Author Interviews, Baylor University Medical Center Dallas, Heart Disease, Surgical Research / 07.06.2016 Interview with: Jeffrey M. Schussler, MD, FACC, FSCAI, FSCCT, FACP Baylor Scott & White Health Care System Cardiology: Baylor University Medical Center, Dallas, Tx Medical Director: CVICU Hamilton Heart and Vascular Hospital Professor of Medicine: Texas A&M School of Medicine What is the background for this study? Dr. Schussler: For the past few years, there has been an increased interest in performing coronary catheterization through the wrist. This is a technique that has been done (with great success and low complication rate) in other countries for years, with adoption rates >90% in some places. The US has been slower to adopt performing catheterization from the wrist, but the rate of using this approach has grown tremendously in the last 5 years. While less than 5% of all interventions were done using radial access previously, it now appraches 30% nationally. This increased rate of adoption been spurred on by studies which have shown lower incidences of complications, as well as some mortality benefit, and in particular in those patients who are highest risk for complications. (more…)
Author Interviews, Cleveland Clinic, Heart Disease, Microbiome / 02.06.2016 Interview with: Dr. W.H. Wilson Tang M.D. Department of Cellular and Molecular Medicine (NC10) Cleveland Clinic Lerner Research Institute Cleveland, Ohio 44195 What is the background for this study? What are the main findings? Response: Our group has recently described the mechanistic link between intestinal microbe-generated phosphatidylcholine metabolite, trimethylamine N-oxide (TMAO), and the pathogenesis of atherosclerotic coronary artery disease (CAD) and its adverse clinical outcomes. Here in a separate, independent, contemporary cohort of patients undergoing coronary angiography, we demonstrated the association between elevated fasting TMAO levels and quantitative atherosclerotic burden (as measured by SYNTAX and SYNTAX II scores) in stable cardiac patients and is an independent predictor for the presence of diffuse (but not focal) lesion characteristics. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA / 01.06.2016 Interview with: Dr. med. Johannes Neumann Resident physician University Heart Center Hamburg Department of General and Interventional Cardiology Universitätsklinikum Hamburg-Eppendorf Hamburg What is the background for this study? What are the main findings? Response: The early decision making in patients with suspected acute myocardial infarction is important. Current guidelines recommend measurement of cardiac troponin at admission and after 3 hours. In our study we evaluated the performance of a high-sensitivity troponin I assay with a rapid measurement after only 1 hour. We included 1040 patients with new onset chest pain and could show, that a low cutoff concentration of 6 ng/L after 1 hour allows safe rule-out of acute myocardial infarction. The results were comparable to the recommended 3-hour approach and were validated in 2 external cohorts. When using the 99th percentile to rule-out myocardial infarction, as recommended by current guidelines, the negative predictive value was much lower. Furthermore, a troponin I concentration above 6 ng/L in combination with an absolute change of 12 ng/L after 1 hour showed a high positive predictive value for the final diagnosis of myocardial infarction. This allows early decision making after only 1 hour. (more…)
ADHD, Author Interviews, BMJ, Heart Disease, Pediatrics / 01.06.2016 Interview with: Nicole Pratt PhD Senior Research Fellow Quality Use of Medicines and Pharmacy Research Centre Sansom Institute, School of Pharmacy and Medical Sciences University of South Australia Adelaide South Australia What is the background for this study? What are the main findings? Dr. Pratt: The cardiac safety of methylphenidate has been debated. This study aimed to measure the risk of cardiac events in a large population of children treated with these medicines. We found that there was a significantly raised risk of arrhythmia in time periods when children were treated with methylphenidate compared to time periods when they were not. While the relative risk of cardiac events was significant the absolute risk is likely to be low as cardiac events are rare in children. (more…)
