3^rd Global Summit on Heart Diseases November 02-03, 2017 Bangkok, Thailand

Biography:

1988-1992:       B.S.c in Mathematics and Computing, University of Esfahan, Iran.

1992-1995:       M.S.c. in Biostatistics, University of Tehran, Iran,

Thesis Title:     Factors associated with eye diseases in carpet weavers in North of Esfahan.

Supervisor:     Professor Kazem Mohammad
2000-2004:      Ph.D. in Bio-Statistics, Department of Statistics, University of Glasgow, U.K.

Abstract:

Background: The association between PM2.5 levels and adverse cardiovascular health outcomes is well-known. Several studies that focused on hospital admissions for cardiovascular diseases showed that increase in PM2.5 concentration was associated with an increase in hospital admissions for ischemic heart disease, arrhythmias and heart failure.

Methods: We examined the impact of daily concentrations of Fine Particulate Matter (PM2.5) on admission to all patients with a diagnosis of cardiovascular disease in all hospitals that has wards, heart and CCU, during the 2011-2012 (March 2011 to February 2012) in Isfahan, using a case-crossover study design. Data were received on PM2.5 concentrations for each hour in a station and were obtained for temperature and humidity in all the weather stations. The analysis was performed using SAS 9.2 software.

Results: There were 16690 hospital admissions for cardiovascular diseases. The average age of the subjects was 59.63±18.87 years. The mean concentration of PM2.5 was 56.64±28.83 µg/m³ during the study period. The effect of PM2.5 on the risk of hospitalization for cardiovascular disease was significant and daily concentrations of PM2.5 is directly related with cardiovascular disease hospitalization rate (OR=1.064, CI: 1.038-1.090). Maximum of the association after adjustment for O3 (OR=1.086, CI: 1.051-1.122). Adjustment for PM10 was not significant (OR=1.014, CI: 0.986-1.043).

Conclusion: this study provides evidence that higher levels of PM2.5 increase the risk of hospital admissions for cardiovascular disease during the 2011–2012 in Isfahan. Also, the level of pollutant is higher than the WHO standard.

Biography:

Janos Magyar has completed his PhD from University of Debrecen and postdoctoral studies from University of Virginia and University of Kentucky. He is the head of Division of Sport Physiology of University of Debrecen. He has published more than 80 papers in reputed journals

Abstract:

Background: Calcium activated Cl⁻ current (I_Cl(Ca)) mediated by TMEM16A and/or Bestrophin-3 may contribute to cardiac arrhythmias. Our goal was to study the I_Cl(Ca) profile during an actual ventricular action potential (AP) under normal calcium cycling as well as in case of altered intracellular calcium concentration ([Ca²⁺]_i). The expression of TMEM16A and/or Bestrophin-3 in canine and human left ventricular myocytes was examined.

Methods: Whole-cell configuration of the patch-clamp technique and action potential voltage-clamp were used to monitor I_Cl(Ca), detected as 9‑anthracene carboxylic acid (9‑AC)-sensitive current. FURA-2-AM dye was used to measure [Ca²⁺]_i. Expression and cellular localization of Cav1.2, Bestrophin-3 and TMEM16A was analyzed with immunocytochemistry and confocal microscopy.

Results: Under AP voltage-clamp conditions the profile of I_Cl(Ca) contained an early fast outward (1.62±0.06 A/F) and a late inward component (-0.16±0.02 A/F). Both components were reduced by ryanodine (1.05±0.03 A/F; -0.07±0.03 A/F), while fully abolished by BAPTA, but not EGTA (1.17±0.09 A/F; −0.13±0.02 A/F). Setting [Ca²⁺]_i to 1.1 µM decreased I_Cl(Ca), while application of Bay K8644, isoproterenol increased the amplitude of I_Cl(Ca). Both L-type Ca²⁺ current and I_Cl(Ca) were eliminated by nisoldipine. TMEM16A and Bestrophin-3 showed strong co-localization with one another and also with Ca_v1.2 channels both canine myocytes and human ventricular myocardium.

Conclusions: Activation of I_Cl(Ca) in canine ventricular cells requires calcium entry through neighboring L-type Ca²⁺ channels and is only augmented by SR Ca²⁺-release. Substantial activation of I_Cl(Ca) requires high Ca²⁺ in the dyadic clefts which can be effectively buffered by BAPTA, but not EGTA.

