23^rd European Heart Disease and Heart Failure Congress February 19-21, 2018 Paris, France

Biography:

Dr. Rafael Otto Schneidewind is a surgeon at the BP Hospital of São Paulo, with his training as a cardiovascular surgeon at Herzzentrum Wuppertal and at the Freiburg Universitäts klinikum in Germany, a specialist in Assist Devices and heart transplants

Abstract:

Statement of the Problem: Patients with cardiac insufficiency with mitral regurgitation number a poor prognosis in the short and medium term, being the therapy for this problem is the replacement or valve repair which takes a  of the frame in the short and medium term. Theoretical Orientation: We have proposed the technique where we construct a Neo ventricle with flexible material inside the left ventricle (Conus) where the native ventricle is kept filling through a Left Atrium Appendage to  Left Ventricular Bypass so that the Left Atrium and the Left Ventricle are double outlet. Findings: The first tests in the Flow Engineering and Hydrodynamics laboratory were very encouraging, we hope to start tests at Animal Lab next year. Conclusion : This technique waits to decrease the Wall Stress of the native ventricle and thus alleviates the La Place Strength in the wall of the ventricle, where theoretically we would improve cardiac remodeling

Biography:

Ms. Phan has completed her MPH at Tufts University, and is currently a 4th year medical student at Virginia Tech School of Medicine. She has a special interest in the Congestive Heart Failure population, and done research and published on the outcomes of LVAD implantation

Abstract:

Heart failure (HF) affects 5 million people in the United States, with almost 80% of cases occurring in patients over the age of 65. Several studies have found that HF is associated with a 2-year mortality rate of approximately 45–50%. Although palliative care can compliment traditional medical management at any stage in HF its role becomes more prominent as patients transition to late stages of HF. There is need to develop and further examine models that integrate symptom guided palliative care interventions with established guideline directed therapies in the advancing HF population. For HF patients with a significantly high disease burden as outlined by the New York Heart Association (NYHA) Stage III/IV there are many under utilized interventions that the Palliative Care Department could use to improve symptom management. This retrospective study will examine whether patients who meet criteria for NYHA Stage III/IV are receiving appropriate services and pharmaceutical interventions for their degree of symptom burden (as measured through use of appropriate anxiolytics, antiemetics, or opioids). Palliative Care intervention will be measured through proxy of implemented DNR orders, and reduced symptom burden measured through reduced Emergency Department (ED) visits from exacerbation of HF symptoms. Hypothesizing earlier palliative care interventions will reduce symptom burden thereby improving quality of life and reducing hospital readmissions. Study group sample sizes will be 61 patients in Group 1 (palliative care intervention group) and 61 patients in Group 2 (control)

Biography:

Jia-Ping Wu has completed his PhD degree from China Medical University and postdoctoral studies from China Medical University and E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. During his Ph.D study, he finished 10 publications since 2012-2015 and 10 projects including my thesis. After published all. he found some subjects that are very interested from this institute. He has been serving as an editorial board member of repute

Abstract:

The aging process is a time-dependent physiological program from birth to elderly. This process has many different molecular biology mechanisms to regulate different aging grade. Indeed, exercise regime or supplementary resveratrol intake can facilitate aging process reversed. However, their combination in the molecular biology interaction is our interesting in this study. We purchased natural aging mice and gene type senescence-accelerated SAMP8 mice. To examine different molecular biology interaction of survival and apoptosis signaling in natural and gene-type senescence-accelerated SAMP8 mice liver after exercise training, supplementary resveratrol intake, or their combination using western blotting. Histological pathophysiology of age-related liver disease was examined using hematoxylin-eosin and Masson's trichrome staining. Apoptosis cells were determined using TUNEL staining. Results showed SIRT-1/AMPK increased induced and Foxo1a/Foxo3a decreased was observed in natural aging after their combination. Upregulation of survival and downregulation of apoptosis was observed in western blotting analysis protein expression levels. In the genetic type of genetic senescence-accelerated mice SAMP8, genetic senescence-accelerated liver cross-section observed adipocytes and collagen. In 3-month-old and 6-month-old genetic type of genetic senescence-accelerated mice SAMP8, combination exercise training and resveratrol intake facilitate PI3K-AKT-ERK1-Bcl2 increased and Bad-Cytochrome c decreased. Combination exercise training and resveratrol intake in the 6-month-old genetic type of genetic senescence-accelerated mice SAMP8 has significant increases in p-PI3K/PI3K ratio (p<0.01), ERK1 (P<0.05), Bcl2 (p<0.0001) and Cytochrome c (p<0.05) compared with 3-month-old SAMP8 mice liver. Exercise training anti-aging function only observed in nature aging but did not find in genetic senescence-accelerated mice SAMP8. Resveratrol intake complementary has good function in natural aging and gene-type SAMP8 mice. Fortunately, their combination has excellently good interaction function in PI3K-AKT-ERK1-Bcl2 increased and Bad-Cytochrome c decreased. We suggest resveratrol intake can help exercise training therapy age-related cardiac disease

Biography:

Prof. Dr.Karan Peepre, has completed  his MBBS,MD,DNM at the age of 32  years from The University of  jabalpur, University of Mumbai and Devi Ahilya University,Indore,India.  He has been  trained in Spect-CT,PET-CT, Nuclear Medicine,Nuclear Cardiology from AIIMS,New Delhi, World number One Emory University, School of Medicine, Atlanta,USA and Nuclear Medicine Centre,BARC,TMC,Mumbai. At present he is  Professor and Head  of Department of  Nuclear medicine and Superintendent of Sultania lady Hospital,Gandhi Medical College,Bhopal,India.he has presented many research  papers & delivered lectures  in national and international conferences and chaired sceintific sessions, He has published more than 15  papers in reputed journals.3-Gold medals are in his credit

Abstract:

In 2015-16  about 40 million people were  globally  affected  by heart failure. In developed countries, around 2% of adults have heart failure and in those over the age of 65, this increases to 6–10%. In the year after diagnosis the risk of death is about 35% after which it decreases to below 10% each year.Heart failure is a common, costly, and potentially fatal condition. Lifestyle changes, such as exercising, reducing salt in your diet, managing stress and losing weight-can improve quality of life. Heart  attack happens when the flow of oxygen-rich blood  to a section of heart muscle suddenly becomes blocked and the heart can’t get oxygen. If blood flow  isn’t  restored quickly, the section of heart muscle begins to die,resulting in to severe weakness and heart failure.Heart attacks most often occur as a result of  corornary heart  disease (CHD), also called coronary artery disease.When plaque builds up in the arteries, called  atheroslerosis. The buildup of plaque occurs over many years.Eventually, an area of plaque can rupture (break open) inside of an artery. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. If the blockage isn't treated quickly, the portion of heart muscle fed by the artery begins to die. Heart failure (HF),signs and symptoms commonly include sweling in legs, shortness of breath, excessive tiredness.Common  casues  are  coronary artery disease(CAD)  including a previous myocardial  infarction (heart attack), fibrillation,alcohol use in excess. Treatments can improve health of patient’s and help live longer

Biography:

Samér Kassem is a cardiac surgeon who works at Centro Cardiologico Monzino, in Milan.
He was born in Siria, where he had spent the first years of his life, between the cities of Latakia and Damascus. His working experience began with General Surgery. During that period he performed a lot of procedures, showing great competence. He then attended the Cardiac Surgery Program and took part to both adult and pediatric surgery. Once he migrated to Italy, he associated with the best trained surgeons at the most specialized centres of the North of the Country. In this way, he improved and refined his skills in both surgical practice and scientific research. Since 2004 he stably operates at Centro Cardiologico Monzino, where he found the excellence in Cardiac Surgery and, most of all, the opportunity to develop new personal surgical techniques in different fields. In fact, doctor Kassem has large and deep experience and knowledge and also a vivid interest in mitral and aortic valve surgery, aortic arch surgery, surgery of the ascending aorta and surgery of left ventricular aneurysms and, finally, coronary surgery. He has recently approached hypertrophic cardiomiopathy and its surgical management.
Kassem is also a talented oil painter. After studying art in Damascus, he has had the possibility to blend two different cultures, the Syrian and Italian one, once he moved to Italy. He had recently performed his last exhibition in an historical place along the Adda river, near Milan, where the “genius” Leonardo DaVinci left important traces of his amazing and all-life-long lasting work

Abstract:

Introduction The Systolic Anterior Motion (SAM) of mitral valve (MV) associated with the asymmetric hypertrophy of left ventricular septum are the two components responsible for left ventricular outflow obstruction (LVOTO) in Hypertrophic Obstructive Cardiomyopathy (HOCM). The transaortic left ventricular septal myomectomy has been proposed as the gold standard surgical procedure for symptomatic patients with severe HOCM since the late 1960s.

Objective We have previously described one technique to prevent SAM post MV repair, the so-called “paradoxical artificial cords to prevent SAM after MV repair”.  The aim of this article is to demonstrate the efficacy of this technique also to treat SAM in HOCM patients, in case of concomitant moderate septal myectomy.

Methods The subjects of the study are 5 patients with both SAM and LVOTO. All of them have been surgically treated, performing moderate transaortic septal myomectomy and correction of SAM by paradoxical artificial cords and ring annuloplasty.   

Results The postoperative course of all patients was regular. No one of them developed the usual complications of this surgery (Ventricular Septal Defect [VSD] or Pacemaker [PM] implantation). Transthoracic Echocardiography TTE has demonstrated good result of the early postoperative interventricular gradient. The MV function was preserved and free of SAM.

Conclusion The paradoxical artificial cords technique could be considered as a valid treatment for SAM in patients with HOCM and LVOTO, if associated with moderate septal myectomy. The combination of these two surgical procedures is particularly important to avoid complications, especially VSD, in patients with a relatively thin interventricular septum, even in presence of hypertrophy

Biography:

Imre Janszky has an MD and a PhD degree from Semmelweis Medical University, Budapest, Hungary and from Karolinska Institutet, Stockholm, Sweden, respectively. He is currently working at the Department of Public Health and General Practice/Medical Faculty/ Norwegian University of Science and Technology as professor in epidemiology. His main focus of research is on risk and prognostic factors for cardiovascular diseases

Abstract:

BACKGROUND:

We analyzed the association between light-to-moderate alcohol intake and the risk of heart failure (HF).

