Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 3rd World Heart Congress Amsterdam, Netherlands.

Day :

  • Cardiovascular Disease | Heart Disease & Failure | Diabetes, Obesity & Stroke | Cardiac Nursing | Heart Diagnosis | Cardiac Surgery | Cardiovascular Disease | Cardio-Oncology
Location: Meeting Place 4+5
Biography:

Ovidio A Garcia-Villarreal is a Cardiac Surgeon dedicated to the private practice, retired from the Social Medicine. He is the Past President of the Mexican Society of Cardiac Surgery, and the current President of the Mexican College of Cardiovascular and Thoracic Surgery. He has been working on the mitral, aortic and tricuspid reconstruction for more than 25 years. He has been pioneering in the field of Cardiac Arrhythmia Surgery, especially in Atrial Fibrillation Surgery (Cox-maze procedure) as well as in aortic valve sparing operations in Mexico. He has implemented national surgical models for valvular heart reconstruction and maze procedure. He has been also dedicated to clinical research, with more than 50 international publications in PubMed and Editor-in-Chief of the journal Cirugia Cardiaca en Mexico, and reviewer of more than 15 international journals. He is active member of the Mexican Society of Cardiac Surgery, Society of Thoracic Surgeons, European Association of Cardiothoracic Surgery, amongst others.

 

Abstract:

Background: Pulmonary vein (PV) isolation has been the cornerstone in the treatment of atrial fibrillation (AF). Many doubts exist about permanent total disconnection of the PV after catheter-based techniques. Surgical division of the PV is the most convincing technique to avoid any further reconnection. We believe this way is the clearest one to investigate how effective PV isolation alone is in the treatment for atrial fibrillation.

Material & Methods: From 1998 to 2010, we operated on 120 adult patients having rheumatic mitral valve disease and concomitant AF. All of them had long-standing persistent AF (> 1 year of duration). PV isolation was performed surgically by means of cut-and-sew in all these cases of mitral valve surgery. All patients were analyzed at three months, six months, one year, and once yearly after operation. Registers were recorded arising from Holter and echocardiographic study during the follow-up to seven years.

Results: Follow up completed at 93% for seven years. There was only one operative death (0.8%), and seven more along the follow-up. The end point was free from any AF, flutter or atrial tachyarrhythmia. Any type of tachyarrhythmia was present at 39%, 47%, 63%, 68%, and 70% at 3 months, one year, three years, five years, and seven years. The odds ratio for AF recurrence at seven years was 2.33 (95% CI, 1.46-3.71; p < 0.001). Left atrial size > 6.5 cm in diameter was directly related to AF recurrence at seven years after surgery (odds ratio= 8.25 [95% CI, 2.84-24.25; p < 0.001).

Conclusions: By dividing PV surgically, there is no doubt about definitive and complete PV disconnection. Surgical isolation of the PV is not enough to eliminate long-standing persistent AF. More complex procedures such as maze procedure should be considered to treat surgically the AF, especially long-standing persistent AF.

 

Biography:

Jun-Yang Liou has his expertise in molecular signaling in regulating cell proliferation and differentiation. His research interests focus on these areas: (1) Gene Regulation and Siganl Transduction in Regulating Cancer Cell Survival, Proliferation, Migration and Invasion. He has identified several regulators involved in Tumor Progression and Metastasis. (2) Molecular Mechanisms and Signal Pathways in Regulating Mouse Embryonic Stem Cell Differentiation and Proliferation. He has identified that inhibition of ROCK signaling contributes to neural, hematopoietic and cardiac differentiation of mouse embryonic stem and induced pluripotent stem cells.

Abstract:

Cardiac and hematopoietic stem/progenitor cells derived from Embryonic stem cells are unlimited cell source and are potentially used for cell transplantation of various heart and hematological diseases. Rho and Rho-associated kinase (ROCK) signaling was implicated in regulating differentiation of various stem cells and ROCK plays an important role in maintaining embryonic stem (ES) cell pluripotency. We have previously reported that suppression of ROCK signaling induced embryonic stem cells different into neural lineages. In this study, we examined whether ROCK signaling is involved in modulating mesodermal differentiation including cardiac stem/progenitor cells and hematopoietic stem cells (HSCs). To determine whether ROCK is involved in ES cell differentiation into cardiac and hematopoietic lineage, we evaluated the effect of ROCK inhibitors, Y-27632 and fasudil on mouse ES and induced pluripotent stem (iPS) cell differentiation. Cells were cultured in hematopoietic differentiation medium in the presence or absence of ROCK inhibitor and colony formation as well as markers of HSCs and ES cells were analyzed. ROCK inhibition resulted in a drastic change in colony morphology accompanied by loss of HSC and increase of cardiac progenitor cell markers. Fasudil-induced cardiac cells were infused into a mouse acute myocardial infarction model. They preserved left ventricular function. These findings provide new insights into the signaling required for ES cell differentiation into cardiac lineage or HSC and suggest that ROCK inhibitors are useful in directing iPS cell differentiation into cardiac progenitor cells for cell therapy of cardiovascular diseases.

