MedicalResearch.com Interview with:
Siobhan Brown, Ph.D.
Biostatistician, ROC Clinical Trials Center
University of Washington
Medical Research: What is the background for this study? What are the main findings?Dr. Brown: There are several observational studies suggesting that patients with out-of-hospital cardiac arrest may be more likely to survive to hospital discharge when emergency medical service provides do not pause for ventilations while performing CPR (i.e., give continuous compressions); however, the American Heart Association recommends that rescuers pause after each 30 compression to give two ventilations (interrupted compressions). We designed and are conducting a randomized clinical trial comparing the two approaches to see which results in better survival.
The trial is still ongoing, so watch for results in late 2015!
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MedicalResearch.com Interview with
Dr. Mary T. Hawn MD
Center for Surgical, Medical Acute Care Research, and Transitions,
Birmingham Veterans Affairs Medical Center
University of Alabama at Birmingham, BirminghamMedical Research: What are the main findings?Dr. Hawn: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1 These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent. In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations.
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MedicalResearch.com Interview with:
Matthew D. Ritchey, DPT
Division for Heart Disease and Stroke Prevention
US Centers for Disease Control and Prevention, Atlanta, Georgia
Medical Research: What is the background for this study? What are the main findings?Dr. Ritchey: This study analyzes the contribution of heart disease subtypes – such as coronary heart disease, heart failure, hypertensive heart disease and arrhythmia – to overall trends in heart disease death rates between 2000 and 2010. Our research revealed that overall heart disease-related deaths declined during that time frame at a rate of almost four percent annually. Most of this decline appears to be driven by decreases in coronary heart disease mortality, which includes deaths due to heart attacks.
However, not all heart disease subtypes saw similar decreases. Arrhythmia and hypertensive heart disease death rates increased annually during this period. In addition, there were differences depending on age group, subtype, gender and race/ethnicity. For example, hypertensive heart disease rates were much higher (more than double) among non-Hispanic blacks in 2010 than among non-Hispanic whites. That could be due to factors including uncontrolled blood pressure and obesity among younger adults. Also, the increase in arrhythmia mortality was highest among non-Hispanic whites, women and adults age 75 and over. That increase might be linked to the growing aging population, the result of individuals living longer with heart failure, increases in chronic kidney disease and hypertensive heart disease prevalence and changes in how the condition is reported.
To determine these findings, we examined de-identified death certificates of U.S. residents ages 35 and up who died from 2000 to 2010. The data was pulled from the CDC WONDER database, which contains death certificate information from every U.S. state and the District of Columbia.
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MedicalResearch.com Interview with:
Dean J. Kereiakes, MD FACC, FSCAI
The Lindner Research Center
The Christ Hospital Health Network
Cincinnati, Ohio 45219
Medical Research: What is the background for this study? Dr. Kereiakes: Bare metal stents (BMS) are a commonly used alternative to drug eluting stents (DES) particularly for patients presenting with acute coronary syndromes or in whom dual antiplatelet therapy (DAPT) has perceived increased bleeding risks. We aimed to determine whether the risks of stent thrombosis and major adverse clinical cardiovascular and cerebrovascular (MACCE; composite of death, MI or stroke) events differ for BMS versus DES and whether the optimal duration of dual antiplatelet therapy differs for BMS or DES. To answer these objectives we performed a propensity matched BMS to DES 0-33 month comparison as well as an analysis of treatment effect among BMS treated patients randomly assigned to 12 versus 30 months of DAPT.
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MedicalResearch.com Interview with:
Dr. Martin Thornhill PhD
Department of Cardiology, Taunton and Somerset NHS Trust
Taunton, Somerset, UK
Medical Research:What is the background for this study? What are the main findings?Dr. Thornhill: In 2008 NICE introduced controversial new guidance recommending that antibiotic prophylaxis to prevent infective endocarditis should no longer be used. It was a rational decision, given the evidence for the effectiveness of antibiotic prophylaxis and potential concerns about costs, the development of antibiotic resistance and possible side effects from antibiotics, but it went against other guidelines from around the world that existed at the time.
The main findings are that in England:
There has been a large and significant decline in the use of antibiotic prophylaxis.
There has been a significant increase in the number of cases of infective endocarditis, above the baseline trend, using hospital coding data, corrected for changes in the size of the English population.
