Day 1 :
Keynote Forum
Louis P. Perrault
Department of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Canada
Keynote: The PleuraFlow Active Chest Tube Clearance System
Time : 10:15-10:45
Biography:
Louis P. Perrault received his medical degree from University of Montreal in 1986. He completed 3 years of training in basic science research in Paris under the supervision of Professor Paul VanHoutte at Université Louis-Pasteur and obtained a doctor degree (PhD) in fundamental research in 1997. He is the current president for the CSCS.Dr. Perrault is a local Principal Investigator for the Cardiothoracic Surgical Trials Network (CTSNet) for the NIH/CIHR since 2007. He is also an investigator of the FRSQ (Fonds de la Recherche en Santé du Québec). Dr. Perrault has authored and co-authored more than 250 articles in peer-reviewed publications including New England Journal of Medicine, J Chir Thorac Cardio-Vasc, Circulation and J Heart Lung Transplant. His areas of clinical expertise include: Coronary Artery Bypass Grafting Surgery (CABG), valve surgery and heart transplantation ,endothelial dysfunction in left ventricular hypertrophy, pulmonary hypertension following CPB, stem cells therapy and heart transplantation.
Abstract:
To address the clinical consequences related to chest tube clogging, a novel chest drainage apparatus, the PleuraFlow Active Tube Clearance System (Clear Catheter Systems, Bend, OR), was developed. The aim of this world's first clinical experience study was to follow clinicians using the PleuraFlow system to assess usability issues and potential areas of improvement in the heart surgery setting.A user preference study was conducted to assess how specified users (surgeons, nurses, and intensive care physicians) used the PleuraFlow system to achieve specified goals in an efficient manner. Data were collected from patient charts and by a questionnaire that they had filled.All the surgeons (n = 7) noted that the device was not any more difficult to insert than a conventional chest tube and was easy to assemble and use. There were no reports of malfunction or complications related to the installation or use of the system. A majority, 77% (24/31), of nurses felt that the device was more time efficient than stripping, milking, or tapping the chest tubes to keep them open. A majority (16/19, 84%) of the PleuraFlow chest tubes and guide tubes were removed together in one piece within 1 day of surgery (on postoperative day 1).rnOverall, the physicians and nurses rated the PleuraFlow system positively for its ability to be incorporated into the postoperative workflow of managing the drainage of patients after heart surgery. This device may be useful to allow caregivers to be certain that chest tubes are functioning in the early hours after surgery, when active bleeding is resolving and when complications from undrained blood can ensue.
Keynote Forum
Sidney Chocron
Cardiac Surgeon University Hospital of Besancon – France
Keynote: Early Detection of Asymptomatic Bypass Graft Abnormalities Using a Cardiac Troponin I Ratio Following Coronary Artery Bypass Surgery
Time : 10:45-11:15
Biography:
Prof. Sidney Chocron is head of department of cardiac surgery in Besancon (France). He has published more than 100 papers in reputed journals. His research Interests Cardiovascular surgeries,Myocardial revascularization.He built internet websites with techniques of surgical myocardial revascularization using only the two mammary arteries (http://www.chirurgie-cardiaque-besancon.org/learncabg) and other surgical videos (http://www.chirurgie-cardiaque-besancon.org/index.php?xlpage=interventions).
