Global Cardiology Summit October 22-23, 2018 Osaka, Japan

Cardiovascular diseases (CVD) are the leading cause of death globally. These are the class of diseases that involve the heart or blood vessels. It is estimated that 90% of CVD is preventable. Existing cardiovascular disease or a previous cardiovascular event such as a heart attack or stroke is the strongest predictor of a future cardiovascular event. The common symptom of CVD is pain or discomfort in the centre of the chest, in the arms and left shoulder, elbows, jaw or back. Feeling sick or vomiting, difficulty in breathing, feeling light-headed or fainting, breaking into a cold sweat and becoming pale may also be shown as additional symptom. At least three quarters of the world's deaths from CVDs occur in low- and middle-income countries. This is because they do not have the benefit of integrated primary health care programmes for early detection and treatment.

Metabolic syndrome is the major cause that contribute to cardiovascular morbidity and mortality. It is a cluster of metabolic disorders, such as dyslipidemia, abdominal obesity, hypertension and impaired fasting glucose which will increase the risk for cardiovascular disease. The dietary lipids are also recognized to contribute in the development and the prevention of cardiovascular risk clustering. This review explores the relevant mechanisms involved in the influence of dietary fatty acids on metabolic syndrome components.

The development of metabolic syndrome mainly due to Genetics and the environmental factors. Approximately 20%-30% of the population in industrialized countries has metabolic syndrome and the people with Metabolic syndrome will have three times higher risk of developing cardiovascular disease. Additionally, statin drugs play a key role in the treatment of people with coronary heart disease, mostly because they lower LDL cholesterol.

The treatment choices include changing lifestyle and weight reduction which usually requires a specifically tailored, multifaceted program that includes diet and exercise. Medications also may be useful.

Interventional cardiology involves the correction of harmed or debilated vessels, narrowed arteries or other affected parts of the heart structure. It is a non-surgical procedure which uses a small flexible tube called catheter for treatment. The heart can be subjected to many procedures by catheterization. It commonly involves the insertion of catheter into the heart chamber/coronary arteries/valves of cardiac system and cannulating the heart under X-ray visualization or most commonly fluoroscopy. The adaptation of this type of treatment avoids the scars and pain and long post-operative recovery. The procedures involved in interventional cardiology result in substantial patient radiation doses due to prolonged fluoroscopy time and radiographic exposure.

Cardiac surgery or heart surgery is surgery on the heart or great vessels. It is performed in order to correct the problems associated with the heart.  Cardiac surgeon is a specialist in cardiac surgery. Newer methods of heart surgery (such as off-pump and minimally invasive) may reduce risks and speed up recovery time when compared to traditional open heart surgery. A heart specialist performs cardiac surgery to repair or replace heart valves, repair abnormal or damaged structures in the heart, implant medical devices that help control the heartbeat or support heart function and blood flow or to replace a damaged heart with a healthy heart from a donor.  

Cardiovascular Pharmacology deals with the study of the effects of drugs upon the heart or circulatory system. It mainly contributes to the safety profile of potential new drugs and provides pharmacological data that can be used for optimization of further compounds and the ultimate selection of compounds suitable for clinical development. The cardiac drugs affect the function of the heart in three main ways. They can affect the force of contraction of the heart muscle (inotropic effects), they can affect the frequency of the heart beat or heart rate (chronotropic effects) or they can affect the regularity of the heart beat (rhythmic effects). Drugs can also affect blood vessels by altering the state of compression of the smooth muscle in the vessel wall, altering its diameter and accordingly directing the volume of blood stream. Such medications are classified as vasoconstrictors or vasodilators depending on the smooth muscle lining contraction and relaxation respectively.

Cardio-oncology is the discipline that concentrates on the intersection of heart diseases and cancer. This field is growing at a faster rate because the survivors after cancer therapies are more prone to develop cardiovascular disease. The increase in cancer disease in the world has led to the emergence of numerous chemotherapeutic agents which are under preclinical or clinical studies. These agents are potent to cause damage to the heart (carddiotoxicity). Cardiotoxic effects of chemotherapy might be decreased by the concurrent use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or beta-blockers. The use of diagnostic imaging, noninvasive stress testing, serum biomarkers, ambulatory blood pressure monitoring and ambulatory cardiac telemetry can help to identify cardiotoxicities and lead to the development of preventative strategies.

