Author Interviews, Exercise - Fitness, Heart Disease, JACC / 19.08.2016

MedicalResearch.com Interview with: Antonio Pelliccia, MD, FESC Chief of Cardiology Institute of Sport Medicine and Science Rome MedicalResearch.com: What is the background for this study? Response: The awareness of the relevant role of arrhythmogenic right ventricular cardiomyopathy (ARVC) as cause of athletic field events and the refined Task Force (TF) criteria for the diagnosis of the disease have prompted a large scientific interest and triggered a vast scientific literature on this issue. Indeed, the recent observations by Heidbuchel and La Gerche based on data from a selected group of ultra-endurance athletes, suggesting that strenuous, chronic endurance exercise may ultimately cause, per se, RV dysfunction have further stimulated the need to define the characteristics and limits of training-induced RV remodelling. At present, however, no studies have assessed the characteristic of physiologic right ventricular remodelling as derived from a large population of highly-trained athletes, including a sizeable number of women and comprising a broad spectrum of summer and winter Olympic sport disciplines. (more…)
Author Interviews, Cost of Health Care, Heart Disease / 19.08.2016

MedicalResearch.com Interview with: Leo F. Buckley, PharmD Virginia Commonwealth University Richmond, Virginia MedicalResearch.com: What is the background for this study? Response: As the prevalence and costs of heart failure are expected to increase through the year 2030, significant efforts have been devoted towards devising alternatives to inpatient hospitalization for the management of heart failure decompensations. Since loop diuretics are the mainstay of treatment during the majority of hospitalizations, administration of high doses of loop diuretics in the outpatient setting has increased in popularity. We intended to answer two questions with his study: first, can a patient-specific dosing protocol based on a patient’s usual diuretic dose achieve safe decongestion? and second, does this strategy alter the usual course of heart failure decompensation, which oftentimes culminates in inpatient hospitalization? (more…)
Author Interviews, Biomarkers, Heart Disease, Microbiome / 18.08.2016

MedicalResearch.com Interview with: Lemin Zheng, Ph.D. Professor, Lab Director, and Principal Investigator The Institute of Cardiovascular Sciences and Institute of Systems Biomedicine Peking University Health Science Center Beijing  China MedicalResearch.com: What is the background for this study? Response: Optical coherence tomography (OCT) has been considered as an ideal tool to characterize accurately atherosclerotic plaques and has potential to detect plaque rupture due to high-resolution (10-20 μm) cross-sectional images of tissue with near infrared light (1-3). Trimethylamine-N-oxide (TMAO) is a gut microbiota-dependent-generated metabolite which is associated with cardiovascular risk by a pathway involving dietary ingestion of nutrients containing trimethylamine, including phosphatidylcholine, choline, and L-carnitine (4-6). In the gut, choline, betaine and carnitine can be metabolized to trimethylamine (TMA) by gut flora microorganism. And TMA could be further oxidized to a proatherogenic species, TMAO, in the liver by flavin monooxygenases 3 (FMO3)4-6. These risk associations have been repeatedly shown in large observational trials (7-10). (more…)
Author Interviews, Cost of Health Care, Heart Disease / 17.08.2016

MedicalResearch.com Interview with: Leo F. Buckley, PharmD Virginia Commonwealth University Richmond, Virginia MedicalResearch.com: What is the background for this study? Response: Heart failure hospitalizations have become a significant burden for both patients and the healthcare systems. Significant efforts have been devoted to identifying alternative treatment pathways for acute decompensated heart failure that do not require hospitalization. Our group previously reported our initial experience with ambulatory intravenous diuretic therapy administered serially over several days to weeks in place of inpatient hospitalization. We found that the rate of hospitalization was significantly reduced compared to expected and that the high dose furosemide protocol utilized was safe and well tolerated by patients. (more…)
Author Interviews, Heart Disease, JACC / 16.08.2016

