Day 2 :
University of Toledo Medical Center, USA
Time : 09:10-09:50
William J Rowe is a board certified Specialist in Internal Medicine. He completed his MD at University of Cincinnati and was in private practice in Toledo, Ohio for 34 years. He was a former Assistant Clinical Professor of Medicine at University of Ohio, School of Medicine. Out of four space syndromes, he has published two: The Apollo 15 Space Syndrome and Neil Armstrong Syndrome.
Neil Armstrong syndrome triggered by very common earth related magnesium (Mg) deficits, invariably with spaces flight (SF); invariable dehydration with exercise-induced sweating with Mg loss and through kidneys; leaks of plasma through oxidative stress-induced defective capillaries; loss of thirst mechanism; in turn, angiotensin, catecholamine (C) elevations to twice earth levels when supine; vicious cycles with Mg ion deficits; can trigger C cardiomyopathy i.e. acute temporary heart failure. Normal earth CO levels about 0.03% with SF, levels can be 0.5-7% as on Mir; this, postulated to trigger calcium (Ca) overload with in turn coronary vasospasm, injuries to mitochondria along with impairment in telomere function; its synthesis is dependent upon Mg and in turn, decreased cardiac function. Since Mg required for thermoregulation was intensified by SF-exercise for at least 2 hours exercise/day; invariable SF mal-absorption with Mg levels reduced to p<0.0001 even though serum Mg lacks sensitivity. Neil Armstrong informed Houston twice at 4 minutes interval, of shortness of breath with heart rate up to 160 (tachycardia conducive to oxidative stress) with marked reduction to 60, half hour before pacific-splashdown over three days later; severe thirst, quenched with in turn, reduced postulated high C. Mg is powerful antioxidant and Ca blocker. Severe dyspnea, thirst, tachycardia; the latter, corrected by water replenishment during three days back to Earth; one of only four- SF syndromes was observed; applicable to Earth in post-menopausal women, particularly if taking Ca supplements which reduces Mg absorption; marathoners at finish line; in tropics with water shortages; may be corrected quickly with I.V fluids or subcutaneous Mg.
Sheba Medical Center, Israel
Keynote: The stress of a patient's heart; heart rehabilitation in patients with systolic and diastolic heart failure
Time : 09:50-10:30
Yehuda Adler is Director of Development of Medical Resource, Director of Internship Committee, Director of the Talpiot Medical Leadership Program (a revolutionary program to build medical leadership in Israel), and Director of health professions at the Chaim Sheba Medical Centre, Israel. He is a member of the National Council for Prevention and Treatment of Cardiovascular Diseases at the Ministry of Health in Israel. He is also a Vice Chair of the Nucleus, The ESC's Committee for Myocardial and Pericardial diseases. He wrote the ESC Guidelines for pericardial disease in 2005 and chaired the ESC Guidelines for pericardial disease in 2015. In the past, he served as General Director at Misgav-Ladach Hospital, Jerusalem, Israel. He has published over 200 original articles in leading professional medical and research journals throughout the world and is an active participant and speaker in international scientific meetings.
There are limited contemporary data regarding the association between improvement in cardiovascular fitness in heart failure (HF) patients who participate in exercise training and the risk for subsequent hospitalizations. Shown in the presentation are the connections between exercise training and skeletal muscle in CHF; the anti-inflammatory effects of exercise training in CHF and the hemodynamic effects of exercise training in CHF (which includes general hemodynamics, endothelial function and small vessels). In addition, pathobiological pathways induced by exercise training in patients with heart failure are displayed. The essential details from research done by David J. Whellan (Jefferson Medical College, Philadelphia, PA) and Christopher M. O'Connor (Duke University Medical Center, Durham, NC) titled: “Efficacy and safety of exercise training as a treatment modality in patients with chronic heart failure” are displayed. Results of a randomized controlled trial investigating outcomes of exercise training (HF-ACTION) are shown as well. Cardiac insufficiency with preserved systolic function; prevailing manifestation of evaluation diastolic impairment using ratio of volume/pressure and pharmaceutical treatment was checked or is being checked on perspective oriented projects. Results regarding exercise capacity, diastolic function & la remodeling and the quality of life are reviewed. In summary, the colleague team work that plays an important role in the field is reflected. Heart failure patients participating in exercise training for improvement of cardiovascular fitness are associated with reduced risk of mortality or hospitalization during long-term follow-up, independent of their baseline fitness.
