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Heart

New superfoods could help key protein keep bodies healthy

Diabetes • • Food & Nutrition • • HeartSep 11 14

New superfoods could help key protein keep bodies healthy

A new generation of new superfoods that tackle heart disease and diabetes could be developed following research into a protein that helps keep cells in our bodies healthy.

Researchers at the University of Warwick found that the protein, called Nrf2, continually moves in and out of the nuclei of human cells to sense the cell’s health and vitality.

When Nrf2 is exposed to threats to the cell’s health it oscillates faster and activates an increase in the cell’s defence mechanism, including raising the levels of antioxidant.

The researchers, from the University’s Warwick Medical School, successfully increased the speed of Nrf2’s movement by artificially introducing health beneficial substances – potential components of new superfoods.

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Mobile app on emergency cardiac care aids best decisions in seconds

Emergencies / First Aid • • HeartAug 29 14

Mobile app on emergency cardiac care aids best decisions in seconds

Saturday 30 August 2014: The ACCA Clinical Decision-Making Toolkit mobile app is now available on the App Store and Google Play.

When dealing with acute cardiovascular diseases, a few seconds can make the difference and instant access to the best recommendations can save lives. This led the Acute Cardiovascular Care Association (ACCA) of the ESC to develop a user friendly interactive application, allowing professionals to have immediate access to diagnostics pathways on their mobile devices.

The Toolkit on emergency cardiac care, first published as a pocket-sized manual, is helping practitioners across the globe to make the best decisions in seconds. The Toolkit was created by expert members of ACCA and can be downloaded here.

Professor Héctor Bueno, President Elect and Acting President of ACCA and Editor in Chief of the Toolkit, said: “We have created the first tool to help all healthcare professionals who treat patients with acute cardiovascular syndromes to make the correct decisions fast.”

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Train your heart to protect your mind

Brain • • HeartAug 25 14

Train your heart to protect your mind

Exercising to improve our cardiovascular strength may protect us from cognitive impairment as we age, according to a new study by researchers at the University of Montreal and its affiliated Institut universitaire de gératrie de Montréal Research Centre. “Our body’s arteries stiffen with age, and the vessel hardening is believed to begin in the aorta, the main vessel coming out of the heart, before reaching the brain. Indeed, the hardening may contribute to cognitive changes that occur during a similar time frame,” explained Claudine Gauthier, first author of the study. “We found that older adults whose aortas were in a better condition and who had greater aerobic fitness performed better on a cognitive test. We therefore think that the preservation of vessel elasticity may be one of the mechanisms that enables exercise to slow cognitive aging.”

The researchers worked with 31 young people between the ages of 18 and 30 and 54 older participants aged between 55 and 75. This enabled the team to compare the older participants within their peer group and against the younger group who obviously have not begun the aging processes in question. None of the participants had physical or mental health issues that might influence the study outcome. Their fitness was tested by exhausting the participants on a workout machine and determining their maximum oxygen intake over a 30 second period. Their cognitive abilities were assessed with the Stroop task. The Stroop task is a scientifically validated test that involves asking someone to identify the ink colour of a colour word that is printed in a different colour (e.g. the word red could be printed in blue ink and the correct answer would be blue). A person who is able to correctly name the colour of the word without being distracted by the reflex to read it has greater cognitive agility.

The participants undertook three MRI scans: one to evaluate the blood flow to the brain, one to measure their brain activity as they performed the Stroop task, and one to actually look at the physical state of their aorta.

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Mass. General study identifies path to safer drugs for heart disease, cancer

Cancer • • Drug News • • HeartMar 23 14

Mass. General study identifies path to safer drugs for hEart disease, cancer

Massachusetts General Hospital (MGH) investigators may have found a way to solve a problem that has plagued a group of drugs called ligand-mimicking integrin inhibitors, which have the potential to treat conditions ranging from heart attacks to cancer metastasis. In a Nature Structural & Molecular Biology paper receiving advance online publication, the researchers provide a structural basis for the design of new and safer integrin inhibitors.