MedicalResearch.com Interview with: Timothy C. Y. Chan, PhD Canada Research Chair in Novel Optimization and Analytics in Health Associate Professor, Mechanical and Industrial Engineering Director, Centre for Healthcare Engineering Department of Mechanical & Industrial Engineering Faculty of Applied Science & Engineering | University of Toronto Toronto Ontario MedicalResearch.com: What is the background for this study? What are the main findings? Response: The immediate access to and use of an automated external defibrillator (AED) can increase the likelihood of survival from out-of-hospital cardiac arrest (OHCA). Currently, guidelines for AED deployment focus only on spatial factors, such as where to place AEDs with respect to cardiac arrest risk, and assume that the buildings housing the AEDs are open and accessible 24 hours a day. However, this is not the case in reality. AED accessibility by time of day has largely been overlooked despite the fact that cardiac arrest incidence and survival vary by time of day and day of week. In this study we performed two main analyses, using data from Toronto, Canada. First, we determined the impact of accessibility on cardiac arrest coverage. That is, we determined what fraction of OHCAs occurred near a registered AED, but when that AED was unavailable based on the hours of operation of the building. Second, we developed a novel optimization model that identifies locations to place AEDs that maximize the number of out-of-hospital cardiac arrestswith an accessible AED nearby. We compared this approach to one where AEDs were placed guided by only spatial information. We found that of the OHCAs occurring within 100 m of an AED, approximately 21% occur when the AED is inaccessible. Nearby AEDs were inaccessible for 8.6% of OHCAs during the day (8 a.m. – 3:59 p.m.), 28.6% in the evening (4 – 11:59 p.m.) and 48.4% at night (midnight –7:59 a.m.). When applying our optimization model to determine new AED locations, we achieved a 25.3% relative increase in the number of out-of-hospital cardiac arrests that occur near an accessible AED over the spatial-only approach. The relative increase was 10.9% during the day, 38.0% in the evening, and 122.5% at night. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Education, Heart Disease, JAMA / 16.08.2016

MedicalResearch.com Interview with: Rory Brett Weiner, MD Assistant Professor of Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: The increased use of noninvasive cardiac imaging and Medicare spending in the late 1990s and early 2000s has led to several measures to help optimize the use of cardiac imaging. One such effort has been the Appropriate Use Criteria (AUC) put forth by the American College of Cardiology Foundation. The AUC for echocardiography have been useful to characterize practice patterns and more recently been used as a tool to try to improve ordering of echocardiograms. Our research group previously conducted a randomized study of physicians-in-training (cardiovascular medicine fellows) and showed that an AUC based educational and feedback intervention reduced the rate of rarely appropriate transthoracic echocardiograms (TTEs). The current study represents the first randomized controlled trial of an AUC education and feedback intervention attending level cardiologists. In this study, the intervention group (which in addition to education received monthly feedback emails regarding their individual TTE ordering) ordered fewer rarely appropriate TTEs than the control group. The most common reasons for rarely appropriate TTEs in this study were ‘surveillance’ echocardiograms, referring to those in patients with known cardiac disease but no change in their clinical status. (more…)
Author Interviews, Heart Disease, Technology / 16.08.2016

MedicalResearch.com Interview with: Dr. Theodore L. Schreiber MD President of the Detroit Medical Center Heart Hospital and DMC Cardiovascular Institute. Doctor Schreiber is involved in ongoing research in carotid artery stenting, has been the principal or co-principal investigator on numerous cardiovascular research studies and has written dozens of book chapters, articles and abstracts on interventional cardiology. Abbott announced July 5, 2016 that the U.S. Food and Drug Administration has approved the company's Absorb bioresorbable heart stent, MedicalResearch.com: What is the background for this stent? What are the main advantages? Response: The Absorb™ bioresorbable vascular scaffold is an advance in the treatment of coronary artery disease, which affects 15 million people in the United States and remains a leading cause of death worldwide despite decades of therapeutic advances. For this reason, DMC Heart Hospital, which serves a population at high risk of cardiovascular disease, was among the first in the state of Michigan to adopt this new stent. While stents are traditionally made of metal, the Absorb™ stent is made of a naturally dissolving material, similar to dissolving sutures. Absorb™ disappears (except for two pairs of tiny metallic markers that remain in the artery to enable a physician to see where the device was placed) in about three years, after it has done its job of keeping a clogged artery open and promoting healing of the treated artery segment. By contrast, metal stents are permanent implants. (more…)
Author Interviews, Heart Disease, Lipids / 14.08.2016

