Cardiology Research

The pharmacology of anti-SARS-CoV-2 drugs, Molnupiravir (M) and repurposed Ivermectin (IV) were compared. The IC 50 for the inhibition of viral replication were 0.3µM for M and 2.8µM for IV. Both drugs have good oral absorption, with M achieving peak plasma concentrations by 2 hours and IV by 5 hours. The plasma half life were 7 hours for M and 81-91 hours for IV. M inhibits viral replication inducing viral mutagenesis in RdRp, causing viral error catastrophe and viral extinction. IV affects viral cell entry, nuclear transport and inhibits replication via RdRp. IV has additional effect to suppress cytokine production through STAT-3 inhibition. M is a more potent antiviral drug and IV has a longer residence in the body. Their effects on RdRp and cytokine inhibition are potentially complimentary for anti-COVID-19 activity. Both IV and M should be compared in randomized controlled clinical trials, and the possibility of their combination for anti-SARS-CoV-2 antiviral actions, explored further.

SALI BERISHA Universally known as a leading researcher in the field of cardiology, Sali conducted a research program on hemodynamics, focusing on the dynamics of blood flow, that is why his scientific papers were adopted by universities throughout Europe. A clever polyglot (Albanian, English, German, Russian, French, Italian), he deepened heart transplants and their efficacy on patients' lives and lectured in different academic contexts, too. Opening new horizons in the scientific fields by means of research, e. g. experiencing new surgical techniques, and improving the Health System became the key goals of his medical career.

Heart Rate variability (HRV) is the method to capture the electrical signals of the heart and analyze the beat-to-beat timing of the heart. The capability of HRV to derive the behavior of the Central Nervous system (CNS) can be a useful feature to get consensus in clinical practice. In this study, we have conducted random trials on positive and control subjects (n=97) for validating the effect of HRV on the autonomic nervous system (ANS) and Vagus Imbalance. Spandan ECG portable Device is used for the recording of the 5-minute Lead II HRV test. The computer Interpreted diagnosis of the HRV test is then validated with the clinical diagnosis of HRV and lead II trace study. The validation is done by evaluating the validation parameters of Specificity, Sensitivity, Negative predictive value, and Positive Predictive Value.

Introduction: Qur'anic verses recitations to ill patients are practiced by many Muslims as a form of healing and worship. The effectiveness has been observed in many medical institutions; however, it has never been objectively measured and documented. This pilot study was conducted to construct a methodological approach to evaluate the therapeutic effects of Yasiin recitation on the haemodynamics of critically ill patients. Methods: Ventilated Muslim patients in coronary care unit of a teaching hospital were evaluated. Yasiin was recited twice; by one of the researchers and then by the patients' relatives. Mean arterial blood pressure, pulse rate, oxygen saturation level and electrocardiographic changes, were observed. The difference of the parameters before and during recitation was analysed. Results: Five patients fulfilling the selection criteria were selected; two acute myocardial infarctions, two congestive cardiac failures, and a third-degree atrioventricular block. Based on a non-parametric two-related-sample test, the haemodynamic parameters were not significantly affected by Yaasiin recitation. At the end of the study, two of the patients passed away, one patient was extubated and survived. Two patients were still on ventilators when the study had been completed. Limitations in the study were observed and highlighted in explaining the equivocal results. Conclusions: The effect of Yasiin recitation on heamodynamics of patients was not proven in this study. Further refinements might be needed based upon the observation on limitations encountered. It is hoped that this humble effort would pave the way for further studies to explore this field.