Integrins are receptor proteins found on the surface of cells that determine whether or not cells adhere to adjacent cells and the surrounding extracellular matrix. Under normal circumstances, integrins only become activated - which allows them to bind to other cells or extracellular molecules - in response to specific signals from within the cell. If integrins become overactive, cells become too “sticky” - leading to clogged arteries, pathological inflammation, the excess tissue growth called fibrosis or the spread of cancer. Current drugs developed to inhibit integrin activation by mimicking the shape of ligands - the molecules that interact with receptors - have had unintended effects in some patients, and as a result only a handful have received FDA approval.

“Integrins have an intrinsic ability to shape-shift when they switch from an inactive to an active, adhesive state,” explains M. Amin Arnaout, MD, director of the MGH Leukocyte Biology Program and the Inflammation and Structural Biology Program, senior author of the study. “Unfortunately, under some circumstances the integrin inhibitors that have been developed to date can inadventently induce this shape shifting, and use of these drugs have produced serious, sometimes fatal side effects such as excessive bleeding.”

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Tweaking MRI to track creatine may spot heart problems earlier, Penn Medicine study suggests

HeartJan 13 14

Tweaking MRI to track creatine may spot heart problems earlier

A new MRI method to map creatine at higher resolutions in the heart may help clinicians and scientists find abnormalities and disorders earlier than traditional diagnostic methods, researchers at the Perelman School of Medicine at the University of Pennsylvania suggest in a new study published online today in Nature Medicine. The preclinical findings show an advantage over less sensitive tests and point to a safer and more cost-effective approach than those with radioactive or contrasting agents.

Creatine is a naturally occurring metabolite that helps supply energy to all cells through creatine kinase reaction, including those involved in contraction of the heart. When heart tissue becomes damaged from a loss of blood supply, even in the very early stages, creatine levels drop. Researchers exploited this process in a large animal model with a method known as CEST, or chemical exchange saturation transfer, which measures specific molecules in the body, to track the creatine on a regional basis.

The team, led by Ravinder Reddy, PhD, professor of Radiology and director of the Center for Magnetic Resonance and Optical Imaging at Penn Medicine, found that imaging creatine through CEST MRI provides higher resolution compared to standard magnetic resonance spectroscopy (MRS), a commonly used technique for measuring creatine. However, its poor resolution makes it difficult to determine exactly which areas of the heart have been compromised.

“Measuring creatine with CEST is a promising technique that has the potential to improve clinical decision making while treating patients with heart disorders and even other diseases, as well as spotting problems sooner,” said Reddy. “Beyond the sensitivity benefits and its advantage over MRS, CEST doesn’t require radioactive or contrast agents used in MRI, which can have adverse effects on patients, particularly those with kidney disease, and add to costs.”

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Method to estimate LDL-C may provide more accurate risk classification

HeartNov 18 13

Seth S. Martin, M.D., of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, and colleagues developed a method for estimating low-density lipoprotein cholesterol (LDL-C) levels that is more accurate than the standard measure.

Low-density lipoprotein cholesterol is the primary target for treatment in national and international clinical practice guidelines. Conventionally, LDL-C is estimated by the Friedewald equation, which estimates LDL-C as (total cholesterol) - (high-density lipoprotein cholesterol [HDL-C]) - (triglycerides/5) in mg/dL. The final term assumes a fixed ratio of triglyceride levels to very low-density lipoprotein cholesterol (TG:VLDL-C) of 5:1. “Applying a factor of 5 to every individual patient is problematic given variance in the TG:VLDL-C ratio across the range of triglyceride and non-HDL-C levels,” according to background information in the study.

The researchers used a sample of lipid profiles obtained from 2009 through 2011 from 1,350,908 children, adolescents, and adults in the United States.

