February 2, 2007, 5:06 AM CT
Stem Cells to Repair Damaged Hearts
The Autologous Cellular Therapy CD34-Chronic Myocardial Ischemia (ACT34-CMI) Trial is the first human, Phase II adult stem cell therapy study in the U.S. designed to investigate the efficacy, tolerability, and safety of blood-derived selected CD34+ stem cells to improve symptoms and clinical outcomes in subjects with chronic myocardial ischemia (CMI), a severe form of coronary artery disease.
Rush University Medical Center is one of the first medical centers in the country, and currently the only site in Illinois, participating in a novel clinical trial to determine if a subject's own stem cells can treat a form of severe coronary artery disease.
"What we're hoping is that these stem cells will be able to stimulate the growth of new blood vessels to bring more blood and oxygen to the heart muscle, so that these patients will have a better quality of life and less chest pain," said Dr. Gary Schaer, director of the Rush Cardiac Catheterization Lab and study investigator.
Myocardial ischemia is a serious heart condition that involves narrowing of coronary arteries and results in limited blood flow to the heart. The disease affects hundreds of thousands of new people each year. A person who suffers from chronic myocardial ischemia continues to experience insufficient flow of oxygen-rich blood to the heart despite optimum medical intervention.........
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January 31, 2007, 8:28 PM CT
Monitoring Patients Heart Daily at their Home
An easy-to-use in home monitoring device for patients is changing the way doctors monitor the health of patients with implanted defibrillators. Rush University Medical Center is participating in a pilot study of the LATITUDE® Patient Management system to determine if the wireless home monitoring system can decrease hospitalizations for heart failure.
A mini-antenna built into the implanted defibrillator sends data to a wireless system placed in the patient's home. The data is automatically transmitted to a secure Internet server where the doctor can access this medical information anytime, from anywhere.
Unlike other remote devices which only transmit data if certain parameters are out of range, the LATITUDE system uploads health information that can help physicians monitor the day-to-day changes in patients. In addition to the data stored before, during and after an arrhythmia, the system employs a wireless weight scale and blood pressure monitor to record vital statistics crucial for the management of cardiac failure patients. An abrupt change in weight could indicate worsening heart failure.
"This sophisticated system allows physicians to manage the patient much more closely. The same information that would normally require a visit to the office every few months can now be downloaded to the doctor at anytime without the patient ever leaving home," said Dr. Kousik Krishnan, a cardiac electrophysiologist at Rush.........
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January 11, 2007, 4:45 AM CT
Less Experienced Surgeons Perform New Techniques On Black Patients
There is racial bias among cardiac surgeons, when it comes to using experimental off pump techniques in coronary artery bypass surgery. Less experienced surgeons tend to perform such procedures in Black patients until they gain confidence on these new techniques.
Writing in the Royal Society of Medicine's, Journal of Health Services Research & Policy, the findings are based on over 15,000 coronary artery bypass grafting (CABG) patients in New York State.
Traditionally, CABG is performed using the cardiopulmonary bypass to circulate blood externally during the operation, giving the surgeon a stable and blood-free environment in which to operate. The use of the cardiopulmonary bypass is not without risk and many cardiac surgeons associate it with serious complications, including cognitive deficits, stroke, renal failure, and pulmonary dysfunction.
Off-pump surgery, which is performed on the beating heart without the use of the cardiopulmonary bypass, was reintroduced in the late 1990s because many surgeons believed it may decrease the incidence of complications.
"Our research shows that surgeons who have less experience with the off-pump technique are more likely to perform this technique on black patients, rather than on white patients," said Professor Dana Mukamel of the University of California, Irvine.........
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January 8, 2007, 9:40 PM CT
Obese Patients Fair Better
Scientists report that for patients hospitalized with acute heart failure, a higher body mass index (BMI) was linked to a substantially lower in-hospital mortality rate. For every 5-unit increase in body mass, the odds of risk-adjusted mortality fell 10 percent. The finding held when adjusted for age, sex, blood urea nitrogen, blood pressure, and additional prognostic factors.
IMPACT: The finding offers more insight into an observed phenomenon in chronic heart failure called the 'obesity paradox.' This is the first study to document that this inverse relationship with BMI holds in the setting of acute hospitalization for heart failure. Further study is mandatory but the finding suggests that nutritional/metabolic support may have therapeutic benefit in specific patients hospitalized with heart failure.
