European Society of Cardiology
Clinician and Researcher / Physician-scientist
Zurich | Switzerland
Main Specialties: Advanced Heart Failure & Transplant Cardiology, Cardiovascular Disease, Clinical Cardiac Electrophysiology, Emergency Medicine
Additional Specialties: Cardiology, Internal Medicne, Emergency Medicine
Dr. Han Naung Tun is a Physician, working with European Society of Cardiology . He got MBBS from Yangon, Myanmar and he also finished Postgraduate General Medicine Training form Myanmar Medical Association in 2015 .After 2 years of his studied in General Medicine from MMA, he worked as a General and Family Physician. He is a former Clinical Doctor with Medecins Sans Frontieres(Holland) in Tropical Medicine and Infectious Diseases ( HIV and TB Medicine) in Yangon, Myanmar in 2014. In additions, he also worked as a Technical Support Coordinator for HIV/TB and Tropical Medicine in USAID's PEPFAR Project for Upper Myanmar Region. He became an International Active Member of American College of Family Physician (AAFP) in 2015 . After that, he received MACTM and joined with Australasian College of Tropical Medicine (ACTM) working group and got FACTM in 2020. As he has strong passion on Cardiology ,he went to Switzerland and attended International Postgraduate Cardiology training in Davos and Zurich Heart House Then, he started to join with European Society of Cardiology in January , 2015 and he is currently a researcher and clinician in ESC working groups . He became an International Active Member of American College of Cardiology and American Heart Association in 2018. He is also an International Associate of Royal College of Physician of Edinburgh and gained MRCPE. His claim to fame was that he is the first clinical doctor from Myanmar to attend Cardiology update conference in Davos , Switzerland and was mentioned about him in European Heart Journal .Han Naung Tun has authored and co-authored over 40 scientific publications and mentored 10 MSc students .His passion is to do clinical and research in Cardiology emphasis on acute cardiac diseases , arrhythmias and heart failure . He is currently a local Primary Investigator of Myanmar and working member of EURObservational Research Programme, Cardiomyopathy & Myocarditis Long-Term Registry and Registry of Pregnancy and Cardiac disease (ROPAC) Preg III :
Prosthesic valve(s) or Aortic pathology . He is also an editorial board member of Journal of Infectious Diseases and Research in SciTech Central , CPQ Microbiology, Journal of Vaccinology and EC Cardiology .
Elected national representative of "Heart Failure Specialist of Tomorrow; HFA HoT Representatives (2018-2020)" for Myanmar in European Society of Cardiology. This very successful organization developed several programmes, including workshops, lectures, and a mentor-programme.
Award - Paul Dudley White International Scholar Award ???? in Boston , 2019 and in Chicago in 2020.
Research ID -T-6264-2018 (researcherid.com/rid/T-6264-2018)
ORCID – 0000-0002-4789-2072 (orcid.org/0000-0002-4789-2072)
Publon ID - a/1590207(publons.com/a/1590207)
Website : annasxhan.blogspot.com
Emai : firstname.lastname@example.org
Supervisors: ESC and ERC
Primary Affiliation: European Society of Cardiology - Zurich , Switzerland
Eur J Case Rep Intern Med 2020 24;7(5):001484. Epub 2020 Mar 24.
Heart and Vascular Centre, Victoria Hospital Yangon, Myanmar.
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EC Cardiology 5.12 (2018): 871-878.
Heart failure (HF) is a complex clinical syndrome and it is one of the common cardiovascular complication seen in diabetes mellitus (DM). The coexistence of heart failure and diabetes is not rare and affects vice versa between severity of Diabetes and Heart Failure in complex pathophysiology. The management of diabetes in heart failure patients is carefully tackled in clinical setting due to different adverse reaction of oral hypoglycemic agents that may affect and worsen the condition of heart failure. So, the selection of the use of effective oral hypoglycemic agents in heart failure especially in patients with heart failure reduced ejection fraction (HFrEF) is very important to control the cardio-endocrinological benefit. Metformin is a biguanide class of antidiabetic medications, was first described in the scientific literature in 1922, as a product in the synthesis of N,N-dimethyl guanidine. Generally, the suppressive action of metformin on liver glucose production (hepatic gluconeogenesis) decreases blood glucose level. Recent multicenter observational studies show metformin is associated with lower mortality rate and reduced the hospitalization in heart failure. This article focuses the metabolic disturbances of Type 2 DM in heart failure and the safely usefulness metformin of in Type 2 diabetes with heart failure. Keywords: Type 2 DM; Heart Failure; Oral Hypoglycemic Agents; Metformin
Tun HN & Mazhar MW. (2018) How to Perform Effective Prophylaxis of Endocarditis in Developing Countries? J Infect Dis Res, 1(1): 9-11.