Biography:

Onur Kaypakli is currently working as an Assistant Professor of Cardiology in the Department of Cardiology at Mustafa Kemal University, Faculty of Medicine - Hatay, Turkey.

 

Abstract:

Aim: Atrial fibrillation (AF) episodes can be silent, symptomatic or emerged with its complications in the pacemaker implanted patients. The aim of this study was to investigate the relation between P wave duration index (PWDI) and silent AF occurence in paitnets with cardiac resynchronization therapy (CRT).

Methods: The study population consisted of 181 CRT device implanted patients. The AF episodes that lasts at least 30 seconds with no symptoms were accepted as silent AF. PWDI is calculated by dividing the P wave duration by the PR interval.

Results: Patients were separated into two groups as “with silent AF” and “without silent AF”. Without silent AF group had 121 patients (mean age 62.9±8.7 years, 62% male). With silent AF group had 60 patients (mean age 67.9±9.7 years, 60% male). Paitents with silent AF had a significantly higher mean age (p=0.001). PR duration was significantly higher in paitents without silent AF (p=0.001). First degree IAB and PWDI values were significantly higher in patients with silent AF (p values were 0.001 and <0.001 respectively). Age (OR: 1.073, %95 CI:1.028-1.119,p=0.001) and PWDI (OR:1.053, %95 CI:1.028-1.078, p<0.001) were detected as independent predictors for silent AF in multivariate logistic regression analysis. In the ROC analysis, the cut off value of PWDI was determined as 0.67 to detect silent AF episodes with 81.7% sensitivity and 50.4% specificity (AUC:0.701, p<0.001).

Conclusion: PWDI and age significantly associated with silent AF in patients with CRT. PWDI can be considered to be a useful and easily applicable parameter to predict patients who will develop sient AF.

 

Biography:

Sahasrabuddhe A has been working as Assistant Professor at the Department of Physiology since 2007. She has keen interest in Research with many national and international publications to her credit. Her area of interest in research is obesity, diabetes cardio-metabolic disorders and endocrinology. Her work ‘Cardiac diastolic dysfunction and regional body fat distribution in insulin resistant peripubertal obese males’ received award in 22nd Annual Congress of American Association of Clinical Endocrinologists held at Phoenix, Arizona from 1st – 5th May 2013. Her project ‘Cord blood levels of insulin and glucose in full term pregnancies’ won 2nd prize in Academy of Medical Sciences (Jan 2008). She is on editorial board of reputed journals and on reviewer board of many journals national and international including BMJ-Case Reports.

 

Abstract:

Background: CAD is a leading cause of mortality and morbidity world-wide. Epicardial adipose tissue is unique visceral fat depot due to its anatomical and functional contiguity with myocardium and coronaries. Though under physiological conditions, it exhibits metabolic, biochemical and thermogenic cardioprotective properties; in pathological conditions it can exert vasocrine and paracrine actions through its pro-inflammatory cytokines on myocardium and coronaries. Though role of inflammation in development of CAD is well documented, the special role played by epicardial adipose tissue is poorly understood and less studied. Plasma inflammatory biomarkers may not adequately reflect this local tissue inflammation.

Aims: To find out the pathologic functioning of epicardial fat in patients with CAD and the difference in gene expression of epicardial fat in CAD and non-CAD patients.

Materials & Methods: After obtaining Ethics Committee clearance 27 patients undergoing CABG, and 16 Controls (non- CAD patients undergoing valvular heart surgeries) were recruited in the project. Epicardial adipose tissue sample was obtained and gene expression of following molecules was studied by TaqMan real-time reverse transcription–polymerase chain reaction (mRNA): UCP-1, MCP-1, Adiponectin, ADORA, VCAM and TNF-alpha. Fasting blood sugar, insulin, lipid profile, hsCRP, Homocysteine, Vitamin D, vitamin B12, TNF-alpha and Leptin levels were also measured.

Results: TNF-alpha, MCP-1, VCAM-1 were found to be up-regulated while the expression of UCP-1, ADORA and adiponectin were down-regulated in cases as compared with controls. After applying multivariate analysis for gene expression, up-regulation of MCP-1 was found to be statistically significant (p= 0.01). Vitamin D levels were low across the groups and there was no difference in the levels of vitamin D, vitamin B12, hsCRP, Homocysteine and TNF-alpha. Leptin levels were significantly high in cases (p=0.018).

Conclusion: Epicardial adipose tissue gene expression is significantly pathogenic in CAD patients with upregulation of inflammatory markers and downregulation of anti-inflammatory ones. Plasma levels of inflammatory markers may not be predictive of CAD risk.

Biography:

Xiao-Hua Wang has completed her PhD majored in Immunology from Soochow University. She has been the Director of Medical Nursing over 10 years. She has published more than 30 papers in impact journals and has been serving as a reviewer of some journals.

 

Abstract:

Background: Depression and anxiety often co-occur in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). However, previous studies have reported the separate impact of depression or anxiety on PCI patients.

