Matters of the Heart

waltky · Apr 19, 2016

New heart patch that can monitor and treat cardiac problems...

Revolutionary Cardiac Patch Could Mend a Broken Heart
April 18, 2016 - Have you ever had a broken heart? Now theres a way to fix that... but perhaps not in the way you think.

Scientists in Israel have created a life-saving heart patch that can monitor and treat cardiac problems. Researchers at Tel Aviv University developed a revolutionary 3D printed patch, consisting of nano-electronics and live heart tissue grown in a lab. The device, which is applied to a damaged heart, can actually regenerate the cardiac muscle by building up cells in the part with a defect. Co-inventor Tal Dvir, a professor in the Department of Biotechnogy, explained that the role of the electronics is to sense the function of the tissue and then to activate the tissue when needed."

The device can also release medication for heart problems relating to inflammation or a lack of oxygen. And because the patch can expand like the heart but is also a self-regulating machine, a doctor can treat his patient from afar. The patient is sitting in his house and not feeling well, and the physician immediately sees the condition of the heart on his computer, and can remotely activate the heart, provide electrical stimulation, and release drugs, said Dvir.

For a heart permanently damaged by disease or a heart attack, the patch could become an alternative to a heart transplant. And it may lead to even more promising discoveries. We are trying to 3D print the whole heart, with the electronics within, Dvir said. "And I believe that in the future, in 10-20 years, there would be such bionic organs in the market or in hospitals to be transplanted." This cyborg heart patch still needs to be tested and it could be years before its available. But in the future, it may provide an alternative for people with heart disease.

http://www.voanews.com/content/revolutionary-cardiac-patch-could-mend-a-broken-heart/3291097.html
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waltky · Apr 29, 2016

Turning Skin cells into heart cells...

Chemical Cocktail Turns Skin Cells Into Beating Heart Cells
April 29, 2016 - Scientists have long been fascinated by the ability of amphibians, such as newts and salamanders, to regrow severed tails. One day, humans may be able to achieve a similar feat by repairing damaged hearts and brains.

Researchers at the Gladstone Institutes Center for Cell Biology and Medicine in San Francisco and in China have developed a chemical cocktail that can reprogram cells without genetic engineering. Their work lays the foundation for one day being able to regenerate lost or damaged cells with pharmaceutical drugs. Writing in the journals Science and Cell Stem Cell, investigators describe how a combination of chemicals can turn readily available skin cells into stem cells master cells that have the potential to become any cell in the body.

A beating heart muscle cell that was created from a human skin cell using a cocktail of nine chemicals.

Sheng Ding is a regenerative medicine biologist at Gladstone Institute. He led the team of researchers that identified nine chemical compounds that reprogrammed skin cells into heart cells. Transplanted into a mouse heart, the cells developed into healthy heart muscle cells. "It's really the Holy Grail we've been working on now for decades," Ding said. A separate group of researchers used a similar chemical process to alter skin cells into neural cells, to repair brain damage caused by disease.

Growing heart cells

A heart attack leaves dead tissue in its wake. Once damaged, those heart muscle cells called cardiomyocytes have very little ability to renew themselves. But with their chemical cocktail, Ding's team was able to take mouse skin cells and transform them into beating heart cells. Previous work in tissue regeneration involved a laborious process of inserting specific genes into stem cells created from skin cells, then infusing the transformed cells into the body to create healthy tissue.

But now tissue repair could become a far simpler process, according to Ding. "There is now a possibility that we can provide patients [with] a pill that contains this small molecule cocktail that really stimulates or regenerates to repair cells," he said.

http://www.voanews.com/content/chemical-cocktail-skin-cells-beating-heart-cells/3309065.html
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waltky · Aug 2, 2016

Recovery help after heart attack...

Omega-3 fatty acids 'help recovery after heart attack'
Tuesday 2nd August, 2016 - High doses of omega-3 fatty acids from fish oil can aid recovery from a heart attack, say scientists.

Taking omega-3 improves heart function and reduces scarring in undamaged cardiac muscle, results from a clinical trial have shown. After a heart attack, the heart's shape and function may be "remodelled" in ways that lead to a poorer prognosis for the patient and increase the risk of heart failure. Heart attack patients taking part in the trial were given either a 4g daily dose of omega-3 fatty acids for six months or a placebo. Those taking omega-3 experienced a 5.8% reduction in left ventricular end-systolic volume index, a clinical marker which predicts heart attack patient outcomes.

Those taking omega-3 experienced a 5.8% reduction in left ventricular end-systolic volume index

They also had a 5.6% lower indication of scarred connective tissue formation in non-damaged heart muscle. Lead researcher Dr Raymond Kwong, from Brigham and Women's Hospital in Boston, US, said: "Heart failure is still a major problem after a heart attack despite all the therapy we have and the advances in interventional care. "Our findings show that omega-3 fatty acids are a safe and effective treatment in improving cardiac remodelling, so it may be promising in reducing the incidence of heart failure or death, which are still major healthcare burdens to patients who suffer a heart attack."

The results, published in the journal Circulation, suggest that omega-3 fatty acids allow the heart to contract more efficiently and reduce scarring, said the scientists. There were also signs that the fish oil fats were reducing inflammation in the heart. The study involved 360 patients who were treated within a month of suffering a heart attack.

http://www.belfasttelegraph.co.uk/n...elp-recovery-after-heart-attack-34930678.html
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Eat more plant protein instead of animal protein for longer life, study suggests
1/08/2016 - Swapping animal for plant protein in your diet can lead to a longer life, research has shown.

A large study found that every 3% increase in calories from plant protein reduced the risk of death from all causes by 10%. It was also associated with a 12% lower risk of death from heart disease. In contrast, raising the animal protein share of calories by 10% led to a 2% higher risk of all-cause death and an 8% greater chance of dying from a heart problem. Animal protein foods include all types of meat, fish, eggs and dairy products such as milk and cheese. Plant sources of protein include cereals, beans, nuts, legumes, soya and bread.

