Heart Disease, Vitamin D / 01.05.2014

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner HospitalMedicalResearch.com Interview with: Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital MedicalResearch.com: What are the main findings of the study? Dr. Lewis: We tested the hypothesis raised by others that calcium supplementation with or without vitamin D increases coronary heart disease and mortality risk in elderly women. To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women. Importantly all events included in this large meta-analysis were verified by clinical review, hospital record or death certificate. We did not observe any significant increase in all-cause mortality or coronary heart disease events that included myocardial infarction, angina pectoris and acute coronary syndromes and chronic coronary heart disease. (more…)
Author Interviews, Diabetes, Heart Disease / 24.04.2014

Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K.MedicalResearch.com Interview with: Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K. MedicalResearch.com: What are the main findings of the study? Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram.  We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality.  We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk.  We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept.  These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats.  Our data suggest that this was due to overactivity of the vagus nerve.  We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy. (more…)
AHA Journals, Author Interviews, Cannabis, Heart Disease / 23.04.2014

Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France.MedicalResearch.com Interview with: Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France. MedicalResearch.com: What are the main findings of the study? Dr. Jouanjus: Our study emphasizes that cardiovascular complications make up 1.8 percent of cannabis-related health complications reported in France. These were cases of peripheral arteriopathies, and cardiac and cerebrovascular disorders, some of which resulted in the death. These findings conducted us to conclude that marijuana is a possible risk factor for cardiovascular disease in young adults. (more…)
Heart Disease, JACC / 16.04.2014

Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com Interview with: Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com: What are the main findings of the study? Dr. Nakanishi: With growing evidence that a measurement of the buildup of calcium in coronary arteries can predict heart disease risk, Los Angeles Biomedical Research Institute (LA BioMed) researchers found that the process of "calcium scoring" was also accurate in predicting the chances of dying among adults with little or no traditional risk factor of heart disease. The study conducted by LA BioMed researchers examined 5,593 adults with no known heart disease and zero or minimal risk factor of heart disease -- including hypertension, dyslipidemia, diabetes, current smoking and family history of heart disease -- who had undergone coronary artery calcium screening by non-contrast cardiac computed tomography from 1991-2011. Among the adults in the study, even those with low coronary artery calcium scores of 1-99 were 50% more likely to die of heart disease than adults with a calcium score of zero. Adults with moderate scores of 100-399 were 80% more likely to die from heart disease than those with a score of zero, and those with scores of 400 or more were three times more likely to die from heart disease, when compared to adults with no calcified plaque buildup, or a score of zero. (more…)
Author Interviews, Heart Disease, JAMA, Mental Health Research / 15.04.2014

https://archinte.jamanetwork.com/article.aspx?articleid=1860496MedicalResearch.com Interview with: Dr. Jeffery  C. Huffman, M.D. Harvard Medical School Department of Psychiatry Massachusetts General Hospital, Boston MedicalResearch.com: What are the main findings of the study? Dr. Huffman: Depression and anxiety in cardiac patients are associated with adverse cardiac outcomes.  We completed a very low-intensity care management intervention to identify depression and anxiety disorders during a cardiac admission and then to assist in the monitoring and management of the condition over the next 24 weeks. There have been other care management trials in cardiac patients, but ours was the first to co-manage depression and anxiety, the first to initiate treatment in the hospital, the first to take a broad population of cardiac patients rather than a single diagnosis, and the first to use such a low-resource strategy with only a single part-time social worker to coordinate care. We found that the care management intervention was associated with significant improvements in mental health treatment, mental health related quality of life, depression, and function at 24 weeks compared to enhanced treatment as usual.  We did not find differences in anxiety, adherence, or cardiac readmissions. (more…)
Dental Research, Heart Disease / 12.04.2014

Dr Ola Vedin University of Uppsala, SwedenMedicalResearch.com Interview with: Dr Ola Vedin University of Uppsala, Sweden   MedicalResearch.com: What are the main findings of the study? Dr. Vedin: That self-reported tooth loss as a marker of periodontal disease is common in patients with established coronary heart disease and is associated with higher levels of LDL cholesterol, glucose levels, systolic blood pressure and waist circumference as well as diabetes and smoking, i.e. risk factors for coronary heart disease. Gum bleeding, another marker of periodontal disease, was associated with higher levels of LDL cholesterol and systolic blood pressure. In summary, patients with few remaining teeth and gum bleeding demonstrated a heavier burden of cardiovascular risk factors. (more…)
Author Interviews, Heart Disease, NEJM / 11.04.2014