MedicalResearch.com with:
Giulio Conte MD
Heart Rhythm Management Centre
UZ-VUB Brussel, Belgium
Medical Research: What is the background for this study? What are the main findings?Dr. Conte: The evolution of Brugada syndrome from pediatric to adult age has not been previously evaluated. It has been shown that the electrocardiographic phenotype of Brugada syndrome do not manifest during childhood in the large majority of cases. Drug challenge with ajmaline is recommended to unmask the diagnostic electrocardiogram in patients with family history of Brugada syndrome and normal electrocardiograms. However, the ideal age to perform such screening has not been established yet. With this study we aimed to investigate the clinical value of repeating ajmaline challenge after puberty in pediatric family members with an initial negative drug test. Repeat ajmaline challenge after puberty unmasked Brugada syndrome in 23% of family members with a previously negative drug test. Of the newly positive patients, 30% developed symptoms, 10% ventricular fibrillation and 10% spontaneous Brugada type 1 electrocardiogram.
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MedicalResearch.com Interview with:
Michael J. Ward, MD, MBA
K12 Scholar
Assistant Professor Vanderbilt University
Department of Emergency Medicine
Nashville, TN 37232
Medical Research:What is the background for this study? What are the main findings?Dr. Ward: The number of Americans living with cardiovascular disease is only expected to increase in the coming years. However, we do not know the national effects of increased medication use and preventive efforts to stop the most serious form of a heart attack, called an ST-elevation myocardial infarction (STEMI). In particular, there are no estimates of how often this serious form of a heart attack shows up in the emergency department.
Between 2006 and 2011 we found an average of 258,000 STEMIs annually in the U.S. or 8.7 per 10,000 U.S. adults per year. Interestingly, the number of STEMIs has decreased by more than 70,000 per year over this time, a 24% reduction. We found similar annual decreases across every age group and geographic region in the U.S. The decreases were most pronounced among those 85 years and older and in the Midwest.
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Medicalresearch.com Interview with:
Mark Rabbat, MD
Assistant Professor of Medicine and Radiology
Division of Cardiology at Loyola University Medical Center
MedicalResearch.com: What are the main findings of this study? Dr. Rabbat : Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice and is responsible for significant morbidity and mortality. Epidemiologic data suggest that obesity as measured by one’s BMI is a risk factor for Atrial fibrillation. But there is more to the story. What may be even more important than overall BMI is how much fat you have around the heart. There are many individuals who, as measured by their BMI, are not considered obese, but they have high volumes of fat around their heart, which may have been a major cause for their atrial fibrillation. Therefore, simple measures such as BMI may fail to completely inform us of a patient’s true CV risk.
In a previous study we found that epicardial adipose tissue (EAT), or the fat around the heart, has been associated with the presence and severity of AF independent of known risk factors and body mass index (BMI). The inflammatory mediators released from the fat are metabolically active, and may promote fibrosis in adjacent heart muscle. Fibrosis of the left atrium appears to be a hallmark feature of atrial fibrillation and higher amounts of fibrosis are linked to recurrence of atrial fibrillation. New innovations in cardiac magnetic resonance imaging (CMR) allow LA fibrosis and EAT to be precisely quantified. Our current study is the first of its kind to demonstrate the association of EAT volume and extent of LA fibrosis in human AF independent of LA size, BMI, and other AF risk factors.
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MedicalResearch.com Interview with:
Vasileia Varvarigou MD, Visiting Scientist at Harvard School of Public Health and Senior Medical Resident, St Elizabeth’s Medical Center, Tufts Medical School and
Stefanos N Kales MD, MPH, Associate Professor, Harvard School of Public Health, Division Chief of Occupational Medicine, Cambridge Health Alliance/ Harvard Medical School
Medical Research: What is the background for this study?
Response: Previous epidemiologic studies of firefighters have documented markedly increased risks of acute death from heart disease during strenuous activities such as fire suppression as compared to non-emergency duties. We hypothesized that certain law enforcement tasks could serve as an occupational trigger in susceptible police officers, leading to an increased frequency of sudden cardiac death during stressful duties.
Our main objective therefore, was to assess the association between risk of sudden cardiac death and stressful law enforcement duties compared with routine/non-emergency duties.
