Meetings International Pte Ltd, Madrid, Spain
26th November, 2018
Preventive Cardiology and Lifestyle Medicine:
Multifactorial risk factor modification and control, especially interventions designed to reduce total cholesterol, systolic blood pressure, smoking prevalence, overweight/ obesity, diabetes mellitus, and physical inactivity, can have a profound and favourable impact on decreasing the incidence of initial and recurrent cardiovascular events. Between 1980 and 2000, mortality rates from coronary heart disease (CHD) fell by 40%. Using a previously validated statistical model (IMPACT), researchers attempted to determine how much of this decrease could be explained by the use of medical and surgical treatments as opposed to changes in risk factors among US adults aged 25 to 84 years. Approximately half of the decline in cardiovascular deaths was attributed to reductions in major risk factors (obesity and diabetes mellitus were notable exceptions), and approximately half was attributed to evidence-based medical therapies (eg, secondary prevention medications, rehabilitation, and initial treatments for acute myocardial infarction [AMI]).
Cardiovascular Disease and Nutrition:
The major cardiovascular diseases affecting the developed world have at their core atherosclerosis and hypertension, both of which are profoundly affected by diet and can be approached, at least in part, from a nutritional point of view, as can the increasing “epidemic” of obesity. Diet is a multi-component mixture of many nutrients, which may interact with one another. The definitive study of nutrients and their impact on cardiovascular disease can be a daunting enterprise. Many dietary risk factors contribute to these diseases in various environmental and ethnic settings. These risk factors are often in evidence in youth so that preventive measures must be initiated early in life. Although most of the information about nutritional risk factors and cardiovascular disease derives from studies in the developed world, the situation is rapidly evolving toward epidemic proportions in the developing world where a major burden on the economy and health services will be imposed.
Echo Cardiography and Cardiac Imaging:
Cardiac imaging is a subspecialty of diagnostic radiology. A cardiac radiologist supervises or performs and then interprets medical images to diagnose diseases of the heart such as heart disease, leaky heart valves and defects in the size and shape of the heart. Its applications include assessment of myocardial ischemia and viability, cardiomyopathies, myocarditis, iron overload, vascular diseases, and congenital heart disease. It is the reference standard for the assessment of cardiac structure and function, and is valuable for diagnosis and surgical planning in complex congenital heart disease. A cardiac radiologist uses imaging techniques such as X-rays, ultrasound (echocardiograms), CT (computed tomography) scans and MRI (magnetic resonance imaging) scans. These tests are used to screen for heart disease, determine what is causing your symptoms and monitor your heart and find out if your treatment is working. Cardiac (heart) imaging procedures include:
The editorial mission of Cardiac-Oncology is to advance the science and practice of this emerging field to find a balance between oncologic efficacy and reducing adverse cardiovascular effects through timely publication and dissemination of peer-reviewed research. As an open access, online journal Cardiac-Oncology provides a high visibility platform for the publication of original research and expert reviews on the cardiovascular effects of cancer treatment. The discussions will be done on the following sections:
Cardiac Care Equipment and Market:
With the never-ending advancements in technology, it is no doubt that we will find better ways to stay safe and remain healthy. Science is an evolving practice that changes as technology improves. This is especially beneficially in the health and safety field, where heart technology is concerned. The AED for example, once did not exist. It was not until technology improved, and we realized that electrical shocks could be administered to the heart to save a life, that these lifesaving machines came into being! Heart technology has advanced to impressive and astonishing heights, and we can only expect it to continue to expand. For now, here are the newest Cardiac Technology Advancements.
The number of cardiac procedures performed increased steadily over the five years to 2017, providing overwhelming demand for operators in the Cardiologists industry. In particular, the growing burden of cardiovascular disease fostered increased demand. In addition, increasing rates of obesity and an aging baby-boomer population have resulted in an uptick in heart-related conditions. As a result, the early onset of chronic health conditions, such as heart disease, hypertension and diabetes, bolstered demand for industry services. . Improving economic conditions through 2022 are expected to underpin steady growth for cardiologists.
Paediatric cardiology is concerned with diseases of the heart in the growing and developing individual. As well as expertise in heart disease, paediatric cardiologists also need a thorough grounding in general paediatrics, in order to provide all-round patient care. Paediatric cardiologists broadly treat congenital heart disease (present at birth), arrhythmias (variations in heartbeat rhythm) and disturbances of circulatory function. The initial assessment performed by the paediatric cardiologist might start with a physical examination using a stethoscope, after which more detailed investigations may be suggested. Patients often present with complex diagnostic and medical problems and after the initial assessment the paediatric cardiologist then chooses an optimal management plan. They work closely with a wide range of specialists as part of a multidisciplinary team to assess and treat patients. Paediatric cardiologists play a vital role in the teaching of medical students, doctors. GPs, nurses and paramedical staff. Most are also involved in research.
