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

Biography:

Attila Czompa, Pharm D, PhD, is responsible for the preparation of isolated working hearts originated from different types of rodents, and studying molecular signaling mechanisms associated with myocardial ischemia/reperfusion-induced injury. His studies also involve the measurement of ventricular function and myocardial infarct size by determining necrosis apoptosis and autophagy, western blot analysis and immunohistochemistry techniques.

Abstract:

Aims: According to the latest WHO mortality rates, ischemic heart diseases within the cardiovascular diseases are the main cause of death among non-communicable diseases. In the following investigation, we have aimed to test the properties of a nitric oxide (NO) donating acetylsalicylic (ASA) derivative, which is newly synthesized, stable, and water soluble compound at the University of Debrecen, Hungary. Based on our hypothesis this molecule could combine the positive effects of the anticoagulant ASA and the vasodilator effect of NO, therefore, it could be a more powerful medication against ischemic heart diseases.

Materials & Methods: In the first part of our experiments, we have aimed to test in vitro the possible cytotoxic effect of our ASA derivative on the MTT cell viability. H9c2 rat embryonic cardio myoblast cells were cultured in 10^-4–10^{-7 M containing medium. Next, we have measured the vasoactive effects on female Sprague Dawley rats ex vivo according to the Langendorff method in the presence or absence of the NO donating molecule.}

Results: Our newly synthesized NO donating ASA derivative did not affect the cell viability at the tested concentrations. Furthermore, we have noticed a dose-dependent vasodilatation was caused by our NO liberating compound.

Discussion: Based on the beneficial observations through our experimental arrangement, the new molecule synthesized at our University is a powerful vasodilator with no significant toxic effects. It may contribute to new therapeutic approaches against ischemic heart diseases and possibly related syndromes, but the molecular mechanisms need to be clarified.

Biography:

Michiaki Nagai has completed his graduation from the Jichi Medical University School of Medicine and has been engaged in the Cardiovascular Medicine. Using volumetric analysis in MR SPGR imaging, he has been investigating the fields for target hypertensive organ damages including the relationships among hypertension, blood pressure variability, brain atrophy, cognitive impairment and central autonomic nervous system including the insular cortex. He was engaged in the Interventional Cardiology at Hiroshima City Asa Hospital as the Vice Director. He won the Japanese Society of Hypertension Award in the International Society of Hypertension 2006, the Young Investigator’s Award in the 8^th Japanese Neurocardiology Workshop 2007 and Young Scientist Award in the second annual scientific forum of clinical hypertension of the Japanese Society of Hypertension 2013.

Abstract:

Transient left ventricular dysfunction in patients under emotional stress, also known as takotsubo cardiomyopathy, has been recognized as a distinct clinical entity. Recent studies have supported a notion that the cardiovascular system is regulated by cortical modulation. A network consisting of the insular cortex (Ic), anterior cingulate gyrus, and amygdala plays a crucial role in the regulation of central autonomic nervous system in relation to emotional stress such as anxiety, fear and sadness. Because, Ic is located in the region of the middle cerebral arteries, its structure tends to be exposed to a higher risk of cerebrovascular disease. And Ic damage has been associated with myocardial injury, increased brain natriuretic peptide and incidence of takotsubo cardiomyopathy. Because, Ic damage has been associated with increased sympathetic nervous system activity, Ic damage is suggested to have a pivotal role in the pathophysiology of takotsubo cardiomyopathy. We focus on the role of Ic as a mediator for the cardiovascular system in relation to emotional stress, and summarizes current knowledge on the relationships between Ic and takotsubo cardiomyopathy.

Biography:

Ima A Kusuma is a General Cardiologist at “JIH” Hospital Yogyakarta. She has passion in research and statistics. Her last research was effect of different fluids on endothelial glycocalyx in post CABG patients.

Abstract:

Introduction: Cerebral venous sinus thrombosis (CVST) is a rare neurovascular disorder with variable clinical presentation. CVST usually affect young individuals and three times more often in women than men. Mainstay therapy for CVST is giving heparin then continued by oral anticoagulant. However, achievement and maintenance of optimal INR is often difficult. One topic that will most likely be examined in the near future is the role of new oral anticoagulants (NOACs) in the treatment of CVST.

