9^th World Heart Congress July 29-30, 2020 Zurich, Switzerland

Biography:

Reema Qayoom is a final-year FCPS Cardiology trainee at Tabba Heart Institute Karachi, Pakistan. She has done her two years General Medicine training at Liaquat National Hospital, Karachi, Pakistan. She received a bachelor’s degree from Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan. She is currently working on 4 research papers in variable fields related to cardiovasular medicine

Abstract:

Inferior wall myocardial infarction accounts for 40-50% of all acute myocardial infarctions.Association of acute inferior wall myocardial infarction and third degree atrioventricular block(AVB)was established, but the effect modifiers are still not known. We assessed the predictors of patients presenting with acute inferior wall myocardial infarction and third degreeatrioventricular block. We conducted a prospective cross sectional studyon patients presented within <12 hours with sign & symptoms of acute inferior wall myocardial infarction at, Liaquat National Hospital, Karachi from February to August 2018 . Third degree AVB was assessed through ECG. The diagnosis of inferiror wall myocardial infarction was established by the presence of ST segment elevation in leads II,III,aVF or Q waves of >0.04 sec in duration in lead II,III and aVF with reciprocal ST segment depression in the lateral and/or high lateral leads ( I, aVL, V5 and V6). Out of 115 patients with acute inferior wall myocardial infarction, 70(80.5%)patients were male. Mean age was 47.5 ±7.47 yearsand duration of symptoms was 4.6 ±1.28 hours. Diabetes was found in 57.4% patients, 72.2% were hypertensive, and 50.4% patients were smokers. Third degree AVBwas observed in 13.0% patients. Smoking status was significantly associated with third degree AVB (OR: 2.1, 95%CI: 87% , p-value: 0.01). Among patients with acute inferior wall myocardial infarction, third degree AVB occurred in 15(13%),and has significant association with smoking. Generalizabilty of results is limited because it was a single centre, non randomized study with small size.

Biography:

Camille-Marie Go-Cacanindin has obtained her Medical Degree at the age of 25 years from University of Santo Tomas Faculty of Medicine and Surgery and Pediatric Residency Training from Philippine Children’s Medical Center. She is currently a Pediatric Cardiology Fellow in training at Philippine Heart Center, a tertiary cardiovascular referral center.

Abstract:

Anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) occur in 1 in 300 000 live births. The most common origin of the abnormal LCA is from the pulmonary truncal sinuses. The rarest form of ALCAPA presents with anomalous left coronary artery arising from the right pulmonary artery. This is a case of 1 month old female presenting with Dyspnea , 2D echocardiography revealed ALCAPA. Intraoperativley, the Left Coronary Artery was found to be originating from the Right Pulmonary Artery. The patient underwent coronary implantation and LeCompte procedure.

In the most common form of ALCAPA, the abnormal coronary artery arises from the adjacent pulmonary valvar sinus, rather than the pulmonary trunk. In this case, the Anomalous Left Coronary Artery originated the Right Pulmonary Artery. Such case has an incident of 1 in 2,000,000 live births. This is the first reported case in a tertiary cardiovascular referral center.  In fetal life, this has no detrimental effect since pressures and saturations are similar in the aorta and pulmonary artery. After birth, however, the pulmonary artery contains desaturated blood at pressures that rapidly fall below systemic pressures. The left ventricle is perfused with desaturated blood at low pressures leading to infarction with ventricular dysfunction. Coronary translocation and Lecompte maneuver was done which provided relief for the patient’s condition.

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:

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:

Abstract:

Introduction: There is no established treatment strategy among human immunodeficiency virus (HIV)-positive patients on antiretroviral therapy (ART) who developed hypercholesterolemia. We intended to assess the effect of statin use on hypercholesterolemia among HIV-infected patients on ART.

Methods: A meta-analysis was done on all randomized controlled trials (RCTs) that studied the effect of statins with placebo or antiretroviral switching on hypercholesterolemia of HIV-positive patients on ART. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used for the study selection process. Two authors independently abstracted the data. Mean difference (MD) were pooled using inverse-variance random-effect method. A number of sensitivity analyses were performed.

Results: Seven RCTs were included with a total of 272 HIV-infected patients receiving ART. Five of these studies have low risk of bias while two had high risk of bias. Statins significantly reduced fasting total cholesterol (TC) (WMD = -1.12, 95% CI = -1.27, -0.97, P<0.00001; WMD = -26.20, 95% CI = -41.63, -10.77, P=0.0009) and fasting low-density lipoprotein-cholesterol (LDL-C) (WMD = -1.03, 95% CI = -1.66, -0.41, P=0.001; WMD = -23.34, 95% CI = -34.60, -12.08, P<0.0001) compared to placebo (after subgroup analysis) and ART switching.

Conclusion: Statins are effective in the treatment of hypercholesterolemia among HIVinfected patients on ART.