ABSTRAK Latar Belakang: Sindrom koroner akut (SKA) adalah penyakit kardiovaskular yang sering menyebabkan mortalitas. Laporan Kasus: Laki-laki 51 tahun dengan keluhan nyeri ulu hati, mual, dan keringat dingin sejak 1 jam sebelumnya. Didapatkan hipotensi dan bradikardi. Gambaran EKG berupa sinus bradikardi dan elevasi segmen ST di lead II, III, aVF. Simpulan: Kondisi bradikardi dan hipotensi sering menyertai kasus SKA, terutama pada kondisi infark inferoposterior dan ventrikel kanan. Kondisi ini akibat oklusi RCA, meningkatnya tonus vagal, berkurangnya kekuatan pompa ventrikel kanan, dan hipovolemi. Kata kunci: Bradikardi, hipotensi, sindrom koroner akut ABSTRACT Background: Acute coronary syndrome (ACS) is the common cause of mortality of cardiovascular disease. Case report: A 51 year-old male with heartburn, nausea, cold sweat since 1 hour ago. Examination revealed hypotension and bradycardia. The ECG showed sinus bradycardia and ST segment elevation in leads II, III, aVF. Conclusion: Bradycardia and hypotension often accompany acute coronary syndrome, especially in inferoposterior and right ventricular infarction. These conditions are caused by RCA occlusion, increased vagal tone, reduced right ventricular pump, and hypovolemia. Bagus Fitriadi Kurnia Putra. STEMI Inferior with Bradycardia and Hypotension: case report

Acute coronary syndrome (ACS) is a significant cause of morbidity and mortality worldwide. Patients can be stratified by symptoms, risk factors and electrocardiogram results but cardiac biomarkers also have a prime role both diagnostically and prognostically. The proper diagnosis of ACS requires reliable and accurate biomarker assays to detect evidence of myocardial necrosis. Currently, troponin is the gold standard biomarker for myocardial injury and is used commonly in conjunction with creatine kinase-MB (CK-MB) and myoglobin to enable a more rapid diagnosis of ACS. Other markers of myocardial necrosis, inflammation and neurohormonal activity have also been shown to have either diagnostic or prognostic utility, but none have been shown to be superior to troponin. The measurement of multiple biomarkers and the use of point of care markers may accelerate current diagnostic protocols for the assessment of such patients.

NStemi merupakan penyakit kekritisan yang membutuhkan penanganan segera. Oleh karena itu diperlukan sebuah panduan (guidance) yang mempunyai bukti klinik dalam penanganan penyakit ini.

Berikut merupakan pembahasan tentang beberapa guideline yang diterapkan di Indonesia dan yang terbaru di dunia pengobatan internasional. Kami menganaisa dua guideline Nstemi dari ESC dan AHA serta membandingkan dengan guideline yang terdapat dan diterapkan di Indonesia

It’s a glad welcome to all the Doctors, Nurses Researchers, Academicians, scientific delegates, cardiologist, Neurologist, young scientists and scholars from Cardiology and Neurology field to appear at our organization and join us for this great understanding leaning assemble. Our 2nd International conference on Neurology  and Cardiology Conference 2018  features prepared educational and training sessions that discuss new experiment data, discover evidence-based research, and reveal the nearly up-to-date techniques that can be instantly practical to clinical and academic practices. This Neurology  and Cardiology event consists of three value-packed days with keynote speakers, presentations, workshops, symposia, poster sessions, and discussions with thought leaders in Neurology and Cardiology field.



2nd International Conference on Neurology  and Cardiology September 28-30, 2018 Osaka, Japan make possible to more alert talk than at a common Cardiology Conferences or Neurology Conferences. With over large pool of attendees, Congregate and attract your matter requiring resolution or discussion to the top notch speakers in the field of Neurology  and Cardiology at this Unique 2nd International Conference on Neurology  and Cardiology 2018  September 28-30, 2018 Osaka, Japan.


Don’t miss this highly-anticipated Neurology  and Cardiology Conference 2018!

Vasquez A. Review of JAMA Cardiology’s 2018 “Associations of Omega-3 Fatty Acid Supplement Use with Cardiovascular Disease Risks”. Video presentation (http://www.ichnfm.org/jama2018n3) and official transcript (https://www.academia.edu/35935996) 2018 February.

