2^nd World Cardiology and Cardiac Rehabilitation Meeting July 01-02, 2020 Athens, Greece

Biography:

William J. Rowe M.D. FBIS (Fellow British Interplanetary Society), FACN (Fellow American College of Nutrition, Retired Fellow Royal Society of Medicine), is a board certified specialist in Internal Medicine. He received his M.D. at the University of Cincinnati and was in private practice in Toledo, Ohio for 34 years. During that time he supervised over 5000 symptom - limited maximum hospital-based treadmill stress tests. He studied 3 world class extraordinary endurance athletes and published their exercise-related magnesium deficiencies. This triggered a 20 year pursuit of the cardiovascular complications of Space flight. All his publications are posted on his website  www.femsinspace.com)

Abstract:

Biography:

Dr. Raja Shakeel Mushtaque graduated from Dow Medical college, Pakistan. Later, he did his internship from a tertiary care hospital, Civil Hospital Karachi. He has taken USMLE Exams and has completed ECFMG certification. He has also acquired valuable research experience at Miami, Florida at Miami Heart Study. He has published his research work which comprises on 2 articles in pubmed indexed journel on topics of microRNA and cardiovascular heart diseases. He is currently working as a resident physician PGY2 at a prestigious tertiary care hospital of Pakistan, Jinnah Postgraduate Medical Center, Karachi.

Abstract:

Acute coronary syndrome (ACS) is an acute and severe manifestation of coronary artery disease (CAD); thus, timely diagnosis can save a life. Commonly, cardiac troponin T (CTnT), cardiac troponin I (CTnI) or creatine kinase muscle/brain subtype (CK-MB) have been used as cardiac biomarkers to assess ACS with certain limitations, such as increased time to rise for diagnosis and increased levels in the patients with chronic kidney disease (CKD). Recently, micro-ribonucleic acids (miRNAs) have become potential candidates as biomarkers for cardiac ischemia due to their remarkable stability and reproducibility. Certain miRNAs, for instance, miR-1, miR-133a/b, miR-208a/b, and miR-499a, strongly increase in the serum or plasma of patients with acute cardiac ischemia, making them as cardio-specific miRNAs and prospective biomarkers in ACS. This literature review gives enlightenment about the regulation of cardio-specific miRNA in acute myocardial ischemia (AMI) and correlation with common cardiac biomarkers and time at which they increase in the blood.

Biography:

Abstract:

Introduction: Heart failure (HF), previously called congestive heart failure, is a serious condition most commonly caused by weak pumping of the heart muscle. Arrhythmia is a common finding in heart failure (HF) patients. It has a greater impact on prognosis in those patients, especially atrial fibrillation arrhythmia type.

Objective: The study aimed to evaluate the effect of arrhythmia on the mortality & morbidity among heart failure patients.

Methods: Were conducted to analyses The effect of atrial / Ventricular Fibrillation on patients with Heart Failure: A prospective observational study at a tertiary care center, study data was collected from period of November to January 2018.This study divided to two groups, 1^st group patients diagnosed with heart failure & 2^nd group controlled group (HF + arrhythmia) .

Results: A total 200 participants, most of the respondents were males 153 (76.5), more participants were have 2 risk factors & highest one is HTN (Hypertensive)149(74.5%), interventionist procedure used among our patients were PCI for both patients have one or more interventions 99(49.3%) ,most of patients with ICD(Implantable Cardioverter Defibrillator) 90(44.8%), most type of arrhythmia atrial fibrillation 71 (35.5), a majority of NHYIA class(New York Heart Association) is class I 137 (68.16), the most symptom palpitation 176(87.56%) , ejection fraction in were patients 30% with total 52(25.87%) & highest medication used is beta-blocker185(92.04%).

Conclusions:  Arrhythmias one of most factors cause of heart failure disease.  AF(atrial fibrillation) is the most common arrhythmia in HF, AF prevalence and its associated complications have been well studied in established HF. Clinical management of HF needs to take into account the high risk of arrhythmias among these patients.

