cardiology Tag

05 Nov

Posted at 11:53h in Heart Disease

Editorial Notice: This profile is for general information and is not specific medical advice. Decisions about heart screening and testing should be based on your individual risk factors and made with your own healthcare provider. If you have chest pain, shortness of breath, or other symptoms of a heart attack or stroke, call 911 immediately. Providers named in this post are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc.

For much of its history, cardiology has been a largely reactive discipline, built around treating a heart that has already started to fail rather than one designed to keep it from failing in the first place.

Dr. Ijaz Ahmad, founder and medical director of Park Slope Cardiac & Diagnostic Center in Brooklyn, has spent his career trying to push that emphasis toward a version of cardiology that finds trouble years before a patient would ever feel it.

08 Oct

Posted at 17:04h in Heart Disease

Heart Health Notice: If you have chest pain or pressure, shortness of breath, pain spreading to the arm, jaw, neck, or back, cold sweat, nausea, or sudden dizziness, call 911 or your local emergency number right away. Do not drive yourself to the hospital. This article is for general education and does not replace advice from your doctor. Do not start, stop, or change any medication, or begin a new exercise program if you have heart disease or symptoms, without talking to your healthcare provider. Programs, tests, and services mentioned or linked here are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc.

Many heart attacks seem to come out of nowhere. A person feels fine on Monday and ends up in the hospital on Friday. But the damage usually starts years before. Plaque slowly builds inside the arteries, and most people never feel it happening. The good news is that you can act early. The first step is to know your own risk factors. When you know what puts your heart at risk, you can work with your doctor to address those things before they cause harm. [caption id="attachment_76521" align="aligncenter" width="500"]how-to-help-prevent-heart-attacks-pexels Photo by freestocks.org: [/caption]

01 Oct

Posted at 12:13h in Heart Disease

Heart Symptom Notice: A treadmill test is a scheduled investigation, not an emergency service. If you have chest pain or pressure at rest, chest discomfort that lasts more than a few minutes or keeps returning, severe shortness of breath, fainting, or chest pain with sweating, nausea, or pain spreading to the arm, jaw, or back, call emergency services immediately (995 in Singapore). Exercise testing is not suitable for everyone, and your doctor will decide whether it is safe and appropriate for you.

A treadmill test sounds almost comically ordinary. You walk on a moving belt while someone watches your heart. Yet the useful part is not the walking itself. It is what changes inside your body as the effort increases: your heart rate, rhythm, symptoms and ability to keep going.

Before booking, it helps to understand what the test can and cannot show.

If you are considering a treadmill test in Singapore, it helps to know what the test is actually trying to discover. It is not simply a fitness challenge and it is not a pass or fail examination. The value comes from seeing what your heart does under controlled stress and then putting those findings together with your symptoms and medical history.

[caption id="attachment_76403" align="aligncenter" width="500"]treadmill-heart-test-pexels Photo by Los Muertos Crew[/caption]

10 Mar

Posted at 14:41h in Heart Disease
Global Destination for Advanced Heart Care Cardiovascular disease remains one of the leading causes of mortality worldwide, making access to timely and high-quality cardiac care critically important. In recent years, patients from many countries — including the United States — have increasingly looked beyond their local healthcare systems for advanced treatment options. One destination gaining international attention is Tel Aviv Sourasky Medical Center (Ichilov), widely recognized as a leading cardiology hospital in Israel. Located in the heart of Tel Aviv, Ichilov has built a strong reputation for providing cutting-edge cardiology in Israel, combining advanced medical technologies with internationally trained specialists and a patient-centered approach. Each year, thousands of international patients travel to the medical center for heart treatment in Israel, seeking highly specialized procedures, innovative therapies, and the opportunity to receive treatment without long waiting lists. This unique combination of medical expertise, efficiency, and international experience has made Ichilov one of the most prominent destinations for cardiovascular disease treatment in Israel.

