Genetic cause of heart valve defects revealed

Heart valve defects are a common cause of death in newborns. Scientists at the University of Bonn and the caesar research center have discovered “Creld1” is a key gene for the development of heart valves in mice. The researchers were able to show that a similar Creld1 gene found in humans functions via the same signaling pathway as in the mouse. This discovery is an important step forward in the molecular understanding of the pathogenesis of heart valve defects. The findings have been published in the journal “Developmental Cell.”Atrioventricular septal defect (AVSD) is a congenital heart defect in which the heart valves and cardiac septum are malformed. Children with Down’s syndrome are particularly affected. Without surgical interventions, mortality in the first months of life is high. “Even in adults, unidentified valve defects occur in about six percent of patients with heart disease,” says Prof. Dr. Michael Hoch, Executive Director of the Life & Medical Sciences (LIMES) Institute of the University of Bonn.For years, there have been indications that changes in the so-called Creld1 gene (Cysteine-Rich with EGF-Like Domains 1) increase the pathogenic risk of AVSD. …

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Exercise training improves health outcomes of women with heart disease more than of men

In the largest study to ever investigate the effects of exercise training in patients with heart failure, exercise training reduced the risk for subsequent all-cause mortality or all-cause hospitalization in women by 26 percent, compared with 10 percent in men. While a causal relationship has previously been observed in clinical practice between improved health outcomes and exercise, this trial is the first to link the effects of exercise training to health outcomes in women with cardiovascular disease. This study, an exploratory analysis, recently was published in the Journal of the American College of Cardiology: Heart Failure.”This trial was uniquely positioned to review results of exercise training in women compared with men since we included a pre-specified analysis of women, we used the largest testing database ever acquired of women and the population was optimized with medical therapy,” said Ileana Pia, M.D., M.P.H., associate chief, Academic Affairs, Division of Cardiology, Montefiore Medical Center, professor of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine of Yeshiva University, the NHLBI-sponsored clinical trial investigator and chair of the Steering Committee. “Heart disease has a major impact on women. Our goal is for these findings to greatly impact the management of this challenging syndrome.”Heart disease is the leading cause of death for women in the United States, responsible for one-in-four female deaths. Although women are twice as likely as men to develop heart failure following heart attack or cardiac ischemia, they are less often directed to complete an exercise program.Women with cardiovascular disease are largely underrepresented in past exercise research, and no large trial has previously studied the impact of exercise training on health outcomes for women with heart failure. The randomized, multicenter, international HF-ACTION (The Heart Failure — A Controlled Trial Investigating Outcomes of Exercise Training) trial included the largest cohort of women with heart failure to undergo exercise training, and examined potential gender differences that could affect physical exercise prescription.”These findings are significant because they represent important implications for clinical practice and patient behaviors,” said Dr. Pia. “Findings suggest physicians should consider exercise as a component of treatment for female patients with heart failure, as they do for male patients.”The clinical trial randomized 2,331 patients with heart failure and a left ventricular ejection fraction of less than or equal to 35 percent to either a formal exercise program plus optimal medical therapy, or to optimal medical therapy alone. Prior to randomization, patients underwent symptom-limited cardiopulmonary exercise tests to assess exercise capacity, as measured by peak oxygen uptake (VO2). …

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New heart failure symptom: Shortness of breath while bending over

UT Southwestern Medical Center cardiologists have defined a novel heart failure symptom in advanced heart failure patients: shortness of breath while bending over, such as when putting on shoes.The condition, which UT Southwestern cardiologists named “bendopnea” (pronounced “bend-op-nee-ah”), is an easily detectable symptom that can help doctors diagnose excessive fluid retention in patients with heart failure, according to the findings published in a recent edition of the Journal of the American College of Cardiology: Heart Failure.”Some patients thought they were short of breath because they were out of shape or overweight, but we wondered if there was something more to it. So we developed this study to further investigate this symptom,” said Dr. Jennifer Thibodeau, Assistant Professor of Internal Medicine in the Division of Cardiology.Dr. Thibodeau cautions that bendopnea is not a risk factor for heart failure, but rather a symptom that heart failure patients are becoming sicker and may need to have their medications or treatments adjusted.Bendopnea is a way for both doctors and patients to recognize something may be amiss with their current heart failure treatment. Patients should speak with their cardiologist or health care provider if they experience bendopnea, notes Dr. Thibodeau.Of the 5.7 million Americans living with heart failure, about 10 percent have advanced heart failure, according to the American Heart Association. The condition is considered advanced when conventional heart therapies and symptom management strategies no longer work.UT Southwestern doctors enrolled 102 patients who were referred to the cardiac catheterization lab for right heart catheterization and found that nearly one-third of the subjects had bendopnea.When the patients were lying flat, clinicians measured both the pressures within the heart as well as the cardiac output — how well the heart is pumping blood to the rest of the body — in all 102 patients. Then, they repeated these measurements in 65 patients after they were sitting in a chair for two minutes, and then bending over for one minute.”We discovered that patients with bendopnea had too much fluid in their bodies, causing elevated pressures, and when they bent forward, these pressures increased even more,” said Dr. Thibodeau, first author of the study.Story Source:The above story is based on materials provided by UT Southwestern Medical Center. Note: Materials may be edited for content and length.

