Author Interviews, BMJ, Brigham & Women's - Harvard, Heart Disease, Nutrition / 25.11.2016

MedicalResearch.com Interview with: Dr. Qi Sun Sc.D, M.D., M.M.S. Assistant Professor in the Department of Nutrition Harvard T.H. Chan School of Public Heath Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: Interpretation of existing human study data regarding saturated fat intake in relation to heart disease risk is quite confusing and distorted in certain publications. It is a fact that, depending on data analysis strategies, the effects of saturated fats may depend on which macronutrients they replace. For example, substituting saturated fats for refined carbohydrates will not lead to an elevated risk of heart disease because both nutrients are harmful whereas replacing saturated fats with good polyunsaturated fats results in risk reduction. In our current analysis, we clearly demonstrated that when total saturated fatty acids were replaced by polyunsaturated fatty acids, monounsaturated fatty acids, whole grain carbohydrates, and plant-based proteins, the diabetes risk would decrease. Furthermore, we showed that major individual saturated fatty acids were all associated with an elevated heart disease risk. (more…)
Author Interviews, Heart Disease, JAMA / 22.11.2016

MedicalResearch.com Interview with: Vinay Kini, MD, MS Division of Cardiovascular Medicine Hospital of the University of Pennsylvania The Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent studies have shown that use of cardiac stress tests has declined by about 25% among Medicare beneficiaries and by about 50% in Kaiser Permanente over the last several years. However, the reasons for these declines is not well understood. Decreases in the use of stress testing could be due to dissemination of appropriate use criteria and other clinical practice guidelines, advances in preventive care, reductions in reimbursement for testing, or other health system organizational characteristics. Therefore, our goal was to determine whether similar declines in testing are observed among a nationally representative cohort of commercially insured patients. We identified over 2 million stress tests performed among 33 million members of the commercial insurance company, and found that there was a 3% increase in the overall use of stress testing in this cohort between 2005 and 2012. Declines in the use of nuclear SPECT tests were offset by increases in the use of stress echocardiography, exercise electrocardiography, and newer stress test modalities such as coronary computed tomography angiography. The largest increase in use of testing was seen among younger individuals - there was a 60% increase in use of testing among patients aged 25-34, and a 30% increase among individuals aged 35-44. (more…)
Author Interviews, Gender Differences, Heart Disease, Surgical Research / 21.11.2016

MedicalResearch.com Interview with: Dr James Spratt Bsc, MD, FRCP, FESC, FACC Spire Edinburgh Hospitals and Spire Murrayfield Edinburgh Spire Shawfair Park Hospital MedicalResearch.com: What is the background for this study? Response: Gender differences exist between male and female patients following routine PCI but data regarding these differences in Chronic Total Occlusions (CTO) Percutaneous Coronary Intervention (PCI) is limited. We maintain a dedicated national (United Kingdom) prospective CTO database contributed to by dedicated CTO PCI operators (lifetime CTO PCI >300). We retrospectively analysed this database from 2011-2015 to compare outcomes and characteristics of male versus female patients undergoing CTO PCI. We attempted to limit the bias of this observational study by propensity matched analysis. (more…)
Author Interviews, Heart Disease, Menopause, Weight Research, Women's Heart Health / 20.11.2016

MedicalResearch.com Interview with: Somwail Rasla, MD Internal Medicine Resident Memorial Hospital of Rhode Island Brown University MedicalResearch.com: What is the background for this study? Response: Weight cycling has been studied as a possible risk factors for all-cause mortality and was found to be insignificant in some studies and significant in other studies when adjusted to age and timing of when the weight cycling occurred. It was proposed that weight cycling may increase risk of chronic inflammation by which weight cycling was considered to be a risk factor for increased morbidity and all cause mortalities. Other studies have reported that frequent weight cycling was associated with shorter telomere length, which is a risk factor for several comorbidities including CHD. Earlier studies showed that weight cycling has an association with increase in size of adipocytes as well as fluctuation of serum cholesterol, triglycerides, glucose, insulin, and glucagon which may contribute to the increased incidence of diabetes. Alternatively, in the nurses’ health study , weight cycling was not predictive of cardiovascular or total mortality. (more…)
Author Interviews, CT Scanning, Heart Disease, JAMA, Women's Heart Health / 16.11.2016