12 Dec

Posted at 23:01h in Author Interviews, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_71774" align="alignleft" width="150"] Prof. Fairbairn[/caption] Prof. Timothy Fairbairn MBChB, PhD FRCP  and [caption id="attachment_71775" align="alignleft" width="150"] Dr. Bell[/caption] Dr.  Jack Bell Liverpool Heart and Chest Hospital Liverpool, UK   MedicalResearch.com: What is the background for this study? Response: Coronary computed tomography angiography (CCTA) is a non-invasive heart scan used in the first-line investigation of patients with suspected stable coronary artery disease (CAD). While CCTA clearly shows blockages in coronary arteries, it is limited in its ability to estimate reduced blood flow, which is necessary to diagnose angina. An artificial intelligence-based tool (Heartflow) has been developed that analyses CCTA images and provides an estimate of blood flow: CT-derived fractional flow reserve (FFR-CT). The real-world, retrospective English FISH&CHIPS study demonstrated that including FFR-CT as a decision-making tool in the diagnosis of stable CAD reduces the number of subsequent invasive and non-invasive tests performed. Whether FFR-CT could also be used prognostically, to predict future major cardiovascular events, was not fully understood. Previous studies have had small patient numbers, short follow-up and investigated combined cardiovascular outcomes. We performed an analysis on the national FISH&CHIPS population, which was large enough to determine if FFR-CT adds incremental value to traditional cardiovascular risk factors in predicting cardiovascular outcomes and death.

05 Nov

Posted at 11:45h in Author Interviews, Heart Disease, Pharmacology
In medicine, we often picture massive, straight-line progress: hypothesis to experiment to result. But the truth is, many of the greatest leaps forward start with something much smaller—an unexpected signal, a moment of deep curiosity, or what scientists playfully call a "blip". That’s exactly how the groundbreaking story of XXB750 began. In a Novartis research lab, scientists noticed a subtle irregularity in the data—something that simply didn't fit their expectations. The easy thing would have been to ignore it, to write it off as an error. Instead, they decided to dig deeper. That single decision, driven by curiosity, is what led to a potential new therapy for heart failure and resistant hypertension—two conditions that profoundly affect millions worldwide. This isn't just a clinical breakdown of molecules and lab tests; it’s a powerful reminder that behind every breakthrough lies persistence, genuine curiosity, and an unwavering desire to give patients a better life. discovery-transform-heart-failure-treatment

06 Oct

Posted at 08:43h in Author Interviews, Heart Disease, NEJM

Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation

MedicalResearch.com Interview with: [caption id="attachment_70865" align="alignleft" width="200"]Gilles Lemesle, M.D., Ph.DRadcliffe Cardiology Interventional Cardiologist Lille University Hospital, Lille, FR Prof. Lemesle[/caption] Gilles Lemesle, M.D., Ph.D Lille University Hospital, Lille, France Guillaume Cayla, M.D., Ph.D Université de Montpellier, France Martine Gilard, M.D., Ph.D Hospital Cavale Blanche, Brest, France   MedicalResearch.com: What is the background for this study? Response: Patients with chronic coronary syndrome (CCS) and receiving long-term oral anticoagulation (OAC), mainly but not solely for atrial fibrillation, are at high risk of both atherothrombotic events on one side and bleeding events on the other side. Therefore, the optimal antithrombotic management for these patients with CCS requiring OAC after stenting is critical, especially in those patients at high residual atherothrombotic risk. Previous studies reported that in this specific context, the addition of antiplatelet therapy on top of OAC increases bleeding without a clear benefit on ischemic outcomes. Nevertheless, these studies presented several limitations, which restricted the applicability of their results in clinical pratice. They were indeed all open-labelled, included patients without stenting and/or at low atherothrombotic risk, and focused on Asian patients who have different atherothrombotic and bleeding risks as compared to Europeans. Thus, the rationale of the AQUATIC trial comes from the need to better identify the optimal antithrombotic regimen in high-risk patients with CCS and previous stenting, who receive long-term OAC, in order to optimize the atherothrombotic/bleeding risks in this population. The AQUATIC trial analyzed the efficacy and safety of adding aspirin to OAC, a combination that is still commonly used for this high-risk population in clinical daily practice.