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Gestational diabetes may raise risk for heart disease in midlife

Pregnant women may face an increased risk of early heart disease when they develop gestational diabetes, according to research in the Journal of the American Heart Association.Gestational diabetes, which develops only during pregnancy and usually disappears after the pregnancy, increases the risk that the mother will develop diabetes later. The condition is managed with meal planning, activity and sometimes insulin or other medications.In the 20-year study, researchers found that a history of gestational diabetes may be a risk factor for early atherosclerosis in women during midlife before the onset of diabetes and metabolic diseases.”Our research shows that just having a history of gestational diabetes elevates a woman’s risk of developing early, sub-clinical atherosclerosis before she develops type 2 diabetes or the metabolic syndrome,” said Erica P. Gunderson, Ph.D., M.S., M.P.H., study lead author and senior research scientist in the Division of Research at Kaiser Permanente Northern California in Oakland, Calif. “Pregnancy has been under-recognized as an important time period that can signal a woman’s greater risk for future heart disease. This signal is revealed by gestational diabetes, a condition of elevated blood sugar during pregnancy.”At the start of the study, researchers measured risk factors for heart disease before pregnancy among 898 women, 18 to 30 years old, who later had one or more births. The women were periodically tested for diabetes and metabolic conditions before and after their pregnancies throughout the 20-year period. Carotid artery wall thickness was measured on average 12 years after pregnancy when women were 38 to 50 years old. The study controlled for age, race, number of births and pre-pregnancy body mass index, and fasting blood glucose, insulin, lipids, and blood pressure.Participants were divided into women who developed gestational diabetes and those who didn’t. Overall, 119 women (13 percent) reported they had developed gestational diabetes (7.6 per 100 deliveries).Carotid artery media thickness is an early measure of sub-clinical atherosclerosis and predicts heart attack and stroke in women. Researchers used ultrasound studies to image the carotid artery, with four measurements from the near and far wall thickness.Among the women who did not go on to develop diabetes or the metabolic syndrome during the 20- year follow up, they found a 0.023 mm larger average carotid artery intima-media thickness in those who had gestational diabetes compared to those who didn’t, and the difference was not attributed to obesity or elevated glucose before pregnancy.”This finding indicates that a history of gestational diabetes may influence development of early atherosclerosis before the onset of diabetes and metabolic diseases that previously have been linked to heart disease,” Gunderson said. …

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Stroke survivors often return to driving without being evaluated for ability

Date:February 13, 2014Source:American Heart AssociationSummary:Stroke survivors often resume driving without being formally evaluated for ability — though stroke can cause deficits that can impair driving, according to researchers.Stroke survivors often resume driving without being formally evaluated for ability — though stroke can cause deficits that can impair driving, according to research presented at the American Stroke Association’s International Stroke Conference 2014.Researchers surveyed 162 stroke survivors a year after their strokes and found:More than 51 percent returned to driving — many a month after suffering a stroke. Only 5.6 percent received a formal driving evaluation. Eleven percent of those who returned to driving reported their strokes had greatly impacted their abilities to perform important life activities. Among those who returned to driving and reported no effect on their abilities to perform important life activities, more than 45 percent limited their driving. Researchers suggest stroke survivors may benefit from formal evaluation before resuming driving.Story Source:The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.Cite This Page:MLA APA Chicago American Heart Association. “Stroke survivors often return to driving without being evaluated for ability.” ScienceDaily. ScienceDaily, 13 February 2014. .American Heart Association. (2014, February 13). …

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Majority of Americans have their heart health facts wrong