Marc A. Pfeffer, M.D., Ph.D. Dzau Professor of Medicine Harvard Medical School Cardiovascular Division Brigham and Women's HospitalMedicalResearch.com Interview with: Marc A. Pfeffer, M.D., Ph.D. Dzau Professor of Medicine Harvard Medical School Cardiovascular Division Brigham and Women's Hospital MedicalResearch.com: What are the main findings of the study? Dr. Pfeffer: We randomized 3445 patients with symptomatic heart failure and a left ventricular ejection fraction greater than or equal to 45% (heart failure with preserved ejection fraction or diastolic heart failure) to spironolactone or placebo and followed them for over 3 years. Our primary outcome the composite of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for management of heart failure was not significantly reduced in the group randomized to spironolactone. We did, however, observe that fewer patients in the spironolactone group were hospitalized for the management of heart failure following randomization. Spironolactone therapy was associated with higher incidence of  hyperkalemia and rises in serum creatinine. (more…)
Author Interviews, Heart Disease, Kidney Disease / 06.04.2014

Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The NetherlandsMedicalResearch.com Interview with: Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The Netherlands   MedicalResearch.com: What are the main findings of the study? Dr. Kooiman: The main finding of our study is that trans radial PCI (TRI) is associated with a significantly lower risk of AKI compared with trans femoral PCI (TFI), after adjustment for confounding factors. (more…)
Author Interviews, BMJ, Heart Disease / 06.04.2014

Professor Ben He Department of Cardiology Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai China.MedicalResearch.com Interview with: Professor Ben He Department of Cardiology Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai China. MedicalResearch.com: What are the main findings of the study? Professor He: Elimination of PVCs by catheter ablation can improve LVEF and reverse LV dimensions. The pooled mean change in LVEF post-ablation meets the prespecified borderline (5%) and can be considered clinically effective. Beneficial effects of ablation of frequent PVCs in improving LV function are more significant in patients with reduced LVEF at baseline. (more…)
Author Interviews, Biomarkers, Emergency Care, Heart Disease, JACC, Karolinski Institute / 04.04.2014

Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, HuddingeMedicalResearch.com Interview with: Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, Huddinge   MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: In a cohort of 8900 consecutive patients who sought medical attention for chest pain, we found that an undetectable high-sensitivity cardiac troponin level (<5 ng/l), and an ECG with no ischemic changes has a negative predictive value of 99.8% (95%, 99.7-99.9%). Thus, this will rule out MI with nearly 100% accuracy, and independent of when the troponin was measured in relation to onset of chest pain, and independent of any risk factors for cardiovascular disease. (more…)
Author Interviews, Heart Disease, NEJM / 04.04.2014

Professor Harvey White MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service Auckland City Hospital Victoria St West Auckland 1142 NEW ZEALANDMedicalResearch.com Interview with: Professor Harvey White MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar, Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service Auckland City Hospital NEW ZEALAND MedicalResearch.com: What are the main findings of the study? Prof. White:   During follow-up (median 3.7 years), the composite primary end point (cardiovascular death, myocardial infarction or stroke) occurred in 9.7% of the 7,924 patients randomly assigned to darapladib and 10.4% of the 7,904 patients in the placebo group (HR 0.94, 95% CI 0.85-1.03 p=0.199). In the first prespecified secondary endpoint of major coronary events (CHD death, MI or urgent revascularization) compared with placebo, darapladib reduced the rate (9.3% vs. 10.3%; HR=0.9; 95% CI, 0.82-1 p=0.045). Total coronary events (14.6% vs. 16.1%; HR = 0.91; 95% CI, 0.84-0.98,p=0.019). (CHD death, MI, any coronary revascularization, hospitalization for unstable angina) were also reduced. No major safety concerns arose during the trial. (more…)
Heart Disease / 01.04.2014

