|The Role of Cardiology in Search of a Paradigm of Psychiatry
Abstract: The paper proposes a new integrated approach to the search for a paradigm of psychiatry, is based on a
thorough study of entropy neuron-glial networks of the brain using a unique research method, the variance of the
amplitude-frequency characteristics of the alpha rhythm of the EEG, which merged to form a new unit with modern
methods of monitoring cardiovascular activity of heart rate variability and dispersion parameters of ECG.
|The Characteristics of Chronic Heart Failure in Rheumatoid Arthritis
||Harutyun S. Hovhannisyan
Abstract: In recent times there is an emerging evidence about the increased risk of cardiovascular disease (CVD) and
rheumatic conditions. This review has been focused on the multiple relationships between rheumatoid arthritis (RA) and
heart failure (HF) features.
Cardiovascular (CV) system involvement is an extra-articular complication of RA and is a major cause of morbidity and
mortality. All heart structures may be affected in RA and different clinical manifestations may be seen.
HF is a complex clinical syndrome which represents universal end-stage of nearly every form of heart disease and has a
poor prognosis. Patients with RA have almost 2-fold higher risk of HF development than non RA-subjects and this high
risk is not explained entirely by traditional CV risk factors. RA patients with HF appear to have a more subtle
presentation of HF, compared to HF patients without RA, while mortality from HF is significantly higher. In RA HF mostly
is manifested by diastolic dysfunction (DD) which is revealed by echocardiography. In general, brain natriuretic peptide
(BNP) is an important clinical and prognostic marker of HF, but there are no final data concerning its screening value in
Nevertheless, up to date HF is still being poorly revealed in most RA-patients, especially on early stages of the disease,
which leads to HF treatment delay, thus contributing to mortality.
These findings emphasize the role and need of further larger studies in this field, which will bring to early identification
and treatment of RA-subjects with HF and a decrease in mortality rates.
|Statins and Malignancies in Cardiovascular Practice
||Wilhelm P. Mistiaen
Abstract: Statins have a proven efficacy in lowering of plasma cholesterol and reduction of atherosclerotic
cardiovascular disease. They also have anti-inflammatory, pro-apoptotic and anti-angiogenic effects which can be
derived from their biochemical activity. The cell cycle could also be arrested at several stages. However, an early
concern was the possibility of increase in malignancy. The first reports were conflicting.
A search in Web of Science has been made with the terms “statins AND malignancy”, from 2012 to 2017.
Twenty of 119 manuscripts were considered as useful. Manuscripts dealing with in-vitro and animal experiments were
excluded, as well as reviews and manuscripts not related to the topic. There was a variety of malignancies under
scrutiny. Most series showed a favorable result on either reduction of incidence in malignancy or, if a malignancy was
diagnosed and improvement in overall or cancer specific survival. Reduction in symptoms and improvement in
inflammatory response after adjuvant chemo and radiotherapy were documented in a few reports.
Elimination of bias has been attempted by taking into account confounding factors or by using a propensity analysis or a
multivariate regression. Interpreting these results is difficult due to the differences in study designs. This precluded a
meta-analysis. The disentangling of the effect of statins on malignancy, plasma cholesterol and changes of this level in
these patients requires a large multicenter prospective trial which might encounter ethical and logistical difficulties.
|Dyslipidemia in Metabolic Syndrome: an Overview of Lipoprotein- Related Disorders
||S. Asha Devi
Abstract: The significance of plasma levels of total cholesterol (TC), triglycerides (TG) and each lipoprotein class
namely chylomicrons, low density lipoproteins (LDL), very low density lipoproteins (VLDL), and high density lipoproteins
(HDL) has been tested time and again for their reliability as diagnostic markers of dyslipidemia. The prevalence of
dyslipidemia-related metabolic syndrome is associated with the risk of cardiovascular disease (CVD) and diabetes. This
review will focus on the characteristics of major classes of lipoproteins (LPs) and their coexistence with TG and
apolipoprotein as estimates of the intensity of metabolic syndrome. It will deal with the suitability of animal models for
dyslipidemic studies that match with clinical conditions of diabetes, atherosclerosis and obesity. It also sums up
published research and clinical case studies in support of the conceptual paradigm shift from the use of simple lipids to
oxidized LDL (OxLDL) and apolipoproteins as diagnostic markers of dyslipidemia. Further, it briefly discusses the use of
non-pharmacological approach such as exercise and diet as an effective means of management of dyslipidemia in
human as well as subhuman species. Finally, it presents evidence for treatment of dyslipidemia with specific targets, LP
and TG as the appropriate therapy only when non-pharamacological means fail to accomplish the standard lipid profile.
|Hibernation of Myocardium in the Case of Neuroleptic Cardiomyopathy: A Statistical Analysis
Abstract: Aim: The purpose of the present study is to summarize and interpret the data, which has been received
earlier, in order to prove the development of the hibernation of myocardium (HM) in cases of the neuroleptic
Methods: Morphometric methods of research were used which meets modern requirements of the evidence based
medicine. The studied micromorphometric parameters describe the condition of three structural components of
myocardium (vasculature, intercellular matrix, and parenchyma). Such parameters as zone of pericapillary diffusion
(ZPD), Kernogan index (KI), Stromal-parenchymatous ratio (SPR), rate of interstitial edema (RIE) were calculated.
Karyometry and cytometry of cardiomyocytes (CMCs) were performed, the specific volumes of hypertrophied CMCs
(SVHC), of atrophied CMCs (SVAC) and – by the method of polarization microscopy – the specific volume of dystrophic
CMCs (SDVC) were determined.
Results: In the absence of NCMP, the changes, which have an acute character, develop in the case of sudden cardiac
death (SCD) and malignant neuroleptic syndrome (NMS) and reflect the statistically significant (p<0.05) shifts of the
respective quantitative parameters. When NCMP is present, the only parameter, which is significantly changed in
connection with SCD and NMS, is SVDC (p<0.05).