Case Report: A 37 years old woman with history of headache for two months admitted to the hospital with mild right sided weakness. She had dyslipidemia and history of taking oral contraceptives several years ago. On physical exam her vital signs were stable and within normal limits. Cerebral CT scan examination showed normal result, then MRI (MRA-MRV) was performed. MRV showed defect at left sinus tranversus. Patient was given new oral anticoagulant, rivaroxaban. It started at dosages of 15 mg twice daily. On the fifth day follow up, the right sided weakness was revealed. Rivaroxaban then continued for 21 days, followed by rivaroxaban 20 mg once daily. On the third months follow up, there were no complications in this patient.

Discussion: In patients with VTE and atrial fibrillation, NOACs are associated with an approximate 50% relative risk reduction in ICHs compared to warfarin. In neurological patients achievement and maintenance of optimal INR is often difficult. Various modifiable factors including diet, choice of drugs and their dosage are important predictors of stability hence should be carefully adjusted. The Rocket trial documented that rivaroxaban, a novel oral anticoagulant, has a lower rate of most concerning bleeds: fatal bleeding and intra cranial haematoma compared to warfarin, which makes it particularly attractive for the treatment of CVST. In this case, the use of rivaroxaban gave excellent result with no complication.

Conclusion: This case suggests a potential role of novel factor Xa inhibitor in the treatment of CVST.

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:

Aim: We aimed to study the clinical profile, risk factors, angiographic distribution and in-hospital outcomes of patients with complete heart block.

Methods: This was a prospective study which included 100 patients who came to the emergency department with complete heart block. Routine blood investigations including serum electrolytes were done. Coronary angiogram was done and lesions were assessed. Temporary pace maker was implanted followed by permanent pacemakers in required patients, and in-hospital complications were noted down.

Results: Commonest age group was >60 years (75%). The patients were predominately males. Most common presentation was chest pain (60%), followed by shortness of breath (30%) and giddiness (20%); 43% patients were on known hypertensives. Blood pressure at the time of admission was 100/70 mmHg, mean heart rate was around 40 bpm, tachypnoea was observed in 5% patients. Auscultation creps were found in 5% patients, creatinine levels were elevated in 5%, hypokalemia in 15%, echo showed regional wall motion abnormality in 30%. Severe and mild LV dysfunction 15% and 12% patients and good LV function in 3%. Degenerative complete heart block seen in 34% patients, diphtheric myocarditis 15%, hypokalemic 15%, dilated cardiomyopathy 2%. Of total, 53 patients had AV block, 14 had bifascicular block, 23 had LBBB, 6 had RBBB, 3 had mobitz I, and 1 had mobitz II. Inferior wall myocardial infarction (MI) was pervasively present in patients. On coronary angiogram, lesions were found in right coronary artery (RCA) (41%), left anterior descending artery (LAD) (23%), left circumflex artery (LCX) (23%), LCX and LAD (8%) and triple vessel disease (8%). Temporary pacemakers were implanted in 6 patients and permanent pacemakers in 43 patients. In-hospital outcomes constituted of complication like cardiogenic shock (10%) and death (26%). The patients who died either had 80-90% stenosis in RCA, triple vessel disease, ostio-proximal LAD occlusion, or diphtheric myocarditis.

Conclusion: Complete heart block was majorly associated with advanced age and inferior wall MI, virtually caused by dominant RCA occlusion. The in-hospital mortality was significantly higher in the patients with CHB.

Biography:

Evan Hindoro is currently an Internship Doctor at Belitung Timur General Hospital. After he graduated as Medical Doctor in 2016, he embarked to enrich his skills and knowledge in Cardiology by working as Research Assistant at National Cardiovascular Centre Harapan Kita (NCCHK), Indonesia. Beside his responsibility as Medical Doctor, he filled up his days with basic research training and workshop. His credibility in medical research has been proved in several publications in local and international journals. In 2015, his paper “Fractional flow reserves: Nurturing a functional perspective in angioplasty” and “Routine thrombus aspiration in primary percutaneous coronary intervention: Is it still necessary?” have been published in European Heart Journal Supplement. He is currently working on coronary artery diseases registry in Department of Cardiology, Siloam Hospital Lippo Karawaci, Tangerang, Indonesia.

