4^th Global Summit on Heart Diseases September 14-15, 2018 Singapore

Biography:

Having attained a PhD in biochemistry at the University of East Anglia, Andrew Cobb is currently a research associate at King’s College London. He is investigating the biochemical pathways underlying vascular calcification and working on elucidating the link between the osteogenic transcription factor Runx2 and DNA damage.

Abstract:

Cardiovascular disease is a leading cause of mortality in developed nations. As ageing has established itself as one of the biggest causative factors of heart disease, we were interested in understanding what age-associated molecular changes were underlying these diseases. Hardening of the vascular network by ectopic calcification commonly occurs as we get older and this can lead to eventual heart failure and death. Accumulation of DNA damage and increased genomic instability are the primary drivers of ageing so we wanted to assess the impact of this upon calcification of vascular smooth muscle cells (VSMCs). Our data has shown induction of calcification with high calcium and phosphate in vitro causes increased levels of DNA damage in cells. Interestingly, addition of H₂O₂ to Ca+P media accelerated VSMC calcification and this was highly dependent on the presence of the osteogenic transcription factor Runx2 as its depletion attenuated this increase. Further analysis of Runx2 showed it localised to sites of DNA damage and its levels were significantly increased following DNA damage induction. We were able to determine a novel role for Runx2 in the regulation of H2AX phosphorylation on Ser139 via mediation of phosphorylation of an adjacent Tyrosine residue that is instrumental in determining cell fate following genotoxic stress. A side-effect of elevated Runx2 levels following DNA damage induction was subsequent enhanced binding of Runx2 to promoter regions of its target genes that are implicated in osteogenic differentiation, thereby explaining how DNA damage accelerates calcification of VSMCs. Importantly, we observed that inhibition of DNA damage response signalling was able to attenuate these effects and slow calcification.

Biography:

Dr.Rahul Hajare is a post doctoral student of Renowned Scientist Respected Dr. R S. Paranjape Retired Director and Scientist ‘G’ National AIDS Research Institute India. He achieved his training at the National AIDS Research Institute, the reputed and primer HIV research institute in India. Dr. Hajare is board certified by Director-in-Charge, National AIDS Research Institute, the Secretory Board of Management KLE Society Belagavi and Registrar Vinayaka Mission’s Research Foundation. Dr Hajare won World Academic Championship-2017 in Pharmacy (Antiretroviral Therapy) and certified as Fellow, Directorate of Pharmacy, IASR (Lifetime Membership).

Abstract:

Statement of the Problem: A medicine is knowledge in process. Researchers have reported that non-teaching men staffs with these experiences are more difficult to treat; many do not access treatment and those who do, frequently do not stay because of difficulty maintaining helping relationships. However, these men’s perspective has not been previously studied, particularly. The purpose of this study is to describe the experience of seeking help for alcohol dependency by men with and a history of chain alcohol dependency with other men the context in which it occurs. Methodology & Theoretical Orientation: An inter subjective in-house study using hermeneutic dialogue was utilized during participant observation, in- depth and focus groups. Classically, as we define reactions to antigens, either environmental or foods, we have broken the immune reaction down and divided them based on specific activity. This definition allows us to describe the difference between. Type I IgE Medicated Hypersensitivity and Type II IgG mediated activity, and Type III driven by complement activation as well as Type IV Cell-Mediated Hypersensitivity. While these descriptions are not wrong, they are not the whole picture. While it is true IgE and IgG maintain distinct activity, it is also true that IgG, particularly type 1-3 will increase the activity of IgE. Patterns of immune response can be seen for other reasons as well. For example, someone who is in general, more up regulated in terms of IgE reactions, may be low in sIgA. A decrease in sIgA creates a deficiency in a first line of defense, the 85% of the immune system that lines the mucosa. Because of this low level of defense or sIgA, the immune system works to compensate. One ways the immune system will compensate is by up regulating IgE activity, relying on a higher level of response in that pathway to overcome short comings created by low sIgA. When we look at various immunoglobulin’s responses together, rather than in isolation, we will get a deeper understanding into what is truly happening with immune function.