Author Interviews, Diabetes, Diabetologia, Heart Disease, Pediatrics / 01.06.2016 Interview with: Dr. Nina Berentzen PhD National Institute for Public Health and the Environment Bilthoven, the Netherlands What is the background for this study? What are the main findings? Dr. Berentzen: Cardiovascular disease and type 2 diabetes often occur together and share risk factors including an unhealthy diet, a lack of physical activity, and being overweight or obese. This study is the first to investigate the occurrence of both diabetes and CVD across two generations of parents and grandparents, and relate it to measurable risk factors in children. We found that one third of the 12-year-olds studied had a strong family history of one or both of cardiovascular disease (myocardial infarction and stroke) and type 2 diabetes. Children had a ‘strong family history’ if they had one affected parent, or at least one grandparent with early disease onset, or 3–4 grandparents with late disease onset. These children had higher levels of total cholesterol, and a higher ratio of total/HDL cholesterol than children with no family history of disease. (more…)
Author Interviews, Heart Disease, Infections, Pediatrics, Pediatrics, Weight Research / 01.06.2016 Interview with: Markus Juonala, MD, PhD Murdoch Childrens Research Institute, Parkville Victoria, Australia What is the background for this study? What are the main findings? Dr. Juonala: This is an epidemiological follow-up study investigating whether childhood infections and socieconomic status are associated with cardiovasular risk factor and early chances in vasculature. The main finding was that childhood infections were associated with obesity and impaired vascular function in adulthood among those individuals with low socioeconomic status. (more…)
Author Interviews, Biomarkers, Heart Disease, Women's Heart Health / 01.06.2016 Interview with: Norman C. Wang, M.D., M.S., Assistant professor University of Pittsburgh School of Medicine Samar R. El Khoudary, Ph.D., M.P.H., Assistant professor of Epidemiology University of Pittsburgh Graduate School of Public Health What is the background for this study? What are the main findings? Response: We studied 252 middle-aged women with no known cardiovascular disease from the Study of Women’s Health Across the Nation [SWAN] Heart Study to determine if 5 blood biomarkers associated with abnormal inflammation/hemostasis were associated with increasing amounts of calcium detected in coronary arteries on computed tomography scans, or coronary artery calcium progression. Only higher blood levels of plasminogen activator inhibitor-1 was associated with coronary artery calcium progression. (more…)
Abuse and Neglect, Author Interviews, Heart Disease, HIV, JAMA / 31.05.2016 Interview with: Steven Grinspoon, MD Professor of Medicine, Harvard Medical School MGH Endowed Chair in Neuroendocrinology and Metabolism Director, MGH Program in Nutritional Metabolism and Nutrition Obesity Research Center at Harvard MGH Boston, MA 02114 What is the background for this study? What are the main findings? Dr. Grinspoon: Numerous epidemiologic studies have shown that people living with HIV face a 1.5 to 2-fold increased risk of heart attack, or myocardial infarction, as compared to individuals without the virus. Mechanisms underlying the increased risk of myocardial infarction in HIV are incompletely understood. It is possible that among people living with HIV, increased systemic immune activation fuels arterial inflammation. Arterial inflammation may, in turn, promote the development of high-risk morphology coronary atherosclerotic plaque, which is liable to rupture and result in myocardial infarction. For people diagnosed with HIV, the overall health benefits of immediate antiretroviral therapy (ART) are clear. However, the effects of newly-initiated antiretroviral therapy on arterial inflammation have not previously been studied. In this study, we set out to assess among a cohort of treatment-naive HIV-infected subjects, the effects of newly-initiated ART with a contemporary regimen on both immune function and arterial inflammation. We found that among treatment-naive HIV-infected individuals without clinical cardiovascular disease, newly initiated combined antiretroviral therapy has discordant effects to restore immune function without reducing the degree of arterial inflammation. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity, Women's Heart Health / 27.05.2016 Interview with: Norman C. Wang, M.D., M.S., Assistant professor University of Pittsburgh School of Medicine Samar R. El Khoudary, Ph.D., M.P.H., Assistant professor of Epidemiology University of Pittsburgh Graduate School of Public Health What is the background for this study? What are the main findings? Response: We examined medical records, blood samples and heart CT scans for 372 black and white women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged just over 51 years old, were not on hormone replacement therapy and had no known heart disease when enrolled. We then looked at blood levels of five biomarkers linked to inflammation. All of the biomarkers were associated with coronary artery calcification, a predictor of heart disease that is measured with a heart CT scan. Taking into account the participants’ body mass index (BMI), a measure of overall body fat, we found that obesity was a key factor linking most of the elevated inflammation biomarkers and coronary artery calcification. Regardless of BMI, black women with higher levels of one particular biomarker, C-reactive protein, were more likely to have coronary artery calcification than whites. In fact, black women with coronary artery calcification had an average level of C-reactive protein in their blood that was almost double that of their white counterparts. (more…)
Author Interviews, Heart Disease, Pain Research, Psychological Science / 26.05.2016 Interview with: Robert W. Levenson, Ph.D. Professor, Department of Psychology Director, Institute of Personality and Social Research (IPSR) University of California Berkeley, CA What is the background for this study? Dr. Levenson: This study comes from a 20-year longitudinal study of Bay Area married couples that we began in the late 1980s. The main purpose of the study was to understand the emotional qualities of successful marriages. Couples came to our laboratory every five years so that we could get a snapshot of the way they interacted with each. We also measured their psychological and physical health. This new paper connects the emotional behaviors we observed when couples discussed a problem in their marriage at the start of the study with the kinds of illnesses they developed over the ensuing decades. (more…)
Author Interviews, Heart Disease / 26.05.2016 Interview with: Ingrid Elisabeth Christophersen MD PhD Postdoctoral research fellow Cardiovascular Research Center (CVRC) Massachusetts General Hospital What is the background for this study? What are the main findings? Dr. Christophersen: Several recent studies have utilized the CHA2DS2-VASc risk score to predict risk of atrial fibrillation (AF). However, the CHA2DS2-VASc was developed for prediction of stroke risk in patients with AF and has not been validated for prediction of AF risk. We have evaluated how well the CHA2DS2-VASc performed at predicting risk of AF compared with the most validated clinical risk score for AF - the CHARGE-AF risk score - in the Framingham Heart Study. We showed that the CHARGE-AF risk score performed better at predicting risk of AF than the CHA2DS2-VASc. (more…)
Author Interviews, Cancer Research, Heart Disease, JAMA / 26.05.2016 Interview with: David Conen MD MPH Department of Medicine University Hospital Basel Basel Switzerland What is the background for this study? What are the main findings? Dr. Conen: A previous study of a contemporary population with atrial fibrillation (AF) treated with oral anticoagulation showed that over a third of all deaths were due to non-cardiovascular causes, and malignancies accounted for the largest proportion of these deaths. These data suggested that AF patients may have an increased risk of malignancies, but little data existed to support this hypothesis. During more than 19 years of follow-up, our study showed that atrial fibrillation was a significant risk factor for the occurrence of malignant cancer. After taking into account a large number of other risk factors and co-morbidities, the risk of cancer was approximately 50% higher among women with new-onset AF compared to women without AF. The risk of cancer was highest in the first 3 months after new-onset AF but remained significant beyond 1 year after new-onset AF (adjusted HR 1.42, p<0.001). We also observed a trend towards an increased risk of cancer mortality among women with new-onset AF. (more…)
Author Interviews, Heart Disease, JAMA, Kidney Disease, Salt-Sodium / 25.05.2016 Interview with: Jiang He, M.D., Ph.D. Joseph S. Copes Chair and Professor Department of Epidemiology School of Public Health and Tropical Medicine Tulane University, New Orleans MedicalResearch: What is the background for this study? Dr. Jiang He: Chronic kidney disease is associated with increased risk of end-stage renal disease, cardiovascular disease, and all-cause mortality. A positive association between sodium intake and blood pressure is well established in observational studies and clinical trials. However, the association between sodium intake and clinical cardiovascular disease remains less clear. Positive monotonic, J-shaped, and U-shaped associations have been reported. Methodologic limitations, including inconsistencies in dietary sodium measurement methods, could be contributing to these conflicting findings. Furthermore, no previous studies have examined the association between sodium intake and incident cardiovascular disease among patients with chronic kidney disease. (more…)
