June 20, 2007, 10:06 AM CT

Obesity And Enlarged Heart

New research from The University of Arizona Sarver Heart Center helps explain why excessive body weight increases the risk for heart disease.

In the largest study of its kind, cardiologist M. Reza Movahed, MD, PhD, and research specialist Adolfo A. Martinez, MD, discovered that excessive body weight is associated with a thickening of the heart muscle in the left ventricle, the hearts pumping chamber. Known to physicians as left ventricular hypertrophy (LVH), the condition potentially can lead to heart failure and rhythm problems.

We observed that the thickening in the muscle wall becomes especially noticeable in obese patients who have a Body Mass Index (BMI) of 30 or greater, says Dr. Movahed. Previous studies have shown that left ventricular hypertrophy is associated with a higher risk of mortality.

Analyzing 17,261 heart ultrasounds, the UA researchers studied moving images of the heart to evaluate structure and function. Results showed that narrowing of the aortic valve, the main valve that carries blood away from the heart to the rest of the body, was the strongest predictor of LVH, followed by gender and Body Mass Index.

While the cause of LVH in obese patients is not known, it may be related to increased work load or to the presence of other cardiac risk factors in these patients......... Posted by: April      Read more         Source

June 13, 2007, 7:51 AM CT

Sleep restriction reduces heart rate variability

Chronic sleep restriction has a negative effect on a person's cardiac activity, which may elevate the risk of cardiovascular disease and mortality, as per a research abstract that will be presented Wednesday at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, conducted by Siobhan Banks of the University of Pennsylvania School of Medicine, was based on preliminary analyses of 39 subjects, each of whom participated in a laboratory-controlled chronic sleep restriction protocol. The subjects underwent two nights of baseline sleep followed by five hours of sleep restriction. The results showed a statistically significant decrease in the heart rate variability after five nights of sleep restriction.

"A reduction in the heart rate variability has been reported in several cardiological and non-cardiological diseases," said Banks. "If our finding is sustained by a larger group and further analysis, it may suggest why short sleep duration is linked to a heightened risk of cardiovascular disease and mortality".

The amount of sleep a person gets affects his or her physical health, emotional well-being, mental abilities, productivity and performance. Recent studies associate lack of sleep with serious health problems such as an increased risk of depression, obesity, cardiovascular disease and diabetes......... Posted by: April      Read more         Source

May 25, 2007, 7:15 PM CT

Insights Into Chronic Inflammation And Atherosclerosis

Rheumatoid arthritis, lupus, and other inflammatory rheumatic diseases are linked to a high rate of death from heart disease. One explanation is a greater susceptibility to atherosclerosis. Eventhough atherosclerosis is associated with inflammation in healthy individuals as well, the mechanism of inflammation and the reason for accelerated atherosclerosis in patients with inflammatory rheumatic disease remain unclear. Does atherosclerosis result from systemic inflammation, a hallmark of these rheumatic diseases, or from local inflammation of vessels?

To shed light on the link between chronic inflammation and atherosclerosis, a team of scientists in Norway and the United States, affiliated with the Cleveland Clinic Foundation and Brigham and Women's Hospital in Boston, focused on the aortas of recent recipients of coronary artery bypass graft (CABG) surgery, comparing biopsy specimens from patients with inflammatory rheumatic disease to those from patients without it. Their study, presented in the June 2007 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), affirms inflammatory rheumatic disease and smoking as independent predictors of vessel wall inflammation. The vascular inflammation might be a factor that promotes atherosclerosis and the formation of aneurysms......... Posted by: April      Read more         Source

May 23, 2007, 8:17 PM CT

Moderate drinking lowers women's risk of heart attack

Women who regularly enjoy an alcoholic drink or two have a significantly lower risk of having a non-fatal heart attack than women who are life-time abstainers, epidemiologists at the University at Buffalo have shown.

Moderation is the key, however. Women in the study who reported being intoxicated at least once a month were nearly three times more likely to suffer a heart attack than abstainers, results showed.

One difference in the protective pattern among drinkers involved those who drank primarily liquor. Women who preferred liquor to wine experienced a borderline increase in risk of heart attack, results showed.

The study is reported in the May 2007 issue of the journal Addiction.

