Scientific Program

Conference Series Ltd invites all the participants across the globe to attend World Congress on Heart and Pediatric Cardiology Tokyo, Japan.

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Scientific Program Day 1

Day 1 :

  • Heart and Pediatric Cardiology

Session Introduction

Li Jiang

The First Affiliated Hospital of Nanjing Medical Universtiyy, Nanjing, China

Title: Hemodynamic effects of dobutamine versus dopamine in preterm infants: an update meta-analysis
Biography:

Dr. Li Jiang has completed her MD at the age of 35 years from Nanjing Medical University. She is a pediatric cardiologist (associate chief physician) in the field of stuctrual congenital heart disease. She has published more than 10 papers in reputed papers.

Abstract:

Hemodynamic effects of dobutamine versus dopamine in preterm infants: an update meta-analysis: It is a meta-analysis to compare the effects and safety of dobutamine versus dopamine in preterm infants with abnormal hemodynamic status. Study sources were up to 2017 for RCTs in which dobutamine and dopamine treatment was adopted. Included studies were conducted on preterm infants with abnormal hemodynamic status that reported mortality < 28 days, treatment failure and organ effects. 7 articles were included with a total 286 patients. 5 studies reported mortality (180 patients), 4 studies reported P/IVL (145 patients), 4 studies reported P/IVH (160 patients), 2 studies reported severe P/IVH (105 patients), 3 studies reported NEC (140 patients), 2 studies reported BPD (55 patients), and 6 studies reported treatment failure (266 patients). Meta-analysis showed an increased probability in treatment failure using dobutamine treatment (RR, 1.67; 95% CI, 1.14-2.45; P = 0.008), whereas there was no significant difference in mortality < 28 days (RR, 1.16; 95% CI, 0.70– 1.91; P = 0.57), P/IVL (RR, 2.90; 95% CI, 0.93-9.11; P = 0.07), P/IVH (RR, 1.23; 95% CI, 0.73-2.08; P = 0.44), severe P/IVH (RR, 0.58; 95% CI, 0.21-1.62; P = 0.30), NEC (RR, 2.21; 95% CI, 0.60-8.09; P = 0.23) and BPD (RR, 1.04; 95% CI, 0.38-2.82; P = 0.94) between two groups. Dopamine was more effective in treatment success in therapy of preterm infants with abnormal systemic hemodynamic status. No difference was found existed in mortality < 28 days and incidence of adverse organ effects in two groups.

Suryakanthi

Rainbow Children’s hospital and Birth right, India

Title: Infants with acute pulmonary hypertensive crisis: a case series
Biography:

Dr Suryakanthi completed her postgraduate training in Pediatrics under Diplomate National Board, New Delhi, and is currently doing fellowship in Pediatric Critical Care in Rainbow Children’s Hospital and Birth right, Telangana, India

Abstract:

Pulmonary hypertension (PH) refers to an abnormal elevation of blood pressure in the pulmonary vascular circulation, and has multiple etiologies. The condition is potentially life threatening and can have varied presentations. We present our experience with 3 infants who were admitted in our tertiary level PICU over a span of 3 months.
 
Case description
 
Three infants presented to us in early infancy with severe PH. All 3 were exclusively breast-fed young infants with normal birth and family histories, and came in respiratory and circulatory failure with severe metabolic acidosis. An observation made retrospectively after the management of the first case led to the prompt diagnosis of the succeeding 2 cases. In view of severe metabolic acidosis in the first infant, as part of workup and management of inborn errors of metabolism, Thiamine was added to the treatment along with mitochondrial cocktail therapy. Reversal of metabolic acidosis and pulmonary hypertension happened over the next 48 hours. All other etiological workup came normal. And retrospectively the possibility of Thiamine deficiency as the cause of PH was thought of. In the other 2 patients, thiamine levels were sent before adding vitamin supplementation, and early intervention reduced the morbidity and hospital stay.
 
Discussion and Implications
 
Before labelling any PH as idiopathic, it is important and life-saving to rule out Thiamine deficiency as a possible etiology. Thiamine is an integral component of cellular metabolism. And it has been found that it can cause severe pulmonary hypertension in exclusively breast-fed infants. It can be easily reversible with the simple intervention of adding Thiamine supplementation. Awareness of this condition is important for early recognition and prevention of mortality.