Keywords: statin, hypercholesterolemia, HIV, antiretroviral therapy.

Biography:

Chunhui He has completed his PhD at the age of 30 years from Xinjiang Medical University and residency training from First Hospital of Peking University. He is a Fellow of Cardiology at Fuwai Hospital of Chines Acedemy of Medical Science, a premier Cardiovascular Clinical and Research organization. He has published more than 10 papers in peer-reviewed journals and has been entitled as FSCAI since 2018

Abstract:

BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) has been associated with worse prognosis after percutaneous coronary intervention (PCI). We sought to assess the incidence and prognostic implications of CI-AKI among an all-comer population of patients who underwent primary PCI (pPCI) due to ST-elevation myocardial infarction (STEMI).

METHODS: Patients with STEMI who underwent pPCI with baseline and peak creatinine after PCI in the prospective, multicenter Chinese Acute Myocardial Infarction (CAMI) registry were included. CI-AKI was defined as a relative ≥1.5-fold increase in serum creatinine from baseline, or an absolute increase of ≥0.3 mg/dL. Major adverse cardiac event (MACE) was defined as the composite of all-cause death, myocardial infarction or stroke.

RESULTS: 5,205 patients were included since Jan 2013 to Feb 2018 from 108 PCI centers in China, 684 (13.14%) developed CI-AKI. Risk factors for developing CI-AKI included older age, female sex, time from onset of chest pain, Killip classification, and GP IIb/IIIa antagonist prescription. Patients with CI-AKI had higher unadjusted and adjusted risks of MACE and death both at 30 days and at one year (Table).

CONCLUSION: CI-AKI was relatively common after pPCI for STEMI, particularly among women and older patients. CI-AKI was an independent predictor of MACE and mortality both at 30 days and 1 year.

Biography:

Yaping Bai has completed her MD at the age of 26 years from Fujian Medical University. She is a member of the Communist Party of China, Who is majoring in chronic disease nursing and nursing management, mainly participating in five national, provincial and departmental projects, participating in the preparation of three "13th Five-Year Plan" textbooks by the People's Medical Publishing House, publishing well-known journal articles 5 articles.

Abstract:

Method: The hook includes a bottom plate, one side is used for fixed connection with a wall or door, and the other side is provided with a vertical slide groove. The slider is slidingly arranged on the vertical chute, and the slider is provided with a threaded through hole corresponding to the groove position of the vertical chute. The spiral long rod includes a fastening section, a threaded section, and a long rod section from left to right, and the threaded section is used to cooperate with the threaded through hole so that the fastening section is closely or away from the vertical towards the bottom of the chute. The hook is arranged on the spiral long rod and is located on the side of the long rod section far from the threaded section, which is convenient for patients to hang the infusion bottle when they go to the bathroom. see picture 1.

Results: The hook is convenient for patients to hang the infusion bottle, and it can freely adjust the height of the hook position according to their height or action needs, so that the infusion bottle hungs at an appropriate height.

Conclusions: The hook solves the problem of placing an infusion bottle when a transfusion patient goes to the bathroom, and can freely adjust the height, which is worth popularizing and applying.

Biography:

Ramachandran  Muthiah published many papers in Cardiosource, American College of Cardiology Foundation, Case Reports in Clinical Medicine (SCIRP) and Journal of Saudi Heart Association. Special research on Rheumatic fever and Endomyocardial fibrosis in tropical belts, Myxomas, Infective endocarditis, apical hypertrophic cardiomyopathy, Ebstein’s anomaly, Rheumatic Taussig-Bing Heart, Costello syndrome and Tetralogy of Fallot.

Abstract:

Myocardial rupture is a catastrophic complication of acute myocardial infarction with an incidence of 10% of cases and most often occurs near the edge of the necrotic myocardium. It involves the free walls of ventricles, interventricular septum and the linear tears may resemble the Emmantel cheese in Switzerland and so described as “Swiss-Cheese” ventricles. Two –dimensional transthoracic echocardiography is the modality of choice at bedside to detect the defects. 50 % of rupture occurs within 3 days and 89% within 2 weeks of infarction and carries high in-hospital mortality. When primary PCI was performed, its incidence was decreased to 2-3% and the prognosis was grave in patients presented with cardiogenic shock. Surgery is superior to conservative management and when multiple defects are present, endocardial patch repair to restore the geometry of myocardium has been performed, ideally between 2-3 weeks after the rupture when the edges of the defect got fibrosed.

Biography:

Bixia Lin has received a master's degree from Fujian University of Traditional Chinese Medicine in 2016. She is a Registered Nurse of Xiamen Cardiovascular Hospital Xiamen University, one of National Regional Certification Center for Chest Pain (There are only four in China). She participated in 4 municipal programs focused on Evidence-Based Nursing and Nursing Informatics, and published 4 papers (were all included in Chinese core journals) as the first author.