The greater risk of dying linked to eating animal protein was more pronounced among people who were obese, had a history of smoking, drank heavily, and who did little exercise. Among the healthiest participants, the association disappeared - possibly because health-conscious people tended to eat more fish and poultry rather than red and processed meat, said the researchers. Replacing processed red meat with plant protein was linked to a 34% lower risk of death from all causes for every 3% of calorie intake. Substituting plant protein for eggs led to a 19% reduction in death risk.

Plant sources of protein include cereals, beans, nuts, legumes, soya and bread

Lead scientist Dr Mingyang Song, from Massachusetts General Hospital, US, said: "Overall, our findings support the importance of the sources of dietary protein for long-term health outcomes. "While previous studies have primarily focused on the overall amount of protein intake - which is important - from a broad dietary perspective, the particular foods that people consume to get protein are equally important. "Our findings suggest that people should consider eating more plant proteins than animal proteins, and when they do choose among sources of animal protein, fish and chicken are probably better choices."

The researchers analysed data from two large US studies focusing on diet and health, the Nurses' Health Study and the Health Professionals Follow-up Study. Together, they recruited a total of 131,342 participants with an average age of 49 whose progress was followed for up to 32 years. Each participant filled out food questionnaires detailing his or her diet. During the follow-up period more than 36,000 deaths were recorded. Almost 9,000 of these were due to cardiovascular disease, 13,000 to cancer and about 14,000 to other causes. The findings are reported in the journal Jama Internal Medicine.

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waltky · Sep 9, 2016

Statins' benefits underestimated...

Statins' benefits underestimated, review says
Thu, 08 Sep 2016 - The benefits of the cholesterol-reducing drug statins are underestimated and the harms exaggerated, a major review suggests.

Published in the Lancet and backed by a number of major health organisations, it says statins lower heart attack and stroke risk. The review also suggests side effects such as muscle pain do occur, although in relatively few people. But critics say healthy people are unnecessarily taking medication.

Dummy drug effect

Statins reduce the build-up of fatty plaques that lead to blockages in blood vessels. According to the report authors:

* About six million people are currently taking statins in the UK
* Of those, two million are on them because they have already had a heart attack, stroke or other cardiovascular event
* The remaining four million take statins because of risk factors such as age, blood pressure or diabetes
* Up to two million more should possibly take statins

The Lancet review, led by Prof Rory Collins from the Clinical Trial Service Unit at the University of Oxford, looked at the available evidence for the effects of taking an average 40mg daily dose of statins in 10,000 patients over five years. It suggested cholesterol levels would be lowered enough to prevent 1,000 "major cardiovascular events" such as heart attacks, strokes and coronary artery bypasses in people who had existing vascular disease - and 500 in people who were at risk due to age or other illnesses such as high blood pressure or diabetes.

The review also said randomised controlled trials - where neither patient nor doctor know who is on the real drug and who is on a dummy version - suggested the average dose led to a relatively low level of side effects. In the same 10,000 population, there would be some side effects, including between 50 and 100 cases of adverse events such as muscle pain, it said. Observational studies - where people know they are taking the drug and will have been told of known side effects including muscle pain - had higher rates.

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waltky · Oct 20, 2016

Good place to have a heart attack...

App helps save Seattle cardiac patient
October 20, 2016 — If your heart is going to stop, right outside a hospital is not a bad place for it. And if 41 people within a 330-yard radius have a cellphone app alerting them to your distress, so much the better.

That's what happened in Seattle last week when Stephen DeMont collapsed at a bus stop in front of University of Washington Medical Center. While a medical student rushed over and began chest compressions, a cardiac nurse just getting off her shift was alerted by her phone, sprinted outside and assisted until paramedics arrived. Five days later, DeMont, 60, is walking, smiling and talking about how the PulsePoint app helped save his life.

Stephen DeMont, center, gets a hug from medical student Zach Forcade, right, as nurse Madeline Dahl looks on as they visit DeMont Wednesday, Oct. 19, 2016 at the University of Washington Medical Center, in Seattle. When DeMont collapsed at a bus stop in front of the UW Medical Center days earlier on his morning commute, Dahl was one of 41 people within a 330-yard radius who happened to have a cell phone app alerting them to the emergency. Forcade witnessed the collapse and rushed over to begin chest compressions, as within moments Dahl, a cardiac nurse just getting off her shift in the hospital, was alerted by her phone and sprinted down the sidewalk, assisting until paramedics arrived.

Seattle officials say the rescue shows the potential the free download has for connecting CPR-trained citizens with patients who urgently need their help. It's being used in 2,000 U.S. cities in 28 states. "I put it on my phone yesterday," said DeMont's wife, Debi Quirk, a former registered nurse. "He would not be here as we see him today." Seattle officials hope DeMont's story will help persuade thousands more people to sign up for notifications; so far, about 4,000 people in Seattle have downloaded PulsePoint since the city adopted it earlier this year with financial support from an employee charitable fund at Boeing. The goal is to have 15,000 using it.

Developed by a former fire chief in Northern California, Richard Price, the app works through a city's 911 system. When a call comes in, operators alert people within a certain radius that CPR assistance is needed, along with the location of the nearest portable defibrillator. About 900,000 people around the country have downloaded and carry the app, and 34,000 people have been activated to respond, he said, adding that alerts have been issued in 13,000 cardiac events.

Madeline Dahl, left, looks on as Zach Forcade, right, pulls out his cell phone while Stephen DeMont sits with them while being interviewed at the University of Washington Medical Center Wednesday, Oct. 19, 2016, in Seattle. When DeMont collapsed at a bus stop in front of the UW Medical Center days earlier on his morning commute, Dahl was one of 41 people within a 330-yard radius who happened to have a cell phone app alerting them to the emergency. Forcade, a medical student, witnessed the collapse and rushed over to begin chest compressions, as within moments Dahl, a cardiac nurse just getting off her shift in the hospital, was alerted by her phone and sprinted down the sidewalk, assisting until paramedics arrived.