MedicalResearch.com Interview with: Maryam Kavousi MD, PhD, FESC Assistant Professor Department of Epidemiology Erasmus University Medical Center Rotterdam The Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The most recent American College of Cardiology/American Heart Association (ACC/AHA) cardiovascular disease (CVD) prevention guidelines recommend statins for a larger proportion of populations. Notably, a large group of women are categorized as low CVD risk by the guidelines and would therefore not typically qualify for intensive management of their standard risk factors. Coronary artery calcium (CAC) scanning allows for the detection of subclinical coronary atherosclerosis and is viewed as the vessel’s memory of lifetime exposure to risk factors. We therefore aimed to address the utility of CAC as a potential tool for refining CVD risk assessment in asymptomatic women at low CVD risk based on the new guidelines. This study involved data on 6,739 low-risk women from 5 population-based cohort studies across the United States and Europe. We found that CAC was present in 36% of low-risk women and was associated with increased risk of CVD. (more…)
Author Interviews, Heart Disease / 16.11.2016

MedicalResearch.com Interview with: Dragana Radovanovic, MD Head of AMIS Plus Data Center Epidemiology, Biostatistics and Prevention Institute (EBPI) University of Zurich Zurich Switzerland MedicalResearch.com: What is the background for this study? Response: Although patients presenting with new or presumed new left bundle branch block (LBBB) represent a minority of the patients admitted with suspected acute myocardial infarction (AMI), they remain a challenging and unresolved diagnostic and therapeutic dilemma in routine clinical practice. Large trials such as PLATO or SHOCK have evaluated AMI therapy and considered ST-elevation MI (STEMI) and new LBBB as a single diagnostic group. Currently, European and American guidelines differ. European guidelines recommend that reperfusion therapy should be considered promptly, preferably using emergency coronary angiography with a view to primary PCI in patients with clinical suspicion of ongoing myocardial ischemia and new or presumed new LBBB. However, the ACCF/AHA guidelines are much less enthusiastic and recommend that patients with new or presumed new LBBB should not be considered as diagnostic of AMI in isolation and consequently provide little guidance on how to react if biomarkers are elevated. Routine clinical practice documentation of prior ECGs, which would confirm whether the LBBB was new or not, is often missing increasing the uncertainty on how to treat these patients. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Education, Heart Disease, Outcomes & Safety / 15.11.2016

MedicalResearch.com Interview with: Dr. Sean van Diepen, MD, FRCPC Assistant Professor of Critical Care Medicine and Cardiology Coronary Intensive Care Unit Co-Director University of Alberta Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have documented a wide variation in CCU admission rates for patients hospitalized with acute coronary syndromes (ACS) or heart failure (HF). The reasons underpinning these differences are incompletely understood and little is known about the associations between hospital type, resource utilization, and clinical outcomes among patients admitted to the CCU with an ACS or HF. In a national cohort of 220,759 patients, we observed that CCU admission rates varied by hospital type: 41% in teaching hospitals, 29.9% in large teaching hospitals, 42.6% in medium community hospitals and13.7% in small community hospitals. The percentage of patients that did not receive critical care therapies within the first 2 days of admission were: 35.5%, 58.0%, 83.3% and 95.6%, respectively. Compared large community hospitals, community hospitals all had higher adjusted in hospital mortality rates. (more…)
Author Interviews, Heart Disease, JACC, Surgical Research / 15.11.2016

MedicalResearch.com Interview with: Opeyemi O. Fadahunsi, MBBS, MPH Department of Medicine Reading Health System West Reading, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcatheter aortic valve replacement (TAVR) is a minimally invasive approach to managing symptomatic severe aortic stenosis in patients who have a high surgical risk or are deemed to be inoperable. One of the most frequent complications is development of conduction abnormalities requiring permanent pacemaker placement. We compared clinical outcomes in patients requiring permanent pacemaker placement post-TAVR to those not requiring a pacemaker using a large US database called the STS/ACC TVT RegistryTM . We used real-world data of patients undergoing TAVR in the US at 229 sites between November 2011 and September 2014. The frequency of pacemaker placement within 30 days post-TAVR was 6.7% (651 of 9,785 patients). Those who needed a pacemaker within 30 days post-TAVR had longer hospital and intensive care unit stays compared to those who did not. Furthermore, those who needed a pacemaker had a higher risk of death from any cause at one year compared to those who did not get a pacemaker. (more…)
Author Interviews, Cannabis, Gender Differences, Heart Disease / 14.11.2016

