Biography:

Dr Naveed has completed his MBBS at the age of 25 years from Liaquat University of Medical Health Sciences,Jamshoro Hyderabad, Pakistan and postdgraduate studies from National Institute of Cardiovascular Diseases Karachi. He is the Clinical Fellow of Adult Cardiology. He is also certified BLS and ACLS Instructor from AHA in College of Physicians and Surgeons in Pakistan.

Abstract:

Introduction: Increased ratio of Triglyceride (TG)/ High-density Lipoprotein (HDL) has been known as an accompanying finding in conditions like obesity and metabolic syndrome. Therefore, the aim of this study was to assess the utility of TG/HDL ratio as a diagnostic tool for the assessment of coronary artery disease (CAD).

Methods: This study was conducted at a semi-private hospital Karachi; patients above 15 years of age and undergone angiography or PCI were included. Patients with Congenital Heart Disease and familial hyperlipidmeia were excluded. TG/HDL ratio was obtained for all patients, severity of the disease was classified as normal, mild to moderate, moderate to severe, and very severe based on coronary angiography. Analysis of variance was applied to assess significant differences in mean TG/HDL ratio among severity of disease. P-value<0.05 was considered significant.

Results:  A total of 2,212 CAD patients were reviewed out of which 1613 (72.9%) were male and 599 (27.1%) were female. Average age of the patients was 55.12 years (±SD=9.93). Of these 2212 patients, 533 (24.1%) had very severe disease, 1213 (54.8%) had moderate to severe disease, 258 (11.7%) had mild to moderate disease, and 208 (9.4%) were normal. A Significant and an increasing trend was observed in TG/HDL ratio with the severity of disease (p=0.0001) Statistically significant difference was observed in the TG/HDL ratio of patients with mild to moderate, moderate to severe and very severe disease from normal patients. However, no statistically significant difference was seen in the TG/HDL ratio between the patients with moderate to severe and very severe disease.

Conclusions: A positive relationship between Triglyceride to HDL Ratio and severity of coronary artery disease was observed. Therefore, TG/HDL ratio can be used as an indicator of severity of coronary artery disease in addition to other parameters of lipid profile.

Biography:

Abstract:

Heart failure (HF) is a progressive process and gradually remodels heart tissue. In this course, we previously documented “predominant myocardial LV base and diminished regional LV basal cavity volume in LVH using real-time three dimensional imaging and predominant septal wall with blunted systolic regional function in myocardial performance analysis compared to free wall documenting that the importance of regional morphologic as well as functional features in remodeling process of heart failure. We also used exercise in hypertensive individuals as the external stressor using combined tissue analysis and exercise stress test to evaluate their adaptation and determine blood pressure and heart rate increase under stress for rate-pressure product representing hyperfunctional myocardial energetics in the early stage disease.

To test and validate our clinical findings, we have planned microimaging studies. Therefore, we have detected ”focal hypertrophy of LV septal base (basal septal hypertrophy, BSH) is the early imaging biomarker of pressure-overload stress leading to heart failure.”  Very recently, we have validated BSH with HYPERFUNCTION by a small animal study using 3 ^rd generation microscopic ultrasound. ^1,2  As the conclusion, early imaging biomarker, “BSH may support to early diagnosis of remodeling and effective medical therapy in a timely fashion.”

Biography:

Abstract:

Introduction: Rheumatic heart disease is one of the most common heart diseases in developing countries. One of the most common complications of Rheumatic Heart Disease is Mitral Stenosis which ultimately leads to pulmonary hypertension and heart failure and death. So, PTMC (Percutaneous Transluminal Mitral Commissurotomy) is a well established simple, effective and safe therapeutic intervention for mitral stenosis.

While much literature reviewed to date have shown that it takes 3-6 months time period for the reduction of pulmonary artery pressure after PTMC, this study is designed to see the result in pulmonary artery pressure immediately after the procedure.

Method: A total of 42 patients with Rheumatic Mitral Stenosis in Cath Lab under the Department of Cardiology of Chitwan Medical College from October 1 2018 to August 30, 2019, were included in the study. Pulmonary artery pressure was assessed by Right heart catheterization by using a multipurpose /pigtail catheter under conscious sedation.

