Day 1 :
Technical University of Munich, Germany & Tulane University, USA
Time : 09:10-09:50
Eckhard U Alt is a Professor at Technical University of Munich, Germany, Tulane University New Orleans LA, and Chair at Sanford University SD. He completed his Medical Degree as Valedictorian at Heidelberg Medical School. From 2001 to 2007, he was President of International Cardiac and Electrophysiology Society. He has authored more than 500 publications. His innovative spirit is demonstrated by more than 700 patents, primarily in the fields of Stem Cells, Electrophysiology and Interventional Cardiology. He introduced several new therapies to clinical practice, such as Rate-adaptive Pacing, Defibrillators, Treatment of Atrial Fibrillation and Stem Cell Treatment that have substantially influenced the practice of medicine. He won Hahn Research Award from European Society of Thoracic Surgery.
Despite revascularization and improved drug therapy, some patients with post myocardial infarction experience a critical loss of functional myocardium leading to remodeling and progression towards heart failure. As the heart is a terminally differentiated organ, renewal and replacement of dead myocardial cells occurs through the intrinsic regenerative potential situated in every organ. As recent research has revealed, the regenerative power of pluripotent stem cells is located throughout the body in small vessels, these cells are able to differentiate into all of the three germ layers. In addition, in every organ we find so-called progenitor cells, which in the heart also constitute the reserve army to replace dying myocardial cells. In light of heart failure with increased ischemia and the survival rate of myocardial cells is significantly reduced, representing an increased turnover and challenge to the stem cells located within the heart. As the ability for stem cells to divide is limited to about 50 to 70 divisions by the telomeres, the regenerative potential in a heart can be exhausted and the functional consequence is a replacement of parenchyma (cardiomyocyte) by fibrous tissue (mesenchyme). Up to now the global understanding why and how cardio myocytes can be replaced is controversial and by most physicians, scientists, and patients obscured. However, the principal of universal stem cells within the body allows obtaining stem cells from one organ, which is not critical such as adipose tissue, to isolate those stem cells and to apply them to the organ in need. The local microenvironment guides the new stem cells through a differentiation program and enables cells to obtain the properties of new cardiomyocytes that completely integrate and synchronize with existing myocardium. The mechanisms of differentiation follow exactly the embryonic differentiation pass way. Hence, it is possible to renew cardiomyocytes by autologous, early stem cells such as the ones that can be retrieved from the stroma of adipose tissue. The mechanism and epigenetic steps of differentiation including results on myocardial regeneration will be presented.
Stem cells reside in virtually all post-natal organs and tissues.
University Children Hospital, Latvia
Time : 09:50-10:30
Aris Lacis is a Cardiac Surgeon and Professor. He completed his MD, PhD and Graduation at Riga Medical Institute. He was a General and Thoracic Surgeon at P. Stradina University Hospital in Riga (1964-1969); Thoracic and Cardiac Surgeon at Latvian Centre for Cardiovascular Surgery (1969-1994). From 1994-2012, he was the Head of Pediatric Cardiology and Cardiac Surgery Clinic at University Children’s Hospital, Riga and; since 2012, he has been a Consulting Professor of this Clinic. He is a Vice President of Latvian Society for Cardiovascular Surgery and; President of Latvian Association for Pediatric Cardiologists. He is an Author of 395 scientific publications, three monographs and 13 patents. He is an Investigator in more than 10 clinical trials including cardio surgical procedures performed under deep hypothermia and hybrid procedures etc.
Fuwai Hospital & Cardiovascular Institute, China
Keynote: The clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy
Time : 10:50-11:30
Wei Hua is a Professor of Cardiology, Deputy Director at Cardiac Arrhythmia Center, Fuwai Hospital & Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, China. He completed his MD at Shanghai Medical University in 1985 and then PhD at Graduate School of Peking Union Medical College. He joined Fuwai Hospital & Cardiovascular Institute in 1985 and became full Professor of Cardiology in 1999. He was trained in Cardiac Pacing and Electrophysiology in Royal Melbourne Hospital, Australia, from 1994-1996. His main work is on “Clinical cardiac pacing and electrophysiology, cardiac arrhythmias service”. He is now Vice Chairman of Chinese Society of Pacing and Electrophysiology (CSPE) and Chairman of Cardiac Pacing Committee of CSPE. He is a Fellow of Heart Rhythm Society (FHRS), European Heart Rhythm Association (EHRA) and New York Academy of Sciences.
Statement of the Problem: Clinical trials have demonstrated that cardiac resynchronization therapy (CRT) is effective in patients with non-ischemic cardiomyopathy. However, patients with dilated-phase hypertrophic cardiomyopathy (DHCM) have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy (IDCM) or ischemic cardiomyopathy (ICM). Methodology & Theoretical Orientation: A total of 312 consecutive patients (DHCM=16; IDCM=231; ICM=65) undergoing CRT in Fuwai hospital were studied respectively. Response to CRT was defined as reduction in left ventricular end-systolic volume (LVESV) ≥15% at six-month follow-up. Findings: Compared with DHCM, IDCM was associated with a lower total mortality [hazards ratio, HR: 0.35 (95% confidence interval, CI 0.13-0.90)], cardiac mortality [HR: 0.29 (95% CI 0.11-0.77)] and total mortality or heart failure (HF) hospitalizations [HR: 0.34 (95% CI 0.17-0.69)], independent of known confounders. Compared with DHCM, the total mortality, cardiac mortality and total mortality or HF hospitalizations favored ICM but were not statistically significant. [HR: 0.59 (95% CI 0.22-1.61); HR: 0.59 (95% CI 0.21-1.63); HR: 0.54 (95% CI 0.26–1.15) respectively]. Response rate to CRT was lower in the DHCM group than the other two groups although the differences didn't reach statistical significance. Conclusion & Significance: Compared with IDCM, DHCM was associated with a worse outcome after CRT; the clinical outcome of DHCM patients receiving CRT was similar to or even worse than that of ICM patients. These indicate that DHCM behaves very differently after CRT.