Day 2 :
Keynote Forum
Manuela Stoicescu
University of Oradea, Romania
Keynote: The hidden cardiovascular disease at a patient with pain in the left hypochondrium
Biography:
Manuela Stoicescu, Consultant Internal Medicine, Doctor (PhD in Internal Medicine), is Assistant Professor of Medical Disciplines Department, University of Oradea,
Faculty of Medicine and Pharmacy, Romania, Internal Medicine Hospital and Office. She is Member of Romanian Society of Internal Medicine, Member of Romanian
Society of Cardiology, Chemistry, Biochemistry and Member of Balcanic Society of Medicine. She was invited as a speaker at 24 International Conferences. She
is editorial board member of three ISSN prestigious Journals in USA and has published 12 articles in prestigious ISSN Journals in USA. She published four books:
two books for students in English and Romanian language: ”Clinical cases for students of the Faculty of Medicine”, one book in English language on Amazon at
International Editor – Lambert Publishing Academic House in Germany- “Side Effects of Antiviral Hepatitis Treatment”, one monograph in Romanian language”
High blood pressure in the young a ignored problem!” two chapter books – Cardiovascular disease: Causes, Risks, Management CVD1- Causes of Cardiovascular
Disease 1.5,1.6, U.S.A on Amazon.
Abstract:
The hidden cardiovascular disease at a patient with pain in the left hypochondrium
Objective: The most important objective of this presentation is to found the real cause of a patient with came at the consultation with sudden pain in the left hypochondrium.
Method: Present the clinical case of a young patient 29 years old, which came at the consultation for sudden onset of pain in the
left hypochondrium, chills and fever 40ºC. At the objective examination BP=120/80 mmHg, HR=100 beats/minute, rhythmic
heart sounds, normal intensity and a systolic murmur heart on the middle of the chest, degree III, without irradiation. Auscultation
of the lung was normal vesicular sound. At palpation of the abdomen presented sensibility in the left hypochondrium. The
laboratory tests showed: ESR=60/80 mmHg, fibrinogen=600 mg/dl, leukocytes=16000/mm3, urine examination normal, the
blood culture Staphylococcus aureus positive. The abdominal ultrasound put in evidence unexpected, many small nodules
inside of the parenchyma of the spleen as small cysts and in rest normal. The echocardiography of the heart put in evidence
unexpected an atrial septum defect medium and vegetation of this level. The patient follows antibiotic therapy I.V. and was
referred to as the cardiovascular surgery department.
Result: This patient was in reality with bacterial endocarditis on an unknown congenital heart disease-atria septum defect and
the small nodules inside of the spleen were microemboli septic in the context of bacterial endocarditis.
Conclusion: This case is interesting because the real cause of the patient with pain in left hypochondrium represented in fact
microemboli in the spleen in the context of endocarditis at a patient with unknown congenital heart disease.
Keynote Forum
Alessandro Delitala
Medical Director of the University Hospital of Sassari, Italy
Keynote: Beta stiffness index in euthyroid subjects: The role of free thyroxine
Biography:
Dr. Delitala is currently joining the Internal Medicine Unit at Azienda-Ospedaliero- the University of Sassari as attending physician. His research focuses on the effect
of subclinical thyroid diseases and their effect on the cardiovascular system. Another area of interest is autoimmune diabetes and factors associated with insulin
dependence.
Abstract:
Beta stiffness index in euthyroid subjects: The role of free thyroxin
Arterial stiffness is an important prognostic factor for cardiovascular mortality in patients with blood hypertension and
in the general population. Recent studies showed that disorders of thyroid gland are associated with an increased aortic
stiffness, although results are not univocal. The effects of free thyroxin on vascular physiology at common carotid level are less
studied. Our study aimed to test the association between free thyroxin and thyrotropin and beta stiffness index at common
carotid level in a cohort of euthyroid patients. This study included 5385 euthyroid patients (2964 women) aged 14-102 years.
Stepwise regression analysis was used to test the association between thyroid hormones and beta stiffness index, the latter
as the dependent variable. We found that beta stiffness index had a direct and positive association with free thyroxin level, after
adjusting for the confounder’s age, systolic and diastolic blood pressure, body mass index, triglycerides and smoke. Our results
suggested that a higher level of free thyroxin, even in euthyroid subjects, could have a detrimental effect of arterial stiffness at
common carotid level. Further longitudinal studies are required to understand the meaning of this association.
- 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