Despite the fact that heart disease is the leading cause of death for both men and women in the U.S., about three-quarters (74 percent) of Americans do not fear dying from it, according to a recent survey from Cleveland Clinic.Conducted as part of its “Love Your Heart” consumer education campaign in celebration of Heart Month, the survey found that Americans are largely misinformed about heart disease prevention and symptoms, and almost a third (32 percent) of them are not taking any proactive steps to prevent it. Even among those Americans with a family history of the disease (39 percent), who are at a significantly higher risk, 26 percent do not take any preventative steps to protect their heart health, according to the survey.Perhaps even more concerning is that the majority (70 percent) of Americans are unaware of all the symptoms of heart disease, even though two out of three (64 percent) have or know someone who has the disease. Only 30 percent of Americans correctly identified unusual fatigue, sleep disturbances and jaw pain as all being signs of heart disease — just a few of the symptoms that can manifest.”Heart disease is the No. 1 killer of men and women in this country, so it’s disappointing to see that so many Americans are unaware of the severity of not taking action to prevent heart disease, or how exactly to do so,” said Steven Nissen, M.D., Chairman of Cardiovascular Medicine at Cleveland Clinic. “This is a disease that can largely be prevented and managed, but you have to be educated about how to do so and then incorporate prevention into your lifestyle.”Unfortunately, the survey shows Americans are not well educated about general heart health and heart disease prevention:Many Americans believe the myth that fish oil can prevent heart disease.Though fish oil does offer health benefits, it does little to prevent heart disease. Even so, more than half of Americans (55 percent) believe the recommended daily dose of fish oil can prevent heart disease. Yet, the truth is that one would have to consume enough fish oil to literally smell like fish for it to have any beneficial effect. In addition, some seafood can be just as high in cholesterol as red meat, a fact that only 45 percent of Americans know.Vitamins are viewed — mistakenly — as a key to heart disease prevention.More than half (61 percent) of Americans incorrectly believe that vitamins or other supplements have a positive effect on hearth health, and 44 percent believe they can lower cholesterol. Studies have shown that vitamins have almost no effect on heart health, and some can be detrimental.There is a lack of awareness about secret sodium sources.About one-third (32 percent) of Americans inaccurately believe that cheese is the biggest source of sodium in the average diet, when in fact bread products have the higher salt content. Only 24 percent identified bread as the leading sodium culprit, leaving three-quarters of Americans completely unaware.Americans believe there is a heart disease gene.According to the survey, 59 percent of Americans believe a heart disease gene could be the key to determining their predisposition to the condition, yet no such gene has been identified. …

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Overnight dialysis boosts kidney health, reduces risk of heart disease

Oct. 18, 2013 — Receiving dialysis at home while sleeping not only improves kidney health and quality of life for people with kidney disease, it could also decrease their risk of heart disease, says new study presented at the Canadian Cardiovascular Congress.”Patients with end-stage renal disease have at least a five-fold increase in cardiovascular complications,” says Dr. Christopher Overgaard, one of the study’s authors and a cardiologist at the Toronto General Hospital. “Longer dialysis, done while patients are sleeping, may improve the health of arteries and could lower the risk of developing heart disease.”The study found that after patients transitioned to overnight dialysis, there were improvements in coronary artery function.Because of the frequency and duration of overnight dialysis, toxins are more evenly and gently removed from the blood. “Increasing the number of hours patients receive their treatment results in less toxin buildup in their blood for shorter durations,” says Dr. Overgaard.Impaired endothelial function — a condition that reduces blood vessel’s ability to dilate — puts kidney patients at a significantly higher risk for the development of atherosclerosis (the buildup of fat in the walls of arteries). Atherosclerosis, in turn, can eventually lead to serious problems including heart attacks, stroke or even death.Conventional hemodialysis in a clinic typically involves dialysis three times a week, for three to four hours at a time — upwards of 12 hours a week.Contrast that with what’s called overnight “home” hemodialysis, done while patients sleep at home. This method allows dialysis six times a week, for up to 12 hours at a time, for up to 72 hours.Beyond the clinical benefits, patients on overnight dialysis no longer have to revolve much of their schedule around clinic trips.”This method also improves quality of life by having the dialysis in the comfort of your home, while sleeping, instead of being stuck in a dialysis unit for hours,” says Dr. Overgaard. “Old-fashioned dialysis is stressful.”A dialysis machine functions as a kidney for people whose kidneys aren’t functioning properly; in essence, cleaning their blood.”This could be revolutionary for kidney patients,” says Dr. …

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Five percent of US children, teens classified as ‘severely obese’