Biography:

Dr. NathanielY.Cortez is a Medical Specialist in Cardiology bat the Ilocos Training & Regional Medical Center, San Fernando, La Union, Philippines. He is a Fellow of the Philippine College of Physicians, Fellow of the Philippine College of Cardiology, and a Fellow of the Philippine Society of Echocardiography.

Abstract:

Ventricular septal defects account for 10 percent of congenital heart diseases in adults. They can either occur alone, or in combination with other cardiac anomalies. Ventricular septal defects, and more commonly aortic valve regurgitation and bicuspid aortic valve, are frequently associated with ruptured sinus of Valsalva aneurysms. Rupture of the aneurysm is the most common complication, which commonly protrude and rupture into the right ventricle or right atrium.

We present the case of a 27-year old male who was admitted because of lightheadedness and dizziness. The patient had a history of a heart murmur since childhood and was diagnosed with a congenital heart disease. 2D-echocardiography with Doppler studies revealed a dilated right coronary sinus of Valsalva with rupture into the right ventricular outflow tract.

Biography:

Abstract:

Background: In developing countries, tuberculosis is one of the leading cause of pericardial effusion and frequently progress into a life-threatening condition. The diagnosis of pericardial TB is still challenging and mainly depends on echocardiography, and pericardial fluid analysis. The importance of proper management in tuberculous pericardial disease determine the patient’s prognosis.

Aim: To presents tuberculosis pericardial effusion cases presenting with haemorrhagic pericardial effusion.

Case Illustration: A 19 years old male came with shortness of breath started 1 month before admitted. He also complains dyspnoe d’ effort, and orthopnoe, feverish and weight loss. He was then get an echo examination and a large pericardial effusion without tamponade was found. A 30 years old female came with a reference from neighbourhood hospital with pericardial effusion. Patient complains shortness of breath, coughs, and fever. Both of the patients had no history of lung disease. They had ADA test and results came back positive. They were treated with anti tuberculosis drug and steroid, and got better afterwards.

Summary: Tuberculosis can appears as hemorrhagic pericardial effusion. Specific treatment brings good results therefore diagnosis must be made as early as possible to shorten patients’ length of stay.

Keywords: Tuberculosis, Hemorrhagic Pericardial Effusion.

Biography:

Abstract:

Background: Echocardiography plays a major role in determining diagnosis, etiology and severity of cardiac calcification. It also adds benefits in analysis of valve anatomy and decision-making for intervention. This technique has also a crucial role to assess consequences of valvular stenosis.

Aim: To review the role of transthoracic echocardiography (TTE) in diagnosing massive cardiac calcification.

Case Illustration:  A 32 year old man came with signs of heart failure. The laboratory shows high calcium level indicating hyperparathyroidism state. TTE was done and there are multiple patchy calcifications at myocardium, chordae, and pericardium suspected dystrophic cardiac calcification. There are multiple patchy calcification at both LV and RV myocardium, chordae, and pericardium. Calcification are seen in aortic, tricuspid and pulmonic valves. Patient has severe MS, mild MR due to extensive calcium deposit dd/ rheumatic process with small mobile calcified structure attached to mitral valve leaflet and chordae.

Summary: Echocardiography plays an important role in diagnosing cardiac calcification.

Keywords: TTE, porcelain heart, calcification.

Biography:

A friend, a philosopher and a guide, Dr Suresh Vatsyayann is a family medicine specialist with an MBBS, FCGP, DNB, FRNZCGP, an international MBA with Distinction, and honours graduate with 1st class honours degree in International Health Development and Policy. He has over 70 publications in the various fields affecting health  and has invented 10s of new techniques in surgery and medicine both. He has shared the principles behind a healthy life every week with doctors, medical staff and the general public for the last 47 years in Cook Islands, in New Zealand, in India and the world over. Most of the lectures have been part of the series of "Health for All Through Wisdom & Action," a crusade against the epidemic of the non-communicable diseases (NCD) affecting us today. He has astonishing results with over 30 thousand followers and beneficiaries of his guidance and management. Dr Vatsyayann has enlightened great medical, management and health policy audiences world over through participating as a speaker in many countries. Many of his enlightening lectures are on multimedia & easily available on YouTube (HTW-Dr Sures,h and ourDoctorco channels). He is a firm believer that if every human being starts to understand their body, especially the principles behind the human life cycle, the publics would get  enlightenment of how and why the body and the society is getting the increasing burden of NCDs. Therefore, the least effort at the levels of education, environment and policy would get us the maximum dividends by way of reducing the NCD burden, untimely disability and death. He is making a visible difference in the lives of individuals, groups of people and the public through one to one, group and mass communication techniques of his, and feels obliged and thankful to all for being able to share his dream, results and educating techniques with his fellow medical fraternity , especially the junior medical and paramedical staff, opinion leaders, general publics and the younger generations while they are at school and colleges.

