Day :
- Clinical Cardiology | Heart Diseases & Heart Failure | Interventional Cardiology | Cardiac & Cardiovascular Research | Clinical Case Reports on Cardiology
Location: Embassy Suites by Hilton Atlanta Airport 4700 Southport Road, Atlanta Georgia 30337, USA
Chair
William J. Rowe
Medical University of Ohio, Toledo USA
Co-Chair
Manuela Stoicescu
Assistant professor University of Oradea, Romania
Session Introduction
Yaping Tian
Chinese PLA General Hospital, China
Title: The amino acids profile variation in dried blood spots from patients with acute coronary syndrome
Biography:
Yaping Tian is the Professor and Director of TRANSLATIONAL MEDICINE LABORATORY, Chinese PLA General Hospital. He received his Master’s Degree in
Medicine from Chinese PLA Postgraduate Medical School and PhD from the Academy of Military Medical Sciences in 1993. He had been trained as Postdoctoral
Fellow for 2 years(1995-1997) in The Queen Elizabeth Hospital, Australia. He has been focusing on the study of the specific serum proteomic profiles and
genetic signatures in different diseases, especially on cancer and cardiovascular diseases. He also has received more than 20 grants and published more than
400 scientific papers in peer-reviewed journals.
Abstract:
The cardiovascular disease (CVD), which includes acute coronary syndrome (ACS) and heart failure (HF), is the global
leading cause of human death. The blood biomarkers, as targets of treatment, will help to prevent and treat CVD. They
could aid in early prognosis and diagnosis of CVD and effectively reduce the morbidity and mortality, which is the focus in
research for CVD. This study aimed to screen effective blood markers for different stages of CVD. We have detected 11 amino
acids and SA in HC and patients with MS, ACS and HF. GLY and PRO were significant difference between the AMI and the
UAP. The ROC curve area of them in multivariate analysis was 0.681 (0.600-0.754) (p<0.001). ARG, GLY, MET, TYR and SA
were significant difference between the AMI and the MS. The ROC curve area of GLY and ARG in multivariate analysis was
0.953 (0.911-0.979) (p<0.001). There were significant differences in 9 amino acids and SA between the AMI and the HC. The
ROC curve area of GLY, ORN, and PHE in multivariate analysis was 0.991 (0.962-0.999) (p<0.001). There were significant
differences in 3 parameters between the CHF and the UAP. The ROC curve area of CIT and L-I-P in multivariate analysis
was 0.839 (0.742-0.910) (p<0.001). Eleven blood amino acids and SA in patients with MS, ACS, and CHF and in HC have
been analyzed and the variation between groups have been found, the results suggested that branched chain amino acids and
aromatic amino acids may be biomarkers for CVD.
Biography:
Kunlun He is the Vice President of Chinese PLA General Hospital and his main Research Direction is Heart Disease. He has published more than 126 papers in
reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
This study examines the interaction between hERG and Kv4.3. The functional interaction between hERG and Kv4.3,
expressed in a heterologous cell line, was studied using patch clamp techniques, western blot, immunofluorescence and
co-immunoprecipitation. Co-expression of Kv4.3 with hERG increased hERG current density (tail current after a step to +10
mV: 26±3 versus 56±7 pA/pF, p<0.01). Kv4.3 co-expression also increased the protein expression and promoted the membrane
localization of hERG. Western blot showed Kv4.3 increased hERG expression by Hsp70. hERG and Kv4.3 co-localized and
co-immunoprecipitated in cultured 293T cells, indicating physical interactions between hERG and Kv4.3 proteins in vitro. In
addition, Hsp70 interacted with hERG and Kv4.3 respectively and formed complexes with hERG and Kv4.3. The α subunit of
Ito Kv4.3 can interact with and modify the localization of the α subunit of IKr hERG, thus providing potentially novel insights
into the molecular mechanism of the malignant ventricular arrhythmia in heart failure.
Biography:
Dr. Jorge A. Sison is had done is MD specialization in internal medicine and cardiology. He is certified Philippine College of Cardiology and Philippine College of
Physicians. He currently serves at Manila medical centre as a Cardiology specialist.
