, Egypt.

Abstract:

Background: No reflow phenomenon is associated with major adverse cardiac events, prediction of no reflow using laboratory and noninvasive imaging techniques can help in early prevention and management of this phenomenon.

Objectives: To investigate the predictive value of serum sP-selectin and endothelial dysfunction assessed by using brachial artery flow mediated dilation (FMD)  in patients with STEMI undergoing primary PCI to address patients with high incidence of no reflow.

Methods: The prognostic performance, clinical and angiographic correlates of sP-selectin and FMD was assessed in 96 patients admitted in National Heart Institute and Ain Shams University Hospitals by STEMI and underwent primary PCI as a reperfusion strategy. Each patient was subjected to (history taking, clinical examination, laboratory investigations including withdrawal of serum samples for detection of sP-selectin levels, echocardiography, and assessment of endothelial dysfunction by measuring the FMD, assessment of the angiographic results using TIMI flow grade and myocardial blush grade. Follow up of the patients during hospital stay and after one month for the incidence of MACE.

Results: A significant correlation between patients with high serum sP-selectin and TIMI flow ≤ II was found (P=0.038) and between the serum levels of the sP-selectin and the MBG score (P=0.009), also a significant correlation between the FMD and the MBG score among the study cases (P=0.029) as well as a significant correlation between the FMD and the serum P-selectin level among study cases (P=0.016). There were no statistical significance between TIMI flow grade and brachial artery FMD (P=0.075). Also no significant correlation was found  between the patients' serum levels of sP-selectin, brachial artery FMD  and the incidence of MACE during the hospital stay or during one month of follow up after discharge (P=0.127 and P=0.693, respectively).

Conclusions: Serum sP-selectin level in patients with STEMI treated by primary PCI can predict the patients who will develop no reflow phenomenon after PCI, FMD could not predict the incidence of no reflow among those patients.

Biography:

Cornelia Zara is a Cardiologist at Theracardia, Romania. She has a keen interest in heart failure patients. Her specialties are in Cardiology, Cardiac Ultrasound and Vascular Ultrasound.

Abstract:

Background & Aim: It is well known that the latest concern of medical community is to identify the predictor factors for heart failure decompensations, in order to avoid undesirable hospitalizations. Identification of predicting factors for HF decompensations remains elusive with current clinical (symptoms, congestion score), biochemical (natriuretic peptides) and imaging (left ventricular ejection fraction, LV filling pressures and pulmonary B-lines) parameters. B lines and LV ejection fraction added to NT pro BNP could predict HF patients outcome and re-hospitalization risk. Thus, the aim of this retrospective study was to point out predicting factors for HF decompensations.

Methods & Results: 138 HF outpatients were included with a median follow-up of 24 months. Management was guided by current HF guidelines. Every patient went through a complete clinical exam including 6 MWT, standard transthoracic echocardiography focused on filling pressures parameters and B lines identification by pulmonary ultrasound. Biochemistry included serum creatinine and NT-pro BNP. Mean age of the group population was 70 years and 62% were men. As it concerns the etiology of HF, valvular disease was the most common (46%), followed by ischemic heart disease (33%) or a mix between them (9%). 50% of the patients were in III and IV NYHA class. Thirteen patients (9%) died during follow-up period. The advanced age, low weight, short distance in 6 MWT and advanced NYHA class correlated with death. NYHA class severity correlated with LV EF, ESV, LVOT VTI, the number of B-lines and also with the levels of NT-pro BNP. The number of HF decompensations were linked to the presence of high blood pressure, abnormal creatinine level, low TAPSE and advanced NYHA class.

Conclusion: B lines, LVEF, ESV and NT-pro BNP added to NYHA class approach could reduce re-hospitalizations in HF outpatients. Also, a good control of the blood pressure and renal function could decrease the risk of HF decompensations.

Biography:

Gobinda Kanti Paul has completed his MD in Cardiology and Post-graduation degree from NICVD under BSMMU in January 2008. He has published more than 10 publications in various index journals. He has passion for non-intervention cardiology specially echocardiography and preventive cardiology. Currently, he is an Assistant Professor/Consultant Cardiology and Residential Physician (RP) in the Mymensingh Medical College and Hospital. He also has a special interest in rheumatic fever and rheumatic heart disease and its prevention.