Biography:

Dr. Mahmood Hasan Khan has his expertise in evaluation and passion in improving the health and wellbeing. His open and contextual evaluation model based on responsive constructivists creates new pathways for improving healthcare. He has years of experience in research, evaluation, teaching and administration both in hospital and education institutions.

Abstract:

Coronary heart disease is the most common category of the heart disease. cTnI is 100% tissue-specific for the myocardium and a very sensitive and specific marker for acute myocardial infarction. Ventricular function provides information on systolic function as well as diagnosis and prognosis. The study aimed at investigating the impact of LVEF on elevated Troponin-I level in patients with first attack of NSTEMI. This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital from December, 2015 to November, 2016. Total 130 first attack of NSTEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group–I: Patients with first attack of NSTEMI with good LV function (LVEF: ≥55%). Group–II: Patients with first attack of NSTEMI with LV systolic dysfunction (LVEF: <55%). In this study mean Troponin-I of were 5.53±7.43 and 16.46±15.79 ng/ml respectively. It was also statistically significant (p<0.05). The mean LV ejection fraction value were 65.31±10.30% and 40.17±4.62% respectively. It was statistically significant (p < 0.05). The Echocardiography showed that patients with high Troponin-I level had low LVEF and patients with low Troponin-I level had preserved LVEF. Analysis showed that patients with highest level of Troponin-I had severe left ventricular systolic dysfunction (LVEF <35%) and the patients with the lowest levels of Troponin-I had preserved systolic function (LVEF ≥ 55%). In our study, it also showed that the levels of Troponin-I had negative correlation with LV ejection fraction levels with medium strength of association (r= -0.5394, p=0.001). Our study also discovered that Troponin-I level ≥6.6 ng/ml is a very sensitive and specific marker for LV systolic dysfunction.

Biography:

Prashanth.Chiliveri has a good experience in molecular analysis, protein characterization and chromatographic analysis by emerging techniques and his area of research is in Human Toxicology, Heart Diseases, Raw and finished products and biosimilar characterization. He started his career at Central Institute for Cotton Research, Maharashtra, India and had gained good experience in characterization of proteins and development of Bio-pesticide. He also worked as a Scientist at Vimta Labs Ltd, Hyderabad on Biosimilar characterization. Currently he is a Research Associate at Bhagwan Mahavir Medical Research Centre, Hyderabad and carrying research in Human Toxicology and Heart Diseases. He published about 29 bacterial sequences in NCBI and 7 Research Articles in National and International Journals. He also involved in conducting many conferences and workshops at national level.

Abstract:

Cytokines are the important mediators of inflammatory and immune responses to RF and RHD. The study aimed to investigate the association of TGF Beta -1 (-509) and TNF-Alpha (-308) gene polymorphisms with susceptibility to RHD. The study was carried out on 56 RHD and 45 ethnically matched healthy subjects for comparison (controls). Demographic data was collected and 2D echocardiography was carried out for confirmation of the disease. Blood samples were drawn from each subject, genomic DNA was isolated from each and subjected to PCR-RFLP to identify the polymorphisms of cytokine genes. Our results showed that GG genotype of TNF-Alpha (-308) was significantly associated with increased risk of RHD (P < 0.05, OR 3.1, CI 1.17-8.4) and G allele was found to be highly significant (P < 0.001, OR 2.81, CI 1.57 to 4.97). AG genotype showed 1.8 folds risk (P>0.05, 1.8, CI 0.65-5.1) and AG+GG combination showed 1.3 fold risk for RHD (P> 0.05 OR 1.3 CI 0.6-2.8). However, none of the genotypes of TGF-β- 1 showed an increase in the RHD patients compared to control subjects thus indicating that TGF-Beta-1 gene was not associated with susceptibility for RHD. Our findings suggest that TNF-Alpha (-308) gene polymorphism plays an important role in predisposition to RHD in Telangana population. However, our results showed that the TGF Beta- 1 (-509) was not associated with increased risk for RHD in this population.