He came up with the idea in 2009, he said. He was in a restaurant when he heard sirens from his crews at the San Ramon Valley fire department. As he wondered where they were going, they arrived at the restaurant. "The patient was unconscious, unresponsive. I was 20 feet away on the other side of the wall," Price said. "The whole time I was listening to that siren, I could have been making a difference." It occurred to him that at any given time, two-thirds of his staff was off duty — in restaurants, out in the community. If there was a way to alert them to such emergencies by phone, it could save lives, Price said. It's not clear how many lives have been saved thanks to the app. Patient confidentiality laws often prevent hospitals from disclosing a patient's outcome.

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waltky · Oct 25, 2016

Bypass surgery may be better than stents...

Bypass surgery may be better than stents for patients who skip meds
October 25, 2016 - For heart disease patients who adhere to optimal medical therapy, outcomes of coronary bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) may not differ, a new study finds.

However, among nonadherent patients, CABG affords better major adverse cardiac eventfree survival. When they dont take their meds as directed, CABG patients are 68 percent more likely to avoid complications than PCI patients. "Therefore, patient compliance with medical therapy may inform clinical decision making and should be incorporated into all future comparative studies of comparative coronary revascularization strategies," the authors write in Circulation October 24th.

For patients who do take their meds, however, it matters less which intervention they got theyre all nearly three times more likely to survive complication-free than those who skip the medications. The take-home message for patients with coronary artery disease is even if you don't feel any differently when taking the medications, your very survival may depend upon them, said lead study author Dr. Paul Kurlansky of Columbia University in New York. To assess how medication compliance influences outcomes, the authors followed 973 CABG patients and 2,255 patients who underwent PCI and stent placement, from February to July of 2004.

Follow-ups were performed between 12 months and 18 months and starting again in 2009 to monitor both adherence to prescribed medication and to report any circulatory difficulties, including fatal and nonfatal myocardial infarction, or any repeated bypass or angioplasty procedures. Optimal medical therapy included blood thinners (aspirin or one year of double antiplatelet therapy for stent patients), statins to lower cholesterol and beta-blockers to curb high blood pressure and maintain a normal heart rhythm for heart surgery patients. Among patients who adhere to recommended medication therapy, there may not be a clinical benefit for bypass over PCI, the authors say.

Patients who got either procedure, left the hospital on aspirin and statins and were still on both medications at all follow-up checkups enjoyed significantly better event-free survival rates than patients who at any point were not on their medication. Some patients may avoid medications due to costs or side effects, but it may also be because they dont feel sick, Kurlansky said. Hypertension is usually clinically silent, we cannot feel our cholesterol level, and we don't perceive our platelet reactivity, therefore, to expend money and effort to take medications, some of which may have side effects, in order to feel absolutely no different is, for most people, highly counterintuitive, Kurlansky said. This, I believe, is why so many people, even after heart attack or heart surgery, discontinue their medications.

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waltky · Dec 23, 2016

JAMA Cardiology finds Higher Heart Disease Risk Seen in People with HIV...

Higher Heart Disease Risk Seen in People with HIV
December 22, 2016 - Current methods of predicting heart attack and stroke risk vastly underestimate the problem in patients with HIV, according to a new study published in the journal JAMA Cardiology.

Based on a study of 20,000 people infected with HIV, investigators found their risk of heart events is nearly twice that of the general population. Researchers at Northwestern University School of Medicine found the elevated risk even in those in whom the virus was undetectable because of the use of antiretroviral drugs.

Matthew Feinstein, a cardiovascular fellow at Northwestern, says it appears chronic inflammation caused by continued viral replication even in treated HIV patients contributes to the higher incidence of heart attack and stroke. The disease activity causes the formation of plaque 10 to 15 years earlier in HIV patients than in the uninfected population, he said. The data analyzed in the study of HIV patients at a number of centers was compared to the predicted heart disease rates in the general population.

Investigators found the risk of heart disease was higher in those infected with HIV regardless of age, sex or race. HIV, said Feinstein, appears to accelerate aging in those with the AIDS virus, thus increasing the risk for heart disease. As individuals taking antiretroviral drugs live longer, researchers expect heart disease in this group will become more common. An estimated 35- to 40-million people around the globe are infected with the AIDS virus or living with the disease.

Investigators said more research is needed to include a larger pool of HIV patients to get a more accurate picture of the problem. Thats because predicting heart disease risk in the general population is generally based on more than 200,000 individuals. A study published earlier this year found individuals with HIV had more scarring in the heart muscle after an attack, suggesting that they dont heal as well as uninfected people. A trial is underway to see whether drugs commonly used to manage heart disease in the general population, like statin medications, benefit people infected with HIV.

http://www.voanews.com/a/higher-heart-disease-risk-seen-in-people-with-hiv/3646973.html
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waltky · Jan 11, 2017

Using stem cells to regenerate the external layer of a human heart...

Researchers use stem cells to regenerate the external layer of a human heart
January 11, 2017 - A process using human stem cells can generate the cells that cover the external surface of a human heartepicardium cellsaccording to a multidisciplinary team of researchers.

"In 2012, we discovered that if we treated human stem cells with chemicals that sequentially activate and inhibit Wnt signaling pathway, they become myocardium muscle cells," said Xiaojun Lance Lian, assistant professor of biomedical engineering and biology, who is leading the study at Penn State. Myocardium, the middle of the heart's three layers, is the thick, muscular part that contracts to drive blood through the body. The Wnt signaling pathway is a group of signal transduction pathways made of proteins that pass signals into a cell using cell-surface receptors. "We needed to provide the cardiac progenitor cells with additional information in order for them to generate into epicardium cells, but prior to this study, we didn't know what that information was," said Lian. "Now, we know that if we activate the cells' Wnt signaling pathway again, we can re-drive these cardiac progenitor cells to become epicardium cells, instead of myocardium cells."

