Heart
Heart Test Found Safe for Pre-Transplant Kidney Patients
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A screening test that measures whether a patient’s heart is healthy enough for a kidney transplant is not as dangerous as once thought, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The findings indicate that the test, called coronary angiography, does not cause a decline in kidney function for patients with advanced chronic kidney disease (CKD) and can help determine when to schedule a patient for transplantation.
CKD may contribute to the development of heart disease, so physicians keep a close eye on CKD patients’ heart health. However, they are reluctant to perform coronary angiography—which uses dye and x-rays to show the inside of the heart’s arteries—in CKD patients, who are thought to have an increased risk of experiencing complications from the procedure. This is unfortunate because coronary angiography can help determine whether a patient is healthy enough to undergo a kidney transplant.
To determine the true risks of the test for patients with advanced CKD, Nicky Kumar, MBChB, MRCP (West London Renal and Transplant Centre, Imperial College Kidney and Transplant Institute, London), and her colleagues analyzed 76 patients with late stage CKD who were potential transplant recipients seen at their clinics from 2004 to 2007.
Heart disease link to prenatal flu exposure
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Children of women infected with influenza during pregnancy have a substantially higher risk of heart disease late in life, according to a study published on Wednesday.
The findings underscore the danger facing pregnant women from the H1N1 swine flu virus, or any other strain of flu, and also demonstrate that what happens in the womb can affect a person decades later.
Caleb Finch of the University of Southern California and colleagues studied records from the 1918 flu pandemic and found that boys whose mothers were infected during the second or third trimester of pregnancy with them had a 23 percent greater chance of having heart disease after age 60 than boys whose mothers were not infected.
Childhood Cancer Survivors Exercise Less, Increasing Diabetes Risk
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In a study of adults who survived cancer as children, St. Jude Children’s Research Hospital investigators found that many survivors lead sedentary lifestyles and are more likely to be less physically active than their siblings. Childhood cancer survivors are at greater risk of diabetes, obesity and heart disease than the rest of the population.
Cancer treatments such as cranial radiation can damage the hypothalamus and pituitary; the result is an abnormal metabolism, which increases the risk of obesity and diabetes. Also, chemotherapy with the drug anthracycline increases the risk of heart disease; and radiation to the body can cause blood vessels to become less pliant.
“Physical activity is a key step that survivors can take to reduce the health risk of these effects,” said Kiri Ness, Ph.D., of the Epidemiology and Cancer Control department at St. Jude. “Medical center programs to encourage physical activity in adult survivors could help significantly. However, one problem is that researchers have not firmly established the factors that affect cancer survivors’ participation in physical activity.”
Prostate cancer patients on hormone therapy at increased risk for various heart diseases
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Berlin, Germany: New research has found that hormone therapy used to treat men with advanced prostate cancer is associated with an increased chance of developing various heart problems. Some choices of therapy appear, however, to be less risky than others.
Researchers told Europe’s biggest cancer congress, ECCO 15 – ESMO 34 [1], in Berlin today (Tuesday 22 September) that the findings of their study, the largest and most comprehensive to date on the issue, indicate that doctors need to start considering heart-related side effects when they prescribe endocrine therapy for prostate cancer and might want to refer patients to a cardiologist before starting treatment.
A few smaller studies have indicated that some types of hormone therapy increase the risk of coronary heart disease and heart attacks in prostate cancer patients, but others have found no increased risk. This is the first large study to investigate how the broader range of hormone therapies affect a wider range of heart problems and provides for the first time a detailed picture of the impact of each sort of hormone therapy on individual types of heart trouble.
Health leaders issue recommendations to improve management of atrial fibrillation
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A diverse collaboration of healthcare leaders today released the AF Stat™ Call to Action for Atrial Fibrillation to serve as a roadmap for reducing the burden of atrial fibrillation (AFib) in the United States. The document outlines critical issues surrounding the management of AFib, and recommends priority actions in the areas of policy, management, education and quality.
“For far too long, AFib has flown under the radar of many healthcare professionals, policymakers and the public,” said Senator Bill Frist, M.D., former Senate Majority Leader and health policy advisor for AF Stat. “AFib disproportionately affects Medicare patients, yet the disease’s impact on both individuals and our healthcare system has never been fully defined or prioritized.”