Journal of Infectious Diseases & Research
Infective endocarditis(IE) is a preventable infectious heart disease that invades to endocardial part of heart. The occurrence of IE is still seen and has impacted to high risk morbidity patients. Despite it can easily be prevented, it is still been a challenge to prevent especially in low economic and developing countries. Antibiotic prophylaxis alone is not recommended to prevent infective endocarditis because there is no strong association between having an interventional procedures and development of IE. Preventive antibiotics are no longer recommended for any other congenital heart disease but may be considered in highrisk cardiac conditions. According to recent NICE and ESC guideline, prevention of IE with antibiotic is needed to give clear information about the benefits and risks of antibiotics prophylaxis. Thus, it is very important to know how to give effective antibiotics prophylaxis in high risk patients. Keywords: Infectious diseases, Endocarditis, Cardiovascular diseases, Prophylaxis
Tun HN. (2018) Infectious Diseases in Treasure Land of Southeast Asia - Experiences on Hilly Region of Myanmar. J Infect Dis Res, 1(1): 21-25
Journal of Infectious Diseases & Research
Between July 2016 to March 2017, I got involved as a Senior Medical Doctor and Technical Support Officer to Northern and Eastern Shan State for the PEPFAR Project of USAID with PSI (Population Service International) and Malteser International. I was responsible for prevention and treatment of infectious diseases especially in HIV/AIDS and Harm Reduction of Narcotic drug users in Shan State. This was professionally very challenging and actively involved the management of multi-faceted on health threats, including HIV, HCV and Blood borne diseases prevention in Lashio and Muse, then Maternal health, Child health and Nutrition Program in Eastern Shan State for Malteser International Organization and Data collection in disease prevalence of Malaria, Dengue Hemorrhage Fever, Diarrhea, Nutritional Deficiency and Environment Hazards. It was personally challenging, with the requirement to travel extensively and negotiate with wide range of individuals and different sectors while the situation was still under the reconciliation for peace and truce. Keywords: Myanmar, Shan State, Healthcare, Facility, Infectious diseases
Tun HN (2018) Cardio-diabetology: New subspecialty and collaborative work to defeat the burden of deadly duo. J Cardiovasc Med Cardiol 5(4): 081-084. DOI: 10.17352/2455-2976.000077
Journal of Cardiovascular Medicine and Cardiology
Cardiovascular disease (CVD) is one of the most global threatened diseases; particularly coronary artery disease (CAD) is a major deadly attack around the world. Diabetes mellitus (DM) is associated with a 2 to 4-fold increased mortality risk from heart disease. Diabetes related microvascular complication is seemed to be a hazardous factor for cardiovascular system and likely to cause coronary arteries disease, hypertension, peripheral arteries, and carotid vessels, especially seen in the type 2 DM populations. The severity of cardiovascular complications are related to prolong hyperglycemia and the control of dysglycemia. Thus, effective glycemic control is one of the imperative aspects of the management for the prevention of CVD in diabetes. In addition, different kinds of antidiabetes agents have different mechanism of actions that has impacted to cardiovascular outcome. The benefit and risk of current anti-diabetic agents are needed to define clearly and that is needed to promote effective clinical care between cardiology and diabetology. There are multiple complications and sequelae of diabetes that requires the involvement of cardiologic expertise in the diabetes care setting in heart disease population. Therefore, the close cooperation between the cardiologist and the diabetologist is new perceptive way of care to defeat diabetes related cardiovascular complications.
BAOJ Cell Mol Cardio 2017, 3: 23: 015
BAOJ Cellular and Molecular Cardiology
Standard 12-lead electrocardiography (ECG) is a widely available technology that is routinely applied in the setting of chest pain to identify patients with ST-elevation myocardial infarction (STEMI) who would beneﬁt from primary PCI .