METHODS AND RESULTS:

We studied 60,665 individuals free of HF who provided information on alcohol consumption in a population-based cohort study conducted in 1995-97 in Norway. Sociodemographic factors, cardiovascular risk factors and common chronic disorders were assessed by questionnaires and/or by a clinical examination. The cohort was followed for a first HF event for an average of 11.2 ± 3.0 years. Mean alcohol consumption was 2.95 ± 4.5 g/day; 1588 HF cases occurred during follow-up. The quantity of alcohol consumption was inversely associated with incident HF in this low-drinking population. The risk was lowest for consumption over three but less than six drinks/week; the multivariate hazard ratio when comparing this category to non-drinkers was 0.67 (95% CI: 0.50-0.92). Among problem drinkers based on CAGE questionnaires, total consumption showed no favorable association with HF, even when overall consumption was otherwise moderate. Excluding former drinkers and controlling for common chronic diseases had minimal effect on these associations. Frequent alcohol consumption, i.e. more than five times/month, was associated with the lowest HF risk; the adjusted hazard ratio comparing this group to alcohol intake less than once/month was 0.83 (95% CI: 0.68-1.03). We found no evidence for a differential effect according to beverage type, nor that the competing risks of death from other causes modified the association.

CONCLUSIONS:

Frequent light-to-moderate alcohol consumption without problem drinking was associated with a lower HF risk in this population characterized by a low average alcohol intake

Biography:

Stefan Hindmarsh is a resident doctor working for the NHS in UK. Graduated from Aberdeen University medical school in 2016. President of the Medical Society as well as playing Secretary of the University Golf Team.

During the final year of training, spent time in a New Jersey ER/Trauma Centre where I got experience in pericardiocentesis as well as acute management of cardiac presentations.

While working as a Cardiology resident, he became adept at ECGs interpretation and Echocardiography. His interest is management of acute heart failure, identification and validation of novel factors predicting and/or affecting heart failure adverse outcomes

Abstract:

In this retrospective study, 96 patients admitted with Heart failure(HF) from the most deprived and least deprived tertile of Scottish Index of Multiple Deprivation (SIMD) (1 – 3 – most deprived and 7 - 9 – least deprived).

Between the two groups, no statistical difference exists between age, gender, haemoglobin or creatinine level; nor was there any difference in past medical history or cigarette use. Patients from the lower tertile has higher incidence of alcohol excess (16% vs 3%, p = 0.043) while higher incidence of AF for the higher tertile (55% vs 33%, p = 0.004). Prescription of diuretics, Beta-Blocker, ACE-I or ARB were not statistically different. Patients from higher tertile is more likely to receive aldosterone antagonist (37% vs 17%, p = 0.031) and combined Beta-blocker and ACE-i/ARB treatment (42% vs 21%, p = 0.025).

6-months follow-up demonstrates composite endpoint of heart failure readmission and mortality was statistically higher among patients of lower socioeconomic tertile (p = 0.042). Stepwise multiple regression analysis also confirmed socioeconomic deprivation as an independent predictor for more adverse clinical outcome for heart failure (p = 0.003, R2 = 22%).

Summary: Despite the establishment of universal healthcare, patients from the lower socioeconomic group are less likely to received prognostically beneficial medication and are more likely to be experience readmission for heart failure or death

Biography:

Aljuhara Tha’ar AlMarzoog has completed bachelor degree in nursing in 2012 from King Saud University in Saudi Arabia and currently finalizing Master degree in Medical – Surgical nursing from the same university . Also She is cardiac nurse and works with heart failure team at King Faisal Heart center in King Faisal Specialist hospital and research center – Riyadh 

Abstract:

The prevalence and incidence of heart failure ( HF ) have been increasing dramatically in Saudi Arabia due to of presence of multiple factors such as coronary artery disease , diabetes , hypertension , and valvular disorders . HF syndrome is very complex in its nature and can cause multiple psychological changes such as depression , therefore patients find it difficult to cope with this psychological change either due to social or spiritual factors . This study aims to find correlation between counseling and its effect on depression level among HF patient , and to address gap in knowledge regarding depression level on this group in Saudi Arabia 

Biography:

Abstract:

In approximately 30-50% of the individuals who develop congestive cardiac failure the systolic function as assessed by left ventricular (LV) ejection fraction is either normal or relatively normal.

Study the relationship between left atrial (LA) volume and LV diastolic dysfunction and LV hypertrophy. Correlate LA volume with cardiovascular risk factors.

A total of 60 patients was included in the study. These patients underwent a screening echocardiography to diagnose left ventricular hypertrophy and diastolic dysfunction.

There is a significant correlation between left ventricular hypertrophy and diastolic dysfunction. 79% patients with evidence of diastolic dysfunction by tissue Doppler had a higher left atrial volume.

Increased left ventricular mass is associated with increasing severity of diastolic dysfunction. Increased left ventricular mass is also associated with increased left atrial volume indexed to body surface area. Left atrial volume correlates with the duration of diabetes mellitus. Increasing severity of left ventricular diastolic dysfunction correlates significantly with left atrial volume indexed to body surface area.  At milder degrees of diastolic dysfunction, left atrial enlargement may not be the best predictor of severity. But with increasing severity of diastolic dysfunction in left ventricular hypertrophy, left atrial volume indexed to body surface area may be a sensitive and easy marker for assessment of severity and thus the long term prognosis in terms of atrial fibrillation, stroke and mortality

Biography:

Xiushan Wu completed his PhD from Stockholm University in 1986-1990, postdoctoral studies from Michegan University and etc in 1990-1994 and Scientist in Karolinska Institute in 1994-2000. He is the Director and Professor of The Center for Heart Development, Hunan Normal University. His research focuses on understanding the mechanisms by which embryonic heart is developed using Drosophila, zebrafish and mice as models. He has published more than 350 papers including over 110 SCI papers