Sheikh Khalifa Medical City, UAE Cleveland Clinic, USA
Time : 10:45-11:25
Samer Ellahham has served as Chief Quality Officer at Shaikh Khalifa Medical City since 2009. In his role, he has led the development of a quality and safety program that has been highly successful and visible and has been recognized internationally by a number of awards. As Chief Quality Officer and Global Leader, he has focus on ensuring that that implementation of this best practices leads to breakthrough improvements in clinical quality and patient safety. He is the recipient of the Quality Leadership Award from the Global Awards for Excellence in Quality and Leadership and the Business Leadership Excellence Award from the World Leadership Congress. He was nominated in 2015 for SafeCare magazine Person of the Year. He is a recognized leader in quality, safety, and the use of robust performance improvement in improving healthcare delivery.
- Congestive Heart Failure|Research on Cardiology | Cardiomyopathy | Hypertension | Coronary Artery Bypass Graft Surgery
Saudi German Hospital, UAE
Policlinico San Matteo IRCCS, Italy
Policlinico San Matteo IRCCS, Italy
Time : 11:25-11:55
Barbara Petracci is a Medical Doctor in Department of Cardiology, University of Pavia, Italy. She is mainly involved in the clinical activity of the Pacing and Electrophysiology Unit of the Department of Cardiology of the IRCCS San Matteo Hospital. As first operator, she usually performs pacemaker and defibrillator implantation procedures, including devices for cardiac resynchronization therapy, and catheter ablation of cardiac arrhythmias, including atrial fibrillation and ventricular tachycardia ablation. She is an experienced operator in laser catheters extraction. She is a member of the Italian Society of Pediatric Cardiology and Congenital Cardiomyopathy (SICP), a member of the Italian Association of Hospital Cardiologist (ANMCO), a member of the European Heart Rhythm Association (EHRA) and a member of the Italian Association of Arrhythmology and Cardiac Pacing.
Cardiac Resynchronization Therapy (CRT) is known as a highly effective therapy in advanced heart failure patients with cardiac dissinchrony. However, still one third of patients do not fully respond to CRT. Among the many contributors for the high rate of non-responders, the lack of procedures dedicated to CRT device settings optimization is known as one of the most frequent. On the other side, the echocardiography optimization is not widely used in the real world of CRT follow up visits. Thus, device-based techniques have been developed to by-pass the need of repeated echo evaluations to optimize CRT settings. There are multiple drivers of non-response. Common factors are AV/VV timing, reduced BiV pacing, LV lead placement, presence of arrhythmias, appropriate patient selection, patient compliance and presence of comorbidities. The current challenge facing practitioners is to maximize the rate of patients who respond to CRT and the magnitude of the response. A very particular and important subgroup of HF population with CRT includes the patients with AF since the optimal use of CRT in this cluster remains uncertain. The current area of interest achieving these goals includes the tailoring patients’ selection, the individualizing LV placement and, in particular, the application of new technologies and algorithms for CRT delivery in optimal fashion, reducing inappropriate shocks incidence and optimizing device longevity.
Landolina M, Morani G, Curnis A, Vado A, D'Onofrio A, Bianchi V, Stabile G, Crosato M, Petracci B, Ceriotti C, Bontempi L, Morosato M, Ballari GP, Gasparini M.
Europace. 2016 Oct 4. pii: euw176. [Epub ahead of print]
Savastano S, Rordorf R, Scotti Foglieni A, Klersy C, Vicentini A, Petracci B, Sanzo A, Marino R, Taravelli E, De Regibus V, Landolina M, De Servi S.
Int J Cardiol. 2016 Oct 15;221:820-6. doi: 10.1016/j.ijcard.2016.07.124
De Regibus V, Rordorf R, Giorgianni C, Canclini C, Vicentini A, Taravelli E, Petracci B, Savastano S, De Servi S, Arbustini E.