27 Mar

Posted at 10:30h in Heart Disease, Personalized Medicine
[caption id="attachment_67598" align="aligncenter" width="500"]personalized-cardiology-care-Dr-Marshall Photo by Pavel Danilyuk[/caption] Sponsored post How we treat heart disease remains a major health concern in today's fast-pace world. More healthcare professionals are turning to personalized, prevention-based care as medical tools improve and our understanding of cardiovascular risk grows. An example of that change is interventional cardiologist Dr. Robert Marshall, who is known for his clinical expertise but also for his patient-centered approach. Building a Strong Foundation Dr. Marshall has spent years refining his approach to cardiology, combining traditional medical training with deep knowledge in nutrition. This background gives him a unique, holistic perspective when it comes to heart health. But what truly makes his care stand out is how he adapts his knowledge to fit the individual needs of each patient.

03 Jul

Posted at 18:50h in Author Interviews, Heart Disease, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_62223" align="alignleft" width="150"]Evan A Stein MD PhD FACCCOO/CSO LIB Therapeutics Cincinnati. OH USA 45227 Dr. Stein[/caption] Evan A Stein MD PhD FACC COO/CSO LIB Therapeutics Cincinnati. OH USA 45227 MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) remains the main cause of morbidity and mortality worldwide and is increasing in rapidly industrializing countries and is projected to cause more than >20 million deaths annually over the next 15 years. Low-density lipoprotein cholesterol (LDL-C) is well established as a major, easily modifiable, risk factor for CVD. Reductions with statins and, more recently, PCSK9 inhibitors, all agents which directly or indirectly upregulate the LDL receptor and enhance LDL-C clearance, have demonstrated CVD event reductions in cardiovascular outcome trials. Extensive data from these trials, provide a rough estimate that every 40 mg/dL reduction in LDL-C will reduce the risk of major CV cardiovascular events by 22% to 24%. Furthermore, trials with PCSK9 inhibitors added to statins which achieve substantial additional LDL-C reduction show and CVD event reduction remains linear to very low LDL-C levels without signals of adverse events. Based on this body of evidence, recent revisions to national and international guidelines, now advocate for greater LDL-C reductions and lower LDL-C treatment goals, for patients not achieving these goals on statins alone. The current consensus target goal for LDL-C in patients with CVD, or who are at very-high risk for of CVD, is now less than <55 mg/dL, and <70 mg/dL for those at high risk. This global trial of over 900 patients with CVD, or at very or high risk for CVD, on maximally tolerated statins assessed the 52-week efficacy and safety of monthly lerodalcibep.

07 Mar

Posted at 19:35h in Heart Disease, Technology
Heart disease remains a leading cause of morbidity and mortality worldwide. Despite advances in medical technology and treatment modalities, managing heart disease remains challenging. This is particularly true in remote or underserved areas with limited access to specialized healthcare. However, remote patient monitoring (RPM) has transformed the landscape of cardiac care, offering innovative solutions for proactive management and early intervention. The market for remote patient monitoring was projected to be valued at $14.0 billion in 2023, according to PR Newswire. By 2028, it is anticipated to increase to $41.7 billion. This article explores the significance of remote patient monitoring in effectively managing heart disease and its evolving role in enhancing patient outcomes.

13 Nov

Posted at 13:31h in Author Interviews, Heart Disease, Stem Cells
MedicalResearch.com Interview with: [caption id="attachment_61040" align="alignleft" width="92"]Prof. Dr. Wolfram-Hubertus ZimmermannDirector, Institute of Pharmacology and Toxicology University Medical Center Göttingen Georg-August University Göttingen, Germany Dr. Zimmermann[/caption] Prof. Dr. Wolfram-Hubertus Zimmermann Director, Institute of Pharmacology and Toxicology University Medical Center Göttingen Georg-August University Göttingen, Germany   MedicalResearch.com: What is the background for this study? Response: Involvement in research and development in the field of tissue engineered heart repair since 25+ years. Bench-to-bed translation of our research. MedicalResearch.com: How are the stem cell obtained? Response: We make use of induced pluripotent stem cells as starting material to obtain heart muscle cells for the engineering of Engineered Human Myocardium (EHM) and its use as Biological Ventricular Assist Tissue (BioVAT).