Abstract:
rnTo identify the best cardiac Troponin I (cTnI) ratio to detect asymptomatic graft or anastomoses anomalies after myocardial revascularization.Patients with a rising cTnI profile, based on measurements at 6 and 12 hours (cTnI 12 hours : 6 hours ratio >1) after the last anastomosis in off-pump surgery or after cardiopulmonary bypass in on-pump surgery, underwent a coronary angiogram, despite an uncomplicated postoperative course and absence of electrocardiogram changes. The optimal threshold value for the ratio was determined using a receiving operator characteristic (ROC) curve.rnFrom April 2005 to May 2011, among 1693 patients undergoing isolated coronary artery bypass graft (CABG), 29 (1.7%) had a cTnI ratio >1 and underwent postoperative angiography. Twenty abnormalities were observed in 16 patients (55%). In the anastomoses, there were four occlusions and four stenosis. In the grafts, there were 12 stenosis: two of the Y graft anastomosis, two dissections, five hematomas and three kinking. TIMI flow grade based on results of the Thrombolysis In Myocardial Infarction trial was 3 in six patients, 1 in five, and 0 in five. In the 16 patients with lesions, the cTnI ratio was 2.1 ± 1.4 versus 1.4 ± 0.3 in patients with no lesions (p = 0.09). A ratio of 1.3 (p = 0.003) was determined by ROC curve analysis as having the greatest discriminant capacity, with associated sensitivity of 87.5% and specificity of 62%.A cTnI 12 hours : 6 hours ratio >1.3 may be indicative of these abnormalities. Early identification of these anomalies may avoid adverse outcomes. rn
Keynote Forum
Annika Odell
Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg. Sweden
Keynote: Restenosis after percutaneous coronary intervention (PCI): Experiences from the perspective of patients
Time : 11:15-11:45
Biography:
Annika Odell has completed a Master of Science in Health Care Science in Nursing 2006. PhD, 2014, at the Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg. With Tite: “Aspects on Revascularisation for coronary artery disease- from a patient, health care provider and societal perspective”. She is Head of the research unit, the development unit and the Tobacco preventive unit at the department of Cardiology at Sahlgrenska University Hospital, GöteborgrnPublications in American Journalof Cardiology, Cardiology and European Journal of Cardiovascular Nursing.
Abstract:
PCI has been established as an effective treatment for coronary artery disease. Restenosis is a recurrence of a significant narrowing in the treated vessel. Although a part of the investigative and research funding is invested in the prevention and resolving the restenosis problem, little is known about its clinical significance apart from further revascularisation.The intention of this study was to clarify the patients perspective of what it means to suffer from documented restenosis after PCI.Patients interviewed had undergone PCI. Data collection and analysis was done simultaneously according to Grounded Theory methodology and continued until new interviews provided no additional information."Living with uncertainty" was identified as the core category, and the central focus in the data explains what it means to patients' to suffer from restenosis. The core category was further illuminated in four additional categories labelled "fighting for access to care", "moderating health threats", "trying to understand" and "controlling relatives anxiety".Patients' perceptions of illness and illness-related events, such as symptoms, diagnosis, treatment and prognosis, are considerably affected by uncertainty. This infiltrates their struggle to acquire the care needed, their endeavour to comprehend and moderate health threats, and caring for their family.
- Cardiovascular Diseases
Session Introduction
Ram Bedi
Affiliate Assistant Professor,Department of Bioengineering,University of Washington, Seattle WA
Title: Detection of Subclinical Atherosclerosis to Guide Prophylactic Medical Intervention
Biography:
Dr. Bedi is an Affiliate Assistant Professor at the Bioengineering Department, University of Washington, Seattle, and serves on the Screening Committee of WINGS, a non-profit angel network that facilitates seed and early stage investments for medical technology companies in Washington State. His professional interests include development of ultrasound based instruments for the detection of subclinical atherosclerosis and neovasculature associated with tumours. Bedi has provided engineering consulting services to leading firms engaged in industrial and medical applications of ultrasound for over 25 years. Bedi completed his Ph.D. in electronics engineering at the University of Wales, UK, and his executive M.B.A. at the University of Washington, Seattle.
Abstract:
The objective of this talk will be to discuss subclinical atherosclerotic cardiovascular disease (ASCVD) detection using B-mode ultrasound, with special emphasis on the incremental value of performing imaging in multiple peripheral arteries, and to compare imaging findings with traditional risk factors for medical intervention eligibility. A simplified metric of atherosclerotic disease burden (FUster-Narula or FUN Score) has been developed from 3D imaging data by summing intima-media volume (IMV) over 5cm arterial segments. Effectiveness of ASCVD prevention guidelines to direct therapy will be compared to results from direct imaging. Data from two North American clinics (n=481, mean age 59.68±11.95, 39% female) showed that 203 subjects (42%) had carotid plaque; 82% of whom would not have qualified for lipid lowering therapy under the ATP III Guidelines. Using the recently published ATP IV Guidelines, 33% of the individuals with carotid plaque would also have failed to qualify for treatment. It will be shown how B-mode ultrasound examination improves identification of individuals who could be targeted for prophylactic medical intervention as an adjunct to traditional risk factor assessment.