Conclusion: NCMP causes irreversible damages in myocardium, it leads to its insensitivity, practically almost fully
prevents it from reacting to any influences, particularly in the presence of SCD and/or development of NMS. The
morphofunctional state of cardiac muscle in the case of NCMP is an independent proof of state of hibernation of
myocardium which appears during the process of morphogenesis of NCMP.
|Cardiac Development and Expression of Some Transcription Factors
||María Luz Gunturiz
Abstract: Cardiac embryogenesis is the result of multiple, highly dynamic processes and with a high degree of
heterogeneity in their gene expression that occurs at different stages of myocardial development and in the fully formed
heart. The aim of this review is to illustrate the different patterns of expression of some gene families of transcription
factors which are expressed specifically in the different stages of the heart formation and provide information on the
progress and results of the function and role of the Transcription Factor associated with microphthalmia MITF, obtained
in the doctoral thesis of the author in the National Institute of Health of Colombia. The knowledge of the molecular
mechanisms that control the specific expression of tissue, the regulatory factors and the interactions which allow the
expression directed to a particular tissue compartment, constitutes the basis for clinical applications. Within the families
of genes with specific expression patterns in the heart contractile proteins, ion channels, and transcription factors whose
study will allow to clarify the association between gene deregulation, and the high incidence of cardiovascular disease.
Necessary to mention that this review focused exclusively in the families of transcription factors which are expressed in a
more widespread way during each stages of the cardiac development and by the design targeted initially, it does not
include studies of gene expression at the level of contractile proteins and calcium regulators of the heart metabolism,
that are as important as the above factors of transcription before mentioned. In conclusion transcription factors such as
MITF-H may be involved not only in the pathogenesis of cardiovascular diseases but early stages of cardiac
|Cardiopulmonary Microcirculation and Gas Exchange in Acute Adrenaline-Induced Injury
Abstract: Microcirculatory alterations lead to cell and organ dysfunction. High levels of catecholamines induce
tachycardia, coronary vasospasm, microcirculatory disruption, hypoxia, ventricular fibrillation. Hypercatecholaminemia
increases pulmonary capillary resistance and permeability as well.
Aim of this research is to study adrenaline-induced alterations in myocardial and lung microcirculation, and gas
exchange parameters in rats.
Experiments were performed in male Wistar rats divided into 2 groups: control (n=11), and animals (n=12) treated with
histotoxic-dose adrenaline. Anesthetized animals were exposed to mechanical lung ventilation at a frequency of 40
breaths/min and were sacrified 20 min after adrenaline injection. Paraffin-embedded myocardial and lung tissues were
stained by hematoxylin and eosin. Myocardial and pulmonary microcirculation was studied by Sisakyan and Chilingaryan
methods for revealing intraorganic MCB based on detection of phosphatase enzymes’ activities (acid phosphatase and
Ca2+-ATP-ase, respectively) in the vessel walls. Mean capillary diameter (MCD) was calculated using ocular-micrometer.
Partial pressures of arterial blood O2, CO2 and pH were measured.
Histological studies showed that adrenaline induced contraction band lesions of cardiomyocytes, diffuse pulmonary
infiltrations, hemorrhages. Myocardial and lung microcirculation studies revealed inhomogeneous and less intensive
staining, tortuous course of capillary walls and their destructive changes. Blood gas analysis data indicated hypoxemia
and hypercapnia developing along with acidosis following adrenaline injection.
In conclusion, high-dose adrenaline induces acute myocardial and lung injuries, manifested in inflammatory and
microcirculatory alterations, disorders of pulmonary gas exchange that may aggravate further development of
cardiopulmonary pathology. The data achieved in present study may allow further adjustment of treatment strategies for
stress-induced myocardial injury considering the role of lung microcirculation and gas exchange disorders in the given
|Consumption of Tree Nuts in the Prevention of Coronary Heart and Cardiovascular Disease
Abstract: Emerging research from epidemiologic studies and clinical trials is demonstrating that tree nuts promote
satiety and weight maintenance. Moreover, tree nuts contain a plethora of nutrients, natural phenolic antioxidants, and
other bioactive compounds (e.g., phytosterols), which are now being recognized for bestowing health benefits. As will be
discussed in this review, tree nuts have been linked to improving heart health, lowering low-density lipoprotein
cholesterol levels, and reducing inflammation. The strongest evidence that tree nuts are cardio-protective foodstuffs
comes from epidemiological observations indicating a consistent and well-defined inverse association between the
frequency of nut consumption and development of coronary heart disease, and several short-term clinical trials
demonstrating the beneficial effects of nut intake on lipid profiles as well as other intermediate markers of heart disease.
In this review research findings from the existing literature published within the last 15 years have been compiled and
summarised. Three bases: SCOPUS, Web Science, and PubMed were used for search.
|Specific of Myocardial Perfusion Scintigraphy Compared to Invasive Coronary Angiography
Abstract: Purpose: The NICE guidance has placed non-invasive ischaemia testing as the primary role for assessing
patients with moderate pre test probability for obstructive coronary artery disease. Functional tests like MPI, have led to
a reduced role for invasive coronary angiography (ICA) in initial patient assessment. Aim of our audit was to assess the
specificity of our nuclear service compared with ICA retrospectively. The standard was set at a false positive rate of no
more than 73%.
Methods: A search was conducted (between Aug2012-Feb2013). MPIs were reported by a radiologist and a cardiologist.
A standard 17-segment model was used for MPI interpretation. Coronary angiograms were interpreted for the
absence/presence of epicardial luminal narrowing >50% by referencing the clinical report on the patient electronic
record. The cases which were positive enough to warrant recommendation for ICA the true positive and false positive
rate was determined.
Results: This cross –sectional study included 51 cases.33 had a stenosis in a major coronary artery of>50% giving a true
positive rate of 65%. There were18 false positive studies (35%). 5 cases were regarded as having evidence of transient
ischaemic dilatation (TID), all of which had a subsequent negative angiogram.3 studies had notable artefact due to
patient body habitus, or inability to position the patient optimally. The percentage of myocardium defects was determined
for each case at stress. The average percentage in the true positive studies was 17%, in the false positive studies it
was7%, excluding those regarding as having TID.
Conclusions: MPI studies deemed sufficiently abnormal to justify a coronary angiogram have a moderate likelihood of
predicting a significant stenosis being present on ICA. False positive scans are frequent when only TID and significant
artefacts are present. It is likely that CT calcium scoring with MPI will increase the specifity of this imaging. It will also
allow CT coronary angiography to be used in cases where artefact is present and the calcified atheroma burden is low.
