Author Interviews, Heart Disease / 20.11.2019

MedicalResearch.com Interview with: Matthew Budoff MD Professor of Medicine, UCLA Endowed Chair of Preventive Cardiology Lundquist Institute Torrance, CA 90502 MedicalResearch.com: What is the background for this study? Response: We present the nine-month interim analysis results from the EVAPORATE mechanistic study of Icosapent Ethyl, after benefits were seen with the REDUCE-IT Trial, demonstrating 25% event reduction. This trial was a serial multi-detector computed tomographic (MDCT) study to look at plaque progression between icosapent ethyl (4 gm/day) and matching placebo.  (more…)
Author Interviews, Cannabis, Heart Disease, Stroke / 17.11.2019

MedicalResearch.com Interview with: Rupak Desai, MBBS Research Fellow, Division of Cardiology Atlanta VA Medical Center MedicalResearch.com: What is the background for this study? Response: Amidst legalization of therapeutic and recreational use of marijuana/cannabis in the United States, cerebrovascular effects of marijuana use remain largely unknown, especially among young adults. We examined the association between cannabis use (18–44 years) among young adults and stroke events. The study analyzed pooled data from the Behavioral Risk Factor Surveillance System (2016–2017)—a nationally representative cross-sectional survey collected by the Centers for Disease Control and Prevention. Overall, 13.6% of total 43,860 young adults (18-44 years) reported using cannabis recently (in the last month), with 63.3% of them being men. Compared with nonusers, marijuana users were often younger, non-Hispanic white or black, and with some college education. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, OBGYNE / 18.10.2019

MedicalResearch.com Interview with: Haitham M. Ahmed, MD, MPH Chair of Cardiology, Advantage Care Physicians Brooklyn, New York MedicalResearch.com: What is the background for this study? Response: This was a meta-analysis of more than a quarter m illion mothers looking at the long-term cardiovascular risk reduction of mothers who breastfed their babies.  (more…)
Alcohol, Author Interviews, Heart Disease, Pediatrics / 06.10.2019

MedicalResearch.com Interview with: Dr Jiabi Qin, MD, PhD Xiangya School of Public Health Central South University Changsha, China  MedicalResearch.com: What is the background for this study? Response: Congenital heart defects (CHDs), defined as a gross structural abnormality of the heart or intrathoracic great vessels occurring in embryonic period and affected nearly 1% of lives births, is the most common of all congenital defects and remains a major cause of mortality and morbidity in fancy and childhood. With a worldwide prevalence of CHDs now estimated to be 1.35 million newborns with CHDs every year, the number of CHDs is steadily increasing, representing a major global health burden. The association between maternal alcohol exposure and the risk of congenital heart defects (CHDs) has been explored, but little is known about the association between paternal alcohol exposure and the risk of CHDs. Furthermore, subsequent studies regarding the association between alcohol exposure and the risk of congenital heart defects have not yield consistent results. Therefore, given the inconsistency of existing literatures and insufficient evidence of primary studies, further an update meta-analysis based on the new and previously is evidently required. Especially, to our knowledge, any meta-analysis between paternal alcohol exposure and the risk of CHDs have not been conducted.  (more…)
Allergies, Author Interviews, Brigham & Women's - Harvard, CMAJ, Dermatology, Heart Disease / 30.09.2019

MedicalResearch.com Interview with: Hyon K. Choi, MD, DrPH Professor of Medicine, Harvard Medical School Director, Gout and Crystal Arthropathy Center Director, Clinical Epidemiology and Health Outcomes Division of Rheumatology, Allergy, and Immunology Department of Medicine, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Allopurinol is a very common and generally safe medication prescribed to lower serum urate levels, most commonly to patients with gout. However, it can be associated with very rare but serious cutaneous adverse events which includes Stevens-Johnson syndrome and toxic epidermal necrolysis. Prior studies have demonstrated several risk factors for these types of cutaneous adverse events, including presence of chronic kidney disease, older age, female sex, higher initial dose of allopurinol, and the HLA-B*5801 allele, which is more commonly found in Asians and Black patients. A prior study in Taiwan suggested that heart disease (ischemic heart disease and heart failure) may also be associated with an increased risk of hospitalizations for these cutaneous adverse reactions related to allopurinol. Thus, our goal was to investigate this association using a general population cohort from Canada. Using Population Data BC, we found that heart disease was in fact independently associated with an increased risk of hospitalization for these cutaneous adverse reactions. (more…)
AHA Journals, Author Interviews, Environmental Risks, Heart Disease, Stroke / 26.09.2019