Sep. 9, 2013 — About 5 percent of U.S. children and teens are “severely obese” — a newly defined class of risk, according to an American Heart Association scientific statement published online in the journal Circulation.”Severe obesity in young people has grave health consequences,” said Aaron Kelly, Ph.D., lead author of the statement and a researcher at the University of Minnesota Medical School in Minneapolis. “It’s a much more serious childhood disease than obesity.”While childhood obesity rates are starting to level off, severe obesity has increased, Kelly said.Severely obese children have higher rates of type 2 diabetes and cardiovascular issues at younger ages, including high blood pressure, high blood cholesterol and early signs of atherosclerosis -the disease process that clogs arteries.Treatment options for children with this level of obesity are limited, as most standard approaches to weight loss are insufficient for them.The statement defines children over age 2 as severely obese if they either have a body mass index (BMI) that’s at least 20 percent higher than the 95th percentile for their gender and age, or a BMI score of 35 or higher. A child in the 95th percentile weighs more than 95 percent of other children of the same gender and age.BMI is a measurement based on weight and height. Age- and gender-specific growth charts are used to calculate BMI for children. Children at the 95th BMI percentile or higher are obese, and those between the 85th and 95th percentiles are overweight.A 7-year-old girl of average height weighing 75 pounds, or a 13-year-old boy of average height weighing 160 pounds, would be defined as severely obese.Most experts recommend a step-wise approach for treating severely obese children, with treatment getting gradually more intensive from lifestyle changes, to medication and potentially surgery.”But the step from lifestyle change and medication to surgery is unacceptably large because weight loss surgery isn’t appropriate for or available to all severely obese children,” Kelly said.The statement calls for “innovative approaches to fill the gap between lifestyle/medication and surgery.”The statement suggests ways to close the gap, including:conduct more research on bariatric surgery’s effects and safety; evaluate effectiveness of lifestyle modification interventions, including adherence to dietary and physical activity plans; fund research to find other useful interventions, including better drugs and medical devices; and recognize severe obesity as a chronic disease requiring ongoing care and management.

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Short-term blood sugar control protects the kidney but not the heart in patients with diabetes

Sep. 6, 2013 — An international study has shown that short-term blood sugar control in patients with diabetes has a limited effect on their risk of cardiovascular problems, such as heart disease and stroke.Conventional belief has been that high blood sugar is a major factor in cardiovascular disease. However, this latest research adds to a growing body of evidence that risk of cardiovascular disease in patients with diabetes cannot be managed meaningfully by controlling blood sugar alone.The study, led by researchers at Harvard Medical School, USA, and Hadassah Medical Centre, Israel, supported by other global institutions, including St George’s, University of London, examined the effect of the drug saxagliptin, a new class of medicine used to reduce blood sugar levels, in patients with Type 2 diabetes.There are 280 million people worldwide suffering with Type 2 diabetes, a disease defined by high levels of blood sugar. Diabetes doubles the risk of heart attack and stroke and can reduce life expectancy by up to six years. Recognised long-term effects of the condition include blindness, kidney failure, stroke and heart attack.More than 16,000 patients were studied for over two years to test saxagliptin’s cardiovascular safety and also measure whether it could reduce the risk of cardiovascular and kidney damage.Researchers found that the drug was as safe as existing glucose-controlling medicines. By lowering blood sugar it also successfully reduced the damage diabetes causes to kidney function.Importantly, however, despite control of blood sugar levels researchers found no significant reduction in the risk of major cardiovascular events such as heart attack or stroke.Professor Kausik Ray, the study’s UK national lead from St George’s, University of London, said: “Through this trial we studied the effects of a glucose reducing drug on patients over a two-year period and observed that there was no significant benefit from lowering blood sugar levels with respect to the large blood vessels, which contribute to heart attacks and strokes. We did, though, observe a benefit on smaller vessels that contribute to kidney disease. This trial tells us that cardiovascular risk among diabetes patients must be managed through other mechanisms.”Controlling blood sugar in the short term certainly doesn’t present a very meaningful benefit to a patient at risk of cardiovascular problems, although there could be gains over a much longer period. The most effective way to manage cardiovascular disease is through established interventions such as reducing blood pressure, managing cholesterol and encouraging healthier lifestyles.”It is clear to us now that, in patients with diabetes, there are effective therapies that will reduce their risk of kidney failure and there are separate therapies that will help reduce their risk of cardiovascular problems. More research is needed if we are to find new ways to manage cardiovascular risk in future.”The study, published by the New England Journal of Medicine on Monday 2 September 2013, is the largest diabetes trial ever carried out, conducted at 788 sites across 26 countries. …

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Heart attack death rates unchanged in spite of faster care at hospitals

