2^nd European Cardiology Congress August 21-22, 2020 Florence, Italy

Biography:

She has completed her medical studies at the age of 24 years from Casablanca University School of Medicine. Now, she is an intern in cardiology unit at university hospital center ibn rochd of casablanca, she is a member in several voluntary medical associations.

Abstract:

INTRODUCTION : Heart failure has different characteristics depending on the sex, In case of STEMI men and women have distinct cardiovascular responses to acute myocardial ischemia with a higher risk for women to develop acute heart failure

OBJECTIVES : The main goal of this study is to determinate the relationships between gender and acute heart failure after STEMI in patients with no prior history of heart failure recorded at baseline.

METHODS : This is a retrospective, study including 210 patients who had been hospitalized in a cardiology intensive care unit for myocardial infarction from september 2017 to february 2019 , The main outcome measures were the incidence of Killip's   class at hospital presentation and introhospital mortality rates.

RESULTS :The main age was 59.3 ± 7.02 Sex ratio: 2,86 (74.1% Male, 25.9% Female) the incidence of de novo heart failure at hospital presentation was higher for women than for men (40,4% vs. 29.5%, odds ratio [OR 1,61 ; 95% confidence interval [CI], 0,83-3,11). Women with de novo heart failure had higher mortality than did their male counterparts (28,6% vs. 20.5%; OR: 1,55 ;95% CI , 0,5-3,15).About treatment 80% have been thrombolysed. The culprit artey was  Left anterior descending artery in 53,4%.

CONCLUSIONS Women are at higher risk to develop de novo heart failure after STEMI and women with de novo heart failure have worse survival than men this may be related to the increased prevalence of microvascular disease in women predisposing them to heart failure after a STEMI.

Biography:

Nigar Babayeva is going to complete her PhD in Scientific-research Institute of Cardiology named after academician J.Abdullayev.

Abstract:

Increase of homocysteine (HC) level in blood plasma ​​is one of the risk factors for cardiovascular disease development. Mechanisms of the HC pathogenic influence include oxidation stress, damage of NO production, changes in homeostasis, activation of inflammatory pathways and others. Hence, HC adversely affects the mechanism of vascular tone, lipid metabolism, and coagulation cascades. Homocysteine ​​also plays an important role in the early stages of atherogenesis: endothelial cells activity inhibition, pro-oxidant effects, mitogenic effects on muscle cells, stimulation of collagen synthesis by protein accumulation in atheroma. The main outcome of these processes is dysfunction of the endothelium and subsequent structural and geometric changes in the vascular wall, resulting in the development of cardiovascular diseases (CVD).

The aim. The aim of this study was to investigate of common carotid arteries (CCA) using ultrasound examination in patients with high blood pressure and different HC levels.

Material and methods. 51 patients with arterial hypertension (AP) were included to the trial. They were examined for homocysteine levels in blood and divided into three groups: normal, mild and middle-class HC level groups. Ultrasound examination of CCA were fulfilled in all investigated patients.

Results. In 31 patients (60,8%) was normal HC level, in 13 patients (25,5%) mild homocysteinemia (HCE), in 7 patients moderate HCE. Intima-media thickness (IMT) in the right CCA was 1,06±0,05 in the group with normal HC ​​level; in mild HCE group IMT was 1.14±0.05; in group with moderate HCE IMT was 1.14±0.10 mm. The mean value of the IMT in the left CCA was 1.075±0.040 in the ​​group with normal HC level; 1.123±0.044 in mild HCE group; and 1,094±0,066 mm in the moderate HCE group. In all three groups, IMT both in right and left CCA was higher than normal meaning (0,9 mm), but in hyper-HCE groups (mild and modarate) IMT were higher than in the ​​group with normal HC level, however observed differences were not statistically significant (for right CCA: F = 0,627; p = 0,539; for left CCA: F = 0,266; p = 0,767).             Increase of IMT was identified in 41 (80,4%) of 51 investigated patients. In 31 patients with normal level of HC IMT indices were high in 11 (74.2%), in 13 patients with mild HCE IMT were increased in 11 (84.6%) patients and in 7 patients with moderate HCE in all 7 (100%) patients IMT were increased. The difference observed between groups was not statistically significant (χ2 = 2,610; p = 0,271). Poor positive correlation was found between HC ​​level and right IMT indices (r = 0,346; p = 0,013).

