5^th World Congress on Cardiology and Cardiovascular Therapeutics August 12-13, 2019 Tokyo, Japan

Biography:

Clarisse E. Cledera has completed her medical studies at the age of 23 years from University of Santo Tomas and underwent residency in Chinese General Hospital . She is currently taking her fellowship training at the Philippine Heart Center. She has written articles and served as a contributor in the Philippine Daily Inquirer, a newspaper in the Philippines.

Abstract:

Acute Kidney Injury (AKI) is a common and significant complication in patients undergoing cardiac surgery. It is associated with progression of chronic kidney disease, increased hospital length of stay and in-hospital mortality. This study was conducted to determine the incidence of AKI in post-coronary artery bypass graft (CABG) patients and to determine the risk factors associated with cardiac surgery-associated AKI (CSA-AKI) in Chinese General Hospital and Medical Center for a period of eight years (2010-2017). This was a retrospective cross-sectional analysis of 160 patients who underwent CABG. Preoperative, intraoperative and post-operative variables were collected and analyzed. Logistic regression analysis was used to determine the factors associated with AKI. Univariate analysis was performed to screen potential factors using a cutoff of p<0.20. Multiple logistic regression analyses with backward elimination technique was then performed. P values ≤0.05 was considered statistically significant. Of the 160 patients, 32 (20%) developed AKI. Among all factors, only hematocrit (OR 0.90 95% CI 0.83-0.99 p=0.026) and history of chronic kidney disease (CKD) was significantly associated with AKI. For every 1% increase in hematocrit, odds of AKI after CABG decreases by 12% (β = -0.12). In multivariate analysis, patients with CKD history are significantly four times more likely to develop AKI after CABG. Mean creatinine value post-op was significantly higher compared to pre-op values using paired t-test (Post: 1.24 mg/dl ± 0.44 vs. Pre: 1.13 mg/dl ± 0.35, p<0.00001). Hematocrit and history of chronic kidney disease were considered to be an independent risk factors for CSA-AKI. Mean creatinine was significantly higher post-operatively compared to pre-operative values.

Biography:

Cristina Tabucan is a second year medical resident from Ospital ng Makati under the Department of Internal Medicine. She finished her Doctor of Medicine at Pamantantasan ng Lungsod ng Maynila. She took her Master in Public Health Major in Systems Development at the Development Academy of the Philippines. Her expertise and interest in the field of Cardiology was rooted from her previous experience as a Doctor to Barrio serving rural area and urban poor communities. Her passion to learn as well as inquisitiveness is an important asset in helping different stakeholders from the grassroots. She is interested in pursuing career in Cardiology post medical residency training in order to bring back service to the community especially to the doctorless rural communities in her province.

Abstract:

We described a 20-year old Filipino male who came in at the emergency room presenting with dyspnea. He was previously asymptomatic, with no limitations in physical activity until three months prior to admission, he started to experience progressive dyspnea. Chest radiograph showed biventricularly enlarged heart with accentuated pulmonary vascular markings. A 12 lead electrocardiogram showed multifocal tachycardia, biatrial enlargement, left ventricular hypertrophy and PACs. A transthoracic 2D echocadiogram revealed that the aorta arises from the morphological right ventricle and the pulmonic trunk arises from the morphologic left ventricle. The systemic right ventricle was dilated and the ejection fraction preserved with good wall motion and function. A large ventriculoseptal defect was seen. A cardiac CT angiogram was done and confirmed the diagnosis. Our case was diagnosed with acute decompensated heart failure secondary to congenitally corrected transposition of great arteries. Transposition of Great Arteries (TGA) is the second most common cyanotic congenital heart disease. However its rare form known as congenitally corrected transposition of great arteries (cc-TGA) occurs only in 1:33,000 of population who can reach adulthood acyanotic despite unrepaired state. In the Philippines, its occurrence remains underreported and to date, case study regarding cc-TGA has not been published. Loop diuretics, aldosterone antagonist, beta blockers and digitalis glycoside were the medications used to control symptoms of our patient. Long term complication of unrepaired TGA often presents as heart failure due to volume overload, arrhythmia due to enlarged chambers, early onset stroke, infection and myocardial infarction due to rhythm disorders and inflammation. Preventive management of complications using diuretics, beta blockers, anticoagulation are among the identified goals of treatment. Definitive management is still surgical correction which requires timely intervention in order to prevent long term complications of the disease.