The group's results, published in Nature Biomedical Engineering, bring them one step closer to regenerating an entire heart wall. Through morphological assessment and functional assay, the researchers found that the generated epicardium cells were similar to epicardium cells in living humans and those grown in the laboratory. "The last piece is turning cardiac progenitor cells to endocardium cells (the heart's inner layer), and we are making progress on that," said Lian.

Heart progenitors cells derived from human stem cells can be further specified to heart cells belong to external layer or muscle layer of a human heart.

The group's method of generating epicardium cells could be useful in clinical applications, for patients who suffer a heart attack. According to the Centers for Disease Control and Prevention, every 43 seconds, someone in the United States has a heart attack "Heart attacks occur due to blockage of blood vessels," said Lian. "This blockage stops nutrients and oxygen from reaching the heart muscle, and muscle cells die. These muscle cells cannot regenerate themselves, so there is permanent damage, which can cause additional problems. These epicardium cells could be transplanted to the patient and potentially repair the damaged region." During their study, the researchers engineered the human stem cells to become reporter cells, meaning these cells expressed a fluorescent protein only when they became epicardium cells. "We treated the cells with different cell signaling molecules, and we found that when we treated them with Wnt signaling activators, they became fluorescent," said Lian.

Another finding, he said, is that in addition to generating the epicardium cells, the researchers also can keep them proliferating in the lab after treating these cells with a cell-signaling pathway Transforming Growth Factor Beta (TGF) inhibitor. "After 50 days, our cells did not show any signs of decreased proliferation. However, the proliferation of the control cells without the TGF Beta inhibitor started to plateau after the tenth day," said Lian. The team will continue working together to further their research on regenerating endocardium cells. "We are making progress on that inner layer, which will allow us to regenerate an entire heart wall that can be used in tissue engineering for cardiac therapy," said Lian.

http://medicalxpress.com/news/2017-01-stem-cells-regenerate-external-layer.html#jCp
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waltky · Jan 12, 2017

Whenever Granny tells Uncle Ferd his g/f is too fat to sit onna sofa - he gets all discombobulated...

Brain activity 'key in stress link to heart disease'
Thu, 12 Jan 2017 - Constant stress could be a key factor in raising the risk of a heart attack, say researchers.

The effect of constant stress on a deep-lying region of the brain explains the increased risk of heart attack, a study in The Lancet suggests. In a study of 300 people, those with higher activity in the amygdala were more likely to develop cardiovascular disease - and sooner than others. Stress could be as important a risk factor as smoking and high blood pressure, the US researchers said. Heart experts said at-risk patients should be helped to manage stress.

A woman stressed at work

Emotional stress has long been linked with an increased risk of cardiovascular disease (CVD), which affects the heart and blood vessels - but the way this happens has not been properly understood. This study, led by a team from Harvard Medical School, points to heightened activity in the amygdala - an area of the brain that processes emotions such as fear and anger - as helping to explain the link.

The researchers suggest that the amygdala signals to the bone marrow to produce extra white blood cells, which in turn act on the arteries causing them to become inflamed. This can then cause heart attacks, angina and strokes. As a result, when stressed, this part of the brain appears to be a good predictor of cardiovascular events. But they also said more research was needed to confirm this chain of events.

Inflammation insight
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waltky · Feb 4, 2017

Dual-use anti-cancer drug could help to regenerate heart tissue...

Cancer drug could promote regeneration of heart tissue
February 3, 2017 - An anticancer agent in development promotes regeneration of damaged heart muscle 0- an unexpected research finding that may help prevent congestive heart failure in the future.

Many parts of the body, such as blood cells and the lining of the gut, continuously renew throughout life. Others, such as the heart, do not. Because of the heart's inability to repair itself, damage caused by a heart attack causes permanent scarring that frequently results in serious weakening of the heart, known as heart failure.

For years, Dr. Lawrence Lum, Associate Professor of Cell Biology at UT Southwestern Medical Center, has worked to develop a cancer drug targeting Wnt signaling molecules. These molecules are crucial for tissue regeneration, but also frequently contribute to cancer. Essential to the production of Wnt proteins in humans is the porcupine (Porcn) enzyme, so-named because fruit fly embryos lacking this gene resemble a porcupine. In testing the porcupine inhibitor researchers developed, they noted a curiosity. "We saw many predictable adverse effects -0 in bone and hair, for example 0- but one surprise was that the number of dividing cardiomyocytes (heart muscle cells) was slightly increased," said Dr. Lum, senior author of the paper, and a member of UTSW's Hamon Center for Regenerative Science and Medicine. "In addition to the intense interest in porcupine inhibitors as anticancer agents, this research shows that such agents could be useful in regenerative medicine."

(From left) Dr. Rhonda Bassel-Duby, Dr. Lawrence Lum, Huanyu Zhou, Dr. Jesung Moon, and Dr. Wei Tan.

Based on their initial results, the researchers induced heart attacks in mice and then treated them with a porcupine inhibitor. Their hearts' ability to pump blood improved by nearly twofold compared to untreated animals. The study findings were published online this week in Proceedings of the National Academy of Sciences. "Our lab has been studying heart repair for several years, and it was striking to see that administration of a Wnt inhibitor significantly improved heart function following a heart attack in mice," said Dr. Rhonda Bassel-Duby, Professor of Molecular Biology and Associate Director of the Hamon Center for Regenerative Science and Medicine.