Conclusion. The obtained results demonstrate the partly role of high HC ​​ blood plasma level in the increase of CCA IMT. Thus, high concentration of plasma HC can​ participate in the acceleration of atherosclerotic process in the arterial walls and lead to increase of IMT.

Biography:

Abstract:

The aim is to study the role of immune-inflammatory processes and the importance of hemorheological changes, as well as to determine correlation relationship between inflammatory markers in patients suffering from stable ischemia disease after coronary angioplasty and stenting.

Materials and methods. 64 patients implanted with 103 stents in general have been included to the research. During 2-24 months after stent implantation angiography examination have been done by defining caugulograma (fibrinogen, PM, INR), C-reactive protein (CRP), fibrinogen, as well as necrosis factor of cysts from pro-inflammatory cytokines (-É‘), interleukins (IL), IL-6, IL-8 in blood serum of patients suffering from IHD. In angiography, 20 patients having stenosis less than 50% has been accepted as control group by evaluating stent as open. The average age of the patients has been 58,6+1,2.

Result. Average indicator of concentration of CRP, fibrinogen and cytokines in patients suffering from IHD has been exact high in comparison with the control group patients whose stents are open after coronary angioplasty and stenting. CRP has been 16,4+1,2 (intragroup variation 6-36) mg/L and 6,8+0,4 (intragroup variation 5-10) mg/L, p<0,001,  fibrinogen as 3,47+0,08 and 4,22+0,11, p<0,001 respectfully in the restenosis and non-restenosis group. During correlative analysis, the expected intense correlation has been defined as r=0,707 p<0,01 between TNF-alpha and IL-6, r=0,575 p<0,01 between CRP and IL-6, r=0,610 p<0,01 between TNF-alpha and IL-8, r=0,502 p<0,01 between IL-8 and CRP, r=0,316 p<0,05 between IL-6 and fibrinogen in the restenosis group.

Conclusion. After angioplasty in the development of coronary restenosis inflammatory-oriented markers and severe phase proteins act as diagnostic and prodiagnostic marker and there is statistic exact correlation between the levels of these markers and complication degree of IHD. In some cases high level of immune-inflammatory markers has been accompanied by change of rheological characteristics of blood. Defining inflammatory response markers in stenocardias after stent implantation can be useful for determining patients biased to high complication risk after myocardial revascularization, as well as preventing aggravation of ischemic incidents in long term.

Biography:

Abstract:

The uncontested urban population and their livelihood activities (transportation, infrastructure development, Industries for employment…) at one side and the government subsidy schemes (gas cylinders for cooking, agriculture fertilizers, purchasing of vehicles...) for upgrading the socioeconomic index another side are developing air pollution constantly. As we aware that, the stir element is transporting the pollution including particulate matter to all ozone connected zones and is showing cascading effects on population reproductive system of all species and mounting “endangered” list year by year all over the world. Also, the development of particulate matter in congested or colder region cities, depriving the quality levels of breathing, nutrients (such as amino acids and electrolytes), oxygen, carbon dioxide, hormones etc and allowing more budgets to safeguard health of family members.  Most of the countries are spending millions of rupees to protect the flora, fauna and humans to control the endangered count. As we aware that, the infant rate of human population is constantly growing in all corners of globe and the rate of Air born lung diseases like “Respiratory problems, pneumothorax, Cardiac arrest… are increasing. Also, in some countries (provinces), the poverty and hereditary problems of their parents is plummet the Immunity and fertility levels in many communities lead rare group. The paper distinguishes the attentive for “Air pollution control” to safe guard the other needy livelihood resources like water and food for sustainable growth on this planet.