Sep. 4, 2013 — Heart attack deaths have remained the same, even as hospital teams have gotten faster at treating heart attack patients with emergency angioplasty, according to a study in this week’s New England Journal of Medicine.Hospitals across the country have successfully raced to reduce so-called door-to-balloon time, the time it takes patients arriving at hospitals suffering from a heart attack to be treated with angioplasty, to 90 minutes or less in the belief that it would save heart muscle and lives.In an analysis led by the University of Michigan Frankel Cardiovascular Center of 100,000 heart attack admissions across the United States between 2005 and 2009, a time period that coincided with a national effort to reduce door-to-balloon time, 4.7 percent of patients died. The rate was virtually unchanged in spite of the faster care.”The data suggests that efforts to reduce door-to-balloon time further may not result in lower death rates,” says lead study author and interventional cardiologist Daniel Menees, M.D., assistant professor of internal medicine at the University of Michigan Medical School.”Potential strategies to improve care may include increasing patient awareness of heart attack symptoms, reducing delays for treatment once symptoms begin, and shortening transfer time between health care facilities once a heart attack is recognized.”Door-to-balloon time describes the amount of time between when a patient arrives at the hospital and when they receive percutaneous coronary intervention (PCI), such as angioplasty, in which a catheter with a small balloon at the tip is inserted and inflated to open a blocked artery.The New England Journal of Medicine study of patients treated for heart attack at 515 hospitals participating in the CathPCI Registry® found door-to-balloon time fell from 83 minutes in 2005-2006 to 67 minutes in 2008-2009.The findings show the result of collaboration and teamwork among teams led by cardiologists, emergency medicine physicians and emergency medical services to reduce the time it takes to treat a heart attack.Health care quality has been measured by how well hospitals meet the 90-minute time goal. The U-M Health System is among those hospitals reporting its own performance publicly on the Web.”But the pendulum may have swung too far,” Menees says. “In our rush to provide treatment even faster, we may be taking patients for angioplasty who don’t need one and possibly even placing those patients at-risk.”Door-to-balloon time is easy to measure and something we can control but it’s only a fraction of the total ischemic time,” he says.Each year, almost 250,000 Americans have the most serious kind of heart attack called a “STEMI,” which stands for ST-elevated myocardial infarction. It is caused by a blocked artery shutting down blood supply to a large area of the heart.”Heart muscle is dying while a patient is thinking, ‘Is this real? Should I call, or should I not call for help?’ ” says senior study author and interventional cardiologist Hitinder Gurm, M.D., associate professor of internal medicine at the U-M Medical School. “We’re seeing a fair amount of delay in seeking treatment. That has been harder to fix.”The study showed the percentage of heart attack patients receiving care in 90 minutes or less improved from 59.5 percent to 83.1 percent. However the heart attack mortality rate remained virtually unchanged at 4.8 percent in 2005 and 4.7 percent in 2009.”Emergency teams and the cardiology community have worked hard with the hope that reducing door-to-balloon time would improve patient outcomes,” Gurm says. …

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Youthful stem cells from bone can heal the heart

Sep. 4, 2013 — Many people who survive a heart attack find themselves back in the hospital with a failing heart just years later. And the outcome often is unfavorable, owing to limited treatment options. But scientists at Temple University School of Medicine’s Cardiovascular Research Center (CVRC) recently found hope in an unlikely source — stem cells in cortical, or compact, bone. In a new study, they show that when it comes to the regeneration of heart tissue, these novel bone-derived cells do a better job than the heart’s own stem cells.According to the study’s senior investigator, Steven R. Houser, Ph.D., FAHA, Chairperson of Temple’s Department of Physiology and Director of the CVRC, it is early days for cortical bone-derived stem cells (CBSCs). Nonetheless, his team’s findings, featured on the cover of the August 16th issue of Circulation Research, have considerable implications for stem cell therapy for the heart.A major challenge in the treatment of heart attack is early intervention, which is key to reducing the chances for long-term complications, such as heart failure. When it comes to stem cells, Houser said, “The strategy is to inject the cells right after [a heart attack].” Currently, though, that approach works only in animal studies. To make it work in humans, Houser explained, “we need cells right off the rack and ready to go clinically.”CBSCs could be those cells. Stem cells are youthful by degrees, and CBSCs are considered some of the most pluripotent — like human newborns, naïve and ready to become anything. …

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Quitting smoking drops heart attack risk to levels of never smokers

Sep. 1, 2013 — Quitting smoking reduces the risk of heart attack and death to the levels of people who have never smoked, reveals research presented at ESC Congress 2013 by Dr James K. Min and Dr Rine Nakanishi from the USA.Dr Min said: “Smoking is an established risk factor for cardiovascular disease. Studies have identified that quitting smoking can reduce heart attacks and death but have not examined the relationship of this salutary effect on the presence and severity of coronary artery disease (CAD). Our study aimed to find out what impact stopping smoking had on the risk of cardiovascular events, death and the severity of CAD.” The prospective CONFIRM (Coronary CT Evaluation for Clinical Outcomes: An International Multicenter Study) registry of 13,372 patients from 9 countries in Europe, North America and East Asia examined the risk of major adverse cardiac events in 2,853 active smokers, 3,175 past smokers and 7,344 never smokers.Both active smokers and past smokers had a higher prevalence of severely blocked coronary arteries compared to non-smokers. This was determined using coronary computed tomographic angiography (CCTA), a non-invasive imaging technique that enables direct visualisation of the coronary arteries. Active and past smokers had a 1.5-fold higher probability of severe stenoses in 1 and 2 major heart arteries, and a 2-fold increased probability of severe stenoses in all 3 major heart arteries.Dr Min, who is director of the Institute of Cardiovascular Imaging at the New York-Presbyterian Hospital and the Weill Cornell Medical College, said: “Our results show that quitting smoking does not reduce the amount of disease smoking causes in the coronary arteries, but it does reduce the risk of heart attack and death to the levels of non-smokers.” After 2.0 years of follow-up, 2.1% of the study patients experienced heart attacks or death. Rates of heart attack or death were almost 2-fold higher in active smokers compared to never smokers. Past smokers had the same rates or heart attack or death as never smokers, despite having a higher prevalence, extent and severity of CAD (see figure). The findings in both active and past smokers persisted even when they were matched with non smokers who were similar in age, gender and CAD risk factors.Dr Min said: “Our study was the first to demonstrate that the presence and severity of coronary blockages do not go away with quitting smoking, but that the risk of heart attack and death does. …

