Heart
New tool finds best heart disease and stroke treatments for patients with diabetes
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Researchers from North Carolina State University and Mayo Clinic have developed a computer model that medical doctors can use to determine the best time to begin using statin therapy in diabetes patients to help prevent heart disease and stroke.
“The research is significant because patients with diabetes are at high risk for cardiovascular disease and statins are the single most commonly used treatment for patients at risk of heart disease and/or stroke,” says Dr. Brian Denton, “and this model can help determine the best course of action for individual patients based on their risk of developing cardiovascular disease.” Denton is an assistant professor in NC State’s Edward P. Fitts Department of Industrial & Systems Engineering and lead author of the study.
Statins are a key component of current cardiovascular medical treatment guidelines, Denton says. They lower cholesterol levels and may significantly reduce the risk of heart attack and stroke, particularly in patients that are considered to be at high risk.
Migraine and Increased Risk of Cardiovascular Disease: Migraine Frequency Plays a Role
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Women who have migraines with aura may be more likely to have a stroke or heart attack than women who don’t have the condition, and the association varies by migraine frequency, according to research published in the June 24, 2009, online issue of Neurology®, the medical journal of the American Academy of Neurology. An aura is a visual or other sensory disturbance that occurs before the migraine starts, such as seeing bright lights.
The study found that women with migraine with aura whose migraines occur at least once a week are more than four times as likely to have a stroke as women who do not have migraines. Women with migraine with aura who have migraines less than once a month were more than twice as likely to have a heart attack and nearly twice as likely to have had heart procedures such as coronary artery bypass surgery or angioplasty. In contrast, women who had migraines with aura once a month had no increased risk of stroke or heart problems.
“These results should be interpreted with caution, since the number of migraine and migraine features were self-reported and there were relatively low numbers of stroke and heart problems in the large study group,” said study author and member of the American Academy of Neurology Tobias Kurth, MD, ScD, of Brigham and Women’s Hospital, Harvard Medical School and INSERM, the French national research institute. “Nonetheless, more research is needed to determine how and why these differences occur and whether preventing migraines could reduce the risk of stroke and heart problems.”
Music, cardiovascular rhythms fall in sync
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Music may indeed soothe the savage breast, according to a study showing that people’s cardiovascular rhythms tend to fall in step with musical ones.
In a study published Monday in the journal Circulation, Italian researchers found that healthy adults’ heart rate, blood pressure and blood flow changed in response to musical crescendos and decrescendos.
Using several classical music selections, the investigators found that musical crescendos—a gradual increase in volume and intensity—generally led to increases in blood vessel constriction, blood pressure, heart rate and breathing rate. The opposite was true with decrescendos, a gradual decrease in the music’s volume.
Protecting Kidney Function During Heart Failure
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Mayo Clinic cardiology researchers have found a peptide that helps preserve and improve kidney function during heart failure, without affecting blood pressure. Earlier variations of this peptide caused blood pressure to drop limiting the potential benefits to the kidneys. The findings appear in the current Proceedings of the National Academy of Sciences.
“Heart failure itself and some of the approaches used to treat it can have detrimental effects on the kidneys,” says Mayo cardiologist and lead researcher Robert Simari, M.D. “Our hope is that this compound will help protect kidney function while you’re being treated, and possibly shorten your hospital stay and keep you out of the hospital.”
This new peptide (a unique link of amino acids) has been tested in the laboratory and in animal models and is expected to move into clinical trials next year.
Cardiologist Urges People to Get Informed about Angioplasty
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A report broadcast during the CBS Evening News on June 8 noted that one in 200 patients die during elective coronary angioplasty procedures and suggested that patients may be safest at institutions where surgical backup is readily available when complications occur. The report also noted that as many as 40 percent of the angioplasties performed may be unnecessary because patients could experience the same benefits from drug therapies.