Methods: A multicenter, prospective, longitudinal study was undertaken with a consecutive sample of 309 primary CAD patients undergoing PCI between June 2015 and May 2016 at 4 hospitals in China. The Hospital Anxiety and Depression Scale (HADS) were completed at baseline to assess anxiety and depression symptoms. Major adverse cardiovascular events (MACEs) were recorded for 12 months through outpatient clinic and monthly telephone follow-up, and medical records and death certificate review.

Results: Among the 309 patients (mean age 62.6±11.2 years, range 31-96), 80 (25.9%) had depression, and 100 (32.4%) had anxiety. The mean follow-up duration was 346 days (range 24 to 365). MACEs occurred in 26 (8.4%) patients, including 1 case of death, 10 cases of nonfatal new MIs, 4 cases of repeated coronary revascularization, 6 cases of in-stent restenosis, 2 cases of heart failure, and 3 cases of severe arrhythmia. The incidence rates of MACEs were significantly higher in patients with depression or anxiety than in those without. The Log Rank test showed that depression and anxiety (c2=9.53, P=0.002 and c2=6.10, P=0.014,) were associated with a higher rate of MACEs. Depression and anxiety were the predictors of higher MACE incidence (HR=3.15, 95% CI: 1.46-6.79, P=0.003; HR=2.55, 95% CI: 1.18-5.52, P=0.017, respectively). After adjustments for baseline characteristics, depression and anxiety remained the independent predictors of MACEs (HR=2.70, 95% CI: 1.22-5.95, P=0.014; HR=2.56, 95% CI: 1.18-5.54, P=0.017, respectively). A separate multivariate Cox regression test for possible interactions did not show an interaction between depression and anxiety. Cumulative event-free survival rates did not differ among depressed and anxious patients and depressed but non-anxious patients (Log Rank P=0.623) or among anxious but non-depressed patients and non-anxious, non-depressed patients (Log Rank P=0.082). The groups including patients with symptoms of depression showed an increased risk for MACEs, whereas there were no significant differences in the risk for MACEs between patients with only symptoms of anxiety and patients without these psychological symptoms.

Conclusions: Depression is associated with an increased risk of 170% for MACEs 12 month’s post-PCI, independent of anxiety. Although anxiety is associated with MACEs, it has no additional predictive value when co-occurring with depression.

Biography:

Liutsiia Feiskhanova is an Associate Professor of department of hospital therapy of Kazan State Medical University, Russia. She has published more than 25 articles in reputed journals. Her interests: cardiology, arrhythmology, rheumatology.

 

 

Abstract:

The risk of cardiovascular pathology in rheumatoid arthritis (RA) is 1.5-2 times higher than in the population. This increased risk is based on systemic chronic inflammation, which is the hallmark of rheumatoid arthritis. Framingham scale and SCORE are insufficiently reliable for assessment of cardiovascular risk in patients with RA, because they have the value of the presence of rheumatoid factor and long-lasting increase of ESR. Cardiovascular risk is correlated with the presence of rheumatoid factor, antibodies to cyclic citrullinated peptide, activity and duration of the disease. Dyslipidemia develops earlier than in the population. Proinflammatory cytokines are involved in atherosclerosis and myocardial fibrosis. Sudden cardiac death occurs in 2 times more often in people with RA, than in the population. The greatest contribution to the development of sudden cardiac death is made by ventricular arrhythmias. Patients with RA have a tendency to develop myocarditis and fibrosis, which leads to diastolic dysfunction. According to our data, the diastolic dysfunction correlates with the degree of activity of the disease (p<0.05). Pericardial damage is a common occurrence in rheumatic diseases. In our study the pericardial effusion is found in about 30% of cases according to echocardiography, but specialists often find it difficult and see this picture as an increase of myocardial mass, which in the calculation of parameters indicates the presence of eccentric hypertrophy. Given the fact that RA is the most common rheumatic disease, it needs the special attention to cardiovascular pathology that increases the risk of fatal consequences in patients with RA.

Biography:

Vijaya pamidimukkala, has completed her DM in Neurology from PGIMER, Chandigarh. She has been a gold medalist at PGIMER, Chandigarh in MD (General Medicine). Her special interest is Stroke Management and main expertise in the Field of Comprehensive Stroke Therapy. Currently, she is running an active stroke program treating about 125 stroke cases per month. She achieved gold medals for 2 consecutive years for World Stroke Day activities from the World Stroke Organization. She started Stroke Volunteer Network Program involving the students and general public as stroke volunteers. She has published papers in international journals and has presented 17 paper presentations at various international conferences. In addition, she has presented 34 scientific paper presentations in national conferences, IMA meetings, CME and as invited guest speaker for scientific forums. She has been a member of 5 reputed organisations.