Purpose: Status epilepticus has been increasingly associated with cardiac injury in both clinical and animal studies. Our group has previously shown that excitotoxic seizure induction results in the formation of ischaemic myocardial infarcts and loss of cardiac haemodynamic function. We hypothesised that attenuation of cardiac sympathetic/parasympathetic balance with a central presynaptic a 2 agonist, clonidine, can reduce the development of interictal ECG and ventricular morphological changes resulting from kainic acid (KA; 10 mg/kg) induced status epilepticus in a conscious rat model. Methods: Using simultaneous ECG and electrocorticogram (ECoG) radiotelemetry, animals were randomised into saline controls, saline-pretreated KA and clonidine (100 mg/kg, b.i.d.)-pretreated KA groups. Baseline ECG, ECoG and behavioural score recordings were acquired in conscious animals for 2 h post-KA administration. Results: Bradycardia and low level seizure activity occurred immediately following KA administration. As seizure activity (ECoG spiking and high level seizure behavioural scoring) progressively increased, tachycardia developed. Both QTc prolongation and T wave amplitude were transiently but significantly increased. Clonidine treatment attenuated seizure activity, increased the latency to onset of seizure behaviour and reduced seizure-induced changes in heart rate, QTc interval, and T wave amplitude. Histological examination of the ventricular myocardium revealed hypercontraction band necrosis, inflammatory cell infiltration, and oedema at 48 h post-KA. In contrast, clonidine-treatment in seizure animals preserved tissue integrity and structure. Conclusion: These results demonstrate that KA-induced seizures are associated with altered ECG activity and cardiac structural pathology. We suggest that pharmacological modulation of sympathetic/ parasympathetic activity in status epilepticus provides a promising therapeutic approach to reduce seizure-induced cardiomyopathy.

Defekti Gerbode eshte nje forme e rralle e defektit septal ventrikular, i cili  konsiston ne  nje komunikim midis ventrikulit te majte dhe atriumit te djathte. Ai është zakonisht kongenital, por mund te  prezantohet edhe si pasojë e Infarktit të Miokardit, traumave të kraharorit, ose si komplikacion i fituar pas ndërhyrjejeve të mëparshme kardio-kirurgjikale. Me rralle, ndodh edhe ne terren te Endokarditit Bakterial si pasoje e shkaterrimit te strukturave kardiake ne kushtet e nje infeksioni akut apo subakut. Kjo është anatomikisht e mundur sepse valvula normale trikuspidale gjendet e zhvendosur në raport me atë mitrale.
Ne do te paraqesim një rast të pacientit tonë me këtë komplikacion të pazakontë të endokarditit që simulonte nje hipertensioni pulmonar te rende. Ne dijenine tone, raste te tilla te Defektit Gerbode te fituar ne kushtet e nje  Endokarditi Bakterial jane shume te rralla, dhe ky eshte rasti i pare i botuar ne gjithe eksperiencen shqiptare.

Fjalë kyçe: defekti Gerbode; ekokardiografi torakale; endokarditi infektiv; atrium i djathte; hipertensioni arterial pulmonar

The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports and case series of the early 20th century which identified infectious, nutritional and idiopathic causes as the most common. With increasing urbanization, changes in lifestyle habits, and ageing of the population, the spectrum of causes of HF has also expanded resulting in a significant burden of both communicable and non-communicable etiologies. Heart failure in sub-Saharan Africa is notable for the range of etiologies that concurrently exist as well as the healthcare environment marked by limited resources, weak national healthcare systems and a paucity of national level data on disease trends. With the recent publication of the first and largest multinational prospective registry of acute heart failure in sub-Saharan Africa, it is timely to review the state of knowledge to date and describe the myriad forms of heart failure in the region. This review discusses several forms of heart failure that are common in sub-Saharan Africa (e.g., rheumatic heart disease, hypertensive heart disease, pericardial disease, various dilated cardiomyopathies, HIV cardiomyopathy, hypertrophic cardiomyopathy, endomyocardial fibrosis, ischemic heart disease, cor pulmonale) and presents each form with regard to epidemiology, natural history, clinical characteristics, diagnostic considerations and therapies. Areas and approaches to fill the remaining gaps in knowledge are also offered herein highlighting the need for research that is driven by regional disease burden and needs.

