Day 2 :
Dalhousie University, Canada
Keynote: ATP Metabolism in the Red Blood Cells as Potential Biomarker for Post Exercise Hypotension and Cardiovascular Protection
Time : 10:15-10:55
Pollen Yeung completed his Ph.D at the age of 30 years from University of Saskatchewan (Saskatoon, SK, Canada) and is currently Professor of Pharmacy and Medicine at Dalhousie University in Halifax, NS, Canada. He has published more than 90 peer reviewed articles in reputed journals and is currently serving as an editorial board member for Recent Review of Clinical Trials, Drug Metabolism Open Journal, Medical Sciences Monitor, Metabolites, Cardiovascular Pharmacology Open Access, and Natural Products Chemistry and Research Open Access.
The importance of adenosine and ATP in regulating many biological functions has long been recognized, especially for their effects on the cardiovascular homeostasis which may be used for management of hypertension and cardiovascular diseases. In response to ischemia, ATP is broken down to release adenosine. The activity of adenosine is very short lived because it is rapidly taken up by myocardial and endothelial cells, erythrocytes (RBC), and also rapidly metabolized to oxypurine metabolites and other adenine nucleotides. Extracellular and intracellular ATP is broken down rapidly to ADP and AMP and finally to adenosine by 5’-nucleotidase. These metabolic events are known to occur in the myocardium as well as in RBC. We investigate in this study the feasibility of exploiting ATP metabolism in the RBC as systemic biomarker for post exercise hypotension and cardiovascular protection. An experimental exercise rat model was used to probe the relationship between post exercise hypotension and ATP metabolism in the RBC. The cardiovascular protective effect of exercise preconditioning was further investigated in an acute myocardial infarction model using mortality and ATP metabolism in the RBC as endpoints. We have shown post-exercise hypotension correlated significantly with RBC concentrations of ATP, and that exercise pre-conditioning reduced cardiovascular mortality and breakdown of ATP in the RBC. The post exercise effect was greater in hypertensive than in normotensive rats. The presentation will also discuss the opportunities, challenges and obstacles of exploiting ATP metabolism as targets for drug development and personalized medicine. Suppored in part by CIHR, NSHRF and DPEF.
The Johns Hopkins University, USA
Time : 11:10-11:40
Robert S. Fitzgerald received his PhD from The University of Chicago. He did post-doctoral training at UCSF/CVRI in San Francisco and in France at Universite de Nancy and Universite de Paris. Returning to his faculty position at The Johns Hopkins Medical Institutions, he eventually became Associate Chair, then Acting Chair of the Dept. of Environmental Health Sciences in the Bloomberg School of Public Health with Joint Appts. in the Depts. of Physiology and of Medicine in the School of Medicine. His CV includes over 200 contributions to peer-reviewed publications.
Chronic Heart Failure (CHF) is among the several cardiopulmonary disorders that are responsible for 74.5% of deaths world wide according to the report from WHO in 2013. The malfunctioning carotid body (CB) is responsible for increasing output from the sympathetic nervous system (SNS). This increase affects breathing patterns, cardiac performance, kidney function. Experiments in animal models have uncovered ways in which the CB can return to normal. It is perhaps an opportune time to understand this interoreceptor, arguably the most important in the organism. Located bilaterally at the junction of the carotid arteries bifurcation into external and internal branches, this structure in humans is tiny…weighing 18 mg. Yet measured blood flow through the feline version exceeds 2 L/min/100gm tissue. CBs are the sole detector of decreases in PaO2; it also is stimulated by increases in PaCO2 and H+, and glucopenia. Stimulation produces reflex responses in the cardiopulmonary, endocrine, and renal systems. CHF reduces the production of nitric oxide (NO) in the CBs, allowing for a greater release of ACh and ATP which stimulates the increase in SNS output. Efforts to reduce CB output in both humans and animal models have uncovered three techniques which show promise. Reduction in CB neural output is the key factor to restore normal cardiac function and reduce hypertension.