MedicalResearch.com Interview with: Zara Berg, Ph.D Fort Peck Community College Poplar, Montana MedicalResearch.com: What is the background for this study? Response: This study is part of the cohort that consist of the Honolulu Heart Program (HHP) and what later became the Honolulu-Asia Aging study. HHP study cardiovascular research starting in the 1960’s, which is equivalent to the Framingham Study. This study was used to establish the epidemiology parameters for cardiovascular diseases and is one of the longest longitudinal (34 years of follow-up) study on cardiovascular diseases and other diseases that effect the elderly. The participants were all Japanese that fought in WWII which is a sample size of 8,006 participants. In additional, there is multiple studies based on this cohort for the last fifty plus years, ranging from occupational exposure, cancer, neurological diseases, and cardiovascular diseases.  (more…)
Author Interviews, Heart Disease, NEJM, Vanderbilt / 18.09.2019

MedicalResearch.com Interview with: Daniel Muñoz, M.D, M.P.A Assistant Professor of Medicine, Division of Cardiology Medical Director for Quality, Vanderbilt Heart & Vascular Institute Medical Director, Cardiovascular ICU Vanderbilt University Medical Center Nashville, Tennessee MedicalResearch.com: What is the background for this study? Response: Despite advances in the prevention and treatment of cardiovascular disease, it remains the number one global killer of both men and women. Patients face a variety of barriers to getting the care need, including cost and complexity of medication regimens. Innovative strategies are needed to improve the delivery of preventive care, especially when it comes to socio-economically vulnerable individuals. The polypill, a fixed-dose combination of 3 blood pressure lowering medications and a cholesterol lowering medication, may be a strategy for improving cardiovascular disease prevention. We enrolled 303 patients at a community health center in Mobile, Alabama. Half of the patients were assigned to take a daily polypill, while the other half received their usual medical care. Participants underwent a standard medical exam, blood pressure measurement, and blood cholesterol testing during their initial visit, a 2-month visit, and a 12-month visit. MedicalResearch.com: What are the main findings?
  • Participants in the polypill group experienced a greater reduction in both systolic blood pressure and LDL cholesterol level, as compared with participants in the usual care group. These differences translate to an approximate 25% reduction in the risk of experiencing a cardiovascular event.
  • At 12 months, adherence to the polypill regimen, as assessed based on pill counts, was 86%.
  • The vast majority of our study participants were African-American (96%), with three quarters reporting an annual income below $15,000.
(more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 17.09.2019

MedicalResearch.com Interview with: Samuel S. Gidding, MD FH Foundation Pasadena, CA MedicalResearch.com: What is the background for this study? Response: Patients with familial hypercholesterolemia are at high risk for atherosclerotic heart disease but little is known about intensification of treatment and event rates in lipid specialty care in the United States. We examined data on 1900 patients, enrolled in the CASCADE FH Registry,sponsored by the Familial Hypercholesterolemia Foundation, to determine if cholesterol lowering therapy increased to improve getting patients to a lower LDL cholesterol and to look at incident cardiac events in tow groups, those with prior heart disease and those without. (more…)
Annals Internal Medicine, Author Interviews, Heart Disease / 17.09.2019

MedicalResearch.com Interview with: Dr Vanessa Selak MBChB, MPH (Hons), PhD, FAFPHM, FNZCPHM Senior Lecturer in the Section of Epidemiology & Biostatistics School of Population Health, Faculty of Medical and Health Sciences University of Auckland MedicalResearch.com: What is the background for this study? Response: For people who have already had a cardiovascular event, the benefits of aspirin generally outweigh its harms but the balance of benefits and risks is unclear in primary prevention. It was hoped that the results of three major trials published last year would determine whether or not aspirin had a role in the primary prevention of cardiovascular disease (CVD) among people at intermediate risk of CVD, but these trials recruited participants at lower CVD risk than expected. An updated meta-analysis of aspirin for the primary prevention of CVD, which incorporated the findings from these three trials, has confirmed that aspirin reduces the relative risk of CVD and increases the relative risk of bleeding. We investigated, using an individualized assessment of the absolute cardiovascular benefits of aspirin and its bleeding harms among New Zealand adults aged 30-79 years without established CVD who had their CVD risk assessed in primary care between 2012 and 2016, whether there are individuals without established CVD for whom the absolute cardiovascular benefits of aspirin are likely to outweigh its absolute bleeding harms. (more…)
Author Interviews, Emory, Heart Disease / 13.09.2019