MedicalResearch.com Interview with: Ziyad Al-Aly, MD, FASN Assistant Professor of Medicine Washington University School of Medicine Co-Director, Clinical Epidemiology Center Associate Chief of Staff for Research and Education Veterans Affairs Saint Louis Health Care System MedicalResearch.com: What is the background for this study? What are the main findings? Response: I think the most important, and novel finding is that elevated levels of HDL-cholesterol (which is thought of as the good cholesterol) are associated with increased risk of death. Previously it was thought that high HDL (increased good cholesterol) is a good thing. We used Big Data approach (over 16 million person-years; 1.7 million people followed for over 9 years) to evaluate the relationship between HDL-Cholesterol (the good cholesterol) and risk of death. We found that low HDL is associated with increased risk of death (which is expected and consistent with prior knowledge). The novel and unexpected finding is the observation that high HDL-Cholesterol is also associated with increased risk of death. The relationship between HDL-Cholesterol levels and risk of death is a U-shaped curve where risk is increased at both ends of the HDL-C values spectrum (at both low and high end); Too low and too high is associated with higher risk of death. The findings may explain why clinical trials aimed at increasing HDL-Cholesterol levels failed to show improvement of clinical outcomes. This finding was not expected, and has not been reported previously in large epidemiologic studies such as Framingham Heart Study and others. The Framingham Heart study and others significantly advanced our understanding of the relationship between cholesterol parameters (including HDL-Cholesterol) and clinical outcomes. However, these studies are limited in that the number of patients in these cohorts was several thousands which is relatively small compared to what a Big Data approach (millions of patients) enables us to see. Big Data approach allows a more nuanced (a more detailed) examination of the relationship between HDL and risk of death across the full spectrum of HDL levels. (more…)
Author Interviews, Cleveland Clinic, Genetic Research, Heart Disease, PLoS / 14.08.2016

MedicalResearch.com Interview with: Qing Kenneth Wang PhD, MBA Huazhong University of Science and Technology Wuhan, P. R. China and Department of Molecular Cardiology The Cleveland Clinic Cleveland, Ohio MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary Artery Disease (CAD) and its complication myocardial infarction (MI or so called heart attacks) are the most common causes of deaths in the US and other parts of the world. Based on the American Heart Association statistics, 620,000 Americans have a new MI each year in the United States alone, 295 000 have a recurrent MI, and nearly 400,000 of them will die from it suddenly. Moreover, an estimated 150,000 silent first MI occur each year. CAD and MI are caused by an occlusion or blockage of a coronary artery, which disrupts blood flow to the heart region, leading to damage or death of cardiac cells, impairment of cardiac function and sudden death. Current treatment of CAD and MI relies on reperfusion therapy with reopening of the occluded coronary artery with percutaneous coronary intervention (PCA) and coronary artery bypass surgery (CABG). However, 12% of patients are not candidates for PCA or CABG due to an unfavorable occlusive pattern, diffuse coronary atherosclerosis, small distant vessels and co-morbidities. An alternative revascularization strategy has to be developed to benefit these patients. (more…)
Author Interviews, Clots - Coagulation, Diabetes, Heart Disease, JACC / 12.08.2016