Abstract:

The Problem: In 30 years from now (deducting from the history over the last 51 years of my medical education and practice) it can easily be expected that there would be at least one death in each family in the world in a year due to the complications of one or the other non-communicable diseases. This will see the annihilation of our species with rarely any  human alive on earth within the next 10-20 years. The cardiovascular disease will be the major player in this saga not by its own doing but as a result of the gastrointestinal system (GIT) and the preprocessing of food that we do making our GIT go against us, or get redundant, lazy, dissatisfied, misused, or abused. What had to happen in a million year, happened in over a few hundred years, worst happened in my 51 years of medical study and practice. My health for all through wisdom and action (action research) started 20 years ago after my coronary artery bypass grafting. Soon it was evident that the action research had very significant effects not only in the heart but in every part of my body and patients’ bodies. 20 years later I can see that this action research brought dividends in cases of every non-communicable disease (NCD) not just the CVD. The research findings are exciting, but the most disturbing thing is that all the planning and action was done on the basis of all available knowledge that all of us have, never in the way the reality story I have made it for the populations and the medical professionals at large. I would take the audience over this lifecycle and the genesis of this lifecycle tale and how I achieved what to everyone seems unachievable, an end to all the NCDs.

Biography:

Maciej Kusztal - 6th year medical student of Warsaw Medical University. His main objects of interest comprise internal medicine and cardiology but also emergency medicine and intensive care. Maciej’s research projects were awarded on several medical congresses for student and young scientists in Poland and his last project was granted with financial support from Ministry of Science and Higher Education in Poland.

Abstract:

Cirrhotic cardiomyopathy(CCM) is a condition concerning heart muscle dysfunction in patients with cirrhosis. Cirrhosis leads to the development of a hyperdynamic syndrome, manifested by high CO, increased HR and effective arterial BP and reduced total systemic vascular resistance. Continuous Noninvasive Arterial Pressure(CNAP) device assess patient’s haemodynamic profile in a non-invasive way. Purpose To screen patients with cirrhosis, which may lead to earlier diagnosing CCM. Methods The study included 70 patients, with cirrhosis, caused by alcohol([ALD],22), autoimmune(26), viral(9) other reasons(13), qualified for Ltx. Each patient had a 6-minute walking test(6MWT) done and hemodynamic monitoring using CNAP device. Results Patients differ between etiologies of liver diseases. Median NTproBNP level was highest in ALD group(253pg/ml) and viral group(177,5 pg/ul) compared to autoimmune group(51 pg/ul) and other(114 pg/ml). Median QTc interval was more prolonged in patients with viral aetiology(456ms) and ALD aetiology(441ms) than autoimmune aetiology(422ms) and other aetiology(431ms). Median SVRI was lowest in viral group(1700 dyn- s/cm–5/m2) and higher in autoimmune group(2067 dyn- s/cm–5/m2) and other group(2432 dyn- s/cm–5/m2). Preliminary results show statistically significant correlations between distance in 6MWT and eGFR(r=0,78;p=0,0082), SVR (r=0,197;p=0,0011), DBP (r=0,45;p=0,014) and NT-proBNP (r=0,28;p=0,0008). Conclusions Preliminary results show that we can detect subclinical alterations in patients’ circulatory system by non-invasive methods. Patients with viral and ALD etiology presented more advanced liver cirrhosis stages and more pronounced manifestations of hyperdynamic syndrome which may progress to CCM. Positive correlation of liver cirrhosis stage and NTproBNP, QTc and 6MWT distance may suggest heart function impairment in course of liver disease.