Erin Flaherty
Boston College, USA
Title: The association of genetics, sleep and cardiovascular disease
Biography:
Erin Flaherty has completed her Bachelor’s and Master’s degrees at the Connell School and then served as a Nurse Practitioner for three years in the US. She has returned to BC as a Doctoral student in the Connell School and is a Resident Assistant.
Abstract:
Background: Cardiovascular disease is the most common cause of death in the United States and has been declared by the Centers for Disease Control and Prevention as a public health issue since 2004. Genetic factors related to sleep and circadian rhythms appear to contribute to CVD risk and disease progression. Objective: The purpose of this integrative review is to summarize the state of science regarding the association between genetics of cardiovascular disease prevention and circadian rhythms. Methods: A comprehensive literature search was conducted in consult with a reference librarian. A two-level search strategy was employed. The records of six electronic databases were searched from the past five years (2012) through the present. Searches were conducted with the terms cardiovascular disease, prevention, genetic and circadian rhythm. An integrative review guided by the Public Health Prevention Model was performed to summarize the state of science on circadian rhythms and CVD prevention. The study selection, data extraction and validation were performed independently by one reviewer. Results: Eight manuscripts were included in the final review. The results of this study showed that clock genes (BMAL1, Per2-13 and Cry 1-2) were affected by temporally restricted feeding, which appeared to cause an increase in obesity and a phase-shift in circadian gene expression. Alterations in clock core genetics can contribute to obesity. Clock core genes also play a role in glucose metabolism by affecting the pancreas through secondary effects of increased cell division and replication. Melatonin is an antioxidant under circadian regulation that can help to counter cellular changes contributing to obesity and CVD. Clock genetic makeup contributes to the effectiveness of dietary interventions in metabolic syndrome. Circadian genetics contribute to day and night time blood pressure differences as well as stroke risk from hypertension. Conclusions: Human sleep/wake cycles, otherwise known as circadian rhythms, appear to have a strong influence on both genetic and environmental components of CVD. Patient populations at higher risk for circadian desynchronization such as nurses, military personnel and other shift workers should be evaluated by clinicians for primary and secondary prevention of accelerated aging and CVD risk.
A.Teddy Weiss
Hadassah University Hospital,Jerusalem,Israel
Title: TED-a low-cost Time and life-saving automatic External Defibrillator for home
Biography:
Prof. Teddy Weiss has completed his MD in 1974 from Hebrew University School of Medicine and cardiology at Hadassah hospital in 1976 and postdoctoral studies at Cedars-Sinai cardiology center in Los-Angeles in 1984 .Since than he is a fellow of the American College of Cardiology. He was the director of the coronary care unit at Hadassah for 30 years and is the co-chairman of the Jerusalem Cardiology Chapter for the last 25 years. He is now the director of the Cardiac Rehabilitation center at Hadassah hospital and has published more than 250 papers in reputed journals with a great impact on nuclear and interventional cardiology and early pre-hospital thrombolysis for acute myocardial infarction
Abstract:
Sudden cardiac death(SCD)-caused by ventricular fibrillation(VF) or standstill- occurs in about 1000 persons/day in US alone. Since survival drops by 10% for every minute delay- no ambulance in the world will be quick enough to save them. The existing AEDs, that are now distributed in public places are not a good solution for home-use, due to their high cost for battery and capacitor not needed in TED. Our TED device modifies by computer the sinusoidal alternating electrical current from the mains to a biphasic defibrillatory wave and its cost-affordable to every household. In addition -it can pace the heart in case bradycardia or standstill caused SCD or it occurred after the electric shock.. In order to prove the safety and feasibility of TED -we performed 2 animal experiments: in the first-we used 5 pigs: defibrillation of stable VF after 15 seconds was applied by TED or by a standard AED. Defibrillation was successful by both devices and thresholds were found to be similar. The second experiment used a rat model: six rats, underwent a mid LAD coronary closure and 3 months later VF was induced and TED defibrillation and external pacing was successfully achieved using TED in all ,at a heart rate above their rate, for an unlimited time before and after defibrillation. We conclude that modified alternating shock delivered by our device-TED- is feasible and as effective as that of the standard AED. This low-cost new technology should be used to prevent sudden cardiac arrest occurring at home/office .