The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports and case series of the early 20 th century which identified infectious, nutritional and idiopathic causes as the most common. With increasing urbanization, changes in lifestyle habits, and ageing of the population, the spectrum of causes of HF has also expanded resulting in a significant burden of both communicable and non-communicable etiologies. Heart failure in sub-Saharan Africa is notable for the range of etiologies that concurrently exist as well as the healthcare environment marked by limited resources, weak national healthcare systems and a paucity of national level data on disease trends. With the recent publication of the first and largest multinational prospective registry of acute heart failure in sub-Saharan Africa, it is timely to review the state of knowledge to date and describe the myriad forms of heart failure in the region. This review discusses several forms of heart failure that are common in sub-Saharan Africa (e.g., rheumatic heart disease, hypertensive heart disease, pericardial disease, various dilated cardiomyopathies, HIV cardiomyopathy, hypertrophic cardiomyopathy, endomyocardial fibrosis, ischemic heart disease, cor pulmonale) and presents each form with regard to epidemiology, natural history, clinical characteristics, diagnostic considerations and therapies. Areas and approaches to fill the remaining gaps in knowledge are also offered herein highlighting the need for research that is driven by regional disease burden and needs.

Statins lower serum cholesterol and are employed for primary and secondary
prevention of cardiovascular events. Clinical evidence from observational studies, retrospective
data, and post hoc analyses of data from large statin trials in various cardiovascular conditions,
as well as small scale randomized trials, suggest survival and other outcome benefits for heart
failure. Two recent large randomized controlled trials, however, appear to suggest statins do not
have beneficial effects in heart failure. In addition to lowering cholesterol, statins are believed
to have many pleotropic effects which could possibly influence the pathophysiology of heart
failure. Following the two large trials, evidence from recent studies appears to support the
use of statins in heart failure. This review discusses the role of statins in the pathophysiology
of heart failure, current evidence for statin use in heart failure, and suggests directions for
future research.

The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports and case series of the early 20 th century which identified infectious, nutritional and idiopathic causes as the most common. With increasing urbanization, changes in lifestyle habits, and ageing of the population, the spectrum of causes of HF has also expanded resulting in a significant burden of both communicable and non-communicable etiologies. Heart failure in sub-Saharan Africa is notable for the range of etiologies that concurrently exist as well as the healthcare environment marked by limited resources, weak national healthcare systems and a paucity of national level data on disease trends. With the recent publication of the first and largest multinational prospective registry of acute heart failure in sub-Saharan Africa, it is timely to review the state of knowledge to date and describe the myriad forms of heart failure in the region. This review discusses several forms of heart failure that are common in sub-Saharan Africa (e.g., rheumatic heart disease, hypertensive heart disease, pericardial disease, various dilated cardiomyopathies, HIV cardiomyopathy, hypertrophic cardiomyopathy, endomyocardial fibrosis, ischemic heart disease, cor pulmonale) and presents each form with regard to epidemiology, natural history, clinical characteristics, diagnostic considerations and therapies. Areas and approaches to fill the remaining gaps in knowledge are also offered herein highlighting the need for research that is driven by regional disease burden and needs.

Recent advances in basic cardiovascular research as well as their translation into the clinical situation were the focus at the last ''New Frontiers in Cardiovascular Research meeting''. Major topics included the characterization of new targets and procedures in cardioprotection, deciphering new players and inflamma-tory mechanisms in ischemic heart disease as well as uncovering microRNAs and other biomarkers as versatile and possibly causal factors in cardiovascular pathogenesis. Although a number of pathological situations such as

Objective: To determine the frequency of hypertension and proportion of patients achieving good control of blood pressure (BP) and to examine the relationship of BP control with different variables in type 2 diabetes.
Methodology: This prospective observational study was onducted at Department of Medicine, 1 Mountain Medical Battalion (Bagh, Azad Kashmir) from April to December 2013. This study was done on diabetic patients. History of previously diagnosed hypertension/ use of any antihypertensive medicines was obtained. BP was measured twice in an upright position and the mean calculated; values <140/90 mmHg reflected good control. Data analysis was carried out with STATA version 12.
Results: Out of 178 patients, 72 (40.45%) had hypertension which was more common in females than males (48.51% vs. 29.87%; p=0.012). A single antihypertensive was used in 37 and two drugs in 35 patients but BP was at goal in only 33 (45.83%) patients. Plasma glucose fasting was ≤7.0mmol/l in 46 (25.84%) patients. HbA1c was <7% in 14 (20.29%) out of 69 patients. Amongst the two groups with good and poor control of BP, there was no difference in proportions of elderly (p=0.705), males (p=0.212), more educated patients (p=0.316) or smokers (p=0.868). Proportions of patients with diabetes or hypertension of more than 5 years duration were also similar as were fractions of patients with increased BMI (p=0.339)or waist circumference (p=0.077), elevated fasting plasma glucose (p=0.488) or HbA1c (p=0.509).
Conclusion: Hypertension is frequently encountered in diabetics. A more aggressive treatment approach is required to achieve a better control of blood pressure.