MedicalResearch.com Interview with: Viola Vaccarino, MD, PhD Wilton Looney Professor and Chair in Cardiovascular Research Dept. of Epidemiology, Rollins School of Public Health Professor, Dept. of Medicine, School of Medicine Emory University MedicalResearch.com: What is the background for this study? Response: Psychological stress has been linked to increased risk for cardiovascular disease. The mechanisms have not been clear. One hypothesis has been that chronic or repeated exposure to psychological stress can cause a phenomenon of “wear-and-tear” of the vascular system due to activation of the neuroendocrine stress systems, eventually leading to accelerated plaque formation and adverse cardiovascular events. However, this has never been demonstrated in humans. In some individuals, psychological stress can induce a transitory impairment of the endothelium, a phenomenon known as endothelial dysfunction. A healthy endothelium is essential in blood flow regulation and in maintaining cardiovascular health. (more…)
Author Interviews, Heart Disease, Social Issues / 11.09.2019

MedicalResearch.com Interview with: Dr. Heather Tulloch, C. Psych Clinical, Health, and Rehabilitation Psychologist Division of Cardiac Prevention and Rehabilitation Associate Professor, Faculty of Medicine University of Ottawa Heart Institute MedicalResearch.com: What is the background for this study? Response: It is well established that many caregivers experience distress when caring for a loved one with cardiovascular disease. For example, over 40% of caregivers in Ontario, Canada, report high psychological, emotional, physical, social, and emotional stresses imposed by the caregiving role. Ironically, caregivers are vulnerable to developing their own poor cardiovascular health. For example, chronic stress brought on by a caregiving role increases caregivers’ cardiovascular reactivity (i.e., blood pressure, heart rate) and impaired endothelial function. Many caregivers also report poor preventative health behaviours and low quality of life scores. (more…)
AstraZeneca, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 10.09.2019

MedicalResearch.com Interview with: Dr. David Berg MD Senior Fellow in Cardiovascular Medicine and Critical Care Medicine Brigham and Women’s Hospital Postdoctoral Research Fellow with the TIMI Study Group. MedicalResearch.com: What is the background for this study? Response: Heart failure is a frequent and important complication of type 2 diabetes mellitus (T2DM), but there are limited tools for identifying which patients with T2DM are at the highest risk of developing heart failure. In this study, we developed and validated the TIMI Risk Score for Heart Failure in Diabetes [TRS-HF(DM)], a novel clinical risk score that identifies patients with T2DM who are at heightened risk for hospitalization due to heart failure. Fortunately, the risk score also identifies patients who have the greatest absolute reduction in the risk of hospitalization for heart failure with a new class of glucose-lowering therapies called sodium-glucose cotransporter-2 (SGLT2) inhibitors.  (more…)
Author Interviews, BMJ, Heart Disease, Sleep Disorders / 10.09.2019

MedicalResearch.com Interview with: Dr Nadine Häusler Department of Medicine, Internal Medicine University Hospital of Lausanne Lausanne, Switzerland MedicalResearch.com: What is the background for this study? Response: There are controversial results regarding the effect of napping on cardiovascular disease (CVD) exist i.e. some studies report adverse effects of napping whereas other find beneficial effects of napping on CVD. Most studies compare nappers to non-nappers or study nap duration but neglect to take the frequency of napping into account. Moreover, studies measure naps in a different way, study different populations and include different confounders, which makes it hard to compare the results. Thus, we aimed to study the association between CVD and napping as a more holistic behavior i.e. not just the duration but also the frequency of napping. (more…)
Author Interviews, BMJ, Heart Disease, Red Meat, Stroke, Vegetarians / 10.09.2019

MedicalResearch.com Interview with: Dr Tammy Y N Tong PhD Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford, Oxford, UK MedicalResearch.com: What is the background for this study? Response: Vegetarian and vegan diets have become increasingly popular in recent years, partly due to the perceived health benefits, but also concerns about the environment and animal welfare. However, the full extent of the potential health benefits and hazards of these diets is not well understood. Previous studies have suggested that vegetarians have a lower risk of coronary heart disease than non-vegetarians, but data from large studies are limited, and little has been reported on the difference in risk of stroke. (more…)
Author Interviews, Heart Disease, JAMA / 10.09.2019