Abstract:

Introduction: According to Global Health Observatory data, Coronary Heart Disease (CHD) ranked first in the world's top ten causes of death in 2016. Although studies have proved that Applications (APPs) can assist patients with CHD to manage disease, there is no standard for APPs to enter the market in China. In addition, In addition, the correctness of the information provided was not welled supervised. Thus, it’s necessary for us to evaluate the quality of existing APPs to determine whether they meet the self-management needs of patients with CHD. Methods: From August to October 2019, we searched iOS (APP Store) and Android (Android market, app treasure, 360 mobile assistant, pea pod) for smartphone APPs related to CHD health management. The search terms included "冠心病", "心脏病", "心血管疾病", "coronary heart disease" and "cardiovascular disease". Two appraisers selected the APP strictly according to the inclusion and exclusion criteria. Based on the pre-established quality evaluation index system, the content analysis method was used to evaluate the quality of the incorporated APPs on functionality, practicability, usability, reliability, safety and timeliness (Scored “1” if mentioned. Otherwise, scored ”0"). Results: We got 2926 APPs after preliminary search, 32 APPs were finally included. The scoring rate of usability was >60%, and the remaining dimensions were <30%. Conclusions: Existing CHD APPs can help patients manage disease to some extent, but the overall quality of APPs need to be improved.

Biography:

Abstract:

Actuality:    The modern principles of existing treatments for patients with CHF are based on the pathogenetic concept of HF that develops as a result of long-term activation of the neurohumoral system. Theoretically, the combined use of different groups of neurohumoral modulators may provide additional benefits in the treatment of patients with chronic heart failure as a result of complete blockade of neurohormones. The essence of such a concept is very simple, so the higher the activation of neurohumoral system, the better the result.

At present, the inhibitor of neprilysin is widely used in the treatment of CHF in the world practice.

In addition to the medical treatment of CHF, device treatments have also developed significantly in modern times. Being one of them, in recent years the resynchronous therapy of the heart is one of the most widely used treatments over the world.

The aim: Our study has been conducted in the form of 2 groups. The first group consists of the patients treated with complex medical therapy including sacubitril / valsartan. And the second group consists of the patients implanted a device for resynchronous therapy of the heart. Our aim is to assess the changes in the clinical indicators in both groups after 6 months.

Materials and methods: The results of 61 male and female with CHF were researched. Patients were over 25 years of age. Eligibility criteria included a history of chronic heart failure, circulatory failure (functional class II-IV, NHYA) and a left ventricular ejection fraction of less than 40%. Exclusion criteria included acute myocardial infarction, hypertrophic cardiomyopathy, congenital heart defects, patients under 25 years of age, heart failure in oncological patients.

Results of our study: At the time of re-examination after 6 months, there is a positive change in the clinical indicators of patients, includings systolic blood pressure, diastolic blood pressure, pulse, complaints during physical activity, functional classes in both groups.  

Conclusion: As a result of the study, we have found that the addition of sacubitril / valsartan combination to the treatment of chronic heart failure has positive effects in the clinical indicators of patients. Both treatments produce close results in the patients’ conditions, so there is not significant difference between them.

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.

Conclusion

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.

Biography:

Asma Murtaza is the FCPS Adult Cardiology Resident Doctor at National Institute of Cardiovascular Diseases, Pakistan. She did her Bachelor of Medicine and Bachelor of Surgery from Liaquat National Hospital and Medical College. She wants to join this congress to challenge her skills and techniques, to work with various types of research institutions worldwide. As well as seeking a good position in hospitality industry where she could add her medical knowledge.

The Author Syed Haseeb Raza Naqvi is the 2^nd year Electrophysiology Fellow at National Institute of Cardiovascular diseases. He’s the author of an ECG book and many articles published Internationally.

Abstract:

Wellens' syndrome, or “Widow Maker”, is referred to as a pre-infarction syndrome with non classical ischemic electrocardiographic (ECG) changes and unremarkable cardiac biomarkers. This syndrome should not be missed by the clinicians as delay in urgent coronary intervention can result in anterior wall myocardial infarction (MI), arrhythmias, left ventricular dysfunction and death. It can be predicted by patient's history and ECG changes. Thus, physicians and health care providers should be familiar with the electrocardiographic manifestations of Wellens' Syndrome. Here, we describe a case of middle aged male patient presenting with history of typical chest pain with slightly elevated blood pressure (BP) with an initial ECG showing Brugada pattern, patient was admitted and started with antiplatelets, anti-ischemic and anticoagulant followed by serial ECGs but after 10 hours ECG done showed wellenoid pattern for which he underwent a Coronary Angiography and it came out to be severe lesion in proximal left anterior descending (LAD) artery.