Abstract:

A 7-year old boy was diagnosed with William’s syndrome clinically with the help of some investigations. This child having mal-occlusion of multiple teeth with dental carries, large forehead, small chin, puffiness around both eye, looks like “elfin facies” with low IQ. He has a systolic murmur (Grade-3/6) in the base of the heart. Echo, Doppler gradient found in the just supra-valvular area, 114mmHg (Supra-valvular Aortic stenosis) & MVP (Mitra valve prolapse). This child also has blockage of naso-lacrimal duct, causing watering of eye. William’s syndrome (WS) is a neuro-developmental, multi-system genetic disorder characterized by distinctive personality traits, facial dysmorphisom (“elfin face”) and congenital cardiac defects, of which supra-valvula aortic stenosis is the most common lesion found. It is characterized by congenital heart defects (CHD), Skeletal and renal anomalies, cognitive disorder, social personality disorder and dysmorphic facies. WS is a rare familial multi-system disorder occurring in 1 per 20,000 live births.

Biography:

Jun-Yang Liou has his expertise in molecular signaling in regulating cell proliferation and differentiation. His research interests focus on these areas: (1) Role of 14-3-3 proteins, focal adhesion kinase and their associated downstream targets in cancer cell survival, proliferation, migration as well as tumor progression and metastasis. (2) Molecular mechanisms and signal pathways of 14-3-3 and Rho-ROCK in regulating mouse embryonic stem cell differentiation and proliferation. He has identified that inhibition of ROCK signaling contribute to neural and cardiac differentiation of mouse embryonic stem and induced pluripotent stem cells.

Abstract:

Cardiac and hematopoietic stem cells (HSCs) derived from embryonic ES cells are unlimited cell source and are potentially used for cell transplantation of various heart and hematological diseases. Rho-ROCK signaling was implicated in regulating differentiation of various stem cells. Rho-associated kinase (ROCK) plays an important role in maintaining embryonic stem (ES) cell pluripotency. However, whether ROCK involves in modulating mesodermal differentiation including cardiac stem/progenitor cells and HSCs remains unclear. To determine whether ROCK is involved in ES cell differentiation into cardiac and hematopoietic lineage, we evaluated the effect of ROCK inhibitors, Y-27632 and fasudil on murine ES and induced pluripotent stem (iPS) cell differentiation. Cells were cultured in hematopoietic differentiation medium in the presence or absence of ROCK inhibitor and colony formation as well as markers of HSCs and ES cells was analyzed. ROCK inhibition resulted in a drastic change in colony morphology accompanied by loss of HSC and expression of cardiac progenitor cell markers. Fasudil-induced cardiac cells were infused into a murine myocardial infarction model. They preserved left ventricular function. These findings provide new insights into the signaling required for ES cell differentiation into cardiac lineage or HSC and suggest that ROCK inhibitors are useful in directing iPS cell differentiation into cardiac progenitor cells for cell therapy of cardiovascular diseases.

Biography:

Carola Y Förster has a convincing track record in Neurophysiology with a strong focus on the dysfunctions of the blood-brain barrier (BBB). A significant aspect of her research is related to regulation of gene expression at the BBB, specifically by non-coding RNA, particular microRNA, to offer pharmacological solutions to the observed BBB alterations. For this, CF systematically studies the mechanisms from gene regulation, through transcription, to protein degradation and cellular morphology, linking basic science with clinical aspects. After years of experience in research, evaluation, teaching and administration both in hospital and education institutions, CF developed different in vitro and in vivo models of cerebrovascular disease and established recently a division of computational model to further strengthen this area of research.

Abstract:

Statement of the Problem: Cardiovascular diseases are the main cause of death worldwide. Aging populations show higher incidences of myocardial infarction, heart failure and stroke. MicroRNAs (miRs), a group of non-coding RNAs involved in mRNA regulation, have been demonstrated to play a role in many cardiovascular disorders. Blood-brain barrier (BBB) integrity is one of the important elements of central nervous system (CNS) homeostasis. Studies on regulators of BBB-physiology in health and disease may lead to new therapeutic strategies in cardiovascular system.

Methodology & Theoretical: An overview of the newest literature considering the miRs and their role in cardiovascular system will be given. In vitro and in vivo models for studying these regulations will be presented with methodological details.  An example of experimental work on brain microvascular endothelial cells and an experimental stroke model will be presented.