Abdallah M. Almaghraby
Department of Cardiology – University of Alexandria - Egypt
Title: A catastrophe caused by central venous catheter insertion – A case report
Biography:
Abdallah Almaghraby has completed his Master degree in Cardiology and Angiology at the age of 31 years from University of Alexandria – Egypt and he was a resident of Cardiology and Angiology for 5 years in the same university. He has about 5 published case reports and more than 10 preserntations in different conferences and meetings around the world.
Abstract:
Central venous catheterization (CVC) is a routine technique done in critical care and emergency departments for monitoring patients and giving certain parenteral medications in special conditions.A 50-year-old male patient with no previous medical history presented to our hospital complaining of high grade fever with gradual onset and stationary course with no response to antipyretics and antibiotics for 1 week. Work-up for fever was unremarkable, mild renal impairment was accidentally diagnosed with Creatinine level of 2.8 mg/dl, fever subsided after giving intravenous antibiotics for 3 days then the patient developed hypotension, blood pressure was 70/40 mmHg, heart rate was 140 beats per minute, electrocardiogram showed sinus tachycardia, liver enzymes were elevated, serum bicarbonate level was very low so the intensive care specialist inserted a central venous catheter to guide his fluid status control, central venous pressure was very low so he received intravenous fluids together with the antibiotics. Chest X-ray was done a day later after central venous catheter insertion and astonishingly we found the introducing guide wire left inside his heart starting from the right internal jugular vein towards the right atrium and ventricle making a loop inside the pulmonary artery then down through the inferior vena cava towards the hepatic vein. The lost wire was retrieved blindly without fluoroscopic guidance and follow-up X-ray showed no residual wire parts, then he was referred to us for echocardiography and we found severe tricuspid valve regurgitation with no signs of chronicity with perforation of the anterior leaflet, no visible vegetations or thrombi, right and left ventricular systolic and diastolic functions were completely normal and no pericardial effusion. Two days later the patient was referred to us again for follow up as he was still hypotensive with elevated central venous pressure. The new echocardiography revealed severely reduced left ventricular systolic function with borderline dimensions and reduced right ventricular systolic function with normal dimensions.
Guy fontaine
Université Pierre et Marie Curie 75013 Paris
Title: Advances in the understanding of inherited Cardiomyopathies
Biography:
Guy H Fontaine has made 15 original contributions in the design and the use of the first cardiac pace makers in the early 60s.He has serendipitously identified ARVD during his contributions to antiarrhythmic surgery in the early 70s. He has developed the technique of Fulguration to replace surgery in the early 80s. He has been one of the 216 individual who has made a significant contribution to the study of cardiovascular disease since the 14th century, one of the 500 greatest geniuses of the 21th century (USA Books), one of the 100 life time of achievement (UK Book). He has 900+ publications including 201 book chapters. Reviewer of 17 scientific journals both in basic and clinical science. 11 master lectures of 90’ each in inland China in 2014. He has developed new techniques of hypothermia for neurologic brain protection in OHCA, stroke and spinal cord injury.
Abstract:
Arrhythmogenic Right Ventricular Dysplasia (ARVD) is mostly due to PKP2 desmosomal mutation with increased RV size with apoptotic thinness of the free wall and segmental anomalies of contraction. This is also due to the presence of fat and interstitial fibrosis mostly observed in the RV free wall and LV apex. This disease is frequent in the general population but become clinically apparent in a small number of cases. Clinical presentation is mostly ventricular arrhythmias which can lead to unexpected sudden cardiac death especially in young people and during endurance sports. Some of these patients seen at a late stage of the disease can be misclassified as IDCM. Brugada syndrome (BrS) has a unique ECG pattern of coved type observed only in lead V1. Structural changes are sometimes suggesting ARVD. However, BrS and ARVD are two different entities with some degree overlap both phenotypically and genotypically in a small number of cases. Right Ventricular Outflow Tract Ventricular Tachycardia (ROVT VT) is generally benign but one personal case of SD with pathologic documentation demonstrated a localised infundibular anomaly suggesting localised ARVD. Hypertrophic Cardiomyopathy (HCM) is produced by a genetic mutation in the contractile molecules of the heart producing hypertrophy of myocardial fibres with disarray. It is also a major cause of SD during sports Idiopathic Dilated Cardiomyopathy (IDCM) is mostly due to multiple genetic mutations lamin and myosin affecting myocardial force of contraction. All of these cardiomyopathies can be affected by superimposed myocarditis which is frequently the determinant of prognosis.