The audit standard was not met. Suggested changes in practice. 1. Greater caution in recommending ICA for cases
where the only evidence for ischaemia is transient ischaemic cardiomyopathy. 2. Increased use of CT to determine
cases where significant reversible ischaemia is present in the context of none or low burden of coronary calcification.
Clinical Relevance/Application: MPI assesses myocardial perfusion by using radiotracers injected under stress/rest
|Effect of Doxorubicin on Cardiac Myocytes: Role of Apoptosis, Autophagy and other Proteolytic Pathways
||Wilhelm P Mistiaen
Abstract: Doxorubicin is a very effective chemotherapeutic agent. However, its use is limited by serious cardiac side
effects, including long-term irreversible cardiac failure which is often fatal. These effects are related to the cumulative
dose but other factors also play a role. Through a systematic search in an electronic database, manuscripts dealing with
this matter were included. Exposure of the heart to doxorubicin s result in three types of stress: 1] genotoxic, 2] energetic
and 3] oxidative stress. These effects are closely related with the dependence of the heart on oxidative phosphorylation,
its low defenses against reactive oxygen species and with the peculiarities of mitochondria, which are abundantly
present in cardiac tissue. In most manuscripts, the cellular effects of doxorubicin are documented by changes in
enzymatic pathways within cardiomyocytes. These pathways have mutual influences, which complicate the interpretation
of results. These pathways often result in proteolysis, cellular damage and apoptotic cell death. Necrosis and autophagy
are also involved as mechanisms. Most of the included manuscripts deal with in-vitro experiments with anti-oxidant
agents, using cardiomyoblasts and H9c2 cell lines as well as in-vivo short-term murine models. However, long-term
animal models are lacking. Clinical articles and experiments with cells other than cardiomyocytes are few. The effects of
doxorubicin on the extracellular matrix also needs further exploration. These areas need further exploration.
|Morphogenesis of a Neuroleptic Cardiomyopathy:A Morphometric Study
Abstract: Aim: A comparative morphometric study of heart condition on various organizational levels (organ, tissue, and
cellular one) in each clinical stage of neuroleptic cardiomyopathy.
Methods and results: Morphometric methods of research were used which meet modern requirements of the evidencebased
medicine. For analysis of data from organometry of heart an own original method was used. For this analysis the
outer volume of heart without atria (V) was determined and two relative parameters (both in percent) were calculated: 1)
Cv - coefficient of volume, this coefficient shows a part of the total volume of heart (without atria), and this part falls on
the volume of cavities of ventricles; and 2) Cl - coefficient of the left ventricle, this coefficient shows the volume size of
the left ventricle with respect to the total volume of both ventricles. In addition, two other parameters were calculated
which use a gravimetric characteristic of the heart (m): mass-volume ratio (MVR) and index of density of myocardium
It was found that on the organ level the process of cardiac remodeling ends during the latent stage of the disease.
Progression of myocardial dysfunction is connected with changes of myocardium microstructure.
The studied micromorphometric parameters describe the condition of three structural components of myocardium
(vasculature, intercellular matrix, and parenchyma). Such parameters as zone of pericapillary diffusion (ZPD), Kernogan
index (KI), SPR, RIE were calculated. Karyometry and cytometry of cardiomyocytes (CMCs) were performed, the specific
volumes of hypertrophied CMCs (SVHC), of atrophied ones (SVAC), and – by the method of polarization microscopy –
the specific volume of dystrophic ones (SVDC) were determined.
In the latent stage the microcirculatory disorders prevail. In the full-scale stage the damages of intercellular matrix come
to the forefront. For the terminal stage the atrophic and dystrophic-degenerative changes of cardiomyocytes are
Conclusion: In the course of morphogenesis of a neuroleptic cardiomyopathy a certain staging of clinical manifestations
of the disease is observed; this staging corresponds to an observed cardiac remodeling on the organ level and to an
observed chain of interconnected pathologic shifts in all microstructures of myocardium.
|Non-Alcoholic Fatty Liver Disease as Risk of Cardiovascular Disease: Myth or Reality?
Abstract: Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver conditions ranging from simple
steatosis to nonalcoholic steatohepatitis (NASH) and advanced hepatic fibrosis. Taking into account that NAFLD shares
many common risk factors with cardiovascular diseases, it is evident that NAFLD may promote to increased
cardiovascular morbidity and mortality.
Cumulative evidence suggests that NAFLD is linked to atherosclerosis, coronary artery disease, obesity, type 2 diabetes,
and also predicts the clustering of risk factors for cardiovascular diseases.
To our opinion, the role of NAFLD in the prediction of cardiovascular risks should be investigated for coronary artery
disease (CAD) prognosis assessment
This review focuses on the pathophysiologic relationships between NAFLD and cardiovascular diseases, subclinical and
clinical cardiovascular manifestations in NAFLD.
|Focus on Pitavastatin
||Angelo Michele Carella
Abstract: Currently, different statins are available for the treatment of dyslipidemia: Atorvastatin, Simvastatin,
Rosuvastatin, Lovastatin, Pravastatin, and Fluvastatin; the newest entry in this class of drugs is Pitavastatin.
The purpose of the present study was to examine the latest evidences on Pitavastatin, more than 10 years after its first
marketing and focuses on the most recent evidence regarding its differences with other available statins. A literature
review of the last 3 years (January 2013 - January 2016) has been carried out via Pub Med. 193 obtained items were
Pitavastatin has been studied against other drugs in its class and has demonstrated high potency in reducing LDLCholesterol
levels and increasing HDL-Cholesterol. Pitavastatin has demonstrated a significant reduction in
atherosclerotic plaque volumes and several pleiotropic effects, which suggest its potential benefits in reducing
At present, Pitavastatin don’t seem to have adverse effects on glucose metabolism; it has no adverse effects on renal
function and currently there is no clinical evidence of Pitavastatin-induced hepatotoxicity. Pitavastatin has favorable
pharmacokinetic and safety profiles and its characteristic structure provides significant efficacy at low doses.
|Tissue Engineered Heart Valve for Aortic Valve Disease. Quo Vadis, Again?
||Wilhelm P. Mistiaen
Abstract: Introduction: Heart valve tissue engineering has been presented as a “promising” solution” for over 20 years.