Orientation Findings: MiR-132/212 has been identified to be increased in hypoxic brain micro-vascular endothelial cells from mouse and humans. Specific targets of these miRs have been identified and studied for their miR-132/212-mediated regulation in vitro. In addition, in vivo inhibition of miRs has been examined in experimental stroke model. Cerebral capillaries were isolated from the control and hypoxic group. The selected target genes were also regulated by miRs in vivo. Inhibition of miRs in experimental stroke led to a decreased apoptosis of hippocampal neurons, as shown by TUNEL staining. However, there was no effect on lesion size and functional outcome.   

Conclusion & Significance: Elucidating the role of miRs in cardiovascular system may open new avenues for therapies and drug delivery.

Biography:

Abstract:

Biography:

Beder Gustavo Farez has completed his Medical studies at Universidad Nacional de La Plata, and has done Post-doctoral studies at Fundación Favaloro in Argentina, Hospital Universitario San Carlos, Madrid, Spain. He is a Professor of Medical Clinic and Physiology at Universidad Católica de Cuyo.

Abstract:

Heart failure with preserved ejection fraction is the most common kind of presentation of this syndrome in the office and laboratory of echo; and it is not easy to define whether the symptoms come from diastolic dysfunction. The patients frequently have comorbidities such as lung disease, anemia, and so on, thus the challenge is to detect the real origin of the symptomatology. There are many techniques to study the diastolic function, some are old and some are new, and most of them can be useful. Unfortunately, not all echo laboratories have machines with emerging techniques, so the results should be very well thought of. The general practitioner’s interpretation is a very important issue, which affects the physician’s treatment decision, and cardiologists often do not keep this in mind. In the echo results there are a lot of numbers, formulas, and conclusions that sometimes are confusing and do not help GPs to guide the treatment. Reports have to include the hemodynamic state, fluids, cardiac index, pulmonary artery pressure, filling pressure, and other data that can improve the treatment of patients. The aim of this presentation is to help GPs take advantage of all the information supplied in echo reports, since echocardiograms are becoming one of the most important complementary studies to evaluate patients with systolic and/or diastolic heart failure.

Biography:

Bambang Budiono has his expertise in Interventional Cardiology for 15 years. He has a lot of clinical experience and involved in some international registration and trials. His interest and expertise in interventional cardiology is well known, which make him invited as faculty in a lot of regional and international meetings.

Abstract:

Statement of the Problem: The aim of using thrombus aspiration in STEMI is preventing distal embolization. Routine use of thrombus aspiration for STEMI has been down grade in recent guidelines from class IIA to Class IIB, and even class III, due to lack of benefit regarding cardiovascular endpoints, and evidence of harm as suggested by the increased risk of stroke. However, in total study there are only 64% with TIMI 0 flow in initial angiography, and 8% without evidence of thrombus. Therefore, in STEMI patients with heavy thrombus burden, or with TIMI-0 flow, the usefulness of thrombus aspiration needs to be evaluated.

Methodology: A prospective non randomized study was conducted with 36 STEMI patients with TIMI 0 flow in initial angiography.  Adult patients (≥18 years of age) with STEMI were eligible for inclusion in this study if they were referred for primary PCI within 12 h of symptom onset. Patients who had undergone previous coronary artery bypass surgery or had received fibrinolytic therapy were not eligible. All participants provided written informed consent. 6 Fr. Compatible thrombus aspirations were used in all of patients.

Result: Final angiography after stenting, demonstrated 34 patients (94.4%) with TIMI 3 flow and 32 (88.89%) patients with TIMI Myocardial Blush Score 3. 2 (5.56%) patients with TIMI 2 flow and TIMI myocardial blush Score 2. 2 Patients (5.56%) with TIMI-1 flow and Myocardial blush score 1. 6-month clinical evaluation, showed no evidence of stroke or repeat revascularization, but 2 patients (5.56%) showed recurrent hospitalization due to heart failure.

Conclusion: In STEMI with TIMI-0 flow, it is unable to recognize the amount of thrombus distal to the occluded vessel. Thrombus aspiration should be used in STEMI patients when the heavy thrombus burden is suspected, to reduce the risk of distal embolization that leads to micro-vascular obstruction. This preliminary study demonstrated potential benefit of thrombus aspiration in STEMI patients with TIMI-0 flow. Further study needs to confirm this preliminary result.