Abstract:

The heart is the first organ that forms and functions during embryonic development and is one of the organs most closely related to human health. In the early 1990s, the author was the first to demonstrate that canonical Wnt signaling controls the embryonic heart development using fruit fly model[1], and thus the signaling was introduced into the cardiac development field. Our finding was further proved by other studies with vertebrate models such as Xenopus, zebrafish and mice. Nowadays, Wnt signaling has become one of the most important signaling pathways in the cardiac development field. However, it was found that studies with different animal models and even in the same animal model can lead to opposed findings. For example, the author demonstrated that canonical Wnt signaling promotes cardiac development in Drosophila, while the others showed that it inhibits the heart development in vertebrate[2]. The two contradictory conclusions about the role of canonical Wnt signaling in the regulation of heart development were not solved until 2007[3]. However, in the same year, it emerged as a new paradox that canonical Wnt signaling activates or inhibits cellular aging[4-5]. Here our studies on the unresolved question of canonical Wnt signaling regulation in cardiac aging, and on the novel co-factors of the canonical Wnt signaling for cardiac development will be discussed based on our recent findings

Biography:

Prof. Dr.Karan Peepre, has completed  his MBBS,MD,DNM at the age of 32  years from The University of  jabalpur, University of Mumbai and Devi Ahilya University,Indore,India.  He has been  trained in Spect-CT,PET-CT, Nuclear Medicine,Nuclear Cardiology from AIIMS,New Delhi, World number One Emory University, School of Medicine, Atlanta,USA and Nuclear Medicine Centre,BARC,TMC,Mumbai. At present he is  Professor and Head  of Department of  Nuclear medicine and Superintendent of Sultania lady Hospital,Gandhi Medical College,Bhopal,India.he has presented many research  papers & delivered lectures  in national and international conferences and chaired sceintific sessions, He has published more than 15  papers in reputed journals.3-Gold medals are in his credit

Abstract:

Myocardial perfusion  imaging  uses an intravenously administered  radiopharmaceutical   99mTc-MIBI  to depict the distribution  of  blood flow in the myocardium. Perfusion imaging  identifies areas of relatively reduced  myocardial blood flow associated with ischemia or scar. The relative regional distribution of perfusion can be assessed at rest, during cardiovascular stress, or both. Coronary artery disease is the  leading cause of death worldwide, and very costly in management. Currently, use of  Dual head gamma camera SPECT-CT  modality in cardiac patient’s  is very good,accuarte and  justified   and   provides added  values  with  respect to prognostic, risk stratification, and cost parameters. CT is used for calcium scoring. The three-dimensional images produced by this study are called perfusion images  because  they show which areas of  the heart muscle are perfused, or supplied, with blood.  99mTc-Sestamibi  SPECT acquisition is initiated 30 minutes after isotope injection. During image interpretation, a semiquantitative visual interpretation  is performed    in the apical, midventricular, and basal slices of the short-axis views and   apical segments on the midventricular long-axis slice. Each segment  has  scored using a 5-point scoring  system (0 indicated normal; 1, equivocal; 2, moderate; 3, severe reduction of radioisotope uptake; and 4, absence of detectable tracer uptake in a segment). Stress/Rest MPI is the most accurate test available for diagnosing coronary artery disease (CAD) early in patients who may be at risk for a heart attack. Abnormal perfusion scans are highly indicative of CAD. MPI  show  overall  function of  the heart  walls and  assess damaged   heart muscle following a heart attack

Biography:

Samér Kassem is a cardiac surgeon who works at Centro Cardiologico Monzino, in Milan.
He was born in Siria, where he had spent the first years of his life, between the cities of Latakia and Damascus. His working experience began with General Surgery. During that period he performed a lot of procedures, showing great competence. He then attended the Cardiac Surgery Program and took part to both adult and pediatric surgery. Once he migrated to Italy, he associated with the best trained surgeons at the most specialized centres of the North of the Country. In this way, he improved and refined his skills in both surgical practice and scientific research. Since 2004 he stably operates at Centro Cardiologico Monzino, where he found the excellence in Cardiac Surgery and, most of all, the opportunity to develop new personal surgical techniques in different fields. In fact, doctor Kassem has large and deep experience and knowledge and also a vivid interest in mitral and aortic valve surgery, aortic arch surgery, surgery of the ascending aorta and surgery of left ventricular aneurysms and, finally, coronary surgery. He has recently approached hypertrophic cardiomiopathy and its surgical management.
Kassem is also a talented oil painter. After studying art in Damascus, he has had the possibility to blend two different cultures, the Syrian and Italian one, once he moved to Italy. He had recently performed his last exhibition in an historical place along the Adda river, near Milan, where the “genius” Leonardo DaVinci left important traces of his amazing and all-life-long lasting work

Abstract:

Introduction: According to current guidelines, in patients with valvular heart disease (VHD), cardiac surgery should be considered before severe ventricular dysfunction develops.

Methods: A 67-years old man was referred to us with moderate mitral regurgitation (MR). He was previously diagnosed at Our Centre for arrhythmogenic RV dysplasia (ARVD), managed with transcatheter ablation (TCA) for paroxistical atrial fibrillation (PAF) and an Implantable Cardioverter Defibrillator (ICD) to prevent further malignant arrhythmias.