Biography:

Min Luo, Director of Pain Department, China-Japan Union hospital of Jilin University, President of Jilin Province Branch of Chinese Pain Physician Association. He has studied the etiology and treatment for chiropractic heart disease for many years. He has established a new model of neurological regulation and treatment of cerebral infarction and has achieved satisfactory clinical effect.

Abstract:

Despite the widespread use of pharmacologic therapy and devices, the overall prognosis of heart failure patients remains poor and new therapies are needed. Release the sympathetic hyperexcitability due to thoracic sympathetic nerve irritation by thoracic pathology ( e.g. herniated disc, hypertrophic ligamentum flavum ) by radiofrequency ablation may be significantly useful for the treatment of heart failure. In our study, 120 patients with heart failure were divided into two groups with Experimental group receiving radiofrequency ablation of the appropriate thoracic spine lesion and the associated thoracic sympathetic  nerve and Control group receiving the usual cardiac medication. Clinical efficacy were evaluated by N terminal pro B type natriuretic peptide (NT-proBNP), Echocardiogram Ejection Fraction (EF%), electrocardiogram (ECG) and Six-minute walk distance test  before and after treatment.  At five year follow up, after treatment, the clinical symptom, quality of life, quality of sleep and the activity of the patients in both groups were significantly improved, but the improvement in NT-proBNP, EF% and Six-minute walk distance were significantly better in Experimental group than Control group.  Moreover, the five-year survival rate of Experimental group is 78.3%  and that in Control group is only 38.3%.  We suspect that hyperactivity of thoracic cardiac sympathetic nerve might be an important cause of heart failure. We postulate that the denervating effect by radiofrequency ablation would be similar to that of implantation of thoracic spinal stimulator ,but at a much lower cost and easier to perform without much postoperative care or complication. Last but not least, we have found a new primary mechanism of heart failure by our further research.

Biography:

Abstract:

Introduction: Rheumatic heart disease is one of the most common heart diseases in developing country. One of the most common complications of Rheumatic Heart Disease is Mitral Stenosis which ultimately lead to pulmonary hypertension and heart failure and death. So, PTMC (Percutaneous Transluminal Mitral Commissurotomy) is a well established simple, effective and safe  therapeutic intervention for mitral stenosis.

While many literatures reviewed till date have shown that it takes 3-6 months time period for the reduction of pulmonary artery pressure after PTMC, this study is designed to see the result in pulmonary artery pressure immediately after  procedure.

Method: Total 42 patients with Rheumatic Mitral Stenosis in Cath Lab under Department of Cardiology of Chitwan Medical College from October 1 2018 to August 30 2019 were included in the study. Pulmonary artery pressure was assessed by Right heart catheterization by using multipurpose /pigtail catheter under conscious sedation.

Results: It is a prospective observational study on a total of 42 patients who underwent PTMC, 30 were female and 12 were male. Age ranged from 30 to 61 years with the mean age of 45.36±10 years. The mean mitral valve area increased from 0.87±0.2 cm2 to 1.74±0.17 cm2 whereas Mean Pressure Gradient decreased from 13.59± 7.30 mmHg to 5.15±30 mmHg. Mean Pulmonary Artery Pressure decreased from 41.50 ±16.00 mmHg to 33.50±12.00 mmHg. Similarly, the mean left atrial pressure decreased from 26.57±8.62 mmHg to 15.50±5.95 mmHg whereas, the mean Aortic Pressure increased from 91.43 ±23.02 mmHg  to  98.29±24.92 mmHg . Eighteen (42.85%) patients had an increase in MR by 2 grades but there is no need of immediate mitral valve replacement. During procedure, paroxysmal PSVT was noted in six (14.285%) patients and also local hematoma was observed in five (11.90%) patients.

Conclusions:  There is reduction in pulmonary artery pressure immediately post PTMC which is directly correlated with left atrial pressure without significant MR and tachycardia.

This study is limited in terms of single center with small sample size.