Author Interviews, Heart Disease, Nutrition, OBGYNE, Pediatrics, Weight Research / 25.05.2016 Interview with: Dr. Brian Stansfield MD Neonatologist Children's Hospital of Georgia and the Medical College of Georgia Augusta University What is the background for this study? Dr. Stansfield: Since the mid-20th century, we have experimental evidence in animal models and human data demonstrating the influence of maternal nutrition on the offspring - both in the short term and long term. Low birth weight has been connected with higher incidence of cardiometabolic diseases including insulin resistance, coronary artery disease, and hypertension. Interestingly, low birth weight infants grow up to be relatively thin adults compared to their normal or high birth weight counterparts. Conversely, high birth weight infants tend to become heavier adults and obesity is directly linked with the same adult outcomes. So the association of cardiac and metabolic diseases with low birth weight is not linked to adult obesity in general. Thus, speculation as to why extremes of birth weight lead to adult onset cardiometabolic disease suggests different mechanisms and modifying factors. What are the main findings? Dr. Stansfield: The findings of our study shed considerable light on the relationship between birth weight and risk factors for insulin resistance and visceral adiposity. Using magnetic resonance imaging (MRI) to achieve precise measurements of visceral adipose content and biomarkers for insulin resistance, we show that both low and high birth weight are associated with increased visceral adiposity and insulin resistance in a healthy population of adolescents aged 13-17 years. This association persists when we account for several recognized confounders including age, sex, race, activity level, and socioeconomic status. The most interesting finding of our study is that when you account for each adolescent’s current body mass index, a measure of obesity, the relationship between increased visceral fat and insulin resistance and low birth weight is strengthened suggesting that these adolescents had relatively high visceral adipose content despite obesity rates that were similar to their normal birth weight counterparts. On the other hand, correction for adolescent BMI (obesity) reduced the relationship between these metabolic markers and high birth weight infants. Thus, low birth weight infants may develop insulin resistance and increased visceral fat, both significant risk factors for cardiovascular disease and metabolic disease, despite having a relatively normal body shape in adolescents. (more…)
Author Interviews, End of Life Care, Heart Disease, JAMA / 24.05.2016 Interview with: James N. Kirkpatrick, MD Director of the Echocardiography Laboratory Division of Cardiology Ethics Consultation Service University of Washington, Seattle What is the background for this study? Dr. Kirkpatrick: With significant advances in technology, implanted cardiac devices like pacemakers and defibrillators, replacement heart valves, and mechanical pumps which assist or replace the pumping function of the heart have become standard therapies for patients with severe cardiac disease. Many patients who would previously have died after living with severe symptoms live longer and with improved quality of life. This is particularly true for elderly patients who receive transcatheter aortic valve replacement (TAVR—valve replacement that doesn’t require open heart surgery) and ventricular assist device (VAD—a durable mechanical heart pump) implantation. However, like everyone, these patients will die, and some of the patients will experience device complications which will shorten their lives. Elderly patients, in particular, are at risk for device complications, high symptom burden, and loss of the ability to make healthcare decisions, due to illnesses like strokes or dementia. Symptom management and advance care planning are the hallmarks of the medical specialty of Palliative Care and are particularly important in patients with TAVR and VADs, yet patients and clinicians don’t often think of Palliative Care when considering high tech, life-prolonging therapies. The Palliative Care Working Group of the American College of Cardiology’s Geriatrics Section therefore sought to gather data on the attitudes toward Palliative Care among cardiovascular clinicians and the current state of involvement of Palliative Care in the care of patients with TAVR and VAD. (more…)