 

Abstract:

Extracranial vertebral artey stenosis is common in patients with posterior circulation ischaemic stroke. In our high volume stroke centre, we analysed the data of symtomatic extracranial vertebral artery stenosis treated with angioplasty from 2003 to 2013. Total 284 patients underwent vertebral angioplasty and were followed up and analysed. Inclusion criteria were: recent ipsilateral posterior circulation stroke, recurrent posterior circulation tias with documented critical vertebral artery stenosis at the origin. Patients with associated critical carotid stenosis and intracranial vertebral stenosis were excluded. Mean age of patients was 58±8 years and 72% were males. Of total, 56% were diabetic, 48% were hypertensive, 58% had coronary artey disease, 38% were smokers. All procedures were performed using standard percutaneous angioplasty protocol. Transfemoral route was approched in 94% procedures. Dual antiplatelets (aspirin 150 mg OD and clopidogrel 75 mg BD) and statins were given. Fifty-six patients received bare metal stents (BMS) and remaining received drug-eluting stents (DES). Mean follow-up of 2.5 years (1-6 years), was performed with clinical and doppler studies. Procedural success was 99.5%. Two patients had femoral hematoma. No major periprocedural complication like stroke or myocardial infarction (MI) or death were observed. Restenosis occurred in 4 patients (3 in BMS group; 1 in DES group). One patient had basilar stroke after 6 months and 2 patients had MI, of which 1 patient died. In conclusion, angioplasty with stenting of extracranial vertebral artery is safe procedure with very high success rate and good clinical outcome. However, further randomised trials should be held on treatment of extracranial vertebral stenosis

Speaker
Biography:

Suneeta Narumanchi is currently a PhD student in Ilkka Tikkanen’s Group, Minerva, Biomedicum 2U, from December 2013. She has worked as a Researcher at Department of Biochemistry, University Of Helsinki, Carl Gahmberg’s lab in Feb 2010 – May 2012. She also published many articles some of them are sept7b is required for the subcellular organization of cardiomyocytes and cardiac function in zebra fish (* in thesis), Microbes in the Treatment of Diabetes and Its Complications etc. 

Abstract:

Introduction: Micro-RNAs are short, noncoding RNA molecules that regulate gene expression. Micro-RNA let-7c has an important role in cardiac regeneration and remodelling after myocardial infarction in mice. Understanding the role of let-7c in regeneration of zebrafish heart remains incomplete.
Methods: Antagomir injections were used to knockdown Let-7c, while injections of scramble RNA were used as control in adult zebrafish. The apex of the ventricle was cooled with a metal probe dipped in liquid nitrogen, this procedure kills cardiomyocytes and mimics myocardial infarction. Knockdown of let-7c was confirmed with qPCR. Cardiac function was followed with cardiac ultrasound before the cryoinjury and after the cryoinjury at day 1, 1 week, 2 weeks, 3 weeks and 4 weeks. Fractional volume shortening (FVS) of the ventricle was found to be the most reliable and repeatable method to quantify cardiac function. Heart, liver and kidney samples were collected at 2 weeks and 4 weeks for qPCR, Acid Fuchsine Orange G staining and immunohistochemistry with proliferating cell nuclear antigen (PCNA).
Results: Let-7c antagomir treatment resulted in faster recovery of cardiac function and improved regeneration after cryoinjury compared to control treatment. FVS returned to pre-cryoinjury levels (35.74%±1.01%) in let-7c antagomir fish three weeks after cryoinjury (29.92 %±1.9%, P=0.053), whereas, FVS was comparable to pre-cryoinjury levels at 4 weeks (29.18 %±0.63%, P=0.052) in the control fish. Let-7c antagomir fish had lower fibrin% (8.64 %±2.20, P=0.039) in the injured area at four weeks compared to control fish (19.67%±4.26). Collagen accumulation started earlier in the let-7c antagomir fish indicating a faster recovery. At 2 weeks fibrin/collagen% was greater in let-7c antagomir fish compared to control fish (43.16%± 4.87 vs. 29.98%±3.97, P=0.05).
Immunohistochemistry with PCNA revealed a trend of higher proliferating cardiomyocytes in the antagomir group at two weeks.
Conclusion: Inhibition of Let-7c improved cardiac regeneration after cryoinjury in adult zebrafish.

Biography:

Maedeh Arabian has completed his PhD from School of Medicine, Iran University of Medical Sciences. She is the faculty member of Rajaie Cardiovascular Medical and Research Center and Head of the Cellular and Molecular Lab. She has published more than 10 papers in reputed journals and has been serving as an Editorial Board Member of Research in Cardiovascular Medicine Journal. She is intrested in “Role of Inflammation in Cardiovascular Diseases”.

