Day 2 :
Keynote Forum
Mary McGown
WomenHeart: The National Coalition for Women with Heart Disease, USA
Keynote: WomenHeart National Hospital Alliance: Supporting women living with heart disease nationwide
Time : 09:15-09:55
Biography:
With over 35 years of non-profit management experience, Mary McGowan currently serves as Chief Executive Officer of WomenHeart: The National Coalition for Women with Heart Disease to ensure the successful implementation of the organization’s strategic direction and increase its visibility and brand recognition nationally. Prior to joining WomenHeart in 2010, McGowan served as Executive Director of the Allergy & Asthma Network. She held various positions with the American Academy of Pediatrics during her service of 18 years. McGowan earned a Masters Degree in Human Resources Development from the George Washington University and a B.A. from Trinity University.
Abstract:
WomenHeart is the only patient-centered organization solely devoted to improving the healthy and quality of life of the 42.7 million American women living with and at risk for heart disease. We have thousands of members, including women heart patients and their families, health care providers, advocates and consumers committed to helping women live longer, healthier lives. We provide an array of support programs for women nationwide, including our 110 local Support Networks in 40 states, each led by trained women heart patient volunteers – WomenHeart Champions. Support Networks meet monthly at National Hospital Alliance (NHA) member hospitals. The NHA, comprised of 40 hospitals, is the nation’s only partnership program between WomenHeart and progressive hospitals across the country committed to advancing women’s heart health and gender specific cardiovascular care in their communities. This valuable alliance gives women heart patients leverage to improve their own lives, which results in better patient outcomes and lower readmission rates. Through the NHA, WomenHeart supports the trained WomenHeart Champions and provides an educational curriculum for their Support Network meetings. Additionally, we work with the hospitals' clinicians to improve their continuing education with quarterly webinars and media and co-branding opportunities. In 2015, WomenHeart launched its NHA Capacity Building Program, giving grants to hospitals who could otherwise not afford the membership in order to reach women heart patients in underserved communities. Our next step is to further expand the NHA by using predictive analysis to target hospitals that show high rates of readmission for specific heart conditions.
Keynote Forum
Mary McGown
WomenHeart: The National Coalition for Women with Heart Disease, USA
Keynote: WomenHeart National Hospital Alliance: Supporting women living with heart disease nationwide
Biography:
With over 35 years of non-profit management experience, Mary McGowan currently serves as Chief Executive Officer of WomenHeart: The National Coalition for Women with Heart Disease to ensure the successful implementation of the organization’s strategic direction and increase its visibility and brand recognition nationally. Prior to joining WomenHeart in 2010, McGowan served as Executive Director of the Allergy & Asthma Network. She held various positions with the American Academy of Pediatrics during her service of 18 years. McGowan earned a Masters Degree in Human Resources Development from the George Washington University and a B.A. from Trinity University.
Abstract:
WomenHeart is the only patient-centered organization solely devoted to improving the healthy and quality of life of the 42.7 million American women living with and at risk for heart disease. We have thousands of members, including women heart patients and their families, health care providers, advocates and consumers committed to helping women live longer, healthier lives. We provide an array of support programs for women nationwide, including our 110 local Support Networks in 40 states, each led by trained women heart patient volunteers – WomenHeart Champions. Support Networks meet monthly at National Hospital Alliance (NHA) member hospitals. The NHA, comprised of 40 hospitals, is the nation’s only partnership program between WomenHeart and progressive hospitals across the country committed to advancing women’s heart health and gender specific cardiovascular care in their communities. This valuable alliance gives women heart patients leverage to improve their own lives, which results in better patient outcomes and lower readmission rates. Through the NHA, WomenHeart supports the trained WomenHeart Champions and provides an educational curriculum for their Support Network meetings. Additionally, we work with the hospitals' clinicians to improve their continuing education with quarterly webinars and media and co-branding opportunities. In 2015, WomenHeart launched its NHA Capacity Building Program, giving grants to hospitals who could otherwise not afford the membership in order to reach women heart patients in underserved communities. Our next step is to further expand the NHA by using predictive analysis to target hospitals that show high rates of readmission for specific heart conditions.