Stephen F. Vatner
Cardiovascular Research Institute, Rutgers-New Jersey Medical School, NJ, USA
Title: Overexpression of Cardiomyocyte Alpha1A-Adrenergic Receptors Protects the Ischemic Heart by Inducing Angiogenesis Through Heterocellular Signaling
Biography:
Dr. Stephen F. Vatner, M.D. currently working as an University Professor of Cell Biology and Molecular Medicine, and he is the Director of Cardiovascular research Institute, Rutgers University- New Jersey Medical School. In past, he worked as a Professor of Medicine at Harvard Medical School.
Abstract:
Four to six weeks after permanent coronary artery occlusion (CAO), transgenic (TG) rats with cardiomyocyte-specific α1A-AR overexpression had better preserved left ventricular ejection fraction and wall stress with less myocardial fibrosis and hypertrophy than their non-transgenic littermates (NTLs). We reasoned that with total permanent CAO, in a model devoid of preformed collateral vessels, that the salutary response to CAO must have involved angiogenesis. Indeed, coronary blood flow, measured with microspheres, increased in the infarct zone in TG compared to NTLs (1.4±0.2 vs. 0.5±0.08ml/min/g) (p<0.05), which is consistent with angiogenesis, as reflected by a 20% increase in capillary density in the zone adjacent to the infarct. The question arose, how does TG overexpression of a gene in cardiomyocytes affect the coronary blood vessels to induce angiogenesis? We identified a paracrine mechanism, whereby vascular endothelial growth factor-A (VEGF-A) mRNA and protein were increased in isolated TG cardiomyocytes, and also by NTL cardiomyocytes treated with an α1A-agonist, resulting in angiogenesis. Conditioned medium from cultured TG cardiomyocytes enhanced human umbilical vein endothelial cell (HUVEC) tubule formation, which was blocked by an anti-VEGF-A antibody. Moreover, improved cardiac function, blood flow and increased capillary density after chronic CAO in TG rats were also blocked by a VEGF-A inhibitor. Thus, cardiomyocyte-specific overexpression of the α1A-AR resulted in enhanced cardiomyocyte VEGF-A expression, which stimulates angiogenesis via a paracrine mechanism involving heterocellular cardiomyocyte/endothelial cell signalling, protecting against heart failure following chronic CAO.
Yosef Blaer
Department of Cardiology, Barzilai University Medical Center, Ashkelon, Israel.
Title: Transient Ventricular Fibrillation, is it a real possibility?
Biography:
Dr. Yosef Blaer RN, has completed his M.Sc. from Tel Aviv University, Israel and PhD from Mind Body Medical University, Natural Health Science, California. USA. He is the supervising nurse of the Cardiology Department at the Barzilai Medical Center, Ashkelon which is affiliated to the Ben-Gurion University of the Negev, Israel. ACLS instructor. He has published more than 30 papers in reputed journals. One of the founders of the Cardiac Nursing Association in Israel. Emeritus Member of the European Society for Cardiac Nursing (NFESC). Lecturer of Cardiovascular physiology at the Nursing Division, Tel Aviv University, Israel
Abstract:
At least 400,000 people in the United States die suddenly every year from coronary heart disease (CHD). The leading cause of cardiac death is malignant arrhythmia such as ventricular fibrillation (VF). The precipitating causes are poorly understood. VF in humans is generally sustained (SVF) which results in death, unless effective artificial defibrillation is applied within minutes. Spontaneous reverting of VF to sinus rhythm is very rare. Sporadic cases of transient ventricular fibrillation (TVF) reported in English literature. The description of human TVF is rare clinically and can be founded in sporadic cases unrelated to any known cardiac or non-cardiac etiology: triggered automatically, idiopathic, local cardiac activation, structurally normal human heart. The same authors described that the cardiologists offered self-terminating VF to 15.6% of ventricular tachyarrhythmias. The AHA/ACC guidelines don't specify the ideal professional level of the monitor watcher, but highly recommend that staff receive formal education related to the monitoring system, goals of monitoring, and ECG interpretation. Early recognition of lethal dysrhythmias and quick action give the patient a best chance to survive. Finally, it is well-established fact, that arrhythmia monitoring with immediately available defibrillation has improved survival and patient outcomes. A TVF may represent in some patients in clinical practice. The patient survive "silent", un witnessed TVF remained at risk for sudden death and a preventive therapy must be established.
