Heart Health

BP reading above normal may up risk of stroke

A new study has found that any blood pressure reading higher than the normal 120/80 mmHg may increase the risk of stroke.

The meta-analysis looked at all of the available research on the risk of developing stroke in people with “prehypertension,” or blood pressure higher than optimal but lower than the threshold to be diagnosed with high blood pressure, which is 140/90 mmHg.

A total of 19 prospective cohort studies with more than 760,000 participants were included in the analysis, and participants were followed for time periods ranging from four to 36 years. From 25 to 54 percent of study participants had pre-high blood pressure.

The analysis found that people with pre-high blood pressure were 66 percent more likely to develop a stroke than people who had normal blood pressure.

The results were the same after researchers adjusted for other factors that could increase the risk of stroke, such as high cholesterol, diabetes and smoking.

The researchers determined that nearly 20 percent of strokes in the study population were due to pre-high blood pressure.

Considering the high proportion of the population who have higher than normal blood pressure, successful treatment of this condition could prevent many strokes and make a major difference in public health, study author Dingli Xu, of Southern Medical University in Guangzhou, China, said.

The study is published in the online issue of journal Neurology®.

Source: Daily news and analysis

Traffic pollution may alter structure of the heart; promote heart failure

Traffic air pollution has been linked to poor health in the past – with wheezing, coughing, and watery eyes just the tip of the iceberg. Later studies have also established a relationship between pollution and a host of heart problems, including left ventricular hypertrophy and heart failure, among others. However, a new study, from the University of Washington’s Medical Center in Seattle, has now found that air pollution emitted from traffic sources also changes the structure of the heart’s right ventricle – further increasing the risk of heart failure for residents’ of pollution-dense areas.

“Although the link between traffic-related air pollution and left ventricular hypertrophy, heart failure, and cardiovascular death is established, the effects of traffic-related air pollution on the right ventricle have not been well studied,” said the study’s lead author Peter Leary, MD, MS, of the UW Medical Center in a press release. “Using exposure to nitrogen dioxide as a surrogate for exposure to traffic-related air pollution, we were able to demonstrate for the first time that higher levels of exposure were associated with greater right ventricular mass and larger right ventricular end-diastolic volume. Greater right ventricular mass is also associated with increased risk for heart failure and cardiovascular death.”

The study observed the health patterns of 3,896 individuals who participated in the Multi-Ethnic Study of Atherosclerosis, each of whom had no prior history of cardiac disruption or disease. All of the test subjects had previously undertaken magnetic resonance imaging (MRI) scans, with authors observing their levels of exposure to pollutant nitrogen oxide in the year leading up to the scan.

On average, the study found that a higher incidence of exposure to nitrogen oxide coincided with a five percent increase (around one gram) in right ventricular mass and a three percent increase (4.1 mL) in right ventricular end-diastolic volume. The researchers combed through a range of differentiating factors that could have skewed the data before confirming their findings, including variations in lung disease, socioeconomic standing, inflammation, and left ventricular mass and volume.

“The morphologic changes in the right ventricle of the heart that we found with increased exposure to nitrogen dioxide add to the body of evidence supporting a connection between traffic-related air pollution and cardiovascular disease,” said Leary. “The many adverse effects of air pollution on human health support continued efforts to reduce this burden.”

It should be noted, however, that while increased exposure to nitrogen oxide led to a notable change in the heart’s structure, the findings have not definitively been linked to traffic air pollution. However, the researchers are confident that these recent findings are aligned with previous studies on the matter, and serve to strengthen beliefs that traffic air pollution is detrimental to cardiovascular health.

The study was published in the American Journal of Respiratory and Critical Care Medicine.

Source: Tech Times

First patient fitted with Carmat artificial heart dies

The first patient fitted with an artificial heart made by the French company Carmat has died, the hospital that had performed the transplant in December said on Monday.

The 76-year-old man died on Sunday, 75 days after the operation, the Georges Pompidou European Hospital in Paris said in a statement, adding that the cause of his death could not be known for sure at this stage.

When he was fitted with the device, the man was suffering from terminal heart failure, when the sick heart can no longer pump enough blood to sustain the body, and was said to have only a few weeks, or even days, to live.

Carmat’s bioprosthetic device is designed to replace the real heart for as much as five years, mimicking nature’s work using biological materials and sensors. It aims to help the thousands of patients who die each year while awaiting a donor, and reducing the side-effects associated with transplants.

“Carmat wishes to pay tribute to the courage and the pioneering role of this patient and his family, as well as the medical team’s dedication,” a company spokeswoman said.

She stressed that it was premature to draw any conclusions on Carmat’s artificial heart at this stage.

Three more patients in France with terminal heart failure are due to be fitted with the device. The clinical trial will be considered a success if the patients survive with the implant for at least a month.