Biography:

Working as a professor in department of biomedical sciences, Debre Tabor university, Ethiopia

Abstract:

Introduction: Prenatal development of Humans might not always end up by producing full term healthy neonate. There are times where infants could be born with different birth defects due to numerous factors. Congenital Heart Defects (CHD) among the commonest type birth defects causing mortality, morbidity and long term disabilities in children especially in middle and low-income countries.

Objectives: The purpose of this study is to assess the magnitude and associated factors of Congenital Heart Defects among under-five children with birth defect in Debre Tabor and Gondar university hospitals.

Methodology: Institutional based retrospective cross-sectional study design was employed. All under-five children with birth defects from September 12, 2015 up to September 08, 2017 were included in the study.

Result: A total of 503 children were found to have birth defect. Among theses CHD accounts 19.3%, where VSD is the predominant of all types of CHD, (38.8%). Among the socio demographic characteristics none of them were significantly associated with the occurrence of CHD. But, maternal alcohol intake during pregnancy and gestational age were found to be associated significantly with AOR 0.48(95% CI, 0.29, 0.79) and AOR 0.448 (95% CI, 0.20, 0.98), respectively. While folic acid supplementation, and ANC follow up remains not significant.

Conclusion: prevalence of congenital heart defects is higher in North and south Gonder. According to this study maternal alcohol intake and pre term delivery were identified risk factors for CHD.

Recommendation: Based on the result of this study, we strongly recommend to strengthen the activities of ANC follow up insuring maternal risk factors for CHD

Biography:

Dr. Syeda Humayra,a remarkably young and talented personality who believes in the advancement of scientific/medical knowledge for the welfare of mankind and society. This true Bengal beauty served as an Honorary Doctor at Ashiyan Medical College Hospital, Dhaka. Born leader, grew up in United Arab Emirates, pursued her higher education in Ukraine and currently doing her Post-Graduation on ‘Cardiovascular Sciences’ at Cyberjaya University College of Medical Science Malaysia; has got tremendous exposure and expertise of being in a multilingual and multi-cultural diversity. This defines her unique bonding with people and having active role in several humanitarian organisations to support children education, women empowerment and other fund raising charity events. As a researcher her primary area of interest revolves around cardiac investigations, latest discoveries involving cardiomyopathies, heart failure, cardiovascular diseases, etc. Her motto in life is: “Gaining Knowledge is the first step towards Wisdom and sharing it with others is the key to Humanity”

Abstract:

Takotsubo syndrome- The acquired cardiomyopathy that has recently gained popularity as ‘broken heart syndrome’ can be described as an acute left ventricular dysfunction presented mostly in postmenopausal women followed by intense stressful event, but its exact pathophysiology remains unclear. The term first came into existence in early 1990’s in Japan as reported by Hikaru Sato et. al. Initially originated from Japanese ‘octopus trap’ because of its distinctive resemblance in shape with the left ventricle in systole. TTC being an unconventionally rare, under recognized syndrome has emerged out as a momentous form of acute cardiac failure over the last decade. Several researches have been revolving around it to quantify its extensive damage on the heart. Clinical diagnosis of takotsubo is largely misguiding due to its inevitable similarity with ACS, but in the absence of evident coronary obstruction in angiographic presentation. Although, there is substantial elevation of cardiac biomarkers like troponin and natriuretric peptide (pro-BNP and NT- pro-BNP) which are major diagnostic keys in differentiating TS from MI.

Methodology: The aim of this retrospective observational study is to investigate and establish the epidemiological events of takotsubo during mass population stress (taking into account the tragic cases of Malaysia Airlines Flight 370 and MH17; and the recent fall of UMNO in 2018 election period ); to contribute sufficient statistical data on the International Takotsubo Registry to fill in the gaps lacking geographic variation and demographic profile due to limited literature on TTC from Asian countries.