Keynote Forum
Guy Hugues Fontaine
Université Pierre et Marie Curie
Keynote: Advances in the understanding of ARVCs
Time : 09:30 AM to 10:00 AM
Biography:
Guy H Fontaine has made 16 original contributions in the design and the use of the first cardiac pacemakers in the early 60s. He has serendipitously identified ARVD during his contributions to antiarrhythmic surgery in the early 70s. He has developed the technique of Fulguration to replace surgery in the early 80s. He has been one of the “216 individuals who have made a significant contribution to the study of cardiovascular disease since the 14th century”, one of the “500 greatest geniuses of the 21th century” (USA Books), one of the “100 life time of achievement” (UK Book). He has 900+ publications including 201 book chapters. Reviewer of 23 scientific journals both in basic and clinical science. He has served as a member of the Editorial Board of Circulation during 5 years after reviewing during decades papers for this Journal. He has given 11 master lectures of 90’ each in inland China in 2014. He has developed new techniques of hypothermia for neurologic brain protection in OHCA, stroke and spinal cord injury. He is the first to have resuscitated his wife at home with an external defibrillator (Schiller) still working after 30 years. He has also invented a high-tech device which can be considered as the ultimate in palliative care
Abstract:
ARVCs is covering a spectrum of mostly inherited cardiomyopathies of increasing interest because od a relatively small number of mututions have been identified in 60% of patients (Fressart Europace 2014). The mechanisms of EGS anomalies are btter understood as well as their long term prognosis leading to CHF (Hulot Circulation 2004)
Arrhythmogenic Right Ventricular Dysplasia (ARVD) is mostly due to PKP2 desmosomal mutation with increased RV size with apoptotic thinness of the free wall and segmental anomalies of contraction. This is also due to the presence of fat and interstitial fibrosis mostly observed in the RV free wall and LV apex. This disease is frequent in the general population 3.7% but become clinically apparent in a small number of cases (Fontaine AJC 2014). Clinical presentation is mostly ventricular arrhythmias which can lead to unexpected sudden cardiac death especially in young people and during endurance sports. Some of these patients seen at a late stage of the disease can be misclassified as IDCM. However, in some rare patients, the disease can stop completely its progression.
Brugada syndrome (BrS) has a unique ECG pattern of coved type observed only in lead V1. Structural changes are sometimes producing a Phenotype suggesting ARVD. However, these dkiseases are two different entities with some degree overlap both phenotypically and genotypically in a small number of cases.
Right Ventricular Outflow Tract Ventricular Tachycardia (ROVT VT) is generally benign but one personal case of SD with pathologic documentation demonstrated a localised infundibular anomaly suggesting localised ARVD.
Naxos disease has been identified in the Greek eponym disease is the homozygous form with associated palmoplantar keratosis. This led to the identification of the first mutation Plakoglobin leading to the discovery of multiple candidate genes and finally other mutations.
UHL’s anomaly is rare form which suggests major early apoptosis creating an arrhythmogenic substrate which proved importaznt to demonstrate the re-entrant mechanism of ventricular arrhythmias.
These cardiomyopathies can be affected by a genetically superimposed myocarditis which is frequently the determinant of prognosis (Lopez-Ayala HR 2016).
Experimental ablation of the disease has been demonstrated on the Zebra fish and the mouse opening new vistas for its treatment and prevention (Saffitz Science 2015).
- Workshop on Using women and heart disease - Specific campaigns to motivate change
Session Introduction
Mary McGowan & Eva Maciejewski
WomenHeart: The National Coalition for Women with Heart Disease, USA
Title: Using women and heart disease - Specific campaigns to motivate change
Time : 09:55-11:10
Biography:
With over 35 years of non-profit management experience, Mary McGowan currently serves as Chief Executive Officer of WomenHeart: The National Coalition for Women with Heart Disease to ensure the successful implementation of the organization’s strategic direction and increase its visibility and brand recognition nationally. Prior to joining WomenHeart in 2010, McGowan served as Executive Director of the Allergy & Asthma Network. She held various positions with the American Academy of Pediatrics during her service of 18 years. McGowan earned a Masters Degree in Human Resources Development from the George Washington University and a B.A. from Trinity University.