These living devices are supposed to have the capacity to grow, heal and repair or remodel. This would avoid structural
valve degeneration of currently used biological heart valve prostheses or the need for life-long anticoagulation or
mechanical devices. Especially for patients with stenotic aortic valve disease, which is the third most common
cardiovascular condition in Western societies, this solution might be useful.
Methods: A literature search has been performed for the years 2010-2014 with focus for results of tissue engineered
valves of in-vitro, in-vivo animal and patient studies
Results: Most experiments were still in-vitro. Especially those experiments which focus on synthetic biodegradable
scaffolds have not left the laboratory, because these cannot withstand systemic pressures. The animal studies involved
scaffolds of biologic origin with or without reseeding with cells. Cells were harvested from vascular, embryonal tissues or
from bone marrow. Large animal studies (ovine, porcine) dealt with implantations in pulmonary position and right
ventricular reconstruction, which might be useful in the treatment of congenital heart defects. Implantation in the
systemic – high pressure – circulation were only performed in small animals (rat model). One goat model showed some
remarkable results, but only on very short time.
Conclusions: Tissue engineered valves seemed very promising, a promise that will not be fulfilled soon. Synthetic
bioresorbable scaffolds have not left the laboratory yet. Scaffolds of biologic origin already have been tested in animals,
mostly in pulmonary origin. It is by no means certain that behavior of tissue engineered valves in animals reflect the
clinical situation, which is much more demanding. Also non-scientific hurdles such as official registration and
commercialization of such devices have to be taken.
|Statin Therapy for Stroke Prevention: Current Status and Controversies
Abstract: Statin therapy has become one of the most widely prescribed medications in the world because of its efficacy
in the primary and secondary prevention of cardiovascular mortality and stroke. Current cardiovascular guidelines
recommend statin use in all patients with stroke due to atherosclerosis (non-cardioembolic stroke). Statin therapy at
stroke onset is associated with good functional outcome and reduced risk of cardiovascular events after stroke via
different mechanisms. These include lipid-lowering effects, platelet aggregation, improved endothelial function, antiinflammation
activity, neuroprotective action, and stabilization of atherosclerotic plaques. Nevertheless, the effects of
statin therapy following major stroke are uncertain and data on the optimal dose and intensity are limited. Statins may
potentially increase the incidence of overall stroke and fatal stroke in patients with a history of renal transplantation, or
regular hemodialysis. There is a need for additional studies since statins benefits do not extend across all etiologic
subtypes of ischemic stroke: they are indicated for thrombotic strokes and some, but not all, lacunar, cardioembolic or
essential strokes, and they are not suitable for ischemic strokes of unusual etiology.
|To a Problem of a Neuroleptic Cardiomyopathy: Brief Review of a Literature and of Own Researches
Abstract: Introduction: Neuroleptic cardiomyopathy (NCMP) belongs to secondary specific metabolic dilated
cardiomyopathies. It is caused by side cardiotoxic effect of antipsychotic drugs. Many aspects of epidemiology,
pathogenesis, morphology, clinical picture and diagnostics of NCMP still remain insufficiently explored.
Results: NCMP passes through 3 stages in its development: 1) a latent one, 2) a full-scale one, and 3) a terminal one.
Each stage has clinical features, electrocardiograph signs and certain morphology.
Lethal termination in a latent and in a full-scale stage either takes place because of intercurrent diseases or it is a
sudden cardiac death of arrythmogenic genesis. In the terminal stage, the direct cause of death is, as a rule, a
progressive congestive chronic cardiac failure.
On the macroscopic level, NCMP is characterized by a moderate cardiomegaly; by a noticeable dilatation of heart
ventricles; by absence of evident coronary atherosclerosis.
On the microscopic level, all structural components of myocardium (microvasculature, intercellular matrix,
cardiomyocytes) are deeply damaged. These pathologic changes are a physical basis of a contractile myocardial
Conclusion: On the basis of the summarizing of the data, which were received in a series of studies, we singled out and
proved clinical and morphological criteria of diagnostics of NCMP.
Taking the described clinical and morphologic peculiarities of NCMP into account, it is advisable and quite logic to singleout
this pathology into an independent nosologic unit.
|Intra-aortic Balloon Pump: Reviewing its Role in Cardiogenic Shock
||Bruno Robalinho Cavalcanti Barbosa
||Alfredo Augusto Eyer-Rodrigues
Abstract: Cardiogenic shock is a high-mortality condition caused, mostly, by ST-elevation myocardial infarction. When
the adequate therapy is implemented in a timely fashion, recovery can be achieved. Treatment is based on intensive
care measures, vasoactive drugs, early revascularization and the use of assist circulatory devices. In this review, the
authors aim to discuss the available evidence on the use of intra-aortic balloon pump (IABP) in this clinical setting.
|First Diagnosed Heart Failure Due to Churg-Strauss Syndrome. A Case Report
Abstract: Churg Strauss Syndrome (CSS) is an autoimmune condition that causes inflammation of small and mediumsized
blood vessels. It is a non-infectious systemic vasculitis, which affects mainly the lungs but also other tissues and
organs. CSS is considered a highly variable condition in terms of its presentation and its course. The most serious
complication of the vasculitic stage is congestive heart failure with reduced ejection fraction. We present a case with first
diagnosed heart failure because of CSS and review of the literature.
|Anthropometric and Lipid Profile in Medical Students. Influence of a Physical Exercise Program
||Diana María García-Cardona
||Pedro Luis Campos Rodríguez
Abstract: Introduction: Most students in health programs do not practice physical exercise due to the high level of stress
involved in their curriculum, a condition that makes them a population at high cardiovascular risk.
Objective: Determine the influence of an exercise program on anthropometric and lipid profile of medical students.
Methods: Acommunity trial type quasi-experimental study, through a 12-week exercise intervention, was made. Athletes
and people doing regular exercise, or with altered lipid profile results were excluded. The anthropometric assessment
was performed as directed by the International Society for the Advancement of Kinanthropometry.
