October 1, 2007, 9:56 PM CT

Depression, Aging, Proteins And Heart Disease

Scientists here have linked an increase in two immune system proteins essential for inflammation to a latent viral infection and proposed a chain of events that might accelerate cardiovascular disease.

The same process may be involved in a host of other ailments plaguing the elderly.

The findings also suggest that chronic depression may play a key role in starting the cascade that can lead to the buildup of plaques clogging coronary arteries.

The researchers' report, their latest in a nearly three-decade-long effort to understand the role psychological stress plays in weakening the immune system, was reported in the journal Brain, Behavior and Immunity.

Ronald Glaser, a professor of molecular virology, immunology and medical genetics at Ohio State University , said, "To me, this suggests a new way of thinking about how these diseases develop. We carry around these latent herpes viruses in our bodies virtually all our lives and periodically they can hurt us, inducing biological events that could lead to an increased risk of atherosclerosis."

Glaser, head of Ohio State's Institute for Behavioral Medicine Research, has focused for years on Epstein-Barr virus (EBV), one of eight different herpesviruses that can remain dormant in the body for a lifetime......... Posted by: April      Read more         Source

October 1, 2007, 5:45 AM CT

Hearts are experts at self-preservation

Bristol researchers have identified a heart protection mechanism in mice that surgeons and cardiologists may be able to exploit to improve treatments for patients in future.

The research, published in the recent issue of the American journal Critical Care Medicine, was funded by the British Heart Foundation and conducted by Saadeh Suleiman, Professor of Cardiac Physiology at the University of Bristol, and his colleagues at the Bristol Heart Institute. It describes surprising responses of the heart to mock cardiac surgery in a mouse model. When the heart was stopped and restarted - mimicking the conditions used in most heart bypass surgery - scientists found that hearts with coronary disease from genetically modified mice were more resistant to damage than hearts without coronary disease.

In the study the researchers have introduced a model of coronary artery disease and heart attack by feeding the genetically modified mice (apoE-/-) a high-fat diet typical of people's diets in North America and the UK. Apo E-/- mice fed a normal rodent diet for the same period do not develop coronary disease. The genetic modification in apoE-/- involves changing cholesterol processing, making the mouse prone to fatty build-up in the coronary arteries, similar to human heart disease......... Posted by: April      Read more         Source

September 27, 2007, 9:48 PM CT

Reduce risk of cardiac event before surgery

People with heart disease should take special precautions before undergoing any kind of surgery, even noncardiac surgery, to reduce their risk of a cardiac event, as per new joint guidelines from the American College of Cardiology and the American Heart Association.

The American College of Cardiology/American Heart Association 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery will be published online ahead of print on September 27 in the October 23, 2007, issues of Circulation: Journal of the American Heart Association and the Journal of the American College of Cardiology.

The guidelines an update of those published in 2002 provide a framework for considering a persons risk of a cardiac event in the perioperative (during or immediately after) period of noncardiac surgery.

As per the recommendations, patients should not stop taking cholesterol-lowering drugs before surgery. In addition, the guidelines say that a number of people with heart disease can safely undergo noncardiac surgery without first fixing their heart disease with an artery-opening procedure or coronary bypass grafting. The guidelines also address how best to treat those people who need a heart procedure before noncardiac surgery, have coronary stents or require anti-clotting medication......... Posted by: April      Read more         Source

September 25, 2007, 8:37 PM CT

Rehabilitation after heart attack

Waltham, MA Despite good evidence that cardiac rehabilitation reduces disability and prolongs life, fewer than one in five people receive rehabilitation services after a heart attack or coronary bypass surgery, as per a Brandeis study in Circulation: Journal of the American Heart Association.

We need to find ways to increase the use of cardiac rehabilitation, because it is used very little by patients who could benefit a lot, said Jose A. Suaya, M.D., Ph.D., lead author of the study and a lecturer and scientist at the Schneider Institutes for Health Policy, Heller School, at Brandeis University in Waltham, Mass.

Overall, the study observed that, despite Medicare coverage of cardiac rehabilitation sessions, among Medicare beneficiaries aged 65 and above, women participated less than men, older people less than younger, and non-whites significantly less than whites. Additionally, the scientists noted striking geographic differences in the use of cardiac rehabilitation after cardiac hospitalizations, ranging from 53.5 percent of patients in Nebraska to 6.6 percent in Idaho. The accompanying map shows rates by state.

