Tag Archives: Heart Health

Heart Health: Sudden Cardiac Arrest Risks

You may think the most common single cause of death in the United States is heart attack. Or cancer. Or stroke.

But it’s actually sudden cardiac arrest (SCA). SCA is a problem with your heart’s electrical system (usually called ventricular tachycardia or ventricular fibrillation).

Most SCA victims survive if they get help very quickly. But SCA is fatal 95% of the time.

Cardiac Tests: B-Type Natriuretic Peptide (BNP)

B-type natriuretic peptide (BNP) belongs to a family of protein hormones called natriuretic peptides. These natriuretic peptides have an important role in regulating the circulation. They act on blood vessels, causing them to dilate, or widen. They also work on the kidneys, causing them to excrete more salt and water. In addition, the natriuretic peptides reduce the production of various hormones that narrow blood vessels, boost the heart rate, or affect fluid retention; examples include adrenaline, angiotensin, and aldosterone.

Technology: AI Offers Window On Heart Health

AI can pick up on subtle clues from a person’s physiological state such as their heart rate, the time differences between each heartbeat or the electrical signals their heart produces in order to identify irregularities that point to medical conditions.

“Being able to detect atrial fibrillation just by wearing a wristwatch all the time, that kind of relatively simple technology could actually have a massive impact,” explained consultant cardiologist Tim Fairbairn, cardiovascular imaging lead at Liverpool Heart and Chest Hospital in the UK.

Clinical: Yale Women’s Heart Health Program

The Women’s Heart and Vascular Program provides state-of-the-art cardiac care for women with heart disease, as well as expert screening of women at risk for heart disease.

Heart disease remains the number one killer of American women and there is a great need for specialized care directed at women’s cardiac needs. The Women’s Heart and Vascular Program is dedicated to screening, educating and treating women at risk for, or with established heart disease.

Under the direction of Lisa A. Freed, MD, FACC, the Women’s Heart and Vascular Program incorporates not only her expertise in cardiology, but also collaborates with experts in diabetes, menopause, nutrition, exercise physiology, and smoking cessation. In addition, Dr. Freed consults with experts in sleep apnea and mental health professionals for intervention with co-existing depression and anxiety.

The program also focuses on clinical research in collaboration with Yale’s Women’s Health Research Center in order to advance the care of women with heart disease. 

Wearable Monitors: Heart Rate Variability Tracking

2021 HEART RESEARCH: TOP FINDINGS OF CARDIOLOGISTS

Coronary artery bypass graft (CABG) was supported as superior to fractional flow reserve (FFR)–guided percutaneous coronary intervention (PCI) for three-vessel coronary artery disease (CAD). PCI failed to meet noninferiority criteria at 1-year follow-up in a study comparing outcomes between FFR-guided PCI using contemporary stents and CABG. This adds to existing evidence showing superior outcomes with CABG in patients with the most-complex CAD.

The sodium–glucose transporter-2 (SGLT-2) inhibitor empagliflozin was found to be beneficial in heart failure with preserved ejection fraction. Empagliflozin is the first medication shown to improve outcomes in this population. It’s unknown if this is a class effect of all SGLT-2 inhibitors, but this could be a game changer.

Poor-quality carbohydrates were linked to cardiovascular mortality, around the world. Consumption of higher-glycemic-index carbohydrates was associated with higher rates of cardiovascular disease and mortality in countries all around the world. These data are particularly important because lower-income countries often have diets high in refined carbohydrates, which may worsen cardiovascular disparities.

New guidelines for managing valvular heart disease were released. These new guidelines add or elevate several recommendations for transcatheter therapy, and they lower thresholds for intervention in some conditions.

The editors of Circulation: Cardiovascular Quality and Outcomes addressed racial-ethnic disparities. The editors affirmed that structural racism is a public health crisis and that the scientific publishing community can play a role in addressing it.

Tricuspid annuloplasty for moderate regurgitation during mitral-valve surgery was of unclear benefit. Annuloplasty was associated with less progression of moderate tricuspid regurgitation but more pacemakers at 2 years. Unfortunately, this mixed outcome does not clearly inform the decision on performing annuloplasty at the time of surgery, and longer-term follow-up is needed.

Immediate angiography was not beneficial in out-of-hospital cardiac arrest without ST elevation. Patients with out-of-hospital cardiac arrest who did not have ST elevation on their initial ECG did not benefit from immediate angiography. Although a potential coronary culprit was identified in about 40% of patients, neurologic injury was by far the most frequent cause of death, negating any benefit from coronary revascularization.

Many statin side effects are related to the “nocebo” effect. A creative study enrolled 60 people with statin intolerance and gave them 12 randomly ordered 1-month treatment periods: 4 periods of no medication, 4 of placebo, and 4 of statin. Symptom intensity did not differ between placebo and statin periods and, interestingly, some even had more symptoms on placebo. This demonstrates that some cases of “statin intolerance” may be related to the “nocebo” effect.

Shorter duration of dual antiplatelet therapy following PCI/stent placement was found to be acceptable in patients with high bleeding risk. A large, randomized trial found that 1 month of dual antiplatelet therapy provided similar clinical outcomes and a lower bleeding risk than 3-to-6-month regimens for this challenging patient subset.

De-escalation” of dual antiplatelet therapy for patients undergoing PCI for acute myocardial infarction (MI). This industry-funded study evaluated patients who had received 1 month of aspirin plus ticagrelor after acute MI and stent placement and “de-escalated” half to aspirin plus clopidogrel. At 1 year, there was significantly less bleeding in the de-escalation group and a nonsignificant trend toward fewer ischemic events as well.

Covid-19 Vaccination: Risks Of Myocarditis

Given the myriad of cardiac concerns associated with SARS-CoV-2 infection, news that the myocarditis associated with mRNA vaccination is mostly mild and resolves quickly in the rare instances in which it occurs was welcome news. The findings continue to tip scales in favor of vaccination and resulted in this week’s top trending clinical topic.

Heart Health: Tricuspid Regurgitation Treatment

The tricuspid valve helps regulate blood flow in the heart. But when it isn’t working properly, a condition known as tricuspid regurgitation can occur. In this video, cardiac surgeon S. Christopher Malaisrie, MD and interventional cardiologist Charles J. Davidson, MD explain how tricuspid regurgitation is being treated in innovative new ways at Northwestern Medicine. For more information, visit http://heart.nm.org

Heart Health: What Is Cholesterol? (AHA Video)

There are two types of cholesterol: LDL cholesterol, which is bad, and HDL, which is good. Learn why too much cholesterol and elevated triglycerides can lead to heart disease and stroke. Make it a priority to have your cholesterol checked.