Results: We studied 50 subjects, distributed in 33 women, 17 men, and average age 20 ± 2.7 years. Weight, waist
circumference, bone percentage, residual percentage and BMI were not significantly different after exercise. While the
waist-hip ratio, muscle percentage, skin percentage and fat percentage were significantly different after exercise. Highdensity
lipoproteins decreased and other profile variables increased significantly.
Conclusion: This study showed that the exercise program positively influences physical structure, given that it increased
muscle percentage and decreased fat percentage, but not enough to positively change the lipid profile of the studied
population. Further it suggests the need for intervention programs on healthy habits (healthy foods, appropriate rest and
sleep intervals) for medical students.
|Xenografts and Tissue Engineered Heart Valve in Pediatric Cardiac Surgery. Quo Vadis, Once More?
||Wilhelm P. Mistiaen
Abstracts: Introduction: Many attempts have been undertaken for surgical correction of congenital heart defects.
Reconstruction of the right ventricular outflow tract (RVOT) is a main component of many procedures. Homograft
devices are considered as benchmark, but these are in short supply. Xenografts and tissue engineered heart valves
(TEHV) have been proposed as solution. This review aims to explore what progress has been made for these two
Methods: A systematic search for TEHV and the commonly used xenograft (Matrix P / P+, Shelhigh and Contegra)
devices through ISI web of Knowledge was performed. The SynerGraft homograft was also included.
Results: Contegra, Shelhigh and Matrix P / Matrix P+ have been used with varying success. The problems are foreign
body reaction, with inflammation, stenosis of the conduit or more distally in the pulmonary arteries and regurgitation. In
spite of efforts during more than 20 years, TEHV has not left the laboratory: there is still an ongoing search for the ideal
scaffold, adequate cell sources for cellular repopulation and culture media. There are no long-term animal models for the
Conclusions: To treat patients with congenital heart disease, reconstruction can be performed with xenograft devices,
but their limitations have to be taken into account. Matrix P and P+ as well as Shelhigh suffer from inflammation with
stenosis. The alternative, TEHV, will not be available for the foreseeable future. In any case, any TEHV device has to
compete against more established values.
|Serum Concentration and Polymorphisms of Apolipoproteins A-I and B, and Risk of Coronary Artery Disease
Abstract: Introduction: Variations in the apoprotein apoA-I and apoB genes have been associated with their serum
concentration, and thus with Coronary Artery Disease (CAD). This study determined the relationship between
polymorphism and the serum concentration of apoA-I and apoB in a group of patients with angiographically documented
Materials and methods: Polymorphic sites, XbaI (in apoB), and MspI (in apo A-I) and serum concentrations in these
lipoproteins were determined in a population of 231patients classified into two groups: patients with significant CAD
(coronary obstruction 50%) and patients with mild CAD (coronary obstruction <50%); the apoB/apoA-I ratio was then
Results: It was found that the M2 allele in the apoA-I acts as a risk factor for coronary artery disease, odds
ratio=1.78(confidence interval: 1.21 – 2.61), p =0.002. Nosignificant differences were found between the apoA-I
concentration values and the corresponding MspI polymorphism genotypes in the two study groups. Meanwhile, the
apoB concentration presented significant differences among the XbaI (p=0.027) polymorphism genotypes, with greater
values for the heterozygous genotype in patients with CAD50%. Likewise, a significantly abnormal difference was
evident in the apoB/apoA-I ratio among the two groups, with a greater value for patients with mild CAD.
Conclusion: the data showed that the M2allele may be a risk factor for CAD in this population. Additionally, it showed
that there is a relationship between apoB serum concentration and XbaI polymorphism; relationship which manifests
itself more strongly in patients with CAD. There was no relationship established between the MspI polymorphism of
apoA-I and its serum concentration. Other studies are necessary in order to establish the anomalous behavior of the
apoB/apoA-I relation in this population.
|Effects of Physical Activity on The Inflammatory Process Related to Insulin Resistance and Obesity
Abstract: Atherosclerosis, the pathophysiological substrate for cardiovascular disease (CVD), is the final stage of an
inflammatory cascade. During the process, endothelial dysfunction ensues and the inflammatory state is perpetuated. A
number of traditional risk factors, as obesity and insulin resistance/type 2 diabetes, are characterized by a
proinflammatory state as well, with increased levels of cytokines, interleukins, vasoactive peptides and enhanced
expression of specific cellular receptors. The anti-inflammatory properties of physical exercise and its positive effects as
a strategy for obesity and insulin resistance have already been shown in terms of cardiovascular protection and survival.
|Cardiac Amyloidosis : Mini Review and a Case Report
Abstract: Amyloidosis is a rare heterogeneous group of systemic disorders, which result due to extra cellular deposition
of an insoluble, amorphous, eosinophilic, substance known as amyloid. The disease is often characterized by a
restrictive cardiomyopathy with a poor prognosis and survival. The treatment of cardiac amyloidosis depends on the
underlying etiology. However, the diagnosis of the type of cardiac amyloidosis is not always straightforward. We present
here a case of cardiac amyloidosis and we discuss the different forms.
|Diet and Inflammation: Effects of Macronutrients and Dietary Patterns
Abstract: Cardiovascular disease (CVD) has already been demonstrated to be related to a chronic and complex
inflammatory process, in which the loss of endothelial protective properties - the so-called endothelial dysfunction - plays
a central role. A number of different approaches, both pharmacological and non-pharmacological, have been tested with
inconclusive results so far. One field of special interest is the impact of the different macronutrients and dietary patterns
in the inflammatory response that, ultimately, leads to endothelial dysfunction and increased cardio-metabolic risk.
Although apparently simple, interventions regarding dietary habits have complex implications and involve a number of
covariates that may interfere in the final results. To date, results about the protective effects of diet - in general -
regarding cardio-metabolic risk remain to be fully proven.
|Transient Global Amnesia and Takosubo Syndrome: A Case Report.