BACKGROUND: The study observed that by weight category, in-hospital mortality rate was 6.3 percent for underweight, 4.6 percent for healthy weight, 3.4 percent for overweight and 2.4 percent for obese patients. "The study suggests that overweight and obese patients may have a greater metabolic reserve to call upon during an acute heart failure episode, which may lessen in-hospital mortality risk," said Fonarow. Obesity is a known risk factor for developing heart disease and heart failure and every effort should be made to avoid it, but once heart failure has manifested, this paradox seems to occur. Scientists utilized data on over 100,000 acute heart failure patient episodes, taken from the Acute Decompensated Heart Failure National Registry (ADHERE). The study and ADHERE is funded by Scios, Inc. The authors have received research grants and served as consultants for Scios.........
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December 28, 2006, 9:20 PM CT
Diabetes, Heart Associations Align Fight Against Heart Disease
In a joint statement released recently, the American Diabetes Association (ADA) and American Heart Association (AHA) summarize the evidence supporting lifestyle and medical interventions that can help to prevent the development of heart disease in people with diabetes.
The statement, published in Circulation: Journal of the American Heart Association and the American Diabetes Association's clinical research journal Diabetes Care, outlines joint guidelines from the organizations that encourage more aggressive prevention and therapy of the risk factors that lead to heart disease, the number one killer of people with diabetes.
Traditional changes in lifestyle for people with diabetes have focused on weight loss. These new joint guidelines emphasize a need for major interventions that more significantly reduce CVD risk factors. It continues to cite the importance of achieving a healthy lifestyle, based on increased physical activity, medical nutrition treatment, and weight control. In addition, the statement calls for increased medical interventions, such as the use of statins, ACE inhibitors, and other drugs to manage lipids, blood pressure, and blood glucose levels in people with diabetes. The recommendations apply equally to people with type 1 and type 2 diabetes.........
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December 28, 2006, 9:14 PM CT
Cardiovascular Disease Kills One In Three
Cardiovascular disease (CVD) as an underlying cause of death accounted for more than one-third (36.3 percent) of all deaths in the United States in 2004, as per the most recent data from the American Heart Association's Heart Disease and Stroke Statistics - 2007 Update. The Update will be available in the Dec. 29 online issue of Circulation: Journal of the American Heart Association at http://www.americanheart.org/statistics.
The Update provides the most recent statistics about cardiovascular diseases, risk factors, therapys, quality of care and costs of care. The American Heart Association does not generate the data, but synthesizes it from a number of sources and provides it online without charge for government policymakers, physicians, researchers, educators and the public to use, making the Update a unique national - and even international - resource.
Cardiovascular diseases (CVD) include heart disease, stroke, high blood pressure, heart failure and congenital cardiovascular defects. Counting only heart disease, this has been the leading cause of death in the United States every year since 1900 except during the 1918 flu epidemic.
A look across the states (including the District of Columbia) shows state and regional differences in the burden of CVD based on 2003 data, the most recent year for which state vital statistics are available. For CVD deaths as a whole, Minnesota had the lowest death rate at 221.2 (per 100,000 population), while Mississippi had the highest at 405.9. For coronary heart disease deaths, Hawaii has the lowest rate (96.0), while Oklahoma carries the highest (228.1). New York has the lowest state death rate for stroke (35.0), but is second highest in coronary heart disease deaths (213.4), just behind Oklahoma.........
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December 20, 2006, 4:30 AM CT
Those Blood Transfusions During Heart Bypass Surgery
Blood transfusions save the lives of millions of heart surgery patients and others each year. But a new study suggests that patients who receive transfusions during heart bypass surgery have a higher risk of developing potentially dangerous infections, and dying, after their operation.
In fact, this increased risk may help explain a longstanding medical mystery: why women bypass patients are more likely than men to die in the first few months after surgery. Women are more likely to receive blood during heart bypass operations, which are performed on more than 465,000 Americans each year.
The findings, from the Patient Safety Enhancement Program (PSEP) at the University of Michigan Health System, are based on data from 9,218 Michigan bypass patients. After adjusting for factors such as the urgency of the operation, those who received blood transfusions from donors were five times more likely to die within 100 days of their operation than those who did not.
The paper is published in the recent issue of the American Heart Journal. It builds on a previous U-M analysis that found that a difference in infection rates accounted for the difference in death risk between men and women bypass patients.