Cardiovascular Risk Reduction:
Cardiovascular disease (CVD) is the leading cause of death and disability in the United States across all racial/ethnic groups. Much of the burden of CVD morbidity and mortality is associated with modifiable lifestyle risk factors. A disproportionate share of the burden of CVD and metabolic/vascular risk factors falls on racial and ethnic communities as a result of a constellation of social, environmental, biological, and systems factors. Disparities are most clearly evident for black compared with white Americans. Discussions will be there for other racial/ethnic minority populations indicate disparities for certain CVD risk factors or outcomes. This article provides a brief overview of the disparities in CVD health status, lifestyle risk factors, and health care. Successful CVD risk reduction strategies targeted to lifestyle behaviours are then described with a focus on research that demonstrates benefit in racial/ethnic minorities. General issues related to cultural competence and cultural tailoring are also discussed.
Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. A large number of procedures can be performed on the heart by catheterization. This most commonly involves the insertion of a sheath into the femoral artery (but, in practice, any large peripheral artery or vein) and cannulating the heart under X-ray visualization (most commonly fluoroscopy). The radial artery may also be used for cannulation; this approach offers several advantages, including the accessibility of the artery in most patients, the easy control of bleeding even in anticoagulated patients, the enhancement of comfort because patients are capable of sitting up and walking immediately following the procedure, and the near absence of clinically significant sequelae in patients with a normal Allen test. Downsides to this approach include spasm of the artery and pain, inability to use larger catheters needed in some procedures, and more radiation exposure.
Nuclear and Molecular Cardiology:
Molecular cardiology is a new and fast-growing area of cardiovascular medicine that aims to apply molecular biology techniques for the mechanistic investigation, diagnosis, prevention and treatment of cardiovascular disease. As an emerging discipline, it has changed conceptual thinking of cardiovascular development, disease etiology and pathophysiology. Although molecular cardiology is still at a very early stage, it has opened a promising avenue for understanding and controlling cardiovascular disease. With the rapid development and application of molecular biology techniques, scientists and clinicians are closer to curing heart diseases that were thought to be incurable 20 years ago. There clearly is a need for a more thorough understanding of the molecular mechanisms of cardiovascular diseases to promote the advancement of stem cell therapy and gene therapy for heart diseases.
Heart disease is the leading cause of death in the western world. Each year in the U.S.A, more than 500,000 men and women die from coronary artery disease. During the past two decades, major strides have been made in the diagnosis and treatment of heart disease. Nuclear Cardiology has played a pivotal role in establishing the diagnosis of heart disease and in the assessment of disease extent and the prediction of outcomes in the setting of coronary artery disease. Nuclear cardiology studies use noninvasive techniques to assess myocardial blood flow, evaluate the pumping function of the heart as well as visualize the size and location of a heart attack. Among the techniques of nuclear cardiology, myocardial perfusion imaging is the most widely used.
Cardiovascular Toxicology and Pharmacology:
Cardiovascular Toxicology deals with the adverse effects on the heart or blood systems which result from exposure to toxic chemicals. It describes safety data of detrimental effects of new cardiovascular drugs. Pharmacology of vascular endothelium deals with alterations of endothelial cells and the vasculature play a central role in the pathogenesis of a broad spectrum of the most dreadful of human diseases, as endothelial cells have the key function of participating in the maintenance of patent and functional capillaries.
Cardiac Regeneration: Stem Cell Therapy:
Ischaemic heart disease is a leading cause of death worldwide. Injury to the heart is followed by loss of the damaged cardiomyocytes, which are replaced with fibrotic scar tissue. Depletion of cardiomyocytes results in decreased cardiac contraction, which leads to pathological cardiac dilatation, additional cardiomyocyte loss, and mechanical dysfunction, culminating in heart failure. This sequential reaction is defined as cardiac remodelling. Many therapies have focused on preventing the progressive process of cardiac remodelling to heart failure. However, after patients have developed end-stage heart failure, intervention is limited to heart transplantation. One of the main reasons for the dramatic injurious effect of cardiomyocyte loss is that the adult human heart has minimal regenerative capacity. In the past 2 decades, several strategies to repair the injured heart and improve heart function have been pursued, including cellular and noncellular therapies. In this Review, we discuss current therapeutic approaches for cardiac repair and regeneration, describing outcomes, limitations, and future prospects of preclinical and clinical trials of heart regeneration. Substantial progress has been made towards understanding the cellular and molecular mechanisms regulating heart regeneration, offering the potential to control cardiac remodelling and redirect the adult heart to a regenerative state.