06 Nov

Posted at 14:24h in Author Interviews, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_61006" align="alignleft" width="125"]Prakriti Gaba, MDCardiovascular Medicine Fellow Brigham and Women's Hospital Dr. Gaba[/caption] Prakriti Gaba, MD Cardiovascular Medicine Fellow Brigham and Women's Hospital [caption id="attachment_31114" align="alignleft" width="120"]Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC Executive Director of Interventional Cardiovascular Programs, Brigham and Women’s Hospital Heart & Vascular Center Professor of Medicine, Harvard Medical School Boston, MA 02115 Dr. Deepak  Bhatt[/caption] Deepak L. Bhatt MD MPH Director of Mount Sinai Fuster Heart Hospital Dr. Valentin Fuster Professor of Cardiovascular Medicine Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study?  Response: Accurate classification of acute myocardial infarction is instrumental for the appropriate diagnosis and effective management of patients suffering from this widely prevalent cardiovascular condition. In the past, there have been a variety of clinical scores published to advise clinicians on the best classifications schemes for patients with acute MI. These have included the Thrombolysis in Myocardial Infarction (TIMI) risk score, the HEART score, and the Killip classification. The strength of these traditional scores includes their practicality, as they can be implemented at the bedside to rapidly assist with prognostication. Nonetheless, as technologic advancements have made imaging and tissue identification more accessible, national and international committees are looking to revise traditional classification schemes of acute MI with novel ones leveraging multimodal approaches.

28 Feb

Posted at 15:14h in Author Interviews, Heart Disease, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_60103" align="alignleft" width="125"]Dr. Muchi Ditah Chobufo MD MPHCardiology Fellow West Virginia University Dr. Ditah Chobufo[/caption] Dr. Muchi Ditah Chobufo MD MPH Cardiology Fellow West Virginia University MedicalResearch.com: What is the background for this study? Response: Ischemic heart diseases are a significant cause of morbidity and mortality in the USA. Also, there exists alarming ethnic disparities in mortality rates following acute myocardial infarction. To this effect, significant efforts have been deployed over the years to curb its burden and reduce extant disparities. It is in this light that we set out to analyze general and ethnic specific trends in acute myocardial infarction related age adjusted mortality rates (AAMR) in the entire USA from 1999-2020. 

30 Aug

Posted at 11:06h in Author Interviews, Heart Disease, NEJM
MedicalResearch.com Interview with: [caption id="attachment_59461" align="alignleft" width="128"]Dr Holly Morgan M.B., B.Ch. Clinical Research Fellow and REVIVED investigator King's College London Dr. Morgan[/caption] Dr Holly Morgan M.B., B.Ch. Clinical Research Fellow and REVIVED investigator King's College London MedicalResearch.com: What is the background for this study? Response: Coronary artery disease is the commonest cause of heart failure.  Whilst individually tailored pharmacological and device therapy (optimal medical therapy, OMT) is the cornerstone of management of ischemic heart failure, rates of death and hospitalization for heart failure remain unacceptably high in this population.  Given the causative relationship between coronary disease and heart failure, coronary revascularization has long been considered as a treatment option for these patients.  Whilst there is randomized evidence to support surgical revascularization with coronary artery bypass grafting (1), none previously existed for percutaneous coronary intervention (PCI) in stable ischemic left ventricular dysfunction. Despite this, patients are frequently offered PCI in this setting (particularly if unsuitable for surgery); driven by the belief that hibernating myocardium will improve in function if blood flow is restored, regardless of the revascularization method.  This approach was supported in some international guidelines, though recommendations varied. The REVIVED-BCIS2 trial aimed to establish whether revascularization with PCI in addition to OMT would improve event free survival in patients with ischemic left ventricular dysfunction, when compared to OMT alone (2).  Inclusion criteria included a left ventricular ejection fraction of ≤35%, extensive coronary artery disease (British Cardiovascular Intervention Society jeopardy score ≥6, indicating significant stenoses in the left main coronary artery, proximal left anterior descending coronary artery, dominant circumflex artery, disease in multiple vessels or a combination of these) and viability in at least four dysfunctional myocardial segments which were amenable to PCI.  The main exclusion criteria were acute myocardial infarction within 4 weeks of randomisation, angina which limited the patient’s quality of life or decompensated heart failure or sustained ventricular arrhythmia within 72 hours. The primary composite outcome was all-cause death or hospitalization for heart failure; minimum follow up was 24 months.  Key secondary outcomes included the change in left ventricular ejection fraction from baseline to follow-up at six and twelve months, myocardial infarction, unplanned revascularization and quality of life assessed with the Kansas City Cardiomyopathy Questionnaire and EQ-5D-5L.