MedicalResearch.com Interview with: Amitoj Singh MD Chief Cardiology Fellow St. Luke’s University Health Bethlehem, Pennsylvania MedicalResearch.com: What is the background for this study? Response: Marijuana use in steadily increasing and it is the most commonly used illicit drug in the US and worldwide. There has been a recent increase in reports of heart and vascular complications associated with its use. These include Myocardial infarctions, stroke and takotsubo. We had two questions that we wanted to answer with our study: a) Is there an association between marijuana use and development of Transient Regional Ventricular Ballooning [TVRB] (aka Stress Cardiomyopathy /Broken Heart Syndrome/ Takotsubo)? b) If the above is true, what are the differences between Marijuana users (MU) and Non Marijuana Users (NMU) who developed Stress Cardiomyopathy. (more…)
Author Interviews, Heart Disease, Pediatrics, University of Pennsylvania / 14.11.2016

MedicalResearch.com Interview with: Maryam Y. Naim, MD Pediatric Cardiac Intensive Care Physician The Cardiac Center The Children’s Hospital of Philadelphia Perelman School of Medicine The University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study?  Response: In adults bystander compression only CPR has similar outcomes to bystander conventional COR therefore the The American Heart Association recommends untrained lay rescuers perform compression only CPR in adults that have an out of hospital cardiac arrest. In children respiratory arrests are more common therefore conventional CPR with chest compressions and rescue breaths are recommended for out of hospital cardiac arrest. (more…)
Author Interviews, Heart Disease, Surgical Research / 30.10.2016

MedicalResearch.com Interview with: Prof. Lars Wallentin MD Department of Medical Sciences, Cardiology Uppsala Clinical Research Center Uppsala University, Uppsala, Sweden MedicalResearch.com: What is the background for this study? Response: The FRISC2 study was performed 1996 – 1998 and reported 1999 for the first time a significant reduction in death and myocardial infarction by early invasive compared to non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). These pivotal results have been the basis for the current international treatment guidelines recommending an early invasive treatment strategy in patients with NSTE-ACS and elevated troponin and/or other indicators of a raised risk. Still there are remaining controversies concerning the long-term effects, the appropriate selection of patients for this approach and the opportunities for a more personalised approach to early invasive procedures. (more…)
Author Interviews, Heart Disease, JACC, Medical Imaging / 29.10.2016

MedicalResearch.com Interview with: Kristina H. Haugaa, MD, PhD, FESC Ida Skrinde Leren MD, PhD Department of Cardiology and Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet Oslo, Norway MedicalResearch.com: What is the background for this study? Response: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inheritable cardiomyopathy, predisposing to life-threatening arrhythmias. Ventricular arrhythmias are frequent in ARVC patients and importantly, arrhythmias may occur also before evident structural changes are seen, making risk stratification challenging. Additional tools are needed to detect early disease and to optimize medication and timing of implantation of a cardioverter defibrillator (ICD). We aimed to explore early markers of ARVC disease and their association with previous ventricular arrhythmias. (more…)
Author Interviews, Heart Disease, JACC, Surgical Research / 28.10.2016

MedicalResearch.com Interview with: Anna Franzone, MD and Prof.Thomas Pilgrim, MD Department of Cardiology Bern University Hospital INSELSPITAL Bern, Switzerland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Surgical aortic valve replacement is the therapeutic standard for patients with pure native aortic regurgitation (AR). However, transcatheter aortic valve implantation (TAVI) is emerging as a novel treatment option for patients deemed inoperable or at high-risk for surgery because of advanced age and multiple comorbidities. We performed a systematic review and meta-analysis including 237 patients with pure native AR undergoing TAVI across 13 studies. The primary study endpoint, all-cause mortality at 30-day, ranged from 0% up to 30% with a summary estimate rate of 7% . The occurrence of complications such as the need for a second valve implantation was relatively low as well as the rates of other endpoints (cerebrovascular events, major bleeding and vascular complications). (more…)
Author Interviews, Chocolate, Heart Disease, Nutrition / 27.10.2016