Biography:

Ala Ashour, PhD, RN. Professional experience: more than fifteen years of professional experience in critical care nursing and academia. Education: Bachelor’s and master’s degree in nursing (critical care nursing) from Jordan University of Science and Technology and PhD in 2014 from University of Ulster, Belfast, United Kingdom. Currently: Assistant professor in nursing, Faculty of Nursing at Hashemite University-Jordan. Research interest:  cardiac care nursing, critical care nursing, refugees health, and primary and secondary prevention particularly for patients with coronary artery disease.

Abstract:

Statement of the Problem: Coronary heart disease (CHD) is a major health problem and the leading cause of death in Jordan. As a result of advances in technology and treatment for patients with CHD, the number of patients undergoing percutaneous coronary intervention (PCI) has increased, and patients are being discharged sooner than ever before. The purpose of this study is to explore and prioritize the actual learning needs of Jordanian patients after undergone PCI, and to examine the relationships between patients’ learning needs and their illness perceptions in order to design nurse-led education programs. Methodology: A descriptive, correlational design was used. Data were collected from 208 PCI patients before their discharge from King Abdullah University Hospital and Prince Hamzah Hospital. The Percutaneous Coronary Intervention Learning Needs Inventory (PCILNI), was developed to assess patients’ learning needs 24-48 hours before their discharge from the hospital, and the Illness Perceptions questionnaire was used to assess their illness perception. Findings: The results showed that patients need a high amount of information. The information about immediate post-procedural knowledge category was indicated to be the most valued by PCI patients (Mean 4.42). The highest rated items were symptoms management, discharge medication, post-procedural medications and complications. There was a significant negative correlation between total learning needs and personal and treatment control respectively (P= 0.012, P= 0.028); Patients who perceived low levels of personal and treatment control over illness, and tend to need more educational knowledge. Conclusion & Significance: Patients undergoing PCI have high and different information needs. These findings would help to develop nurse-led education programs based on actual patient’s needs and their illness perception, which will facilitate the recovery of patients after undergone PCI.

Biography:

Yin Kang has been trained in clinical cardiac pacing and electrophysiology under the direction of Professor Hua Wei for many years. During her doctoral study in Chinese Academy of Medical Sciences and Peking Union Medical College, she systemically reviewed the patients who had been implanted an ICD at Fuwai Hospital in the nearly recent 30 years with the guidance of Professor Hua Wei. After hard work of follow-up and thorough study of patients with arrhythmic right ventricular cardiomyopathy (ARVC) and an ICD, she presented the effectiveness of ICDs in prevention of sudden cardiac death, and the prevalence, treatment measures and prognosis of ICD electrical storm in those patients. Her research provides reference for the treatment and further investigation of this kind of patients.

Abstract:

Background: Implantable cardioverter defibrillator (ICD) is the most important management for prevention of sudden cardiac death (SCD) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However, some patients may receive multiple ICD therapies in a short period, a condition referred as “electrical storm” (ES). Objectives: This study aimed to determine the prevalence, therapeutic options, and prognostic implications of ES in ARVC patients with an ICD. Methods: We retrospectively analyzed the baseline and follow-up data of 39 ARVC patients with an ICD. ES was defined as three or more separated episodes of ventricular tachycardia or ventricular fibrillation (VT/VF) within a 24-hour period. Results: During a median follow-up of 49 months (range 6–225), 12 of 39 (31%) patients suffered at least one episode of ES. The interval between the first ES and the initial ICD implantation ranged from 1 month to 109 months, and ES was the first ICD discharge in three patients. The median number of VT/VF events per ES was four (range 3–39). Five patients experienced 20 episodes of ES that were treated by antitachycardia pacing only, while the other seven patients suffered shock therapies during ES. In three patients, ES required emergency hospitalization, and the repeatedly occurred VT/VF was finally subsided by intravenous amiodarone. There was no significant difference in actual survival between patients with and without such an event. Conclusions: ES is not rare in ARVC patients with an ICD for prevention of SCD, but it does not independently confer increased mortality. Intravenous amiodarone is effective in management of ES when VT/VF repeatedly occurred.

Biography:

Dr.Srinivasa Kumaran, has passion in both adult and paediatric cardiac surgery. Graduated from Dr. MGR medical university in the year 2006 and has 7 years’ experience in general surgery and 3 years’ experience in cardiothoracic surgery.