Importantly, in addition to the improved pumping ability of hearts in the mice, the researchers noticed a reduction in fibrosis, or scarring in the hearts. Collagen-laden scarring that occurs following a heart attack can cause the heart to inappropriately increase in size, and lead to heart failure. "While fibrotic responses may be immediately beneficial, they can overwhelm the ability of the heart to regenerate in the long run. We think we have an agent that can temper this fibrotic response, thus improving wound healing of the heart," said Dr. Lum, a Virginia Murchison Linthicum Scholar in Medical Research and Associate Director of Basic Research at the Harold C. Simmons Comprehensive Cancer Center.

Additionally, Dr. Lum said, preliminary experiments indicate that the porcupine inhibitor would only need to be used for a short time following a heart attack, suggesting that the unpleasant side effects typically caused by cancer drugs might be avoided. "We hope to advance a Porcn inhibitor into clinical testing as a regenerative agent for heart disease within the next year," Dr. Lum said.

https://medicalxpress.com/news/2017-02-cancer-drug-regeneration-heart-tissue.html#jCp
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waltky · Feb 9, 2017

Anybody know if calcium supplement for elderly increase risk of death?...

Atherosclerosis in Young Patients Increases Risk of Early Death
February 08, 2017 - A new study suggests that even small calcium deposits in the arteries of young patients can predict an early heart attack or death within a dozen years.

The study also suggests that it's easy to spot the trouble and can be a "call to action" for doctors and patients to begin taking preventive action. The cardiac study conducted at four centers in the U.S. involved 5,000 young adults between the ages of 18 and 30. Jeff Carr, a radiologist and cardiologist at Vanderbilt University Medical Center, was lead author of the study.

Carr said it appears that any amount of atherosclerosis, or calcium deposits, in the cardiac arteries of young people can dramatically shorten their lives, even if its just one little dot or a very low whats called a calcium score are at markedly elevated risk. So if you have any amount of coronary calcium your risk increases over the next 10 to 15 years by about 10 percent. If you have a lot, your risk increases significantly and your chance of dying over those next years is approximately 22 percent.

A man jogs at Pier A Park in Hoboken, New Jersey, Jan. 15, 2014. Atherosclerosis, or calcium deposits, in the cardiac arteries of young people have been found to dramatically shorten life expectancy, a new study found.

In the study, which began in 1985, 3,300 African American and white young adults received a CT scan, looking for evidence of atherosclerosis. The remainder of the participants were followed based on known risk factors for heart attack. Atherosclerosis was seen on CT in 30 percent of those who were scanned. The study followed up after 12 years when doctors noted the high early mortality rate in those with calcium deposits. The study was published in the journal JAMA Cardiology.

Carr said its not necessary to do a heart scan on everyone to project their risk of death from heart attack. He said a clinician can assess a persons risk of an attack by doing a health profile measuring and weighing a number of risk factors. Risk factors like blood pressure and cholesterol, even when modestly elevated in early adult life in these people at high risk, may provide opportunity to identify them and treat risk factors more aggressively, and just potentially be able to lower the risk of future heart attacks that we saw over the past 15 years in the cohort [study participants], Carr said.

Carr said medications to lower high blood pressure and elevated cholesterol, weight loss and stopping smoking are proven to be effective in fighting heart disease. And of course a healthier diet, with lots of fruits and vegetables and less red meat, doesnt hurt.

http://www.voanews.com/a/atherosclerosis-study/3715169.html
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waltky · Jun 16, 2017

Bacteria Could Help Heart Attack Sufferers...

Oxygen-Producing Bacteria Could Help Heart Attack Sufferers
June 15, 2017 - Photosynthetic bacteria and light may offer hope to heart disease patients, a new study suggests.

Researchers at Stanford University say that after injecting the bacteria into the hearts of rats with cardiac disease and using light to start photosynthesis, they were able to increase the flow of oxygen, improving heart function. “The beauty of it is that it’s a recycling system,” said Joseph Woo, senior author of the study. “You deliver the bacteria, they take up carbon dioxide, and with energy from the light, they form oxygen.”

The findings could help many who have a condition called cardiac ischemia, which restricts blood flow and the delivery of oxygen to the heart muscles. “We thought there is an interesting relationship in nature,” Woo said. “In nature, humans exhale carbon dioxide and plants convert it back to oxygen. During a heart attack, the muscle is still trying to pump. There’s carbon dioxide but no oxygen. We wondered if there were any way to use plant cells and put them next to heart cells to produce oxygen from the carbon dioxide.”

Photosynthetic cyanobacteria could help patients suffering from heart disease, according to a new study.

At first, the researchers tried to use spinach and kale cells, but the chloroplasts, the structures where photosynthesis occurs, were not stable enough to live outside the plant. “So we kept looking around,” Woo said, saying the next option was photosynthetic bacteria called cyanobacteria because it is “more rugged” and could survive with heart cells in a petri dish.

After that, Woo and his team injected cyanobacteria into the beating hearts of anesthetized rats, comparing the oxygen levels among rats with their hearts exposed to light and rats that did not have light shined on their hearts. “The group that received the bacteria plus light had more oxygen and the heart worked better,” Woo said, adding that the bacteria “dissipated” in about 24 hours. Improved cardiac function lasted at least four weeks, he said. “This is still very preliminary,” Woo said. The study was published in the journal Science Advances.

https://www.voanews.com/a/mht-cyanobacteria-could-help-heart-attack-sufferers/3901770.html
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Aspirin Linked to Higher Risk of Serious Bleeding in the Elderly
June 13, 2017 — People who are aged 75 or older and take aspirin daily to ward off heart attacks face a significantly elevated risk of serious or even fatal bleeding and should be given heartburn drugs to minimize the danger, a 10-year study has found.

Between 40 percent and 60 percent of people over the age of 75 in Europe and the United States take aspirin every day, previous studies have estimated, but the implications of long-term use in older people have remained unclear until now because most clinical trials involve patients younger than 75. The study published on Wednesday, however, was split equally between over-75s and younger patients, examining a total of 3,166 Britons who had suffered a heart attack or stroke and were taking blood-thinning medication to prevent a recurrence. Researchers emphasized that the findings did not mean that older patients should stop taking aspirin. Instead, they recommend broad use of proton pump inhibitor heartburn drugs such as omeprazole, which can cut the risk of upper gastrointestinal bleeding by 70 to 90 percent. While aspirin — invented by Bayer in 1897 and now widely available over the counter — is generally viewed as harmless, bleeding has long been a recognized hazard.