MedicalResearch.com Interview with: Xiaochen Lin, PhD Student and Simin Liu MD ScD MPH Professor of Epidemiology and Medicine Department of Epidemiology and Center for Global Cardiometabolic Health Brown University Providence, RI MedicalResearch.com: What is the background for this study? What are the main findings? Response: There have been quite a few studies implicating cocoa as a beneficial nutritional strategy to improve cardiometabolic health, and we and others have done work indicating that cocoa flavanol may be the active compound responsible for the beneficial effects. Therefore, we conducted this systematic review and meta-analysis of randomized trials that we could identify in studying cocoa flavanol and a variety of circulating cardio-metabolic biomarkers. The meta-analysis of 19 RCTs, involving 1,139 participants, shows that flavanol intake from cocoa products may reduce dyslipidemia, insulin resistance and systemic inflammation, and therefore improve cardiometabolic health. Through this research, we also identify the additional gaps in the current knowledge and potential target for future investigations. (more…)
Author Interviews, BMJ, CT Scanning, Heart Disease / 27.10.2016

MedicalResearch.com Interview with: Professor Marc Dewey Heisenberg professor of radiology Vice Chairman of the Department of Radiology at Charité (Campus Mitte) Berlin Germany  MedicalResearch.com: What is the background for this study? Response: Over 3.5 million cardiac catheterisations are performed in Europe each year. This study, jointly conducted by radiologists and cardiologists at Charité – Universitätsmedizin Berlin and published in today’s issue of The BMJ, compares computed tomography (CT) with cardiac catheterisation in patients with atypical chest pain and suspected coronary artery disease (CAD). MedicalResearch.com: What are the main findings? Response: CT reduced the need for cardiac catheterisation from 100% to 14% in the group of patients who received CT first instead of catheterisation. If catheterisation was needed in the CT group, the proportion of catheterisations showing obstructive CAD was 5 times higher than in the catheterisation group. Over a period of 3.3 years, the patients in the CT group neither had more cardiac catheterisations nor an increase in cardiovascular events. Moreover, CT shortened the length of stay by 23 hours and 79% of patients said they would prefer CT for future examinations of the heart. Overall, the results of the BMJ study show that CT is a gentle test for reliably ruling out CAD in patients with atypical chest pain who are currently being referred for cardiac catheterisation in routine clinical practice. (more…)
AHA Journals, Author Interviews, Heart Disease / 20.10.2016

MedicalResearch.com Interview with: Joseph A. Ladapo, MD, PhD Division of General Internal Medicine and Health Services Research David Geffen School of Medicine UCLA Los Angeles, CA 90024 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Four million adults in the U.S. undergo stress testing or coronary computed tomographic angiography (CTA) each year because of suspected coronary disease. These patients are high risk for adverse cardiovascular events, but they are often not treated with the right medications after testing. Little is known about how CTA or stress testing affect physician and patient decisions about cardiovascular medications and preventive lifestyle choices like exercise and weight loss. Using data from patients in the PROMISE trial (PROspective Multicenter Imaging Study for Evaluation of chest pain), we found that patients who underwent CTA for suspected coronary artery disease were more likely to start a statin and aspirin and more likely to eat better and lose weight. (more…)
AHA Journals, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Clots - Coagulation, Heart Disease / 18.10.2016

MedicalResearch.com Interview with: Eric A. Secemsky, MD MSc Interventional Cardiology Fellow Massachusetts General Hospital Harvard Medical School Fellow, Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Use of oral anticoagulant (OAC) therapy prior to coronary stenting is a significant predictor of post-procedural bleeding events. Previous studies have estimated that the frequency of chronic OAC use among patients undergoing percutaneous coronary intervention (PCI) is between 3% to 7%. Yet many of these analyses examined select patient populations, such as those admitted with acute myocardial infarction or atrial fibrillation, and preceded the market approval of non-vitamin K antagonist oral anticoagulants (NOACs). As such, the contemporary prevalence of OAC use among all-comers undergoing PCI, as well as associated risks of adverse events, are currently unknown. Therefore, we used PCI data from a large, integrated healthcare system to determine current use of  oral anticoagulant use among all-comers undergoing coronary stenting and the related short- and long-term risks of therapy. (more…)
Author Interviews, Coffee, Heart Disease, JAMA / 17.10.2016