Cardiovascular diseases (CVDs) account for high morbidity and mortality worldwide. Both, genetic and epigenetic factors are involved in the enumeration of various cardiovascular diseases. In recent years, a vast amount of multi-omics data are accumulated in the field of cardiovascular research, yet the understanding of key mechanistic aspects of CVDs remain uncovered. Hence, a comprehensive online resource tool is required to comprehend previous research findings and to draw novel methodology for understanding disease pathophysiology. Here, we have developed a literature-based database, CardioGenBase, collecting gene-disease association from Pubmed and MEDLINE. The database covers major cardiovascular diseases such as cerebrovascular disease, coronary artery disease (CAD), hypertensive heart disease, inflammatory heart disease, ischemic heart disease and rheumatic heart disease. It contains~1,500 cardiovascular disease genes from 2,4000 research articles. For each gene, literature evidence, ontology, pathways, single nucleotide polymorphism, protein-protein interaction network, normal gene expression, protein expressions in various body fluids and tissues are provided. In addition, tools like genedisease association finder and gene expression finder are made available for the users with figures, tables, maps and venn diagram to fit their needs. To our knowledge, CardioGen-Base is the only database to provide gene-disease association for above mentioned major cardiovascular diseases in a single portal. CardioGenBase is a vital online resource to support genome-wide analysis, genetic, epigenetic and pharmacological studies.

SummaryThe increased atherothrombotic risk in patients with metabolic syndrome (MetS) has been classically explained by the multiplicative effect of systemic concomitant pro-atherosclerotic factors. In particular, centripetal obesity, dyslipidaemia, glucose intolerance, hypertension (differently combined in the diagnosis of the disease) would be expected to act as classical cardiovascular risk conditions underlying accelerated atherogenesis. In order to better understand specific atherosclerotic pathophysiology in MetS, emerging evidence focused on the alterations in different organs that could serve as both pathophysiological targets and active players in the disease. Abnormalities in adipose tissue, heart and arteries have been widely investigated in a variety of basic research and clinical studies in MetS. In this narrative review, we focus on pathophysiological activities of the liver and kidney. Considering its key role in metabolism and production of soluble inflammatory media...

Citation: Breijo-Marquez FR. How you should comment on a mistake with a comrade. Must it always be troublesome?. Madridge J Inter Emerg Med. 2018; 2(1): 51-53. Document This possibility, far from being unusual, can be quite frequent. Sometimes and depending on the type of hospital, it can be very widespread. It is a difficult task when it comes to deciding what to do with the comrade. On the one hand, our ethical sense obliges us to give him a comment on the mistake. On the other hand, we don't want to hurt the professional esteem of the comrade in question.

"Background. Treatment of hyperlipidemia is helpful in both primary and secondary prevention of coronary heart disease and stroke. Aim. To compare lipid-lowering efficacy of rosuvastatin with atorvastatin. Methodology. This open-label randomized controlled trial was carried out at 1 Mountain Medical Battalion from September 2012 to August 2013 on patients with type 2 diabetes, hypertension, myocardial infarction, or stroke, meriting treatment with a statin. Those with secondary causes of dyslipidemia were excluded. Blood samples for estimation of serum total cholesterol, triglycerides, HDL-C, and LDL-C were collected after a 12-hour fast. Patients were randomly allocated to receive either atorvastatin 10 mg HS or rosuvastatin 5 mg HS daily. Lipid levels were rechecked after six weeks. Results. Atorvastatin was used in 63 patients and rosuvastatin in 66. There was a greater absolute and percent reduction in serum LDL-C levels with rosuvastatin as compared to atorvastatin (0.96 versus 0.54 mg/dL; P= 0.011and 24.34 versus 13.66%;P = 0.045), whereas reduction in all other fractions was equal. Myalgias were seen in 5 (7.94%) patients treated with atorvastatin and 8 (12.12%) patients treated with rosuvastatin (P: 0.432). Conclusion. Rosuvastatin produces a greater reduction in serum LDL-C levels and should therefore be preferred over atorvastatin."