Int J Cardiol. 2016 Apr 1;208:67-9. doi: 10.1016/j.ijcard.2016.01.160. No abstract available.
4. Longevity of implantable cardioverter-defibrillators for cardiac resynchronization therapy in current clinical practice: an analysis according to influencing factors, device generation, and manufacturer.
Landolina M, Curnis A, Morani G, Vado A, Ammendola E, D'onofrio A, Stabile G, Crosato M, Petracci B, Ceriotti C, Bontempi L, Morosato M, Ballari GP, Gasparini M.
Europace. 2015 Aug;17(8):1251-8. doi: 10.1093/europace/euv109.
Rordorf R, Chieffo E, Savastano S, Vicentini A, Petracci B, De Regibus V, Valentini A, Klersy C, Dore R, Landolina M.
Pacing Clin Electrophysiol. 2015 Feb;38(2):187-95. doi: 10.1111/pace.12539.
King's College London, UK
Title: Novel nesprin-1 mutations associated with dilated cardiomyopathy cause nuclear envelope disruption and defects in myogenesis
Time : 11:55-12:25
Qiuping Zhang has her expertise in “Nesprin family research in Cardiovascular Biology field, specifically on understanding the complex roles of nesprin-1 and -2, family members of multi-isomeric scaffolding proteins, in regulating normal and pathological processes in the heart and muscle”. She has studied extensively the role of nesprins in myoblast differentiation and function as well as mutations in nesprin-1 or -2 in associations with Emery Dreifuss muscular dystrophy and dilated cardiomyopathy. Her current research focuses on “Defining the roles of nesprins in cardiac cell function by determining the functional significance of novel nesprin-1 and -2 mutations on the linker of nucleoskeleton-and-cytoskeleton complex that connects the nuclear envelope to the actin cytoskeleton, and also identifying novel roles for nesprins in the sarcomere”. This may reveal novel pathways that contribute to the development of cardiac cell dysfunction and cardiomyopathy.
Nesprins-1 and -2 are highly expressed in skeletal and cardiac muscle and together with SUN (Sad1p/UNC84)-domain containing proteins and lamin A/C form the linker of nucleoskeleton and cytoskeleton (LINC) bridging complex at the nuclear envelope (NE). Mutations in nesprin-1 and -2 have previously been found in patients with autosomal dominant Emery-Dreifuss muscular dystrophy 4 (AD-EDMD 4, OMIM 612998) and 5 (AD-EDMD5, OMIM 612999) as well as dilated cardiomyopathy (DCM). In this study, three novel rare variants (R8272Q, S8381C and N8406K) in the C-terminus of the SYNE-1 gene (nesprin-1) were identified in 7 DCM patients by mutation screening. Expression of these mutants caused nuclear morphology defects and reduced lamin A/C and SUN2 staining at the NE. GST-pull down indicated that nesprin-1/lamin/SUN interactions were disrupted. Nesprin-1 mutations were also associated with augmented activation of the ERK pathway in vitro and in hearts in vivo. During C2C12 muscle cell differentiation, nesprin-1 levels are increased concomitantly with kinesin light chain (KLC-1/2), and immunoprecipitation and GST-pull down showed that these proteins interacted via a recently identified LEWD domain in the C-terminus of nesprin-1. Expression of nesprin-1 mutants in C2C12 cells caused defects in myoblast differentiation and fusion associated with dysregulation of myogenic transcription factors and disruption of the nesprin-1 and KLC-1/2 interaction at the outer nuclear membrane. These findings support a role for nesprin-1 in myogenesis and muscle disease, and uncover a novel mechanism whereby disruption of the LINC complex may contribute to the pathogenesis of DCM.