"These findings have important implications, because heart disease is the leading cause of death for women," said Joan M. Dorn, Ph.D., associate professor of social and preventive medicine in the UB School of Public Health and Health Professions and first author on the study.

Women seem to have a quicker reaction to a smaller amount of alcohol, she noted: "Overdoing it is harmful, and what is too much depends on each individual. In some women, one drink can cause intoxication".

Moderate alcohol consumption has been shown to lower the risk of heart attack, but most studies have been done with men. The current study compared alcohol drinking volume and drinking patterns of women who had been hospitalized due to a heart attack, with age-matched controls without heart problems......... Posted by: April      Read more         Source

May 23, 2007, 8:15 PM CT

Gene Therapy To Reverse Heart Failure

Heart scientists at the Center for Translational Medicine at Jefferson Medical College have used gene treatment to reverse heart failure in animals. In addition, they observed that this gene treatment strategy had "unique and additive effects" to currently used, standard heart failure drugs called beta-blockers.

Reporting in the American Heart Association journal Circulation, scientists led by Walter J. Koch, Ph.D., director of the Center for Translational Medicine and the George Zallie and Family Laboratory for Cardiovascular Gene Therapy in the Department of Medicine at Jefferson Medical College of Thomas Jefferson University in Philadelphia, used a virus to carry the gene for a protein, S100A1, into the heart cells of rats with heart failure. The virus expressed the S100A1 gene only in heart cells and not in other organs, essentially making it a tailored treatment. After 18 weeks, those animals that received the gene treatment had significantly improved heart function in comparison to animals that did not receive the therapy.

Specifically, the Koch team, including Patrick Most, M.D., and Joseph Rabinowitz, Ph.D.Typically , also in jefferson's center for translational medicine, experimentally produced heart failure in the animals, which is characterized by a dramatic reduction in the heart's pumping ability. The researchers then delivered a modified adeno-associated virus (AAV) that contained the S100A1 gene to the heart's coronary arteries with the help of a novel heart-specific "gene promoter" that enabled the gene to be present only in heart cells......... Posted by: April      Read more         Source

May 21, 2007, 11:44 AM CT

Sleep apnea increases risk of heart attack

The nighttime breathing disorder known as obstructive sleep apnea increases a persons risk of having a heart attack or dying by 30% over a period of four to five years, as per a research studypresented at the American Thoracic Society 2007 International Conference, on Monday, May 21.

The more severe the sleep apnea at the beginning of the study, the greater the risk of developing heart disease or dying, the study found.

While prior studies have shown an association between sleep apnea and heart disease, ours is a large study that allowed us to not only follow patients for five years and look at the association between sleep apnea and the combined outcome of heart attack and death, but also adjust for other traditional risk factors for heart disease, says researcher Neomi Shah, M.D., of Yale University.

We recommend that patients who experience symptoms of obstructive sleep apneaexcessive daytime sleepiness, or snoring along with breathing pausesconsult their physician, Dr. Shah says. There is some evidence to make us think that when sleep apnea is appropriately treated, the risk of heart disease can be lowered.

In obstructive sleep apnea, the upper airway narrows, or collapses, during sleep. Periods of apnea end with a brief partial arousal that may disrupt sleep hundreds of times a night. Obesity is a major risk factor for sleep apnea......... Posted by: April      Read more         Source

May 21, 2007, 10:37 AM CT

Combination Of Medicines To Get Blood Pressure Under Control

Millions of Americans take medications for high blood pressure but do not achieve control of their blood pressure. Single-tablet combinations of drugs may be what it takes to get blood pressure under control, even in people with moderate hypertension, as per results from a new international study involving more than 10,700 people with high blood pressure.

Just six months of therapy was enough to bring the blood pressure of 73 percent of patients into an acceptable range, with an average reading of 132/74 mmHg. Thats a near-doubling of the proportion that started the study with their high blood pressure under control -- despite the fact that nearly all patients came into the study on other medicine before switching to one of the two-drug combinations used in the study.

A year later, after 18 months of therapy, patients continued to have good blood pressure control. In fact, more than 80 percent of participants from the United States achieved control, with a mean systolic blood pressure of 129mmHg. This is exceptional news in that only 36 percent of study subjects in the U.S. treated by clinicians achieve a blood pressure of 140/90.