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MedicalResearch.com Interview with:
Thanh Huyen T Vu MD, PhD
Research Assistant Professor
Preventive Medicine-Epidemiology
Northwestern University Feinberg School of Medicine
Medical Research: What is the background for this study? Response: Ideal levels of all major cardiovascular disease (CVD) risk factors (RF), i.e., low risk (LR), in younger age are associated with lower subsequent CVD morbidity and mortality in older age. However, data are limited on the long-term relationships of LR profile in younger age with functional disability in older age.
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MedicalResearch.com Interview with:
Prof Gavin D. Perkins MD
Clinical Professor in Critical Care Medicine Warwick Clinical Trials Unit Co-Director of Research;
Warwick Medical School and Heart of England NHS Foundation Trust
Medical Research: What is the background for this study?Prof. Perkins: Each year around 30,000 people in the United Kingdom suffer out of hospital cardiac arrests and less than one in twelve of those returns home alive. Early high quality Cardio- Pulmonary Resuscitation (CPR – ventilation and chest compressions) is critical to survival. However maintaining high quality chest compressions during resuscitation is difficult for crews of emergency vehicles, especially if they are on their own, because of fatigue and the need to perform other actions. Chest compression is particularly difficult in moving vehicles.
A number of mechanical devices, suitable for out of hospital use, have been developed over the years to improve the quality of chest compressions and therefore attempt to improve patient outcomes. Some NHS organisations decided to purchase devices to use although there is limited evidence of their effectiveness. To equip all emergency vehicles in the NHS would cost tens of millions of pounds plus costs for on-going training and maintenance. This prompted the UK Joint Royal College Ambulance Liaison Committee to advise against the purchase of further mechanical chest compression devices until further research had been carried out.
The aim of this trial was to compare the effects of the mechanical chest compressions (LUCAS-2) device versus standard manual chest compressions (crew using their hands) on survival.
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MedicalResearch.com Interview with:
Dr. Yacov Shacham MD
Department of Cardiology Tel-Aviv Sourasky Medical Center,
Affiliated to the Sackler Faculty of Medicine
Tel-Aviv University, Tel-Aviv, Israel.
Medical Research: What is the background for this study? What are the main findings?
Dr. Shacham: Acute kidney injury (AKI) is a common complication among ST elevation (STEMI) patients undergoing primary percutaneous coronary intervention (PCI), and it is associated with poor long-term clinical outcomes. No studies have yet evaluated the association between cardiac function and the risk of AKI in this patient population. We conducted a retrospective study of consecutive STEMI patients who underwent primary PCI and had a full echocardiography study performed within 72 hours of hospital admission. We evaluated the relation between systolic and diastolic parameters and AKI. We demonstrated that the occurrence of AKI following primary PCI was associated with worse left ventricular systolic and diastolic function, however only left ventricular EF emerged as an independent predictor of AKI.
For every 1% reduction in EF, the risk of AKI increased (OR 1.1, 95% CI 0.86-0.96; p=0.001)
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MedicalResearch.com Interview with:
Dr Guillaume Geri, MDMedical Intensive Care Unit
Cochin Hospital Paris, France
Medical Research: What is the background of the study? What are the main findings?Dr. Geri: Culprit coronary artery occlusion is the main cause of out-of-hospital cardiac arrest. This has been well demonstrated since pioneer study of Spaulding et al in the New England Journal of Medicine in 1997. Several studies highlighted the favorable prognostic impact of an immediate successful PCI in cardiac arrest patients but inclusion biases or the lack of data on in-hospital management limit the generalization of such findings.
In this large French cohort of out-of-hospital cardiac arrest patients who were admitted after successful return of spontaneous circulation from 2000 to 2012, those who received immediate PCI had better short- and long-term survival than those who did not undergo the procedure, new data presented here concluded.
The researchers examined the association between immediate PCI and survival at 30 days, 2 years and 10 years, and evaluated other potential predicting factors. Furthermore, they used a propensity score method to analyze the impact of PCI on 30-day and long-term survival in matched patients.
Overall, 1,722 patients (71.5% male; median age, 59.9 years) were analyzed during a median 2 year follow-up. OHCA (out-of-hospital cardiac arrest ) was witnessed in 86.7% of patients, and occurred in a public space in 32.2% of patients and with an initial shockable rhythm (eg, ventricular fibrillation/ventricular tachycardia) in 54.6% of cases.