Wenger Nanette K
Professor of Medicine (Cardiology) Emeritus,Emory University School of Medicine,Consultant, Emory Heart and Vascular Center
Title: Transforming CVD Prevention for Women
Biography:
Dr. Wenger is Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine. She is a Consultant to the Emory Heart and Vascular Center. Coronary heart disease in women is one of Dr. Wenger’s major clinical and research interests. She chaired the U.S. National Heart, Lung, and Blood Institute Conference on Cardiovascular Health and Disease in Women. Dr. Wenger has expertise in cardiac rehabilitation. She chaired the World Health Organization Expert Committee on Rehabilitation after Cardiovascular Disease, and co-chaired the Guideline Panel on Cardiac Rehabilitation for the U.S. Agency for Health Care Policy and Research.
Abstract:
The transformation of cardiovascular disease prevention for women must address that a number of nontraditional atherosclerotic cardiovascular disease risk factors are unique to or predominant in women. As well, many traditional atherosclerotic cardiovascular disease risk factors impart differential risks for women and for men. Gender-specific risk assessment and management have the potential to improve atherosclerotic cardiovascular disease outcomes in women.
Mohamed Soliman
Catharina Hospital, Eindhoven, The Netherlands
Title: Postoperative renal replacement therapy and long-term outcome after cardiac surgery
Biography:
Mohamed Soliman is a cardiothoracic surgeon in the Catharina Hospital in Eindhoven. Moreover, he is the head of the cardiac surgery research department. He completed his PhD from Maastricht University in the Netherlands. He has published more than 70 papers in reputed journals mostly about risk stratification in cardiac surgery.
Abstract:
In the present study, we investigated the survival of patients who received postoperative renal replacement therapy (RRT) after cardiac surgery. We specifically focused on factors predicting long-term outcome in elderly patients. Data of all patients that received unintentional renal replacement therapy following cardiac surgery between 2004 and 2010 were analyzed. Logistic- and Cox regression analyses were performed to detect the predictors of early and late mortality respectively. During the study period, 11 899 patients underwent cardiac surgery in our centre. Postoperative RRT was performed in 138 patients (1.2%). In this group of patients, thirty-day mortality included 72 patients (52%) and the total overall mortality included 107 patients (77.5%). Regression analyses revealed that age predicted 30-day mortality [Odds ratio=1.08 (1.03-1.12)] as well as late mortality (Odds ratio=1.05 (1.02-1.07). Patients requiring RRT after cardiac surgery have a poor prognosis with a high mortality. Older age predicted both 30-day and late mortality in these patients.
Luigi Gianturco
Galeazzi Orthopedic Institute, GSD Foundation, Milan, Italy
Title: Cardiovascular and autoimmune diseases in females: the role of microvasculature and dysfunctional endothelium
Biography:
Luigi Gianturco has completed his graduation in Medicine and Surgery at the age of 25 years from Sapienza University of Rome (Italy) and post-graduation specialty in Cardiology from the same Sapienza University University School of Medicine. In 2009 he has achieved the Master fo Sciences in Echocardiography practice for clinic from Milan University School of Medicine. He is actually the Assistant Director of Cardiology Unit in Galeazzi Orthopedic Institute of Milan (Italy) and Assistant Clinic Director in the same Hospital. He has published more than 10 papers in reputed journals and has been serving as an editorial board member of repute. Moreover, he is the Chief of Biomedical Commission in Italian Soccer Referees Association.