Abstract:
WomenHeart has been conducting women and heart disease-specific campaigns for the past two years with the goal of formulating key policy and research recommendations to advance the prevention, diagnosis, and treatment of heart disease in women. Drawing from our database of 20,000 members, we developed and conducted national patient education surveys approved by the Institutional Review Board and led telephone focus groups and patient round-tables. We obtained valuable input from women heart patients on specific topics related to heart disease. We then held key opinion leader workshops, in which researchers and policy experts discussed the results gathered from these surveys, focus groups, and round-tables and formulated key recommendations. WomenHeart released the results of these studies and key opinion leader workshops at briefings on Capitol Hill, thereby raising awareness among congressional staff. Additionally, these findings were published in peer reviewed journals such as Elsevier’s Women’s Health Issues, consequentially underscoring the importance of these heart health issues throughout the medical community. In this workshop, we will highlight how our topic-specific campaigns on heart disease in women have the potential to draw the attention of policy-makers, healthcare professionals, and the public. We will focus on the following three recent topic-specific campaigns:
· Cholesterol and Familial Hypercholesterolemia
· Heart Failure and Women
- Young Researchers Forum
Location: Philadelphia
Chair
Mary McGowan
WomenHeart: The National Coalition for Women with Heart Disease, USA
Session Introduction
Jiabao Liu
The First Affiliated Hospital of Nanjing Medical University, China
Title: Epicardial injection of Ad-HGF activates endogenous c-kit+ cardiac stem cells and fosters survival and regeneration of the infarcted rat heart
Time : 11:30-11:50
Biography:
I am a PhD.candidate, 29 years old, male and study in Nanjing medical university, Nanjing, China. My Ph.D. supervisor is Dr. Zhijian Yang. He has published more than 20 papers in reputed journals and has been serving as an editorial board member of repute. As his Ph.D. student, I am now engaged in the study regarding the regeneration of the infarcted heart. Our study results are encouraging and the abstract is shown above.
Abstract:
Ischemic heart disease is the leading cause of morbidity and mortality worldwide due to the inability of the heart to replace lost myocytes. While the discovery of c-kit+ cardiac stem cells (CSCs) provides us a new opportunity to repair the damaged heart, the proliferation, differentiation and regulation of the CSCs remains elusive. Therefore, here we investigated whether adenovirus vector containing hepatocyte growth factor gene (Ad-HGF) can promote the proliferation and differentiation of c-kit+ CSCs into cardiomyocytes, smooth muscle cells or endothelial cells. We firstly discovered a positive correlation between the expression levels of HGF and c-kit+ CSCs among neonatal, adult and senior SD rats in vivo. Notably, epicardial injection of Ad-HGF following MI activates c-kit+ CSCs and promotes proliferation and differentiation into cardiomyocyte, endothelial cell and smooth muscle cell in vivo. Ad-HGF treatment promotes angiogenesis, inhibits fibrosis and improves the cardiac function of the rat following MI. The protective role of HGF may be due to the activation of c-Met receptor, and subsequent activation of the p-Akt-p21/p27-cell cycle pathway. Meanwhile, the levels of Bcl-2/Bcl-xL were elevated, while the levels of cleaved caspase 3 and Bax were reduced. Taken together, Ad-HGF promotes heart repair by regulating c-kit+ cardiac stem cell proliferation and differentiation and prevents heart failure following MI. This approach may provide new strategy for the treatment of ischemic heart disease.
Yunle Wang
Nanjing Medical University, China
Title: Exogenous HGF prevents cardiomyocytes from apoptosis after hypoxia via up-regulating cell autophagy
Time : 11:50-12:10
Biography:
Yunle Wang is a Ph. D. student in Nanjing Medical University. She is major in cardiology and works for the team of Prof. Zhijian Yang. Her studies focus on the protection effect of hepatocyte growth factor on myocardial infarction, and the function of autophagy in myocardial ischemia disease.
Abstract:
Hepatocyte growth factor (HGF) is widely known as a protective factor in ischemic myocardium, however the mechanism remains unclear. Autophagy at early stage of hypoxia has been demonstrated to play an important role in protecting myocardium both in vivo and in vitro. We performed this study to investigate the association between the protective effect of HGF and autophagy. We found that autophagy in neonatal rat ventricular myocytes (NRVMs) increased at early stage after hypoxia and HGF release was consistent with the change of autophagy. Then we added exogenous HGF to the cells and enhanced autophagy was detected, while neutralizing HGF got opposite effects. However, after inhibition of autophagy using 3-methyladenine, apoptosis of myocytes increased, indicated that the protective effect of HGF was autophagy-dependent. This may be associated with clearance of injured mitochondria as the marker of mitochondrial autophagy, Parkin, was induced when HGF was added to cell medium. Our results provided insight into a potential mechanism in which exogenous HGF prevented NRVMs from apoptosis after hyoxia. Upregulation of Parkin through administration of exogenous HGF may be a potential therapeutic strategy for myocytes ischemia.
Waleed Al Darzi
Henry Ford Hospital, USA
Title: Intracardiac thrombosis during orthotopic liver transplantation: A case report
Time : 12:10-12:30
Biography:
Waleed Al-Darzi has completed his medical school from Ain Shams University, Faculy of Medicine, Egypt. He is ECFMG certified. He is currently a second year Internal Medicine resident at Henry Ford Hospital, Detroit, Michigan, USA.