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Texting heart medication reminders improved patient adherence

Heart • • Public HealthNov 17 13

Getting reminder texts helped patients take their heart medicines (anti-platelet and cholesterol-lowering drugs) more regularly, according to research presented at the American Heart Association’s Scientific Sessions 2013.

In a 30-day, randomized controlled trial of 90 coronary heart disease patients, one group received customized text education messages and medication reminders; a second group got education messages only; and a third received no texts.

The text messaging groups had a 16 percent to 17 percent higher rate of taking correct doses and a higher rate of taking doses on schedule compared to the group who didn’t receive text messaging.

“There is now a major initiative to apply more innovative technologies such as mHealth, eHealth, and telehealth to effectively intervene to promote medication adherence,” said Linda Park, Ph.D., study lead author and post-doctoral fellow at San Francisco VA Medical Center in California.

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Hybrid heart valve is strong, durable in early tests

HeartNov 17 13

A hybrid heart valve created from thin and highly elastic mesh embedded within layers of human cells was strong and durable in a study presented at the American Heart Association’s Scientific Sessions 2013.

Researchers created a three-dimensional cell culture by coating a scaffold of nickel-titanium alloy (Nitinol), used for devices that require flexibility and motion, with layers of smooth muscle, connective tissue and lining cells. The valves performed well in a heart simulator, opening and closing under various pressures and remaining stable and strong throughout the tests.

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Cardiopoietic ‘Smart’ Stem Cells Show Promise in Heart Failure Patients

HeartApr 10 13

Translating a Mayo Clinic stem-cell discovery, an international team has demonstrated that therapy with cardiopoietic (cardiogenically-instructed) or “smart” stem cells can improve heart health for people suffering from heart failure. This is the first application in patients of lineage-guided stem cells for targeted regeneration of a failing organ, paving the way to development of next generation regenerative medicine solutions. Results of the clinical trial appear online of the Journal of the American College of Cardiology.

The multi-center, randomized Cardiopoietic stem cell therapy in heart failure (C-CURE) trial involved heart failure patients from Belgium, Switzerland and Serbia. Patients in the control group received standard care for heart failure in accordance with established guidelines. Patients in the cell therapy arm received, in addition to standard care, cardiopoietic stem cells—a first-in-class biotherapeutic. In this process, bone marrow was harvested from the top of the patient’s hip, and isolated stem cells were treated with a protein cocktail to replicate natural cues of heart development. Derived cardiopoietic stem cells were then injected into the patient’s heart.

“The cells underwent an innovative treatment to optimize their repair capacity,” says Andre Terzic, M.D., Ph.D., study senior author and director of the Mayo Clinic Center for Regenerative Medicine. “This study helps us move beyond the science fiction notion of stem cell research, providing clinical evidence for a new approach in cardiovascular regenerative medicine.”

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Vitamin D deficiency ups heart disease risk

Dieting • • HeartSep 26 12

Low levels of vitamin D are associated with a markedly higher risk of heart attack and early death, according to a new research.

The study involved more than 10,000 Danes and was conducted by the University of Copenhagen and Copenhagen University Hospital.

Vitamin D deficiency has traditionally been linked with poor bone health. However, the results from several population studies indicate that a low level of this important vitamin may also be linked to a higher risk of ischemic heart disease, a designation that covers heart attack, coronary arteriosclerosis and angina. Other studies show that vitamin D deficiency may increase blood pressure, and it is well known that high blood pressure increases the risk of heart attack.

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Heart surgery safe in Jehovah’s Witnesses

Heart • • SurgeryJul 02 12

Jehovah’s Witnesses, whose religious beliefs don’t allow for blood transfusions, seem to do as well or better than other patients after heart surgery, new research suggests.