Occupational cardiovascular disease or occupational heart disease is the disease of the heart or blood vessels that are caused by working conditions. Certain toxins including carbon disulfide, nitroglycerin and carbon monoxide in the work area are known to cause heart diseases. Additionally extreme heat and cold, exposure to tobacco smoke, depression and occupational stress is the reason for heart disease. Other occupational hazards potentially related to cardiovascular disease include noise exposure at work, shift work and physical activity at work.

Pediatric cardiology is a branch of medicine deals with heart related problems in new born, infants, children and adolescents. A pediatric cardiologist is a pediatrician who has received extensive training in diagnosing and treating children's cardiac problems. Currently, evaluating and treating the disease condition may begin with the fetus since heart problems can now be detected before birth. Hence this division is actively involved in therapeutic conclusion and treatment of preventing both congenital and acquired heart disease in children. Finally, the division is committed to educating the next generation of physicians and offers advanced training in pediatric cardiology.

Cardiogeriatrics or geriatric cardiology deals with the cardiovascular   diagnosis and management of heart disease in the elderly population. As the population ages, an increasing number of elderly people will develop cardiovascular diseases and will suffer their consequences. Cardiac disorders such as coronary heart disease and others are common and are a major cause of mortality in elderly people. Vascular disorders such as atherosclerosis and peripheral arterial disease cause significant morbidity in aged people. Cardiovascular disease at elderly age is superimposed on the cardiovascular changes of aging, most of which underlie many common disorders of aging and limit the physiologic compensatory mechanisms for disease.

CVD is also usually more hazardous in older patients. It often erupts with multiple simultaneous CVD processes (e.g., acute coronary syndrome, heart failure, and atrial fibrillation) and in combination with non-cardiac pathologies (e.g., pneumonia, renal insufficiency, anemia, chronic lung disease, diabetes, stroke). Such multisystem disease combinations are more liable to overwhelm the diminished CV reserve capacity of aging, thus leading to adverse outcomes.

Sports and Exercise Cardiology is concerned with the cardiovascular care of athletes and exercising individuals of all ages, advancing the knowledge through fostering education, clinical expertise and research. Sports medicine, also known as sport and exercise medicine (SEM) is a branch of medicine that deals with physical fitness and the treatment and prevention of injuries related to sports and exercise. In recent years, athletic participation has increased in all major demographic groups, while simultaneously, children and adults with established heart disease desire participation in sports and exercise. Despite conferring favorable long-term effects on well-being and survival, exercise can be associated with risk of adverse events in the short term. Cardiologists face various challenges in evaluating the athletes due to complex individual cardiovascular demand and adaptations imposed by exercise.  

Cardiac diagnostic tests are the methods and techniques of detecting heart conditions related with healthy and pathologic heart function. Doctor will diagnose coronary heart disease (CHD) based on patient’s medical and family histories, risk factors, a physical exam and the results from tests and procedures. No single test can diagnose CHD. The patient may have to undergo one or more tests.  Common diagnostic tests include Angiogram, Blood tests, Blood pressure monitoring, Chest X-ray, Echocardiogram, MRI and ECG, Electrophysiology studies, Stress test or Tilt test. New tests are constantly being developed to further the understanding of disease, injury and congenital (present at birth) or acquired abnormalities of the heart. 

Cardiac regeneration aims to correct irreversibly damaged heart tissue with cutting-edge science, including cell-free and stem cell therapy. Reparative tools have been engineered to restore the damaged heart tissue and function using the body's natural capability to regenerate. The cardiac specialists with the support of are finding regenerative solutions that restore, renew and recycle patients' own reparative capacity. 

The damaged skeletal muscle has a profound capacity to regenerate, heart muscle, at least in mammals, has poor regenerative potential. This deficiency is attributable to the lack of resident cardiac stem cells, combined with obstacles that limit adult cardiomyocytes from entering the cell cycle and completing division. The idea of regeneration came into existence due to the innate ability to regenerate in animals. The innovation of stem cell and reprogramming technologies and a clearer understanding of the cardiomyocyte genetic program and key extrinsic signals helped to undertake further study on heart regeneration. Strategies to augment heart regeneration have potential to counteract the high morbidity and mortality of cardiovascular disease.

Cardiac nursing is a specialty nursing that works with patients who experience the ill effects of different states of the cardiovascular system. A cardiac care nurse or cardiac nurse is an expertise who cares specifically for patients with heart issues. While the obligations and duties of a nurse with this title may change from setting to setting, they will treat patients who have experienced or endure different sorts of heart problems under the direction of cardiologists. They perform various tasks such as performing stress tests, care for a patient after an operation, complete health assessments or closely monitor the patient’s heart rate.  