Characterized by an irregular and frequently fast heartbeat, AFib is the most common form of heart arrhythmia. It affects approximately 2.5 million Americans, and its prevalence is expected to increase as the U.S. population ages. AFib is associated with a five-fold increase in risk for stroke ; worsens underlying cardiovascular disease ; and doubles the risk of all-cause mortality .
Surprising rate of recurring heart attacks, strokes globally
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Despite many medicines and other treatments for patients with vascular disease, a large international study shows these patients have a surprisingly high rate of recurring events such as strokes, heart attacks and hospitalizations as well as mortality.
Also unexpected: patients in North America (including the U.S.) experienced an above-average rate of these events. Patients in Eastern Europe had the highest rate, and those in Australia and Japan had the lowest.
The results from the international REACH (Reduction of Atherothrombosis for Continued Health) Registry, presented by a researcher from Northwestern University Feinberg School of Medicine, examined data for 32,247 patients one and three years after they enrolled in the registry. Patients who had symptomatic vascular disease had a 14.4 percent rate at one year and 28.4 percent rate at three years of having a heart attack, stroke, rehospitalization for another type of vascular event or vascular death. Patients with vascular disease in more than one location of the body had the highest event rate at 40.5 percent at three years.
New European guidelines on pulmonary hypertension provide new 6-group clinical definition
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New 2009 Guidelines for the diagnosis and treatment of pulmonary hypertension are made public today. The Guidelines have been jointly produced by a Task Force of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS); the Task Force also included experts from the International Society of Heart and Lung Transplantation (ISHLT).
The new 2009 Guidelines provide a new clinical classification of pulmonary hypertension which identifies six different clinical groups. However, whatever the underlying causative mechanism, pulmonary hypertension is characterised by a poor prognosis. Indeed, says Professor Nazzareno Galiè, from the Institute of Cardiology at the University of Bologna, Italy, and Chairperson of the Guidelines Task Force: “It is the multidisciplinary nature of pulmonary hypertension and its severity which have made the new guidelines necessary.”
Pulmonary hypertension (the increase of blood pressure within the lung circulation) is a condition which may complicate the majority of heart and of lung diseases, or may develop without a clear initiating cause. The new 2009 Guidelines identify six different clinical groups.
Mild glucose intolerance in pregnancy may be associated with cardiovascular risk
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Mild glucose intolerance in pregnancy may be an early identifier of women who are at increased risk of heart disease in the future, found a new study http://www.cmaj.ca/press/cmaj090569.pdf published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca.
In a large population-based cohort study, researchers from the University of Toronto and the Institute for Clinical Evaluative Sciences (ICES) studied data on 435,696 women in Ontario, Canada, who gave birth between April, 1994 and March, 1998. All women were followed until March 31, 2008. The study excluded women with pre-existing diabetes.
As cardiovascular disease is the leading cause of death in Canadian women, it is important to identify early predictors of future vascular risk. While women with gestational diabetes have a higher risk of cardiovascular disease than those without, it previously has not been known whether mild glucose intolerance in pregnancy is associated with heart disease. The study sought to answer this question.
“Brat Pack” director John Hughes dies of heart attack
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Filmmaker John Hughes, who made some of the most memorable teen comedies of the 1980s and turned Macaulay Culkin into a major star, died suddenly of a heart attack in New York on Thursday. He was 59.
Hughes, who had largely turned his back on Hollywood in the past decade to become a farmer in the Midwestern state of Illinois, collapsed while strolling in Manhattan, where he was visiting family.
His films, such as “Sixteen Candles,” “The Breakfast Club” and “Ferris Bueller’s Day Off,” are considered standard-bearers of the teen genre, exploring American adolescent behavior with warmth and affection. He supplied his awkward characters with natural dialogue, allowing audiences to empathize with their travails.
Many heart disease patients not referred for rehab
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Despite evidence that cardiac rehabilitation helps patients following discharge from the hospital, almost half of heart disease patients eligible for such rehabilitation are not referred for it, according to a new study.
Cardiac rehabilitation involves exercise and counseling on diet and other risk factors. It has been shown to decrease the likelihood of future heart problems.
Dr. Todd M. Brown, from the University of Alabama at Birmingham, analyzed data from the American Heart Association’s Get With The Guidelines program. Included were 72,817 patients who were discharged from 156 hospitals in the US after a heart attack or procedure such as placement of a stent or bypass surgery to clear blocked arteries feeding the heart, between January 2000 and September 2007.