"Background: With ever-changing lifestyles in the developing countries prevalence of coronary heart disease is on the increase. This study was conducted to determine differences in frequencies of different risk factors between hypertensive male and female patients.
Material & Methods:  This cross-sectional study enrolled hypertensive patients of either gender older than 30 years. Unwilling patients, those on lipid lowering drugs, those with secondary hypertension and patients not yet started on antihypertensive drugs were excluded. Different risk factors assessed included diabetes, physical inactivity, alcohol consumption, family history of premature coronary heart disease in first degree relatives and smoking. BMI was also calculated. Plasma glucose fasting, serum total cholesterol, serum triglycerides, spot urinary albumin creatinine ratio were measured. Ultrasound abdomen was done to look for non-alcoholic fatty liver disease. Findings were compared between the two genders and odds ratios were calculated for different risk factors.
Results:  There were 220 patients including 126(57.27%) males and 94(42.73%) females. Predisposing age (96.03% vs 82.98%), smoking (59.52% vs 2.13%) and past history of stroke (7.14% vs 1.06%) were more common in males, whereas obesity (26.98% vs 48.94%), physical inactivity (41.27% vs 70.21%) and non-alcoholic fatty liver disease (9.52% vs 27.66%) in females. There was no difference in frequencies of family history (7.94% vs 12.77%), diabetes (20.63% vs 22.34%), hypertriglyceridemia (54.76% vs 60.64%) and microalbuminuria (6.35% vs 2.13%).
Conclusion:  Smoking is more common in males whereas physical inactivity, obesity and non-alcoholic fatty liver disease are more common in hypertensive females. Risk factor reduction should therefore take gender of the patient into consideration."

The pointed feature of the traditional Iranian medicinal system, Ayurveda, is its emphasis on the maintenance of positive health effects of them. As per Ayurveda, Iranian medicinal plants are rich sources of substances that have several therapeutic features including cardio-protection. Globally, cardiovascular disorders are a leading cause of mortality. This review deals with some medicinal plants which possess cardio tonic, cardio protective and antioxidant or positive effects on heart such

The morbidity and mortality caused by the dilated cardiomyopathy arise from fatal complications like ventricular tachy and bradyarrhythmias and congestive cardiac failure. A 36 year's old male residing at Navi Mumbai was admitted with the chief complaints of breathlessness on exertion since last 4 months, swelling over the body with distension of abdomen since last 3 months. There is no history of chest pain, syncope, and weight / appetite loss, Hypertension (HT), Ischemic Heart Disease (IHD), Valvular Heart Disease (VHD), Tuberculosis (TB) or any drugs in the past. On examination it was found that 2 D Echo-Dilated LA, LV, RA, RV; Mild MR,TR; LVEF <25%, normal blood reports, chest X-ray shows a marked cardiomegaly, ECG-Sinus tachycardia, LBBB, intra-ventricular conduction defects, poor progression of r waves. Other investigation shows TB PCR, Thyroid profile, Anemia profile, RFT and Urine (r/m) has not been detected any abnormality. USG (abdomen) detected minimal ascites with hepatomegaly. A liver enzyme, cardiac enzymes and serum potassium shows marginal elevation.