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MedicalResearch.com Interview with:
Matthew L. Springer, Ph.D.
Associate Professor of Medicine
Division of Cardiology
Cardiovascular Research Institute
Broad Center of Regeneration Medicine and Stem Cell Research
Center for Tobacco Control Research & Education
Helen Diller Family Comprehensive Cancer Center
University of California, San Francisco Medical Research: What is the background for this study? What are the main findings?Dr. Springer: The general public is aware that cigarette secondhand smoke is harmful. However, many people who actively avoid tobacco secondhand smoke don't feel the need to avoid marijuana secondhand smoke; they don't consider it harmful because there's no nicotine and because we who tell them to avoid tobacco smoke don't tell them to avoid marijuana smoke. However, secondhand smoke from tobacco and marijuana is very similar in chemical composition (4000-7000 chemicals depending on whom you ask), aside from the nicotine and the THC (the psychoactive drug in marijuana).
We and others have shown that brief exposure to tobacco secondhand smoke, such as 30 minutes, at real-world levels impairs vascular function in humans. We developed a way to study vascular function (measured as arterial flow-mediated dilation; FMD) in living rats, and recently published that even one minute of sidestream smoke from the burning tips of tobacco cigarettes, a well-accepted model for secondhand smoke, is enough to start detecting impairment of FMD. The main findings of the current study are that in laboratory rats, FMD was substantially impaired by a 30 minute exposure to marijuana secondhand smoke, when measured 10 minutes after the end of exposure. Impairment was comparable to that resulting from exposure to tobacco sidestream smoke, although whereas impairment from tobacco smoke was temporary and had normalized by 40 minutes later, FMD was still impaired 40 minutes after the end of exposure to marijuana smoke. Smoke from marijuana lacking THC still impaired FMD, showing that (more…)
MedicalResearch.com Interview with:
Manesh Patel, MD
Associate Professor of Medicine
Director Interventional Cardiology and Catheterization Labs
Duke University Health System
Duke Clinical Research Institute
Medical Research: What is the background for this study? What are the main findings?Dr. Patel: In clinical practice, patients with acute myocardial infarction are found to have non-IRA disease of varying significant and location. The current recommendations are to have patients recover from the acute myocardial infarction and get non-invasive testing to determine revascualrization after 4-6 six weeks in uncomplicated patients. These data demonstrate that non-IRA disease is common (>50% of STEMI patients) and that these patients have an elevated 30-day mortality.
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MedicalResearch.com Interview with:Marco Valgimigli, MD, PhD
Associate Professor of Medicine
Erasmus MC, Thoraxcenter,
Rotterdam The Netherlands
Medical Research: What is the background for this study? What are the main findings?Dr. Valgimigli: Drug-Eluting Stents are regarded as more thrombogenic devices as compared to Bare Metal Stents. We have pooled all available datasets comparing a specific second generation Drug-Eluting Stent, namely cobalt chromium everolimus eluting stent (co-Cr EES) versus Bare Metal Stents and found that cardiac mortality along with all other non-fatal endpoints investigated, including myocardial infarction or stent thrombosis were reduced after co-Cr EES.
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MedicalResearch.com Interview with:
Dr. Bilal Iqbal MD
Royal Brompton and Harefield NHS Foundation Trust
Harefield Hospital
Middlesex United Kingdom.Medical Research: What is the background for this study? What are the main findings?
Dr. Iqbal: The optimal strategy for revascularization of bystander coronary disease at the time of PPCI is unknown. Certainly, this has been the focus of recent debate and randomized controlled trials. We evaluated a strategy of culprit vessel versus multivessel intervention at the time PPCI in the real world setting. We conducted an observational analysis of 3984 consecutive patients with STEMI undergoing Primary percutaneous coronary intervention (PPCI) who had multivessel disease. We excluded patients with cardiogenic shock and patients with bystander LMS disease, which may potentially dictate staged surgical intervention. When analysing all-cause mortality at 1 year, we found that a strategy of culprit vessel intervention only at the time of PPCI was associated with increased survival at 1 year.
