10^th World Heart Congress August 23-24, 2021 Prague, Czech Republic

Biography:

Abstract:

Objective To explore the early warning of acute aggravation in discharged patients with chroninc heart failure.

Methods Patients of chronic heart failure with reduced effection fraction (HFrEF) were selected from consecutive cases discharged from Songshan hospital in 2016 to 2020. A follow-up table of integrals (EWI, early warning Integral) according to the ralative factors of pathogenesis, inducement, EF, early sympotum, early sign and BNP level was designed to investigate retrospectivly the latest acute aggravation before hospitalization. Logistic regresion was used to define early warning factors and their judgement criterium.

Results Altogether 100 patients were selected from 105 consecutive discharged patients. Male/female was 46/54 with age 63.5±7.6 years and EF 41.3±5.2%. Annual hospitalization was 1.8±0.7 times. All patients complicated with organic heart disease and most of them were atrial fibrillation, hypertension, coronary heart disease and degenerative valvular disease (18%-56%). Regression showed that early acute aggravation was significantly related to pathogenesis 0.89, EF0.87, overwork 0.83, aggravated edema 0.72, shortness of breath 0.68, declined activity 0.56 (P<0.05～0.01). EWI was designed according to 2 major factors (organic heart disease and reduced EF 2 scores in each ) and at least 1/4 minor  factors (overwork, aggravated edema, shortness of breath, declined activity 1 score in each). A score larger than 5/8 suggests strongly high risk of early acute aggravation of chronic HFrEF. Subsequent BNP tests were positive in the whole group of patients.

Conclusions Discharged patients with chronic HFrEF exist identifinable sigh of early warning. EWI could be used to find their early acute aggravation. Defined diagnosis could be made by subsequent BNP test.

Biography:

Afrah Aladwani , he is  a PhD candidate at the University of Strathclyde, UK. His areas of interests include clinical pharmace, cardio-oncology and geriatric oncology.  He  supposed to earn my degree this year.

Abstract:

Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with an increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC).

Methods: In a prospective comparative population-based study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (Ë‚60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%.

Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients, respectively (IQR 8%; p-value = 0.22), although older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value Ë‚0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab-induced cardiotoxicity (OR 4; p-value Ë‚0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (<50%).

Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with a significant increased risk of cardiotoxicity.

Biography:

Dr. Zara Shirazi is a final year resident of Cardiac Surgery. She is completing her cardiac surgery training from National Institute of Cardiovascular Diseases (NICVD) which is one of the best Cardiac Centres in Pakistan, Karachi, Pakistan .Her training will end in January 2021.She has completed her two years of General Surgery training from K.M.Ruth Pfau Civil Hospital Karachi in the year of 2018 at the age of 26 years. She has done graduation and has taken her MBBS degree in the year 2015 from Dow University Of Health Sciences ( DUHS) . She has published papers and case reports in reputed journals. She has always taken interest in researches. Her practise focuses on cardiac surgery and works in conjunction with researchers at the national level. Dr Zara hopes her work will continue to bring new innovations in the field of cardiac surgery and encouraging people to have more self-confidence to pursue the things they love and believe.

Abstract:

Background

Isolated mitral valve replacement is a routinely performed procedure at our institute due to higher prevalence of rheumatic heart disease in every age category. Hardly any researches are available that dictate the predictors of surgical mortality in isolated mitral valve procedure. The aim of this study was to identify the most prevailing pre-operative factors in patients who had mortality after isolated mitral valve surgery.

Methodology

A retrospective observational study of two years was performed from January 2018 to December 2019 at the Adult Cardiac Surgery Department of a tertiary care cardiac center in Karachi, Pakistan. Patients of either gender of age ranging from 16 to 65 years who had mortality within 30 days after isolated mitral valve surgery were included in the study. Variables assessed from records were anemia, New York Heart Association (NYHA) functional classification, prolonged symptoms, poor nutritional status, degree of left ventricular (LV) dysfunction, valve pathology, pulmonary artery hypertension, and cardiac arrhythmias.

Results

We report our isolated mitral valve mortality rate of 5.5% (38/697) in the two-year duration. The most commonly encountered pre-operative factors were severe mitral regurgitation and pulmonary artery hypertension, which were observed in 32 (84.2%) and 23 (60.5%) patients, respectively. Other factors that were common to these patients were higher NYHA functional class (class III in 23 [60.5%] and class IV in 9 [23.7%]), prolonged duration of symptoms (20 [52.6%]), and right ventricular dysfunction (moderate in 21 [55.3%] and severe in 7 [18.4%]).

Conclusions

The outcome of our study suggests that severe mitral regurgitation, pulmonary artery hypertension, high NYHA functional class, LV dysfunction, and prolonged symptoms were the common predisposing factor in patients with peri-operative mortality after isolated MVR

Biography:

Abstract:

Purpose: Diabetes is a strong risk factor for cardiovascular disease. Prediabetes (Glu: 110-126mg / dl) is five times more likely to progress to Diabetes Mellitus (DM). According to the guidelines of the World Health Organization, the diagnosis of diabetes requires a glycosylated hemoglobin (HbA1c) value greater than 6.4%. This study was designed to investigate the relationship between HbA1c and coronary artery disease (CAD), as well as the relationship between HbA1c and the ultrasound markers of patients under study.

Material-Method: 69 participants (35% women, 65% men), aged 25 to 79 years without diagnosis of MD  based on fasting glucose measurements (Glu: <110mg / dl), who did not receive anti-diabetic medication, were recorded. The participants were divided into 2 groups. The first group (n = 29) with HbA1c value from 5.5% to 6.4% while the second group (n = 40) with HbA1c value ≤5.5%.

Results: In the 1st group, CAD was found at 49.6%, while in the second group the corresponding percentage of CAD was found at 28.5% with a statistically significant correlation. No statistically significant difference was observed in the ultrasound indices of the two study groups [mean Simpson ejection fraction (EF) 55.3% vs 50.43%, mean left ventricular diastolic diameter (LVEDD) 49.62 mm vs 48.15mm, mean left atrium diameter (LAd) 38.2mm vs 39.6mm].

Conclusions: In conclusion, the group with HbA1c values ​​of 5.5% -6.4% showed CAD at a rate of 21% higher compared to the group with HbA1c ≤5,5%. The ultrasound indices studied did not show statistically significant differences between the two groups, which means that they do not help to predict coronary heart disease in the groups with the specific HbA1c levels.