Almost all patients with stable angina or a recent heart attack, bypass surgery, or a coronary stent could benefit from cardiac rehabilitation, Suaya said. Importantly, this benefit applies regardless of age, gender or race......... Posted by: April      Read more         Source

September 18, 2007, 5:06 AM CT

How a statin drug reduces cholesterol and fat?

Researchers have provided new details about how a drug used against heart disease helps to unclog blood vessels from an excess of cholesterol and fats. The results help explain how the drug works and may provide ways to improve similar drugs in the future.

A type of white blood cell called macrophage is responsible for the accumulation of fat in blood vessels, leading to inflammation and plaque formation on the inner linings of the vessel. Macrophages produce enzymes called lipases that have been shown to promote fat accumulation in blood vessels. Drugs called statins reduce the accumulation of fat in macrophages but their effects on lipases have not been explored yet.

John S. Hill and his colleagues studied the effect of a statin drug called atorvastatin on two lipases, called lipoprotein lipase and endothelial lipase, which break down different types of fats. The scientists showed that the statin significantly reduced the levels of both lipases in macrophages and described in detail the proteins that are affected within the macrophages. These results may help to understand how other statin drugs work and could help design better drugs against heart disease in the future, the researchers conclude.

Article: Atorvastatin Decreases Lipoprotein Lipase and Endothelial Lipase Expression in Human THP-1 Macrophages, by Guosong Qiu and John S. Hill......... Posted by: April      Read more         Source

September 14, 2007, 5:21 AM CT

Metabolic syndrome and uric-acid kidney stones

Researchers at UT Southwestern Medical Center have found that patients suffering from the metabolic syndrome - a cluster of conditions that increases the risk for heart disease, stroke and diabetes - also have a propensity to develop highly acidic urine, which increases the risk of developing kidney stones.

The first study, to demonstrate this relationship independent of age and renal function, appears in the recent issue of the Clinical Journal of the American Society of Nephrology.

Typically typically the metabolic syndrome is characterized by a group of risk factors that include obesity, high blood pressure, diabetes and high cholesterol. The American Heart Association estimates that more than 50 million Americans suffer from the syndrome.

"Our findings suggest that the presence of an increasing number of metabolic syndrome features augments the propensity for uric-acid stone formation," said Dr. Naim Maalouf, assistant professor of internal medicine and the study's lead author.

In previous studies, UT Southwestern researchers have found that people who were overweight or suffered from diabetes had highly acidic urine, which often leads to the development of uric-acid kidney stones.

The current findings indicate that people with the other components leading to the metabolic syndrome also have highly acidic urine......... Posted by: April      Read more         Source

September 10, 2007, 9:23 PM CT

Two drugs equally effective for heart patients

In lifesaving procedures to open blocked heart arteries a key question haccording tosisted for years: Is use of the more expensive drug, abciximab, justified over use of the less-expensive eptifibatide".

A new Mayo Clinic study would be reported in the current edition of Value in Health, Volume 11, Issue 4 and now available as an e-publication, offers clinicians the first large-scale contemporary study to help answer the question. The study found no significant difference between the drugs in the length of hospital stay or in the rate of cardiovascular event rates.

Our results provide data to show using the lower cost drug does not jeopardize patient health in contemporary percutaneous coronary intervention practice, explains the studys lead author, Kirsten Hall Long, Ph.D. Percutaneous coronary intervention (PCI), also known as angioplasty, is a procedure in which a balloon-tipped catheter is inserted into the narrowed vessel. The balloon is inflated and improves blood flow.

Scientists evaluated records of all Mayo Clinic patients who underwent PCI from November 2000 to August 2004. Of these, 2,123 patients received eptifibatide, and 951 received abciximab.

It is not likely that there will ever be a randomized clinical trial comparing the two drugs, as it would require over 30,000 patients, says Henry Ting, M.D., Mayo Clinic heart specialist and co-author. Our study fills an evidence gap by providing data to help guide therapy decisions......... Posted by: April      Read more         Source

September 6, 2007, 9:41 PM CT

Risk of heart failure while on imatinib

Congestive heart failure rarely occurs among leukemia patients who take imatinib, scientists at The University of Texas M. D. Anderson Cancer Center found after an exhaustive review of the detailed medical histories of 1,276 patients who enrolled in clinical trials for the drug.