Ain Shams University, Egypt
Title: Benefits of Sildenafil to patients suffering from severe pulmonary hypertension secondary to mitral stenosis undergoing mitral valve replacement
Time : 12:25-12:55
Sherif A S A Mansour is a Consultant of Cardiothoracic Surgery in Ministry of Health Hospitals, in addition to working as a Surgeon in Royal Stoke Hospital, Stoke-on-Trent, UK. He works at the Ain Shams University in Cairo, Egypt as a Senior Lecturer. He is subspecialized in Off Pump CABG, minimal invasive cardiac surgery with fantastic results and many contributions to various cardiac surgery centers in the Middle East, Asia and Africa. He shared in the establishment of more than one cardiac surgery center across Egypt with training of the staff and the surgical assistants and registrars. He also had publications in the peer reviewed journals and contributions in some published cardiothoracic books with many contributions at international conferences across Europe and Asia. Recently, he started to explore the field of Robotic Heart Surgery with strong steps toward achieving his goal of mastering it.
Saudi German Hospital, UAE
Time : 15:00-15:30
Mridula Dhakad is a senior interventional Cardiologist with more than 25 years of experience in Interventional and Clinical Cardiology. She has actively participated in many national and international conferences. She has been extensively involved in treating many complex and critical cardiac patients. She has received her interventional training at well reputed large public and private hospitals. She did her fellowship in Interventional Cardiology at a world renowned large volume centre at Paris. She was instrumental in establishing Cardiology department at various reputed institutions. She is an active member of European Society of Cardiology and a life member of Cardiology.
Aortic dissection has varying presentations. This disease entity can mimic other acute emergencies posing a diagnostic dilemma. There should be high index of suspicion in diagnosing aortic dissection in patients of all ages. With newer advanced modalities of diagnosis and the risk score algorithms, the clinical outcome of an otherwise catastrophic disease has improved to a great extent. All the patients of collagen disease, bicuspid aortic valve, coarctation of aorta, uncontrolled HT and unexplained AR should be thoroughly evaluated. This interesting case of a 73 year old elderly gentleman presented with sudden onset chest discomfort radiating to the jaw with a short episode of sudden shortness of breath. The physical examination was unremarkable with stable hemodynamics and well felt peripheral pulses with no discrepancy. His D dimers were found to be markedly elevated with raised serum creatinine. The cardiac enzymes were normal. ECG was not indicative of myocardial ischemia. Echo showed minimal AR, mild anterolateral pericardial effusion with good LV systolic function and PA pressure of 32 mm Hg. He was hyper-tensed on medication with history of CVA 3 years ago and was on Warfarin since then. He remained stable hemodynamically for the initial 24 hours after admission, later he developed atrial fibrillation with controlled ventricular response. Owing to renal dysfunction, instead of pulmonary CT angiography, VQ scan was done to rule out pulmonary embolism. It revealed multiple perfusion defects in both lung fields. Simultaneous repeat echocardiography revealed increase in grade of AR to more than 1/4 and mild increase in PE with echogenicity seen within the effusion behind RV (possibly blood). CT chest was immediately performed which clinched the diagnosis of type A aortic dissection. He was immediately referred to the cardiac surgeon who did emergency surgical correction with successful recovery.
Betsi Cadwalader University Health Board, UK
Time : 15:30-16:00
Amjed Eljaili, MBBS October 2010, University of Al-Zaiem Al-Azhari, Sudan, currently practicing in UK , Wales deanery , foundation year-2 trainee, BCUHB, emergency department, Ysbyty Gwynedd, He attended several a cademic meetings, regionally and nationally, He has participated in various national work-shops, congress. participation and membership with British institute of Radiology, UK.
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Sri Manakula Vinayagar Medical College and Hospital, India
Time : 16:15-16:45
Arunkumar Arasappa is a Consultant Cardiothoracic Surgeon and is an Assistant Professor in the Department of Cardiothoracic Surgery at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. He started the Department of Cardiothoracic Surgery in this Medical College Hospital which is located in a village called kalitheerthalkuppam, Pondicherry, India. We have started this cardiothoracic program and open heart surgeries since April 2016 onwards till date. His team has successfully completed more than 90 open heart surgeries in a span of 10 months which includes beating heart CABG, On-Pump CABG, valvular heart surgeries and both adult and pediatric congenital heart surgeries.