MedicalResearch.com Interview with: Luis E. Rohde, MD, ScD Postgraduate Program in Health Science: Cardiology and Cardiovascular Sciences, Medical School, Federal University of Rio Grande do Sul, Cardiovascular Division, Hospital de Clínicas de Porto Alegre MedicalResearch.com: What is the background for this study? Response: Caffeine-rich beverages have been implicated as a common cause of several cardiac-related symptoms, such as palpitations, tachycardia, or irregular heartbeats. Because of this “intuitive” assumption, counseling to reduce or avoid caffeine consumption is still widely recommended in clinical practice by most physicians for patients with any heart disease. (more…)
Author Interviews, BMJ, Heart Disease, Technology / 15.10.2016

MedicalResearch.com Interview with: Dr. Ngai-yin Chan Princess Margaret Hospital Lai Chi Kok, Hong Kong MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is the most common sustained heart rhythm disorder which can cause stroke, heart failure and an increased risk of death. The risk of stroke can be reduced substantially with drug treatment. However, a quarter of patients with AF causing stroke have silent and asymptomatic AF before stroke. The current guidelines recommend opportunistic screening for AF. Whether systematic community screening for AF with a convenient smartphone ECG can reduce the burden of AF remains unknown. (more…)
Author Interviews, Heart Disease, OBGYNE, Pediatrics / 14.10.2016

MedicalResearch.com Interview with: Prof. Chung-Yi Li Department of Public Health College of Medicine National Cheng Kung University Tainan Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Congenital heart disease is the leading congenital malformation that causes perinatal and infant deaths. However, little information is available about the risk factors, especially modifiable environmental and behavioral factors that may have posed adverse effects on fetal cardiac development. We conducted a nationwide population-based study in Taiwan to further evaluate the potential role of maternal chronic diseases in the risk of developing congenital heart disease in offspring. We found that children of women with several kinds of chronic disease were at elevated risk for congenital heart disease; these diseases included type 1 and type 2 diabetes, hypertension, congenital heart defects, anemia, connective tissue disorders, epilepsy, and mood disorders. (more…)
Author Interviews, Breast Cancer, Heart Disease, JAMA / 12.10.2016

MedicalResearch.com Interview with: Husam Abdel-Qadir, MD, FRCPC, DABIM (Cardiology and Internal Medicine) Graduate student, Clinical Epidemiology and Health Care Research Elliot Philipson Clinician Scientist Training Program University of Toronto MedicalResearch.com: What is the background for this study? Response: Breast cancer is the most common malignancy among North American women. The successes of screening and treatment have led to a marked increase in the number of breast cancer survivors, whose cardiovascular health is becoming of prime concern. Many recent publications have raised alarm about the incidence of cardiovascular abnormalities after breast cancer treatment. However, there is a paucity of data about the frequency of death from cardiovascular disease rather than breast cancer. Contemporary estimates of the incidence of competing risks like cardiovascular disease are important to guide discussions about prognosis, subsequent follow-up, and survivorship plans. It is important that such incidence estimates are generated using methodology that appropriately accounts for competing risks to avoid providing results that are biased upwards. (more…)
AHA Journals, Author Interviews, Heart Disease, Pharmacology / 06.10.2016

MedicalResearch.com Interview with: Xiaoxi Yao, PhD, MPH, MS Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation (AF) is the most common arrhythmia requiring treatment, affecting 3-6 million Americans. AF is associated with a 5 fold risk of stroke, which can be substantially reduced by oral anticoagulants. For over a half century, warfarin was the only option for long-term oral anticoagulation in the U.S., but the use of warfarin can be cumbersome. Warfarin has numerous interactions with food and other drugs, and requires regular lab testing and dose adjustment. Since 2010, four non–vitamin K antagonist oral anticoagulants (NOACs) have been approved by the FDA. In comparison to warfarin, the fixed-dosage NOACs provide more convenient therapeutic options and demonstrated at least equivalent efficacy and safety in large phase III clinical trials. However, the outcomes achieved in idealized clinical trial settings may not necessarily translate to routine clinical practice. In this large cohort of patients with nonvalvular AF, we assessed the real-world effectiveness and safety of three NOACs (dabigatran, rivaroxaban, and apixaban), comparing each agent with warfarin. We found apixaban was associated with lower risks of both stroke and major bleeding, dabigatran was associated with similar risk of stroke but lower risk of major bleeding, and rivaroxaban was associated with similar risks of both stroke and major bleeding in comparison to warfarin. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, JACC, Salt-Sodium / 06.10.2016