Background: The effects of electromagnetic fields (EMFs) on cardiovascular calcification is unknown. We sought to evaluate the effects of EMF on vascular calcification in normal rats and in rats with chronic kidney disease (CKD)-a condition which promotes calcification. Methods: We used four groups of rats: group 1-exposed to EMF, group 2-not exposed to EMF, group 3-rats with CKD exposed to EMF, group 4-rats with CKD not exposed to EMF. In order to induce CKD, groups 3 and 4 rats were fed with a uremia-inducing diet. Groups 1 and 3 rats were continuously exposed to EMF using a system similar to an electrical transformer, which consists of a primary coil, a ferrite ring, and a secondary coil. The system transmitter emitted a series of exponentially decaying electromagnetic sine waves (continuous exposure with pulsed peaks) in randomly selected frequencies between 150 and 155 kHz, with random exposure intensities between 4 and 7 mG. Clinical investigations included multislice computed tomography of the aortic roots. Pathological examinations of the aortas included histological characterization, and antigen expression analyses. Results: No calcification was found in either group of rats with normal kidney function. Aortic root cal-cification was significantly higher in rats exposed to EMF (group 3) compared with group 4 rats-with a mean Agatston score of 138±25 vs. 80±20 respectively (p < 0.05). Pathological examination showed massive aortic calcification in group 3 rats. The calcification pattern was unique as it formed circular rings along the length of the aortic media. Although increased calcification was noticed in group 3 rats, antigen expression of osteoblast markers was significantly decreased in group 3 compared with group 4. Conclusions: EMF exposure may have potential harmful effects on the cardiovascular system, as it promotes severe vascular calcification in CKD miliue.

Introduction: This study describes the relationship between Body Mass Index (BMI) and the cardiac geometry and heart function assessed by transthoracic echocardiography.
Materials and methods: We analyzed 5,898 echocardiographic studies in an age range between 18.0 and 98.6 years.
Results: The BMI ranged from 15.23 to 49.61 kg/m2. The increased BMI had a statistically significant direct association with left ventricular mass initially observing a light concentric hypertrophy, which becomes eccentric as it increases, especially when allometric ratio is normalized (Height2.7). An increase in ejection volume and cardiac output was observed, as well as an inverse association between body mass index and
the E/A ratio of mitral filling, with a significant reduction of e’ velocity of tissue Doppler, showing a relaxation-type diastolic dysfunction in overweight or obese individuals. We observed a slight yet significant increase in the left atrial area and volume indexed to body mass. There were no differences in the right ventricular geometry and function.
Conclusions: The present study demonstrated a significant direct association between the increase in BMI and LV myocardial mass. Indexing LV mass to height 2.7 avoids artifacts related to body mass index, especially in subjects with grade II and III obesity.

Aim: Diuretics are a cornerstone in treatment of heart failure (HF). Torasemide is a loop diuretic with a potential advantage over other diuretics. We aim to meta-analyse and compare the effect of torasemide with furosemide in HF patients. Methods: A comprehensive literature search using 12 databases including PubMed, Scopus, and Web of Science was performed. All randomized controlled trials (RCTs) comparing furosemide and torasemide in HF patients were included and meta-analysed. We assessed the risk of bias using Cochrane Collaboration's tool. The protocol was registered in PROSPERO (CRD42016046112).

The objective was to relate the response of the HSP70 and P53 genes to the cessation and the recovery of cardiac muscle cell functions when submitted to ischemia-reperfusion. We have measured the electromechanical activity, the released enzymes and HSP70 RNA and protein levels in cultured neonatal rat cardiomyocytes (CM) in a substrate-free, hypoxia-reoxygenation model of ischemia-reperfusion. In parallel the expression of the two genes P53 (the key apoptosis regulator gene) and P21/Waf1 (the P53 target gene) has been evaluated. The functional recovery during post-'ischemic' reoxygenation was associated with an overexpression of HSP70 and P53 lasting until the functional parameters reverted back to the normal, prehypoxic values. In contrast, extending the substrate-free hypoxic treatment worsens the dysfunction of the cardiac muscle cell and, in these conditions, reoxygenation failed to restore cell functions and to activate HSP70. Finally, in the conditions of reversible 'ischemic' cell injury, an early and transitory activation of P53 was associated with the functional recovering process of the CM submitted to simulated ischemia. These observations are suggestive of a contributive role of both HSP70 and P53 to a cytoprotective program activated by reoxygenation in post-'ischemic' CM.