Abstract:
Cardiovascular (CV) diseases are becoming increasingly frequent and associated with a high incidence of CV events, disability and death. It is known that there is a relationship between CV burden and systemic autoimmune diseases (SADs) that is mainly due to inflammation and autoimmunity, but the other mechanisms underlying the high CV risk of SAD patients have not yet been fully clarified. The aim of this review article is to discuss some of the specific factors associated with the accelerated atherosclerosis (ATS) characterising SADs (female sex, the microcirculation and the endothelium) in order to highlight the importance of an early diagnosis and the prompt implementation of preventive measures, as well as the possible role of new therapeutic strategies such as vaccine immunomodulation. Finally, as the natural history of ATS begins with endothelial injury (a potentially reversible process that is influenced by various factors) and microvascular damage plays a central role in the etiopathogenesis of SADs, it underlines the crucial need for the development of reliable means of detecting sub-clinical abnormalities in the microcirculation, particularly coronary microcirculation dysfunction.
- Cardiovascular Nursing
Session Introduction
Xiao-hua wang
Nursing School of Soochow University, Suzhou 215006, China
Title: Improvement of Left Ventricular Remodeling and Reduction of CHF-rehospitalization Using a 12-month Weight Management Intervention
Biography:
Xiao-hua Wang has completed her PhD majored in immunology from Soochow University. She has been the director of Medical Nursing over ten years. She has published more than 30 papers in impact journals and has been serving as a reviewer of some journals.
Abstract:
The study was to determine the effectiveness of a 12-month weight management (WM) intervention on prognosis of chronic heart failure (CHF). Methods: CHF patients meeting our inclusion criteria were randomly assigned to the WM group (N=66) and the control group (N=64). WM consisted of the education of correct daily weight monitoring and the knowledge to deal with sudden weight gain, monthly telephone visits and diary kept by patients. We compared New York Heart Association (NYHA) classifications, the Left Ventricular Internal Diameter at end-diastole (LVIDd), Minnesota Living with Heart Failure Questionnaire (MLHFQ), CHF-related re-hospitalization and CHF-related mortality. Results: There were no significant differences in outcome variables at baseline. In 12 months, compared with the control group, the adherence to weight monitoring (60.61% vs 7.81%; P<0.001) and NYHA classification (P<0.001) were significantly improved; LVIDd was reduced (P=0.006). The global score of MLHFQ of WM group in 12 months was significantly lower than that of the control group and the baseline of WM group. The number of CHF-related re-hospitalization during the 12-month in WM group was significantly smaller than that of the control group (0.590±0.841 vs 1.170±1.409, P=0.005), but there was no significant reduction in CHF-mortality (1.49% vs 5.88%, P=0.366). Conclusion: This study demonstrates that the 12-month WM intervention had a positive impact on patients’ adherence to weight monitoring and WM ability, NYHA classification and left ventricular remodeling, quality of life and CHF-related re-hospitalization. However, the WM intervention has not improved CHF-mortality.
Adriano Marçal Pimenta
Federal University of Minas Gerais, Brazil
Title: Night-shift work is associated with cardiovascular risk among employees of a public university in Brazil
Biography:
Adriano M. Pimenta has completed his PhD in Nursing from Federal University of Minas Gerais – UFMG (Brazil) and postdoctoral studies in Public Health from University of Navarra (Spain). He is professor of Public Health in Graduate, Master and Doctoral courses from School of Nursing (UFMG). He has published more than 45 papers in reputed journals and has been serving as a reviewer board member of important journals as the British Medical Journal (England).
Abstract:
Cardiovascular diseases represent a significant public health problem and are responsible for one-third of all deaths in worldwide. Night-shift work has become common around the world, with approximately 22% of the population of industrialized countries performing their work activities during this period. We conducted a cross-sectional study with 211 workers of both genders, aged between 30 and 64 years, working on the health campus of a public university in the state of Minas Gerais, Brazil. The aim was to estimate the association between night-shift work and high cardiovascular risk. Night-shift work was defined as a work shift between 7 pm and 7 am, and high cardiovascular risk was calculated based on the Framingham score. The association between night-shift work and high cardiovascular risk was estimated by the prevalence ratio (PR) and its 95% confidence interval (95% CI) after adjusting for potential confounding factors, calculated by Poisson regression. Night-shift work was performed by 38.4% of the individuals, and high cardiovascular risk was diagnosed in 28% of the sample. In the bivariate analysis, night-shift work, passive and high job strain categories at the demand-control scale, work time > 120 months, schooling > 9 years, family income > 6 minimum wages, level 2 abdominal obesity, and triglyceride levels > 150 mg/dL were associated with high cardiovascular risk. After multivariate analysis, night-shift work remained independently associated with high cardiovascular risk (PR = 1.67; 95% CI = 1.10-2.54). This association should be considered when discussing the promotion of workers' health regarding changes in the work process.
