November 1, 2007, 10:12 PM CT

Link between pre-eclampsia and heart disease

Two studies, published together on bmj.com today, add further weight to the theory that pre-eclampsia and cardiovascular diseases may share common causes or mechanisms.

The first study finds that women who have had pre-eclampsia during pregnancy have a more than two fold higher risk of heart disease in later life, while the second shows that women with cardiovascular risk factors that are present years before pregnancy may be predisposed to pre-eclampsia.

Pre-eclampsia is a serious condition where abnormally hypertension and other disturbances develop in the second half of pregnancy. It affects about 5% of all first-time pregnancies and is dangerous for both mother and child.

In the first study, scientists in London analysed 25 studies involving over 3 million women to calculate the future health risks of women who have had a pregnancy affected by pre-eclampsia that is likely explained by the association with heart disease.

They found a small increase in overall mortality among women who had had pre-eclampsia. Women with a history of pre-eclampsia also had an almost four fold increased risk of hypertension (hypertension) and a two fold increased risk of fatal and non-fatal ischaemic heart disease, stroke, and blood clots (venous thromboembolism) in later life......... Posted by: April      Read more         Source

October 31, 2007, 6:48 PM CT

Heart attacks, pneumonia falls short of national goals

Emergency departments across the nation are failing to meet national goals in treating a number of heart attack and pneumonia patients, as per a research studyby Johns Hopkins scientists reported in the recent issue of Academic Emergency Medicine.

In a survey that also found care levels dependent on race, geography and type of health insurance, the researchers studied records of 1,492 heart attack patients and 3,955 pneumonia patients seen at 544 emergency departments between 1998 and 2004. Results showed only 40 percent ED compliance with recommended aspirin treatment and 17 percent with recommended beta blocker therapy of heart attack patients.

Only 69 percent of patients with pneumonia got recommended antibiotics, and fewer than half (46 percent) had blood oxygen levels assessed as recommended by the American Thoracic Society.

The Joint Commission regulating hospitals and the Centers for Medicare and Medicaid Services say all eligible heart attack and pneumonia patients presenting to EDs should receive aspirin/beta blocker treatment, or antibiotic and oxygen assessment, respectively. If these numbers are applied nationwide, we estimate that as a number of as 22,000 deaths a year could be prevented in the U.S. if ED caregivers followed practice standards, said Julius Pham, M.D., principal investigator for the study and assistant professor of medicine in the Johns Hopkins departments of Emergency Medicine and Anesthesiology and Critical Care Medicine. More resources should be directed at studying why this is happening and developing strategies to ensure that 100 percent of patients get the recommended therapys......... Posted by: April      Read more         Source

October 25, 2007, 10:08 PM CT

Cholesterol transporter to vascular disease

Low-density lipoprotein (LDL), a transporter of cholesterol, may also contribute to vascular diseases by a previously unidentified mechanism, as per a report published online this week in EMBO reports. The study reveals a link between native LDL (nLDL) and the vascular endothelial growth factor receptor 1 (VEGFR1), which plays a central role in blood vessel formation.

LDL is responsible for transporting cholesterol from the liver to peripheral tissues. During transit in the blood, cholesterol can be deposited causing the formation of plaques that lead to hardening of the arteries. Vascular diseases such as thrombosis, stroke and heart attacks are linked to this condition, and are attributed to eleven deaths every hour in the UK alone.

Using cell lines and mouse models, Yoshiro Maru and his colleagues observed that when nLDL is bound to the LDL receptor, it can activate VEGFR1 and accelerate migration of macrophages, scavenger cells that accumulate in the plaques. Both effects could contribute to the progression of the plaques and blocking of the arteries. The authors hope that their discovery of the link between VEFGR1 and nLDL could be exploited as a potential therapeutic target for medical applications......... Posted by: April      Read more         Source

October 19, 2007, 5:00 AM CT

Are women at greater risk from angioplasty?

Research will be reported at TCT 2007, the annual scientific symposium of the Cardiovascular Research Foundation (CRF), that demonstrates that early intervention saves lives in women who have a heart attack or unstable chest pain.

Responding to media reports of recent studies that emphasized the dangers of angioplasty in women in comparison to men, Dr. Alexandra J. Lansky, MD, Director of the Angiographic Core Laboratory and the Women's Cardiovascular Health Initiative at the Cardiovascular Research Foundation, said that the comparison to men overshadows the true benefit to women of early intervention.