Biography:

Prof. Naveed has completed his MBBS at the age of 25 years from Liaquat University of Medical Health Sciences,Jamshoro Hyderabad, Pakistan and postdgraduate studies from National Institute of Cardiovascular Diseases Karachi. He is the Clinical Fellow of Adult Cardiology. He is also certified BLS and ACLS Instructor from AHA in College of Physicians and Surgeons in Pakistan.

Abstract:

Introduction: Increased ratio of Triglyceride (TG)/ High-density Lipoprotein (HDL) has been known as an accompanying finding in conditions like obesity and metabolic syndrome. Therefore, the aim of this study was to assess the utility of TG/HDL ratio as a diagnostic tool for the assessment of coronary artery disease (CAD).

Methods: This study was conducted at a semi-private hospital Karachi; patients above 15 years of age and undergone angiography or PCI were included. Patients with Congenital Heart Disease and familial hyperlipidmeia were excluded. TG/HDL ratio was obtained for all patients, severity of the disease was classified as normal, mild to moderate, moderate to severe, and very severe based on coronary angiography. Analysis of variance was applied to assess significant differences in mean TG/HDL ratio among severity of disease. P-value<0.05 was considered significant.

Results:  A total of 2,212 CAD patients were reviewed out of which 1613 (72.9%) were male and 599 (27.1%) were female. Average age of the patients was 55.12 years (±SD=9.93). Of these 2212 patients, 533 (24.1%) had very severe disease, 1213 (54.8%) had moderate to severe disease, 258 (11.7%) had mild to moderate disease, and 208 (9.4%) were normal. A Significant and an increasing trend was observed in TG/HDL ratio with the severity of disease (p=0.0001) Statistically significant difference was observed in the TG/HDL ratio of patients with mild to moderate, moderate to severe and very severe disease from normal patients. However, no statistically significant difference was seen in the TG/HDL ratio between the patients with moderate to severe and very severe disease.

Conclusions: A positive relationship between Triglyceride to HDL Ratio and severity of coronary artery disease was observed. Therefore, TG/HDL ratio can be used as an indicator of severity of coronary artery disease in addition to other parameters of lipid profile.

Biography:

Seema Jaga completed her M.D. from Medical University of Sofia. She is currently a second year Internal Medicine resident at Largo Medical Center with aspirations of becoming a Cardiologist.

Abstract:

Idiopathic chylopericardium is a rare clinical condition that consist of pericardial effusion composed of high concentrations of triglycerides known as chyle. It may occur as a result of chest trauma, mediastinal neoplasms, mediastinal tuberculosis, mediastinal radiotherapy, and thrombosis of the subclavian vein or can be idiopathic. We hereby present a case that illustrates a healthy female fitness trainer in her 50s who presented with dyspnea that progressively worsened to the point where she was referred to a Cardiologist. Subsequently, chylopericardium was diagnosed with pericardiocentesis. She successfully responded to two and a half weeks of continuous drainage and low fat diet. It has only been a month since discharge. In conclusion, this case demonstrates an rare condition to help elucidate medical literature.

Biography:

Chery Lou M. Cabanero the primary author in this study fnished her medical school education in Davao Medical School Foundation Inc in 2013. She had her post graduate internship in Southern Philippines Medical Center. After passing the board examinations for doctors in 2014, she started her residency training program for General Surgery in Southern Philippines Medical Center Davao City Philippines. She graduated from residency training in 2019 in the same institution. At present the author is a prefellow in training in the Cardiac Surgery section in Southern Philippines Medical Center.

Abstract:

Worldwide, only <3% of the general population are diagnosed with the disease. In this ten year report, the authors described thirteen cases of Sinus of Valsalva defects in the first cardiac center in Mindanao. All were Filipinos and came from different regions in Mindanao. There was a bimodal age distribution with a mean age of diagnosis 14.18- 36.74 years old. All patients were presenting with signs and symptoms of heart failure with an ejection fraction of >55%. Preoperative two dimensional echocardiography revealed coexistent cardiac conditions which are ventricular septal defect (25%), aortic (22%), ventricular (22%) and atrial (11%) dilation, pulmonary hypertension (14%) and pericardial effusion (3%). Majority of the cases described had an initial presentation of dyspnea. Signs and symptoms depend on the degree of left to right shunting. In this study, common coexisting cardiac defect were aortic regurgitation and a subpulmonic ventricular septal defect. Sakakiboro and Konno types I and IIIv were noted among the patients in this study, all of them underwent repair under cardiopulmonary bypass. Repairs were done using a Sauvage Patch for RCSOV and VSD while dysfunctional valves were replaced with a mechanical valve. Mean CPB time in this ten year report was 2.58hrs for type I and 2.45hours for type IIIv. When compared both CPB types had a p-value of 0.783 indicating no significant difference between the two types of RCSOV. There were no reported mortalities in this ten year analysis, with a 100% survival rate.