Day 1 :
Keynote Forum
Ingolf Schimke
Berlin Cures GmbH, Berlin
Keynote: The aptamer BC 007 for in vivo neutralization of pathogenic autoantibodies directed against G-protein coupled receptors present in patients with cardiomyopathy: Steps to a new treatment option
Time : 10:15 - 11:15
Biography:
Ingolf Schimke has completed his Ph.D. at the age of 27 years from “Academia der Wissenschaften” of the German Democratic Republic and postdoctoral studies from “Humboldt Universität zu Berlin” Medicine. Until 2014, he was Professor for Clinical Chemistry and Laboratory Medicine at the “Charité – Universitätsmedizin Berlin” and is presently Director of Research & Development at “Berlin Cures GmbH”. He has published more than 100 papers in reputed journals. He is serving as an editorial board member of reputed journals.
Abstract:
With the finding of autoantibodies directed against G-protein coupled receptors (GPCR-AABs) in diseased subjects – mainly those suffering from diseases of the cardiovascular system – a new class of autoimmune diseases (functional autoantibody disease) has been introduced. While autoantibodies in the classic autoimmune diseases play a role in the destruction of their targets and target tissues, GPCR-AABs are so-called “functional autoantibodies” that mainly activate agonistically their related receptors in a similar way to physiologic agonists. However, receptor down regulation and desensitization for controlling of over-boarding effects of physiologic agonists are lacking for GPCR-AABs. Patients suffering from cardiomyopathies such as idiopathic dilated cardiomyopathy (DCM), Chagas’ cardiomyopathy and Peripartum cardiomyopathy present with autoantibodies against G-protein coupled receptors (GPCR-AABs) mainly such directed against the beta1-adrenergic receptor (beta1-AABs) which are clearly evidenced as driving the pathogenesis. For the treatment of “functional autoantibody disease” and in particular of DCM, the removal of the beta1-AABs by immunoadsorption (IA) has been studied with convincing patient benefit. To overcome cost and logistics problems of IA, the application of the aptamer BC 007 (single short DNA molecule for highly-specific binding of GPCR-AABs) for in vivo neutralization of beta1-AABs could help. BC 007 neutralized in vitro beta1-AABs prepared from cardiomyopathy patients as well as other GPCR-AABs present in cardiomyopathy patients who additionally suffering for example from metabolic syndrome, hypertension or diabetes mellitus. The aptamer’s in vivo beta1-AAB neutralizing potency was demonstrated in animals and recently for the first time in a beta1-AAB positive human. Due to BC 007’s safety, demonstrated in pre-clinical studies and phase 1 clinical trial, BC 007 treatment of beta1-AAB positive cardiomyopathy patients would, in our view, have a comparable benefit as that was seen after IA. Consequently, steps have been taken for bringing BC 007 as a drug for in vivo neutralization of GPCR-AABs closer to patients.
- Heart Diseases | Arrhythmia | Heart Stroke | Interventional cardiology | Heart Diseases Diagnosis and Treatment Session Chair
Location: Busakaram II
Chair
Ingolf Schimke
Berlin Cures GmbH, Berlin
Session Introduction
Sayed Mohsen Hosseini
Professor, Department of Biostatistics and Epidemiology, Faculty of Health, Esfahan University and Medical Sciences
Title: The effect of daily concentrations of Fine Particulate Matter (PM2.5) on cardiovascular diseases hospitalizations in Isfahan
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 (ICl(Ca)) mediated by TMEM16A and/or Bestrophin-3 may contribute to cardiac arrhythmias. Our goal was to study the ICl(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 ICl(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 ICl(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 ICl(Ca), while application of Bay K8644, isoproterenol increased the amplitude of ICl(Ca). Both L-type Ca2+ current and ICl(Ca) were eliminated by nisoldipine. TMEM16A and Bestrophin-3 showed strong co-localization with one another and also with Cav1.2 channels both canine myocytes and human ventricular myocardium.
Conclusions: Activation of ICl(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 ICl(Ca) requires high Ca2+ in the dyadic clefts which can be effectively buffered by BAPTA, but not EGTA.
Ala Ashour
Faculty of Nursing at Hashemite University-Jordan
Title: Perceived learning needs of Jordanian patients after undergoing percutaneous coronary intervention
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.
Yin Kang
MD PhD, Fuwai Hospital, Beijing, China
Title: Electrical Storm in ICD Recipients with Arrhythmogenic Right Ventricular Cardiomyopathy
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.
Srinivasa Kumaran
MGR medical university, India
Title: Institutional study on surgical management of cardiac diseases
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