MedicalResearch.com Interview with: Raffaele Piccolo, MD Department of Cardiology Bern University Hospital University of Bern Bern, Switzerland MedicalResearch.com: What is the background for this study? Response: Over the past two decades, the prevalence of diabetes mellitus has doubled in Western countries and future projections are even worse by showing a 55% increase by 2035 when approximately 592 million of people are expected to live with diabetes all over the world. Acute myocardial infarction still represents the most common diabetes-related complication and its occurrence is associated with a higher risk of mortality. Timely recanalization of the occluded coronary vessel with primary percutaneous coronary intervention (PCI) represents the therapy of choice for acute ST-segment elevation myocardial infarction (STEMI). Our study investigated whether the direct application of an intracoronary bolus of abciximab, which is an antiplatelet drug blocking the glycoprotein IIb/III a receptor, at the time of primary PCI improves the outcomes at 1-year follow-up compared with the standard intravenous route. The study was in individual patient-level pooled analysis of 3 randomized trials including 2,470 patients, of whom 473 (19%) had diabetes. (more…)
Author Interviews, Heart Disease, JACC, Stroke, Surgical Research / 12.08.2016

MedicalResearch.com Interview with: Josep Rodés-Cabau, MD Director, Catheterization and Interventional Laboratories Quebec Heart and Lung Institute Professor, Faculty of Medicine, Laval University Quebec City, Quebec, Canada MedicalResearch.com: What is the background for this study? Response: Transcatheter aortic valve replacement (TAVR) is increasingly used in patients with severe aortic stenosis deemed at prohibitive or high surgical risk. Recently, a randomized trial demonstrated the non-inferiority of TAVR compared to surgical aortic valve replacement in intermediate risk patients for the outcome of death and disabling stroke at 2 years. Therefore, TAVR indications are likely to expand to younger and lower risk patients in the near future. While the short-term (30-day) cerebrovascular event (CVE) rate post-TAVR has decreased over time, it remains the most dreadful complication of TAVR, and still occurs in 2% to 3% of patients. A few dedicated studies identified numerous predictors of CVE which mainly differ from one study to another. However, identifying the risk factors of CVE is of paramount relevance in clinical practice to implement preventive strategies, either instrumental (embolic protection devices) or pharmacological in high-risk patients. Thus, we performed a systematic review and meta-analysis using random-effect models to provide pooled estimates of sixteen (8 patient-related and 8 procedural-related) clinically-relevant predictors of CVE within 30 days post TAVR. (more…)
Author Interviews, Dental Research, Heart Disease / 10.08.2016

MedicalResearch.com Interview with: John Liljestrand, DDS Department of Oral and Maxillofacial Diseases University of Helsinki MedicalResearch.com: What is the background for this study? Response: There is an increased amount of evidence supporting the hypothesis that oral inflammations increase the risk for cardiovascular diseases (CVDs). The association between marginal periodontitis, a common inflammatory disease in the tooth supporting tissues, and CVDs is well established. The link is thought to depend on transient but repeated bacteremia, endotoxemia and an increased systemic inflammatory burden. Apical periodontitis is a common manifestation of an endodontic infection, most often caused by dental caries. It is an inflammatory reaction surrounding the root tip of a tooth and it restrains the dental infection from spreading into the bone. Apical periodontitis is similar to marginal periodontitis regarding its microbial profile and ability to increase systemic inflammatory markers. Therefore, it is justified to suggest that apical periodontitis might also increase the risk for CVDs. There is only a minor amount of publications on this topic and further research is still needed.  (more…)
Author Interviews, Heart Disease, JACC / 08.08.2016

MedicalResearch.com Interview with: Ruben Casado-Arroyo, MD, PhD Heart Rhythm Management Center Cardiovascular Division, UZ Brussel–Vrije Universiteit Brussel, Cardiology Department, Arrhythmia Section Erasmus Hospital, Université Libre de Bruxelles Brussels, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study is to evaluate the evolution of the presentation of Brugada Syndrome (BrS) during the last 30 years. Only the first diagnosed patient of each family was included. The database was divided in two periods (early and latter group) in relation to the consensus conference of 2002. Aborted sudden death as the first manifestation of the disease occurred most frequently in the earlier period 12.1% versus 4.6% of the latter group. Inducibility (induction of ventricular fibrillation) during programmed electrical stimulation was achieved in 34.4% (earlier) and 19.2% (latter) of patients, respectively. A spontaneous type 1 electrocardiogram pattern that is a coved type ST elevation with at least 2 mm (0.2 mV) J-point elevation a gradually descending ST segment followed by a negative T-wave was presented at diagnosis 50.3% (earlier) versus 26.2% (latter patients). Early group patients had a higher probability of a recurrent arrhythmia (sudden cardiac death or ventricular arrhythmias) during follow-up (19%) than those of the latter group (5%). All these difference were significative. Overall, the predictors of recurrent arrhythmias were previous sudden cardiac death and inducibility. In the latter period, only previous sudden cardiac death was a predictor of arrhythmic events. (more…)
Author Interviews, Emory, Heart Disease, JAMA / 06.08.2016

