Risk Factors For Sudden Death in Heart Failure with Preserved Ejection Fraction

MedicalResearch.com Interview with:

Muthiah Vaduganathan, MD MPH Heart and Vascular Center Brigham and Women's Hospital 

Dr. Vaduganathan

Muthiah Vaduganathan, MD MPH
Heart and Vascular Center
Brigham and Women’s Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The prevalence of heart failure with preserved ejection fraction (HFpEF) is rising globally, yet no medical therapies are currently available to alter its natural history and its progression remains incompletely understood.

Sudden death may represent a target for therapy in this disease entity. In 1,767 patients with HFpEF enrolled in the Americas region of the TOPCAT trial, we found that sudden death accounts for ~20% of all deaths. Male sex and insulin-treated diabetes mellitus identify patients at higher risk for sudden death. Sudden death was numerically lower but not statistically reduced in those randomized to spironolactone.

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Detecting Underlying Cardiovascular Disease in Young Competitive Athletes

MedicalResearch.com Interview with:
Dr. James McKinney MD MSc FRCP(C)
Division of Cardiology
University of British Columbia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sudden cardiac death (SCD) is the leading medical cause of death in young athletes. Sporting activity may predispose athletes with underlying cardiovascular conditions to develop life threatening ventricular arrhythmias during physical exercise. Despite being a relatively rare event, the death of a young healthy person is a tragic event that is difficult to comprehend. The prevalence of an underlying cardiovascular disorder in young athletes that predisposes to SCD is approximately 0.3%.

Sudden cardiac death is often the first clinical manifestation of an underlying cardiovascular condition; up to 80% of athletes are previously asymptomatic. Pre-participation screening is the systematic practice of medically evaluating athletes for the purpose of identifying (or raising suspicion of) abnormalities that could provoke sudden death. There is agreement amongst sporting and medical bodies that athletes should undergo some form of pre-participation screening. An Achilles’ heel of screening is the significant number of false-positive screens that require subsequent costly secondary testing to rule out disease. Prevention of sudden cardiac death among athletes is a common goal, however the optimal strategy for its achievement is uncertain.

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Male Basketball Players With LVH Most At Risk of Sudden Cardiac Arrest and Death

MedicalResearch.com Interview with:
Headshot portrait of Dr. Kim Harmon, family medicine, sports medicine.Kimberly G. Harmon, MD

University of Washington
Seattle, WA 98195.

MedicalResearch.com: What is the background for this study?

Response: Sudden cardiac death (SCD) in a young athlete is tragic devastating families and communities.  It has been characterized as “rare” by some, however, previous studies have looked at broad age ranges of athletes and used various methods to determine the incidence rate, sometimes only including athletes which have events during school sponsored events.  In addition, many studies only look at sudden cardiac death and do not include sudden cardiac arrest (SCA) where the athlete has a cardiac arrest but is resuscitated and survives. SCA is important to include as ideally we would like to prevent both SCA and SCD in athletes.  In this paper, over 1/3 of all US high school athletes were studied for six years to determine the incidence and the causes of SCA/D.   Media reports were used to identify cases and then autopsies were obtained in those who died.

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EKG Marker of Sudden Death in Brugada Syndrome Identified

MedicalResearch.com Interview with:
Leonardo Calo’, MD, FESC and Annamaria Martino, MD

Policlinico Caslino, Rome, Italy

MedicalResearch.com: What is the background for this study

Response: Brugada syndrome is a genetic syndrome associated to an increased risk of sudden cardiac death. For years, dispersion of repolarization within the right ventricle has been considered the cause of arrhythmogenesis in Brugada syndrome. However, recent studies have suggested that the pathophysiologic basis of this syndrome is a conduction delay in the right ventricular outflow tract.

The risk stratification of sudden cardiac death in patients affected by Brugada syndrome, especially those who are asymptomatic, is unclear. An S wave in lead I reflects the depolarization of the right ventricular outflow tract, and appears to be prominent when right ventricular enlargement and fibrosis are present (i.e in cor pulmonale or congenital cardiac diseases). Therefore we aimed at verify whether, a prominent S in DI lead could identify Brugada syndrome patients at risk of sudden cardiac death.

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CHEST 2014: Electronic Stethoscope For Evaluation of Lung and Heart Disease

MedicalResearch.com Interview with: Ilina and Medha KrishenMedicalResearch.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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Sudden Cardiac Death Risk Increased By Proximity To Major Highway

Jaime Hart, ScD Instructor in Medicine Channing Division of Network MedicineMedicalResearch.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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