Scientists found 22 patients, or 1.7 percent, had symptoms that could have been caused by heart failure. Of those, 18 had prior medical conditions that could also cause heart failure, such as type II diabetes, hypertension, irregular heartbeat or coronary artery disease. Six had congestive heart failure before entering therapy. The results were published in the Aug. 15 edition of the journal Blood.

"Imatinib remains a safe drug, but monitoring patients and knowing their medical histories are always important," says Jorge Cortes, M.D., senior author of the report and professor in M. D. Anderson's Department of Leukemia. "There is no current need for routine cardiac-specific monitoring of all patients taking imatinib. However, those with significant cardiac history need to be closely monitored. Patients who develop symptoms of heart failure should be reviewed carefully and treated with standard treatment".

Of the 22 patients found to have cardiovascular conditions, 11 were able to continue on imatinib for their leukemia after dose adjustments and management of the heart failure symptoms. The standard of care for therapy includes the use of beta blockers and angiotensin converting enzyme inhibitors or angiotensin receptor blockers, notes co-author of study Jean-Bernard Durand, M.D., an assistant professor in M. D. Anderson's Department of Cardiology. Both classes of drugs are approved by the FDA for therapy of heart failure and recommended by the Heart Failure Society of America......... Posted by: April      Read more         Source

August 27, 2007, 9:25 PM CT

Early treatment can reverse heart damage

University of Minnesota scientists have discovered that treating people who have early cardiovascular abnormalities, but show no symptoms of cardiovascular disease, can slow progression and even reverse damage to the heart and blood vessels.

In a recent double-blind study, scientists enrolled 76 asymptomatic subjects with early markers for cardiovascular disease, based on a 10-factor scale called the Rasmussen Disease Score. During the first six months of the study, 38 subjects received a placebo, and the other 38 subjects took 160mg of Valsartan, a drug that blocks a hormone that is detrimental to the blood vessels and the heart. During the next six months, both groups took Valsartan.

Those who took the drug for the first six months significantly reduced their Rasmussen Disease Score compared with those who took the placebo. At the 12-month mark after both groups were taking the drug every patient showed better Rasmussen Disease Scores, effectively demonstrating that Valsartan can slow progression and even reverse early cardiovascular disease in asymptomatic high-risk patients. The findings of the study are reported in the Aug. 28, 2007 issue of the Journal of American College of Cardiology.

Cardiovascular disease is the No. 1 killer in our society not only in the U.S. but in the rest of the world, said Daniel Duprez, M.D. professor of medicine, and the principal researcher. These patients have no symptoms, so most of them would have waited to seek therapy. Asymptomatic people are still treated based on risk factors, such as elevated blood pressure and cholesterol, but not on a personalized assessment of the presence of early cardiovascular disease. This is the first study that shows if you interfere early, you can cause regression of these cardiovascular abnormalities......... Posted by: April      Read more         Source

August 21, 2007, 6:18 PM CT

Hypertension frequently undiagnosed in children

In a study of children and adolescents with hypertension, only about one in four had been previously diagnosed with the condition, according to a study in the August 22/29 issue of JAMA.

Hypertension, with an estimated prevalence of between 2 percent and 5 percent, is a common chronic disease in children and is increasing in prevalence with the pediatric obesity epidemic. Diagnosis of hypertension in children is complicated because normal and abnormal blood pressure values vary with age, sex, and height, according to background information in the article.

Matthew L. Hansen, M.D., of Case Western Reserve University, Cleveland, and colleagues conducted a study to determine the frequency of undiagnosed hypertension and prehypertension in 3- to 18-year-old children. The study included 14,187 children and adolescents who were observed at least three times for well-child care between June 1999 and September 2006 in outpatient clinics.

The researchers found that the criteria for hypertension were met by 507 children (3.6 percent). Of the children with hypertension, only 131 (26 percent) had a diagnosis of hypertension or elevated blood pressure documented in the electronic medical record; i.e., 376 of 507 participants (74 percent) had undiagnosed hypertension. Criteria for prehypertension were met by 485 children (3.4 percent). Of these children, 55 (11 percent) had a diagnosis of hypertension or elevated blood pressure documented in the electronic medical record......... Posted by: April      Read more         Source