Recent news reports show that women do not fare as well as men following angioplasty. However, a cumulative view of the research on this topic overwhelmingly indicates that early intervention does benefit women, and in fact, prevents death and heart attacks, said Alexandra J. Lansky, MD, Director of the Angiographic Core Laboratory and the Women's Cardiovascular Health Initiative at the Cardiovascular Research Foundation.

A national expert on the topic of interventional cardiology in women, Dr. Lansky is the medical director of www.hearthealthywomen.org and is the lead author of the American Heart Association Statement on Interventional Cardiology in Women......... Posted by: April      Read more         Source

October 17, 2007, 8:25 PM CT

Obese children show early signs of heart disease

Children who are obese or who are at risk for obesity show early signs of heart disease similar to obese adults with heart disease, a study by scientists at Washington University School of Medicine in St. Louis has found.

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," said Angela Sharkey, M.D., associate professor of pediatrics at Washington University School of Medicine and a pediatric heart specialist at St. Louis Children's Hospital.

The study was reported in the Winter 2007 issue of the Journal of Cardiometabolic Syndrome.

Childhood obesity in the United States is an epidemic - nationwide, 19 percent of children ages 6 to 11 and 17 percent of those 12 to 19 are overweight, as per the Centers for Disease Control and Prevention (CDC). Those who are overweight during childhood also have an increased risk of obesity in adulthood and are at greater risk for complications such as diabetes, hypertension and heart disease, because obesity increases total blood volume, which leads to extra stress on the heart.

Sharkey and Steven M. Lorch, M.D., a former fellow at the School of Medicine now at University of Texas Health Science Center at Houston, analyzed data from 168 children ages 10 to 18 who had been referred to them for cardiac ultrasound with symptoms including heart murmur, chest pain, acid reflux or high blood cholesterol. Based on CDC guidelines for body mass index for age (BMIA), 33 patients were found to have a BMIA as obese, or the 95th percentile or above for their age; 20 had a BMIA that classified them as at risk for obesity, or between the 85th and 94th percentile; and 115 were considered normal, or below the 85th percentile......... Posted by: April      Read more         Source

October 11, 2007, 10:39 PM CT

Taking the stress out

Stress tests are good front-line tests indicators of heart disease, but just how good depends on ordering the right one, scientists say.

Thirty percent of all women, for example, have a false positive exercise treadmill test, in which they walk for several minutes at a slightly increasing incline with an electrocardiogram measuring the electrical activity of the heart, they say.

So if you are female, I put you on a treadmill and the waves that measure the electrical activity of your heart drop. You say, Am I going to die? says Dr. Vincent J.B. Robinson, nuclear heart specialist at the Medical College of Georgia and the Veterans Affairs Medical Center in Augusta. That probably is not the case. But instead of then taking those 30 percent of women to the catheterization lab to look for blood vessel blockages, we put them back on the treadmill this time with a contrast medium so we can see the heart work and possibly with a pharmacologic stress agent as well.

To help ensure all physicians know the best strategy, a team of MCG heart specialists evaluated the literature on stress tests and wrote a comprehensive article for the recent issue of Southern Medical Journal.

Coronary artery disease is a very, very prevalent condition and every physician, regardless of specialty, has to face the disease one way or the other, says Dr. Rakesh N. Patel, MCG research assistant who will start a cardiology fellowship in July. A lot of stress tests are available to help assess disease. To maximize the sensitivity and specificity, you have to choose the appropriate stress test. Dr. Patel is the papers first author......... Posted by: April      Read more         Source

October 10, 2007, 4:48 AM CT

Chronic job stress doubles the risk of a second heart attack

People who experience chronic job strain after a first heart attack double their risk of suffering from a second one, reports a research team from Universit Lavals Faculty of Medicine in the October 10 issue of the Journal of the American Medical Association.

This study is the first to clearly demonstrate the risks linked to job strain for workers who have been victim of a first heart attack. Research had previously shown a relationship between work-related stress and a first coronary heart disease (CHD) event, but studies examining job strain and recurrent CHD were few, limited in scope, and inconsistent in their findings.

The research team supervised by Chantal Brisson followed a group of 972 participants, ages 35 to 59, who had suffered a heart attack. These people were interviewed six weeks, two years, and then six years after returning to work in order to collect data on their health, lifestyles, sociodemographic status, and levels of work stress A job was defined as stressful if it combined high psychological demands (heavy workload, intense intellectual activity, and important time constraints) and little control over decision-making (lack of autonomy, creativity, and opportunities to use or develop skills).