Biography:

Iin Fadhilah has completed her MBBS at the age of 21 from Hasanuddin University, Indonesia. She is currently a clinical student of Hasanuddin University, Indonesia. Her enthusiasm in Cardiovascular Medicine made her continuously writing and publishing cardiovascular journal.

Abstract:

Introduction: Serum uric acid is an end product from metabolism in purine, an increased risk of hypertension, cardiovascular disease, and chronic kidney disease have been shown to be associated with serum uric acid in previous epidemiological studies. In contrast, a number of studies have suggested that uric acid is not independent of other established risk factors, especially hypertension, for the development of cardiovascular disease. Whether serum uric acid contributes to the disease progress is still controversial. This study aimed to analyze and compare the correlation between serum uric acid level, hypertension, and severity of coronary artery disease.

Methods: This is an observational study with cross sectional approach of 131 patients of coronary artery disease in Cardiac Center of Wahidin Sudirohusodo Hospital. Data analyzed using SPSS 20.0

Results: A total of 131 coronary artery disease patients examined (mean age 57 ± 7.7 years), The total 56 of hypertensive patients has among them 23 (41,1%) hyperuricemia statuses and 33 (58,9%) without hyperuricemia with its p value >0,05. From 36 patients having diabetic status, 15 (42,9%) of them had hyperuricemia and 20 (57,1%) with normal serum uric acid levels with p value >0,05. And for the severity of coronary artery disease, our results showed that the mean value of gensini score in normal serum uric acid level was 12,7 as almost the same with 12,1 in hyperuricemia patients with p value >0,05. Although the hyperuricemia comprised the most in severe coronary artery disease (44,8%) but with p value >0,05 showing that there was no significance found. However, our results found that the severity of coronary artery disease was associated with body mass index (p value: 0,004) with 91 (69,5%) of samples having abnormal (overweight/obese) BMI. Also, severe coronary artery disease was mostly found in 39 (73,6%) patients who had abnormal BMI (overweight/obese).

Conclusion: In conclusion, the mechanisms of hyperuricemia associated with atherosclerotic vascular disease or whether it is a valuable marker for cardiovascular disease remain to be clarified. Further studies and large samples research that focused on correlation between hyperuricemia, hypertension and coronary artery disease are expected.

Biography:

Jelita Siregar has completed her Master at the age of 32 years and Speciality of Clinical Pathology at the age 33 years from Universitas Sumatera Utara and Medical Doctor studies from Universitas Sumatera Utara. She is the secretary of the clinical pathology at Universitas Sumatera Utara. She has published 3 papers in reputed journals and has been serving as an Co-Author in 2 papers in reputated journals.

Abstract:

Biography:

Ping Zhang, a PHD student in Jinan University, China, currently working in Pathology and Pathophysiology, under the guidance of professor Xuesong Yang. Maintaining a high degree of enthusiasm and professional research attitude, she is working on embryonic development under environmental toxicology and food toxicology , including neural develpment and Cardiovascular development and has published the research results on Toxicology Letters and Cell Physiol Biochem.

Abstract:

It is now known that excess alcohol consumption during pregnancy can cause fetal alcohol syndrome (FAS) in which several characteristic craniofacial abnormalities are often visible. However, the molecular mechanisms of how excess ethanol exposure affecting cranial neural crest cells (CNCCs), the progenitor cells of the cranial skeleton, is still not clear. In the study, we investigated the effects of ethanol exposure on CNCCs migration both in early chick embryo and in vitro explant culture. First of all, we demonstrated that ethanol treatment caused alizarin red-stained craniofacial developmental defects including parietal defect. Second, Immunofluorescent staining with neural crest special markers indicated that CNCCs generation was inhibited by ethanol exposure. And, double immunofluorescent stainings (Ap-2α/PHIS3, HNK1/BrdU and AP-2α/c-caspase3) revealed that ethanol exposure inhibited CNCCs proliferation and increased apoptosis. In addition, it inhibited NCCs production by repressing the expression level of key transcription factors which regulate neural crest development by altering expression of Epithelial-mesenchymal transition (EMT)-related adhesion molecules in the developing neural crests. Moreover, ethanol treatment of the dorsal neuroepithelium increased Laminin, N-Cadherin and Cadherin 6B expressions while Cadherin 7 expression was repressed. In summary, our experimental results demonstrated that ethanol treatment interferes with the production of cranial NCCs by affecting the proliferation and apoptosis of these cells. In sum, we have provided experimental evidence that excess ethanol exposure during embryogenesis disrupts CNCCs survival, EMT and migration, which in turn causes defective cranial bone development.

Biography:

Kewal Krishan is the Director of Heart Transplant and Ventricular Assist Devices, Principal, Consultant, Cardiothoracic Surgeon at Max Super Speciality Hospital, New Delhi. He has done four years (2 years each) Advanced Clinical Fellowships at world’s top hospitals including Mayo Clinic, Rochester MN, USA and Mount Sinai Medical Center New York, USA where he gained expertise in advanced therapies like heart transplant, LVADs and ECMO.

Abstract:

Ventricular assist devices are an established therapy for advanced heart failure. Continuous flow devices are representing an innovative design with potential for small size and greater reliability by simplification of pumping mechanism. A small percentage of patients who are too ill to wait for donor heart Left Ventricular Assist Device (LVAD) offers lifesaving therapy in them. We started our program in Feb 2015. So far, we have put 17 LVADs in 16 patients. Out of 17, five were Heart Mate II and four were Heart Ware and 8 were Heart Mate III. Twelve patients were male and four were females. Twelve patients had dilated cardiomyopathy and four had ischemic cardiomyopathy. Average ICU stay was 5 days and hospital stay was 18 days. One had thrombosis of device on post-operative day three which required exchange of the device. One of them died on postoperative day 12 because of ventricular arrhythmia and right ventricular failure. In one patient device was removed as bridge to recovery after 18 months. One patient was bridge to transplant. A LVAD provides effective hemodynamic support in patients with end stage heart failure with improved functional status and quality of life. LVAD is the only alternative that offers a ray of hope to thousands of patients whose hearts are too weak to survive and those waiting for a heart transplant. Improvements in device design, along with advances in surgical and medical management have allowed VAD patients to return home, to work, and to their communities, with excellent quality of life.

Biography:

Abstract:

Anterior spinal cord syndrome is a rare condition that can present with many different clinical signs and symptoms. This is a report of a 72 year old female who presented to the emergency department complaining of severe chest pain and bilateral shoulder pain. She had a history of hypertension and hypercholesterolaemia. Her examination was unremarkable and vital signs were within the normal range. A chest X-ray showed no mediastinal widening. ECG showed RBBB and high sensitivity TnT was raised at 42. She was treated as having a non-ST elevation MI with Aspirin, Clopigogrel and LMWH and admitted to the cardiology ward. Six hours after admission she had an episode of urinary incontinence and while attempting to get out of bed was unable to move her lower limbs. Examination revealed grade 0/5 power in lower limbs with numbness to pain and temperature, but vibration and fine touch were preserved. Knee reflexes were absent and anal tone reduced. Bedside echo and CT aortogram excluded an aortic dissection and an MRI showed signal change with a diffuse pattern within the spinal cord at T1-T5 and cord swelling. The patient was treated for neurogenic shock after developing hypotension unresponsive to fluid therapy and required admission to the intensive care unit for four days. Follow-up angiocardiography showed no evidence of obstructive coronary disease. The patient was transferred to the care of the stroke team for a prolonged period of rehabilitation. The early diagnosis of spinal stroke vs. a NSTEMI may be clinically challenging.