Abstract:
By definition, Resistant Hypertension (RH) is Blood Pressure (BP) that remains above 140/90 despite appropriate tripledrug
regimen including a diuretic (JNC 7) or controlled BP requiring at least 4 medications. Prevalence of RH is 10-30% in
general practice (Kaplan 2006), 12.8% in drug-treated US adults. Prevalence continues to increase. Uncontrolled BP that leads
to suspect RH can be of two types: A. Pseudo-resistance which may be due improper BP measurement, “White-coat” effect, or
poor medication adherence; B. True resistant hypertension. Self BP measurement has shown to minimize white-coat effect. In
a study by dela Sierra (Hypertension 2011) 1/3 of clinic RH is actually white-coat by ABPM. Regarding issue of adherence, in a
study by Jung (J Hypertension 2013), among 375 RH patients, analysis of urine showed only 3.5% were true RH. Confirmation
of true RH is important because controlling their BP to <140/90 has reduced morbidity and mortality (Bangalore 2014).
The causes of true RH are secondary hypertension, drug-induced, volume overload, high aldosterone levels, obesity, high
alcohol intake, sleep apnea and clinical inertia. These factors must be well investigated to achieve success in BP control. In the
management of RH, in association with lifestyle modification, three drugs to be used are Diuretics, ACE inhibitors or ARBs
and calcium antagonists. Beta-blockers should be used if there is a compelling indication. Among the diuretics, chlorthalidone
has the best profile among the thiazide and thiazide-like classes. Potassium-sparing diuretics particularly spironolactone is also
efficacious in uncontrolled RH. Finally, clinical inertia is another factor that leads to uncontrolled BP, wherein, clinicians fail
to intensify therapy when indicated. The role of renal denervation (RD) is still inconclusive. Meta-analysis of 10 RCTs suggests
that RD is not superior to drug treatment.
Biography:
William J. Rowe M.D. 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. He is a former Assistant Clinical Professor of Medicine at the University of Ohio, School of Medicine at Toledo. Of only 4 space syndromes, he
has published 2: "The Apollo 15 Space Syndrome" and "Neil Armstrong Syndrome." He published Neil Armstrong's probable lunar acute heart failure. He has been
listed in the Marquis Whos Who of the World from 2002-2009,2013, 2014, 2015, 2016.
Abstract:
Neil Armstrong syndrome applies both to Earth with common magnesium (Mg) deficits and with Mg deficits invariably
occurring in Space (S); this can trigger acute temporary heart failure i.e., (catecholamine (C) cardiomyopathy). Whereas
the normal CO2 levels on Earth are 0.03% in S, during the Euro Mir 94 missions, levels over 10 times higher (0.5-0.7% CO2).
It has been postulated that there is, with S flight, an intracellular shift of calcium (Ca) conducive to vasospasm and damage to
mitochondria. Mg is a Ca blocker and strong antioxidant and is required for thermoregulation with loss of Mg in sweat and
renal Mg loss and dehydration; this will increase potential for heart failure and hypertension. C levels in S are twice supine
levels on Earth. Armstrong, during his last 20 lunar minutes, notified Houston twice during a 4-minute interval that he was
“short of breath” along with heart rates up to 160; tachycardia will intensify oxidative stress in S from Mg ion deficits, high C,
high free fatty acids and vicious cycles. This syndrome has severe dyspnea, severe thirst, severe tachycardia corrected by fluid
replenishment, applies to Earth as well; it would be more likely to occur in post-menopausal women with 90% of cases of C
cardiomyopathy reported in this group, marathoners particularly at the finish line and those in the tropics, particularly with
water shortages. It is likely to be corrected, relatively quickly either by intravenous fluids or a subcutaneous Mg injection.
David Jaeger
University of Detroit Mercy, USA
Title: Combating heart disease with $80 million heart institute in just 15 months
Biography:
David Jaeger is an Architect and has been practicing Healthcare Design for more than 30 years. He has completed his Bachelors of Science, Architecture from
Lawrence Technological University, USA. He is a certified Lean leader and helps transform hospital environments with Lean design processes. He has been a
leader in the design of environments that help shape the future.