U.S. facing severe shortage of heart surgeons
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The U.S. is likely to face a severe shortage of heart surgeons in the next 10 years, say representatives from medical schools and thoracic surgeons’ groups.
Writing in the journal Circulation, Dr. Atul Grover of the Association of American Medical Colleges in Washington, DC and colleagues point out that the number of active cardiothoracic surgeons in the U.S. “has fallen for the first time in 20 years.”
More than half of today’s cardiothoracic surgeons are older than 50 years, and more than 15 percent are between the ages of 65 and 74 years, the researchers note.
Agent Orange linked to heart disease, Parkinson’s
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Agent Orange, used by U.S. forces to strip Vietnamese and Cambodian jungles during the Vietnam War, may raise the risk of heart disease and Parkinson’s disease, U.S. health advisers said on Friday.
But the evidence is only limited and far from definitive, the Institute of Medicine panel said.
“The report strongly recommends that studies examining the relationship between Parkinson’s incidence and exposures in the veteran population be performed,” the institute, an independent academy that guides federal policy, said in a statement.
Risk factors of cardiovascular disease rising in poor, young
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Cardiovascular disease is increasing in adults under 50 and those of lower socioeconomic status, despite recent trends which show that cardiovascular disease is declining in Canada overall, say researchers at the Peter Munk Cardiac Centre. Untreated cardiovascular disease can lead to heart failure, coronary artery disease and death, and is the most common cause of hospitalization in North America.
By exploring national trends in heart disease, hypertension, diabetes, obesity and smoking prevalence from 1994-2005, researchers found that cardiovascular disease is on the rise in adults under 50 and those of lower socioeconomic status according to a study published in the July edition of the Canadian Medical Association Journal.
“Our results indicate that young people are increasingly bearing the burden of cardiovascular risk factors,” says Dr. Douglas Lee, cardiologist and scientist at the Institute for Clinical Evaluative Sciences (ICES). “This is an important group because they are the ones who will predict future heart disease, and earlier onset of cardiovascular disease means potentially longer and more intense treatment over their lifetime.”
New heart disease risk score outperforms existing test
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An independent external validation of QRISK® — a new score for predicting a person’s risk of heart disease — has shown that it performs better than the existing test and should be recommended for use in the United Kingdom by the National Institute for Health and Clinical Excellence (NICE).
The University of Nottingham and leading healthcare systems supplier EMIS worked together, through the not-for-profit partnership QResearch, to develop the ground-breaking formula which has been strongly endorsed in new research published in the British Medical Journal.
Researchers from the University of Oxford have recommended its widespread use across the UK in place of the more commonly-used Framingham equation.
Biomarker of breathing control abnormality associated with hypertension and stroke
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A study in the July 1 issue of the journal SLEEP identified a distinct ECG-derived spectrographic phenotype, designated as narrow-band elevated low frequency coupling (e-LFCNB), that is associated with prevalent hypertension, stroke, greater severity of sleep disordered breathing and sleep fragmentation in patients suffering from obstructive sleep apnea (OSA).
Results indicate that the odds ratio for prevalent stroke was 1.65 [CI: 1.19ԃ.29] in those with versus without the presence of e-LFCNB. The biomarker was detected in 1,233 participants (23.5 percent), with statistically significant differences between those with and without it. Patients with the biomarker tended to be older (average 64.7 years versus 61.4 years), male (63.3 percent versus 45.1 percent), slightly heavier (average body mass index 29.3 versus 28.6) and sleepier (according to the Epworth Sleepiness Score test results). Sleep apnea severity and use of diuretics, calcium blockers, and B-blockers were associated with increased e-LFCNB. After adjustment for age, sex, body mass index, hypertension, and diabetes, only prevalent stroke remained associated with both categorical and continuous measures of e-LFCNB, while treated and total hypertension were associated only with the ECG biomarker as continuous measure.
According to lead author Robert J. Thomas, MD, assistant professor of medicine at the Beth Israel Deaconess Medical Center & Harvard Medical School in Boston, Mass., the electrocardiogram (ECG)-based technique allows the tracking of interactions (“coupling”) of breathing amplitude and heart-beat rate changes, which are both influenced by sleep, thus providing a ‘map’ of sleep behaviors. Use of this technique allows physicians to assign patients with sleep apnea into groups who have or do not have breathing control abnormalities.