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MedicalResearch.com Interview withDr. Sunny Jhamnani MD
Clinical Fellow in Cardiology at Yale School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Jhamnani: Lifestyle modifications are the crux of atherosclerotic disease management. However adherence to them is not adequate. Additionally, randomized controlled trials (RCTs) looking effects of diet and exercise on atherosclerotic disease progression have not been convincing.
We did a systematic review and a meta-analysis of all RCTs looking at the effects of diet and exercise on coronary and carotid atherosclerotic disease progression. We found that , lifestyle modifications were associated with a decrease in coronary atherosclerotic burden in percent stenosis by -0.34 (95% CI: -0.48 to -0.21) standardized mean difference (SMD), with no significant publication bias and heterogeneity (p:0.21, I2:28.25). Similarly, in the carotids, there was a decrease in the carotid intimal medial thickness in mm by -0.21 (95% CI: -0.36 to -0.05) SMD and by -0.13 (95% CI: -0.25 to -0.02) SMD, before and after accounting for publication bias and heterogeneity (p:0.13, I2:39.91 and p:0.54, I2:0), respectively.
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MedicalResearch.com Interview withFrank B. Hu, MD, PhD
Professor of Nutrition and Epidemiology
Harvard School of Public Health
Professor of Medicine Harvard Medical School
Boston, MA 02115
Medical Research: What is the background for this study? What are the main findings?Dr. Hu: There has been much confusion and sensational headlines about the role of different types of fat in coronary heart disease. A recent meta-analysis suggested that higher saturated fat intake was not associated with coronary heart disease (CHD), but people don't consume saturated fat in isolation from other components of diet. Typically people swap for one type of fat for another. Therefore it is important to look at replacement nutrient when we talk about health effects of saturated fat. Randomized clinical trials have shown that replacing saturated fat with polyunsaturated fat reduces total and LDL cholesterol. Thus it is important to examine whether such replacement confers long-term beneficial effects on heart disease prevention. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the link between dietary intake of linoleic acid (the predominant type of polyunsaturated fat) and heart disease risk in generally healthy people. We identified 13 published and unpublished cohort studies with a total of 310,602 individuals and 12,479 total coronary heart disease events including 5,882 CHD deaths. We found that dietary linoleic acid intake is inversely associated with coronary heart disease risk in a dose-response manner—meaning, higher intake of linoleic acid resulted in a lower risk of CHD. Comparing the highest to the lowest level of consumption, dietary linoleic acid was associated with a 15% lower risk of coronary heart disease events and a 21% lower risk of CHD deaths. These results were independent of common coronary heart disease risk factors such as smoking and other dietary factors such as fiber consumption.
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MedicalResearch.com Interview with:
Dr. Andrea M. Isidori, MD, PhD
Consultant - Assistant Professor of Endocrinology
Department of Experimental Medicine
Medical Pathophysiology
Sapienza University of Rome
Medical Research: What is the background for this study? What are the main findings?Dr. Isidori : Our meta-analytic research originated to clarify some controversies emerging from the available human studies. We wanted to analyze if chronic PDE5i administration was cardioprotective and safe, and, if so, where the benefits were mainly seen: cardiac muscle, peripheral vessels, or both. In the last sixteen years pre-clinical and clinical research into the extra-urological effects of PDE5i has expanded dramatically, revealing previously unsuspected indications for these drugs. Several animal studies have shown that PDE5i attenuates cardiac remodeling, with an anti-hypertrophic and anti-fibrotic effect, and protects the heart against different types of injury. Some small clinical trials have demonstrated that chronic PDE5 inhibition improves cardiac performance and geometry in various clinical conditions, including heart failure, myocardial infarction and diabetic cardiomyopathy.
We showed that continuous administration of Viagra improves cardiac performance (increase of ejection fraction and cardiac index) and has an anti-remodeling effect (decrease of left ventricular mass and increase of end diastolic volume) without a major impact on vascular parameters (blood pressure and vascular resistance) suggesting that it does indeed have a direct effect on the heart. The novelty of this meta-analysis is the identification of subgroups of patients that may benefit more from PDE5i: patients with cardiac hypertrophy and heart failure. Our study is the first to show in a large patient cohort that chronic PDE5i administration improves cardiac output and decreases heart rate. This could result in longer survival, increased exercise tolerance and a better quality of life. Surprisingly, the magnitude of effects was similar to that seen with the drugs currently used to treat these clinical conditions, and was obtained in a relatively brief period (3 to 12 months). Most strikingly, we found that PDE5is are among the very few drugs that are able to improve diastolic relaxation, thus helping the correct refilling of the ventricle after each contraction, a nearly unique feature in drugs used in cardiology, and with incredible potential for future development in the prevention of heart failure. We also demonstrated their high tolerability and safety in a population that included elderly patients with various stages of cardiac disease and numerous comorbidities who were taking multiple pharmacological treatments. This setting resembles what we normally see in real life, supporting that daily administration is safe and involves no increase in the risk of adverse events compared to on-demand use.