 

Abstract:

The main causes of aortic valve stenosis (AS) are extracellular matrix remodeling and inflammation. However, the molecular mechanisms contributing to these inflammatory processes are not well established. Finding the novel biomarkers and targeted therapy of inflammation are considered as an attractive strategy in AS and atherosclerosis. The purpose of our study was to evaluate the level of resistin and modulatory role of sirtuin-1 (SIRT1) in patients with AS before and after the cardiac surgery and also evaluate the effects of resveratrol on the expressions of resistin and SIRT1. Twenty patients with AS which underwent an aortic valve replacement surgery were enrolled. Blood samples were collected before and 72 hr after the operation. Isolated peripheral mononuclear cells (PBMC) from the blood samples were cultured and treated with resveratrol (50 µM) and eventually analyzed for the levels of resistin and SIRT-1 activity and compared to the healthy subjects as a control. Resistin expression was higher in patients with AS compared to control (p<0.05) and its level augmented 72 hr post operation in patients group (p<0.05). SIRT1 activity was negatively associated with resistin mRNA levels and its activity was lower in patients group compared to control group. Cardiac surgery caused to more decrease in SIRT1 activity. Treatment with resveratrol, significantly diminished resistin mRNA level (p<0.05), whereas increased the SIRT1 activity (p<0.01) in patients group. Our findings revealed that in patients with AS resistin levels were increased whereas activity of SIRT1 reduced and cardiac surgery could augment these alterations. The results also suggest that, resveratrol could improve the inflammatory state by increasing SIRT1 activity and reduction in resistin. These findings suggest that resveratrol could modify inflammation through the regulation of SIRT1 activity and resistin level and could be a novel approach to decrease inflammation either in patients with AS or post operation conditions.

 

  • Hypertension | Cardiac Pharmacology | Heart Devices | Cardiology - Future Medicine | Heart Regeneration | Cardiologists | Nuclear Cardiology
Location: Meeting Place 4+5

Session Introduction

Charles H Gaymes

University of Mississippi Medical Centre, USA

Title: Catheter ablation of arrhythmia in Ebstein anomaly (EA)
Speaker
Biography:

Charles H Gaymes is a director of pediatric cardiac electrophysiology and working as a professor at the university of Mississippi Medical Center in USA.

Abstract:

There is a high incidence of accessory pathways both manifest and concealed as well as atrial re-entry tachycardia in EA. Catheter ablation is the preferred therapy. The abnormal anatomy in EA may make WPW less obvious than normal and SVT presentation with a wide QRS. Familiarity with the abnormal anatomy and physiology with mechanical arterialization of the inlet right ventricle but electrically right ventricle. The underdeveloped muscle wall has a greater risk for perforation and coronary injury and Av node block.
Methodology and Results: a search of current literature and review of catheter ablation at the University of Mississippi medical center was performed and summarized.
Conclusion: catheter ablation of tachy-arrhythmia in EA is the preferred method of treatment. Familiarity with the anatomy and electrophysiology is essential for successful results with low risk for complications.

Biography:

Li Dong is a grade 2 Master’s student, who was admitted to Soochow University for a 3-year Master’s degree program, majoring in Nursing at School of Nursing of Soochow University in September 2016.

Abstract:

Objective: To explore the current situations of anticoagulation treatment and related factors in patients with nonvalvular atrial fibrillation.

Methods: From January 2017 to September 2017, eligible participants were recruited from two hospitals in Suzhou. We analyzed the basic characteristics, clinic data and medical treatment plan of enrolled patients.

Results: A total of 453 patients were enrolled, 80.57% of whom were the CH2DS2-VASc score ≥2. There were 19 (5.2%), 87 (23.8%) and 119 (32.6%)non-valvular atrial fibrillation patients who received new oral anticoagulants, warfarin and aspirin, respectively. Age between 60 to 69, mild and moderate symptoms was associated with usage of anticoagulation treatment in high risk of stroke.

Conclusion: The rate of anticoagulant therapy was still low, and the measures should be taken to improve this condition.

Biography:

Yuan Xue is a Grade 1 Master’s student, who was admitted to Soochow University for a 3-year Master’s degree program, majoring in Cardiovascular Nursing at School of Nursing, Soochow University in September 2017.

 

 

Abstract:

Objective: Objective of the study is to investigate the status of the quality of life (QoL) in patients with different clinical features of atrial fibrillation (AF).

Methods: A total of 572 patients with AF from 7 hospitals in Jiangsu Provence were investigated by using AF-QoL-17 questionnaire and analyze the status of QoL in patients with different clinical features of AF.

Results: Mean age of AF patients at admission was 71.28 ± 11.16 years; 52.8% of these patients were male. Patients with paroxysmal, persistent and permanent AF were 368 (64.3%), 155 (17.8%) and 38 (6.6%), respectively. 11 patients didn’t indicate the type of AF. QoL score in patients with AF was 46.00 ±13.53. Univariate analysis showed that there were significant differences in the score of QoL in comorbidities, LVEF class, anticoagulant and antithrombotic therapy, the severity of AF symptoms, and the score of CHA2DS2-VASC (P<0.05). From the subgroup analysis shown, QoL score of patients at high risk of stroke with anticoagulant therapy was significantly higher than that of patients at high risk of stroke without anticoagulation therapy (P <0.01). QoL score of paroxysmal AF patients at high risk of stroke with anticoagulant therapy was significantly higher than that of paroxysmal AF patients at high risk of stroke without anticoagulation therapy (P <0.05).