04 Aug

Posted at 18:26h in Author Interviews, Genetic Research, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_59392" align="alignleft" width="133"]Dr. Christine Seidman Dr. Seidman[/caption] Christine Seidman, MD Thomas W. Smith Professor of Medicine and Genetics Director, CV Genetics Center Brigham and Women’s Hospital Harvard Medical School Dept of Genetics Boston, MA 02115  MedicalResearch.com:  What is the background for this study?    Response: Heart failure is a common and incurable disorder that is known to arise from many different underlying causes.  By exploiting a new technology, single nuclear transcriptional analyses, we aimed to define molecular profiles in human hearts tissues that were obtained from patients with different genetic and non-genetic causes of heart failure. Our goal was to determine if there were distinctive signatures that could provide new opportunities to develop precise treatments, based on the specific cause of heart failure.

20 Jul

Posted at 15:18h in Author Interviews, Heart Disease, Salt-Sodium
MedicalResearch.com Interview with Weihao Liang on behalf of Professor Chen Liu Department of Cardiology, Sun Yat-sen University First Affiliated Hospital Guangzhou, Guangdong, China MedicalResearch.com:  What is the background for this study?    Response: -Salt intake restriction is frequently recommended in heart failure guidelines, but is restricting salt intake to "as least as possible" appropriate? Evidence is lacking. Besides, the effect of salt restriction on patients with heart failure with preserved ejection fraction isn’t clear as they have often been excluded from relevant studies.

19 Apr

Posted at 11:02h in Author Interviews, Brigham & Women's - Harvard, Fertility, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_59055" align="alignleft" width="200"]Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital Dr. Lau[/caption] Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Emerging data suggest that a woman’s reproductive history influences her future risk of heart disease. Infertility is a reproductive risk factor that affects ~14% of women but has not been rigorously studied with respect to its relationship with cardiovascular disease risk. We studied over 38,000 women enrolled in the Women’s Health Initiative and found that infertility was associated with greater risk of heart failure. In particular, we found that the association was driven by greater risk of heart failure with preserved ejection fraction, a form of heart failure that is far more common among women.

06 Apr

Posted at 21:31h in Author Interviews, Gender Differences, Heart Disease, JACC, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58987" align="alignleft" width="200"]Left: Mario Gaudino, MD PhD; Right: Antonino Di Franco, MD Left: Mario Gaudino, MD PhD; Right: Antonino Di Franco, MD[/caption] Mario F.L. Gaudino, M.D. PhD Attending Cardiac SurgeonDepartment of Cardiothoracic Surgery Antonino Di Franco, MD Adjunct Clinical Assistant Professor of Cardiothoracic Surgery Weill Cornell Medicine   MedicalResearch.com:  What is the background for this study?  What is the aim of this review?  Response: Biological and socio-cultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the two sexes. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low, and sex-specific management strategies are generally not provided in guidelines. We summarized the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery.