Abstract:
Intracardiac thrombosis (ICT) during orthotropic liver transplantation (OLT) is not a common event; however, it is associated with high mortality. Although many risk factors are suggested, these events were considered multifactorial. We are reporting a case of right cardiac chamber thrombus during OLT presented as a sudden cardiac arrest during reperfusion stage. A 54-year-old male with history of decompensated liver disease secondary to primary biliary cirrhosis with secondary portal hypertension, ascites, and hydrothorax who presented for liver transplantation with MELD score of 31. Patient was listed for liver transplantation from a deceased donor. Pertinent pre-operative laboratory studies showed PT of 38 seconds, INR of 1.27, PTT of 15.9 seconds, and platelets of 331 X 109/L. Intraoperatively, reperfusion was not well tolerated. Severe hypotension developed followed by cardiac arrest with chest compressions for 1 minute. Ventricular fibrillation and ventricular tachycardia were recorded. Trans-esophageal Echocardiogram (TEE) showed Right sided intra cardiac thrombus. Heparin 5000 Units was administered with clot resolution. Patient developed profound coagulopathy post reperfusion. Despite one hour of packing and resuscitation, reversal was not sufficient for definitive closure. Temporary abdominal closure was performed. Unfortunately, patient’s course postoperatively was further complicated; including liver ischemia, renal failure and wound infection. Eventually, the received liver didn’t recover; patient was relisted and re-transplanted with a favorable outcome. Cardiac thrombosis should always be considered in patients having hemodynamic compromise during liver transplant surgery. TEE is a useful diagnostic tool in identifying these thrombi intraoperatively. Treatment and prevention of ICT is challenging.
Ahmed Abuzaanona
Henry Ford Hospital, USA
Title: Vagococcus fluvialis causing severe infective endocarditis presenting with embolic stroke; A case report
Time : 12:30-12:50
Biography:
Ahmed Abuzaanona has completed his MD from Al-Quds University, Faculty of medicine, Palestine. He is currently a second year internal medicine resident at Henry Ford hospital in Detroit, Michigan, USA.
Abstract:
Introduction:
Infective endocarditis (IE) is most commonly caused by staph, streptococcus or enterococcus species. Vagococcus is a distinct genus that has been identified in 1989. One case of human infection was reported causing periodontal abscess. We report the first case of IE caused by Vagococcus fluvialis involving both aortic and mitral valves, presenting as an embolic stroke and requiring surgical intervention.
Case presentation:
A 34 year old female with a history of intravenous drug abuse and endocarditis presented with headache, fever and new onset blind spots after two weeks of toothache and purulent discharge in her oral cavity. On exam she was septic, with new left sided facial weakness, inferior quadranopsia and an apical pansystolic murmur. MRI of the brain showed subacute right occipitoparietal infarct. TEE then revealed mobile vegetations involving aortic and mitral valves, causing severe aortic and mitral insufficiency with ulceration of two of the aortic cusps, and felt to be the source of her embolic stroke. She was started on vancomycin and gentamycin, then switched to intravenous ampicillin and ceftriaxone after blood culture growth of Vagococcus fluvialis. She underwent bioprosthetic valve replacement of both valves with repair of aortic defect with pericardial patch four weeks into her treatment, and received 6 total weeks of antibiotics with resolution of her symptoms on follow up.
Discussion:
Embolic stroke due to IE should always be considered in patients presenting with neurological deficit in the setting of poor dentition and intravenous drug abuse. Vagococcus fluvialis appears to have a fulminant course when causing IE.
Jeffery Maldo
University of Puerto Rico School of Medicine, USA
Title: High output cardiac failure in a patient presenting with acute myeloid leukemia and leukostasis
Time : 12:50-13:10
Biography:
http://cardiac.conferenceseries.com/Dr. jeffrey Maldonado has completed his Medical School from Universidad Nacional Pedro Henriquez Urena (UNPHU) in the Dominican republic in 2008. He is 3rd year resident of Internal Medicine at San Juan City Hospital in San Juan Puerto Rico. He has presented a poster presentation in the ACP in Boston 2015 named “An atypical case of autoimmune hepatitis in a 88 year old men”, Jeffrey also won first place at the research presentation in the ACP in Puerto in October 2015, named “Can Monocytosis be used as Independent Variable for diagnose of Deep vein thrombosis”. Besides that, Jeffrey went to the Jeopardy of the ACP to represent Puerto Rico during years 2014 and 2015.
Abstract:
In this case report a patient presents with high-output cardiac failure in the clinical setting of acute leukemia and leukostasis. Case particulars are presented, literature is reviewed and a potential mechanistic explanation is proposed to describe presentation and clinical findings.