Objective Medically refractory angina remains a significant health concern despite major advances in revascularization techniques and emerging medical therapies. We aimed to determine the safety and efficacy of extracorporeal shockwave myocardial therapy (ESMT) in managing angina pectoris. Methods A single-arm multicenter prospective study was designed aiming to determine the safety and efficacy of ESMT. Patients of functional Canadian Cardiovascular Society class 11–IV, despite stable and optimal medical management, with documented myocardial segments with reversible ischemia and/or hibernation on the basis of echocardiography/single-photon emission computerized tomography (SPECT) were enrolled from 2010 to 2012. A total of 111 patients were enrolled, 33 from Indonesia, 21 from Malaysia, and 57 from Philippines. Patients underwent nine cycles of ESMT over 9 weeks. Patients were followed up for 3–6 months after ESMT treatment. During follow-up, patients were subjected to clinical evaluation, the Seattle Angina Questionnaire, assessment of nitrate intake, the 6-min walk test, echocardiography, and SPECT. Results The mean age of the population was 62.9 ± 10.9 years. The summed difference score on pharmacologically induced stress SPECT improved from 9.53 ± 17.87 at baseline to 7.77 ± 11.83 at follow-up (P = 0.0086). Improvement in the total Seattle Angina Questionnaire score was seen in 83% of patients (P < 0.0001). Sublingual nitroglycerin use significantly decreased (1.14 ± 1.01 tablets per week at baseline to 0.52 ± 0.68 tablets per week at follow-up; P = 0.0215). There were no changes in left ventricular function on echocardiography (0.33 ± 9.97, P= 0.93). The Canadian Cardiovascular Society score improved in 74.1% of patients. Conclusion This multicenter prospective trial demonstrated that ESMT is both a safe and an efficacious means of managing medically refractory angina.

Background: Cardiotoxicity as a result of anthracycline chemotherapy has been linked to increased morbidity and mortality in breast cancer patients. There is a need for early detection through risk factor identification. To date, no large multicenter study has been conducted to describe the incidence, risk factors and clinical and demographic profiles of breast cancer patients with anthracycline-induced cardiotoxicity (AIC) in the Philippines.Methods: This was a nationwide multicenter retrospective cohort study among adult breast cancer patients who underwent anthracycline chemotherapy from 2015 to 2020 in 10 sites in the Philippines. Baseline characteristics and possible risk factors for AIC were re-trieved from medical records and cancer registries. AIC was defined as a reduction of left ventricular ejection fraction (LVEF) by > 10% from baseline to a value of < 53% or the development of overt left ventricular systolic dysfunction or heart failure (HF). Odds ratios from logistic regression were computed to determine risk factors associated with AIC using STATA-15.0 software. Results:Out of 341 patients included, 33 had AIC, accounting for an incidence of 9.68%. Nine patients (2.6%) had clinical HF. AIC patients had a mean age of 53.91 ± 10.84 years. Breast cancer AIC patients were significantly older and had lower body mass index (BMI) than those without AIC. AIC patients had significantly more comorbidities, especially hypertension and atrial fibrillation. Multivariate analysis showed that patients with any preexisting comorbidity are approximately 12.37 times as likely to have AIC, while those with concurrent chemotherapy are 0.07 times or 93% less likely to have AIC. Conclusion:Among adult breast cancer patients undergoing anthracycline chemotherapy, we determined a high incidence of cardiotoxicity at 9.68%. Having preexisting comorbidities gave patients 12 times increased odds of developing anthracycline cardiotoxicity. The presence of concurrent non-anthracycline chemotherapy showed an inverse association with the development of AIC which we attribute largely to patient selection in a retrospective study. The significantly higher propensity for AIC development in patients with preexisting comorbidities may warrant closer monitoring and control of patient comorbidities such as hypertension among patients undergoing anthracycline chemotherapy.

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Funding Acknowledgements Type of funding sources: None. BACKGROUND Acute respiratory injury is the main culprit for majority of the morbidity and mortality among COVID-19. However, there is a high prevalence of cardiovascular complication among these patients. Assessment of echocardiographic parameters provides clinical characteristics for utilization in the management of patients with COVID-19. OBJECTIVE To determine the predictors of mortality and analyze the echocardiographic findings of Filipino patients with COVID-19 Pneumonia and its correlation to the severity of the disease. METHOD This is a retrospective observational cohort study of the echocardiographic findings among 173  Filipino patients who acquired COVID-19 pneumonia from June to August 2020. Logistic regression analysis was used to identify predictors of dichotomous outcome variable. RESULTS The results showed that there was a significant direct correlation between the severity of COVID-19 and wall motion abnormality (r = 0.171; p = 0.024). There was also a significant direct correlation between length of hospital stay and the wall motion abnormality (r = 0.140; p = 0.050). Furthermore, there was a significant difference noted in the proportion of subjects with or without wall motion abnormality according to mortality (p = 0.007). The results also exhibit significant difference in the left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and left atrium according to mortality as shown by the p values 0.001, 0.001 and 0.030 respectively. However, there is no significant correlation noted between the severity of COVID-19 and mortality to the right ventricular size and function. Multivariate analysis using logistic regression, two variables were found to be significant predictors of mortality, this includes LVEDD and LVEF. CONCLUSION Among Filipino patients with COVID-19 pneumonia, the study demonstrated that left ventricular end diastolic diameter and left ventricular ejection fraction are significant predictors for mortality.