03 Mar

Posted at 00:05h in Author Interviews, Biomarkers, Heart Disease, NEJM
MedicalResearch.com Interview with: [caption id="attachment_58828" align="alignleft" width="150"]Dr. PJ.Devereaux Dr. PJ.Devereaux[/caption] PJ Devereaux MD PhD Professor of Medicine, and of Health Research Methods, Evidence and Impact McMaster University President of the Society of Perioperative Research and Care  MedicalResearch.com:  What is the background for this study?  Response: More than 1 million patients undergo cardiac surgery in the United States and Europe annually. Although cardiac surgery has the potential to improve and prolong a patient’s quality and duration of life, it is associated with complications. Prognostically important heart injury – detected by an elevated blood concentration of either cardiac troponin or creatine kinase myocardial MB isoform (CK-MB) – is one of the most common complications after cardiac surgery and is associated with increased mortality. Although elevated CK-MB was historically used to define heart injury after cardiac surgery, this assay is no longer available in many hospitals worldwide, and consensus statements have recommended high-sensitivity cardiac troponin assays as the preferred biomarker. Based on expert opinion, the Fourth Universal Definition of Myocardial Infarction suggested that a cardiac troponin concentration >10 times the upper reference limit, in patients with a normal baseline measurement, should be the threshold used in the diagnosis of heart attack along with evidence of ischemia (e.g., ischemic ST changes on an ECG) in the first 48 hours after coronary artery bypass grafting (CABG). Although the Academic Research Consortium-2 Consensus stated there was no evidence-based threshold for cardiac troponin after CABG, they endorsed a threshold for the diagnosis of heart attack of ≥35 times the upper reference limit together with new evidence of ischemia, based on expert opinion. They also defined a threshold of ≥70 times the upper reference limit as a stand-alone criterion for clinically important periprocedural myocardial injury. Globally, many hospitals now use high-sensitivity cardiac troponin assays; however, limited data are available to define a prognostically important degree of myocardial injury after cardiac surgery based on these assays. We undertook the Vascular Events in Surgery Patients Cohort Evaluation (VISION) Cardiac Surgery Study to examine clinical outcomes after cardiac surgery. A primary objective was to determine the relationship between postoperative levels of high-sensitivity cardiac troponin I and the risk of death 30 days after cardiac surgery. 

05 Aug

Posted at 16:59h in Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_57864" align="alignleft" width="200"]Fernando Ribeiro Dr. Ribeiro[/caption] Fernando Ribeiro PhD School of Health Sciences Institute of Biomedicine - iBiMED University of Aveiro Aveiro, Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Resistant hypertension is a puzzling problem without a clear solution. The available treatment options to lower blood pressure, namely medication and renal denervation, have had limited success, making nonpharmacological strategies good candidates to optimize the treatment of this condition. Exercise training is consistently recommended as adjuvant therapy for patients with hypertension, yet, it is with a great delay that the efficacy of exercise training is being tested in patients with resistant hypertension. Having that in mind, the EnRicH trial was designed to address whether the benefits of an exercise intervention with proven results in hypertensive individuals are extended to patients with resistant hypertension, a clinical population with low responsiveness to drug therapy. Exercise training was safe and associated with a significant and clinically relevant reduction in 24-hour, daytime ambulatory, and office blood pressure compared with control (usual care).

05 Feb

Posted at 11:26h in Author Interviews, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_56573" align="alignleft" width="143"]Sumeet S. Chugh MD Price Professor and Associate Director, Smidt Heart Institute Medical Director, Heart Rhythm Center Director, Center for Cardiac Arrest Prevention Director, Division of Artificial Intelligence in Medicine, Dept of Medicine Cedars-Sinai, Los Angeles Dr. Chugh[/caption] Sumeet S. Chugh MD Price Professor and Associate Director, Smidt Heart Institute Medical Director, Heart Rhythm Center Director, Center for Cardiac Arrest Prevention Director, Division of Artificial Intelligence in Medicine, Dept of Medicine Cedars-Sinai, Los Angeles MedicalResearch.com: What is the background for this study? Response: For a variety of reasons, sudden cardiac arrest during nighttime hours is the most perplexing and challenging form of this problem and needs to be investigated in detail. Patients are in a resting state, with decreased metabolism, heart rate, blood pressure, and in the absence of daytime triggers, presumably at the lowest likelihood of dying suddenly. The event can often go unrecognized, even by others sleeping in close proximity. Finally, survival from cardiac arrest at night is significantly lower compared to the daytime. There are no community-based studies out there. Small studies of rare heart disease conditions report that men are more likely to suffer this affliction but the reality is that there were not enough women in those studies to do justice to sex-specific analyses.