Abstract:

This study elucidates the surgical management of Heart disease in a tertiary care center in Southern India. A total of 139 cases of heart disease were surgically managed from May 2015 to July 2017 at Stanley Medical College. In this, the average age of patient population is 43.94 with 43.16 % in age group of 30- 44. Male to female ratio is (1.13: 1).Both valve replacement and CABGs are performed. Of the total cases, 83 patients underwent valve replacement surgeries, 41 patients underwent CABG. In congenital cardiac disease a total of 13 cases were done with ASD (OS) being most common. Mitral valve disease secondary to rheumatic pathology is the most common valvular disease. Of the 83 patients who underwent valvular replacement, MVR (55) is the most common followed by MVR with /devega tricuspid annuloplasty (13), AVR and DVR. Of the 41 patients who underwent CABG, LIMA was harvested in 9 cases and RIMA in 1 case. All cases were done under cardiopulmonary bypass. The increased number of rheumatic heart disease compared to coronary heart disease establishes the still widely prevalent problem of rheumatic heart disease in this part of the world.

Keywords – CABG –coronary artery bypass grafting

Valve replacement, ASD – atrial septal defect

Biography:

Dr Mohammad Abdul Matin, after completing graduation (MBBS) in 2005 dedicated him for higher education in Cardiology and completed post-graduate diploma in Cardiology (D-Card) in 2009 from Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh and become one of the youngest cardiologist of the country at the age of 30 years only. Then entered in Govt. services and involved in emergency medical services ant gathered a lot of experiences. To achieve more knowledge in Cardiology he entered in postgraduate fellowship course (MD Cardiology) in National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh and achieved MD Cardiology in January 2017 which is considered as highest postgraduate degree in Bangladesh. Within these periods of service and fellowship course he gathered a lot of experience in different discipline of Cardiology mainly in transradial coronary intervention. He is now working as consultant Cardiologist and also involved in research work.

Abstract:

Background: Although transradial approach (TRA) has better outcome and reduced vascular complications, radial artery occlusion (RAO) is now a major concern as it limits future radial artery use for further TRA, for use as a conduit during CABG, for invasive hemodynamic monitoring and for creation of arteriovenous fistula for hemodialysis in CKD patients. Vascular Doppler study is the most accurate method for evaluation of RAO and yet this is not practiced in our population. Objectives: To detect the frequency and identify the predictors of RAO after coronary procedure through TRA. Methods: This cross-sectional analytical study was done in the Department of Cardiology, NICVD from July-2015 to June-2016 by including a total 125 patients undergoing coronary procedures (CAG and/or PCI) through TRA. Vascular Doppler study of the radial artery were performed before and one day after the procedure. RAO was defined as an absence of antegrade flow and monophasic flow on Doppler study. Univariate and multivariate logistic regression analysis were done to evaluate the predictors of RAO. Results: On the day after the procedure, radial artery Doppler examination revealed RAO in 12 (09.6%) patients. On univariate analysis female gender (p= 0.038), diabetes mellitus (p= 0.024), prolonged hemostatic compression for more than 02 hours after sheath removal (p= 0.003) were identified as predictors of RAO. Interestingly hypertension, low BMI, smaller radial artery diameter and use of reprocessed sheath were not identified as predictors of RAO. On multivariate analysis diabetes mellitus (p= 0.016), prolonged hemostatic compression for more than 02 hours after sheath removal (p= 0.004) were found as independent predictors for RAO. Conclusion: Frequency of RAO was 09.6% after coronary procedure through TRA. Diabetes mellitus and hemostatic compression after sheath removal for more than 02 hours were identified as independent predictors of RAO. Strategies should be taken from patient selection for TRA to end of hemostatic compression removal to prevent RAO.

Biography:

Abstract:

Introduction :

Acute total occlusion of the left main (LM) is rarely encountered in the cathlab, its incidence is difficult to determine because most often fatal. This is a frightening situation where there is a paucity of data and that we might be led to meet.

We report 4 cases of total occlusion of the left main revealed by an acute coronary syndrome observed between the year 2015 and 2016 in our cathlab

Results:

The age of patients was between 29 and 72 years with tobacco as a common risk factor; three patients were admitted for NSTEMI at high risk and two for STEMI, one of whom was thrombolysed with failure. Of the 5 patients 3 presented in shock. The delay for revascularization was between 1 hour and 5 hours for the first four patients, this delay was

26 hours for the last one. The EKG of our patients was characterized by a labile aspect from one patient to another, the ST segment elevation in AVR was observed in all the patients. Only one patient had an LVEF altered at the echography. In the first three patients, coronary angiography showed a completely occluded LM (TIMI 0, RENTROP 0), (figure 1) they underwent instrumental thrombectomy under anti-GPIIbIIIa treatment with restoration of a satisfactory coronary flow at a first step, a delayed angiographic control of 48 hours showed a coronary arteries without significant lesion in one patient while the two others underwent angioplasty (figure 2). The fourth patient had a complete occlusion of the LM, a dominant RCA with a tight stenosis on its second segment overtaking the LAD (RENTROP II), an urgent surgical revascularization was performed for this patient (figure 3). For these first four patients the evolution was favorable. The fourth patient illustrates the severity of this lesion, the patient came late to our level after the failure of thrombolysis where coronary angiography revealed an occluded LM without collaterals (REnTROP 0), thrombo-aspiration associated with anti GpIIbIIIa therapy could restor a TIMI III flow but a bad LAD artery, alas he continued to degrade its cardiac insufficiency leading to the death at the 5th day of hospitalization (figure 4).