Results: It is a prospective observational study on a total of 42 patients who underwent PTMC, 30 were female and 12 were male. Age ranged from 30 to 61 years with the mean age of 45.36±10 years. The mean mitral valve area increased from 0.87±0.2 cm2 to 1.74±0.17 cm2 whereas Mean Pressure Gradient decreased from 13.59± 7.30 mmHg to 5.15±30 mmHg. Mean Pulmonary Artery Pressure decreased from 41.50 ±16.00 mmHg to 33.50±12.00 mmHg. Similarly, the mean left atrial pressure decreased from 26.57±8.62 mmHg to 15.50±5.95 mmHg whereas, the mean Aortic Pressure increased from 91.43 ±23.02 mmHg to  98.29±24.92 mmHg. Eighteen (42.85%) patients had an increase in MR by 2 grades but there is no need for immediate mitral valve replacement. During the procedure, paroxysmal PSVT was noted in six (14.285%) patients and also local hematoma was observed in five (11.90%) patients.

Conclusion: There is a reduction in pulmonary artery pressure immediately post PTMC which is directly correlated with left atrial pressure without significant MR and tachycardia. This study is limited in terms of a single-center with a small sample size

Biography:

Abstract:

Hypertension is a serious medical condition that increases the risk of heart, kidney, brain diseases and is a leading cause of premature death worldwide. Differences in the demographics, customs and habits in an area result in differences in the main risk factor for hypertension. This study aimed to determine the risk factors for hypertension among the people in the Banjar Pengiasan community. We used a community based cross-sectional study with a sample of 125 people selected using simple random sampling was conducted among adults 30 years and older living in Banjar Pengiasan in July until October 2019. The study collected data on sociodemographic, stress, food and physical activity using questionnaire. Anthropometric, blood pressure, and total cholesterol measurements were performed following standard procedures. Multiple logistic regression was used for analysis and odds ratios with 95% confidence intervals were calculated to identify risk factors associated with hypertension. The prevalence of hypertension was 67.2%. The logistic regression analysis shows age [OR=18.576(CI95% 2.955-116.782)], family history [OR=10.480(CI95% 1.106-99.288)], total cholesterol [OR=12.628(CI95% 2.406-66.279)], obesity [OR=4.750(CI95% 1.240-20.060)], salt consumption [OR=6.069(CI95% 1.162-31.689)], physical activity [OR=9.191(CI95% 1.360-62.108)] and coffee consumption [OR=5.833(CI95% 1.031-33.009)] significantly associated with hypertension. Smoking, sex and stress are not risk factors for hypertension. In this study, it was found that being >60years age, high total cholesterol, family history, low physical activity, high salt consumption, coffee consumption, and obesity are risk factors for hypertension. With these it expected that preventive efforts can be made to reduce the prevalence of hypertension. (Up to 250 words)

Biography:

Abstract:

WHO, public health experts, and stakeholders have declared NCDs a global priority, as documented in the 2011 United Nations (UN) high-level meeting, with a target towards reducing this growing burden in Africa and other low and middle-income countries (LMICs), where an existing burden from many infectious diseases has contributed to a double burden of disease.

Hypertension is reported to be the fourth most common cause of premature death in developed countries and the seventh in developing countries (Reddy, 1996). Recent reports demonstrate that almost 1 billion grown-ups (approximately a fourth of the total populace) have hypertension, and this rate is anticipated to increment to 1.56 billion constantly 2025. Surveying the personal satisfaction of hypertensive patients is a significant issue. Quality of life (QOL) is a central issue for patients, providers, and policymakers, and interest in health-related quality of life (HRQOL) has increased markedly in recent years (Smith et al., 1999). QOL is of particular concern to those with chronic disease for which a cure is unlikely (Guyatt et al., 1993). Additionally, psychosocial elements can impact wellbeing results; self-evaluated wellbeing status has been demonstrated to be a superior indicator of mortality and dreariness than numerous target proportions of wellbeing (Joshua et al., 2002). The HRQOL of hypertensive patients is a lot of more awful than solid people (Bardage and Isacson, 2011; Liu et al., 2005; Banegas et al., 2011; Wang et al., 2009; Raskeliene et al., 2009; Kwasniewska and Drygas., 2005). The personal satisfaction of hypertensive patients is reliant on the circulatory strain, organ harm, comorbidities, and treatment (Kawecka et al., 2006).