MedicalResearch.com Interview with: Nariman Sepehrvand, MD Research Associate & PhD Candidate Canadian VIGOUR Centre, and Department of Medicine, University of Alberta, Edmonton, Canada Medical Research: Can you tell us a little bit about the background of this study? Dr. Sepehrvand: As you know the traditional randomized clinical trials (RCT) have been criticized from time to time for the lack of generalizability, high costs and lengthy processes. Pragmatic trials with the primary goal of informing patients, clinicians, healthcare administrators and policy-makers about the effectiveness of biomedical and behavioral interventions have the potential to address those shortcomings by enrolling a population representative of the populations in which the intervention will be eventually applied to and by streamlining and simplifying the trial-related procedures. We knew about the challenges that trialists encounter in the design and implementation of pragmatic trials, so we were wondering how pragmatic or explanatory are cardiovascular (CV) RCTs and if there has been any change over time! (more…)
Author Interviews, Brigham & Women's - Harvard, Clots - Coagulation, Diabetes, Heart Disease, Lancet / 08.09.2019

MedicalResearch.com Interview with: Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC Professor of Medicine, Harvard Medical School Executive Director of Interventional Cardiovascular Programs, Brigham and Women’s Hospital Heart & Vascular Center MedicalResearch.com: What is the background for this study? Response: Dual antiplatelet therapy (DAPT) is known to improve outcomes in patients with acute coronary syndromes (ACS), prior myocardial infarction (MI), or recent coronary stenting. What was unknown is whether patients with diabetes and stable coronary artery disease – a group generally believed to be at high ischemic risk – would benefit from initiation of long-term DAPT with low-dose aspirin plus ticagrelor versus low-dose aspirin (plus placebo). This is what THEMIS was designed to test, with THEMIS-PCI designed prospectively to examine those patients specifically who had a history of previous percutaneous coronary intervention (PCI). (more…)
Author Interviews, Heart Disease, JAMA, Occupational Health / 07.09.2019

MedicalResearch.com Interview with: Rachel Zeig-Owens, Dr.P.H., MPH FDNY Research Assistant Professor Albert Einstein Medical Center MedicalResearch.com: What are the main findings? Response: We found that the most exposed members, those who arrived first at the World Trade Center (WTC ) site—when the air-borne dust was thickest—have a 44% increased risk of cardiovascular disease (CVD) compared to those who arrived later in the day. This is a level risk that was similar to other known risk factors for CVD.  (more…)
Author Interviews, Diabetes, Heart Disease / 06.09.2019

MedicalResearch.com Interview with: Jose Carlos Nicolau, MD PhD Heart Institute University of Sao Paulo Medical School, Sao Paulo, Brazil  MedicalResearch.com: What is the background for this study? Response: There are few evidence about the late phase (1-3 years) of patients with diabetes and myocardial infarction, especially regarding quality of life (qol) and health resource utilization. Our study showed that the population with diabetes (dm), compared with the population without diabetes, have worse quality of life, more hospitalizations, and when hospitalized showed a longer hospital stay. Additionally, as expected, dm population have worse outcomes, including the composite of cv death, myocardial infarction or stroke, and all-cause death. (more…)
Author Interviews, Diabetes, Heart Disease / 06.09.2019

MedicalResearch.com Interview with: Prof. John McMurray Professor of Cardiology Institute of Cardiovascular & Medical Sciences University of Glasgow MedicalResearch.com: What is the background for this study? Response: SGLT2 inhibitors prevent the development of heart failure (HF) in patients with type 2 diabetes (T2D) – can they be used to treat patients with established heart failure? Also, although introduced as a glucose-lowering treatment for T2D, experimental evidence suggests these drugs may have non-glucose mediated benefits. So, might they be a treatment for HF even in patients without diabetes?  (more…)
Author Interviews, Diabetes, Heart Disease / 06.09.2019

MedicalResearch.com Interview with: Nicolas Danchin MD, FESC Professor of Medicine, Consultant Cardiologist Intensive Cardiac Care Unit Hôpital Européen Georges Pompidou Paris, France MedicalResearch.com: What is the background for this study? Response: FAST-MI is a programme of nationwide French surveys, carried out every 5 years in France since 2005 in patients hospitalised with STEMI or NSTEMI. Patients are included consecutively for one month and 10-year follow-up is organized. We can thus analyse patients' outcomes in relation with their profile. Knowing that diabetic patients represent a large proportion of patients with AMI, we thought it would be worthwhile determining whether they suffered specific complications, and in particular, heart failure, both at the acute stage and in the subsequent months. (more…)
Author Interviews, Heart Disease, Women's Heart Health / 29.08.2019