Suggestive Findings: It’s rationally conceptualized that TS cases reported under stressful scenario would be higher in comparison to control, which would help determine cardiovascular complications, misdiagnosed cases, recurrent TTC and mortality rates.

Conclusion: Recent studies suggest that TTC isn’t rare anymore, but awareness is required to facilitate better management mostly in emergency department. As it presents with catecholamine toxicity and enhanced nitric oxide signalling; providing incorrect treatment would eventually harm the patient. Therefore, acknowledging the overall effect it has on patient’s heart is certainly important.

Biography:

Dr. Abhilasha Singh have worked on diverse and interdisciplinary projects at IIT Madras and University of Madras, Chennai, India. To her credit, she has almost nine years of research experience. She is also a member of various national and international organizations and currently she is member editorial board of two reputed journals. Her research interests focuses on novel therapeutic approaches from natural sources for the treatment of inflammatory diseases. Currently she is working on Aging and Inflammation in Hyperlipidemic Subjects using rat as Animal Model. Her past research projects were studies on Stem cells in Microgravity condition, Brain Aging and Effects of Fiestin as antioxidant and anti-aging component.

Abstract:

Overview:-Lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) is one of the major receptors for oxidized low-density lipoprotein (OxLDL) in the aorta of aged rats. OxLDL attenuates LOX-1 activation in endothelium of lipid accumulating sites of both animal and human model of hypercholesterolemia. This study has explored the binding affinity of Aegeline to LOX1 for the first time in comparison to Atorvastatin. Targeting LOX1 may provide novel diagnostic strategy for hypercholesterolemia and vascular diseases. Objective: This study was planned to address whether the possible effect of Aegeline on LOX-1 could be related to modulation of ox-LDL receptor in hypercholesterolemia. Methods: Thirty-six Wistar rats were divided into six groups. The pathology group rats were fed with HCD for 16 weeks and treatment groups rats were fed with HCD for 12 weeks and further supplemented with AG/AV for another 4 weeks. In vivo and in vitro experiments were carried out to find out the relative markers of the pathological condition likely Oxidized LDL (Ox-LDL) and LOX1 levels were determined. Standard biochemical parameters were carried out. Also, histopathological examination of aorta tissue sections was carried out. Oil red O staining was performed in IC21 macrophage cell lines. Docking studies were performed to find out the binding affinity of AG to LOX1. Results: AG administration effectively decreased the lipid levels induced by HCD as evidenced by lipid profile. Further, the lowered levels of Ox-LDL and LOX1 in AG administered rats deem it to be a potent anti-hypercholesterolemic agent. Compared to AV, AG had a pronounced effect in down- regulating the expression of lipids evidenced by Oil red O staining. AG binds with LOX1 at a higher affinity. Conclusion: This study thus validates AG to be an effective stratagem in bringing down the lipid stress induced by HCD and can be deemed as an anti-hypercholesterolemic agent.

Biography:

Dr. Jeffri Gunawan has completed his general medicine education at the age of 24 years-old from Universitas Padjadjaran and specialty program in internal medicine (internist) in 2018 in Universitas Indonesia. He has published several research papers and clinical cases in reputed journals and conducted studies in internal medicine and by now practicing medicine in several hospitals in Jakarta.

Abstract:

Background: Acute coronary syndrome (ACS) is the leading cause of increased morbidity and mortality across the globe. This mortality was known to be associated to the serum potassium level on admission. Conflicting results exist between recent studies and established guidelines, while in Indonesia it becomes more complex due to the limitation of provision of drugs by the National Healthcare Insurance/Jaminan Kesehatan Nasional (JKN).

Aims:         To determine the association between serum potassium levels on admission of subjects with acute coronary syndrome and in-hospital mortality. Especially in the era of JKN. To redefine the optimal serum potassium target in acute coronary syndrome patients.