Abstract: Broken heart syndrome, also called apical ballooning syndrome or Takotsubo cardiomyopathy, is
characterized by an acute, transient systolic dysfunction of the apical and mid segments of the left ventricle. There have
been reports showing an association with neurologic disorders. In this article, we present the case of a female patient,
who suffered from an episode of transient global amnesia followed by takotsubo cardiomyopathy.
|Complex Atheromatosis of the Aortic Arch: An Emerging Diagnosis in Cerebral Ischemia of Unknown Cause
Abstract: Complex atheromatosis of the aortic arch has been increasignly recognized as a cause of cerebral infarction
in patients with stroke of uncertain etiology. The incorporation of transesophageal echocardiographic studies in routine
clinical practice allows direct visualization of cardiac and vascular structures previously innaccessible, including
atherosclerotic plaques in the aortic arch. Large atheromatous plaques, which protrude strikingly into the aortic arch
lumen and have obvious mobile components are associated with a high probability of being the etiology of embolism.
Aortic arch atheromatosis should be considered a dynamic process entailing a non-negligible risk of recurrent
cardiovascular events. Therefore, adequate diagnosis and optimal treatment is mandatory for secondary prevention of
cerebral ischemic infarction and progression of aortic arch atheromas.
|Predictive Value of Circulating SPARC-Related protein Osteonectin in Patients with Symptomatic Moderate-to-Severe Ischemic- Induced Chronic Heart Failure
||Alexander E. Berezin
||Alexander A. Kremzer
Abstract: Aim: To evaluate the prognostic value of circulating osteonectin for cumulative survival and hospitalization in
patients with ischemic chronic heart failure (CHF).
Methods: One hundred fifty four patients with ischemic symptomatic moderate-to-severe CHF were prospectively
enrolled at discharge from the hospital. Observation period was up to 3 years (156 weeks). Blood samples for
hematology, chemistry, and biomarker measurements were collected at baseline prior to study entry. ELISA method for
measurement of circulating osteonectin (OSN) was used.
Results: During a median follow-up of 2.18 years we identified 21 deaths and 106 readmissions. Medians of circulating
levels of OSN in survivors patient and subjects who died were 670.96 ng/mL (95% confidence interval [CI] = 636.53-
705.35 ng/mL) and 907.84 ng/mL (95% CI = 878.02-937.60 ng/mL). Receive Operation Characteristic curve analysis has
shown the best balanced cutoff point of OSN concentration for cumulative survival equal 845.15 ng/mL. A significantly
divergence of Kaplan-Meier survival curves constructed for patients with high (> 845.15 ng/mL) and low (<845.15 ng/mL)
concentrations of OSN was found. Circulating OSN independently predicted all-cause mortality (OR = 1.23; 95% CI =
1.10–1.36; P < 0.001), CHF-related death (OR = 1.46; 95% CI 1.22–1.80; P < 0.001), and also CHF-related readmission
(OR = 1.92; 95% CI = 1.77 – 2.45; P<0.001) within 3 year of follow-up period.
Conclusion: Increased circulating SPARC family member OSN associates with increased 3-year CHF-related death, allcause
mortality, and risk for readmission due to CHF
|Pacemakers and Implantable Cardioverter Defibrillator
Abstract: The history of cardiac pacing therapy must be viewed within the broader framework of electro-diagnosis and
electro-therapy. Electro-therapy has a simple core concept: the use of an outside source of electricity to stimulate human
tissue in various ways to produce a beneficial therapeutic effect. This has shown a prolonged, halting development
through the ages, sometimes being looked upon as mysterious magic produced by complex machines. The field of
paediatric open heart surgery gave a major impetus to the development of pacemakers since heart block often
accompanied impeccably performed intra-cardiac repairs of congenital defects. This review deals various of aspects of
pacemaker functioning, indications, contraindications and complications.
|Neuroendocrine Mediators, Food Intake and Obesity: A Narrative Review.
||Angelo Michele Carella
Abstract: Obesity is a chronic multifactorial disease caused by imbalance between caloric intake and energy
expenditure. The Neuroendocrine system is one of the main factors regulating energy intake in humans. The
Neuroendocrine system is made up of cells able to synthesize and secrete amines, peptides, growth factors and
biological mediators, known as neurohormones, which modulate various biological functions by interacting with the
nervous and immune system. In the central nervous system, neurosecretory elements are mainly located in the
hypothalamus which is the anatomical site of the hunger (lateral nucleus) and satiety (ventromedial nucleus) centers;
thus it plays a key role in chemical coding of food intake. Dopamine, Noradrenaline and Serotonin are historically
considered key points in the regulation of feeding behavior. However, other neurohormones have been identified; these
substances, also synthesized in peripheral tissues (especially adipose tissue and digestive tract), influence food intake.
Some of these hormones have orexigenic activity; conversely, other substances have anorexigenic activity. A constant
balance between orexigenic and anorexigenic neurohormones is essential to ensure a smooth feeding behavior,
whereas a subtle and progressive disruption of neurochemical transmission is sufficient to induce hyperphagia or
anorexia. Several factors affect the synthesis and release of neuropeptides: genetic, hormonal, psychological,
environmental, receptorial, type of feeding and meal frequency. In the recent past some drugs, as Sibutramine and
Rimonabant, modulating the activity of several neuroendocrine mediators (Serotonin, Noradrenaline,
Endocannabinoids), have proven to be effective in reducing weight excess, even if they were withdrawn because of
serious side effects. Recently, promising results in this way have been obtained with Glucagon like Peptide-1 analogs,
showing significant efficacy in counteracting weight excess without side effects. Further knowledge developments on
these complex neuroendocrine circuits and their hypothalamic interactions in food intake regulation could open new
frontiers for effective pharmacological therapeutic approach to Obesity and other nutritional disorders.
|Heart Failure after Aortic Valve Replacement for Aortic Valve Stenosis: Possible Mechanisms
||Wilhelm P. Mistiaen
Abstract: Introduction: Aortic valve stenosis imposes a pressure overload on the left ventricle. Congestive heart failure is
one of the complications which can appear, even years after the operation. The main questions are: why do patients still
develop heart failure? Which types of congestive heart failure can be expected? Which factors related to it are known?