Author Interviews, Heart Disease / 23.05.2016 Interview with: Ramzi Tabbalat, MD, FACC Khalidi Hospital and Medical Center Amman Jordan What is the background for this study? What are the main findings? Dr. Tabbalat: Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing open heart surgery. It occurs in about 26% of such patients and leads to increase morbidity and hospital cost. This makes prevention of AF a priority and several interventions have had variable success in this regards. Colchicine, a potent anti-inflammatory agent, has shown promise in AF prevention in the COPPS-1 trial. Our study aimed to determine if colchicine administered preoperatively and continued until hospital discharge can prevent AF in post open heart surgery patients. In our study of 360 patients, colchicine failed to significantly reduce the incidence of postoperative AF (RRR 29%, p=0.14). Its use was associated with significant diarrhea in 25% of patients. Diarrhea led to discontinuation of colchicine in more than half of affected patients. (more…)
Author Interviews, Heart Disease, Hospital Acquired, Infections, Surgical Research / 22.05.2016 Interview with: Luis Nombela-Franco, MD, PhD Structural cardiology program. Interventional Cardiology department. Hospital Clínico San Carlos, Cardiovascular Institute Madrid, Spain (Dr. Nombela-Franco, has a special interest in interest on percutaneous treatment of structural heart disease and coronary interventions with special focus on chronic total occlusion) What is the background for this study? Dr. Nombela-Franco: In-hospital infections are one of the most common complications that may occur following medical and surgical admissions, significantly impacted length of hospital stay, costs and clinical outcomes. In addition, approximately one third of hospital-acquired infections are preventable. Transcatheter aortic valve replacement (TAVR) is currently the standard of care for symptomatic patients with severe aortic stenosis deemed at high surgical risk or inoperable. Patients undergoing TAVR have several comorbidities and the invasive (although less invasive the surgical treatment) nature of the procedure and peri-operative care confers a high likelihood in-hospital infections in such patients. This study analyzed the incidence, predictive factors and impact of in-hospital infections in patients undergoing transcatheter aortic valve implantation. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA / 19.05.2016 Interview with: Yvan Devaux, PhD Associate Head of Laboratory Cardiovascular Research Unit Department of Population Health Luxembourg Institute of Health Luxembourg What is the background for this study? What are the main findings? Dr. Devaux: Being able to predict outcome after cardiac arrest would allow tailoring healthcare and would represent a major step forward towards personalized medicine. However, available predictive tools suffer serious limitations and would benefit from novel biomarkers. The value of microRNAs (miRNAs) as biomarkers has been investigated in various clinical contexts and initial small-scale studies suggested that miRNAs might be useful indicators of outcome after cardiac arrest. Our work aimed at testing whether these molecules, and in particular the brain-enriched miR-124-3p, can be used to predict outcome after cardiac arrest. We found that, indeed, circulating levels of miR-124-3p measured 48h after cardiac arrest are robust predictors of neurological outcome and mortality. The strengths of the study are the use of a large multicenter international cohort (TTM-trial) and the collaboration between LIH and European partners (members of the TTM-trial and the Cardiolinc network) bringing complementary clinical and basic expertise. (more…)
Author Interviews, Heart Disease / 18.05.2016 Interview with: Paul D. Loprinzi, PhD. Assistant Professor Health, Exercise Science & Recreation Management and Ovuokerie Addoh, MBBS. PhD Student: Health Behavior & Promotion. Graduate Asst: Cardiac Rehabilitation The University of Mississippi University, MS What is the background for this study? What are the main findings? Response: The Pooled Cohort Risk (PCR) equations, developed by the American College of Cardiology/American Heart Association (ACC/AHA), were initially developed to predict an individual’s 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event. Individuals with a PCR score of 7.5% or higher are considered to have an elevated risk of a first ASCVD event within 10 years. The PCR equation takes into consideration an individual’s age, gender, race-ethnicity, total cholesterol level, high density lipoprotein (HDL) cholesterol, treated or untreated blood pressure, diabetes status, and smoking status. The PCR equations have previously been utilized to predict an individual’s 10-year risk of a first ASCVD event; however, less research has evaluated the extent to which the equations can predict an individual’s risk for early mortality. Adults 40-79 years and free of cardiovascular disease (CVD) who had a higher score from the PCR equations had an increased risk of CVD-specific and all-cause mortality risk. Adults with a higher PCR score had a 47% to 77% increased risk of all-cause mortality. (more…)