- Tracks : Gestational Hypertension Hypertension Management | Case Reports & Hypertension Epidemiology
Location: Toronto , Canada
Mashhud Zia Chowdhury
Ibrahim Cardiac Hospital and Research Institute, Bangladesh Session
Northwell Health, USA
Time : 11:40-12:10
The American College of Obstetricians and Gynecologists (ACOG) recommends against the use of butorphanol in patients diagnosed with preeclampsia or chronic hypertension secondary to a theoretical concern that the drug will further elevate blood pressures. No study has examined the drug’s potential to elevate blood pressures in laboring patients. In this retrospective cohort study, all chronic hypertensive and preeclamptic patients who underwent an induction of labor and delivered a viable, singleton pregnancy between the dates of 1/1/2013-12/31/2014 at a Single Academic Hospital were included. The use of butorphanol in chronically hypertensive patients during labor was not associated with the presence of severe range blood pressures during labor [OR=0.92, 95% CI: (0.04-19.34) P=0.96]. In preeclamptic patients, there was similarly no change in the frequency of severe range blood pressures with the use of the drug [OR=0.59, 95% CI: (0.19-1.83) P=0.36]. In laboring patients with chronic hypertension or preeclampsia, butorphanol is not associated with severe range blood pressures and therefore it is a reasonable option for providing pain relief in these populations.
Ibrahim Cardiac Hospital and Research Institute, Bangladesh
Time : 12:10-12:40
Dr. Mashhud Zia Chowdhury, completed his MBBS in 1987, joined BIRDEM hospital, Dhaka. He completed his Diploma in Chest Diseases in 1990 and MD (Cardiology) in 2003. In 2007, he joined Ibrahim Cardiac Hospital & Research Institute- a specialized cardiac hospital, as Assistant Professor, later promoted to Associate Professor. During his nine year carrier as interventional cardiologist, he was trained in Japan and Germany and participated in various cardiac conferences also as faculty. He has 24 publications and is serving as editorial board member of the journal of his hospital. Dr. Chowdhury is a Fellow of the American College of Cardiology.
Bangladesh has been elevated from the low income status to lower middle income nation last year. According to the Bangladesh Bureau of Statistics, the per-capita income will increase by 11.39% from $1316 in 2014-15 to $1,466 this financial year. Communicable diseases have also been reasonably in good control. Both of these lead to epidemiological transition from communicable to non-communicable disease (NCD). Hypertension (HTN) is one of the ‘fatal four’ NCD i.e. Cardiovascular, Cancer, Chronic Respiratory Disease and Diabetes. The prevalence of HTN in Bangladesh is showing an increasing trend. A meta-analysis showed pooled HTN prevalence in Bangladesh within each 5 year time period was, 11% in 1995-2000, 12.8% in 2001-2005, and 15.3% in 2006-2010. According to a recent multilevel analytic survey, overall age standardized prevalence of pre-hypertension and HTN were 27.1% and 24.4%, respectively. HTN was found more common in elderly (ranging 40-65%) and urban population. Low awareness of disease is common in low-income and low educated population. According to NCD risk factors survey, only half of the hypertensive patients were aware of their illness and 33% had never measured their blood pressure in life time. Moreover, hypertension is largely untreated especially in rural area and only 41% were undergoing treatment. Non-adherence to treatment was very high, only 31.4% had their hypertension controlled. On the contrary of present guide line, Beta-blocker was found to be the highest prescribed drug. Strategies for early detection, awareness buildup and adherence to treatment are urgently necessary to halt the growing disease burden of hypertension.
Shahid Beheshti University of Medical Sciences, Iran
Title: Comparison of the short-term efficacy of two educational methods (face to face vs. group training) on self-pulse rate taking ability
Time : 12:40-13:10
The simple and rather rapid traditional method for assessing pulse rate has remained as a common method for monitoring pulse rate. It seems that most people cannot detect and assess their pulse rhythm correctly. In this prospective study, 300 patients admitted due to cardiovascular diseases were included and then were randomly divided into two groups. One group received individual face-to-face training. The other group received group training via displaying an animation movie (using a three minute animation about taking radial pulse rate and assessing its regularity). Immediately after the training and then after 48 hours, the patients were tested by the nurse to find out whether they have learned the correct technique of taking radial pulse rate or not. Immediately after the interventions, 84.9% in face-to-face group and 81.8% in training group were able to correctly count their radial pulse rate (P=0.536). After 48 hours, 71.7% in face-to-face group and 60.8% in training group were able to correctly count their radial pulse rate with a marginal significant difference (P=0.051). Both methods were effective in enhancing the skill of the patients in counting their radial pulse rate. No significant difference was observed between the two groups. Though after 48 hours, it seemed that face-to-face method was marginally superior. We suggest face-to-face educational method in future relevant studies as a potential method in this regard.