Ahmad Pandu Pratama

Universitas Indonesia

Title: Multimodality Approach to Determine Anomalous Left Coronary Artery Arising from The Pulmonary Artery (ALCAPA) Diagnosis
Biography:

Ahmad Pandu Pratama is a Cardiology trainee in National Cardiovascular Center Harapan Kita, teaching hospital of Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia.

Abstract:

Introduction. Anomalous left coronary artery arising from pulmonary artery (ALCAPA) is a very rare congenital anomaly. The incidence is about 1:300.000 live births and accounts for 0.25%–0.5% of all congenital heart defects. ALCAPA is one of the most common causes of myocardial ischemia and infarction in children. If left untreated, up to 90% of patients with ALCAPA syndrome will die within the first year of life. In patients who live to adulthood, ALCAPA syndrome may cause myocardial infarction, left ventricular dysfunction and mitral regurgitation, or silent myocardial ischemia, which can lead to sudden cardiac death. Early diagnosis and prompt surgical intervention with an aim to restore two-coronary-arteries circulatory system have shown an excellent results and lead to gradual myocardial recovery.
 
Case Report. Here we have 3 babies with ALCAPA came with signs and symptoms of heart failure. First and third case patients developed symptoms during 2-3 month of age, while second case patient at the 6 month of age. Diagnosis of ALCAPA confirmed by echocardiography in the first case patients. The second case beside echocardiography examination, also underwent multi-slice computed tomography (MSCT) scan examination. The third case patient have to underwent coronary angiography because coronary sinus was not well visualized by echocardiography. First and third case patient underwent ALCAPA repair with LCA implantation into Aortic root technic, showing favorable result, while second case patient scheduled to receive ALCAPA repair.
 
Conclusion. Diagnosing ALCAPA is challenging, but features like episodes of irritability during feeding that associated with sweating or pallor should alert us to suspect ALCAPA. Echocardiography is the most important non-invasive diagnostic tool and has replaced coronary angiography as the standard method of diagnosis. However, if it fails to visualized coronary sinus, other modalities such as MSCT Scan and magnetic resonance imaging (MRI) could be useful in order to make an early and accurate diagnosis. ALCAPA repair with left coronary artery (LCA) implantation was chosen due to favorable results found following re-establishment of the dual coronary system.

Roya Kelishadi

University of Medical Sciences, Iran

Title: Association of Beverage Consumption with Cardio-metabolic Risk Factors and Liver Enzyme in Children
Biography:

Roya Kelishadi is a Professor of Pediatrics in Isfahan University of Medical Sciences, Iran. She has more than 500 publications in English peer-reviewed journals. She is the chair of the Research Institute for Primordial Prevention of Non-Communicable Disease. She had presented her scientific works in several international conferences.

Abstract:

This nationwide study aims to evaluate the association of beverage consumption with cardiometabolic risk factors and alanine transaminase (ALT) levels in children and adolescents. Students, aged 7-18 years, were selected from 30 provinces by multi-stage cluster sampling. The weekly use of six different beverage types including milk, juice, tea, coffee, soda and non-alcoholic beer, was documented. Data of 3733 students were complete for this study. The mean (SD) age of participants was 12.58 (3.15) years; 52.6% were boys, and 72.7% lived in urban areas. Beverages types were clustered into healthy, containing high amounts of sugar and containing high caffeine levels categories. Mean ALT level was 7.70(3.42) IU/L. Tea was the beverage with highest frequency of consumption (73% had daily or weekly consumption). Beverages containing high levels of sugar such as soda and non-alcoholic beer were significantly associated with higher levels of ALT. Model coefficient of regression (SD) was 0.66 (0.31) (P-value:0.034). Healthy beverages such as milk and fresh juice and also beverages containing high levels of caffeine did not have significantly association with ALT levels (p-value=0.32, p-value=0.60). Healthy beverages had a significant and inverse relationship with triglycerides (P-value=0.029), total cholesterol (P-value=0.008) and low density lipoprotein (P-value=0.008) levels. This study showed that consuming sugar sweetened beverages are significantly associated with higher levels of ALT, whereas healthy beverages are associated with a better cardiometabolic profile meaning that consuming healthy beverages leads to lowers TG, TC and LDL levels. The effects of beverages on children health should be emphasized in health recommendations.