Author Interviews, Breast Cancer, Weight Research, Women's Heart Health / 18.05.2016 Interview with: Julie M. Kapp, MPH, PhD Associate Professor 2014 Baldrige Executive Fellow University of Missouri School of Medicine Department of Health Management and Informatics Columbia, MO 65212 What is the background for this study? Dr. Kapp: For the past several decades the U.S. has had the highest obesity rate compared to high-income peer countries, and for many years people in the U.S. have had a shorter life expectancy. For female life expectancy at birth, the U.S. ranked second to last. At the same time, the U.S. has the third highest rate of mammography screening among peer countries, and the pink ribbon is one of the most widely recognized symbols in the U.S. While the death rate in females for coronary heart disease is significantly higher than that for breast cancer, at 1 in 7.2 deaths compared to 1 in 30, respectively, women have higher levels of worry for getting breast cancer. (more…)
Author Interviews, Heart Disease, JACC, Kidney Disease / 15.05.2016 Interview with: Ambarish Pandey, MD Cardiology Fellow, PGY5 University of Texas Southwestern Medical Center Dallas, Texas What is the background for this study? What are the main findings? Dr. Pandey: Previous studies have reported an underutilization of guideline based heart failure therapies among patients with heart failure (HF) and end-stage renal diseases. However, it is not known if the proportional use of these evidence-based medical therapies and associated clinical outcomes among these patients has changed over time. In this study, we observed a significant increase in adherence to heart failure process of care measures over time among dialysis patients with no significant change in clinical outcomes over time. (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 13.05.2016 Interview with: Michael Miller, MD, FACC, FAHA Professor of Cardiovascular Medicine, Epidemiology & Public Health University of Maryland School of Medicine Staff Physician, Baltimore VAMC Director, Center for Preventive Cardiology University of Maryland Medical Center Baltimore, Maryland What is the background for this study? Dr. Miller: It has become an article of faith that HDL (the good cholesterol) is an independent risk factor for heart disease. However, previous studies did not examine the importance of HDL after accounting for both LDL (bad cholesterol) and triglycerides (blood fats).  This is important because HDL is associated with LDL and triglycerides. We hypothesized that if HDL is truly an independent risk factor, then low HDL levels in isolation would continue to be linked to an increased risk of heart disease while high HDL levels would continue to protect the heart even if LDL and triglycerides levels were elevated. (more…)
Author Interviews, Heart Disease, Transplantation / 12.05.2016 Interview with: Jaimin Trivedi, MD, MPH Instructor Department of Cardiovascular and Thoracic Surgery University of Louisville Louisville, KY 40202 What is the background for this study? What are the main findings? Dr. Trivedi: There is a donor heart shortage in United States and certain donor hearts are likely to be turned down because the donors required cardiopulmonary resuscitation (CPR) prior to procurement. The rationale behind conducting the study was to identify impact of donor CPR and its duration on recipient survival after transplantation. Our findings show that presence of CPR and duration of CPR does not adversely impact the post heart transplant survival. The study also shows that ejection fraction and peak cardiac troponins between the CPR and non-CPR donors were comparable at time of transplant suggesting recovery of cardiac function. (more…)
Author Interviews, Heart Disease, JAMA, Social Issues / 12.05.2016 Interview with: Erica Spatz, MD, MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale University School of Medicine/Yale-New Haven Hospital New Haven, CT 06520 What is the background for this study? What are the main findings?  Dr. Spatz: Rates of heart attack have declined during the last 15 years. But whether communities of different economic status or in different geographic regions experienced similar declines is unknown, especially as efforts to prevent cardiovascular disease and manage heart attacks may not have been equally successful in communities with different resource capacity. Our study shows that trends in the incidence of and mortality from heart attack were similar in low, average and high income communities. However, low-income communities had higher hospitalization rates than average and high income communities throughout the 15 year study period. Interestingly mortality rates were similar. (more…)