Doctors sometimes give heart patients a transfusion of red blood cells if tests show they have low levels of hemoglobin or hematocrit after the procedure to prevent severe anemia, despite some transfusion-related risks. Because Jehovah’s Witnesses don’t have that option, surgeons typically take extra pre-procedure precautions - such as giving patients B vitamins and iron - to ensure their red blood cell counts don’t get too low during surgery. And those precautions seem to be working, according to the new study.

“The current management strategy… does not appear to place patients at increased risk, and actually some of the complications are fewer,” said Dr. Colleen Koch, who worked on the study at the Cleveland Clinic. That could have implications for managing people who are okay with getting blood transfusions - but might be better off if they could avoid one, Koch said.

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Magnet helps target transplanted iron-loaded cells to key areas of heart

HeartJun 26 12

Optimal stem cell therapy delivery to damaged areas of the heart after myocardial infarction has been hampered by inefficient homing of cells to the damaged site. However, using rat models, researchers in France have used a magnet to guide cells loaded with iron oxide nanoparticles to key sites, enhancing the myocardial retention of intravascularly delivered endothelial progenitor cells.

The study is published in a recent issue of Cell Transplantation (21:4), now freely available on-line at http://www.ingentaconnect.com/content/cog/ct/,

“Cell therapy is a promising approach to myocardial regeneration and neovascularization, but currently suffers from the inefficient homing of cells after intracavitary infusion,” said Dr. Philippe Menasche of the INSERM U633 Laboratory of Surgical Research in Paris. “Our study was aimed at improving and controlling homing by loading human cord-blood-derived endothelial progenitor cells (EPCs) for transplant with iron oxide nanoparticles in order to better position and retain them in the hearts of myocardial-injured test rats by using a subcutaneously implanted magnet.”

The researchers found that the cells were sufficiently magnetic to be able to be remotely manipulated by a magnet subsequent to implantation.

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Screening programs detect cases of undiagnosed rheumatic heart disease in low-resource countries

Heart • • Rheumatic DiseasesApr 22 12

Widespread screening of children in poorer countries is now being studied and is resulting in the diagnosis of rheumatic heart disease (RHD) in patients that would likely have gone undetected under normal circumstances, according to two new studies carried out in Fiji and Uganda presented today at the World Congress of Cardiology.

Coordinated screening and control programmes can help to identify patients before they progress to severe RHD for a fraction of the cost associated with treating these patients. While more work needs to be done to determine if these programmes should be widely promoted, there has been limited evidence to suggest that they are feasible in countries that have few resources – until now.

In one study carried out in Uganda, 4,869 school children were screened simply using a stethoscope and a portable echocardiography machine. Of the children screened, 72 (1.5 per cent) were diagnosed with possible, probably or definite RHD that required follow-up.

“This is one of the largest single-country child echo-based RHD screening studies that has been carried out,” said Dr. Andrea Beaton Children’s National Medical Center, USA. “This study proves that even in low-resource settings it is possible to embark on a screening programme that will identify children with probable or definite RHD, that would otherwise not have been seen until they had progressed to severe disease.”

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Comic Gallagher suffers second heart attack

Heart • • Public HealthMar 26 12

Just days after being released from treatment following a heart attack and a medically induced coma, comedian Gallagher suffered a second heart attack Sunday.

His rep confirms to E! News that the 65-year-old funnyman is now awake and resting in an Arizona hospital.

The sledgehammer-wielding comedian was not feeling well Sunday and was taken by his son to the hospital. While there, he suffered a second heart attack.

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Comedian Gallagher still in medically induced coma

Heart • • Public HealthMar 18 12

Doctors have decided to wait before bringing the comedian Gallagher out of the medically induced coma he was put in after his heart attack last week in Texas.

Doctors had planned to wake the 65-year-old comedian on Saturday. But his promotional manager, Christine Scherrer, says he was trying to wake on his own. Doctors are keeping him sedated because they want to wake him slowly. She says they may try Sunday.

Scherrer says the comedian had two stents replaced after collapsing Wednesday before a performance at a bar in Lewisville, a Dallas suburb.

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