Day 1 :
- Cardiac and Cardiovascular Research
Hawthorne Effect: Making Heart Failure trials accessible and convenient for everyone, everywhere.
Hawthorne Effect is a novel decentralized, patient-centric clinical trial platform that enables clinical trials to be accessible to patients anywhere, anytime via a convergence of digitization, home health and a gig work force. With a community, consisting physicians and healthcare professionals, as well as a novel integrated technology solution it is possible transform the future of healthcare. By enabling remote in home or virtual visits. This decreased patient burden, increases participation and quality data collection and improves interpretability, costs and timing of clinical trials.
Focusing on enabling participation through comprehensive clinical trial follow-up may enable clinical trials design to advance to a new level of impact as well as close the inequity gap for more generalized populations to participate in innovative clinical trials.
Cardiological diseases represents a major growing health problem in the developed world. Clinical research is the cornerstone of continuous improvement in prevention and treatment of heart diseases. An average pivotal trial evaluating novel cardiovascular therapies can require more than10,000 visits and the collection of millions of data points. An important factor of success in clinical trials is the accessibility and diversity of participants and the quality and completeness of data. In order to collect all the data, the follow-up examinations are particularly relevant. A significant problem is that 79% published clinical trials have significant missing data resulting in issues of interpretability and generalizability of results. This causes incongruities of health burden to population which costs trillions and therefore the number of studies on new preventions and therapies in heart failure is kept low.
- Cardiovascular Research
Dr. Syed Bukhari United States
Title: Transthyretin Cardiac Amyloidosis is a Predictor of Thromboembolism in Atrial Fibrillation, Independent of CHA2DS2Vasc Score
Time : 9:40
Dr. Syed Bukhari United States Clinical and Experimental Cardiology,7070 forward avenue Apt 106, Pittsburgh, PA, USA, 15217
Transthyretin cardiac amyloidosis (ATTR-CA) results from the myocardial interstitial deposition of misfolded transthyretin fibrils, and is non-invasively diagnosed with the help of Tc-99m pyrophosphate (PYP) scintigraphy. The amyloid infiltration is thought to increase the risk of intracardiac blood stagnation and hence intracardiac thrombosis. However, the impact of ATTR-CA on thromboembolic risk in patients with atrial fibrillation (AF) is unknown.
Our study was aimed to investigate the prevalence of AF as well the incidence of thromboembolism in the patient population with ATTR-CA.
We studied patients who underwent Tc-99m pyrophosphate scintigraphy (PYP) between 6/2015 and 6/2019. Those with positive Tc-99m PYP and a negative serum studies for light-chain amyloidosis were diagnosed with ATTR-CA. We compared the prevalence of AF in patients with and without ATTR-CA and the incidence of thromboembolism (stroke, TIA or systemic embolism) in AF patients with ATTR-CA (AF-ATTR) and without (AF-controls).
- Clinical and Experimental Cardiology
Kozani General Hospital- Cardiology Department
VASILIOS VASILAKOPOULOS,Kozani General Hospital- Cardiology Department,Greece
Introduction: Flecainide, administered iv, is highly effective and safe in relieving the recent onset of atrial fibrillation (VT).
Purpose: Flecainide intravenous solution is a relatively new therapeutic approach to atrial fibrillation reduction. This study was designed to record the experience of our clinic from its use in patients with paroxysmal atrial fibrillation.
Material - Method: Intravenous flecainide was administered to 16 consecutive patients (10 men - 6 women), mean age 67.8 ± 14 years, who were admitted to the Cardiology Clinic of the General Hospital of Kozani, due to paroxysmal atrial fibrillation, while exclusion criteria (SN, NYHA II-IV, HCM, second or third degree atrioventricular block, left ventricular block known as CKD). Intravenous flecainide 150 mg / 15mL was administered at a dose of 2 mg / Kg within 10 minutes and the administration time was 10-15 minutes, preceded by oral beta-blocker. Patients were monitored and the recovery time as well as the occurrence of proarrhythmic phenomena were recorded. All patients underwent a cardiac ultrasound and any comorbidities were recorded. Patients were monitored for 45 min, 60 min, 3-6 hours, 6-12 hours, 12-24 hours and 24-36 hours for any side effects.
Results: Of the 16 patients, 12 (75%) recovered with intravenous flecainide in combination with β-blocker. The remaining 4 patients (25%) did not recover with the above combination, although the intravenous drip infusion of flecainide followed, at which time an electrical reduction was performed. The average reduction time for the former was 9 ± 6.5 minutes. No proarrhythmic effects were observed in any patient.
- Interventional Cardiology
Shahid rajaie cardiovascular medical and research center, tehran, Iran
Zahra hosseini, is an interventional cardiologist, who educated from Iran, Shiraz Medical Science University as a general physician and also, she trained as a general cardiologist from Rajaie Cardiovascular Medical and research Center, Iran University of Medical Sciences, Tehran, Iran; and passed the interventional course in the same hospital. Now, she is assistant professor of interventional cardiology.
Statement of the Problem: TA, is an inflammatory disease of unknown etiology which dominantly involved the aorta (pan-arteritis) from ascending to the abdominal aorta and the origin of the large vessels. Renal arteries, left subclavian artery, left carotid artery, innominate artery, and coronary arteries are predominantly compromised. Cardiac complications range between 10-30% including, the coronary ostial stenosis, aortic valve insufficiency, and myocarditis.2 The coronary lesions are classified as ostial stenosis, diffuse involvement or skip lesions, and aneurysm formation. Methodology & Theoretical Orientation: As the coronary arteries stenosis is associated with inflammation, intimal proliferation, and fibrous contraction, treatment of these patients is challenging; revascularization is highly suggested, particularly during inactive phase. According to the previous investigations, CABG is the preferred option; as the rate of stent restenosis is high (50% during 1 year). Also, as the diseased LSC, LIMA, and RIMA is frequent in these patients, vein graft is more desired. Findings: In this case report, we introduce, a 45 years TA patient, who was undergone AV repair and CABG 5 years ago; she presented with recent onset chest pain. Significant stenosis of the proximal anastomotic site of LIMA and the LSA were demonstrated. In this case, revascularization of LIMA proximal anastomotic site was performed antegradely. Conclusion & Significance: Regarding that the coronary artery disease in TA patients has a poor prognosis either by PCI or CABG, some new techniques are recommended to reduce the chance of stent or graft failure.