Coronary angioplasty is widely practiced and is also known as percutaneous coronary intervention, or PCI. The procedure is minimally-invasive and performed both in emergency situations and on an elective basis. During PCI, interventional cardiologists thread a catheter up through a small incision in a patient’s groin or wrist into the coronary artery. There, they inflate a surgical balloon to clear away plaque blockages and insert stents to keep arteries open.
Michael Ragosta, M.D., Director of Cardiac Catheterization Laboratories and Director of Interventional Cardiology at the University of Virginia Health System, recommends that patients considering elective angioplasty do their homework before deciding to proceed. “Make sure you know if medications or other therapies would work just as well for you, and find out about your hospital’s PCI mortality rates, PCI experience levels and surgical back-up capabilities,” he says. “Do your best to learn about the risks and benefits of this procedure. Make the most informed decision possible.”
New Algorithm for Ruptured Aneurysms Improves Mortality Rate
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Researchers from the University of Washington in Seattle report that algorithms for the management of ruptured abdominal aortic aneurysm (rAAA) with a preference for endovascular repair (EVAR), serve as surrogates for an organized approach to managing the disease process and reducing overall mortality. These findings are from a study presented today at the 63rd Annual Meeting of the Society for Vascular Surgery®.
“The staff at Harborview Medical Center treat between 30 and 50 patients per year with rAAAs,” said Benjamin W. Starnes, MD, chief in the division of vascular surgery and associate professor of surgery at the University of Washington. “In this study we sought to evaluate the effect on mortality with the implementation of an algorithm to manage these patients with a preference for EVAR when feasible.”
During the study period, 187 patients with rAAA underwent attempted repair at Harborview Medical Center. Thirty-day mortality ratios were calculated and compared using Chi Square and Fisher’s Exact Test where appropriate, continuous variables were compared with a Mann-Whitney U test. Before implementation of the algorithm, (between July 1, 2002 and June 30, 2007) a total of 131 patients with rAAA were managed and treated. One-hundred and twenty-eight underwent surgical treatment and the 30-day mortality rate was 58 percent. Sixty-five percent of these patients were hypotensive at presentation.
Heart saves muscle
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A heart muscle protein can replace its missing skeletal muscle counterpart to give mice with myopathy a long and active life, show Nowak et al. The findings will be published online on Monday, May 25, 2009 (http://www.jcb.org) and will appear in the June 1, 2009 print issue of the Journal of Cell Biology.
The contraction machinery protein, actin, exists in different forms in the adult heart and skeletal muscles. The heart form, ACTC, is also the dominant form in skeletal muscle of the fetus. But during development, the skeletal form, ACTA1, increases in production and by birth has taken over. It is not clear why the switch occurs, or why it doesn’t occur in the heart, but it happens in every higher vertebrate and, for that reason, has been considered vitally important.
Mutations to the ACTA1 gene cause a rare but serious myopathy. Most patients die within the first year of life and some are born almost completely paralyzed. Mice lacking ACTA1 die nine days after birth. Nowak et al. wondered if ACTC could compensate for a lack of ACTA1. The two proteins differ only slightly but, like the developmental switch in production, this difference is conserved across species. Many researchers therefore assumed such compensation would never work.
Porn star Marilyn Chambers died of heart disease
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Porn star Marilyn Chambers, who was found dead at the age of 56 at her Los Angeles-area home in April, died of complications of heart disease, coroner’s officials said on Monday.
The body of Chambers, who starred in “Behind the Green Door,” one of the first pornographic films to be released widely in the United States, was found at her suburban Canyon Country home on April 12.
Los Angeles coroner’s officials said at the time that Chambers had likely died of natural causes despite her relatively young age.
Heart disease risk persists in Hodgkin’s survivors
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Survivors of Hodgkin’s disease are at high risk for cardiovascular disease, a Swedish study confirms. The risk is particularly high for patients treated for Hodgkin’s disease before the age of 40 years and with a family history of heart disease.
In the International Journal of Cancer, the investigators note that “previous studies have shown increased cardiovascular mortality as late side effects (in) Hodgkin’s lymphoma patients.” The aim of the current study, Dr. Anne Andersson of Umea University and colleagues explain, was to stratify heart disease risk factors for surveillance.