Conclusion:

For this type of lesion angioplasty is a saving option; the prognosis is generally related to the right or left dominance, the development of collateral circulation and especially the celerity of revascularization. Delayed stenting seems to appear safe in order to reduce the risk of embolization and no reflow. Surgical revascularization is a reasonable attitude when the patient is stable with a low operative risk.

Biography:

Dr.Srinivasa Kumaran, has passion in both adult and paediatric cardiac surgery. Graduated from Dr. MGR medical university in the year 2006 and has 7 years’ experience in general surgery and 3 years’ experience in cardiothoracic surgery.

Abstract:

Statement of the Problem: Prosthetic valve thrombosis is a rare but serious complication of valve replacement, most often encountered with mechanical prostheses. The incidence of prosthetic valve thrombosis varies according to the following variables: efficacy of anticoagulation; type and location of the implanted prosthesis; and presence of atrial fibrillation. Obstruction of the prosthesis is more frequent during the first postoperative year. The clinical findings vary from lack of symptoms to extreme cases of cardiogenic shock. The most common symptoms are progressive dyspnea on exertion, lipothymia, and syncope. Systemic embolism and acute pulmonary edema may also be the first manifestations of the disease. For any given patient, the risks of thrombolytic therapy, including bleeding, systemic embolism, and failure to restore valvular function, must be weighed against the risks of surgical intervention. Once the decision is made to operate, the choice of valve replacement versus debridement is best made intraoperatively, upon visual inspection of the valve apparatus. We report a case of a perimenopausal woman who underwent mitral valve replacement 4 years back presenting with symptoms of congestive cardiac failure. The patient was diagnosed with valve thrombosis from a transthoracic echocardiogram and underwent valve replacement. The relevant literature is reviewed.

Biography:

Agung Anugerah is currently studying medicine in Faculty of Medicine, University of Jember. Interested in agromedicine and public health subject drives him to progressively learn toward particular subject. He is also interested in human rights issue especially in medical settings. He has conducted several training session at his university or in national scale with him being the trainer, therefore he is skilled in public speaking and conducting an oral presentation. He active writing scientific paper recently and passionate to learn more about scientific thinking, scientific writing, and progress in the scientific world.

Abstract:

Statement of the Problem: Cardiovasular disease hold the title for the biggest public health burden worldwide. It accounts for 17.3 million deaths each year and continuously increasing. Atherosclerosis is the leading pathological cause among millions of cardiovascular disease happened. Preventive measure must be taken to decrease atherosclerosis induced cardiovascular disease. A study from America reveals America has halved it’s cardiovascular incident in 20 years and 79% of the reduction is due to primary prevention. Methodology & Theoretical Orientation: A literature study was utilized on understanding the effect of coffee toward atherosclerosis progression and determining the strategic intervention to promote cardiovascular health, particularly about atherosclerosis. Findings: Coffee is infamous with it’s caffeine, which cause adverse impact on cardiovascular health. But coffee also contain a lot of cardioprotective substance like phenol, vitamin B3, magnesium, kalium, and fiber. An in vivo study in periodontitis rat model reveal that coffee halt and decrease atherosclerosis progression though increase in intima media thickness and density, also reduction in stenosis, fat deposition, and endothelia disintegration. Proving that the net effect of coffee as a whole is cardioprotective. Furthermore, caffeine and diterpenes substance can be removed through filtration. Consuming one to four cups of coffee each day is safe. Coffee is the most consumed drink, second only to water. While coffee is familiar worldwide, it’s strategic to promote cardiovascular health by promoting health coffee consumption. It’s also important to emphasize the overall effect of coffee, especially in countries where coffee consumption is decreasing. Coffee is identical with lifestyle, so, spreading the message through media influencer will more likely to develop impact. Conclusion & Significance: Emphasizing coffee as a lifestyle which is also an preventive measure from atherosclerosis-induced cardiovascular disease at the same time is strategic because it’s already known widely, so it’s likely to also be accepted widely.