Biography:

Supriya Sharma is a senior Ph.D. scholar, working in the area of pharmacology, specifically in epilepsy and associated cardiac damage. She has expertise in molecular biology and has established a chronic epilepsy associated cardiac damage model in the lab. Through this study she is trying to decipher the associated molecular mechanisms of sudden death in epilepsy (SUDEP). She has five years of experience in this field and seven years of research exposure. In addition, she has also established the zebrafish model for the same condition for further understanding the SUDEP pathophysiology.

Abstract:

Background: Epilepsy is a chronic neurological condition that is mainly characterized by occurrence of spontaneous recurrent seizures.  Study has also shown that temporal lobe seizure lead to development of ventricular fibrillation, shortening or prolongation of QT intervals, producing prolongation in the action potential, propensity to malignant tachyarrhythmia’s thus risking cardiac damage. These cardiac repercussions often lead to life-threatening condition known as “Sudden Death in Epilepsy or SUDEP”.

Methods: The present study was envisaged to understand the cardiac changes during different phases of epileptogenesis and molecular changes in rat lithium-pilocarpine (Li-pilo) model of epilepsy. The animals were exposed to Li-pilo for induction of spontaneous recurrent seizures (SRS). Non-invasive blood pressure and electrocardiography was recorded at 7^th, 28^th and 75^th day after pilocarpine administration, considered as latent, initial SRS and late SRS phases, respectively. Following electrocardiography on the day 75, blood was collected for serum biochemistry and animals were sacrificed for cardiac histopathology, specific protein levels and gene expression.

Findings: Latent mean arterial pressure decreased as compared to the basal, whereas it was increased during initial and late SRS phases. Prolonged QTc interval was observed during late SRS as that of basal and latent phase. A significant increase in the serum level of lactate dehydrogenase and creatine kinase was observed in epileptic animals, along with hypertrophy, degenerative changes and fibrosis in heart sections. Increase in the expression of TGF-β, S6 ribosomal, phospho-S6 ribosomal, HIF-1α, Na⁺/K⁺-ATPase α1, collagen I, mTOR and phospho-mTOR proteins was observed in the cardiac tissue. The cardiac mRNA level of HIF-1α, mTOR, Rps6, Scn1b, Scn3b, Na_v1.5 and TGF-β was also increased as compared to control.

Conclusion: The results concluded that Li-pilo-induced SRS leads to cardiac dysfunction via mTOR pathway upregulation, thus suggested the regulatory control of mTOR pathway as a potential target for SUDEP management.

Biography:

He is a healthcare  professional with over 23 years experience. He has following roles, responsibilities and accomplishment.

Consultant Cardiologist and Acute Physician, Head of the Department of Medicine Chairman, Resuscitation committee, Regional Coordinator for Medical Education, Royal College of physicians of Edinburgh, External Examiner, Arabian Gulf Medical University, Bahrain, Examiner, Royal College Physicians of Edinburgh, Member and Fellow of various International Medical societies, Peer review author of various International medical journals, have published research and scientific work in various reputed journals, have  presented scientific and research work in various national, regional and international medical conferences.

Abstract:

Antithrombotic therapy has revolutionized the medical management of patients. Over the past 20 years, the development of new antithrombotic medications and strategies has reduced ischemic events very significantly. With every approach to reduce thrombosis, however, there is an accompanying risk of increasing bleeding complications. Conversely, reducing bleeding complications may increase thrombotic (ischemic) events Due to increasing number of elderly populations, prevalence of thrombosis related complications and bleeding associated with anti -thrombotic treatment is constantly rising. There are various tools to assess thrombotic risk, but assessment of bleeding risk is often ignored Thrombosis and bleeding, both increase morbidity and mortality. Balancing both ends of the spectrum is essential, and an individualized approach to therapy is advocated. The author will present various strategies to balance the thrombotic and bleeding risk assessment and management. This presentation will be of interest to Physicians, Cardiologists, Haematologists, Surgeons, Anesthetists and nurses.