EC Cardiology 5.3 (2018): 82-89
Studying the genetic of human renin angiotensin system, AGT M235T polymorphism has been associated with the mechanism of the pathophysiology of essential hypertension. The present study efforts on the association between the AGT M235T polymorphism and plasma angiotensinogen level of different genotypes in essential hypertension in local area by the molecular technique that dis-sects the understanding pathophysiology of essential hypertension in Myanmar population.The study involved 144 subjects, 72 hypertensives and 72 normotensives. After getting informed consents, the AGT M235T geno-types were determined by PCR-RFLP followed by enzyme digestion and Enzyme-Linked Immunosorbant Assay (ELISA) was used to determine plasma angiotensinogen level. In the TT and MT genotypes that were mutant homozygous and heterozygous genotypes, the plasma angiotensinogen level was signiicantly increased in hypertensives than those of normotensives (p = 0.005 and < 0.001 respectively). In the present study, sub -jects carrying the homozygous TT genotype possessed three folds increased in plasma angiotensinogen level than subjects carrying homozygous MM genotype in essential hypertension. There was signiicant difference between the genotypes of AGT M235T poly- morphism and plasma angiotensinogen level in the study group χ 2 = 38.16 and ρ < 0.001. This study supported the signiicant association of the AGT M235T variant and plasma angiotensinogen level with essential hy-pertension in Myanmar. That may lead to indicate that AGT variants might play a critical role in the pathogenesis of essential hyper-tension in local area.
EC Cardiology 5.8 (2018): 563-571
Radial artery occlusion is a usually silent complication of transradial approach that may prevent future transradial procedures.TR Band provides quick, effective, comfortable hemostasis and reduces arterial occlusion. The purposive significance of this study was to evaluate the usefulness of TR band after coronary angiogram in decreasing the frequency of radial artery occlusion. Method A total of 180 patients with undergoing coronary angiogram through transradial access of any gender between age 18 - 70 years were included. Patients with history of previous coronary angiogram through transradial access, undergoing PCI and h/o peripheral arterial disease were excluded. Full demographic informations including age, gender were included in the study. The radial artery occlusion (RAO) was assessed by Barbeau test after 24 hours of coronary angiography. Results: Mean age was 54.19 ± 12.30 years. Out of the 180 patients, 123 (68.33%) were male and 57 (31.67%) were females with male to female ratio of 2.16:1. Radial artery occlusion was found in 14 (7.78%) patients. It was also found that presence of confounding variables i.e. diabetes mellitus, hypertension and smoking, increased the risk of radial artery occlusion though this difference was found to be only statistically signiicant for diabetes mellitus. Conclusion: This study concluded that TR pneumatic compression band is a very useful and safe method with frequency of radial artery occlusion is only 7.78% after transradial cardiac catheterization.
Tun HN (2018) Nature of Human Gut Microbiome: How do they play in Cardiovascular Disease? J Cardiovasc Med Cardiol 5(4): 064-066. DOI: 10.17352/2455-2976.000074
Journal of Cardiovascular Medicine and Cardiology
Cardiovascular disease is the number one killer of death around the world. Most of the cardiovascular diseases are caused by sedentary life style, bad eating habit, tobacco smoking, high alcohol intake, dyslipidemia and genetic factors .Recently the idea of human microbiome science has emerged in diseases pathogenesis .The human gut is a house of trillions of microbial floral. Since a couple of decades ago, there has been interesting insights into the human gut microbiota and have highlighted its increasingly association to cardiovascular (CV) and metabolic diseases. Trimethylamine N-oxide (TMAO), which is a metabolic product from gut microbiota plays a central role in cardiovascular disease pathogenesis. Nature of microbial inhabitants within the host has been noticed by the numbers of scientists and researchers to understand more about the hidden mechanism of diseases pathogenesis including cardiovascular disease, metabolic and autoimmune diseases and it has become a good hope to develop new drug designs to prevent metabolic and cardiovascular disease in near future.