Abstract:

Statement of the Problem: Lipid has been identified as one of the pathogenic factors of atherosclerotic lesion in the last decade, especially coronary artery. Recent lipid guideline recommends the achievement of optimal lipid profile in very high risk patients. The purpose of this study is to support the proposition that serum lipid levels correlate with the severity of coronary artery lesions observed by coronary angiography.

 Methodology & Theoretical Orientation: 180 patients who had undergone coronary angiography were included in this study. Blood samples were taken to undergo lipid profile assessment, including total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL) and triglyceride (TG). New emerging lipid workups comprising atherogenic index (AI) and TG/HDL ratio were also calculated to predict the severity of coronary artery disease. Significant stenosis was defined as a reduction of at least 50% in the coronary artery. Angiographic findings were classified into multi-vessel disease, multi-lesion and extensive lesion. The correlation between lipid profiles and coronary angiography characterizations were analyzed by two ways ANOVA (SPSS 14.0).

Findings: There was significant correlation between lipid parameter level and angiographic findings respectively (multi-vessel disease, multi-lesion and extension lesion) (0.05, 0.001 and 0.001). Both atherogenic index and TG/HDL ratio have significant correlation to severity of coronary artery lesion.

Conclusions & Significance: Dyslipidemia is a significant risk factor in coronary artery disease. Nearly all routine parameters of lipid variables were associated with extent of coronary artery lesion. Atherogenic index and TG/HDL ratio are correlated to coronary angiography findings. As the sample size was small in our study, further large-scale population studies are required on this subject to draw solid conclusions.

Biography:

Dr. Ellahham has served as Chief Quality Officer for SKMC since 2009. In his role, Dr. Ellahham has led the development of a quality and safety program that has been highly successful and visible and has been recognized internationally by a number of awards.

As Chief Quality Officer and Global Leader, Dr. Ellahham has a focus on ensuring that that implementation of this best practices leads to breakthrough improvements in clinical quality and patient safety.

Dr. Ellahham is the recipient of the Quality Leadership Award from the Global Awards for excellence in Quality and Leadership and the Business Leadership Excellence Award from the World Leadership Congress. He was nominated in 2015 for SafeCare magazine Person of the Year. 

Abstract:

Nearly half of all patients with heart failure have a normal ejection fraction (EF). The prevalence of this syndrome, termed heart failure with preserved ejection fraction (HFpEF), continues to increase likely because of the increasing prevalence of common risk factors, including older age, female gender, hypertension, renal dysfunction, metabolic syndrome and obesity. In contrast to heart failure with reduced ejection fraction (HFrEF), no treatment has been proven in pivotal clinical trials to be effective for HFpEF, largely because of the pathophysiological heterogeneity that exists within the broad spectrum of HFpEF. This syndrome was historically considered to be caused exclusively by left ventricular diastolic dysfunction, but research has identified several other contributory factors, including limitations in left ventricular systolic reserve, systemic and pulmonary vascular function, nitric oxide bioavailability, chronotropic reserve, right heart function, autonomic tone, left atrial function, and peripheral impairments. Multiple individual mechanisms frequently coexist within the same patient to cause symptomatic heart failure, but between patients with HFpEF the extent to which each component is operative can differ widely, confounding treatment approaches.

Clinical trials have not yet identified effective treatments for HFpEF. Incomplete understanding of the pathophysiology of HFpEF, the likelihood that there is substantial pathophysiologic heterogeneity among affected patients, and the interplay of various risk factors have all been barriers in the development of effective treatments. Ongoing research initiatives given the rapidly increasing number of patients with this form of heart failure are critically important.

Biography:

Fontaine Guy Hugues has made 15 original contributions at the inception of cardiac pacemakers in the mid-60s. He has identified ARVD by serendipity in the late 70s, published 900 scientific papers including 201 book chapters. He is got place in 3 books: 216 Profiles in Cardiology since the 14^th century (Hurst 2003), 500 greatest Geniuses of the 21^st century (ABI) 2005 USA, the 100 Life time of Achievement (IBC) 2005 Cambridge UK. He is Reviewer of 17 journals both in clinical and basic Science. He has given 11 master lectures in China (2014). He is also working on brain and heart protection in cardiac arrest and stroke by therapeutic hypothermia.