MedicalResearch.com Interview with: Dr. Amit J. Shah MD MSCR Research Assistant Professor Assistant Professor of Epidemiology Rollins School of Public Health Emory University Adjunct appointment in Medicine (Cardiology) Atlanta VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nearly ½ of sudden cardiac deaths occur in individuals who were not aware that they had heart disease; this increases the need for primary prevention. We studied whether the electrocardiogram could be a useful tool in helping to measure risk of cardiovascular disease in approximately 10,000 community-based adults aged 40-74 with a simple risk equation that is based on age, sex, and 3 numbers from the ECG: heart rate, T-axis, and QT interval. We found that such an equation estimates risk as well as the Framingham risk equation, which is the standard of care (based on traditional risk factors like smoking and diabetes). When combining both the Framingham and ECG risk assessments together, the accuracy improved significantly, with a net 25% improvement in the risk classification of cardiovascular death compared to using the Framingham equation alone. (more…)
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Heart Disease, Omega-3 Fatty Acids / 02.08.2016

MedicalResearch.com Interview with: Raymond Y. Kwong, MD MPH Director of Cardiac Magnetic Resonance Imaging Associate Professor of Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? Response: In the past several decades, Omega-3 fatty acids (O3FA) primarily from fish oil have been reported to have many beneficial effects, either directly on the heart or through other effects that indirectly help the heart. However, when it was tested on patients who suffered an acute heart attack by looking at whether patients can live longer by taking omega-3 fatty acids early after the heart attack, there has been some conflicting data in some of the large clinical trials. There are several major factors that inspired the designs of the current OMEGA-REMODEL study: a) Over recent years, many highly effective treatments to improve the survival of heart attack victims have become routine. b) The studies in the past used a relatively lower dose of  Omega-3 fatty acids (1g per day). c) Some have also raised the question whether just patient mortality should be the only/best way we should considered in assessing new treatments for heart attack patients. d) Cardiac remodeling: after a heart attack, heart muscle not damaged by the initial heart attack insult has to overwork to compensate for the damage from the heart attack. Over time scarring may form in the overworked heart muscle, in addition to weakened heart function, may lead to the heart to fail. e)New imaging method: a MRI of the heart, can precisely determine the heart function and the amount of scarring of the overworked heart muscle not damaged from the heart attack. (more…)
Author Interviews, Columbia, Heart Disease, JACC / 27.07.2016

MedicalResearch.com Interview with: Ajay J. Kirtane, MD, SM, FACC, FSCAI Associate Professor of Medicine at Columbia University Medical Center Chief Academic Officer, Center for Interventional Vascular Therapy Director, NYP/Columbia Cardiac Catheterization Laboratories New York, NY  10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with inpatient heart failure are a higher-risk patient population who can benefit from the identification and treatment of coronary artery disease. We sought to identify how frequently these patients in fact underwent testing for coronary artery disease. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Heart Disease / 22.07.2016