Mary E. Arthur, MD Cardiothoracic and ICU Anesthesia Department of Anesthesiology and Perioperative Medicine Georgia Regents University, Augusta, GAMedicalResearch.com interview with: Mary E. Arthur, MD Cardiothoracic and ICU Anesthesia Department of Anesthesiology and Perioperative Medicine Georgia Regents University, Augusta, GA   MedicalResearch.com: What made this cardiac case challenging? Dr. Arthur: The left ventricle of our patient’s heart was functioning very poorly, and he required maximum pharmacologic support after he was weaned from cardiopulmonary bypass at the end of a 4-vessel coronary artery bypass graft procedure. His blood pressure and cardiac output were extremely low and his heart was not pumping well and so we put him back on bypass. Under routine circumstances, using an intra-aortic balloon pump is the next logical step, however it was inadvisable in this patient because he had moderate aortic insufficiency (a leaky aortic valve). (more…)
Author Interviews, Heart Disease, Kidney Disease, McGill / 27.03.2014

Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill UniversityMedicalResearch.com Interview with: Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill University MedicalResearch.com: What are the main findings of the study? Dr. Pilote: Our study found that in patients with atrial fibrillation (AF) undergoing dialysis, warfarin use, compared to no-warfarin use, did not reduce the risk for stroke (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.78 to 1.67) but it was associated with a 44% higher risk for bleeding event (adjusted HR: 1.44, 95% CI: 1.13 to 1.85). However, warfarin use in non-dialysis patients with AF was associated with a 13% lower risk for stroke (adjusted HR: 0.87, 95% CI: 0.85 to 0.90) and only a 19% higher risk for bleeding event (adjusted HR: 1.19, 95% CI: 1.16 to 1.22). (more…)
Author Interviews, Heart Disease, PTSD / 20.03.2014

Dr. Nancy Crum-Cianflone Deployment Health Research Department, Naval Health Research Center San Diego, CAMedicalResearch.com Interview with: Dr. Nancy Crum-Cianflone MD Deployment Health Research Department, Naval Health Research Center, San Diego, CA MedicalResearch.com: What are the main findings of the study? Dr. Nancy Crum-Cianflone: There have been several studies examining the health outcomes of service members who recently deployed to the conflicts in Iraq and Afghanistan.  However, none of these studies to date had examined the potential role of military deployment experiences and PTSD on coronary heart disease (CHD) among young US service members.  We believed that this would be an important study to undertake since these data would not only be useful to the US military, but may also have implications regarding job-related stressors on the health of young adults in the general population. After studying over 60,000 current and former US military personnel, we found that those who deployed and experienced combat were at a 60%-90% increased risk of subsequently developing CHD.  This finding was noted when we examined both self-reported CHD and medical record validated coronary heart disease.  These data suggest that experiences of intense stress may increase the risk for coronary heart disease over a relatively short period among young, previously healthy adults. (more…)
Author Interviews, CMAJ, Emergency Care, Gender Differences, Heart Disease, McGill / 20.03.2014

MedicalResearch.com Interview with: Roxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology  McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, QcRoxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, Qc MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks?  Dr. Pelletier:  Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality. (more…)
Author Interviews, Heart Disease, JAMA, NIH, Omega-3 Fatty Acids / 19.03.2014

MedicalResearch.com Interview with: Denise Bonds, MD, MPH National Heart, Lung, and Blood Institute (NHLBI)  MedicalResearch.com: What are the main findings of the study? Dr.Bonds: We found no cardiovascular benefit to supplementation of the diet with either omega-3 fatty acids or with the macular xanthophyll’s lutein and zeaxanthin. (more…)
AHA Journals, Author Interviews, Diabetes, Heart Disease, OBGYNE / 18.03.2014

Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304MedicalResearch.com Interview with: Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304 MedicalResearch.com: What are the main findings of the study? Dr. Gunderson: The study found that: -   Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease. -   Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy. -   Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes.  The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy. -   Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness. (more…)
Annals Internal Medicine, Author Interviews, Heart Disease, Lipids, Nutrition / 17.03.2014