Conclusion: For patients at high risk of stroke without anticoagulant therapy, especially patients with paroxysmal AF, quality of their lives may be improved by carrying on clinical intervention under the premise of reducing the risk of stroke.

 

Biography:

Rohit Sane is the first to conceptualize the idea that ancient Indian Medical Science, Ayurveda, can play a big role in chronic cardiac disease. He is the founder of Madhavbaug Clinics & Hospitals in India, used his education in Modern Medicine and undertook a meticulous research into Ayurveda. Extensive experimentation and delving deeper into every minute aspect of his study led him to find scientific evidence to substantiate this novel idea. His effort resulted in a combination of modern medical science and the well-established therapies prescribed in Ayurveda, which could prove highly effective alternative way to treat chronic heart failure.

 

 

Abstract:

Ischemic heart disease (IHD) incidence has increased in India at a rapid speed and shows regional variations, early onset, greater mortality and poor management. Stress thallium test is useful in diagnosing IHD early in patients who may be at risk for a heart attack. The aim of the present study was to assess the cardiac muscle activity in IHD patients before and after ischemic reversal programme (IRP). The present open label study involved 14 IHD patients who underwent IRP (21 IRP sittings) in Madhavbaug clinics (multicentric). The inclusion criteria were subjects with known IHD, age group between 40-70 yrs, BMI > 20 kg/m2, and stress test positive for inducible ischemia. However, subjects with recent myocardial infarction/ known hypo- or hyper- thyroidism/ chronic kidney disorder were excluded. Stress thallium test was performed after enrolment, 21 IRP sittings and 25-30 IRP sittings. VO2max and time of ischemia after stress test were also recorded in all the patients. Further, Seattle Angina Questionnaire (SAQ) was taken via telephonic conversation by research coordinators. Observations from stress thallium test showed significant difference in Summed Stress Score [SSS] (13.5±10.3, baseline vs. 10.7±10.1, post 21 IRP sittings; p=0.01) as well as Summed Difference Score [SDS] (8.9±6.2, baseline vs. 6.2±6.3, post 21 IRP sittings; p=0.03) in IHD patients. Similarly, we observed increase in VO2max levels (12.8±5.7, baseline; 19.4±7.8, post 21 IRP sittings and 23.6±6.0, post 25-30 IRP sittings) and time of ischemia in seconds (370.7±201.1, baseline vs. 597.8±201.9, post 21 IRP sittings and 702.0±138.0, 30-days follow-up). Further assessment of SAQ scores showed significant improvement post IRP (30.2±3.6, baseline vs. 32.7±3.5, post 21 IRP sittings) whereas, ejection fraction score was not found to be significantly changed post IRP as compared with baseline. Results of the present study suggest an improvement in cardiac muscle activity after IRP in IHD patients and depicts positive role of IRP in IHD management.

 

Speaker
Biography:

Maedeh Arabian has completed his PhD from School of Medicine, Iran University of Medical Sciences. She is the faculty member of Rajaie Cardiovascular Medical and Research Center and Head of the Cellular and Molecular Lab. She has published more than 10 papers in reputed journals and has been serving as an Editorial Board Member of Research in Cardiovascular Medicine Journal. She is intrested in “Role of Inflammation in Cardiovascular Diseases”.

Abstract:

The main causes of aortic valve stenosis (AS) are extracellular matrix remodeling and inflammation. However, the molecular mechanisms contributing to these inflammatory processes are not well established. Finding the novel biomarkers and targeted therapy of inflammation are considered as an attractive strategy in AS and atherosclerosis. The purpose of our study was to evaluate the level of resistin and modulatory role of sirtuin-1 (SIRT1) in patients with AS before and after the cardiac surgery and also evaluate the effects of resveratrol on the expressions of resistin and SIRT1. Twenty patients with AS which underwent an aortic valve replacement surgery were enrolled. Blood samples were collected before and 72 hr after the operation. Isolated peripheral mononuclear cells (PBMC) from the blood samples were cultured and treated with resveratrol (50 µM) and eventually analyzed for the levels of resistin and SIRT-1 activity and compared to the healthy subjects as a control. Resistin expression was higher in patients with AS compared to control (p<0.05) and its level augmented 72 hr post operation in patients group (p<0.05). SIRT1 activity was negatively associated with resistin mRNA levels and its activity was lower in patients group compared to control group. Cardiac surgery caused to more decrease in SIRT1 activity. Treatment with resveratrol, significantly diminished resistin mRNA level (p<0.05), whereas increased the SIRT1 activity (p<0.01) in patients group. Our findings revealed that in patients with AS resistin levels were increased whereas activity of SIRT1 reduced and cardiac surgery could augment these alterations. The results also suggest that, resveratrol could improve the inflammatory state by increasing SIRT1 activity and reduction in resistin. These findings suggest that resveratrol could modify inflammation through the regulation of SIRT1 activity and resistin level and could be a novel approach to decrease inflammation either in patients with AS or post operation conditions.