14 Jan

Posted at 17:21h in Author Interviews, Cost of Health Care, CT Scanning, Heart Disease, JACC, Statins
MedicalResearch.com Interview with: Prasanna Venkataraman MBBS Thomas H. Marwick MBBS, PhD Baker Heart and Diabetes Research Institute Monash University, Melbourne Melbourne, Australia   MedicalResearch.com: What is the background for this study?
  • Coronary artery calcium score (CAC) quantifies coronary calcium as determined by computed tomography and is a good surrogate marker for overall coronary plaque burden. It can help to reclassify patients at intermediate risk – many of whom are actually at low risk and can be reassured. Conversely, the finding of coronary calcium can also motivate patients (and their clinicians) to more aggressively control their cardiovascular risk factors. This is particularly problematic in those with a family history of premature coronary artery disease, where standard risk prediction tools are less accurate. However, CT CAC does not routinely attract third party payer support limiting its access and utilisation.
  • We screened 1084 participants who have a family history of premature coronary disease and a 10-year Pooled cohort Equation (PCE) cardiovascular risk >2% with CAC. We then assessed the cost-effectiveness of commencing statins in those with any coronary calcium compared to a strategy of no CAC testing and commencing statins if their PCE risk was ≥7.5% consistent with current guidelines. 

30 Nov

Posted at 15:08h in AHA Journals, Author Interviews, Heart Disease, Women's Heart Health
MedicalResearch.com Interview with: [caption id="attachment_56073" align="alignleft" width="200"]Justin A. Ezekowitz, MBBCh, MSc Professor, Department of Medicine Co-Director, Canadian VIGOUR Centre Director, Cardiovascular Research, University of Alberta Cardiologist, Mazankowski Alberta Heart Institute Dr. Ezekowitz[/caption] Justin A. Ezekowitz, MBBCh, MSc Professor, Department of Medicine Co-Director, Canadian VIGOUR Centre Director, Cardiovascular Research, University of Alberta Cardiologist, Mazankowski Alberta Heart Institute MedicalResearch.com: What is the background for this study? What are the main findings? Are women older, sicker when they experience heart disease? Response: Previous research looking at sex-differences in heart health has often focused on recurrent heart attack or death, however, the vulnerability to heart failure between men and women after heart attack remains unclear. Our study includes all patients from an entire health system of over 4 million people and includes information not usually available in other analyses. Women were nearly a decade older and more often had a greater number of other medical conditions when they presented to hospital for their first heart attack, and were at greater risk for heart failure after the more severe type of heart attack (also known as a ST-elevation MI). This gap between men and women has started to narrow over time.

17 Nov

Posted at 23:45h in AHA Journals, Author Interviews, Heart Disease, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_55974" align="alignleft" width="125"]Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine Dr. Saberi[/caption] Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by HCM? How common is it and whom does it affect? Response: HCM is short for hypertrophic cardiomyopathy, the most common genetic myocardial disorder. It occurs in 1:500 people worldwide and because it is inherited in an autosomal dominant fashion, it affects men and women equally. HCM is characterized by unexplained left ventricular (LV) hypertrophy, hypercontractility, myofibrillar disarray and myocardial fibrosis with associated abnormalities in LV compliance and diastolic function. In some patients, there is progressive adverse cardiac remodeling, associated with chronic heart failure and atrial fibrillation as a result of diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction, or less commonly, LV systolic dysfunction. Current medical management of obstructive HCM (oHCM) is limited to the use of beta blockers and non-dihydropyridine calcium channel blockers, or disopyramide, none of which have been shown to modify disease expression or outcomes after onset. Mavacamten is a first-in-class, small molecule, selective inhibitor of cardiac myosin specifically developed to target the underlying pathophysiology of HCM by reducing actin–myosin cross-bridge formation. The phase 3 EXPLORER-HCM trial showed that mavacamten improved exercise capacity, LVOT gradients, symptoms, and health status compared with placebo in patients with symptomatic oHCM. At selected study sites, participants were enrolled in a cardiac magnetic resonance (CMR) imaging substudy. CMR is the gold standard for measurement of ventricular mass, volumes and noninvasive tissue characterization, making it an ideal imaging modality to assess the effect of mavacamten on cardiac structure and function in patients with HCM.