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Harmonizing a broken heart: Stem cells keep cardiac beat in synchrony

Sep. 1, 2013 — Stem cell therapy used to regenerate injured tissue in the heart restores synchronous pumping, shows research published today [1 September] in The Journal of Physiology. The study proposes a novel strategy of ‘biological resynchronisation’ in which stem cells repair heart muscle damage to reestablish correct cardiac motion.Heart attacks limit local oxygen, which can kill areas of cardiac tissue — called ‘infarcted’ areas — and also leave scarring. This damage leads to a lack of synchrony in the heart beat motion.Current therapies use pacing devices, but these require healthy tissue for optimal outcome, meaning a third of patients do not respond well to this treatment. However, this new approach discovered by a team at Mayo Clinic in Rochester, Minnesota, USA overcomes this limitation as stem cells actually form functional cardiac tissue and reconstruct heart muscle.Professor Andre Terzic, who led the study, explains the importance of this potential new therapy: “Heart chambers must beat in synchrony to ensure proper pumping performance. Damage to the heart can generate inconsistent wall motion, leading to life-threatening organ failure.”The heart is vulnerable to injury due to a limited capacity for self-repair. Current therapies are unable to repair damaged cardiac tissue. This proof-of-principle study provides evidence that a stem cell-based regenerative intervention may prove effective in synchronizing failing hearts, extending the reach of currently available therapies.”Doctor Satsuki Yamada, first author of the study, further explains how the research was carried out:”Stem cells, with a capacity of generating new heart muscle, were engineered from ordinary tissue. These engineered stem cells were injected into damaged hearts of mice. The impact on cardiac resynchronization was documented using high-resolution imaging.”The observed benefit, in the absence of adverse effects, will need to be validated in additional pre-clinical studies prior to clinical translation.

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Family history doubles aortic stenosis risk

Sep. 1, 2013 — Aortic stenosis is the most common heart valve disease in the elderly. It is associated with congenital bicuspid aortic valve and previous rheumatic heart disease, but is also often caused by calcification of a normal valve. Calcification of a normal valve may be associated with atherosclerotic changes in the portion of the aorta closest to the valve.Dr Ranthe said: “Genetic factors may play a role in the development of aortic stenosis. A single nucleotide polymorphism in the lipoprotein(a) locus has been associated with aortic valve calcification and aortic stenosis.1 Elevated lipoprotein(a) is a risk factor for atherosclerosis, including ischaemic heart disease, which is known to aggregate in families. Our aim was to discover whether aortic stenosis also aggregates in families.”The study used information from national Danish registers and included the 4.2 million Danes born in or after 1920. The cohort was followed for more than 73 million person-years, starting in 1977 (the year the Danish Hospital Discharge Register began) and ending in 2012. Cases of aortic stenosis were recorded when they occurred at age 35 years or older.Patients with any registration of a congenital heart defect and those with cardiovascular disease diagnosed at <35 years were excluded. Family history was defined as a first degree relative registered with aortic stenosis before the cohort member.</p>During the study period 29,983 patients were registered with aortic stenosis at age >35 years. Of those, 193 had a first degree relative with aortic stenosis and the relative risk was 2.04 (95% confidence interval [CI] 1.77-2.35). …

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Stroke systems of care essential to reducing deaths, disabilities