If it passes the test, Carmat has said it would fit the device into about 20 patients with less severe heart failure.

EXTENDING LIFE

“The doctors directly involved in the post-surgical care wish to highlight the value of the lessons learned from this first clinical trial, with regard to the selection of the patient, his surveillance, the prevention and treatment of difficulties encountered,” the hospital said in its statement.

An in-depth analysis of the medical and technical data gathered since the patient’s operation will be needed to establish the cause of his death, the hospital added.

Carmat estimates around 100,000 patients in the United States and Europe could benefit from its artificial heart, a market worth more than 16 billion euros ($22 billion).

Among Carmat’s competitors for artificial heart implants are privately-held SynCardia Systems and Abiomed, both of the United States.

SynCardia’s artificial heart is the only one approved both in the United States and the European Union and has been implanted in more than 1,200 patients to keep them waiting for a heart from a matching donor. The longest a patient has lived with the device is just under four years prior to a transplant.

Carmat’s heart is designed to serve not as a bridge to transplant but as a permanent implant, extending life for terminally ill patients who cannot hope for a real organ, generally because they are too old and donors too scarce.

Source: Reuters

Three ways to keep your heart healthy

Though cardiovascular disease is the leading cause of death, there are ways by which you can significantly reduce the risk.

Judith Mackall, MD, Cardiologist at University Hospitals (UH) Case Medical Centre in Cleveland, Ohio, offers three tips to help reduce risk of heart diseases.

1. Exercise: Thirty minutes of moderate exercise every day can have a big impact on heart health. If 30 minutes is too much time to dedicate, then divide it into ten minutes and exercise thrice a day. Within ten weeks your cholesterol numbers will improve, blood pressure will come down and you will lose a few pounds. Just running a few miles can help improve cardiovascular fitness by increasing the flexibility of the coronary arteries.

2. Eat healthy: Eat a healthy, balanced diet. Remember the “Five Rule”, i.e. consume at least five fruits and vegetables every day as part of a balanced diet. This helps manage blood pressure and decrease inflammation in the body, preventing risk of cardiovascular disease. Replace saturated fats with mono or polyunsaturated fats and reduce salt intake to ensure blood pressure and cholesterol levels remain in healthy ranges.

3. Quit smoking: If you are a heavy smoker or even a social smoker, it’s time to call it quits. Smoking knocks off seven years of your life. And, if you have cardiovascular disease and you smoke, you’ll die 15 years sooner than you would otherwise, Dr Mackall adds.

Source: Zee news

Angry people ‘risking heart attacks

anger

Having a hot temper may increase your risk of having a heart attack or stroke, according to researchers.

Rage often precedes an attack and may be the trigger, say the US researchers who trawled medical literature.

They identified a dangerous period of about two hours following an outburst when people were at heightened risk.

But they say more work is needed to understand the link and find out if stress-busting strategies could avoid such complications.

People who have existing risk factors, such as a history of heart disease, are particularly susceptible, they told the European Heart Journal.

In the two hours immediately after an angry outburst, risk of a heart attack increased nearly five-fold and risk of stroke increased more than three-fold, the data from nine studies and involving thousands of people suggests.

The Harvard School of Public Health researchers say, at a population level, the risk with a single outburst of anger is relatively low – one extra heart attack per 10,000 people per year could be expected among people with low cardiovascular risk who were angry only once a month, increasing to an extra four per 10,000 people with a high cardiovascular risk.

But the risk is cumulative, meaning temper-prone individuals will be at higher risk still.

Five episodes of anger a day would result in around 158 extra heart attacks per 10,000 people with a low cardiovascular risk per year, increasing to about 657 extra heart attacks per 10,000 among those with a high cardiovascular risk, Dr Elizabeth Mostofsky and colleagues calculate

Dr Mostofsky said: “Although the risk of experiencing an acute cardiovascular event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger.”

It’s unclear why anger might be dangerous – the researchers point out that their results do not necessarily indicate that anger causes heart and circulatory problems.

Experts know that chronic stress can contribute to heart disease, partly because it can raise blood pressure but also because people may deal with stress in unhealthy ways – by smoking or drinking too much alcohol, for example.

The researchers say it is worth testing what protection stress-busting strategies, such as yoga, might offer.

Doireann Maddock, senior cardiac nurse at the British Heart Foundation, said: “It’s not clear what causes this effect. It may be linked to the physiological changes that anger causes to our bodies, but more research is needed to explore the biology behind this.

“The way you cope with anger and stress is also important. Learning how to relax can help you move on from high-pressure situations. Many people find that physical activity can help to let off steam after a stressful day.

“If you think you are experiencing harmful levels of stress or frequent anger outbursts talk to your GP.”

source: BBC news

 

Removing infected teeth before heart surgery increase complications

Removing an infected tooth prior to cardiac surgery may increase the risk of major adverse outcomes, including risk of death prior to surgery, according to a study in the March 2014 issue of The Annals of Thoracic Surgery.