Peter Rothwell, one of the study authors, said that taking anti-platelet drugs such as aspirin prevented a fifth of recurrent heart attacks and strokes but also led to about 3,000 excess-bleeding deaths annually in Britain alone. The majority of these were in people older than 75. "In people under 75, the benefits of taking aspirin for secondary prevention after a heart attack or stroke clearly outweigh the relatively small risk of bleeding. These people needn't worry," Rothwell said. "In the over-75s the risk of a serious bleed is higher, but the key point is that this risk is substantially preventable by taking proton pump inhibitors alongside aspirin."

Packages of aspirin fill the shelves of a drugstore

Faculty of Pharmaceutical Medicine President Alan Boyd, who was not involved in the study, said it had been considered that the benefits of aspirin outweighed the risks of bleeding in all patients and that the new research would force a reappraisal. Rothwell, director of the Center for Prevention of Stroke and Dementia at Oxford University, and his colleagues found that the annual rate of life-threatening or fatal bleeds was less than 0.5 percent in under-65s, rising to 1.5 percent for those aged 75 to 84, and nearly 2.5 percent for over-85s.

Because the majority of patients studied were taking low-dose aspirin, rather than more modern anti-platelet drugs such as clopidogrel or AstraZeneca's Brilinta, the study could not draw conclusions about combined drug use. However, a commentary in The Lancet medical journal, where the study was published, noted that patients on dual anti-platelet therapy were known to have a higher risk of bleeding than those on monotherapy and that the research showed the need for regular evaluation of older patients.

https://www.voanews.com/a/aspirin-linked-higher-risk-serious-bleeding-elderly/3899590.html
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waltky · Sep 13, 2017

Rare Surgical Infection at New Orleans Children's Hospital...

Child Heart Patients Treated for Rare Surgical Infection
September 12, 2017 — At least a dozen children who had heart surgery at Children's Hospital New Orleans between late May and July have infected incisions, apparently from contaminated equipment.

The hospital's chief medical officer says the infections were linked to a machine that regulates a patient's temperature during heart surgery. Dr. John Heaton says the machine was replaced and patients are responding to intravenous antibiotics.

He says a handful who haven't shown symptoms will see doctors this week, to make sure. Heaton says the hospital's paying for treatment and related costs, such as parents' hotel rooms and meals.

An operating room is seen through a window at a sanitizing station in New Orleans.

The Centers for Disease Control and Prevention describes the bacteria in question as common in water, soil and dust. It says contaminated medical devices can infect the skin and soft tissues under the skin.

https://www.voanews.com/a/child-heart-patient-treated-for-rare-surgical-infection/4025731.html
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waltky · Jan 29, 2018

Adults with a childhood history of heart defects face problems...

Children Who Survive Congenital Heart Defects Can Face New Problems As Adults
January 28, 2018 - A few weeks ago, our family gathered for a meeting that we hope will save my sister's life. Our goal was to demonstrate to a hospital social worker that we could take care of her should she get a heart transplant.

My sister Sara is now 50. (NPR isn't using her last name to protect her medical privacy.) For her to get on the transplant list, her anatomy needed to be suitable and her antibody levels low despite prior surgeries. She had to show that she could withstand the grueling transplant process; that she could consistently take her anti-rejection medications; didn't abuse drugs or alcohol; and had a stable home life. A heart transplant costs about $1.4 million, according to data from the actuarial firm Milliman. And there aren't enough hearts to go around. Sara had to show that she could pay for three months of living near the hospital for the daily checkups and weekly heart biopsies, as well as the anti-rejection medications she would need daily for the rest of her life. My sister has the most gallant heart of anybody I know. But her patched up heart has been slowly failing over the last three to four years.

She was born a "blue baby" in 1967 with transposition of the great arteries, a relatively common but serious heart defect, which deprived her body of oxygenated blood. In a procedure called a Blalock-Taussig shunt, her doctors made a small hole in her heart to allow oxygenated blood to mix with the other blood in her body. At that point, that was the only option. The doctors told our mother to keep her alive until they improved surgical techniques enough to operate again. She was a spindly toddler with purple lips and fingertips. During those years, she couldn't do much, and we would pull her around in a red Radio Flyer wagon. In 1972, when Sara was a kindergartner, surgeons performed a Mustard procedure, attempting to reroute her blood flow. It was an incomplete fix, but her lips and fingers turned pink. Of the three cardiac surgeries performed in the hospital that week, she was the only child to survive.

Sara's nephew and Wendy's son Benny painted this image of a heart that hangs in the author's home.

According to the Centers for Disease Control and Prevention, 1 percent of children, about 40,000 babies, are born with congenital heart defects a year in the U.S., ranging from simple conditions that don't even need surgery to life-threatening problems like my sister's. "It is the No. 1 birth defect," says Dr. Michael Landzberg, director of the Boston Adult Congenital Heart program. Out of those children with a congenital heart problem, an estimated 5 to 7 percent — about 1,250 babies a year — are born with some variation of transposition, like my sister. According to Landzberg, because of improved medical care, by the 1980s and 1990s more children with serious congenital heart disease were surviving to adulthood. Programs sprouted at major medical centers to provide specialized care and train doctors to deal with this growing population with complex medical needs, who also needed to deal with finding insurance and employment, having children or simply finding a swimsuit that hid the surgical scars.