The U-M team, with the help of Neil Blumberg, M.D., of the University of Rochester Medical Center, focused on blood transfusions as a contributing factor. Prior research has shown that recipients of stored donor blood have more post-surgical infections, and that women receive more transfusions because they tend to have lower hemoglobin concentrations.........
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December 14, 2006, 9:35 PM CT
Moderate Drinking May HelpYou Live Longer
A study published in Journal of the American Geriatrics Society finds that moderate alcohol intake (1-2 drinks/day for 3-6 days/week, depending on alcoholic content) may lead to increased quality of life and survival in older women. The Australian Longitudinal Study on Women's Health followed nearly 12,000 women in their 70's over a 6 year period. The group was comprised of non-drinkers, occasional drinkers and moderate drinkers.
The study found that non-drinkers and women who rarely drank had a significantly higher risk of dying during the survey period than did women who drank moderately. Of those who survived, the women who drank the least reported the lowest health-related quality of life. Previous studies have shown that women who have at least one drink per day stand at a lower risk for cardiovascular disease and ischemic stroke than non-drinkers.
"The results of this study indicate that moderate alcohol intake in keeping with current guidelines may carry some health benefits for older women," says Dr. Julie Ellen Byles, author of the study. This contrasts previous studies which have suggested that moderate alcohol intake can be detrimental to older women and may lead to accidents, cancers, even dementia.
The potential causes of increased health and survival may be ingredients found in wine or ethanol, the social and pleasurable benefits of drinking or the improved appetite and nutrition that often accompanies modest alcohol intake. The author notes that the study does not advocate non-drinkers to begin drinking. Changes in diet need to be determined through consultation with a doctor due to the potential complications of mixing alcohol and medication.........
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December 14, 2006, 9:29 PM CT
Height Loss And Heart Disease
Men who lose 3 centimeters or more of height as they age have an increased risk of death and of coronary heart diseases events, as per a report in the December 11/25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Changes in bone, muscles and joints typically lead men and women to become shorter as they age, as per background information in the article. Eventhough a small amount of height loss is normal and probably not linked to any disease, more significant height loss may be a sign of osteoporosis (thinning of the bones). Substantial height loss can affect breathing and digestive functions, leading to poor eating habits and weight loss, and may be linked to sarcopenia, the loss of muscle mass.
S. Goya Wannamethee, Ph.D., Royal Free and University College Medical School, London, and his colleagues studied 4,213 men who originally enrolled in the British Regional Heart Study between 1978 and 1980. Follow-up examinations were conducted 20 years later, when the men were 60 to 79 years old. At that time, the men completed a questionnaire providing details about their lifestyle and medical history. They were asked to describe their current health status-excellent, good, fair or poor-and whether their doctor had ever told them they had cardiovascular disease or many other conditions. Participants' height and weight were measured both at the beginning of the study and at the 20-year follow-up; they were monitored through 2004 to see if they had developed cardiovascular disease, and deaths were tracked through 2005.........
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December 14, 2006, 9:21 PM CT
Folic Acid Supplementation And Heart Disease
An analysis of prior studies suggests that for people with a history of vascular disease, folic acid supplementation does not decrease the risk of coronary heart disease or stroke, as has been suggested in some research, as per a review article in the December 13 issue of JAMA.
Cardiovascular disease (CVD) is the leading cause of death in the United States and worldwide, accounting for 30.9 percent of deaths world-wide and 10.3 percent of the global burden of disease. Of all deaths in the United States, 37.3 percent (910,120 or 1 in every 2.7) are due to CVD. It is estimated that approximately 71.3 million persons in the U.S. have 1 or more forms of CVD, as per background information in the article.
Observational epidemiologic studies have indicated that increased folate intake is correlation to a lower risk of CVD, and randomized controlled trials have documented that dietary supplementation with folic acid reduces blood levels of homocysteine, which has been linked to an increased risk of CVD. Most trials generally have had insufficient statistical power on their own and have provided inconsistent findings, the authors write.
Lydia A. Bazzano, M.D., Ph.D., of Tulane University School of Public Health and Tropical Medicine, New Orleans, and his colleagues performed a meta-analysis of randomized clinical trials to determine the relationship between folic acid supplementation and risk of CVD and all-cause death among persons with pre-existing vascular disease. The study included 12 randomized controlled trials (with 16,958 participants) that compared folic acid supplementation with either placebo or usual care for a minimum duration of 6 months and with clinical cardiovascular disease events reported as an end point.........
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