Aug. 29, 2013 — The American Heart Association/American Stroke Association has identified several key elements needed for systems of care to effectively reduce stroke-related deaths and disability.Share This:The systems should quickly and appropriately address patients’ needs from when stroke symptoms appear and EMS is called, during transport to and treatment in the hospital and through rehabilitation.Several key elements in systems of care can reduce stroke deaths and disabilities, according to a new American Heart Association/American Stroke Association policy statement published in its journal Stroke.Stroke is the number four cause of death and a leading cause of adult disability in the United States. On average, every 4 minutes someone dies of a stroke.The policy statement addresses patients’ care from the time stroke symptoms are identified, to the emergency medical services’ (EMS) response, to the transport and treatment in the hospital and rehabilitation.Recommendations include:Develop public education programs to improve awareness of stroke symptoms and the need to call 9-1-1 to get to the hospital quickly for treatment. Ensure EMS personnel can quickly assess stroke patients and get them to the hospital with appropriate care within 15-20 minutes. Establish protocols to optimize the transfer of patients between hospitals offering different levels of care and within the different departments of a hospital. Support the certification of stroke centers that follow treatment guidelines designed to improve patient care and outcomes. Use telemedicine, especially in rural areas, to ensure patients have 24/7 access to consultation and care. The association also calls for patients to have access to post-stroke care, including rehabilitation and nursing services, regardless of their financial status or socio-economic background.Authors of the statement also address issues related to adequate reimbursement for stroke treatment and care and the need for quality improvement and public reporting initiatives.Share this story on Facebook, Twitter, and Google:Other social bookmarking and sharing tools:|Story Source: The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length. For further information, please contact the source cited above. …

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A wine a day … keeps the psychiatrist away? Light drinking linked to lower risk of depression

Aug. 29, 2013 — Drinking wine in moderation may be associated with a lower risk of developing depression, according to research published in Biomed Central’s open access journal BMC Medicine. The reported findings by the PREDIMED research Network suggest that the moderate amounts of alcohol consumed may have similar protective effects on depression to those that have been observed for coronary heart disease.Alcohol consumption around the world is increasing, and previous studies have shown that heavy alcohol intake is related to mental health problems, such as depression. Few studies have looked at the relationship between mental health and moderate alcohol intake. In a new article in BMC Medicine, researchers report on a cohort study that followed over 5,500 light-to-moderate drinkers for up to seven years. The results show an inverse relationship between alcohol intake and incidence of depression.The study participants are from the PREDIMED study, aged between 55 and 80 years old, had never suffered from depression or had alcohol-related problems when the study started. Their alcohol consumption, mental health and lifestyles were followed for up to seven years through yearly visits, repeated medical exams, interviews with dieticians and questionnaires.The main alcoholic beverage drunk by the study participants was wine. When analysed, it was shown that those who drank moderate amounts of wine each week were less likely to suffer from depression. The lowest rates of depression were seen in the group of individuals who drank two to seven small glasses of wine per week. These results remained significant even when the group adjusted them for lifestyle and social factors, such as smoking, diet and marital status.Professor Miguel A. …

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Collagen patch speeds repair of damaged heart tissue in mice

Aug. 29, 2013 — You can’t resurrect a dead cell anymore than you can breathe life into a brick, regardless of what you may have gleaned from zombie movies and Dr. Frankenstein. So when heart cells die from lack of blood flow during a heart attack, replacing those dead cells is vital to the heart muscle’s recovery.But muscle tissue in the adult human heart has a limited capacity to heal, which has spurred researchers to try to give the healing process a boost. Various methods of transplanting healthy cells into a damaged heart have been tried, but have yet to yield consistent success in promoting healing.Now, researchers at the Stanford University School of Medicine and Lucile Packard Children’s Hospital have developed a patch composed of structurally modified collagen that can be grafted onto damaged heart tissue. Their studies in mice have demonstrated that the patch not only speeds generation of new cells and blood vessels in the damaged area, it also limits the degree of tissue damage resulting from the original trauma.The key, according to Pilar Ruiz-Lozano, PhD, associate professor of pediatrics, is that the patch doesn’t seek to replace the dead heart-muscle cells. Instead, it replaces the epicardium, the outer layer of heart tissue, which is not muscle tissue, but which protects and supports the heart muscle, or myocardium.”This synthetic tissue has the mechanical properties of the embryonic epicardium,” said Ruiz-Lozano, who is the senior author of a study that describes the researchers’ findings. The study will be published online Aug. 29 in Biomaterials. Vahid Serpooshan, PhD, a postdoctoral scholar in cardiology, is the lead author.Embryonic epicardium is significantly more flexible than adult epicardium, but more rigid and structured than existing materials, making it more conducive to growth of new tissue. …

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Early diabetes interventions may also reduce heart disease risk