Biography:

Maciej Kusztal researcher in 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:

Background/Introduction: Cirrhotic cardiomyopathy (CCM) is a condition concerning heart muscle dysfunction, occurring among patients with cirrhosis. Cirrhosis leads to the development of a hyperdynamic syndrome, which is manifested by high cardiac output, increased heart rate and effective arterial blood volume, accompanied by reduced total systemic vascular resistance.

Purpose: The aim of the study is to screen patients with cirrhosis, which may lead to earlier diagnosing CCM and hyperdynamic syndrome with its consequences among them.

Methods: The study included 70 patients over 18 years old, with cirrhosis, caused by alcohol ([ALD], 22), autoimmune (26), viral (9) other reasons (13), qualified for liver transplantation. 39 of them were male. Median age was 47. We disqualified patients with a history of cardiovascular diseases. Each patient had a 6-minute walking test (6MWT) done and a hemodynamic monitoring using non-invasive hemodynamic monitor device was also performed. 

Results: Basic group characteristic differs between aetiologies 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). Highest median CO were observed in viral group (6L/min) and ALD group (5,7L/min) and lower in autoimmune group (5,35L/min) and other (5,2L/min). Median SVRI was lowest in viral aetiology (1700 dyn- s/cm –5 /m 2 ) and ALD aetiology (1888 dyn- s/cm –5 /m 2 ) and higher in autoimmune aetiology (2067 dyn- s/cm –5 /m 2 ) and other aetiology (2432 dyn- s/cm –5 /m 2 ). There was no statistical difference in distance median value between aetiological groups (407m in ALD patients’ group, 412,5m in autoimmune patients’ group, 384m in viral patients’ group and 400m for other aetiology patients’ group; p=NS). The haemodynamic parameters (CO, SV, SVRI) were not correlated with MELD score and Child Pugh score (p=NS). DBP was positively correlated with MELD score (r=-0,25; p=0,009) and Child-Pugh score (r=-0,31; p=0,003). The distance was negatively corelated with severity of the liver disease based on MELD score (r=-0,34; p=0,0048) score and Child- Pugh score (r=-0,321 ; p=0,0072).Preliminary results show statistically significant correlations between distance in 6MWT and eGFR (r=0,78;p=0,0082), Systemic Vascular Resistance(SVR) at the end of 6MWT (r=0,197 ;p=0,0011), Diastolic Blood Pressure (DBP) at the end of 6MWT (r=0,45;p=0,014) and NT-proBNP (r=0,28 ;p=0,0008) level, patient’s weight (r=0,286; p=0,044) and height (r=0,37; p=0,008)

Conclusion(s): Preliminary results show that we can detect subclinical alterations in patients’ circulatory parameters by non-invasive haemodynamic monitoring. In our study patients with viral and ALD etiology presented more advanced liver cirrhosis stages and more pronounced manifestations of hyperdynamic syndrome which may later 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:

Dr Thushara Rodrigo has completed his primary medical degree (MBBS) from Faculty of Medicine University of Peradeniya, Sri Lanka in 2011 with a second class honors. He completed his post graduate diploma in child health with a Gold Medal awarded by Sri Lanka College of Paediatricians in 2014 and MD in paediatrics in 2017 from University of Colombo, Sri Lanka. Dr Rodrigo had worked as a Senior Registrar in Paediatric Cardiology in Lady Ridgeway Hospital from 2017 to 2019 july and recently started working as a Clinical Fellow in Paediatric Cardiology in Great Ormond Street Hospital NHS trust London. He has 10 publications both international and mainly at national level.