Hypertension is defined as the presence of the blood pressure (BP) elevation to a level which might place the patient at an increased risk for target organ damage in several of vascular beds including Heart, Large Conduit Arteries and other main functional body organs (Kidney, Brain, Retina). Hypertension accounts for 25% cases of heart failure. In elderly it accounts for 68% cases of Heart Failure. The risk of heart failure depends on the gender. Risk is generally increased by 2 fold in men and 3-fold in women. The uncontrolled and prolonged elevation of BP can lead to a variety of changes in the myocardial structure, Coronary Vasculature and Conduction System of the Heart.

Health care is the maintenance or improvement of health by means of preventing, diagnosing and treating of illness, sickness, damage and other physical and mental hindrances in individuals. Healthcare is conveyed by health professionals in different health professions. It incorporates the work done in providing primary care, secondary care and tertiary care in addition to public health.

Clinical trials are generally refers to research oriented study that investigates whether a medical methodology or device is safe for use and effective for humans being. These studies additionally show that medical approaches work best for certain diseases or groups of individuals. Clinical trials produce the best data available for health care decision making. A clinical trial will help to find a new strategy, treatment or device. There are four possible outcomes from a clinical trial. Positive trial, Non-inferior trial, Inconclusive trial, Negative trial.

Veterinary Cardiology generally deals with the study and treatment of disease condition of cardiovascular system in cats and dogs (pet's heart and blood vessels). The heart problems may include canine and feline congestive heart failure, hypertension, dilated and hypertrophic cardiomyopathy and valvular disorders. Due to the interrelation in the function of pet's heart and lungs, veterinary cardiologists are also knowledgeable about lung diseases as well as diseases of the chest cavity. Many pets with heart disease are asymptomatic. A veterinary cardiology specialist will perform a complete and thorough physical examination on animal and further animal’s past history and current medications are reviewed and based on these findings, additional tests will be performed.

Advances in cardiology include the current research and new innovative methods that are emerging in the field of cardiology and its related fields. Advanced research in this field allows early detection of CHD in order to halt or reverse the progress of the disease. It focuses on the research related to devices, development of Nuclear Cardiology techniques for the detection of heart disease, drug development and evaluation of treatments used in heart disease, identification of novel biological markers to predict the presence of heart disease etc.

Personalized medicine is a novel medical model with all judgments and practices being tailored to individual patients in whatever ways possible. Personalized medicine may allow the physician to provide a better therapy for patients in terms of efficiency, safety and treatment length to reduce the associated costs. And when used in patient treatment, personalized medicine is most often used in risk prevention (54 percent), genetic testing (53 percent) and lifestyle change (50 percent). Genetic assessments, combined with assessment of lifestyle risk factors including family history of cardiovascular disease determine if they are at greater risk for future health complications and thus provide steps they can take to lower their risk. All patients with the same disease condition receive the same first line treatment even though it may be only 30% to 60% effective. Therefore personalized treatment can be adapted to lesser the wastage of medicine and to reduce the cost of medication. Personalized medicine is likely to change the face of cardiovascular treatment in the near future.

Cardiology is one of the most dynamic and variable medical disciplines. In the era of evidence based medicine, progress in cardiology requires continuous inflow of scientific data that support new standards and newly-formulated hypotheses. As any other healthcare specialists, cardiologists are expected to adhere to highly standardized diagnostic and therapeutic guidelines that are developed by international consensus groups on the basis of evidence from large clinical trials. Management of cardiologic patients should be also based on the principles of professional morality expressed in internationally recognized documents such as Good Laboratory Practices and country-specific Codes of Medical Ethics. However, application of the ethical principles becomes highly challenging to a highly variable population of cardiologic patients including both pediatric and geriatric subjects. Cardiologic research should adhere to the same ethical principles as studies in any other discipline of clinical medicine. 

Each year 17.3 million people die of cardiovascular disease, 80% in the developing world. The case report in general is a short article which describes an interesting fact in medicine.  It may include a new medical condition, a new disease, a new diagnostic approach or a new therapeutic strategy. Case reports usually document episodes in the initial emerging phase or in a small outbreak.  These documental information becomes the basic for further case series, reviews and studies. The World Heart Federation exists to prevent and control these diseases through awareness and action, promoting the exchange of information, ideas and science among those involved in cardiovascular care, promoting for disease prevention and control by encouraging healthy diets, physical activity and tobacco free living at an individual, community and policy maker level. Cardiology conference is a suitable platform to uncover various developments and case studies in the field of cardiology.