Methods: Methods. Included in the study were 673 acute coronary syndrome patients hospitalised in Indonesian National Cipto  Mangunkusumo Hospital. The outcome of the study was all-cause   in-hospital   mortality. Logistic regression models adjusted for risk factors, hospital treatment and co-morbidities were constructed.

Results: Total of 163 patients (24.22%)          with abnormal serum potassium (K  <  3.50  mEq/L  or           >  5.0  mEq/L)  and  510  subjects  with  normal  serum  potassium (75.78%). Logistic  regression  shows  significant  association  between  serum  potassium level  on admission  and  in-hospital  mortality  with  p  value  of  0.04  (adjusted  RR  2.184; 95% CI: 1.037-4.601).  The  risk  of  dying  for  patients  with serum  potassium  of  4.0-<4.5 mEq/L was increased compared to subjects with potassium of 3.50-<4.0 mEq/L (relative risk 1.4; 95% CI: 0.497-3.93).

Conclusion: ACS patients with abnormal serum potassium level at admission have significant association with in-hospital mortality. Admission serum potassium level of > 4.0 mEq/L may be associated with increased mortality risk in patients with ACS. Optimal target of serum potassium level in acute coronary syndrome may be considered to be redefined to a range of 3.50-3.99 mEq/L.

Biography:

Ms. A. Jerline  Amutha MCA, M.Phil, is  working as an Assistant Professor in the Department of Computer Science- M.Sc (CST), Women’s Christian College, Chennai and a part time research scholar in Bharathiar University, Coimbatore. Area of Interest- interdisciplinary research. Specialization- Data Mining in Healthcare. Published papers titled “Study and Evaluation of Data mining And Statistics Based Temperature Control” International Journal of Applied Engineering Research and Development (IJAERD) ISSN 2250-1584 Vol. 3, Issue 3, Aug 2013, 7-14 and  “A Novel Approach for the Prediction of Treadmill Test in Cardiology using   Data Mining Algorithms implemented as a Mobile Application” in Indian Heart Journal (2018), https://doi.org/10.1016/j.ihj.2018.01.011.

Abstract:

Statement of the Problem:  Cardiovascular diseases account for a considerable percentage of untimely deaths. A statistical study conducted by WHO revealed that, around 17.7 million people had died due to Coronary Artery Heart Disease (CAHD) every year. Timely diagnosis and the correct decision on treatment can save precious lives. In the process of diagnosis of the disease, Treadmill Test (TMT) is considered as one of the important screening tests that is used to determine the condition of the heart when external stress is applied. When the patient is subjected to stress there is also a small element of risk in case of serious silent Coronary Artery Heart Disease (CAHD). To simplify and safely perform a screening procedure a Data Mining approach has been proposed in this research to predict the results of TMT. Methodology: Using a 1000 patient dataset the clinical attributes such as Age, Gender, Body Mass Index (BMI), Diabetes, Dyslipidemia and Systemic Hypertension are found to be the contributing factors for heart disease and are chosen for analysis.  The combination of Data Mining techniques - Decision Tree algorithm, K-Sorting & Searching (KSS) which is a modified version of K-Nearest Neighbors (KNN) algorithm and Curve Fitting Mathematical Technique have been applied on these attributes to predict the results of TMT. This method was then tested on 300 prospective patients. Conclusion & Significance: From the analysis, the combination proves to have an improved accuracy over the individual algorithms specified in the methodology.  The above mentioned technique utilizes data mining algorithms with a minimum number of six/seven clinical attributes. It is observed that this method has a high negative predictive value for TMT indicating that it is a useful tool to rule out CAHD. The result analysis has also given interesting outputs like reduced Accuracy if the age is more than 60 years, indicating that there are other factors that will have to be analyzed in the future. The proposed methodology implemented as a mobile application “TMT Predict” could be a future digital replacement for the manual TMT as an initial screening tool to rule out CAHD.