Cnoga Medical Ltd, Israel
Time : 13:10-13:40
Yosef Segman is the CEO & CTO of Cnoga Medical Ltd. Prior to founding Cnoga Medical Ltd., he founded Oplus Technologies Ltd., where he served as CEO and Chief Scientist until 2005 when Oplus was acquired by Intel. Dr. Segman holds a PhD degree in applied mathematics from the Israeli Institute of Technology and was a guest researcher at Harvard University and Siegen University, Germany. He is the author of fundamental papers and patents on signal processing, neural computation and brain modelling
Hypertension is a major risk indicator for coronary heart diseases, renal failure, stroke and other various illnesses, and it is the primary global risk for mortality. Blood pressure measurements are essential for managing the risks resulting from hypertension. Today, the most common technique used for monitoring blood pressure is the oscillometric technique based on the sphygmomanometer arm cuff pressure. In this paper we will present a new device, the TensorTip MTX, which computes hemodynamic blood pressure noninvasively and without the need of air pumping. This technique uses the color imaging resulting from a set of monochrome light source that traverse the tissue under consideration and is projected onto the color image sensor. We have found that the variation in the pressure flow can be determined from the changes in the height of the temporal color histograms and additional temporal volume information. A new extended solution of the Windkessel model is being displayed in the paper and provides additional insight on various functional resistance rather than a constant resistance. The TensorTip MTX was clinically evaluated in two medical centers and was found to perform well at standard blood pressure measurements and also in monitoring patients who suffered from alterations of blood pressure due to cardiac surgery. The device successfully fulfilled the ISO 81060-2 recognized standard requirements for various notified bodies.
Air University, Pakistan
Time : 14:25-14:55
Waqas Hussain is an internationally awarded computer scientist and project developer. He is working on different international research based projects and presenting is research work all over the world. Waqas was named by Time as one of the most influential people and one of the top innovators in the world. Waqas, who is also an ACM and IEEE fellow, worked for World Wide Fund which is the world's largest conservation organization. He organized international research conferences using IEEE platform, an annual conference for scientists and researchers. After many years of research in computer science he has turned his attention to medical science, particularly bacteria attacking the white blood cells, Alzheimer’s disease which is the fourth leading cause of death in the world causing about 32.6 million deaths a year and automated morphological analysis of human sperms, according to World Health Organization 1/5 families have problems in conception worldwide.
High blood pressure (hypertension) puts extra strain in our heart and blood vessels. This can cause them to become weaker or damaged. If we have other health conditions, such as diabetes or high cholesterol, this increases the risk of health problems even more. It is then even more important to lower our high blood pressure. Nattokinase decreases the ability of blood to clot. This "thins the blood" and might protect against conditions caused by blood clots such as stroke, heart attack, and others. A recent 8-week, randomized double-blind study examined the effects of nattokinase supplementation on 86 untreated adults with high blood pressure. The participants ranged from 20 to 80 years old, and had a systolic blood pressure of 130 to 159. Systolic pressure is the number on top, (i.e. 120/80) which measures the pressure inside the blood vessels at the moment our heart beats. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.
Deepika Narasimha is a Cardiology fellow at the Loma Linda University Medical Center and her research interests include clinical trials in cardiovascular disease especially coronary artery disease, atrial fibrillation and cardiomyopathies. She have been actively involved in two single center randomized controlled trials as a resident including writing the IRB proposal, enrolling patients, data analysis and manuscript preparation. She is also currently involved in retrospective studies evaluating systolic dysfunction in post liver transplant patients, and pre-operative work-up of renal transplant patients. She was the Chief resident at Internal Medicine residency program and received the 2014-2015 Thomas Frawley research fellowship awarded to upcoming young investigators. She have published several peer reviewed articles, one book chapter, and presented abstracts at various national and regional conferences including the ACC, ISHLT, HRS and ACP meetings.