Abstract:

Therapeutic hypothermia produced by evaporation of Per Fluoro Carbon in the fossa nasalis in a flow of oxygen reported in a prospective multicentre study has demonstrated a tendency to improve outcome in out of hospital cardiac arrest . When I saw the experiments on pigs at the Weil Institute of Cardiac Care Medicine (WICCM), I was immediately convinced that another approach of cooling could be abrupt decompression of gas. After multiple experiments, I demonstrated that it was possible to obtain on the same model a drop of brain temperature similar to the work previously reported at the WICCM. This work was presented in a Poster at the EHRA meeting Milano 2015. However, the simultaneous work on infrared images on severed pig heads suggested that it was possible to cool the brain by the decompression of gas inside the mouth instead of the nose which looks to be an even less invasive and faster method on the field. It was during these experiments that my wife watching TV beside me experienced on June 2011 an episode of cardiac arrest that I was able to diagnose immediately. I started Cardio Pulmonary Resuscitation followed by defibrillation performed by an old but still working defibrillator that I kept in the basement of my house when the original study of the method of “Fulguration” was completed. Before arrival of Fire Brigade I used a 900 ml bottle of compressed CO2 gas also available in the basement of my house and delivered the cooling gas at that time in the fossa nasalis. Despite a period of 6 min of no-flow she was able to recover after 5 days of coma with absolutely no neurologic deficit. This fortuitous resuscitation used for the first time for brain cooling by decompressed gas will be used for the first pilot study supported by the Schiller Company (Switzerland). It will start soon in the city of Lugano which is already famous for its highest success rate of resuscitation (50%). The second major interest of this new technique seems to be its application in stroke also suggested by multiple animal models experiments.

Biography:

Tassaniya Kraisornsawat has her expertise in “development in improving the health and wellbeing”. She has built this after years of experience in research and teaching both in hospital and education institutions. Now, she is the Head Nurse of Pediatric Cardiac Intensive Care Unit of Sunpasitthiprasong Hospital, Thailand. She published works particularly on heart diseases.

Abstract:

Vaso-vagal reflex is a significant and common complication in pediatric patients with cardiac catheterization. Vaso-vagal reflex includes several symptoms, such as tachycardia, pressure, lightheadedness, nausea, or cyanosis, are severe threats to cause death. To understand the vaso-vagal reflex among pediatric patients with cardiac catheterization, we conducted integrative literature to review content about nursing with the reflex. We reviewed, analyzed, and synthesized published research and grey literature between 2006 and 2016. Results were found that there were 9 papers related to vaso-vagal reflex among pediatric patients with cardiac catheterization. Overall, content about vaso-vagal reflex in pediatric patients with cardiac catheterization included three aspects. First, it was assessment of disorders and complications. Because pediatric patients with cardiac catheterization experienced changes in emotional and behavioral signs, nurses should concern and focus on these changes. Second, it was nursing to prevent irregularities and complications. Nurses need to care of the pediatric patients to reduce the pain, reducing anxiety and reducing fear. Lastly, it focuses on nursing after disorders and complications. Nurses care for the patients to get drugs or fluids to cause nausea and vomiting. Moreover, they nurse the patients with Trendelenburg position to prevent vaso-vagal reflex. Although there was little paper about the vaso-vagal reflex among pediatric patients with cardiac catheterization, it was the fundamental information to study and develop nursing practice guidelines based on the evidence vaso-vagal reflex in pediatric patients with cardiac catheterization for the future research.

Biography:

Irham Khairi has completed his graduation in Doctor of Medicine at Hasanuddin University, Makassar, Indonesia. Now, he is on duty in a primary care service at a local hospital. He is interested in conducting a study on the cardiovascular scope considering the incidence of cardiovascular disease, especially coronary heart disease, as it still holds quite high incidences in Indonesia, in addition to lifestyle of local people who have not been healthy.