A few years ago, I had the opportunity to interview Landzberg in his tiny office filled with textbooks. He thought I looked familiar. We had never met; it was my sister he remembered. She and her husband had consulted with him to ask if it would be safe for her to become pregnant. I told him that her son was a middle schooler now. Landzberg's face lit up. Landzberg advocates lifetime follow-up for all children born with congenital heart disease. About half only need occasional checkups by their physician under the guidance of an adult congenital heart disease specialist, he says, but the rest need to be monitored more frequently directly by a specialist. Landzberg noted that between the ages of 18 and 25, these patients' mortality risk due to their hearts' anatomical limitations may double or even quadruple, depending upon the severity of their condition. Increasing age intensifies the effect on the heart and body of physiological stressors such as growth spurts, exercise and pregnancy, as well as infections, surgeries and other diseases.

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Survivors Of Childhood Diseases Struggle To Find Care As Adults
June 21, 2017 - Rachael Goldring was born with congenital heart disease. Had she been born a few decades earlier, she probably would have died as a baby. Goldring is now 24 and among a population of patients who present new challenges to a health care system unaccustomed to dealing with survivors of once-fatal conditions.

Today there are more adults than kids living with some of these diseases, and medical training is lagging. Young adults who can't find suitable doctors may drop out of care, and their conditions may worsen. Goldring's condition was pulmonary atresia with tetralogy of Fallot. She was born without a pulmonary valve directing blood from her heart to her lungs. It's the condition that talk show host Jimmy Kimmel's baby was born with this spring. "I had my first surgery when I was 9 months," Goldring says. "Now, they do it from birth." Her condition has also meant three more surgeries, a heart valve from a cadaver, complicated secondary diseases and a lifetime in and out of doctors' offices. "I just celebrated my one-year anniversary of staying out of the hospital for the first time since birth," Goldring says. "So, this year, knock on wood, it's been amazing."

But she fears it might not last. Right now, she is in limbo between pediatric and adult medical care. For Goldring, finding a good doctor could be a matter of life and death. Today, survivors of congenital heart disease can live well past childhood. Dr. Patrick Burke, a pediatrician at Valley Children's Healthcare in Madera, Calif., says other once-fatal ailments like sickle cell disease and spina bifida have undergone similar advances. "This is the so-called medical miracle promised to our parents and grandparents," Burke says, adding that miracle kids like Goldring grow up to be complicated adults. "The job's not done after the surgery or the initial treatment. Many if not most of these conditions require ongoing medical care — lifelong medical care."

As a child, Rachael Goldring had multiple open-heart surgeries to treat her congenital heart disease. At 24, she still sees pediatricians because she has had difficulty finding the right care in adult medicine.

Burke is in charge of a new program at his hospital in the new field of "transitional care." He says many conditions worsen around age 18, right as children age out of pediatric care. For instance, he says, that is when patients with congenital heart disease suffer complications with their blood and organs. The trend is particularly stark for cystic fibrosis. "We're seeing this spike of deaths that are happening in the early 20s. And it's bizarre," he says. Dr. Megumi Okumura, a pediatrician with the University of California, San Francisco, became interested in this transition during her residency in the early 2000s. She would see 40- and 50-year-olds in pediatric wards. The reason, she says, partly lies with a fragmented health care system. "They are transferring from differing systems of care," she says, noting the silos that separate pediatric care from adult care. "We have different funding streams and programs."

Now, Okumura and other researchers are looking for ways to remove what she considers artificial barriers. Clinics around the world are trying out new strategies such as giving nonpediatric doctors more training or bringing in transitional specialists to connect young adults who are chronically ill with new providers. A relatively new fellowship track even trains doctors to work specifically with adults with congenital heart disease. Goldring is fortunate in that she can remain with her pediatricians until she finds the right adult provider. She's working on it, but at the moment, she's much more focused on another transition: She'll be getting married in October.

https://www.npr.org/sections/health...hood-diseases-struggle-to-find-care-as-adults
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waltky · Feb 2, 2018

Some Breast Cancer Therapies Put Heart at Risk...

Doctors Warn of Heart Risk From Some Breast Cancer Therapies
February 01, 2018 - Save your life but harm your heart? Health experts are sounding a warning as potential side effects of a growing number of breast cancer treatments come to light.

In its first statement on the topic, the American Heart Association on Thursday said women should consider carefully the risks and benefits of any therapies that may hurt hearts. Not all treatments carry these risks, and there may be ways to minimize or avoid some. "We want patients to get the best treatment for their breast cancer," said Dr. Laxmi Mehta, a women's heart health expert at Ohio State University who led the panel that wrote the statement. "Everyone should have a conversation with their doctor about what are the side effects."

Chapel Hill, N.C. Health experts are stepping up warnings as more cardiac side effects of some breast cancer treatments come to light. In its first guidance on the issue, released on Thursday, Feb. 1, 2018, the American Heart Association urges that women and their doctors carefully weigh the risks and benefits of any therapy that may cause heart damage.

There are more than 3 million breast cancer survivors and nearly 48 million women with heart disease in the United States. "Most people with breast cancer fear death from breast cancer. Even after they survive that, they still fear it," but heart disease is more likely to kill them, especially after age 65, Mehta said. Some treatments for other types of cancer may pose heart risks, but they are growing more common for breast cancer patients and the statement addressed only that form of the disease. Here are some questions and answers:

Q: What are the problems and which treatments can cause them?

A: Side effects can include abnormal rhythms, valve problems or heart failure, where the heart slowly weakens and can't pump effectively. Symptoms may not appear until long after treatment ends. Herceptin and similar drugs for a specific type of breast cancer can cause heart failure. Sometimes it's temporary and goes away if treatment is stopped, but it can be permanent. Radiation can affect arteries and spur narrowing or blockages. Other drugs can lead to abnormal heart rhythms or artery spasms, which can cause chest pain and possibly lead to a heart attack. Still others can damage DNA.