MedicalResearch.com Interview with: Jari Laukkanen MD, PhD Cardiologist Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this population-based study we found a strong inverse association between long-term change in directly measured cardio-respiratory fitness (CRF), using maximal oxygen uptake (VO2peak) and all-cause mortality. A small decrease in CRF over 11-years was associated with a lower risk of all-cause death in a graded fashion. The observed association was independent of risk factors. This population-based study with repeated and direct assessment of CRF using a very similar time-interval for all participants, whereas some previous studies showing the value of CRF were constructed on participants referred to exercise testing at varying time-intervals between two repeated tests using only indirect cardio-respiratory fitness assessment or other exercise scores. Cardiorespiratory fitness was assessed at baseline and follow-up using respiratory gas analyzer which is a golden standard for assessing aerobic fitness level. A single assessment of CRF predicts outcomes, however, no previous studies using directly measured VO2max have shown the association between long term changes in VO2max (i.e. 10 years) and its association with mortality. In the recent study VO2max defined from respirator gases with similar time-interval between two separate assessments of VO2max (=directly measured). This is a very novel finding in the field of exercise sciences, as well as in cardiovascular prevention and rehabilitation. Although cardio-respiratory fitness is recognized as an important marker of functional ability and cardiovascular health, it is currently the major risk factor that is not routinely and regularly assessed in either the general or specialized clinical setting, although it is suggested that an individual’s CRF level has been even a stronger or similar predictor of mortality than the traditional risk factors, including smoking, hypertension, high cholesterol, and type 2 diabetes mellitus. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA / 21.07.2016

MedicalResearch.com Interview with: Dr Fiona Bragg Clinical Research Fellow Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford MedicalResearch.com: What is the background for this study? Response: Diabetes is known to be a risk factor for cardiovascular disease. It is less clear, however, whether higher blood glucose levels in individuals without diabetes are also associated with higher risk for cardiovascular diseases. It is important to examine this association because it may help us to understand the mechanisms underlying these diseases as well as appropriate approaches to preventing them. We therefore looked at this association in the China Kadoorie Biobank study of 0.5 million Chinese adults, examining the relationship between blood glucose levels and the subsequent risk for cardiovascular diseases among participants with no history of diabetes at the time of recruitment to the study. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 18.07.2016

MedicalResearch.com Interview with: Evan L. Thacker, PhD. Assistant Professor College of Life Sciences Brigham Young University Provo, UT MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is diagnosed more commonly in whites than blacks in the United States. This seems paradoxical because blacks have higher prevalence of many risk factors for AF. Various explanations for this paradox have been proposed, including biological explanations as well as potential biases in research studies. We investigated one such bias – selection bias – as a potential explanation for the paradox. We did this by comparing the racial difference in atrial fibrillation prevalence among people who enrolled in an epidemiologic study versus people who were eligible to enroll in the study but did not enroll. (more…)
AHA Journals, Author Interviews, Heart Disease / 18.07.2016

MedicalResearch.com Interview with: Seamus Kent, MSc, Research Fellow and Borislava Mihaylova, MSc DPhil, Associate Professor Health Economics Research Centre, Nuffield Department of Population Health University of Oxford, UK MedicalResearch.com: What is the background for this study? Response: Niacin lowers the LDL cholesterol and increases the HDL cholesterol and it was hoped this would translate into reduced risks of vascular events. This hypothesis was assessed in the Heart Protection Study 2 – Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE) trial in which over 25,000 adults aged 50 to 80 years with prior cardiovascular disease were randomised to either niacin-laropiprant or placebo, in addition to effective LDL-cholesterol lowering therapy, and followed for about 4 years. Previously published results from the study demonstrated that niacin-laropiprant did not significantly reduce the risk of major vascular events but did significantly increase the risk of various adverse events including infections, bleeding, gastrointestinal, musculoskeletal, skin, and diabetes-related events. (more…)
Author Interviews, CT Scanning, Heart Disease / 13.07.2016