Abstract:

Background: A large amount of literature has discussed the utility of lipid levels as risk factors in the prediction of cardiovascular events in the future. Many lipid and non-lipid biomarkers have been proposed as an indicator of risk factors for cardiovascular diseases. Lipid biomarkers assessed were total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. However, in all studies the major atherogenic lipoprotein LDL is identified by the National Cholesterol Education Project (NCEP) as the primary target of cholesterol-lowering therapy. Dyslipidemia is a disorder of lipoprotein metabolism and included as a risk factor for coronary heart disease (CHD). Dyslipidemia may be manifested through the increase of total cholesterol, LDL cholesterol, triglyceride concentration and lower concentration of HDL cholesterol in the blood. To determine whether clinically lipids are the risk factors for CHD events, a study was conducted at RS Pendidikan Universitas Hasanuddin, Makassar, Indonesia.

Objective: This study aims to determine the frequency distribution of blood lipid levels as a risk factor in the incidence of coronary heart disease (CHD) at the RS Pendidikan Universitas Hasanuddin, Makassar, Indonesia period October 1, 2014 and November 1, 2014.

Methods: This study is a descriptive study design (cross-sectional) that aims to recognize definite lipid levels in the blood as a risk factor for CHD events. Data was taken from the primary data, where researchers visited and conducted interviews of CHD patients and from secondary data recorded on the CHD patient’s medical record, obtained from RS Pendidikan Universitas Hasanuddin, Makassar, Indonesia during the period from October 1, 2014 to November 1, 2014.

Results: The results of this study show the incidence of CHD, patients who were treated in RS Pendidikan Universitas Hasanuddin, Makassar, Indonesia, was most commonly found in men, as many as 17 people (56.7%). CHD patients were obtained highest in the age group 60-69, as many as 12 people (40.0%). CHD patients who have dyslipidemia are as many as 20 people (66.7%). In patients with dyslipidemia, we found the highest levels of lipid as increased triglycerides (TG) in as many as 6 people (20.0%), followed by increased LDL-only in as many as 5 people (16.7%). Patients with coronary heart disease who have comorbidities in which most have hypertension, in as many as 12 people (40%).

Biography:

M Parvaiz Farshori is currently working as a Professor at Department of Physiology, College of Medicine University of Hail, Saudi Arabia.

Abstract:

Introduction: According to WHO 2014 world health ranking survey Saudi Arabia ranks 27^th in coronary heart disease (CHD) related deaths. According to the same survey CHD was also the leading cause of deaths in Saudi Arabia followed by stroke, influenza, diabetes, and the kidney disease (WHO, 2014 survey). Several studies have suggested relationship between inheritance of blood group antigens and certain diseases such as diabetes, cardio vascular disease and cancers. Although many studies have suggested an association between the blood groups and the cardiovascular diseases however results have been inconsistent. For example one study suggests an association between the O blood groups and the increased risks of coronary heart disease, while others show blood group A to be associated with an increased risk CHD.

Aim: Since there are different studies with different conclusions about the association between CAD and the inheritance of AB and Rh (D) antigens, and since it is the leading cause of death in Saudi Arabia, we decided to perform a small study on 120 CHD patients who have had an acute myocardial infarction (MCI) in the recent past and were admitted to King Khaled Hospital (KKH) in Hail region of Saudi Arabia.

Materials & Methods: This study included 329 control and 111 male myocardial infarction patients enrolled at (KKH) Cardiology Department in Hail region of Saudi Arabia. On these patients’ ABO data was collected along with some other risk factors such as diabetes, smoking habits, age, gender, obesity and the family history of CAD. Data was statistically analysed using Z- test for two population proportions.

Results: Out of 329 control male population (age range 12-86, mean age 32.7 years), 3.35% were A^- and 20.7% were A⁺, 3.95% were B^- and 14.28% were B⁺, 2.43% were AB^- and 8.2% were AB⁺, 8.5% were O^- and 38.3% were O⁺. In comparison, when we analysed the blood group distribution among patients with myocardial infarction (age range 16-90, mean age 49.4 years), we found: Out of 111 male patients 0.9% were A^- and 30.6% were A⁺, 1.8% were B^- and 18.01% were B⁺, 0.9% were AB^- and 6.3% were AB⁺, 0.9% were O^- and 40.5.3% were O⁺.

Conclusions: As compared to control group A⁺ male patient show statistically high incidences of MCI and O^- show significantly low incidences of MCI.