Some research suggests that powerful new drugs that harness the immune system to fight cancer may, in rare cases, cause heart damage, especially when used together. "The problem is, no one has this on their radar," so patients are not routinely checked for it, Dr. Javid Moslehi, head of a Vanderbilt University clinic specializing in heart risks from cancer therapies, said when a study reported this problem about a year ago.

Q: What can be done to avoid harm?
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waltky · Aug 5, 2018

Even low air pollution may damage heart...

Low levels of air pollution linked to changes in the heart
3 Aug.`18 - Regular exposure to even low levels of air pollution may cause changes to the heart similar to those in the early stages of heart failure, experts say.

A study of 4,000 people in the UK found those who lived by loud, busy roads had larger hearts on average than those living in less polluted areas. This was despite the fact people in the study were exposed to pollution levels below the UK guidelines. Researchers called on the government to reduce air pollution more quickly. A team of scientists, led from Queen Mary University of London, analysed health data of people who had no underlying heart problems and were part of the UK Biobank study, including the size, weight and function of their hearts.

Researchers also looked at the pollution levels in the areas they lived in. Their study found a clear link between exposure to higher pollution levels and larger right and left ventricles - important pumping chambers in the heart. For every extra one microgram per cubic metre of PM2.5 - small particles of air pollution - and for every 10 extra micrograms per cubic metre of nitrogen dioxide, the heart enlarged by about 1%. The changes were comparable to being consistently inactive or having elevated blood pressure, said Dr Nay Aung, who led the study's data analysis. "Air pollution should be seen as a modifiable risk factor," he said. "Doctors and the general public all need to be aware of their exposure when they think about their heart health, just like they think about their blood pressure, their cholesterol and their weight."

While the exact locations where people lived were not included in the study, most were outside of the major UK cities and all of them were exposed to levels of PM2.5 air pollution well below current UK limits. In the study, average annual exposures to PM2.5 ranged from eight to 12 micrograms per cubic metre. This is lower than the UK limits of 25 micrograms per cubic metre but closer to the World Health Organization's recommended limit of 10 micrograms per cubic metre. This fine particle pollution is particularly dangerous because it can penetrate deep into the lungs and cardiovascular system.

Diesel cars are a big contributor of air pollution

Exposure to nitrogen dioxide in the study ranged from 10-50 micrograms per cubic metre - the UK and WHO limits are 40 micrograms per cubic metre. Dr Aung said the changes in the heart were small and potentially reversible. But he said the fact any change at all was detectable suggested even relatively low levels of air pollution may have a harmful effect on health. "If you think the current levels of air pollution are safe, then in theory we shouldn't be able to detect any changes," Dr Aung added.

'Can't expect people to move'
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waltky · Aug 13, 2018

Multi-gene Test May Find Risk for Heart Disease and More...

Multi-gene Test May Find Risk for Heart Disease and More
August 13, 2018 | WASHINGTON — You know your cholesterol, your blood pressure ... your heart gene score? Researchers say a new way of analyzing genetic test data may one day help identify people at high risk of a youthful heart attack in time to help.

Today, gene testing mostly focuses on rare mutations in one or a few genes, like those that cause cystic fibrosis or sickle cell disease, or the BRCA gene responsible for a small fraction of breast cancer. It is less useful for some of the most common diseases, such as heart disease or diabetes, because they are influenced by vast numbers of genes-gone-wrong working together in complicated ways. Monday, researchers reported a new way to measure millions of small genetic variations that add up to cause harm, letting them calculate someone’s inherited risk for the most common form of heart disease and four other serious disorders. The potential cardiac impact: They estimated that up to 25 million Americans may have triple the average person’s risk for coronary artery disease even if they haven’t yet developed warning signs like high cholesterol. “What I foresee is in five years, each person will know this risk number, this ‘polygenic risk score,’ similar to the way each person knows his or her cholesterol,” said Dr. Sekar Kathiresan who led the research team from the Broad Institute, Massachusetts General Hospital and Harvard Medical School.

If the approach pans out and doctors adopt it, a bad score wouldn’t mean you’d get a disease, just that your genetic makeup increases the chance — one more piece of information in deciding care. For example, when the researchers tested the system using a DNA database from Britain, less than 1 percent of people with the lowest risk scores were diagnosed with coronary artery disease, compared to 11 percent of people with the highest risk score. “There are things you can do to lower the risk,” Kathiresan said — the usual advice about diet, exercise, cholesterol medication and not smoking helps. On the flip side, a low-risk score “doesn’t give you a free pass,” he added. An unhealthy lifestyle could overwhelm the protection of good genes.

Stephanie Richurk, a nurse at the University of Pittsburgh Medical Center, sorts blood samples collected from participants in the "All of Us" research program in Pittsburgh

The scoring system also can predict an increased risk of Type 2 diabetes, inflammatory bowel disease, breast cancer and an irregular heartbeat called atrial fibrillation, the team reported in the journal Nature Genetics — noting that next steps include learning what might likewise lower those risks. It doesn’t require the most sophisticated type of genetic testing. Instead, Kathiresan can calculate risk scores for those five diseases — eventually maybe more — simply by reanalyzing the kind of raw data people receive after sending a cheek swab to companies like 23andMe. A geneticist who specializes in cardiovascular disease, he hopes to open a website where people can send in such data to learn their heart risk, as part of continuing research. Kathiresan and co-author Dr. Amit Khera, a Mass General cardiologist, are co-inventors on a patent application for the system.

Other scientists and companies have long sought ways to measure risk from multiple, additive gene effects — the “poly” in polygenic — and Myriad Genetics has begun selling a type of polygenic test for breast cancer risk. But specialists in heart disease and genetics who weren’t involved with the research called the new findings exciting because of their scope. “The results should be eye-opening for cardiologists,” said Dr. Charles C. Hong, director of cardiovascular research at the University of Maryland School of Medicine. “The only disappointment is that this score applies only to those with European ancestry, so I wonder if similar scores are in the works for the large majority of the world population that is not white.”

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