Abstract:
WVU Medicine is tackling one of the toughest challenges related to high rates of heart disease with a new $80 million
heart and vascular institute. The need is essential with heart disease the state’s No. 1 killer. WVU’s vision to become a
leading academic institution delivering cutting edge cardiac services was developed with an aggressive campaign to recruit
top specialists. WVU Health was constructing a 10-story tower, originally designed as a Children’s Hospital. Once the Heart
program was deemed top priority, several floors of the building were redesigned while it was being constructed. The task
was to complete design and construction in 15 months, in lieu of the traditional three years. The team met the aggressive
schedule utilizing design-assist, design-build and an intense amount of creativity. The success of the cardiac program is evident:
inpatient cardiovascular procedures are up 57%, clinic visits increased by 33% and vascular surgery is 12% higher than last
year. WVU Medicine built a new $80 million Heart and Vascular Institute in 15 months, working with a facility that was under
construction, originally designed as a Children’s Hospital. The team met the aggressive schedule utilizing design-assist, design-build
and an intense amount of creativity. Success is evident: cardiovascular procedures are up 57% and clinic visits increased
33%. An objective for learning include (1) Learn how the hospital created the vision, recruited the talent and is positioning
WVU Health for success across the entire Southeast. (2) Transforming a building under construction into the new Heart and
Vascular Institute while maintaining schedule and budget. (3) How to achieve speed to market through creative methods
including design-assist, design-build, and intense collaboration and (4) Learn the value of utilizing lean design workshops to
expeditiously complete design with concentrated user input.
Biography:
Carina Dalay Dizon has completed her MD from University of St. Tomas School of Medicine and is Trained in Internal Medicine and Nephrology in St. Lukes Medical
Center Quezon City. She is currently working as the Resident Training Officer of the Internal Medicine Department of St. Lukes Medical Center.
Abstract:
Contrast-Induced Nephropathy (CIN) is a reversible form of acute kidney injury that occurs soon after the administration of
contrast media. Currently accepted methods for prevention of CIN include intravenous (IV) hydration, administration of
oral n-acetylcysteine and use of atorvastatin. Nicorandil, a novel anti-angina drug has been studied to have a beneficial effect
as well in preventing CIN. This paper aims to determine the efficacy of Nicorandil in preventing the incidence of contrast-induced
nephropathy in patients who will undergo coronary angiography. Search for randomized controlled trials was done,
evaluating the efficacy of Nicorandil in preventing contrast-induced nephropathy in patients undergoing coronary angiography.
Articles were critically appraised for inclusion. Pooled analysis revealed a Chi2 value of 4.32, dF =3 (P=0.21), I2 of 31%.
The computed relative risk for incidence of CIN following Nicorandil administrations was 38% (CI: 0.19, 0.71). Administration of
Nicorandil showed absolute risk reduction in the incidence of CIN by 8% as compared to IV hydration seen in the Forest plot with
a number needed to treat of 12. It showed a trend favoring Nicorandil for the prevention of contrast-induced nephropathy. The
studies also showed that Nicorandil together with IV hydration significantly caused the reduction in cystatin C levels and change
from baseline eGFR as compared with standard intravenous hydration.
- Clinical Cardiology | Heart Diseases & Heart Failure | Interventional Cardiology | Cardiac & Cardiovascular Research| Clinical Case Reports on Cardiology
Location: Embassy Suites by Hilton Atlanta Airport 4700 Southport Road, Atlanta Georgia 30337, USA
Chair
William J Rowe
Medical University of Ohio, USA
Co-Chair
Manuela Stoicescu
Assistant professor University of Oradea, Romania
Session Introduction
Kunlun He
Chinese PLA General Hospital, China
Title: Kv4.3 Modulates the distribution of herg
Biography:
Kunlun He is the Vice President of Chinese PLA General Hospital and his main Research Direction is Heart Disease. He has published more than 126 papers in
reputed journals and has been serving as an Editorial Board Member of repute.