 

  • Poster Presentations
Location: Pre-function Area
Speaker

Chair

Marius Bermam

Royal Papworth Hospital, United Kingdom

Session Introduction

Olesia Nasonenko

Zaporizhzhia State Medical University, Ukraine

Title: Features of myocardial deformation and arterial stiffness in hypertensive men with low testosterone
Speaker
Biography:

Olesia Nasonenko is currently pursuing her Post-graduation from Zaporizhzhia State Medical University in Ukraine. She is also working on a PhD thesis “Optimization of diagnostics and treatment of hypertension in men with androgen deficiency”.

Abstract:

Ninety six non-obese male hypertensive patients were screened for the androgen deficiency symptoms via MASSQ questionnaire. 82 subjects with suspected low total testosterone (TT) were included into the study for subsequent TT measurement. 51 patients with confirmed androgen deficiency (group 1) and 24 hypertensive male with normal TT (group 2) were exposed to further examination. 18 healthy men of comparable age were recruited as a control group. The lower TT was associated with higher systolic BP, but not with diastolic BP, and also with the prevalence of nondipper pattern. TT significantly correlated with age (r=0.46, p<0.05), aaoPWV (r=0.32, p<0.05), AIx (r=0.26, p<0.05), correlation with LV mass index and LVEF was non-significant. Global longitudinal strain (GLS) becomes markedly declined in subjects from group 1 and group 2 (up to -17%) compared to the control group. GLS in group 1 was decreased the most, it was in strong correlation with aoPWV (r=0.38, p<0.05). There was no significant difference between group 1, group 2 and control group in circumferential and radial strain. The multiple regression analysis has shown the relationship between TT and SBP, aoPWV, GLS. The study demonstrates the additional influence of low TT on the development of cardiovascular remodeling in men with hypertension. Enhanced arterial stiffness and reduced myocardial deformation in these subjects not only reflects the normal aging processess, but also may be the reason of an unfavorable BP circadian pattern.

Speaker
Biography:

Laszlo Deres has completed his PhD in 2015 at the University of Pecs Medical School. He is a member of the Genomic and Experimental Cardiology Research Group taking place at the Szentágothai Research Center, University of Pecs.

Abstract:

Introduction: Mitochondria form a highly dynamic network, which current state is determined by fusion-fission processes. Oxidative stress induced fragmentation of cardiac mitochondria is a well known phenomenon, which has profound effects on cell viability. Thus, influencing these processes may have therapeutic importance. In our experiment, we evaluated the effect of PARP-1 inhibition on cardiac mitochondrial changes due to persistent hypertension.
Methods: 10 weeks old male SHR rats received 5 mg/kg/day L-2286 PARP-1 inhibitor (SHR-L) or placebo (SHR-C) treatment for 32 weeks. Normotensive controls were male Wistar rats (WKY). After the treatment, electron microscopic preparations were made from cardiac tissues. We evaluated the average areas of inter-fibrillar mitochondria (IFM) on longitudinal sections. The levels of proteins involved in mitochondrial dynamics (the pro-fission Drp1 GTPase and cristae membrane integrity influencing Opa1) were monitored by fractioned Western blot samples.
Results: Mitochondria showed greater heterogeneity in both shape and size in the SHR-C group, and dilatation of cristae spaces were observed. These alterations were less pronounced in the treatment group. We found increased fragmentation of mitochondria in the SHR-C group (p<0.05 vs. WKY), which was significantly attenuated by the L-2286 treatment. Western blot analysis showed decreased translocation of the pro-fission Drp1 protein into the mitochondria in the SHR-L group compared to the SHR-C group. No significant changes were observed in the level of Opa1 expression.
Discussion: In a hypertensive animal model, the oxidative stress-induced cardiac mitochondrial fragmentation was significantly attenuated by L-2286 treatment. This may be due to the favorable signaling effect of PARP-1 inhibition beside its well-known effect on increased oxidative stress resistance and on increased bioenergetic stability of the heart.

Speaker
Biography:

Anass Assaidi,is a Medical Doctor and an Assistant Professor of Interventional Cardiology at Mohammed VI University of Health Sciences and Cheikh Khalifa ibn Zaid Hospital. He is a Graduate Cardiologyist from Aix Marseille II University and Casablanca Medicine University, got Interuniversity Diploma of "Pediatric and Congenital Cardiology" in 2012 from Aix-Marseille II University, “Echocardiography" from Bordeaux II University and "Endovascular treatment of valvular heart disease" from Paris V University. He is an active member of European, French & Moroccan Societies of Cardiology and Member of the Interventional Cardiology Reflection Group. He participated in many research projects related to cardiovascular diseases and author of several publications.