Abstract:

Kawasaki disease is an acute medium and small vessel vasculitis, which has a predilection for coronary arteries. Coronary artery involvement can vary from mild ectasia occurring nearly 40% to giant coronary artery aneurysms. Hence, we sought to determine a correlation between selected clinical and laboratory criteria in order to predict high risk children with Kawasaki disease for coronary involvement in order to optimise the initial management and follow up. Serial analysis of Clinical, biochemical and echocardiographic parameters of 101 patients with diagnosed Kawasaki disease within the first 10 days of the illness and followed them up paying special attention to coronary artery dilatation according to coronary artery standard deviation charts and visual assessment until 12 weeks of the disease for 15 months at the National Paediatric Cardiology unit, Colombo Sri Lanka. Maximum recorded internal diameter of the coronaries was considered for the analysis during the follow up. Thereafter, analysis had been performed to identify coronary artery risk predictors with Pearson chi square test and odds ratio. Mean age of the sample was 44months (±36.8 months) , 62(61.4%) were males and 42(41.6%) patients had coronary involvement (Coronary artery diameter >2 SD adjusted to the Body Surface Area/ visual dilatation to Coronary artery aneurysm formation. All children were treated with at least a single dose of intravenous immunoglobulin during the acute stage. Age between 7 months to 60 months, fever more than 1020F, CRP more than 100 mg/L and increased coronary echogenicity within first 10 days of the illness showed significant association with coronary involvement. However, duration of fever, platelet count, AST (Aspartate aminotransferase), ALT (Alanine aminotransferase), Serum bilirubin and Serum sodium or ESR did not demonstrate statistically significant association with coronary dilatation or aneurysm formation in Sri Lankan sample, although utilised in standard risk stratification scores. Also, diagnosis of complete Kawasaki disease, hypoalbuminemia and hyper echogenic coronaries found to be important predictors of coronary aneurysms, which amount to a significant morbidity and mortality. Hence, In the Sri Lankan centre, Age between 7 months to 60 months, fever more than 1020 F, CRP more than 100mg/dl, increased coronary echogenicity, hypoalbuminemia and diagnosis of complete Kawasaki disease during early stage of Kawasaki disease demonstrated high predictive utility for the development of coronary pathology.

Biography:

The author has obtained her medical degree from the Manila Central University Filemon D. Tanchoco College of Medicine at age 25. She had her residency training in Internal Medicine at the St. Luke’s Medical Center Quezon City, and is currently a 1st year Cardiology fellow at the Henry B. Calleja, Heart and Vascular Institute, St. Luke’s Medical Center Quezon City

Abstract:

BACKGROUND:  Arteriovenous malformations (AVM) are pathologic connections between arteries and veins. They may occur as an isolated lesion or in combination with other lesions, which may be part of a syndrome. Data on congenital peripheral AVM occurring concomitantly with a coronary arteriovenous fistula (CAVF) is limited. 

CASE:  A 20-year-old female presented with a 3 year-history of easy fatigability and recurrent exertional chest pain not relieved with analgesics and nitrates. Her previous medical history included recurrent AVM of the right leg despite percutaneous gel foam embolization six years ago. Her physical examination was unremarkable. Apart from a chest X-ray that showed cardiomegaly, preliminary work-up was essentially normal (Troponin, 12-L ECG, 24-hour Holter monitor, 2DEchocardiogram, Stress Echocardiography, Myocardial Perfusion Imaging). CT coronary angiography (CTA) showed a CAVF of the left circumflex artery and great cardiac vein. The patient is now referred to TCVS for surgical intervention. 

DISCUSSION:  Despite extensive work-up for the patient that showed unremarkable results, we pursued a CTA due to a clinical suspicion of a CAVF in a background of congenital AVM. This resulted to a definitive diagnosis, which may otherwise be dismissed as a non-cardiac cause of chest pain. 

CONCLUSION:  We highlight the importance of increased clinical suspicion for CAVF for young patients with persistent chest pain, especially in the setting of previous congenital lesions. Further investigation is needed to determine whether an anomalous arteriovenous connection at one site predisposes an individual to having an arteriovenous connection at another. This is an underreported phenomenon that could be a part of a rare syndromic condition.

Biography:

She has completed her medical studies at the age of 24 years from Casablanca University School of Medicine. Now, she is an intern in cardiology unit at university hospital center ibn rochd of casablanca, she is a member in several voluntary medical associations.