Abstract:
This study examines the interaction between hERG and Kv4.3. The functional interaction between hERG and Kv4.3,
expressed in a heterologous cell line, was studied using patch clamp techniques, western blot, immunofluorescence and
co-immunoprecipitation. Co-expression of Kv4.3 with hERG increased hERG current density (tail current after a step to +10
mV: 26±3 versus 56±7 pA/pF, p<0.01). Kv4.3 co-expression also increased the protein expression and promoted the membrane
localization of hERG. Western blot showed Kv4.3 increased hERG expression by Hsp70. hERG and Kv4.3 co-localized and
co-immunoprecipitated in cultured 293T cells, indicating physical interactions between hERG and Kv4.3 proteins in vitro. In
addition, Hsp70 interacted with hERG and Kv4.3 respectively and formed complexes with hERG and Kv4.3. The α subunit of
Ito Kv4.3 can interact with and modify the localization of the α subunit of IKr hERG, thus providing potentially novel insights
into the molecular mechanism of the malignant ventricular arrhythmia in heart failure.
Raghav Lumb
Bharti Vidhyapeeth Hospital, India
Title: Study of left atrial compliance in rheumatic mitral stenosis
Biography:
Raghav Lumb is Graduated from Kurukshetra University, Haryana, India and has completed his Post Graduate in Internal Medicine from Bharati Vidyapeeth
University Medical College, Pune, India. He is presently an Aspiring Resident of DM Cardiology.
Abstract:
Study of left atrial compliance in rheumatic mitral stenosis
Introduction & Aim: Left Atrial Compliance (LAC) is an important determinant of cardiac function, both in the normal and pathological state. The basic hemodynamic features of Mitral Stenosis (MS) are an elevation of Left Atrial (LA) pressure, resulting from antegrade flow across the Mitral Valve (MV). The severity of MS and the extent of narrowing of MV orifice determines the degree of LA pressure. The aim is to study the left atrial compliance in patients with Rheumatic Mitral Stenosis, to analyze the predictors of LA pressure in rheumatic MS, to study effects of successful Balloon Mitral Valvuloplasty (BMV)on left atrial compliance.
Method: 50 patients undergoing BMV by Inoue technique where included in this study. Doppler echocardiography was
performed in all before BMV. Left atrial size, left ventricular end-diastolic dimension, left ventricular end systolic dimension and left ventricular ejection fraction was calculated. Mitral valve area (MVA) was measured by 2D echo planimetry andpressure half time method from continuous mitral flow velocity profile. Mean Mitral Valve Gradient (MVG) was also measured by continuous wave Doppler echocardiography. During BMV procedure right heart catheterization was performed with balloon-tipped catheter. Pulmonary capillary wedge pressure, systolic, diastolic and means pulmonary artery pressures were measured with fluid-filled catheters. Trans-septal puncture was done from the right femoral vein with broken brought needle and
Mullins transeptal sheath. Left heart catheterization was performed through it. The left atrial ‘a’ and ‘v’ waves amplitude were measured at end-expiration cardiac output was determined by Fick’s method. LAC was calculated by dividing the systolic rise in LA pressure by stroke volume.
Result: Though LAC was depressed in patients with rheumatic MS and improved dramatically (from 2.5±0.51 to 7.11±1.71
cm3/mmHg) following successful BMV. Those with higher LA mean pressure had lower LAC. Those with higher PA pressure,
higher TMG, Lower MVA, and lower LAC had higher mean LA Pressure with the strongest negative relationship noted with LAC.
However, in multivariate analysis, only TMG and LAC were predictors of LA pressure.
Conclusion: LAC is an important determinant of left atrial pressure in patients of rheumatic mitral stenosis and which correlates
with symptomatology. Rheumatic MS has markedly depressed LAC. This depressed compliance improves immediately following
successful balloon mitral valvuloplasty. This improvement in compliance occurs irrespective of left atrial mean pressure