Background: Noncommunicable diseases are the leading cause of death in the world and low and middle-income countries suffer from preventable premature death. The aim of this study was to assess the risk factors for non- communicable disease (NCDs) in general and particular cardiovascular diseases (CVDs) among the outpatients of our department of medicine. Methods: We performed a cross-sectional study from April to December 2017 by the consecutive enrollment of outpatients who attended in our department of medicine of Hopital Somine DOLO de Mopti, Mali. Clinical and laboratory data were measured for cardiovascular risk assessment. Framingham Risk Score (FRS) and Systemic Coronary Risk Estimation (SCORES) were computed by using Framingham and SCORE equations. Metabolic syndrome was defined using the harmonized criteria from the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). Data were captured in excel and analyzed with R version 4.0.3. The statistical significance was set at p = 0.05. Results: A total of 292 patients were enrolled in this study. The prevalence of traditional cardiovascular risk factors was 36.64%, 21.57%, 14.04%, and 13.01% for high blood pressure, hyperglycemia, smoking, and alcohol consumption, respectively. The metabolic syndrome accounted for 23.63%. The mean body mass index was 26.10 ± 7 kg/m2. The overall 10-year risk for cardiovascular events or death was 26.3% and 8.6% according to the FRS and SCORE equation, respectively. The 10-year risk of cardiovascular events according to the FRS was significantly higher in subjects aged 50 and above compared to subjects aged under 50 years, 34.46% vs 13.16%, p &lt; 0.001. Likewise, the 10-year risk for cardiovascular death according to SCORE equation was also significantly higher in subjects aged 50 and above compared to subjects under 50 years, 9.43% vs 2.09%, p = 0.02. Regarding gender, the FRS was significantly higher in men compared to women 49.50% vs 7.84%, p &lt; 0.001. This same trend was observed with the SCORE, 14.67% vs 4.13%, p = 0.03. Conclusion: Our data corroborate the increasing prevalence of cardiovascular risk factors in SSA. A comprehensive cardiovascular risk factors assessment should be implemented in all stages of health facilities and a longitudinal follow-up could help shed a light on the epidemiology of NCDs in general and particularly CVDs and thereby improve their control policies in SSA.

According to the World Health Organization, health has been
defined as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” [1]. Health
websites are an internet-based source providing information
regarding all aspects of medicine. In recent years, with increasing
numbers of people using the Internet, health websites have gained
tremendous popularity. An article published in 2009 says, 51%
of adults in the ages of 18-64 in the US had used the Internet to
look up health information [2]. An article published in the Health
Informatics Journal that compared the use of information on
the internet during 2000 and 2006 states that there has been a
dramatic and significant increase in the number of people using
using the internet for information regarding their health by 39%
[3] According to an article, “more than 70,000 websites disseminate
health information” with over “50 million people seeking health
information online”

Background: Myocarditis of viral origin can be frequently missed due to its various manifestations and possible false negative results after a classical fluoroscopyguided endomyocardial biopsy. The 3D-electroanatomic mapping (3D-EAM)-guided endomyocardial biopsy reduces the false negative results by targeting the tissue areas with abnormal electrical voltage while also reducing the radiation exposure for patients and operators. Results: we report on two clinical cases of acute/subacute myocarditis with a first arrhythmic presentation, in which the endomyocardial biopsy guided by 3D-EAM system was fundamental in achieving the diagnosis and guiding the optimal medical therapy. As far as we know these are the two first published cases that show a documented link between Erythroparvovirus and sustained ventricular tachycardia and which moreover show the use of a developing technology such as 3DEAM-guided myocardial biopsy. Conclusion: 3D-EAM-guided endomyocardial biopsy is promising not only in reducing radiation exposure for patients and operators during such procedures, but also in identifying the tissue areas that must be targeted in order to reduce the false negatives. We also demonstrated how the first manifestation of a myocarditis due to Erythroparvovirus can be a ventricular arrhythmia.

Major Diagnostic Criteria Positive blood culture for typical infective endocarditis organisms (S. viridans or S. bovis, HACEK organisms, S. aureus without other primary site, Enterococcus), from 2 separate blood cultures or 2 positive cultures from samples drawn >12 hours apart. Echocardiogram with oscillating intracardiac mass on valve or supporting structures or new partial dehiscence of prosthetic valve or new valvular regurgitation. Minor Diagnostic Criteria Predisposing heart condition or intravenous drug use.