MedicalResearch.com Interview with: Amy Ferry Cardiology Research Nurse Centre for Cardiovascular Science The University of Edinburgh MedicalResearch.com: What is the background for this study? Response: The fourth universal definition of myocardial infarction now recommends the use of sex-specific diagnostic criteria. This approach has revealed a population of patients with myocardial infarction (predominantly women) who were previously unrecognised. The impact of these diagnostic criteria on the presentation and clinical features of men and women with suspected acute coronary syndrome is unknown.  (more…)
Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA, Race/Ethnic Diversity / 14.08.2019

MedicalResearch.com Interview with: Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: African Americans are disproportionally affected by hypertension-related cardiovascular disease compared with other racial/ethnic groups in the United States and have higher blood pressure levels inside and outside the clinic than whites and Asians. However, little is known, among African Americans, regarding whether higher mean blood pressure measured outside of the clinic setting on 24-hour ambulatory blood pressure monitoring is associated with an increased risk for cardiovascular disease events, independent of blood pressure measured in the clinic setting. (more…)
Author Interviews, Heart Disease, JAMA, Pediatrics / 14.08.2019

MedicalResearch.com Interview with: Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hypertrophic Cardiomyopathy?  Response: Hypertrophic cardiomyopathy (HCM) is a genetic condition characterised by abnormal thickening of the muscle of the heart and can affect people of all ages. It is associated with an increased risk of sudden cardiac death (SCD) and, in the last few years, a clinical risk tool that estimates the 5-year risk of SCD in adults with HCM has been developed. However, there are no similar risk models in children, where risk stratification has traditionally been based on clinical risk factors extrapolated from the adult population. We have recently shown that this approach does not discriminate risk well in children, and so the aim of this study was to develop a new risk tool to provide an individualised risk of SCD in children with HCM.  (more…)
Author Interviews, Heart Disease, Pharmaceutical Companies, Stem Cells, Technology / 12.08.2019

MedicalResearch.com Interview with: Misti Ushio, Ph.D. Chief Executive Officer Michael Graziano, PhD Chief Scientific Officer TARA Biosystem MedicalResearch.com: What is the background for this study? Response: Almost half of all drug recalls are due to cardiac toxicity that was not picked up during early screens. These human cardiac liabilities can go undetected because historically it has been challenging to predict how human hearts will respond to potentially cardiotoxic drugs despite rigorous testing in both animals and in vitro systems throughout drug development. Traditional in vitro systems and animal models do not translate well to humans, and human donor tissue availability is limited for in vitro testing. There is great potential for human-induced pluripotent stem cell cardiomyocytes (iPSC-CMs) to bridge this human translation gap, but it’s been a challenge to train these cells to recapitulate pharmacology seen in mature human heart cells. This stems from the fact that existing experimental models utilize immature human iPSC-CMs which lack relevant physiological hallmarks of adult human cardiac muscle and therefore fail to predict drug responses seen in the clinic. (more…)
Author Interviews, Genetic Research, Heart Disease / 11.08.2019

MedicalResearch.com Interview with: Ambry GeneticsNancy Niguidula, MS, DPH Doctorate in Public Health in Toxicology Ambry Genetics   MedicalResearch.com: What is the background for this study? Response: The clinical presentations of many inherited cardiovascular conditions overlap; thus, genetic testing may clarify diagnoses, help with risk stratification, facilitate appropriate clinical management decisions, and aid in identifying asymptomatic, at-risk relatives. A large number of professional societies have developed practice guidelines and recommendations for genetic testing of cardiovascular diseases. These include international and collaborative expert panels that establish genetic screening and treatment recommendations by drawing on evidence-based medicine. To further strengthen the clinical utility of cardiovascular genetic testing, the American College of Medical Genetics and Genomics (ACMG) published a guideline for 59 genes with clinical actionability that should be reported if found on whole exome sequencing, even when unrelated to the testing indication. (more…)
Author Interviews, Circadian Rhythm, Heart Disease, JACC / 11.08.2019