Psychological well-being can be conceptualized as having positive feelings and thoughts towards life. It includes constructs such as satisfaction, positive emotion, optimism, and emotional vitality, and represents something more than simply the opposite or absence of ill-being (Diener E, Emmons RA. 1984 &Ryff CD, et al. 2006). A recent review identified two constructs of psychological well-being as having consistent associations with reduced risk of cardiovascular disease (CVD): emotional vitality, that is, a whole-hearted spirit for life and the ability to regulate emotions; and optimism, a tendency to believe that good event will occur more frequently than bad events (Boehm JK, Kubzansky LD. 2012 ). It has been discovered that drugs such as Antiplatelet used to manage hypertensive patients have side effects on patients such as erectile dysfunction. Our goal in this work is to explore what these effects are, how to manage them and what is being done to manage them, the quality of life and psychological well-being of patients taking these drugs, and then provide insight to improve the quality of life of hypertensive patients within the teaching hospital.

Keywords: Hypertension, Antiplatelet, Quality of Life, and Psychological well-being.

Biography:

Abstract:

Hypertension is a serious health issue and a major cardiovascular disease and stroke risk factor. In the Philippines, it is the major cause of mortality resulting from undiagnosed and unmanaged hypertension. Many of those affected are from low-income communities due to lack of access to healthcare services, less health education causes modifiable hypertension factors such as lifestyle changes (e.g. reduction of salty foods, weight loss, reduction of alcohol consumption and smoking cessation), and difficulties in accessing hypertensive drugs due to distance from pharmacies. The study aims to examine the effects of a lifestyle intervention program using BASNEF model among non – adherent hypertensive respondents in relation to the introduction of a lifestyle intervention in the management of hypertension. The result indicated that the Phase 1 mean (146.5) of the systolic readings differ significantly from the Phase 4 mean (134.92) of the systolic readings. This result suggested that the BP readings of the participants had a significant decrease based only on Phase 1 and Phase 4. However, since these two means came from phases that were not consecutive, the result, as a whole, did not show a significant decrease or change when analyzed chronologically from one phase to the next. Such lifestyle interventions, alone or preferably in combination, have the potential to reduce BP and/or improve the effectiveness of hypertensive medicines.

Keywords: hypertension, BASNEF model, blood pressure, medication adherence

Biography:

Abstract:

Introduction: Heart failure has different characteristics depending on the sex, In the case of STEMI men and women have distinct cardiovascular responses to acute myocardial ischemia with a higher risk for women to develop acute heart failure

Objectives: The main goal of this study is to determine the relationships between gender and acute heart failure after STEMI in patients with no prior history of heart failure recorded at baseline.

Methods: This is a retrospective, a study including 210 patients who had been hospitalized in a cardiology intensive care unit for myocardial infarction from September 2017 to February 2019, The main outcome measures were the incidence of Killip's class at hospital presentation and intrahospital mortality rates.

Results:The main agewas 59.3 ± 7.02 Sex ratio: 2,86 (74.1% Male, 25.9% Female) the incidence of de novo heart failure at hospitalpresentationwashigher for womenthan for men (40,4% vs. 29.5%, odds ratio [OR 1,61 ; 95% confidence interval [CI], 0,83-3,11). Womenwith de novo heart failurehadhighermortalitythandidtheir male counterparts (28,6% vs. 20.5%; OR: 1,55 ;95% CI , 0,5-3,15).About treatment 80% have been thrombolysed. The culpritarteywasLeftanteriordescendingarteryin 53,4%.

Conclusions: Women are at higher risk to develop de novo heart failure after STEMI and women with de novo heart failure have worse survival than men this may be related to the increased prevalence of the microvascular disease in women predisposing them to heart failure after a STEMI.