Methods: A literature search was performed with the terms “aortic valve disease/replacement AND heart failure”. Some
secondary references derived from their reference list were also included. The study design of the selected papers
differed considerably. Therefore, the analysis is descriptive and concerns factors which can be related to congestive
heart failure. Furthermore, surrogate outcomes are ejection fraction, hypertrophy, long axis ventricular function, torsion,
left atrial indices, pressures in the left sided heart and in the pulmonary circulation as well as a number of other
Results: It has become clear that decrease in ejection fraction, which is the most commonly used parameter, occurs late
in the course of aortic valve stenosis, when damage to the left ventricle has already been inflicted. Several more
sensitive imaging and Doppler parameters can demonstrate these changes earlier in the course of aortic valve stenosis.
This damage proves to be irreversible, at least in part. This might explain the appearance of heart failure after aortic
valve replacement. Although this type of heart failure is mostly “diastolic” in nature, a continuum with the systolic type
probably exists, at least in patients with aortic valve stenosis.
Conclusions: Damage to the left ventricle in patients with aortic valve stenosis can go unnoticed if ejection fraction is
used as sole determinant of left ventricular function, for the timing of operation. Detection of more subtle changes, even
in asymptomatic patients with severe aortic valve stenosis should lead to early replacement. This might result in less
postoperative heart failure.
|Effect of Bitter Melon Aqueous Extract and Pomegranate Oil on Glucose Concentration and Lipid Profile in Blood of Rats – Preliminary Study
Abstract: Conjugated fatty acids is a term given to a group of polyunsaturated fatty acids with conjugated double bonds
systems in their carbon chains. Conjugated linolenic acids (CLnA) are present in seeds of certain plants e.g. -
eleostearic acid (cis-9, trans-11, trans-13 C18:3) in bitter melon (Momordica charantia, Cucurbitaceae) or punicic acid
(cis-9, trans-11, cis-13 C18:3) in pomegranate (Punica granatum, Punicaceae), where usually they are most prevalent
among fatty acids. Bitter melon and pomegranate have been widely investigated as they are commonly consumed plants
which also have been used in traditional medicine, mainly in Asia, for treatment of many diseases, such as diabetes and
The aim of this study was to evaluate the influence of a diet supplemented with an aqueous extract of bitter melon fruits
and/or with pomegranate oil on health status and lipid profile of blood. Sprague-Dawley female rats were divided into
four groups with different diet supplementation: pomegranate oil (G), aqueous extract of bitter melon (M), pomegranate
oil and aqueous extract from bitter melon (M+G), and control group (C). During the experiment fasting glucose
concentration and total cholesterol (TC), HDL, LDL, and triglyceride (TG) concentration were measured in blood
collected intravitally from the tail vein.
The modifications introduced into the diets did not influence negatively overall health condition of the animals. Bitter
melon fruits extract slightly decreased the fasting glucose concentration during the experiment but its action was not
statistically significant (p>0.05). Pomegranate oil caused an increase of fasting glucose level in G group (p=0.03657) but
in M+G group its influence was diminished by the opposite activity of bitter melon fruits extract (p>0.05). TC was the
lowest in G group and it did not change during the time of experiment, which can suggest that the diet supplementation
with pomegranate oil prevents the age-related increase in cholesterol level. TC in blood of G group was significantly
lower than in other groups in 14th (p=0.01057) and 21st (p=0.01433) weeks respectively. Aqueous extract of bitter melon
fruits slightly diminished age-related TG increase, whereas pomegranate oil strongly prevents this tendency, as the TG
content in G group was significantly lower than TG content in C and M groups at 14th (p=0.00060) and 21st (p=0.00003)
week respectively. Similar activity, although not so pronounced, was visible as far as the M+G group was concerned.
|Evaluating the Intergration Process of Green Practices in Upgrading of informed Settlements in Medium Sized Towns in Kenya.
Informal settlements in developing countries have
been growing and so has been the need to better
their interventions. The international development
community and governments have been actively
working to improve living conditions of informal
settlement dwellers through adaptive and
proactive measures implemented through a variety
of upgrading initiatives. However, there has been
limited study on evaluation of integration process
of green practices interventions that ensure
improved human well-being and efficient
utilization of resources while significantly
reducing environmental risks. This study evaluates the integration process of green practices in water, energy and
waste sectors in upgrading of informal settlements in three informal settlements namely: Munyaka, Kamukunji and
Huruma in Eldoret town, Uasin Gishu County, Kenya. Developing a view of ascertaining what was involved in the
upgrading, how it was done as well identification of various stakeholders involved in upgrading process. The study
was anchored on Triple Bottom Line Model of sustainability. The findings of the study established that there are
various activities involved in integration process which included street and security lighting, footpath and bike path
and storm water drainage. The study also established that various stakeholders were involved in the upgrading process
and that there was low informal settlement dwellers participation. The study recommends that to be effective and to
fully integrate green practices all stakeholders should be involved and instead of wholly depending on development
actors the informal settlements residents should also embrace green practices at individual level.
|Theoretical and Experimental Studies of Thermodynamic Properties, Anharmonic Effects and Structural Determination of HCP Crystals
||Dinh Quoc Vuong
||Nguyen Van Hung
Abstract: Thermodynamic properties, anharmonic effects and structural determination of hcp crystals have been studied
based on their theoretical and experimental Debye-Waller factor presented in terms of cumulant expansion up to the
third order in X-ray absorption fine structure (XAFS). The results have been achieved based on the present advanced
method using that the calculations and measurements are necessary only for the second cumulants from which all the
considered XAFS quantities have been provided. This advantage has resulted based on the description of XAFS
quantities in terms of second cumulants. The many-body effects included in the present one-dimensional model have
been taken into account based on the first shell near neighbor contributions to the vibration between absorber and
backscaterer atoms. Morse potential is assumed to describe the single-pair atomic interaction included in the
anharmonic interatomic effective potential. Numerical and experimental results for Zn in hcp phase obtained by the
present advanced method are found to be in good agreement with one another and with those measured at HASYLAB
|Modelling and Simulation of Self Heating in GaN Based High Electron Mobility Transistors (HEMTs)
Abstract: In this paper we present the numerical simulation and characterization of GaN based high electron mobility
transistors (HEMTs) using commercial device simulation software ATLAS from Silvaco international. Device has been
characterized in terms of its electrical and thermal behavior by simulating its transfer and output characteristics without
self-heating and with self-heating. Also we simulated the distribution of lattice temperature inside the device for thermal
characterization of the device. For electrical characterization the fundamental equations responsible for charge transport
of charge carriers have been solved using finite element method. For thermal characterization fundamental equations of
charge transport and heat flow equations have been solved self consistently.