Abstract:

Introduction: Several studies confirm that combining ivabradine with beta-blockers, reduce more effectively the heart rate in patients with heart failure and/or angina than beta-blockers alone.
Methods: Non-interventional cohort study, conducted in Morocco Cardiology clinical practice, in patients with heart failure or angina treated with ivabradine in combination with beta-blockers. The primary outcome, measured at 1 and 4 months, were HR, NYHA classification, and SEATTLE quality of life questionnaire for angina patients.
Results: 497 patients were included, their mean age was 65.6±10.3 years, mean HR was 89.4±14.5 bpm and 61.6% were male. 10.9% treated with less than the initial beta-blockers dosage, 56.8% under initial dosage, 21.9% under less than recommended dosage and 10.4% under recommended dose. After 4 months, the mean HR showed a significant reduction of 27±13.8 bpm (p<0.0001) and no statistical significant difference (p=0.46) observed between beta-blockers dosages which was respectively 26.2±0.8, 28.2±2, 32.2±2, and 26.08±1.3, for initial, recommended, less than initial and less than recommended dosage. 42% of patients became NYHA I, 55% NYHA II, only 4% were NYHA III and no patient remained NYHA IV regardless of BB dosages. There was no-significant difference associated to the BB dose (p=0.53) in the 5 SAQ domain-scores between baseline (V0) and 4 months follow up visit (V2).
Conclusion: In this study, ivabradine was effective in reducing HR in CHF and angina patients over a period of 4 months irrespective of the dose of beta-blockers. There was a marked shift from higher to lower NYHA classes independently of the BB administered dose.

Speaker
Biography:

Jana Mrzílková has completed her MD and Post-doctoral studies from Charles University, Prague, Czech republic. She is the Director of Experimental Micro CT laboratory at Third Faculty of Medicine, Charles University, Prague, Czech republic. She has published more than 8 papers in reputed journals and has been also involved in neuroscience research.

Abstract:

During past years, several staining methods were developed in order to increase the contrast of soft tissues. However, most of these methods are complicated, time-consuming and use toxic contrast agents. One of the best and mostly used contrasts agents for soft tissue imaging are aqueous solutions of osmium tetroxide, phosphomolybdic acid (PMA) or phosphotungstic acid (PTA). Osmium tetroxide is very toxic, does not stain well if samples have been in alcohol and also its penetration is slow. PTA penetrates tissues slowly also, but it is less toxic, simpler to use and effectively stains alcohol-stored samples. PMA gives better contrast among different tissues, but requires longer incubation; conversely, its contrast between different tissues was superior. Our goal was to create a simple, cheap and stable fixation method for ex-vivo soft tissues scanning in micro-CT, a method which would give sufficient contrast among soft tissues in organs. Ethanol provided contrast enhancement in both studied organs in all used types of fixation. Fixation in 97% ethanol enhanced contrast among the tissues already after 72 hours, however, it caused hardening of the organs and in some cases even rupture of the specimens. Fixation in 50% ethanol provided best results after 336 hours, and details were not visualized as well as in 97% ethanol; conversely, samples were not that stiff. Best results provided fixation in a row of ascending ethanol concentrations; all organs were visualized in great details without being damaged.

Speaker
Biography:

Sahar Alborikan is a postgraduate clinical researcher and she has completed her MSc at the age of 26 from King’s College of London and she is currently a PhD student at William Harvey institute, Queen Mary University of London in the area of adult congenital heart disease. She is a senior Cardiac Technology Specialist at King Fahad Specialist Hospital, Dammam Saudi Arabia. Her main research interest is advanced echocardiographic techniques in adult and paediatric.

Abstract:

TThe aims of this study were to evaluate the influence of malignant hypertension (MHT) on left ventricular mass and mechanics using advanced echocardiographic techniques. Material and methods: Children with MHT ≤16 years of age were identified. Left ventricular assessment was performed retrospectively using M-mode and two-dimensional echocardiography (2DE), in addition to 2D and 3D speckle tracking echocardiography (STE). Hypertension was defined according to the Fourth Report of the National Blood Pressure Education Program. LV mass (LVM) was calculated by Devereux formula and indexed to height (g/m2.7). Left ventricular hypertrophy (LVH) was defined as indexed LVM (LVMI) for height z-scores>1.64SD. 
Results: 37 patients (age9±6years) with mean glomerular filtration rate (82.11±34.9 ml/min/1.73m²) and mean SBP z-scores (6.25±2.82), showed abnormal LVM and mechanics at presentation. The mean LVMI z-score was 2.1±2.4, with 22 patients (62%) exhibiting LVH at presentation. There were significant changes for 2DSTE longitudinal strain (LS) (-14.82±4.2 vs. -20.74±2.8, %; p<0.001) and circumferential strain (CS) (-13.74±5.5 vs. -20.65±5.2,%; p<0.001) between baseline and last visit. Similarly, significant changes were observed in 3DSTE LS (p 0.002), CS (p0.020) and radial strain (RS) (p.0.004). LVMI z-scores showed significant reduction (2.1±2.4 vs. 01±2.1; p<0.001) over time. These changes though were not related to extent of reduction in the blood pressure despite relatively strong positive association (r²=.6; p0.65). Conclusions: Abnormal indices of LV mass and mechanics are evident in children with MHT with changes reversible on management of blood pressure. It is possible that other factors such as class of anti-hypertensive agent have an impact on LVM and deformation beyond reduction of blood pressure alone.