During the six-year follow-up period, 124 participants suffered a second heart attack and 82 experienced unstable angina for a total of 206 recurrent CHD events. People who had reported high levels of stress at work during the first two interviews were twice as likely to fall victim to another CHD event. The risk remained the same even after taking into account factors such as severity of the first heart attack, other health conditions, family history, lifestyle, sociodemographic status, personality, and other work-environment characteristics......... Posted by: April      Read more         Source

October 8, 2007, 3:50 PM CT

Cardiovascular benefit for people with chronic kidney disease

New research, published recently in the Journal of American Society of Nephrology by The George Institute for International Health in Sydney, has observed that lowering blood pressure protects stroke victims with Chronic Kidney Disease from further strokes or heart attacks. Given the high risk of cardiovascular complications in people with Chronic Kidney Disease (CKD), these results have significant implications for millions of people across the world.

As per lead author, Dr Vlado Perkovic at The George Institute, most of the CKD population will die from cardiovascular complications. People with Chronic Kidney Disease are at a significantly greater risk of cardiovascular events than those without the disease. We observed that approximately twice as a number of cardiovascular events were prevented when a perindopril based blood pressure lowering regimen was used in these people, in comparison to people with normal kidney function.

The findings are based on a unique data set of around 1,800 patients who were part of a large clinical trial conducted on blood pressure and stroke, called PROGRESS. Dr Perkovic added that The findings from PROGRESS have shifted the focus away from treating individuals with hypertension to focusing on those people at especially high risk of heart disease and stroke. This research suggests that kidney function is an important parameter to consider in identifying these high risk individuals......... Posted by: April      Read more         Source

October 4, 2007, 9:40 PM CT

Stem cell therapy for heart patients

University of Florida doctors on Wednesday (Oct. 3) treated their first patient enrolled in a new study designed to test whether injecting stem cells into the heart helps restore blood flow to the organ by prompting new blood vessels to grow.

UF scientists plan to test the experimental treatment in people with severe coronary artery disease and daily chest pain who have not responded to traditional medications or surgical procedures designed to restore blood flow, such as angioplasty or bypass surgery.

The general idea is that by providing these cells of blood vessel origin, we hope to either generate new blood vessels from the growth of these implanted cells or stimulate the heart to regenerate new blood vessels from the cells that reside in it, said study investigator Carl J. Pepine, M.D., chief of cardiovascular medicine at UFs College of Medicine. Its not completely clear whether its the actual cell itself that would do this or whether its just the milieu and the chemical signals that occur from the cells that would result in this.

Each year, nearly half a million Americans with heart disease experience severe chest pain because coronary arteries and the smaller vessels that supply oxygen-rich blood to the heart muscle become narrowed or blocked by plaque deposits or clots. These blockages can trigger mini-heart attacks that, while too small to be noticed as they occur, over time irreversibly damage the heart leading to disability, progressive heart failure or even death......... Posted by: April      Read more         Source

October 2, 2007, 10:30 PM CT

Algorithms to reanimate the heart

When an adult suffers a cardiorespiratory arrest the rapid application of an electrical discharge with a defibrillator can avoid sudden death in a number of cases. Nevertheless, defibrillation also has its impediment or enemy: time. For every minute that passes from the moment of the attack, the possibilities of survival drop by 10%. This is why, in order to avoid avoidable deaths, more and more easy-to-handle, automatic defibrillators are being designed, sold and installed.

Automatic defibrillators or AEDs (Automatic External Defibrillators) have been around now for some ten years. The main elements of these devices are based on algorithms that help undertake a study and diagnosis of the electrical signals from the heart. The defibrillator reads the patient's heartbeat and carries out a continuous report of the state of the organ. Once this analysis is completed, it communicates whether or not an electric discharge is necessary, i.e. it will tell if, on applying electro-treatment, the heart will recover its usual pace or not.

In fact, this last was the starting point for scientists at the Department of Electronics and Telecommunications at the Higher Technical Engineering School in Bilbao (the University of the Basque Country - UPV-EHU); i.e. drawing up algorithms for defibrillators designed for adults. In this research, however, they are investigating algorithms that are reliably applicable for children and overcoming that obstacle of time......... Posted by: April      Read more         Source