EC Cardiology 5 .4 (2018): 224-228
Electrolytes imbalance caused by potassium disorders are commonly seen in many clinical conditions due to alterations in potas-sium intake, changes in excretion or transcellular shifts. Hypokalemia is a common electrolyte disorder in clinical practice and that can lead to serious arrhythmias. Most of the arrhythmias caused by electrolytes imbalance can be usually noticed by electrocardio-gram changes. Despite the underlying causes of arrhythmia can be predicted by history taking from patients and ECG changes, some-time it can be missed to provide optimal care and effective medication in time. Thus, physicians and health care providers should be familiar with ECG changes and of electrocardiogram manifestations about electrolyte imbalance in clinical care. Typically, the irst ECG manifestation of hypokalemia is decreased T-wave amplitude but arrhythmias associated with hypokalemia include sinus brady- cardia, premature ventricular contractions, ventricular tachycardia, or ibrillation, and torsade de pointes can lead to life threatening condition. The present case report article shows the association between the premature ventricular contraction and severe hypoka-lemia caused by electrolyte imbalance due to chronic diarrhea. Keywords: Hypokalemia; ECG Changes; Ventricular Arrhythmia; Premature Ventricular Contraction
Cardiology & Vascular Research, SciVision Publisher
Introduction: There is alarming problem in increasing incidence of hypertension and its complications in Myanmar. The genetic background of hypertension is not known well in Myanmar population. The present study aimed to nd out the association with angiotensinogen gene M235T polymorphism, plasma angiotensinogen level, BMI and essential hypertension in local area. Methods: There were 144 subjects, 72 hypertensive and 72 normotensives from internal medicine unit of Mandalay General Hospital and Mandalay area. After getting informed consents, determination of blood pressure and BMI were done. The AGT M235T genotypes were determined by polymerase chain reaction followed by digestion of the products with Tth111I. The determination of plasma angiotensinogen level was done by ELISA method. Results: The odd ratio for essential hypertension of TT genotype was 4.93 (95% CI- 1.97-5.40) and genotype frequency was statistically signicant between hypertensive and normotensives, p<0.001. And subjects carrying T allele has 2.5 times greater chance for essential hypertension [OR=2.56 (95% CI-1.59-4.13)]. The plasma angiotensinogen level in hypertensive was 65.00 ± 27.73 ng/ml and 24.87 ± 15.06 ng/ml in normotensives (p<0.001). Moreover, subjects carrying TT genotype have increased plasma angiotensionogen than other genotypes in both hypertensive and normotensives (P<0.001). Determination of their BMI, there was found that signicance difference between hypertensive than that of normotensives (p<0.001). In normotensives, 9.7% has TT genotypes and interestingly they have increased BMI than other genotypes. Conclusion: In fact, the study noted that there was association between AGT M235T polymorphism and increased plasma angiotensinogen and increased BMI in essential hypertension
Diagnostic accuracy of TIMI versus GRACE score for prediction of death in patients presenting with Acute Non-ST Elevation Myocardial Infarction (NSTEMI
Journal of Cardiology and Cardiovascular Medicine
Background: Acute Coronary Syndrome describes a spectrum of disease ranging from unstable angina through non-ST-Elevation Myocardial Infarction (NSTEMI) to ST-Elevation Myocardial Infarction (STEMI). Early death in NSTEMI is usually due to an arrhythmia. Patients should be admitted immediately to hospital, preferably to a cardiac care unit because there is a significant risk of death.
Objective: To compare the diagnostic accuracy of TIMI versus GRACE for prediction of death in patients presenting with Acute Non-ST elevation Myocardial Infarction.
Material & Methods: This present cross sectional study was conducted at Department of Cardiology, CPEIC, Multan. All patients assessed according to given scores in the two scoring system i.e. TIMI risk score and GRACE score. Then patients were labeled as high or low risk for death. Data was collected by using pre-designed proforma. 2x2 tables were generated to measure the sensitivity, specificity, positive predictive value, negative Predictive value and diagnostic accuracy of TMI Risk score and GRACE Score for prediction of death in NSTEMI patients.
Results: In our study the mean age of the patients was 55.73±9.78 years. The male to female ratio of the patients was 1.6:1. The diabetes as risk factor was found in 145(39%) patients, smoking as risk factor was found in 53(14.2%) patients and hypertension as risk factor was found in 174(46.8%) patients. the sensitivity of TIMI risk was 97.7% with specificity of 92.93% and the diagnostic accuracy was 95.16%, similarly the sensitivity of GRACE risk was 100% with specificity of 95.96% and the diagnostic accuracy was 97.85%.
Conclusion: Our study results concluded that both the TIMI risk and GRACE risk are good predictor of death in patients presenting with Acute Non-ST elevation Myocardial Infarction with higher sensitivity and diagnostic accuracy. However the GRACE risk showed more accurate results as compared to TIMI risk