MedicalResearch.com Interview with: Nancy Cook ScD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School Public Health Brigham & Women’s Hospital Division of Preventive Medicine Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of sodium intake with later mortality has been controversial. While there is a well-accepted effect on blood pressure, the effects of sodium on later cardiovascular disease, and particularly mortality, have been subject to dispute. While the adverse effects of high sodium are now widely accepted, effects at lower levels of sodium intake are less clear. Some recent studies have found a J-shaped relationship, with increased disease rates among those consuming lower levels of sodium, contrary to the effects on blood pressure. In contrast, we found a direct linear relationship of usual intake of sodium with later mortality over 20 years of follow-up. Those with the lowest sodium intake experienced the lowest mortality. Our measure of intake was based on the average over 1-3 years of several measures of 24hr urine sodium excretion, the gold standard of sodium measurement. This is much more precise than measurements based on a single 24hr sodium excretion or especially on a spot urine sample, which is used in many publications that found the J-shaped curve. Our data were assessed in a healthy cohort of men and women without hypertension or cardiovascular disease, so had less potential bias due to these factors. We thus believe that our results showing the lowest mortality among those consuming the lowest levels of sodium are more accurate. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JACC, Pediatrics / 03.10.2016

MedicalResearch.com Interview with: Dr. James McKinney MD MSc FRCP(C) Division of Cardiology University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sudden cardiac death (SCD) is the leading medical cause of death in young athletes. Sporting activity may predispose athletes with underlying cardiovascular conditions to develop life threatening ventricular arrhythmias during physical exercise. Despite being a relatively rare event, the death of a young healthy person is a tragic event that is difficult to comprehend. The prevalence of an underlying cardiovascular disorder in young athletes that predisposes to SCD is approximately 0.3%. Sudden cardiac death is often the first clinical manifestation of an underlying cardiovascular condition; up to 80% of athletes are previously asymptomatic. Pre-participation screening is the systematic practice of medically evaluating athletes for the purpose of identifying (or raising suspicion of) abnormalities that could provoke sudden death. There is agreement amongst sporting and medical bodies that athletes should undergo some form of pre-participation screening. An Achilles’ heel of screening is the significant number of false-positive screens that require subsequent costly secondary testing to rule out disease. Prevention of sudden cardiac death among athletes is a common goal, however the optimal strategy for its achievement is uncertain. (more…)
Author Interviews, BMC, Heart Disease, Mediterranean Diet, Nutrition / 30.09.2016

MedicalResearch.com Interview with: Dr Nita Forouhi, MRCP, PhD, FFPHM Programme Leader MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Institute of Metabolic Science Cambridge Biomedical Campus MedicalResearch.com: What is the background for this study? What are the main findings? Response: The benefits of the Mediterranean diet for cardiovascular health are well documented in countries of the Mediterranean region and some other countries, but there is little such evidence in the UK general population. Our work fills this research gap. In our study we followed up 23,902 initially healthy Britons living in Norfolk (Eastern England) for an average of 12 to 17 years, and determined the occurrence of new cases of cardiovascular diseases (CVD) and deaths due to CVD during that time period. Our results showed that those adults who adhered to a Mediterranean diet had 6% to 16% lower risk of developing CVD, compared to those who had dietary habits further away from the Mediterranean-type diet pattern. This was the case even when we accounted for several important risk factors and correlates of CVD, including as age, sex, body mass index, lifestyle habits such as smoking, alcohol intake and physical activity, and socio-economic factors. We also modelled what would happen in the study population if all the participants increased their adherence to the Mediterranean-type diet. From this we estimated that nearly 4% of all new cardiovascular disease cases, or 12.5% of cardiovascular deaths in the population could potentially be avoided. This is novel information about the potential health benefit of a Mediterranean-type diet in a UK context. However, we should remember that our study was an observational study, not a clinical trial with a dietary intervention, and thus we cannot imply a cause and effect relationship between increasing adherence to the Mediterranean diet and reduction in cardiovascular disease. We defined the Mediterranean diet using a 15 point score based on guideline recommendations from a Mediterranean dietary pyramid published by the Mediterranean Diet Foundation. The recommendations had not previously been specifically tested for their associations with health, so our findings, for the first time, show the utility of the Mediterranean dietary pyramid. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 29.09.2016