Author Interviews, Heart Disease, Johns Hopkins, Nature, Technology / 11.05.2016 Interview with: Natalia Trayanova PhD, FHRS, FAHA Murray B. Sachs Endowed Chair Professor of Biomedical Engineering Joint Appointment, Medicine Johns Hopkins University Institute for Computational Medicine Johns Hopkins University Baltimore, MD What is the background for this study? What are the main findings? Dr. Trayanova: The methodology for modeling cardiac electrical function has matured sufficiently that we can now create computational models of the electrical functioning of the entire heart. My research is focused on translating this methodology into the clinic. The goal is to create, if you will, "a virtual heart for every patient", that will enable the physician to play our scenarios that manifest the heart dysfunction in the given patient, and to enable physicians to make personalized decisions about patient treatment. The present paper is the first application of this overall vision. The motivation for this particular paper was that determining which patients are at risk for sudden cardiac death represents a major unmet clinical need. Patients at risk receive life-saving implantable defibrillators (ICDs), but because of the low sensitivity and specificity of current approach (based on low ejection fraction), risk assessment is inaccurate. Thus, many patients receive ICDs without needing them, while others die of sudden cardiac death because they are not targeted for ICD therapy under the current clinical recommendations. Our goal was to develop a non-invasive personalized virtual-heart risk assessment tool that has the potential to ultimately prevent sudden cardiac death and avoid unnecessary ICD implantations. (more…)
Author Interviews, Heart Disease, Stem Cells / 11.05.2016 Interview with: Timothy D. Henry, MD, MSCAI Director, Division of Cardiology Cedars-Sinai Heart Institute What is the background for this study? What are the main findings? Dr. Henry: Heart failure it the #1 cause of morbidity, mortality and cost in the United States today.  Patients with Class 3 heart failure, despite optimal medical therapy and device therapy have limited options beyond heart transplantation and left ventricular cyst device. Transplantation and LVAD are expensive and are challenged by both availability and complications.  Therefore, treatment for patients with ongoing symptoms despite medical therapy is an admiral goal.  Stem cell therapy appears to be an attractive choice for these patients, in particular patients with ischemic cardiomyopathy. The ATHENA trial was designed to treat patients with ischemic cardiomyopathy and ongoing ischemia with autologous adipose-derived regenerative cells.  Patients would undergo liposuction with onsite processing of their stem cells in 1 ½ - 2 hours, followed by intramyocardial injection of adipose-derived regenerative cells (ADCRs) vs. placebo. (more…)
Author Interviews, Heart Disease, University Texas, Weight Research / 11.05.2016 Interview with: Sanghamitra Mohanty, MD MS FHRS Director, translational research, Texas Cardiac Arrhythmia Institute and Associate Professor (affiliate) Dell Medical School What is the background for this study? What are the main findings? Dr. Mohanty:  In the last few years, several trials from a research group in Australia have generated tremendous interest in life-style modifications to manage AF more effectively. These studies reported significant decrease in arrhythmia burden and symptom severity and improvement in ablation outcome in patients with paroxysmal and persistent atrial fibrillation. We investigated the impact of weight-loss on procedure outcome in terms of arrhythmia burden, quality of life and arrhythmia-free survival in long-standing persistent (LSPAF) patients undergoing catheter ablation. Our main findings were the following;
  1. In patients with long-standing persistent atrial fibrillation, weight loss improved quality of life but had no impact on symptom burden and long-term ablation outcome
  2. No change in AF type or status was detected after the weight loss
  3. Extensive ablation including pulmonary vein (PV) isolation plus ablation of posterior wall and non-PV triggers resulted in comparable outcome in both groups at 1-year follow-up, irrespective of weight-loss interventions (63.8% vs 59.3%, p=0.68).