17 Nov

Posted at 11:38h in Author Interviews, COVID -19 Coronavirus, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_55944" align="alignleft" width="200"]Benjamin D. Horne, PhD Cardiovascular and Genetic Epidemiologist Intermoumtain Health Dr. Horne[/caption] Benjamin D. Horne, PhD Cardiovascular and Genetic Epidemiologist Intermoumtain Health MedicalResearch.com: What is the background for this study? Response: The Intermountain Mortality Risk Score (IMRS) is a risk prediction tool developed in 2009 and repeatedly validated over the last decade to predict death, major adverse health events such as heart attack and stroke, and the onset of major chronic diseases. IMRS is computed using sex-specific weightings of parameters from the complete blood count (CBC) and basic metabolic profile (BMP), and age. The CBC and BMP are commonly-ordered clinical laboratory panels that include hemoglobin, white blood cell count, glucose, creatinine, sodium, calcium, and other factors whose testing is standardized and the results are objective and quantitative with no need to know what diagnoses a patient may have. IMRS is known to be a superior predictor of death compared to comorbidity-based risk scores and has been found to predict health outcomes in people with no chronic disease diagnoses as well as patients with coronary heart disease, atrial fibrillation, heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and various other diagnoses. IMRS has not been evaluated as a predictor of health outcomes for people with COVID-19, but if it does it could be useful for people to use to evaluate their own risk of poor outcomes if they are infected with SARS-CoV-2, for clinical personnel to guide the care of patients with COVID-19, and for public health professionals to use to determine who among those never diagnosed with COVID-19 is at higher risk of poor health outcomes and should be the first to receive a COVID-19 immunization. 

05 Nov

Posted at 12:51h in AHA Journals, Author Interviews, Blood Pressure - Hypertension, Circadian Rhythm
MedicalResearch.com Interview with: Kazuomi Kario, MD, PhD, FACP, FACC, FAHA, FESC, FJCS Professor, Chairman Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine (JMU) JMU Center of Excellence, Cardiovascular Research and Development (JCARD) Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network Shimotsuke, Tochigi, 329-0498, JAPAN MedicalResearch.com: What is the background for this study? Response: To date, it remains unclear whether disrupted blood pressure (BP) circadian rhythm is associated with adverse outcomes independent of nighttime BP. The JAMP study includes 6359 outpatient population who had ambulatory BP monitoring to evaluate the association between both nocturnal hypertension and nighttime BP dipping patterns and the occurrence of cardiovascular events in patients with hypertension.

30 Oct

Posted at 18:30h in AHA Journals, Author Interviews, Heart Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_55798" align="alignleft" width="160"]Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology Dr. Drakos[/caption] Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology MedicalResearch.com: What is the background for this study? Response: Heart transplantation and LVADs are first line therapies for advanced chronic heart failure. There were some earlier anecdotal observations and single center small studies from several programs in the US and overseas that left ventricular assist devices (LVADs) significantly reduce the strain on failing hearts and in some cases, using LVADs for limited periods of time has allowed hearts to “rest” and remodel their damaged structures. As a result of these repairs, described as “reverse remodeling,” heart function can improve to the point that the LVAD can be removed. The new study sought to broaden the reach of the research with a multicenter trial involving physicians and scientists at the University of Utah Health, the University of Louisville, University of Pennsylvania, the Albert Einstein College of Medicine/Montefiore Medical Center, the Cleveland Clinic, and the University of Nebraska Medical Center.