Hodgkin’s disease, also known as Hodgkin’s lymphoma, is a cancer of the lymphatic system, a part of the immune system. Compared with some other types of lymphoma, Hodgkin’s lymphoma usually responds to treatment and most patients can be cured. Because it frequently affects children and young adults, there is a prolonged period in which long-term side effects can develop.
Blueberries are good for the heart, study hints
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Eating blueberries, as part of a healthy diet, may help ward off several key risk factors for cardiovascular disease and diabetes, such as an accumulation of belly fat, high cholesterol, and high blood sugar, according to research reported Sunday at the Experimental Biology conference in New Orleans.
The health benefits of blueberries are thought to be due to their high levels of phytochemicals - naturally occurring antioxidants called anthocyanins found in darkly pigmented fruits and vegetables.
“In the long-term Women’s Health Study, it was shown that women who had diets high in anthocyanins had a significantly reduced risk for heart disease,” University of Michigan research scientist E. Mitchell Seymour told Reuters Health.
Heart Procedure? Bring Your iPod Along, Review Suggests
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The right mix of Portuguese instrumentals calms Philadelphia researcher Joke Bradt. That’s what she’d want to hear during a serious medical procedure — that or classical music.
She points out quickly that this is her musical preference. She knows the right music can help her and, as a music therapist, she uses it to help others as well. “If you can relax patients, if you can calm them down a bit, that is only going to be beneficial,” says Bradt, who is assistant director of the Arts and Quality of Life Research Center at Temple University.
Bradt and Cheryl Dileo, another Temple researcher, conducted a review of 23 studies that focused on the use of music with 1,461 patients with coronary heart disease. They found that listening to music reduced heart rate, respiratory rate and blood pressure. However, Bradt cautioned that the quality of evidence was not strong and the clinical significance unclear.
High blood lead levels linked to heart deaths
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Older women with high levels of lead in their blood are likely to die sooner—particularly from heart disease—than their counterparts with low lead levels, new research indicates.
Researchers followed 533 women aged 65 to 87 years old for roughly 12 years. Those with lead concentrations above 8 micrograms per deciliter of blood were 59 percent more likely to die of any cause, and three times more likely to die of heart disease, than women with lower blood lead levels.
“Despite declines in blood lead concentrations during the past 30 years, environmental lead exposure continues to be a public health concern,” Dr. Naila Khalil of University of Pittsburgh, Pennsylvania and colleagues wrote in BioMed Central’s online journal Environmental Health.
Germy mouths linked to heart attacks, study finds
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People with the germiest mouths are the most likely to have heart attacks, U.S. researchers reported on Wednesday.
A study that compared heart attack victims to healthy volunteers found the heart patients had higher numbers of bacteria in their mouths, the researchers said.
Their findings add to a growing body of evidence linking oral hygiene with overall health.
Super Bowl loss may cause fans more than heartache
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Passionate football fans take heed: watching your team lose in the Super Bowl could be hazardous to your health.
Researchers have found that overall and circulatory death rates in Los Angeles rose significantly after a crushing defeat for the Rams in the 1980 Super Bowl. Four years later, deaths declined after the city’s other team—the Raiders—triumphed in the U.S. football championship game.
“The emotional stress of loss and/or the intensity of a game played in a high profile rivalry such as the Super Bowl can trigger total and cardiovascular deaths,” said Dr. Robert Kloner, a professor of medicine at the University of Southern California, who presented the study at the American College of Cardiology scientific meeting in Orlando.
Facemasks may help shield the heart from pollution
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Heavy air pollution can have immediate effects on the heart and blood vessels, but a simple facemask may offer some protection, new research suggests.
In one study, researchers found that when young men were exposed to air polluted with diesel exhaust, their arteries temporarily stiffened.
Meanwhile, a second study showed that healthy adults had higher blood pressure and a less healthy heart-rate pattern when they walked through the streets of Beijing without a facemask.