Dental extraction of abscessed or infected teeth is often performed to decrease the risk of infection during surgery and endocarditis (an inflammation of the inner layer of the heart) following surgery.

Cardiac surgeon Joseph A. Dearani, MD, along with anesthesiologists Mark M. Smith, MD and Kendra J. Grim, MD, and colleagues from the Mayo Clinic in Rochester, Minn., evaluated the occurrence of major adverse outcomes in 205 patients who underwent at least one dental extraction prior to planned cardiac surgery from 2003 to 2013. The median time from dental extraction to cardiac surgery was 7 days (average 35 days).

“Guidelines from the American College of Cardiology and American Heart Association label dental extraction as a minor procedure, with the risk of death or non-fatal heart attack estimated to be less than 1%,” explained Dr. Smith. “Our results, however, documented a higher rate of major adverse outcomes, suggesting physicians should evaluate individualized risk of anesthesia and surgery in this patient population.”

In this study, patients who underwent dental extraction prior to cardiac surgery experienced an 8% incidence of major adverse outcomes, including new heart attack, stroke, kidney failure and death. Overall, 3% of patients died after dental extraction and before the planned cardiac surgery could be performed.

Noting the limitations of their retrospective review, Dr. Dearani said: “With the information from our study we cannot make a definitive recommendation for or against dental extraction prior to cardiac surgery. We recommend an individualized analysis of the expected benefit of dental extraction prior to surgery weighed against the risk of morbidity and mortality as observed in our study.”

Departure from Current Thinking
In an invited commentary in the same issue of The Annals, Michael Jonathan Unsworth-White, FRCS, from Derriford Hospital in Plymouth, United Kingdom, discussed the need for surgeons to take note of the study results. “‘Accepted wisdom’ leads surgeons to request dental reviews prior to cardiac surgery in many thousands of patients annually around the world,” said Unsworth-White. “Dr. Smith’s group asks us to question this philosophy. It is a significant departure from current thinking.”

Unsworth-White noted another recent paradigm shift in the relationship between dental surgery and cardiac surgery. Prophylactic antibiotics have routinely been prescribed for patients undergoing dental work who also had existing heart problems because it had been accepted that there is a link between dental bacteremia and endocarditis. Individuals with pre-existing heart problems tend to have a higher incidence of endocarditis. “The American Heart Association and the National Institute for Health and Clinical Excellence in the UK have withdrawn support for this practice of prophylactic antibiotics because the danger from overuse of antibiotics outweighs any other potential risks. Regular tooth brushing, flossing, and even chewing gum are now recognized to dislodge as much, if not more, bacteremia than most dental procedures,” he said.

Source: science daily

3D-printed heart aids life-saving surgery on US baby

3d-printed-splint-family-13

A newly developed 3D-printed heart has helped doctors perform a life-saving heart surgery on a 14-month old infant in the US.

Researchers from the University of Louisville and Kosair Children’s Hospital created a 3D printed model of the organ 1.5 times its actual size that helped the surgeons to prepare for the surgery.

Built in three pieces using a flexible filament, the printing reportedly took around 20 hours and cost USD 600.

Roland Lian Cung Bawi of Owensboro, Kentucky, was born with four congenital heart defects and his doctors were looking for greater insights into his condition prior to a February 10 operation.

Philip Dydynski, chief of radiology at Kosair Children’s Hospital wondered if a 3D model of the child’s heart could be constructed using a template created by images from a CT scan to allow doctors to better plan and prepare for his surgery.

The result was a model heart 1.5 times the size of the child’s.

Once the model was built, Erle Austin III, cardiothoracic surgeon at Louisville, was able to develop a surgical plan and complete the heart repair with only one operation.

“I found the model to be a game changer in planning to do surgery on a complex congenital heart defect,” he said.

Roland was released from Kosair Children’s Hospital on February 14. His prognosis is good, doctors said.

Source: zee news

If You Have An Irregular Heartbeat, Take Blood Thinners

The American Academy of Neurology on Monday issued new guidelines on the use of blood thinners for people with an irregular heartbeat, after last considering the issue in 1998. Since then, several new anticoagulants have proven at least as effective as the traditional warfarin treatment for non–valvular atrial fibrillation, and is safe for those who’ve survived stroke or its precursor, a transient ischemic attack.

Dr. Antonio Culebras, an Academy fellow at SUNY Upstate Medical University, says blood thinners are especially important for people at risk of stroke. “The World Health Organization has determined that atrial fibrillation is nearing epidemic proportions, affecting 0.5 percent of the population worldwide,” he said in a statement.