Rajiv Chowdhury MD, PhD Cardiovascular Epidemiologist Department of Public Health and Primary Care University of CambridgeMedicalResearch.com Interview with: Rajiv Chowdhury MD, PhD Cardiovascular Epidemiologist Department of Public Health and Primary Care University of Cambridge MedicalResearch.com: What are the main findings of the study? Dr. Chowdhury: Total saturated fatty acid, whether measured as a dietary intake variable or in the bloodstream as a biomarker, was not associated with coronary disease risk in combining all available prospective observational studies. Similarly, there were non-significant overall associations in the prospective studies that involved assessments of total monounsaturated fatty acids, long-chain omega-3 and omega-6 polyunsaturated fatty acids. However, we found diversity in the observational associations between specific circulating long-chain omega-3 and omega-6 fatty acids with coronary risk, with some evidence that circulating levels of eicosapentaenoic and docosahexaenoic acids (ie, the two main types of long-chain omega-3 polyunsaturated fatty acids), and arachidonic acid are each associated with lower coronary risk. Similarly, within saturated fatty acids, there were positive, however, non-significant associations observed for circulating blood composition of palmitic and stearic acids (found largely in palm oil and animal fats, respectively), whereas circulating margaric acid (a milk fat) had a significant inverse association. Additionally, when we investigated the randomised controlled trials that reported on the effects of omega-3 and omega-6 fatty acids on reducing coronary outcomes, there was no significant overall association observed. (more…)
Author Interviews, BMJ, Heart Disease, Outcomes & Safety, Surgical Research / 17.03.2014

Dr Tahir Hamid MRCP (UK), FESC Department of Cardiology, Royal Albert Edward Infirmary NHS Trust,  Wigan, UKMedicalResearch.com Interview with: Dr Tahir Hamid MRCP (UK), FESC Department of Cardiology, Royal Albert Edward Infirmary NHS Trust,  Wigan, UK MedicalResearch.com: What are the main findings of the study? Dr. Hamid: Traditionally patients undergoing diagnostic and interventional coronary artery procedures are kept Nil-by-mouth, but until yet there exists neither evidence nor clear guidance about the benefits of this practice in such patients. In our study performed at two National Health Services (NHS) institutes, we demonstrated in our 1916 patients, that such procedures could be undertaken without the need for being 4-6 hours fasting. None of our patients had major complications leading to pulmonary aspiration or emergency cardiac surgery. (more…)
Heart Disease, Orthopedics / 16.03.2014

Bheeshma Ravi, MDMedicalResearch.com Interview with: Bheeshma Ravi, MD Orthopedic Surgery University of Toronto Medical Center   MedicalResearch.com: What are the main findings of the study? Dr. Ravi:  This study suggests that in persons with moderate-severe osteoarthritis of the hip or knee, total joint replacement is associated with a significant reduction in the risks for serious cardiovascular events. (more…)
AHA Journals, Heart Disease, Karolinski Institute, Kidney Disease / 13.03.2014

Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden.MedicalResearch.com Interview with: Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden. MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes. (more…)
Author Interviews, Heart Disease, JAMA, Karolinski Institute, Kidney Disease / 04.03.2014

Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.MedicalResearch.com Interview with: Juan Jesus Carrero PhD (Pharm and Med) Associate Professor in Renal Medicine Karolinska Institutet, Sweden.   MedicalResearch.com: Why did you choose to study this particular question? Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation. (more…)
Annals Thoracic Surgery, Author Interviews, Dental Research, Heart Disease, Infections, Mayo Clinic / 01.03.2014

Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905MedicalResearch.com Interview with: Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com: What are the main findings of the study? Dr. Grim: “The current guidelines say that if possible, treating the dental problems that patients have before heart surgery is best, to try to prevent both early and late heart infections. But the data is very unclear, because it’s very difficult to study. We found in our study that their risk of serious complications after having teeth removed may be higher than we thought. We were primarily looking at stroke, heart attack, renal failure and death. We found that actually the incidence of having one of those major morbidities was 8 percent.  Of that 8 percent, we had six patients, or 3 percent, of the total group who died between their dental surgery and scheduled heart surgery, so these patients never made it to their heart surgery. An additional 3 percent of patients died after heart surgery. “ (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care, Heart Disease, UCSF / 25.02.2014

Dhruv S. Kazi, MD, MSc, MS Assistant Adjunct Professor Division of Cardiology San Francisco General Hospital Department of Medicine, and Department of Epidemiology and Biostatistics University of California San FranciscoMedicalResearch.com Interview with: Dhruv S. Kazi, MD, MSc, MS Assistant Adjunct Professor Division of Cardiology San Francisco General Hospital Department of Medicine, and Department of Epidemiology and Biostatistics University of California San Francisco MedicalResearch.com: What is the background of your study? Dr. Kazi: When we first asked the research question -what is the role of genotyping among patients receiving a stent for ACS, we quickly realized that there were no RCTs that had directly compared ticagrelor with prasugrel. But in our opinion, that was precisely the reason to build a model and systematically synthesize the available literature. There are nearly half a million PCIs for ACS in the US each year, and each time, the physician and patients have to examine the trade-offs between the various alternatives. What our model does is that it explicates the trade-offs - makes them transparent, and quantifies them.  So patients and physicians can make an informed decision on what is the optimal therapy for them. (more…)
Author Interviews, Heart Disease, JAMA / 22.02.2014

Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC
 Professor Department of Medicine, Cardiology Division
 Program Director Cardiac Electrophysiology and Autonomic Physiology Fellowship
 Arrhythmia & Pacing Service McMaster University-HHSC
 Director Syncope and Autonomic Disorder Unit
 Senior Investigator, Arrhythmia & Global Health, Population Health Research Institute
 Hamilton, ON, CanadaMedicalResearch.com Interview with: Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC
 Professor Department of Medicine, Cardiology Division Program Director Cardiac Electrophysiology and Autonomic Physiology Fellowship
,Hamilton, ON, Canada MedicalResearch.com: What are the main findings of the study? Dr. Morillo: The main findings were that Ablation of atrial fibrillation was superior to conventional antiarrythmic drug therapy in patients with Paroxysmal atrial fibrillation that had not been treated with Antiarrhythmic medications. Ablation extended the time to first recurrence of atrial fibrillation within the 2 year follow-up of the study and significantly reduced the  recurrence of repeated episodes of AF. (more…)
Author Interviews, Heart Disease, Surgical Research / 19.02.2014

Sammy Elmariah, MD, MPH Massachusetts General Hospital Boston, MAMedicalResearch.com Interview with: Sammy Elmariah, MD, MPH Massachusetts General Hospital Boston, MA   MedicalResearch.com: What are the main findings of the study? Dr. Elmariah: Within the randomized PARTNER I trial, we evaluated the effect of left ventricular (LV) dysfunction on clinical outcomes after transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively) and the impact of valve replacement technique on recovery of LV function. We found that LV dysfunction, defined as an LV ejection fraction < 50%, had no impact on 30-day and 1-year mortality after either TAVR or SAVR. In those with baseline LV dysfunction, marked improvement in LV ejection fraction was observed within 30-days of valve replacement in approximately half of patients, with an equivalent degree of improvement observed after TAVR and SAVR. Permanent pacemaker at study entry, low mean aortic valve gradient, and high LV ejection fraction were associated with reduced odds of LV functional recovery after valve replacement. (more…)
Annals Internal Medicine, Author Interviews, General Medicine, Heart Disease / 18.02.2014

MedicalResearch.com Interview with: Caroline A. Kim, MD, MS; Beth Israel Deaconess Medical Center Boston, MA 02215. MedicalResearch.com: What are the main findings of the study? Dr. Kim: We conducted a systematic review of 62 studies that examined functional status and quality of life in patients who underwent transcatheter aortic valve replacement (AVR) for their symptomatic severe aortic valve stenosis.  In 11,205 patients who underwent TAVR, a clinically meaningful improvement was seen in physical functional measures and disease-specific quality of life measures, whereas improvement in psychological measures or more general health measures were modest and inconsistent.  Given the dismal prognosis of severe aortic stenosis treated conservatively, it was clear that transcatheter AVR improved functional status and quality of life.  However, there was insufficient evidence that compares these patient-centered outcomes between transcatheter AVR and surgical AVR. (more…)
Author Interviews, Heart Disease, Vitamin D / 14.02.2014

Eirik Magnus Meek Degerud Department of Clincal Medicine University of BergenMedicalResearch.com Interview with:  Eirik Magnus Meek Degerud Department of Clincal Medicine University of Bergen MedicalResearch.com: What are the main findings of the study? Answer: That among patients with established coronary artery disease there was no observable relationship between the amount of vitamin D circulating in their blood and the extent of disease progression during the following year. (more…)
Author Interviews, Heart Disease / 10.02.2014

Bríain ó Hartaigh, Ph.D. Assistant Research Professor of Epidemiology Dalio Institute of Cardiovascular Imaging Weill Cornell Medical CollegeMedicalResearch.com Interview with: Bríain ó Hartaigh, Ph.D. Assistant Research Professor of Epidemiology Dalio Institute of Cardiovascular Imaging Weill Cornell Medical College MedicalResearch.com: What are the main findings of the study? Answer: Sustained elevations in resting heart rate measured longitudinally over the course of 6 years were strongly and independently associated with a greater risk of death from all causes in adults aged 65 years or older. (more…)