To discuss the feasibility of starting and establishing a superspecialty department like cardiothoracic surgery in rural and semi-urban centers is a herculean task. We planned to setup a pilot project on how to start a superspecialty department in Rural and semiurban places and also to do open heart surgical procedures at an affordable cost. We discussed our plan with a medical college hospital in our locality and they helped us to start this within their premises with available infrastructure. We closely followed up the inpatient crowd of the hospital and secured cases from all fields of medicine and especially from cardiology department. We managed to maintain a registry of cases and categorized patients based on their symptoms and who needed surgery. Our next task of building the infrastructure was aimed and we procured materials necessary to start this program which included setting up of operation theatre, CT ICU and postoperative wards. Our other task of recruiting staffs for caring the patients was breathtaking and was managed successfully. After establishing this we started our first open heart procedure on April 2016 and continued from thereon. Today, we had crossed more than 90 open heart surgeries apart from vascular and thoracic surgeries. We have now established a center which can perform all cardiac surgery programs that are done at any standard hospitals or medical colleges in major cities. Today we proudly say that the task is well started and could be achieved with the help of a supporting team of dedicated doctors and paramedical staffs and equally supported with the necessary infrastructure by the hospital to cater the underprivileged people with the support of various schemes and insurance assistance.
To be updated soon...
Bahauddin Zakariya University, Pakistan
Title: Treating heart disease by managing marital conflict among female patients with CHD through cognitive behavioral couple therapy
Time : 17:15-17:45
Sarwat Sultan is the Chairperson of the Department of Applied Psychology, BZU, Pakistan. She has done her PhD in Applied Psychology in 2009, and has completed her Post-doctorate from Curtin University, Australia in 2013. She is serving the Department of Applied Psychology, Bahauddin Zakariya University Multan since the last 15 years. She has contributed more than 75 research articles in national and international journals, has presented more than 60 papers in conferences at national and International levels, and has supervised more than 150 dissertations. She has one book published in Germany to her credit. She is a distinguished teacher having experience of research and psychological testing and interventions.
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Green Life Hospital, Bangladesh
Title: Congenital heart diseases among the hospital live birth in Bangladesh: A retrospective study in national institute
Time : 17:45-18:15
S M Tajdit Rahman is a Resident Thoracic Surgeon of National Institute of Bangladesh. He has completed his MBBS from Sir Salimullah Medical College, Bangladesh and has a fascination for research in cardiac and thoracic diseases. He is doing research under renowned professors and has a great achievement in extracurricular activities. He is the Convener of first ever biomedical conference for students in Bangladesh. He has attended more than 15 national and international conferences.
Congenital cardiac disease is not uncommon in daily medical practice. Many studies have been carried out worldwide, showing incidence variation in different parts of the world as 5-10/1000 live birth. In Bangladesh, a mere study was done in this respect. This retrospective study was conducted from the records preserved in hospital register, compiled by the author from pediatric cardiology and cardiac surgery department over a period of 4 years extends from 2010-2013 in National Institute of Cardio Vascular Diseases Hospital. 6520 cases of live births weighing more than 1500gm and age over 28 weeks of gestational period were recorded by clinical examination and echocardiography with color Doppler. This study showed that 196 babies out of 6520 live births had CHD as 30/1000 live births. Study also expressed that higher incidence of CHD was observed in preterm baby than full term baby. Among the congenital heart lesions, atrial septal defect, ventricular septal defect, Patent ductus arteriosus, Tetralogy of Fallot`s, TGA were commonest having 20.41%, 13.78%, 10.71%, 8.67% and 4.59%, respectively. 15.81% of the patients had other associated somatic anomalies among which down syndrome was the commonest (7.14%). CHD of various patterns deserves crucial challenge among the newborns for management in Bangladesh. Various factors like high maternal age, drugs intake, antenatal infection, family history, gestational DM, down’s syndrome, mother having SLE are related to these diseases. Moreover, appropriate research can be accomplished taking large relevant sample gathering from different tertiary medical college hospitals to reveal actual scenario to prevent and treat the diseases.