Results: The preoperative transthoracic echocardiogram (TTE) showed bad RV and preserved LV function. Although the MV wasn’t on time for surgery, we decided to treat the patient to prevent biventricular dysfunction.

The patient successfully underwent mitral valve replacement (MVR), without any attempt to repair the valve, to reduce the time on cardiopulmonary bypass (CPB) and left atrial appendage (LAA) closure.

The postoperative (PO) course was uneventful and the patient was discharged on the PO day 7th.

Discussion: The indication for MV surgery changes in presence of ARVD or RV failure due to other conditions. In normal population, surgery is performed in case of severe MR, as suggested by current guidelines, while in these patients, when the MR is still moderate, we can’t no longer ‘wait and see’. According to our experience, this can be considered the right time to indicate surgery

Biography:

Ramzi EL FEGHALI has completed his PhD at the age of 27 years from Lyon 1 University and attached lecturer, postdoctoral, and young research engineer studies from the University of Versailles, the French National Center of Scientific Research and the French National Institute of Medical Research respectively. Currently he is the Director of Omics & Nanotech and a lecturer of science at private schools. He has published over 10 papers and was a member of the International Society of Computational Biology and the International Society of Clinical Biostatistics and a peer reviewer for Dove Medical Press

Abstract:

 

Metabolic alterations and hypertension are the major risk factors of heart diseases development. Today a panel of 40 biomarkers jointly with clinical markers are used by the cardiologists for the diagnosis of coronary and heart diseases. Some predictive biomarkers are used for the prognostic of the coronary and heart diseases but those biomarkers present a lack of accuracy due to the complex molecular system of the blood, the vessels and the heart. For this reason, I have proposed a new study design coupled to a robust biostatistics analysis in order to select the most relevant predictive protein biomarkers of atherosclerosis and hypertension. Material and methods: The plasma of 30 patients with 6 different phenotypes (hypertension, hypercholesterolemia, diabetes mellitus, stroke/transient ischemic attack, coronary artery diseases  and healthy controls) included by the Utrecht Medical Centre University in Netherlands was profiled with the LC-MS/MS proteomics mass spectrometry technique after the depletion of the major proteins and the digestion of the proteome. A coupled robust comparative statistical analysis allowed to sort the identified proteins and to validate the most discriminative and predictive set of proteins that are under patenting. Conclusion: Twenty robust predictive biomarkers including renin, phospholipases, membrane matrix proteins and an uncharacterized protein were selected after this pilot study as a predictive set of biomarkers for the prognosis of atherosclerosis and hypertension. Acknowledgements: This work has been partly funded with a grant from the French Research Institute for Development of Marseille; the first experiments were realized by the CLinical Innovation Proteomic Platform of Dijon in France

Biography:

DR. ESSAM HAMED AMIN ALI; DBA, MQM, TQM is Professional with strong quality management and Hospital Management, planning and interpersonal skills possessing 26 years of rich experience in the health industry, Experience in JCI with an established hospital."

Abstract:

Total Quality Management (TQM) is not a new concept.

In 1931; W.A Shewhart recognized that variability within Industry production could be understood using the principles of probability and statistics (Schultz, 1988).

Variability is the dispersion exhibited by evaluations of successive events resulting from a common process.

During the 1950’s, Joseph J.Juran tackled the cost of achieving quality and discovered it could be divided into avoidable and avoidable cost (Crosby ,1987).W. Edward Deming, in the 1950’s, asked “Who can put a price on a satisfied costumer, and who can figure the cost of dissatisfied one?”(Strickland, 1989).

TQM is just a program but an active corporate strategy to optimize resources and reduce inefficiencies, rework cost and costumer complaints.

TQM seeks to raise the collective vision of quality and change the focus from the product to all the contributing processes that determine the quality of the product (Strickland, 1989).

TQM applies to all facets of clinical and administrative operations .Its implementation within health care is unique; therefore, to fully understand this environment, three fundamental assumptions must be made.

The first is that medicine is a service field, not just technical or industrial.

Second, is the linear process of medicine, all parts must come together at the right time and place for the process to progress.

Third, the limiting steps in each process are either process or resource – driven (Wright-Patterson AFB Study, 1989).

TQM in health care strives to refine systems to meet or exceed goals for achieving quality technical outcomes, maintaining cost effectiveness, and for ensuring the most effective use of resources for providing continuous quality service to all customers

Biography:

Adiba Tarannum has completed her MBBS from Dhaka University and now pursuing her career in clinical nutrition. She also has a great interest in the public health context of clinical nutrition.  She has attended few conferences regarding this. She is trying to establish a field of clinical nutrition in Bangladesh which is becoming major issues in developing countries. She is doing several researches regarding nutritional issues of cardiovascular disease and obesity

Abstract:

Cardiovascular diseases are the most common causes of premature morbidity and mortality worldwide. Cardiovascular disease burden is increasing in developing country like Bangladesh which is creating adverse effect to whole health system. A cross-sectional, descriptive study among the higher secondary students of Bangladesh was performed using convenience sampling to assess the student’s knowledge and perception of cardiovascular risk factors and prevention. Students had a good knowledgeable about cardiovascular risk factors but did not perceive themselves at risk for cardiovascular disease. More than 60% students have one or more risk behavior related to cardiovascular diseases. The knowledge about cardiovascular diseases risk factors and prevention among the participants is high, but it has little role on practicing health life

Biography:

Fereidoon Noohi Bezanjani has completed his Internship from Mashhad University and internal medicine specialty from Shaheed Beheshty University of Medical Sciences. He has completed cardiology from Shaheed Rajai Cardiovascular Medical Center, Iran University of Medical Sciences, Tehran, Iran. He also has 103 published articles

Abstract:

Introduction: Thrombotic and thromboembolic events are important causes of mortality and morbidity in patients with prosthetic heart valve. Prosthetic heart valve thrombosis (PVT) incidence is ranging from 0•1% to almost 6% per patient-year in mitral and aortic valves, and up to 20% in tricuspid valve. The aim of this study is to evaluate the factors that may contribute to PVT. Method: This is a descriptive study of all Rajai Heart Centre’s patients with prosthetic heart valve malfunction, within a year. According to the echocardiographic (trans-thoracic and trans-esophageal) and fluoroscopic findings, the patients were divided into 2 groups. The first group included patients with thrombosis and the second group included patients without thrombosis. The patients’ demographic, clinical and laboratory data recorded in the desired form and then compared with each group. Result: A hundred and forty two patients included in this study. Ninety six patients (66.2%) were female and 48(33•8%) were men with the mean age of 49•8 and the standard deviation of 13•13. Ninety four (66•2%) of patients diagnosed with thrombosis and 48 (33•8%) patients were without thrombosis. There was no significant correlation between thrombosis and sex, age, season of hospitalization, ESR, blood group and patient’s ejection fraction. There was significant correlation between thrombosis and unstable INR, recent infection history, atrial fibrillation, multi-valve replacement, concurrent use of the warfarin and aspirin and the presence of proteinuria. Conclusion: Totally, we can say unstable INR was the most important risk factor for PVT and the incidence of thrombosis was lower in patients with regular INR control. Thus, informing and teaching the patients can play a key role in decreasing the incidence of PVT. In addition, according to the higher rates of thrombosis in patients with the history of recent infection especially upper respiratory infection, this factor can be a candidate in prosthetic valve risk assessment and needs further investigations with larger populations

Biography:

Mohadese Firouzi has finished his cardiology in Zanjan university of medical science in 2017

Abstract:

Background: T helper mediated responses to CADs can affect the disease progression. IL-27 plays a role as a double-edged sword in T helpers regulating and Has important roles in CAD progression.The aim of this study is to determine the relations of plasma IL-27 level and CAD patients' characteristics. Materials: 121 patients with CAD were enrolled in this study. Needed information gathered by questionnaire. Blood samples of each group were obtained at the time of admission to the emergency room and 3 months after revascularization. Left Ventricle Ejection Fraction (LVEF) and Gensini Score were recorded after revascularization. IL-27 plasma level was measured by ELISA. Results: The mean of pre-procedure IL-27 level in each group of patients were 255.86±116.23 pg/ml in AMI patients, 145.08±114.52 pg/ml in UA patients, 92.53±40.22 pg/ml in SA patients and 136.67±78.02 pg/ml in control group, the defference between AMI and other groups was significant (p<0.05). The mean of post-procedure IL-27 level in each group of patients was 174.36±123.15 pg/ml in AMI patients, 172.49±115.06 pg/ml in UA patients, 202.61±122.22 pg/ml in SA patients and 132.62±141.59 pg/ml in control group there was no significant difference between each pair of groups (p=0.144). Alteration of IL-27 plasma level 3 months after revascularization compared with pre-revascularization level was significant in all groups except control group, this change was an increment in UA and SA patients and decrement in AMI group (p<0.05). The relation between Gensini score and EF with pre-revascularization IL-27 plasma level was not significant in none of all groups except in SA (p<0.005 for both Gensini score and LVEF). The relation between Gensini score and EF with pre-revascularization IL-27 plasma level was not significant in none of all groups (p≥0.05). Conclusion: Plasma level of IL-27 is acutely relative with the extent of the coronary atherosclerotic plaque rupture area. And it can be used as a novel biomarker for surveying the stability and coronary plaque rupture status and can help cardiologists to modulate the medications and decide for next therapeutic steps

Biography:

Dr Deepak Puri is Executive Director and Head Cardiovascular Sciences IVY Healthcare, India

Abstract:

Session 1: Cardiomersion-Non Invasive management of Heart Failure

Session 2: Cardiomersion-Interventions for Heart Failure

Session 3: Cardiomersion-Prevention and Rehabilitation of Heart Failure

Biography:

Mohadese Firouzi has finished his cardiology in Zanjan university of medical science in 2017

Abstract:

Background: T helper mediated responses to CADs can affect the disease progression. IL-27 plays a role as a double-edged sword in T helpers regulating and Has important roles in CAD progression.The aim of this study is to determine the relations of plasma IL-27 level and CAD patients' characteristics. Materials: 121 patients with CAD were enrolled in this study. Needed information gathered by questionnaire. Blood samples of each group were obtained at the time of admission to the emergency room and 3 months after revascularization. Left Ventricle Ejection Fraction (LVEF) and Gensini Score were recorded after revascularization. IL-27 plasma level was measured by ELISA. Results: The mean of pre-procedure IL-27 level in each group of patients were 255.86±116.23 pg/ml in AMI patients, 145.08±114.52 pg/ml in UA patients, 92.53±40.22 pg/ml in SA patients and 136.67±78.02 pg/ml in control group, the defference between AMI and other groups was significant (p<0.05). The mean of post-procedure IL-27 level in each group of patients was 174.36±123.15 pg/ml in AMI patients, 172.49±115.06 pg/ml in UA patients, 202.61±122.22 pg/ml in SA patients and 132.62±141.59 pg/ml in control group there was no significant difference between each pair of groups (p=0.144). Alteration of IL-27 plasma level 3 months after revascularization compared with pre-revascularization level was significant in all groups except control group, this change was an increment in UA and SA patients and decrement in AMI group (p<0.05). The relation between Gensini score and EF with pre-revascularization IL-27 plasma level was not significant in none of all groups except in SA (p<0.005 for both Gensini score and LVEF). The relation between Gensini score and EF with pre-revascularization IL-27 plasma level was not significant in none of all groups (p≥0.05). Conclusion: Plasma level of IL-27 is acutely relative with the extent of the coronary atherosclerotic plaque rupture area. And it can be used as a novel biomarker for surveying the stability and coronary plaque rupture status and can help cardiologists to modulate the medications and decide for next therapeutic steps

Biography:

Mariya Maslarska is a medical student in her final year at the Albert-Ludwig University of Freiburg,Germany. Together with Christoph Weis she is a member of the Shear wave elastography research group under the supervision of Prof. Christoph Hehrlein and his team at the Vascular Center of the University Medical Center of Freiburg. They have been intensively researching the diagnostic impact of shear wave elastography for patients with chronic heart failure

Abstract:

It is well established that patients with heart failure often suffer from severe peripheral muscular weaknesses resulting in difficulties performing daily life tasks. Reduced oxygen delivery, lowered lactate turnover and mitochondrial capacity are thought be responsible for a diminished contractility of peripheral muscles in heart failure patients. Purpose: We sought to investigate whether shear wave elastography (SWE) is useful tool in identifying weaknesses in extension (stretch) and flexion of peripheral muscles. Material and Methods: 28 patients (pts) with chronic congestive heart failure (CHF, age 64,9 ± 13) with mid-range (HFmrEF,LVEF 40-49%)and reduced ejection fraction (HFrEF,LVEF<40%) and 17 healthy control persons(CP, age 55,8±20,4, p= 0,115) participated in the study. SWE of the gastrocnemius- and flexor carpi muscles was performed using a Loqiq E9 XDClear ultrasound maschine applying a 9L-linear array scanner. Resting kPa and exercise kPa between the muscles were assessed within a range of 0-300 kPa. Data were expressed as mean±SD and compared using the unpaired Student’s t-test with Bonferonis correction whenever appropriate. Results: Resting kPa was not different in CHF and CP , neither for muscle flexion (19.,8 ±5,1 vs. 20,5 ± 6 p=0,683) nor in the muscle extension group (12,7 ± 3,9 vs 13,3 ± 3; p=0,602). Exercise -kPA of gastrocnemius muscle (57,2.±19,5 vs. 87,1± 13,7; p<0,001) and flexor carpi muscle(44,3± 13,3 vs. 61,6± 21.7; p=0,005) were markedly reduced in CHF- compared with CP pts. Conclusion: Shear wave elastography appears to be an extremely valuable tool to diagnose muscle weaknesses in patients with chronic heart failure.

Biography:

Multiple GWAS and meta-analysis studies have implicated the role of 9p21 chromosomal region to be associated with coronary artery disease (CAD). Till date no data pertaining to rs1333049 G>C variant of non-coding RNA in the INK4 locus (ANRIL) and CAD risk has been documented in the North Indian population. The high propensity of Indians to develop CAD demands studies on genetic markers linked with increased risk in this population group

Abstract:

Biography:

Kucherenko Kirill Nikolayevich is a student of the medical faculty of the medical university "Reaviz" in the city of Samara, directs the work of the scientific society of students, performs scientific research in the clinical centers of this medical university. The field of scientific interests is related to cardiology. The results of scientific research are presented at various scientific conferences (XXIII Congress of the I.P. Pavlov Physiological Society, Voronezh, 2017; XXIII All-Russian Conference of Young Scientists with International Participation, St. Petersburg, 2017 and others)

Abstract:

According to clinical and experimental studies (Rosenman, 1975, Friedman, Bokenberger et al., 2014, Steca et al., 2016) type A behavior pattern (TABP) is a risk factor for the development of coronary heart disease, atherosclerosis and other cardiovascular pathologies.  The data available to date on TABP are based on clinical observations of patients in the older age group (30-60 years).  In this study, the daily monitoring of cardiac and hemodynamic parameters was conducted, the features of the mechanisms of blood circulation regulation and its adaptive potential in students of the medical university aged 20-22 (n=144) with different types of behavior were studied.  It was found that during the training sessions and during night sleep in students with TABP, the mean values ​​of blood pressure, heart rate were maintained at a higher level compared to students with behavior of the type AB and B. Performing an orthostatic test and Martine test in students with TABP led to a pronounced activation of sympathetic adrenal mechanisms and the formation of less adaptive reactions of the cardiovascular system.  In some cases, the pathological type of response to functional loads was determined.  Students with TABP had a lower cortisol level in the morning.  This fact may indicate a possible violation of the circadian rhythm of the development of this adaptive hormone.  It is concluded that students with severe TABP are at risk for developing cardiovascular diseases and need an effective system for the prevention of this pathology

Biography:

Rebecca Perez de Amorim is a student on her 4^th year of medical school at the University of the State of Pará in Brazil. She assists Doctor Moacyr Magno Palmeira in his researches. Palmeira has a Ph.D. in Biological Sciences from the University of the State of Pará, a Master’s of Cardiology from the Federal University of São Paulo, is a Cardiology Specialist from the Brazilian Society of Cardiology, and Doctor in the Urgency and Emergency department at Gaspar Vianna Public State Hospital Foundation

Abstract:

Acute aortic dissection (AAD) is a lethal and prevalent cardiovascular emergency. Atrioventricular conductivity disorders caused by coronary artery dissection involving AAD are rare. When it happens, both coronary arteries can be affected and acute myocardial infarction (AMI) is the most frequent clinical sign. Many deceased patients do not have the diagnosis confirmed until autopsy, and 85% receive the wrong therapy as a result of misdiagnosis. A 49-year-old male patient presenting prolonged, intense, sharp precordial pain radiating to his back, along with cold sweats, nausea and vomiting, was admitted to the cardiac emergency service. Thoracic examination revealed normal bilateral breath sounds and a respiratory rate of 24 incursions/min (SpO2 97%). Cardiac auscultation revealed a regular, bradycardiac rhythm. There was a visible high-intensity pulsation in the suprasternal notch, a diastolic murmur audible on the aortic focus, and a fourth heart sound on auscultation. After stabilization, a hemodynamic evaluation was run for urgent catheterization that showed an aortic dissecting aneurysm and a right coronary false lumen area. The patient was diagnosed with Stanford type A AAD, concomitant complete atrioventricular block, and impairment of the right coronary artery, progressing to acute coronary syndrome and spontaneous rupture of the aortic aneurysm. The patient was transferred to urgent surgical treatment and died during surgery. Physical examination is essential to disregard AAD as the main cause of AMI. The consequences of a misdiagnosis can be fatal if thrombolytic or anticoagulant therapy is chosen as the initial treatment; therefore, surgery is the best treatment for aortic dissection

Biography:

Rebecca Perez de Amorim is a student on her 4^th year of medical school at the University of the State of Pará in Brazil. She assists Doctor Moacyr Magno Palmeira in his researches. Palmeira has a Ph.D. in Biological Sciences from the University of the State of Pará, a Master’s of Cardiology from the Federal University of São Paulo, is a Cardiology Specialist from the Brazilian Society of Cardiology, and Doctor in the Urgency and Emergency department at Gaspar Vianna Public State Hospital Foundation

Abstract:

Cytomegalovirus (CMV) infection commonly leads to default of symptoms in immunocompetent individuals. Complications are unusual. In the presented research, a case of myocarditis and cardiac insufficiency due to primary CMV infection was reported. The ELISA method was used to confirm the presence of the vírus. A 41-year-old man without previous comorbidities presenting dyspnea, fever and edema was admitted to the cardiac emergency department. His fever and dry cough worsened to progressive respiratory disorders, lower limb edema and orthophonia 30 days before hospitalization. The electrocardiogram revealed sinus tachycardia, right bundle branch block and left atrial and ventricular overload, along with diffuse and non-specific ventricular repolarization disorders. A transthoracic echocardiogram revealed 35% ejection fraction (EF) of the left ventricle (LV) and an increase in the left cavity (70 mm LV). Serological tests were performed for HIV-1 and HIV-2, hepatitis B and C, and Chagas disease, all with negative results. For CMV, ELISA showed positive results for IgM (1.54 UI/mL) and IgG (2.5 UI/mL). The patient was diagnosed with heart failure due to CMV myocarditis. He was treated with ganciclovir for 10 days and received supportive medication, he was discharged in functional class I (New York Heart Association) after 14 days of hospitalization. One month after discharge, a routine echocardiography showed EF LV = 75% and almost normal values for the diameter of the left chambers. This case reaffirms the possibility of cardiac involvement in CMV infection and emphasizes the importance of viral etiologies as differential diagnoses for acute myocarditis

Biography:

Abstract:

BACKGROUND:  Adverse cardiovascular habits often form early in life and many young people are not educated about health habits. Finding ways to engage adolescents and young adults with health messages is one strategy to improving cardiovascular health. In order to best design appropriate health messages, we employed surveys to evaluate health status of young people

METHODS:  A cohort of 57 adolescents and young adults between ages 13-25 were recruited from U.S. middle schools, high schools, and colleges. We collected baseline in order to assess the feasibility of delivering weekly health questions and tips via automated text messages.  Surveys were administered assessing diet quality, physical activity, stress levels, hours of sleep, and tobacco use using a scaled response (graded from 1 to 5, or from none to always). This study has been approved by the UCLA Institutional Review Board.

RESULTS: Mean age of participants was 19.7 + 1.9 years (67.8% female).  Only 9% of respondents felt “very knowledgeable” about heart disease or cardiovascular risk factors.  62% admitted they did not know how to prevent heart disease.  Most participants do not smoke, most eat high quality diets and most sleep at least 7 hours nightly.  Most participants feel that stress is their greatest risk factor for heart disease.  When asked “In the last 3 months how often were you stressed or had trouble relaxing?” 95% responded “half of the time.” 

DISCUSSION:  Among U.S. adolescents and young adults knowledge about heart disease and cardiovascular risk factors is low.  Fortunately tobacco use is declining and diets are improving among adolescents and young adults in the U.S.. Unfortunately stress is highly prevalent and many young people feel unprepared to address this risk factor and this may adversely affect future cardiovascular health