Biography:

Abstract:

This study deals in general with no communicable diseases and in particular with hypertension and its predictive risk factors in Burundi. A sample of 353 selected randomly from a population of 4,380 patients admitted in 2019 in a military hospital and University teaching hospital of Kamenge. The predictive risk factors have been carried out by fixed-effect logistic regression.The result shows that more than 15% of the patients were hypertensive. Hypertension’s associated risk factors founded are advanced age, chronic kidney failure, overweight, educational level, smoking, and familial history of hypertension. The coexistence of risk factors on the same patients increases at least 2 times the probability of having permanent high blood pressure, therefore becoming hypertensive. The highest probabilities are observed to patients who are at the same time smokers, overweight, with chronic kidney failure, burnt in the hypertensive family with secondary or university as the highest educational level. The probabilities, more than 60 % are observed to people with more than 40 years old, with the presence of all other risk factors with probabilities between85.0 % and 99.9% .In this study, only 15 patients had zero risks of cardiovascular diseases. More than 1/3 had low risk (<0.15), 25 had moderate risk between 0.15 and 0.20,126 patients a high risk of less than 0.30, and 35 patients had very high risk of more than 30%. This study has the particularity to study cardiovascular risk of hypertensive and normotensive people at the same time, to combine descriptive and inferential statistic, to build the ROC curve and complexities parameters using a decision tree, to estimate the area under the curve, and build bootstrap AUC interval confidence using the Bootstrap method, to analyze model’s residuals using Welsh-Kuh’s distance and predict probabilities of becoming hypertensive risk factors being known.

Keywords: High blood pressure, logistic regression, Hoaglin criterion, Welsh-Kuh distance

Biography:

Abstract:

Background: Heart failure places a significant burden on the patients and the health system worldwide. However, information about its burden in Low-income countries is scant. Witnessing a lack of adherence to heart failure guidelines amongst physicians in our environment prompted this study. The main objective is to determine physician adherence to ESC pharmacotherapy guidelines in heart failure in an economically resource-poor tertiary health facility.

Method: Review the prescription pattern of Neurohormonal blocker agent of 102 confirmed heart failure with reducing LVEF was carried out. Data from adherence evaluation were obtained from follow up information form outpatient clinic notes, while data on acute care medication and precipitating factors were from inpatient hospitalization notes.

Result: Heart failure (HFrEF) patients aged 59.03 ± 15.15 years, had NYHA III/IV symptoms (44.1%) and remain hypertension (21.5%), mean LVEF was 30.60± 7.14. hypertension and diabetes were predominant comorbidities, Etiology of heart failure was ICM (50%), Pharmacotherapy average three drug classes and consisted of ACEI/ARB (86.3%), Beta-blocker (50%), and MRA (32.24%) respectively. The use of Beta-blocker and MRA tents to be suboptimal. Combination pharmacotherapy: ACEI/ARB+BB (42.1%), ACEI/ARB+MRA (23.5%), BB+MRA (15.7%), three classes combination (18.7%). Target dose achievement ACEI (1.5%), beta-blockers, and MRA were not. the prescribing dosages were lower than the doses recommended by the guideline Most of the patients were prescribed starting doses in accordance with the guidelines: ACEI- 5mg/d (62.1%), BB-6,25mg/d (72.5%), MRA-25mg/d (97%). However, the maximum dose in this study was low: ACEI (40 mg/d), Beta-blocker (25mg/d), MRA (25mg/d).

Conclusion: As in the other country of the world nonadherence to guideline substantial problem in Laos. Our data confirm the need for a dedicated heart failure treatment program to optimize heart failure outcomes in a low resource environment. Our physicians will benefit from a structured heart failure education and feedback program. Better strategies for heart failure surveillance and management in Laos are need.

Biography:

Abstract:

Hypertension in Africa was estimated at 30.8%  in  2010  with a dramatic increase in some regions ranging between 36.2%-77.3%  (Adeloye  Basquill,  2014).  In  Rwanda,  the prevalence of hypertension was estimated to  15.0%  in  2015,  (Nahimana et al.,  2017).  In  Rwanda, there is no model that can help decision-makers to know the behavior of hypertension in the future. The objective of this study was to predict the prevalence of hypertension in  Rwanda for  10 years using the Markov Chain Monte Carlo method and other related diseases.  Data used were from , Gibbs method for sampling helped to find the transition matrix.  It was found that the prevalence of hypertension, tobacco use, overweight, obesity, and another subject will be predicted 17.82%, 26.26%, 17.13%, 4.80%, and 33.99% in 2025 respectively. This implies that Rwanda needs to take the measure of healthy diets and physical exercises to prevent and reduce the prevalence of the diseases.