Biography:

Kavya Pingali has completed her MBBS at Siddhartha Medical College, Vijayawada. Subsequently, she obtained her MD in General Medicine at Guntur Medical College and DM Cardiology at Osmania Medical College, Hyderabad. She is currently a Senior Resident at Government Hospital, Guntur. She has an apt adroitness in performing coronary interventions. She had done multifarious coronary interventions independently, with a high success rate and a negligible number of complications. Moreover, she has a finesse to perform device closures for ASD and VSD and to implant the prosthetic heart valves.

Abstract:

Background: Implantation of prosthetic cardiac valves to treat hemodynamically significant valvular diseases has become common; however it is associated with complications. Thus this study was intended to evaluate the indications for implantation of prosthetic valve and complications after its implantation and prognosis after treatment of one of its complication, i.e., stuck valve.

Methods: This was a single-centered study wherein 50 patients who came to the emergency department with stuck valve were assessed. The 2D echocardiography was performed in all patients. Thrombolysis was done and the gradients were reassessed; further, response to treatment and development of complications before and after treatment were observed.

Results: Of total patients, 60% were females; mean age group was 30-40 yrs. Of these 80% presented with shortness of breath, 20% with palpitations, tachycardia was seen in 80% patients, blood pressure was <100/70 mmHg in 80% patients, hemoglobin was <8 gm% in 60% patients, serum bilirubin elevated in 45% patients, most of them were asymptomatic for 6 years and there was lack of compliance in 90% of patients. Drug used was Acitrom (acenocoumarol) 2 mg in 90% patients and drug interaction with digoxin is seen in 4% and INR was less than 1.5 in 25% of patients. Cardiomegaly was observed in 60% and 2D echocardiography showed global hypokinesia in 60% patients. Most common indication for valve replacement was mitral stenosis (60%) followed by mitral regurgitation (20%), aortic regurgitation and aortic stenosis (10%), combined mitral and tricuspid regurgitation (10%). Commonest valve was St. Jude (90%). Pannus was observed in 10% patients and thrombus was observed in 50% patients. Most patients had gradients 45/20 mmHg across mitral valve. In about 90% patients gradients decreased after thrombolysis (12/5 mmHg). The complications after valve placement were hemiparesis (4%), death before thrombolysis (5%) and death after thrombolysis (4%).

Conclusion: In light of these results, it can be concluded that prosthetic valves are seldom associated with some complications. Further, thrombolysis can be effective in patients with prosthetic valve thrombosis.

Biography:

Donglu Shi has received his PhD in Materials Science and Engineering in 1986 from the University Massachusetts at Amherst. He was a PI and Staff Scientist in the Materials Science Division of Argonne National Laboratory between 1988 and 1995. In 1995, he joined the faculty in the Department of Materials Science and Engineering at University of Cincinnati. He is currently the Chair of the Materials Science and Engineering Program at University of Cincinnati. He has so far published 265 refereed SCI journal publications including Physical Review Letters and Nature. He has edited 10 books on superconductivity, functional thin films, nanomaterials, biomaterials, tissue engineering, and nano biomedicine. He is the Editor-in-Chief of Nano LIFE, and Associate Editor of Materials Science & Engineering: C, and J. of Nanomaterials. He has won the Graduate Fellow Award, Excellent Researcher Award, SIGMA XI Research Recognition Award, and Neil Wandmecher Teaching Award.

Abstract:

In this presentation, we report the design of a new nanostructure that ideally satisfies the important biomedical requirements in medical diagnosis and treatment. Quantum dots (QDs) were conjugated on magnetic nano spheres (MNS) of polystyrene-Fe₃O₄ composites. Surface-associated QDs on these MNS exhibited intense visible emissions using fluorescent spectroscopy and successfully facilitated in vivo soft tissue imaging in mice. Furthermore, application of an alternating electromagnetic field effectively induced heating of the MNS into temperature ranges suitable for therapeutic hyperthermia. The magnetic nano spheres were incorporated with PLGA for drug delivery through an emulsion technique. The drug loading efficiency of PLGA-coated MNS were investigated. MNS were also functionalized with antibodies to target a lesion. Experimental results on MNS surface structure development, in vivo imaging, cell targeting, and hyperthermia will be presented. Future requirements, aims, and trends in the development of multi-functional nano particles, including graphene, particularly with intelligent functionalities for fundamental studies, are also given in this presentation.