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MedicalResearch.com Interview with:Professor Pranas Serpytis
Vilnius University Hospital Santariskiu Clinic
Vilnius, Lithuania
Medical Research: What are the main findings of the study?Professor Serpytis:The main findings of the study were that women are more likely to develop anxiety and depression after acute myocardial infarction. In our study depression was assessed by HADS scale: no depression (0-7 score), possible depression (8-10 score), definite depression (11+ score). The mean score of assessing depression were 6.87 (± 4.6) among men and 8.66 (± 3.7) among women (p <.05). Cardiovascular disease risk factors such as smoking increases patients anxiety levels, and low physical activity is associated with an increased risk to suffer from depression.
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MedicalResearch.com Interview with:Ilina and Medha Krishen
Michigan high school students and sisters Ilina and Medha Krishen, have developed screening tools using electronic stethoscopes to detect lung and heart disease. Their research was presented at the 2014 CHEST national meeting. Ilina and Medha have kindly agreed to discuss their work for the MedicalResearch.com audience.
Medical Research: Ilina, please tell us a little about you and the background for your study.Ilina: I am a senior at Port Huron Northern High School in Fort Gratiot, Michigan. I was exploring the effects of air pollutants on lungs using frequency analysis of lung recordings. My goal was to see if I could pick up early changes in healthy smokers and firefighters.
Dr. Sridhar Reddy, a local pulmonologist and occupational medicine expert mentored me. He lent me his electronic stethoscope. I am a violinist and a clarinet player, so initially had a lot of fun analyzing music frequencies. Later, I moved to lung sounds (a little more difficult!).
I used a Thinklabs Electronic Stethoscope for recording lung sounds. The inventor, Mr. Clive Smith, helped me understand the stethoscope.
I used the MATLAB program for analyzing frequencies. Mr. Charles Munson, a graduate student at the University of Michigan, helped me write the software program for it.
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MedicalResearch.com Interview with: Dr. Matthew Budoff, M.D.
Los Angeles Biomedical Research Institute
Torrance California
Medical Research: What are the main findings of the study?Dr. Budoff: We evaluated whether patients undergoing coronary CT angiography (non-invasive angiography) had better outcomes than those treated without the test. We found survival was better with CT angiography. Finding atherosclerosis allows cardiologists and primary care doctors to treat the patient better, including more statin therapy, more anti-platelet therapy, more lifestyle modifications. Several small studies showed similar results, but this was by far the most significant and largest study of it’s kind.
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MedicalResearch.com Interview with: David L. Katz, MD, MPH, FACPM, FACP
Director, Yale University Prevention Research Center
Griffin Hospital
Medical Research: What are the main findings of the study?Dr. Katz: We did not see any adverse effects of short-term, daily egg ingestion in adults with established coronary artery disease.
Medical Research: What was most surprising about the results?Dr. Katz: Eggs are routinely banned from 'heart healthy diets.' in particular eggs are always absent from cardiac care units, with egg beaters substituting. However, these same units routinely serve products with refined starch and added sugar. The scientific basis for excluding eggs from diets to improve cardiac health has long been suspect. Here, we show that in the short term at least, there are no discernible harms of daily egg ingestion even in adults with heart disease.
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MedicalResearch.com Interview with: Jordi Salas-Salvadó Professor of Nutrition
Human Nutrition Unit Department of Biochemistry & Biotechnology
IISPV School of Medicine.
