Organic acid and probiotic derived from grass silage improved egg quality in Pegagan laying duck: a research note

The aim of this study was to evaluate the effect of supplementation of organic acid and probiotic derived from grass silage on the egg quality of duck. Seventy-two Pegagan laying ducks (average age: 24 weeks) were randomly allocated to six treatment groups: basal diet, basal diet + organic acid, basal diet + probiotic, basal diet + tetracycline, basal diet + probiotic + organic acid, and basal diet + organic acid + tetracycline. The result showed that the feeding diets containing probiotics and organic acid significantly (P < 0.05) reduced yolk fat and yolk cholesterol and increased eggshell weight, egg index, yolk color score, Haugh unit, and protein content. However, egg weight, albumen weight, yolk weight, albumen index, yolk index, and water content were not significantly (P > 0.05) different. It is concluded that dietary supplementation of organic acid and probiotic derived from grass silage improved egg quality in terms of yolk color score, fat, and cholesterol content.

Coronary artery fistula features associated with clinical symptoms in adults with non coronary artery disease detected with coronary computed tomography angiography

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): National Cardiovascular Center Harapan Kita, Jakarta, Indonesia

Background

 Coronary artery fistula (CAF) is rare coronary artery anomaly (&lt;1% in general population). It is often diagnosed accidentally during coronary angiography. Most of CAF cases have no clinical significance, however, some may present with hemodynamic instabilities, requiring invasive or surgical intervention. Recently, coronary computed tomography angiography (CCTA) has been increasingly used to detect CAF at higher rates. Correlation between CAF and significance of clinical presentation, however, remains unclear.

Purpose

To evaluate association of CAF features with any symptomatic trends present in non coronary artery disease (CAD) patients.

Methods

 This was a single-center, observational, analytic cross-sectional study. A total 45 cases of CAF with no documented CAD or non-significant stenosis CAD diagnosed by coronary CT angiography were collected from 10,175 consecutive patients in National Cardiovascular Center Harapan Kita spanning 5-years from January 2015 to December 2019. The imaging findings, morphologic features and relevant clinical history were recorded and analyzed.

Results

 The prevalence of CAF determined with CCTA in our study was 0.44%. Among 45 patients with CAF, thirty (67%) were female. Mean age was 49.4 ± 12.9 years. Most common symptoms reported, in decreasing frequency, were chest pain (60%), dyspnea (22.2%), palpitation/arrhythmia (11.2%), syncope (4.4%) and general weakness (2.2%). Most common site of CAF origin was the left anterior descending artery (66.7%), followed by right coronary artery (51.1%). The fistula most commonly terminated in the main pulmonary artery (75.5%). The CAF size, in descending order, were small (35.6%), medium (33.3%), and large (20%). Mixed and multiple CAF were presented in 5 cases (11.1%). Aneurysm formation were identified in 10 cases (22.2%). CAF were mainly associated with congenital atrial and ventricular septal defects (6.7%; 4.4%, respectively). Other coexistent cardiac abnormalities presented with CAF were pulmonary hypertension (8.9%), infective endocarditis (4.4%), and pericardial effusion (2.2%). Large-sized CAF was significantly associated with chest pain and palpitation/arrhythmia (p = 0.017; p = 0.003, respectively). Aneurysm formation revealed to be significantly associated with chest pain and palpitation/arrhythmia (p = 0.044; p = 0.006, respectively) as well. Mixed and multiple CAF were significantly correlated with syncope (p = 0.003). CAF with concomitant cardiac diseases (congenital heart disease, pulmonary hypertension, valvular heart disease) were significantly associated with symptoms of chest pain and palpitation/arrhythmia as compared to isolated CAF only (p = 0.004; p = 0.007, respectively).

Conclusion

 CAF features (large-sized, mixed and multiple, aneurysmal and presence of concomitant cardiac disease) were associated with significant trends of clinical symptoms in adults without CAD.

P194 Trimetazidine preserves right ventricular function on pulmonary arterial hypertension patients in national cardiovascular center harapan kita hospital indonesia

Funding Acknowledgements

National Cardiovascular Center Harapan Kita Hospital

Background

Right ventricular dysfunction is the worst mortality predictor in pulmonary arterial hypertension (PAH). Recent animal PAH studies have demonstrated the benefit of partial fatty acid inhibitor such as trimetazidine in improving right ventricular function. Therefore, we hypothesize that trimetazidine can improve right ventricular ejection fraction (RVEF) in PAH patients.

Purpose

Investigating the effect of  trimetazidine on right ventricle function in PAH patients.

Methods

We conducted 3 months randomized double blind placebo controlled trial on PAH patients at outpatient clinic in National Cardiovascular Center Harapan Kita Hospital Indonesia. Those who fulfilled the inclusion criteria will be randomized into trimetazidine or placebo group for 3 months on top of their standard PAH regime. Clinical and cardiovascular magnetic resonance imaging (CMR) parameters will be evaluated before and after 3 months therapy. The primary outcome of this study is the differences of RVEF from CMR.

Results

We randomly enrolled 26 PAH patients equally to receive placebo or trimetazidine for 3 months on top of their standard PAH regime. Total of 10 patients in each group was able to finish the study. There was significant improvement of RVEF in trimetazidine group 3.78 + 1.5% compared to placebo 2.76 + 1.6% (p 0.008, CI 1.96 to 10.96). Furthermore, we also observed improvement of functional capacity in trimetazidine group 0.24 + 0.09 compared to placebo -0.44 + 0.16 (p 0.002, CI 0.28 s/d 1.08).

Conclusions

Trimetazidine therapy for 3 months on top of standard PAH regime significantly improve RVEF and functional capacity in PAH patients.

Abstract P194 Figure. Effect of trimetazidine on RV function