Although presenting no immediate danger, an irregular heart rhythm allows blood to collect in the heart’s upper chambers, where it may clot. Eventually, blood clots forming in the heart may flow to the brain, obstructing vessels and arteries. Approximately one in 20 Americans with an untreated irregular heartbeat will suffer stroke this year, the Academy says. To date, doctors have exercised caution in prescribing blood thinners, wary of the risk of bleeding. However, new drugs on the market carry a reduced risk of bleeding in the brain, with much greater convenience. Patients on warfarin today require frequent blood testing to monitor risk for bleeding.

But wait, there’s more. A greater safety profile for blood thinners extends the range of patients who might benefit. Such drugs may now help more elderly patients, including those with dementia and those at moderate risk of falls — factors considered too dangerous for the old-line of anticoagulants.

“Of course, doctors will need to consider the individual patient’s situation in making a decision whether or not to use anticoagulants, and which one to use, as the risks and benefits can vary for each person,” Culebras said.

Source: Medical Daily

 

Carmat artificial heart patient in satisfactory condition

A patient with terminal heart failure is in “satisfactory condition” two months after becoming the first person to be fitted with Carmat’s artificial heart which is designed to beat for several years, his hospital said.

The 76-year-old man is eating normally, no longer needs constant respiratory assistance and is able to walk a little further every day thanks to physical therapy, the Georges Pompidou European Hospital in Paris said in a statement on Tuesday.

“The Carmat bioprosthesis continues to function satisfactorily, without any anti-clotting treatment since January 10,” said the hospital, where the implant surgery was performed on December 18 and where the patient is being treated.

It praised the patient’s “exemplary courage, sense of humour and family support” for playing a role in his recovery.

Heart-assistance devices have been used for decades as a temporary solution for patients awaiting transplants, but Carmat’s product is designed to replace the real heart over the long term, mimicking nature using biological materials and sensors.

It aims to extend life for thousands of patients who die each year while awaiting a donor, while reducing the side-effects that can be associated with transplants, such as blood clots and rejection.

Three more patients in France are due to be fitted with Carmat’s device. The people selected in this first series of clinical studies suffer from terminal heart failure – when the sick heart can no longer pump enough blood to sustain the body – and would otherwise have only a few days or weeks to live.

Success will be judged on whether the patients survive with the implant for at least a month. If deemed safe, the device will then be fitted into about 20 lower-risk patients.

A spokeswoman for Carmat declined to say when the other three patients in the first round of tests would be fitted with its artificial heart.

The company estimates around 100,000 patients in the United States and Europe could benefit from its artificial heart, a market worth more than 16 billion euros ($22 billion)

Chief Executive Marcello Conviti told Reuters in November that Carmat hoped to finish human trials of the heart by the end of 2014 and to obtain approval to market them in the European Union by early 2015.

Among its competitors for artificial heart implants are privately-held SynCardia Systems and Abiomed, both of the United States.

Source: Diabetes Support

10 things that happen during a heart attack

The number of people who suffer from heart disease is constantly on the rise. Many die due to heart attacks and doctors tirelessly tell you about the classic symptoms of the condition. But do you know what exactly happens inside your body and to your heart during a heart attack? Well, here is a look at a heart attack from your body’s perspective.

1. Most heart attacks happen because of a blockage in the blood vessels that supply the muscles of the heart. This blockage happens because of plaque (a sticky substance that is made of fats, cholesterol and white blood cells) buildup on the arterial walls of the heart

2. When this plaque gets disturbed it breaks up into a number of tiny pieces that then go an lodge themselves in various places.

3. Thinking that there is a threat to your blood vessel, your red blood cells and white blood cells go an attach themselves to the plaque (just like the would in the case of a wound). While this is a repair mechanism, these cells end up blocking the blood vessel.

4. Once blocked the blood flowing through the heart stops and can no more reach the other parts of the heart muscle. Because of lack of oxygen those parts of the heart muscle start to die.

5. Your body then realizing that the heart is not working properly goes into the ‘fight or flight’ mode. It sends signal to the spinal cord that the heart in trouble.

6. The spinal cord in turn sends a message to your brain which it interprets as pain in the jaw, left hand and chest – also known as referred pain

7. In an attempt to survive your body starts to sweat profusely (this is actually a very useful mechanism since it makes you look ill and people are more likely to take you to the hospital).

8. Your breathing also becomes labored as your heart can no longer supply your lungs with blood and oxygen, so it also stops functioning optimally.

9. Apart from the lungs the brain also gets affected and one starts feeling dizzy. This is when you are likely to collapse from lack of oxygen to the essential organs of your body.

10. The muscles of your heart that have been deprived of oxygen die. The sad part is that once a part of the heart muscle dies it can never be regenerated.

Incidentally when you suffer a heart attack, the first one hour from onset is the most crucial time and your life could be saved if you are given adequate medical care within that time. Doctors call this the ‘golden hour’ as it is the only time that dying muscle fibers, the rest of the heart and other organs can be salvaged.

Source: Health India