Rovira i Virgili University CIBERobn, Instituto Carlos III
Medical Research: What are the main findings of the study?Response: In this large, multicenter, randomized clinical trial conducted in Mediterranean individuals at high cardiovascular risk, Mediterranean-diet supplemented with extra-virgin olive oil was associated to a lower increase in the prevalence of metabolic syndrome compared to the advice on a control low-fat diet. However, no beneficial effect of Mediterranean-diet on the incidence of metabolic syndrome among participants free of this condition at baseline was observed. Therefore, the lower increase in prevalence was especially due to the reversion of metabolic syndrome in those individuals with metabolic syndrome at baseline.
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MedicalResearch.com Interview with:Jaime Hart, ScD
Instructor in Medicine
Channing Division of Network Medicine
Medical Research: What are the main findings of the study?Response: The main findings are, that among 107,130 women in the Nurses' Health Study, even after adjusting for a number of traditional cardiovascular risk factors, those women living within 50 meters of a major roadway had a 38% increased risk of sudden cardiac death and 24% increased risk of fatal coronary heart disease, compared to women living 500 meters or more away.
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MedicalResearch.com Interview with: Zainab Samad, M.D., M.H.S.
Assistant Professor of Medicine
Duke University Medical Center
Durham, North Carolina
Medical Research: What are the main findings of the study?Dr. Samad: This was a sub study of REMIT, an NHLBI funded study. Our research team headed by Dr. Wei Jiang conducted the REMIT study between 2006-2011 at the Duke Heart Center. We found that women and men differ significantly in their physiological and psychological responses to mental stress. We explored sex differences across various domains felt to have implications towards cardiovascular disease pathophysiology and prognosis. We found that women had greater negative emotion, less positive emotion, while men had greater blood pressure increases in response to mental stress. On the contrary, women showed greater platelet reactivity compared to men in response to mental stress. A greater frequency of women had cardiac ischemia in response to mental stress compared to men.
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MedicalResearch.com Interview with: Joseph A. Ladapo, MD, PhD
New York University School of Medicine
Department of Population Health
New York, NY 10016
Medical Research: What are the main findings of the study?Dr. Ladapo: We showed that the use of cardiac stress testing has risen briskly over the past two decades, with the use of imaging growing particularly rapidly. We also showed that national growth in cardiac stress test use can largely be explained by population and provider characteristics, but the use of imaging cannot. Importantly, nearly one third of cardiac stress tests with imaging tests were probably inappropriate, because they were performed in patients who rarely benefit from imaging. These tests--about 1 million each year--are associated with about half a billion dollars in healthcare costs annually and lead to about 500 people developing cancer in their lifetime because of radiation they received during that cardiac stress test.
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MedicalResearch.com Interview with: Naga Pothineni, MD
Division of Cardiology
University of Arkansas for Medical Science
MedicalResearch: What are the main findings of the study?Dr. Pothineni:Hepatitis C is a blood borne infection that is very common worldwide. Most pateints who contract hepatitis C develop a chronic form on infection that progresses to liver damage and eventually hepatocellular cancer. Coronary heart disease is a worldwide problem as well. There has been interest in chronic infections being a mechanism of progression of atherosclerosis and coronary heart disease. We wanted to study the association of coronary heart disease events in patients with hepatitis C. We conducted a retrospective study of around 24,000 patients of which around 10,000 were hepatitis C positive. Our study showed that patients who have hepatitis C have a higher incidence of coronary heart disease events (myocardial infarction) when compared to patients who are negative for hepatitis C. In our analysis, we found that hepatitis C positivity is an independent risk factor for coronary events after adjusting for traditional cardiovascular risk factors like age, hypertension, smoking and diabetes.
Another interesting finding in our study was that patients with hepatitis C have lower levels of cholesterol compared to patients without hepatitis C. Low cholesterol levels in these patients do not seem to be protective against future coronary heart disease events.
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MedicalResearch.com Interview with: Elizabeth Blanchard Hills, BSN MSJ
President, Informed Health Solutions
Medical Research: What is your role?Response: My name is Elizabeth Blanchard Hills, BSN, MSJ. My company, Informed Health Solutions, currently has the privilege of “transitioning” Dr. Smith’s work into clinical practice. We have been conducting an on-going pilot project with the University of Kansas Hospital since November 2013, and our results are corroborating the results of Dr. Smith’s randomized clinical trial. We have renamed SMAC-HF; it is now called CareConnext.
Medical Research: What are the main findings of the study? Response: That we could, in fact, significantly lower hospital readmissions among heart failure patients.
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