Abstract:

INTRODUCTION : Pulmonary hypertension and mitral regurgitation are frequently associated in the context of patients with aortic stenosis , but  there are no specific quantitative studies about how much mitral regurgitation  is related to pulmonary hypertension, The purpose of the study was to investigate whether the quantification of Mitral Régurgitation reveals a link to Pulmonaryy hypertension H in patients with aortic stenosis.

METHODS: This is a retrospective study from February 2018 to October 2019 including all patients with Aortic stenosis admitted to the day hospital of the cardiology department. Effective regurgitant orifice area (ERO) was obtained using the proximal isovelocity surface area method. Systolic pulmonary artery pressure was calculated by adding right atrial pressure to the tricuspid regurgitation pressure gradient.

RESULTS: The mean age,was 60 ± 14 years; mean ejection fraction : 56 ± 9%; mean aortic valve area : 1.04 ± 0.45 cm2); Mitral régurgitation was present in 67,4%. the ERO was < 0.20 cm2 in 75%, betwen 0,20 ans 0,30 cm² in 13,3% and over 0,3cm² in 11,7%. Associations betwen ERO and systolic pulmonary artery pressure was statistically significant  (P < .0001). This relationship persisted after multivariate adjustment and in the subgroups of patients with severe aortic stenosis  or reduced ejection fraction (P < .0001)  For each 0.10-cm2 increase, the odds ratio for hypertension pulmonary  were 1,43 (95% CI, 0,4-5) ;  2,05(95% CI,1,18-3,5) ; and 3.08 (95% CI, 2.19-6,09) respectively .

CONCLUSIONS: In this study we conclued  to a relationship between Mitral Regurgitation severity and pulmonary hypertension  in patients with aortic stenosis, the presence of MR and its quantitative assessment could become a prognostic marker of a high-risk for  patients with aortic stenosis.

Biography:

Dr. Jane Gargaritano is a medical graduate from Cebu Institute of Medicine, a premier medical institution in the Philippines. She is currently a 2nd year internal medicine resident in Perpetual Succour Hospital, a topnotch training medical center in Southern Philippines with a reputable cardiovascular fellowship training program with world-class cardiac catheterization facilities and specialists. This case report not only highlights her clinical eye for interesting cases with practical applications, but also emphasizes the kind of quality guiding influence of the medical center she is proud to be a part of.

Abstract:

BACKGROUND:
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS- STEMI). Literature highlights its low incidence and it is estimated to only comprise 0.2% of all coronary angiography cases. It is commonly reported among peripartum patients without risk factors for atherosclerosis. Its diagnosis is a challenge because its symptoms such as dyspnea, chest pain and orthopnea may present in the late stage of normal pregnancy and early puerperium. SCAD carries with it a high mortality rate if not recognized immediately, thus prompt recognition of the presentation and appropriate therapy must be determined early. 

Objective: This paper presents a case of Spontaneous Coronary Artery Dissection presenting as ACS NSTEMI in a 30year old postpartum woman with no known comorbidities and a seemingly unremarkable pregnancy.

Case: We present a case of a 30-year-old postpartum woman who presented with chest pain at 13 days postpartum, and was managed as a case of ACS STEMI.  2D echocardiography with Doppler was initially done to rule out common causes of symptomatology. She was subsequently diagnosed with spontaneous coronary artery (LAD) dissection via coronary angiogram. She eventually underwent Percutaneous Coronary Intervention with application of 2 stents and was discharged improved after 2 days.

Conclusion: SCAD is an uncommon, fatal disease, which occurs, in young, healthy subjects, usually peripartum women and still remains to be a rare cause of ACS-STEMI. Thus, it should be considered in any young pregnant woman who present with angina or dyspnea with no risk factors for coronary artery disease and myocardial ischemia. SCAD has a high mortality rate if not recognized early. Although, various reports prefer conservative management as the initial approach, in the presence of features such as cardiogenic shock and unstable cardiac status like the case presented, Percutaneous Coronary Intervention remains the reperfusion strategy of choice.