Aug. 27, 2013 — Two treatments that slow the development of diabetes also may protect people from heart disease, according to a recent study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).Researchers examined the effect that making intensive lifestyle changes or taking the medication metformin had on cholesterol and triglyceride levels. The study, part of the National Institutes of Health’s Diabetes Prevention Program, found that both treatments induced positive changes in the level of particles that carry cholesterol and triglycerides through the blood stream. These changes could lower the chances of plaque building up in blood vessels.”Cardiovascular disease is the most significant cause of death and disability in people with diabetes,” said the study’s lead author, Ronald Goldberg, MD, of the University of Miami’s Miller School of Medicine. “Our findings demonstrate that the same therapies used to slow the onset of diabetes also may help allay the risk of heart disease.”The randomized clinical trial analyzed blood samples from 1,645 people with impaired glucose tolerance. Participants were randomly assigned to one of three groups — one taking the medication metformin, another taking a placebo and a third undergoing an intensive lifestyle modification program. Researchers compared baseline blood samples from the start of the study to samples taken a year later to measure the interventions’ effects. The study used advanced techniques to obtain a detailed picture of the various particles in the blood.People who took part in the lifestyle modification program had lower levels of triglycerides and the particles that carry this kind of fat in the blood after a year. Both the metformin and lifestyle interventions were linked to reductions in the number of small low-density lipoprotein (LDL) particles, which carry cholesterol that may contribute to plaque formation, and increases in high-density lipoproteins (HDL), the form of cholesterol that reduces heart disease risk.”Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person’s blood,” Goldberg said. “Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population.”Other researchers working on the study include: M. …

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Genetic variant associated with coronary heart disease in type 2 diabetes

Aug. 27, 2013 — Joslin scientists, in collaboration with researchers from the Harvard School of Public Health and Italian research institutes, have identified a previously unknown genetic variant associated with an increased risk of coronary heart disease (CHD) in type 2 diabetic patients. This discovery has the potential to lead to the development of new treatments for CHD in diabetic patients.The findings appear in the Journal of the American Medical Association (JAMA).CHD is the leading cause of morbidity and mortality among diabetic patients. Diabetic individuals have a two- to threefold increased risk for CHD and two- to fourfold higher CHD morbidity and mortality rates. In people with diabetes, CHD occurs at a younger age. While overall mortality rates of CHD have been declining in the U.S., the number of CHD deaths in the diabetic population has escalated as the prevalence of the disease has increased.It has been known for years that genetic factors influence susceptibility to CHD in the general population. However, studies have suggested that the genetic factors related to CHD risk may be different in the diabetic population. Investigating genetic variants related to cardiovascular disease in diabetes is an active area of research in the Section on Genetics and Epidemiology at Joslin.The scientists were interested in finding out whether there were genetic determinants of CHD specific to diabetic patients. In collaboration with colleagues from the Harvard School of Public Health and research institutes in Italy, they conducted genome-wide association analyses of 1,517 type 2 diabetic patients with CHD and 2,671 type 2 diabetic subjects without CHD. They compared the results to analyses of 737 non-diabetic participants with CHD and 1,637 non-diabetic participants without CHD. …

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New implanted defibrillator works well without touching heart

Aug. 26, 2013 — A new type of defibrillator implanted under the skin can detect dangerously abnormal heart rhythms and deliver shocks to restore a normal heartbeat without wires touching the heart, according to research in the American Heart Association journal, Circulation.The subcutaneous implantable cardiac defibrillator (S-ICD®) includes a lead placed under the skin along the left side of the breast bone. Traditional implantable cardiac defibrillators (ICDs) include electrical conducting wires inserted into blood vessels that touch the heart.ICDs can greatly reduce the risk of death in patients at high risk for sudden cardiac arrest.Physicians insert the new device without X-ray guidance, and have reduced concerns about broken lead wires, vessel damage, vessel infection and scarring that make traditional device removal difficult.”Defibrillation has repeatedly proven to be a great asset in prolonging the lives of cardiac patients, but there are still some risks to address,” said Martin C. Burke, D.O., senior author of the study and a professor of medicine and director of the Heart Rhythm Center at the University of Chicago. “This new system was developed over a dozen years to combine some of the best aspects of traditional implanted ICDs and external defibrillators.”In the 33-site study, 314 of 330 patients (average age 52) evaluated had the S-ICD® implanted. During an average 11-month follow-up, 21 patients spontaneously developed 38 episodes of ventricular fibrillation or ventricular tachycardia. All were successfully restored to a normal heart rhythm. In addition, 41 patients (13.1 percent) received shocks that were inappropriate because they weren’t preceded by a dangerous heart rhythm.The study surpassed goals set by the U.S. Food and Drug Administration for evaluating the safety and effectiveness of the new device:Ninety-nine percent of the S-ICD® patients remained free of complications 180 days following implantation, compared with a 79 percent goal. When tested by a purposely-induced abnormal rhythm following implantation, the S-ICD® was 100 percent effective at consistently detecting and reversing ventricular fibrillation. …

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