- Cardiovascular Epidemiology
Session Introduction
Kimberly S McClane
Sentara College of Health Sciences, USA
Title: Changing the health of a nation: A multiphase health promotion community
Biography:
Kimberly S McClane has completed her dual graduate degrees in MBA and MSN. She completed her PhD in 2003 at the Hahn School of Nursing at the University of San Diego. She had the opportunity to teach at International School, International University of Nursing on St. Kitts in the West Indies for over six years and spearheaded the conversion of the school to a baccalaureate program. She has been responsible for over 30 classes for traditional, hybrid, and online courses. She is currently an Adjunct Professor at Sentara College of Health Sciences.
Abstract:
St. Kitts is a small developing black island in the West Indies. There was a large population of women with hypertension and diabetes; where cardiovascular disease was the third cause of Kittitian women’s death. It was projected to increase 60% from 2000 to 2010 in the Caribbean with associated diabetes. The International University of Nursing (IUON) conducted a research project in 2007, was initiated to reduce the risks of cardiovascular diseases in women employed in the local manufacturing plants. The purpose of choosing female participants was that they would influence the family unit regarding diet, exercise and other health issues. 372 participants were recruited from five manufacturing sites with approval of either the owner or the plant manager. The field team of this project included nursing faculty and nursing students from IUON. The framework was Pender’s Health Promotion Model and the WHO STEPwise chronic disease risk factor surveillance. Pre and post physiological parameters were obtained including blood pressure, random blood sugars, body mass index and the waist to hip ratio. Information concerning their age, literacy, cultural and marital information, dietary preparation and diet were also collected. The educational focus was on hypertension and associated complications, diabetes, My plate measurements, portions, salt, alcohol consumption, and smoking. The educational sessions were conducted once in a month at the plants. In 2013, there was a meeting with several participants to discuss how successful the study was, and how we could have had a bigger impression of the participants.
- Nursing Education
Session Introduction
Kasey Carlson
Chippewa Valley Technical College,USA
Title: Application of Augmented Reality Integrated Simulation Education in Healthcare Education
Biography:
Kasey Carlson has been a Registered Nurse for 16 years. She holds a Master’s degree in Nursing Education from the University of Wisconsin – Eau Claire and has been teaching associate degree nursing for over 10 years. She also has a second Master’s degree in Learning Design and Technology from San Diego State University. Ms. Carlson specializes in healthcare simulation design and is the creator of the ARISE conceptual framework.
Abstract:
Simulation in nursing comes in a wide variety of forms – from low fidelity mannequins in a lab course to high fidelity trauma training. However, not all facilities and academic institutions have funding or space for such equipment. Augmented Reality Integrated Simulation Education (ARISE) is an inexpensive, emerging, and versatile instructional method for health care disciplines. ARISE merges the concepts of simulation with augmented reality and game-based situated learning theory. ARISE scenarios are developed using open source ARIS software, QR codes, and medical images yet completed using an iPad. This presentation will focus the results of a recent study of ARISE prototypes for nursing education developed as part of a Department of Labor TAACCCT 4 grant which was published in the April 2016 edition of Clinical Nursing Simulation. Four prototypes were trialed with representatives in the Wisconsin Technical College System in low and high fidelity environments. Demonstration of a scenario will be shown as well as utilization of ARISE scenarios in a variety of settings will be discussed. The results showed that ARISE positively enhances simulation and provides authentic interactions that may lead to future implications for nursing education. Further ARISE research, including student learning, student experience, and faculty evaluation is recommended as well as expanding the concept to other disciplines.