MedicalResearch.com Interview with: Dr. Alan Cheng, MD MBA Vice President at Medtronic Clinical Research and Therapy Development, Cardiac Rhythm Management Medtronic, Minnesota 55112  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ventricular arrhythmias can be life threatening among patients with certain types of heart disease. While implantable cardioverter defibrillators (ICDs) have become the primary means in managing these events, we still don’t fully understand when ventricular arrhythmias occur and whether they are just random events that occur at any time of the day. We pooled patient-level data from 6 prospective studies of ICD recipients and leveraged the continuous monitoring features of the ICD to understand when ventricular arrhythmias occur. Across almost 4000 patients with almost 2 years average follow up from the time of implant, we saw that ventricular arrhythmias aren’t randomly distributed throughout the day. In fact, there is a predilection for these events to occur during normal waking hours as compared to the times of the day when most patients are asleep. Additionally, we found that across the year, the spring season had higher rates of arrhythmia occurrence when compared to summer. We didn’t observe any differences in arrhythmia occurrence by the days of the week or months of the year. This analysis is not the first to explore this question but it is the largest to date.  (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Race/Ethnic Diversity / 05.08.2019

MedicalResearch.com Interview with: Muhammad Ali Chaudhary, MD Research Scientist Center for Surgery and Public Health Department of Surgery Brigham and Women’s Hospital Harvard Medical School Harvard T. H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Many studies have documented disparities in cardiovascular care for minorities, specifically African Americans compared to white patients. Coronary artery bypass grafting (CABG) is a common procedure in the United States, and the outcomes and post-surgical care for African Americans tend to be worse. We examined whether patients insured through TRICARE — a universal insurance and equal-access integrated healthcare system that covers more than 9 million active-duty members, veterans and their families — experienced these disparities. We found no racial disparities in quality-of-care outcomes, providing insights about the potential impacts of universal insurance and an equal-access health care system. The study included 8,183 TRICARE patients, aged 18-64, who had undergone CABG. The study took its data from TRICARE health care claims from the Military Health System Data Repository for the years of 2006 to 2014. (more…)
Author Interviews, Heart Disease, Lancet, Mayo Clinic, Technology / 02.08.2019

MedicalResearch.com Interview with: Paul Friedman, M.D. Professor of Medicine Norman Blane & Billie Jean Harty Chair Mayo Clinic Department of Cardiovascular Medicine Honoring Robert L. Frye, M.D. MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is an irregular heart rhythm that is often intermittent and asymptomatic.  It is estimated to affect 2.7–6.1 million people in the United States, and is associated with increased risk of stroke, heart failure and mortality. It is difficult to detect and often goes undiagnosed. After an unexplained stroke, it is important to accurately detect atrial fibrillation so that patients with it are given anticoagulation treatment to reduce the risk of recurring stroke, and other patients (who may be harmed by this treatment) are not. Currently, detection in this situation requires monitoring for weeks to years, sometimes with an implanted device, potentially leaving patients at risk of recurrent stroke as current methods do not always accurately detect atrial fibrillation, or take too long. We hypothesized that we could train a neural network to identify the subtle findings present in a standard 12-lead electrocardiogram (ECG) acquired during normal sinus rhythm that are due to structural changes associated with a history of (or impending) atrial fibrillation.   Such an AI enhanced ECG (AI ECG) would be inexpensive, widely available, noninvasive, performed in 10 seconds, and immensely useful following embolic stroke of unknown source to guide therapy. To test this hypothesis, we trained, validated, and tested a deep convolutional neural network using a large cohort of patients from the Mayo Clinic Digital Data Vault. (more…)
Author Interviews, Frailty, Geriatrics, Heart Disease / 29.07.2019

MedicalResearch.com Interview with: Dr-Dalgaard MedicalResearch.com: What is the background for this study? Response: We know that having atrial fibrillation puts you at a higher risk of falls, especially if you are elderly and frail. Additionally, some of the medications used to treat it can cause bradycardia (low heart rate), which could itself increase the risk of falls. Therefore, the aim of this study was to investigate if common medications used to treat atrial fibrillation in older patients were associated with fall-related injuries and syncope (fainting). The medications investigated were rate-lowering drugs (beta-blockers, digoxin, verapamil, diltiazem) and the anti-arrhythmic drugs (amiodarone, propafenone, and flecainide). (more…)
AHA Journals, Author Interviews, Cleveland Clinic, Exercise - Fitness, Heart Disease / 26.07.2019

MedicalResearch.com Interview with: Dermot Phelan, MD, PhD Director of the Sports Cardiology Center Cleveland Clinic in Cleveland, Ohio MedicalResearch.com: What is the background for this study? Response: It is well recognized that long-term elite endurance athletes are at higher risk of atrial fibrillation.  We wished to evaluate whether this held true for primarily strength-type athletes. We had the opportunity to screen almost 500 former NFL athletes.  It became clear that we were seeing more atrial fibrillation than one would expect during the screenings. (more…)