Stem Cell Therapy: Stem cell therapy as applied to cardiology has shown partial progress. A large number of patients with coronary artery disease experience angina with vessels that are not suitable for revascularization. The angina in so called end stage coronary artery disease is refractory to conventional medical therapy. Laboratory and preclinical studies have provided evidence for the safety and potential efficacy of autologous CD34+ stem cell therapies as treatment for angina. Clinical studies investigating intramyocardial transplantation of autologous CD34+ stem cells by catheter injection for patients with refractory angina show that this is safe and feasible. It remains unclear whether intracoronary infusion of CD34+ stem cells exerts beneficial effects in patients with angina as well. In a controlled clinical trial enrolling 112 patients with refractory angina, no myocardial infarction was observed during intracoronary infusion. No serious adverse events occurred in either group. The reduction in the frequency of angina episodes per week 3 and 6 months after infusion was significantly higher in the treatment group (-14.6 ± 4.8 at 3 months and -15.6 ± 4.0 at 6 months) than in the control group (-4.5 ± 0.3 and -3.0 ± 1.2, respectively; p < 0.01). Other efficacy parameters such as nitroglycerine usage, exercise time and the Canadian Cardiovascular Society class also showed an improvement in the treatment group compared to the control group.
Myocardial infarction (MI), commonly known as a heart attack occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Often it occurs in the centre or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat, or feeling tired. About 30% of people have atypical symptoms. Women more often have atypical symptoms than men. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock, or cardiac arrest. Most MIs occur due to coronary artery disease. Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol intake, among others. The complete blockage of a coronary artery caused by a rupture of an atherosclerotic plaque is usually the underlying mechanism of an MI. MIs are less commonly caused by coronary artery spasms, which may be due to cocaine, significant emotional stress, and extreme cold, among others.
The emerging field of geriatric cardiology reflects a shift in clinical practice as the typical cardiovascular (CV) patient is now much older than in the past with distinctive goals and complexities related to age. Typical patients routinely present with coexisting geriatric syndromes that affect healthcare goals, care processes, and outcomes. Health systems and payers have also changed, with greater focus on patient-centred outcomes like function and quality of life. Whereas CV medicine continues to progress with technical advances, it is no longer as certain if and how they will align with shifts in patients and payers. Within this context, several programs in geriatric cardiology have been developed over recent years, although the precise definition of what constitutes both clinical practice and training in this field is still evolving. Concomitantly, there has been a substantial increase in scholarship at the intersection of aging research and CV medicine: whereas even a decade ago the terms “geriatrics” and “cardiology” were seldom mentioned together in the scientific literature, this has changed markedly. We expect that in the near future this nascent discipline will continue to grow to keep pace with the burgeoning older demographic and the evolving needs of an aging population. In this context, the purpose of this review is to highlight the development of geriatric cardiology, its current state, and future directions.
Percutaneous Cardiovascular Interventions:
Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat narrowing (stenosis) of the coronary arteries of the heart found in coronary artery disease. After accessing the blood stream through the femoral or radial artery, the procedure uses coronary catheterization to visualise the blood vessels on X-ray imaging. After this, an interventional cardiologist can perform a coronary angioplasty, using a balloon catheter in which a deflated balloon is advanced into the obstructed artery and inflated to relieve the narrowing; certain devices such as stents can be deployed to keep the blood vessel open. Various other procedures can also be performed. Primary PCI is the urgent use of PCI in people with acute myocardial infarction (heart attack), especially where there is evidence of heart damage on the electrocardiogram (ST elevation MI). PCI is also used in people after other forms of myocardial infarction or unstable angina where there is a high risk of further events. Finally, PCI may be used in people with stable angina pectoris, particularly if the symptoms are difficult to control with medication. PCI is an alternative to coronary artery bypass grafting (CABG, often referred to as "bypass surgery"), which bypasses stenotic arteries by grafting vessels from elsewhere in the body.
Cardiac Medication: Drugs & Therapy
The article provides an overview of cardiovascular pharmacology by relating the mechanism of action of different classes of drugs to their effect on the control of the cardiovascular system. It will cover both newer types of drug, and recent advances in the understanding of the older drugs. Understanding the mechanism of action of any new drug allows anaesthetists to incorporate new drugs into their clinical practice. The cardiovascular system uses a complex series of control mechanisms to maintain homeostasis. The controls utilise multi-layered, interrelated mechanisms which help to minimise system redundancy and duplication. They utilise diverse methods from simple molecular function to principles of fluid dynamics in whole organs. This complexity has led to a diverse array of therapeutic agents being developed which target different areas. This diversity causes difficulty in constructing a system for classifying drugs which can also explain their mode of action.
Cardiac Surgery and Transplantation:
Cardiac surgery, or cardiovascular surgery, is surgery performed on the heart or blood vessels by cardiac surgeons. It is often used to treat complications of ischemic heart diseases like coronary artery bypass grafting, to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation. There will be an expanded discussions regarding the new advanced technologies in cardiac transplantation and surgery processes.
- CT Coronary Angiography (CTCA)
- Coronary Artery Calcium Scoring
- MRI Heart (Cardiac MRI)
- Adult Oncology
- Clinical Cardiology
- Clinical Trials
- Geriatric Oncology
- Paediatric Oncology
- Radiation Oncology
- Translational Cardiology
- Development of pace making
- Cardiac conduction system lineages
- New heart technology advancement
- Role of platelets and antiplatelet therapy in cardiovascular disease
- Molecular targets of antihypertensive drug therapy
- Personalized medicine in cardiology
- Real-world evidence and outcomes research