MedicalResearch.com Interview with: Dr Maksymilian P. Opolski Department of Interventional Cardiology and Angiology Institute of Cardiology Warsaw, Poland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Valvular heart disease (VHD) that requires surgery is increasingly encountered in industrialized countries. Of particular interest, the presence of concomitant coronary artery disease (CAD) in patients with VHD is related to worse clinical outcomes, and various clinical studies suggested that combined valve and bypass surgery reduces early and late mortality. Consequently, in the majority of such patients, pre-operative evaluation for coronary artery disease (CAD) with invasive coronary angiography is recommended. However, provided that most patients with valvular heart disease are found to have no significant coronary stenoses, coronary computed tomography angiography (coronary CTA) appears as an extremely appealing noninvasive alternative to invasive coronary angiography for exclusion of significant CAD. This is further justified when the risks of angiography outweigh its benefits (e.g. in cases of aortic dissection or aortic vegetation). (more…)
Author Interviews, Heart Disease, Nutrition / 12.07.2016

MedicalResearch.com Interview with: Hsin-Jen Chen, PhD MS Assistant Professor Institute of Public Health National Yang-Ming University Taipei City MedicalResearch.com: What is the background for this study? Response: The number of eating occasions may affect health. Laboratory experiments have been showing that splitting daily food consumption into more eating occasions could improve metabolic profiles, such as healthier blood glucose and lipids levels. However, such kinds of experiments usually design a highly controlled diet for the participants in the lab. It is questionable whether such metabolic benefits remain in our daily life (namely, no controlled diets) where we can eat at anytime when we want to eat. (more…)
Author Interviews, Heart Disease, Lipids / 11.07.2016

MedicalResearch.com Interview with: Joost Besseling, PhD-student Academic Medical Center Dept. of Vascular Medicine Amsterdam MedicalResearch.com: What is the background for this study?  Response: It was unkown to what extent statin therapy reduces the risk for coronary artery disease and mortality in patients with heterozygous familial hypercholesterolemia (FH). One previous study found that the relative risk reduction was 76%, but the study population in this study consisted of with a very severe FH phenotype. This result is therefore an overestimation of the risk reduction in the general heterozygous familial hypercholesterolemia population. (more…)
AHA Journals, Author Interviews, CDC, Heart Disease / 11.07.2016

MedicalResearch.com Interview with: Suzanne Meredith Gilboa, PhD Epidemiologist at the Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities MedicalResearch.com: What is the background for this study? What are the main findings? Response: Because of advancements in care, there has been a decline in mortality from congenital heart defects (CHD) over the last several decades. However, there are no current empirical data documenting the number of people living with CHD in the United States (US). The purpose of this study was to estimate the  congenital heart defects prevalence across all age groups in the US for the year 2010. Using prevalence data from Québec, Canada in the year 2010 as a foundation for a mathematical model, we estimated that approximately 2.4 million people (1.4 million adults, 1 million children) were living with CHD in the US in the year 2010. Nearly 300,000 subjects had severe CHD. Overall, there was a slight predominance of females compared to males. (more…)
Author Interviews, CDC, Diabetes, Heart Disease, JAMA / 09.07.2016

MedicalResearch.com Interview with: Edward Gregg, PhD Chief of the Epidemiology and Statistics Branch Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: The research was led by the lead author, Karen R. Siegel, PhD, as part of her PhD graduate studies at Emory for her dissertation. Although subsidized foods are intended to ensure adequate availability of storable, staple foods, studies at the population level have linked these subsidies to risk of cardiovascular disease and type 2 diabetes. This study is the first of its kind to examine these relationships at the individual level – specifically, the relationship between diets made up of more subsidized foods, and an individual’s personal risks for developing cardiovascular disease and type 2 diabetes. The study design that was used here does not allow us to say that these subsidized foods specifically cause type 2 diabetes and cardiovascular disease. Rather, people whose diets contain more corn, soybean, wheat, rice, sorghum, dairy, and livestock products are at greater risk for type 2 diabetes and cardiovascular disease. According to this research, people whose diets contained more subsidized foods were on average younger, less physically active and more likely to be smokers. They also had much less income, education and food security - or the ability to get enough safe and healthy food to meet their dietary needs. (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 07.07.2016