Hypertension is a major risk factor for cardiovascular morbidity and mortality. The risk for coronary artery disease is doubled, and the risk for congestive heart failure and stroke is tripled in patients with hypertension. In addition to this, hypertensive heart disease itself encompasses a very wide range of disorders including left ventricular hypertrophy, systolic and diastolic dysfunction which can down the line lead to symptomatic heart failure and precipitate arrhythmias. There are several structural and functional changes in hypertensive heart disease which first lead to concentric left ventricular hypertrophy which if left untreated leads to dilated cardiomyopathy or the ‘burned-out’ left ventricle. Cardiac complications from hypertension cause significant morbidity and mortality and also influence the choice of appropriate therapy and diagnostic tests. My talk will focus on the clinical manifestations and natural history of hypertensive heart disease as well as the various diagnostic and therapeutic modalities available to diagnose and treat the same. In addition to these we will also discuss some of the common cardiovascular co-morbidities associated with hypertension including atrial fibrillation, coronary artery disease and concomitant aortic stenosis with hypertension.
AMREF Health Africa, Kenya
Time : 16:50-17:20
Tecla Namusonge, has completed her masters from Africa Nazarene University. She is the Monitoring and Evaluation Assistant, AMREF Health Africa. She has authored an abstract on Behavioral Factors Inhibiting Data Quality among Health Care Workers in Kenya that was presented in the 1st Annual monitoring and evaluation best practice conference.
Background: Hypertension is the leading cause of NCD related morbidity and mortality in Kenya with the prevalence of elevated BP in Kenya at 23.8%. In a bid to address this burden, the Ministry of Health developed a protocol for management of hypertension which states that an elevated BP reading should be confirmed on three separate occasions. The objective of this study is to evaluate hypertension diagnosis following initial BP screening in Kibera Informal Settlement. Methodology: This is a retrospective cohort study where clients reached with hypertension screening through the Healthy Heart Africa Project between October 2015 and March 2016 were followed for diagnosis. Data was recorded in manual linkage registers and analysis done for individuals with initially elevated BP who came for subsequent readings until final diagnosis. Results: A total of 34,779 people were screened, out of whom 6,150 (17.7%) an initially high BP. Only 1,270 (20.7%) with an elevated BP returned for a second reading and only 220 individuals retuned for the third reading. Overall, 23% (1421) of clients with elevated BP were diagnosed. Due to the use of manual records, some of the clients returning for follow-up were captured as new clients’ further delaying diagnosis. Discussion: There was a high attrition rate along the hypertension diagnosis process. The long diagnostic process posed a challenge for hypertension management in this highly mobile population. There is need for strategies to strengthening the diagnosis process within this population and adoption of an electronic medical records system to facilitate follow-up.
Location: Toronto, Canada
Hossein Tabriziani obtained his Medical degree with honor at the age of 25. He compleleted his Internal Medicine residency at St. Barnabas Hospital, Weill Cornell Medical College in New York. With the passion for Transplant, he accedted a clincial Nephrology and Hypertension fellowship at Georgetown University in Washington, DC and conitnued his eduction at University of California San Francisco (UCSF) with a Transplant Nephrology fellowship. He was appointed at the Medical director of Pancreas Transplantation at Westchester Medical Center, New York Medical college before moving to Loma Linda Univeristy in California to accept the position as an Assistant Professor of Medicinie in Transplant Nephrology division. He is an active member of American Society of Nephrology (ASN) and American Society of Tranplantation (AST). He has mutiple publications and has been involved in many clinical researches. His interests are in Hypertension and oxidative stress in patintes with chronic kidney disease and transplantaion.
"Incidence of End Stage Renal Failure is rising in US. By the year 2030, the number of patients with end-stage renal disease (ESRD) is projected to exceed 2.2 million. This is more than five times the current prevalence. Increasing in Kidney disease and subsequently ESRD is related to ageing of the society and high morbidity due to lifestyle diseases such as diabetes, atherosclerosis, and hypertension. During the past decade, kidney transplantation has increasingly been recognized as the treatment of choice for medically suitable patients with ESRD. As well as improving quality of life, successful transplantation accords major benefits by improving mortality and morbidity of ESRD patients who receive kidney transplant over those who undergo Renal Replacement Therapy (RRT). Although reducing Cardiovascular (CV) risk in these patients remains the leading cause of this improvement but still CV diseases remain the leading cause of morbidity and mortality in kidney transplant recipients.