MedicalResearch.com Interview with: Headshot portrait of Dr. Kim Harmon, family medicine, sports medicine.Kimberly G. Harmon, MD University of Washington Seattle, WA 98195. MedicalResearch.com: What is the background for this study? Response: Sudden cardiac death (SCD) in a young athlete is tragic devastating families and communities.  It has been characterized as “rare” by some, however, previous studies have looked at broad age ranges of athletes and used various methods to determine the incidence rate, sometimes only including athletes which have events during school sponsored events.  In addition, many studies only look at sudden cardiac death and do not include sudden cardiac arrest (SCA) where the athlete has a cardiac arrest but is resuscitated and survives. SCA is important to include as ideally we would like to prevent both SCA and SCD in athletes.  In this paper, over 1/3 of all US high school athletes were studied for six years to determine the incidence and the causes of SCA/D.   Media reports were used to identify cases and then autopsies were obtained in those who died. (more…)
Author Interviews, Heart Disease, Kidney Disease, Surgical Research / 25.09.2016

MedicalResearch.com Interview with: Pablo Codner, MD; Amos Levi, MD (firsts authors) and Prof. Ran Kornowski, MD, FACC, FESC (senior author) Rabin Medical Center Derech Ze`ev Israel. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe aortic stenosis (AS) who are deemed inoperable by the “heart team”, for those at high risk for surgery and also for patients at intermediate surgical risk. Currently this therapeutic alternative is being compared with surgical aortic valve replacement in patients at low risk for surgery. Patients with chronic kidney disease were excluded from most randomized trials. We evaluated outcomes within a large multicenter cohort of patients undergoing TAVR distinguished by renal function, from 11 high volume centers in 8 different countries across Europe and Asia. In our experience patients with renal dysfunction were associated with poor clinical outcomes. All-cause and cardiovascular mortality rates during the follow-up period increased with declining renal function. A glomerular filtration rate ≤30 mL/min was identified on multivariate analysis as an independent predictor for all-cause and cardiovascular mortality. We also found higher rates of severe bleeding and vascular complications among patient with advanced or end stage renal failure. (more…)
Author Interviews, Heart Disease, Technology / 23.09.2016

MedicalResearch.com Interview with: biotricityWaqaas Al-Siddiq, Founder and CEO of Biotricity MedicalResearch.com: Would you tell us a little about yourself? How did you get interested in combining healthcare with technology? Response: I am the president and CEO of biotricity which is a healthcare technology company dedicated to providing diagnostic and post-diagnostic solutions for both the physician and consumer for long-term chronic care management. I got interested in combining healthcare and technology while I was doing research for monitoring remote environments in critical scenarios. I thought that it would be very interesting to apply that to healthcare because it’s a problem that no one has figured out how to solve yet. And it’s a problem that is driving healthcare costs out of control. (more…)
Author Interviews, Genetic Research, Heart Disease, JACC / 20.09.2016

MedicalResearch.com Interview with: Prof. dr. P. van der Harst Interventional Cardiologist Scientific Director Cardiac Catheterization Laboratory University Medical Center Groningen Groningen The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The electrocardiogram harbors important clues for the development and progression of heart diseases. We studied the voltages of the QRS-complex, a measure of cardiac hypertrophy which is associated with heart failure and various cardiomyopathies. We carried out a genome-wide association study (GWAS) and identified 52 regions in the genome that were associated with one or more QRS characteristics. 32 of these were novel. In these 52 regions we found 67 candidate genes that are might play a role in the adequate function of the human heart and the development of heart disease. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JACC, Kidney Disease / 19.09.2016

MedicalResearch.com Interview with: Elvira Gosmanova MD Department of Nephrology University of Tennessee Health Science Center Memphis TN, 38163 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been long known that elevated blood pressure is a risk factor for numerous adverse health-related outcomes. However, the majority of individuals do not have blood pressure in a constant range. In contrary, blood pressure measured in the same individual tends to fluctuate over time. Moreover, some individuals have more blood pressure fluctuation, as compared with others. The impact of fluctuation in blood pressure is still poorly understood. Smaller studies suggested that increased fluctuation in blood pressure may be associated with hazardous health outcomes. However, large scale studies were still lacking. Therefore, we conducted a study involving close to 3 million US veterans to investigate the association of increased visit-to-visit variability of systolic blood pressure (which was our measure of fluctuation of blood pressure over time) and all-cause mortality, and incident coronary heart disease, stroke, and end-stage renal disease. We found that there was strong and graded increase in the risk of all the above outcomes with increasing visit-to-visit variability of systolic blood pressure. (more…)