The news was also good among people with diabetes or kidney disease who need to aim for lower blood pressures than others in order to reduce their risk of heart disease and stroke, but who often have a harder time getting their BP down. People with diabetes in the study achieved a mean systolic BP of 131 mmHg while those with chronic kidney disease were at 136 mmHg. These groups also saw sustained blood pressure control......... Posted by: April      Read more         Source

May 13, 2007, 10:09 PM CT

Short-Term Use Of Statin In Heart Failure Patients

Statin drugs, known primarily for their ability to lower cholesterol, also may reduce the overactive sympathetic nervous system response that contributes to the worsening of heart failure and increases the risk of sudden cardiac death. A result of heart attack or conditions such as coronary artery disease or hypertension, heart failure is the leading cause of morbidity and mortality in the United States.

On May 1, Dr. James Fisher, a postdoctoral fellow in the University of Missouri laboratory of Dr. Paul Fadel, reported one of the first studies on the effect of the popular statin drugs on the sympathetic nervous system activity of human patients with heart failure. His presentation at Experimental Biology 2007 in Washington, DC, is part of the scientific program of The American Physiological Society.

Heart failure, sometimes called congestive heart failure, is a chronic condition in which the heart can no longer pump enough blood to the rest of the body, causing damage and negatively impacting the quality and duration of life.

In several large clinical trials, cholesterol-lowering statin medications improved survival and other health outcomes in patients with heart failure, an effect that appeared not to be solely due to lowering these patients' cholesterols levels. In the search for a possible mechanism to explain this observation, researchers have turned to measures of sympathetic nervous system activity......... Posted by: April      Read more         Source

May 7, 2007, 10:45 PM CT

New therapies for end-stage heart failure

Implanted pumps improved heart function enough in a small percentage of patients awaiting a heart transplant that they were able to leave the hospital without a pump and without a new heart, as per a research studyin Circulation: Journal of the American Heart Association.

The heart-assist devices also significantly improved the cardiac function in a number of other heart failure patients.

"This suggests that, while the devices alone may not be sufficient to allow a meaningful number of patients to come off the heart pump instead of having a heart transplant, there may be other therapies that can be added to enhance recovery," said Simon Maybaum, M.D., lead author of the study.

In end-stage heart failure, the heart weakens, gets larger and shows other signs of deterioration. Implantable heart pumps, called left ventricular assist devices (LVADs), pump blood through the body, which lets the hearts main pumping chamber rest. Pumps are currently approved for two purposes:

• To help keep patients with end-stage heart failure alive until a donor heart becomes available for transplantation.
• To serve as a long-term treatment for patients deemed unacceptable for a heart transplant.

However, for some time, transplant specialists have debated the potential for LVADs to be used as a "bridge to recovery" for the patients own heart. Previous small studies have yielded contrasting results. "Some centers were reporting that up to a third of their patients implanted with a heart pump were able to come off the pump without a transplant, and some centers were saying they just did not have that experience," said Maybaum, associate professor of clinical medicine and medical director of the Center for Advanced Cardiac Therapy at the Albert Einstein College of Medicines Montefiore Medical Center in New York City......... Posted by: April      Read more         Source

May 6, 2007, 5:02 PM CT

Genetic Variation Linked to Substantial Risk in Heart Attack

A common genetic variation on chromosome 9p21 is associated with a substantial increase in risk for heart attack, as per a new international research study. The findings are published recently in the online edition of Science, and will appear in an upcoming printed edition of the journal.

Scientists found individuals with the variation have a 1.64-fold greater risk of suffering a heart attack (myocardial infarction) and a 2.02-fold greater risk of suffering a heart attack early in life (before age 50 for men and before age 60 for women) than those without the variation. Approximately 21 percent of individuals of European descent carry two copies of the genetic variation (one from each parent), found on chromosome 9p21.

The research project was led by the Icelandic genomics company deCODE Genetics, along with U.S. scientists at Emory University School of Medicine, Duke University, and the University of Pennsylvania.

Myocardial infarction is the death of heart tissue that results when the blood supply to the heart is cut off. It is the leading cause of death in the industrialized world. Nearly half of men and one-third of women who reach the age of 40 will suffer a heart attack in their lifetime.

The study led by deCODE Genetics uncovered the first common variant found to be consistently associated with substantial risk of heart attack in multiple case-control groups of European descent......... Posted by: April      Read more         Source