App helps to detect fluid in the lungs in HF patients
Voice analysis by a smartphone app has been shown to identify lung congestion in heart failure patients, permitting early intervention before deterioration. In these patients, the pumping function of the heart does not work properly, with the most common symptom being shortness of breath caused by water congestion in the lungs. This congestion causes subtle changes in speech patterns, which may be a tool for assessing clinical status. To that end, researchers examined the ability of a mobile application to distinguish between congested and noncongested states. The study included 40 individuals admitted to the hospital with acute heart failure and lung congestion. They were asked to record five sentences into a smartphone when they were admitted and then again just prior to discharge. The technology was able to distinguish between the congested state at admission and the noncongested state at discharge. “Speech is personal and as such, very small changes (related to the same person) can be detected – for example, the ability of parents to notice health issues by listening to their kids,” said study author Offer Amir, director of the Heart Institute, Hadassah Medical Centre, Jerusalem, Israel. “Today we report results of the first easy to use, noninvasive, personalized heart failure monitoring device. It requires a simple 30-second recording each day, in any language.” Amir noted that the technology could be used by patients at home. The findings were presented on HFA Discoveries, a scientific platform of the European Society of Cardiology.
Connection between opioids and heart surgery
Researchers from the Perelman School of Medicine at the University of Pennsylvania have found that about 10% of patients who are prescribed opioids following heart surgery will continue to use these meds more than 90 days after the procedure. Appearing June 17, 2020, in JAMA Cardiology, the findings also highlighted a direct link between the dosage of opioids, or oral morphine equivalent (OME), first prescribed following discharge and the likelihood of persistent opioid use 90 to 180 days after the procedure. Patients who were prescribed more than 300 mg OMEs had a significantly higher risk of prolonged use vs. those who received a lower dosage. Specifically, the team sought to determine the proportion of opioid-naïve patients who develop persistent opioid use after heart surgery and to investigate the link between the dosage first prescribed and risk of prolonged use. They looked at the data of 25,673 patients who underwent coronary artery bypass grafting (CABG) or heart valve repair or replacement between 2004 and 2016. Roughly 60% of CABG patients and 53% of valve surgery patients filled an opioid prescription within 14 days of the surgery. Additionally, 9.6% of the cardiac surgery patients continued to fill prescriptions between three and six months after surgery, with the refill rate slightly higher among CABG patients. A higher incidence rate was seen in women, younger patients and those with preexisting medical conditions, such as congestive heart failure, chronic lung disease, diabetes and kidney failure. “Our findings support a much-needed shift toward decreasing opioid dosages at discharge and using alternative approaches to reduce the risk for persistent opioid use,” said study lead author Chase Brown, a cardiovascular surgery resident and research fellow.
3D map of the heart’s neurons
A team at the University of Central Florida (UCF) College of Medicine have developed a virtual 3D heart that shows the body’s neurons and their connection to the heart. The idea is to help develop better life-saving therapies for cardiac disease. The findings appeared May 26, 2020, in the iScience by Cell Press Journal and was the project of an interdisciplinary team of researchers from UCF, the Thomas Jefferson University and their industry partners Strateos and Mbf Bioscience. “This project was geared at creating a blueprint of how the body’s intrinsic cardiac nervous system is anatomically connected to the heart structure, by mapping the pathways of these neurons and identifying their functions as it relates to how they control the heart,” explained Zixi Jack Cheng, principal investigator of the UCF team. Over a two-year period, the group developed a comprehensive map of the cardiac nervous system at the cellular level, mapping specific neuron clusters called ganglia. This should allow scientists and physicians to more precisely study the neuroanatomy of the heart. Through an understanding of an individual’s anatomical structures and functions, health care providers could possibly manipulate specific nerves to emit bioelectrical signals that repair the heart and treat conditions affecting the organ. Jin Chen, a postdoctoral fellow in Cheng’s lab and a co-author of the study, has gone on to inject colored tracers into the heart of animal models to map the pathways neurons use as they send and receive signals from the cardiac nervous system. The team is aiming to further develop a digital, interactive 3D map to better understand heart disease. “So far we have worked on normal animal models, but it’s also really important to compare the differences between healthy and diseased models down the road, because that’s our end goal for the study – to help patients with abnormalities,” Chen said.