MedicalResearch.com Interview with: Amanda M. Perak, MD Division of Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, and Department of Preventive Medicine Northwestern University Feinberg School of Medicine Donald M Lloyd-Jones, MD/ScM (senior author) Senior Associate Dean for Clinical and Translational Research; Chair, Department of Preventive Medicine Director, Northwestern University Clinical and Translational Sciences Institute (NUCATS) and Eileen M. Foell Professor Professor in Preventive Medicine-Epidemiology and Medicine-Cardiology MedicalResearch.com: What is the background for this study? Response: Heterozygous familial hypercholesterolemia, or FH, affects up to 1 in 200 individuals in the United States. FH is a genetic disorder that should be suspected in individuals with very high levels of low-density lipoprotein cholesterol (LDL-C; at least 190 mg/dL) plus a first-degree relative with similar degree of high cholesterol or with premature coronary heart disease. Individuals with FH are exposed to high levels of "bad" cholesterol from birth, so if they are not treated with cholesterol-lowering therapy, they are at elevated risk for atherosclerotic cardiovascular disease (ASCVD; diseases related to hardening of the arteries, including heart attack and stroke). However, these risks previously had not been well quantified in untreated individuals with familial hypercholesterolemia in the general US population. (more…)
Author Interviews, Heart Disease, JAMA, Radiology / 04.07.2016

MedicalResearch.com Interview with: Venkatesh Locharla Murthy MD, PhD, FACC, FASNC Assistant Professor, Internal Medicine Frankel Cardiovascular Center University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Technetium-99m, which is very commonly used for cardiac stress testing, has had multiple supply disruptions due to aging nuclear reactors where it is produced coupled with changing regulations to minimize the risk of nuclear proliferation. The most severe of these disruptions occurred over six months in 2010. We asked whether this disruption lead to changes in patterns of care among Medicare beneficiaries. We found that during this time, use of technetium-99m in nuclear stress testing fell from 64% to 49%, reflecting a shift towards thallium-201, which has higher radiation exposure and lower diagnostic specificity. This was reflected in a 9% increase in the rate of cardiac catheterization after a nuclear stress test during the study period, implying nearly 6,000 additional, possibly unnecessary, catheterizations during that time. (more…)
Author Interviews, Heart Disease / 01.07.2016

MedicalResearch.com Interview with: Dr. Mieke Louwe (1) and Prof. dr. Miranda van Eck (2) 1Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands 2Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands MedicalResearch.com: What is the background for this study? Response: ATP-binding cassette transporter A1 (Abca1) is a key protein facilitating the production of high-density lipoprotein (HDL) and the maintenance of macrophage cholesterol homeostasis. Patients and mice with mutations in the Abca1 gene have virtually no HDL in their circulation. Since HDL plays a key protective role in atherosclerosis, by exerting several cardioprotective functions, up regulation of Abca1 is considered as an important novel therapeutic strategy to prevent atherosclerotic cardiovascular disease. Although the role of Abca1 in atherosclerosis is extensively studied, the interplay between Abca1 and myocardial infarction, an acute cardiovascular event often resulting from rupture of advanced atherosclerotic plaques, has not yet been investigated. (more…)
Author Interviews, Depression, Heart Disease, JAMA / 01.07.2016

MedicalResearch.com Interview with: Prof. Dr. med. Christiane E. Angermann, FESC, HFA Deutsches Zentrum für Herzinsuffizienz Würzburg Comprehensive Heart Failure Center (CHFC) Universitätsklinikum Würzburg Würzburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous meta-analysis indicates that depression prevalence in patients with heart failure is much higher than in the general population, 10 percent to 40 percent, depending on disease severity. Depression has been shown to be an independent predictor of mortality and rehospitalization in patients with heart failure, with incidence rates increasing in parallel with depression severity. Furthermore, it is associated with poor quality of life and increased healthcare costs. It would, against this background, seem desirable to treat the depression, and when planning the study we hypothesized that by doing so we might be able to improve depression and thus reduce mortality and morbidity of this population. Long-term efficacy and safety of selective serotonin reuptake inhibitors (SSRIs), which are widely used to treat depression and have proven efficacious in individuals with primary depression, is unknown for patients with heart failure and (comorbid) depression. (more…)