Scientific Program

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

Submit your Abstract
or e-mail to

events@conferenceseries.com
euroheartcongress@annualconferences.org
euroheartcongress@annualconferences.org

Scientific Program Day 1
Scientific Program Day 2

Day 2 :

Keynote Forum

Marius Berman

Transplant Surgeon Papworth Hospital, United Kingdom

Keynote: Multi-disciplinary approach to post-infarct ventricular septal defect

Time : 09:30-10:15

Conference Series Euro Heart Congress 2018 International Conference Keynote Speaker Marius Berman photo
Biography:

Marius Berman is a Consultant Cardiothoracic and Transplant Surgeon at Royal Papworth Hospital, Cambridge, UK. His main interests are management of acute cardiogenic shock, and inter-hospital transfer of patients on VA ECMO as bridge to recovery or therapy.            
 

 

Abstract:

In an era of PPCI, mortality due to AMI has fallen substantially over the past three decades. Nevertheless, patients with post-infarction ventricular septal defect (PIVSD) carry a grim prognosis and resource demanding. The management of PIVSD is complicated, and requires substantial critical care, imaging, interventional, and surgical expertise. It is therefore advisable, when clinically feasible, to transfer these patients to regional centers with adequate individual experience in the care of these patients. Traditionally, the main stream of treatment was surgery, pending hemodynamically stability and size of left to right shunt. There is no clear evidence to guide the surgical management of patients who are in shock, as all approaches have shown extremely high mortality. Possible strategies include emergency surgery, a period of mechanical circulatory support in the form of IABP or ECMO, prior to a delayed surgical or percutaneous intervention, or emergency placement of a percutaneous closure device to reduce the shunt. Often, there is a natural selection when pathway chosen was optimized, with those surviving a healing phase proceeding to therapy. Percutaneous closure may also be a viable option for patients in the sub-acute to chronic period whose comorbidities preclude surgical repair, and whose septal anatomy is favorable to device placement. We encounter incidences of percutaneous closure post-surgical closure where the patch dehisced due to further progression of the ischemic insult. We favor the establishment of a multidisciplinary PIVSD team, including interventional cardiologist, cardiac surgeon, anesthetist and radiographer in order to tailor patient specific treatment based on presenting symptoms and co-morbidities.

 

Keynote Forum

Charles H Gaymes

University of Mississippi Medical Center, USA

Keynote: Risk Stratification for AICD implantation for Hypertrophic Cardiomyopathy in the young
Conference Series Euro Heart Congress 2018 International Conference Keynote Speaker Charles H Gaymes photo
Biography:

Charles H Gaymeswas has completed his graduation from High School with top honors and attended the University of the West Indies Medical School, graduating class of 1978. He completed Residency in Pediatrics at the University of Mississippi Medical Center in 1989 and was “Outstanding Resident” in 1989. He completed his Pediatric Cardiology Residency at MUSC, South Carolina in 1992. He has been on faculty at UMMC 1992 – Present. He was “Outstanding Pediatric Faculty Member” in 1995. Currently, he practices as a Professor of Pediatrics/Cardiology and Director of Children Arrhythmia Services.

 

Abstract:

Introduction: Ninety-five percent of hypertrophic cardiomyopathy are related to defects present in four genes MYH7, MYBPC3, TNNT2 and TNN13. The cause of sudden cardiac arrest (SCA) in hypertrophic cardiomyopathy has not been determined. The guidelines for risk stratification for SCA and AICD implant from the ACC and AHA are not based on any large studies in children. Anecdotal cases do not support their usefulness. We report our data base analysis of a cohort of patients with HCM followed at a single center from 1995-2017 and found no consistent risk factors for SCA.

Methods: We reviewed our database for all hypertrophic cardiomyopathy patients followed by pediatric cardiac electrophysiology. Data was tabulated for presenting symptoms, EKG finds, ambulatory monitoring, and echocardiogram measurements. In decreased patients, autopsy results were also compiled and tabulated.

Results: Total of 57 candidates (37 male and 20 female) of age 1-29 (mean 19) years with 3 syncope 6 SCA as first symptom (3 resuscitated) and palpitations 20/57 were included in the study. 7/57 had family history of HCM 3/57 (SCA). 16/57 had no sustained VT (ambulatory monitor). 5/47 AICD received appropriate therapy (only 1/5 met guidelines for AICD) 2/47 patients inappropriate therapy. 1/47 with AICD died from ventricular fibrillation (patient within guidelines for AICD).

Conclusions: We could not identify specific criteria for risk stratification of SCA/AICD implantation in our population of patients with hypertrophic cardiomyopathy. The current guidelines are not sensitive or specific enough in children to guide AICD implant. The risk for SCA likely resides in the cellular dysfunction and may be related to the genetics. Until larger studies could better risk stratify SCA the decision for AICD should be discussed with the patient and a decision made even if the guidelines are not met.

  • 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.

Li Dong

Soochow University, China

Title: Anticoagulation treatment and related factors in patients with nonvalvular atrial fibrillation
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.

Yuan Xue

Soochow University, China

Title: Quality of life in patients with different clinical features of atrial fibrillation
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.

 

Rahul Mandole

Cardiac Care Clinics and Hospitals, India

Title: Evaluation of the efficacy of Ischemia Reversal Program in Indian patients with ischemic heart disease with the aid of stress thallium test
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.

 

Maedeh Arabian

Iran University of Medical Sciences, Iran

Title: SIRT1 and resistin as a therapeutic targets of resveratrol in aortic stenosis
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.

Laszlo Deres

University of Pecs, Hungary

Title: Effect of PARP-1 inhibition on the mitochondrial fragmentation in an in vivo SHR model
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.

Anass Assaidi

Mohammed VI University of Health Science, Morocco

Title: Combination of ivabradine and beta-blockers: Results of an observational study in daily practice in Morocco
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.

Jana Mrzílkova

Charles University, Czech Republic

Title: Ethanol fixation method for ex-vivo heart and lungs imaging in micro-CT
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.

Sahar Alborikan

King Fahad Specialist Hospital, Saudi Arabia

Title: Evaluation of changes in myocardial mechanics in children during treatment of Malignant Hypertension
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.