|Absorption in One-Dimensional Lossy Photonic Crystal
Abstract: In this work we have obtained the absorption property in one-dimensional (1D) defective lossy photonic
crystals (PCs) composed of double-negative (DNG) and double-positive materials by using transfer matrix method . The
considered asymmetric geometric structures contain a defect structure at the center of the host crystal as a photonicquantum-
well (PQW) with two different types of DNG layers. This study investigates the effect of the stack number of the
bilayers PQW defect on the number, position, and the rate of the absorption of anti-resonant modes for both types of the
DNG defect. The results show that these factors of the anti-resonant modes depend on the types of the DNG
metamaterial corresponding to the defect layers. Accordingly, by changing the types of PQW defect, the anti-resonant
modes are red-shifted or blue-shifted as a function of the stack number of PQW. Furthermore, the effect of loss factors
on the rate of absorption is examined for the two different types of PQW. The results can present helpful information for
designing new types of narrowband and multichannel filters at the microwave.
|Fabrication of Titanium Dioxide Nanorod Arrays-Polyaniline Heterojunction for Development of UV Photosensor
Abstract: An ultraviolet (UV) photosensor is successfully fabricated via heterojunction device consisted of n-type
titanium dioxide (TiO2) nanorod arrays (TNAs), and p-type polyaniline (PANI) by a facile method on fluorine tin oxide
(FTO)-coated glass substrate. The fabricated UV photosensor demonstrated a UV-catalyst activity through the
generation of photocurrent under UV irradiation (365 nm, 750 μW/cm2). The measured UV response showed the highest
generation of photocurrent of 0.52 μAcm-2, and responsivity of 0.65 mA/W at 1.0 V reverse bias. The results indicate that
the fabricated TNAs/PANI heterojunction-based device could be a promising candidate for the application of UV
|Lanthanum-Doped Barium Stannate - a New Type of Critical Raw Materials-Free Transparent Conducting Oxide
Abstract: A pulsed laser deposition-based process for growth of highly-doped epitaxial La:BaSnO3(001) layers on (001)-
oriented SrTiO3 is developed. The growth window of single-phase epitaxial Ba0.93La0.07SnO3 films is determined and the
influence of growth parameters on crystalline quality is studied.
Reciprocal space maps showed fully relaxed Ba0.93La0.07SnO3 epitaxial layers on SrTiO3 (001). The crystalline quality of
material obtained was evidenced through HR-XRD measurements with a full width at half maximum (FWHM) of 290
arcsec for the Rocking curve of the symmetric (002) peak and 108 arcsec for the asymmetric (103) peak. The band gap
of the layers, determined from Reflection measurements employing the Kubelka-Munk method, was estimated as 2.97 -
3.01 eV, i.e. very suitable for the applications envisaged. The layers demonstrated electrical conductivity value of 1024
(Ω·cm)-1 at a free carrier concentration of 2.18×1021 cm-3 and a high transparency (up to 90%) in the visible and NIR
range of spectrum. The Ba0.93La0.07SnO3 layers grown could be regarded as a cost-effective and thermally and chemically
stable alternative to highly doped ZnO-based transparent conductive oxides and to In2O3:Sn in applications ranging from
solar energy utilization to optoelectronics as well as for the emerging field of transparent and radiation hard electronics.
|TCAD Based Assessment and Performance Optimization of ZnO/Si Heterojunction Based Thin-film Solar Cell
Abstract: In this paper 2D numerical simulation of n-ZnO/i-ZnO/p-Si p-i-n heterojunction solar cell using TCAD has been
presented. In this work the design and performance optimization of p-i-n heterojunction solar cell using two-dimensional
computer aided design (TCAD) tool has been presented. The device has been simulated and analyzed with respect to
the I-V characteristics of the device in dark and illuminated condition. Further figure of merits like short circuit current
(Isc), Open circuit Voltage (Voc), fill factor (FF), internal and external quantum efficiency (IQE &EQE), maximum power
generated (Pmax) and conversion efficiency of the designed solar cell has been extracted. The I-V characteristics of the
device and performance in terms of power conversion efficiency has been optimized for the proposed structure of solar
cell with respect to doping concentration in n-ZnO and i-region thickness of the device. The simulation results indicate
that the n-ZnO/i-ZnO/p-Si p-i-n heterojunction solar cell could be a good candidate for solar cells.
|Periodic Structure Containing Lossy Metamaterial and Defect Mode
Abstract: We theoretically investigate the properties of defect mode in one-dimensional lossy metamaterial photonic
crystal doped with single-negative materials photonic-quantum-well (PQW). We examine the defect mode as a function
of the type of negative index materials (NIMs) and the number of the unit cells of four different defected structures. The
results obtained that the parameters; frequency, height, and the number defect modes can be tuned by varying the type
of NIM in defect layers, PQW structure, and the unit cells as well in the defected structure. The defect modest end to
show a shift in the frequency based on the particular type of NIM and the number of the unit cells. The results can lead to
possible information for designing new types of narrow tunable filters at microwave frequency.
|Elaboration of Novel NanoparticulateTiO2-P25@n-TiO2 Composite for Photocatalysis
||Guy Didier Fanou
Abstract: A new mechanically stable TiO2-P25@n-TiO2 nanocoating was prepared after grafting of size-selected
titanium-oxo-alkoxy particles on P25-TiO2 nanoparticles surface and their immobilization on a glass substrate followed by
a thermal treatment. The 5-nm oxo-TiO2 particles were prepared in a sol-gel reactor with rapid reagents micromixing. The
photocatalyst with 65% TiO2-P25 loading shows the highest activity towards ethylene degradation in a continuous-flow
fixed-bed reactor. This material has a higher activity compared to that prepared by a conventional sol-gel method with
strongly polydispersed titanium-oxo-alkoxy nanoparticles and clusters. The reaction conditions were explicitly analyzed
along the reactor as a function of the ethylene concentration in framework of a kinetic model, which shows interplay
between zero and first order processes.