Keeping you up to date on recent headlines in cardiovascular healthcare:
Report: Stem cell treatment of end-stage disease successful ... Researchers have reported successful use of an adult stem cell therapy from Regenocyte Therapeutic (Bonita Springs, Florida) to treat a patient with idiopathic dilated cardiomyopathy and ejection fraction (EF) of 18%. At three months the patient's EF improved to 40% and at six months 51%. Regenocyte said it has treated several similar patients and they are demonstrating similar improvements. Athina Kyritsis, MD, chair of Regenocyte's scientific advisory board, said, "We have had consistent success in generating viable heart tissue and growing new vessels, treating diseases like cardiomyopathy and peripheral vascular disease.... [W]e have only begun to discover what adult stem cells can accomplish in altering the course of diseases until now thought to be untreatable." The Alliance for the Advancement of Adult Stem Cell Therapy and Research.
Europace pushes use of remote monitoring ... Only about 1% of patients in Europe with implantable cardiac devices are being monitored with remote devices despite wide availability of remote monitoring in many European countries. "Even in countries that have introduced remote monitoring, there are widespread disparities between centers," said Professor Angelo Auricchio, a spokesman for the European Society of Cardiology (ESC; Sophia Antipolis, France). Implants in Europe are estimated increasing 5%-10% per year, and Auricchio said that once a device has been implanted, it needs effective follow-up for greatest efficiency. "[M]more than 2 million follow-up encounters with device patients are now needed in Europe each year, which is pushing the healthcare system to the breaking point," Auricchio said, and that there should be an increase in the number of devices interrogated remotely. The report was made at Europace 2009 in Madrid.
Endurance athlete arrhythmias a problem for sports cardiologists ... Competitive sports and endurance training will increase the risk of cardiac arrhythmias and sudden death for athletes in middle age or with pre-existing cardiac diseases. Luis Mont, MD, of the Hospital Cl nic de Barcelona (Barcelona, Spain) said, in a presentation at Europace 2009, that AF is more frequent in middle-aged individuals who formerly took part in competitive sports and continue to be active, or simply in those involved in regular endurance training without having actually participated in competitive sports. He added that the cost-effectiveness of routine pre-participation screening in a broad population of athletes and endurance sports participants has not yet been clarified. "Given ... that an increasing number of individuals engage in regular endurance sports," said Mont, "it is certainly of great interest to define which recommendations for sport should be implemented in an individual patient, and how best to manage arrhythmias in participants."
'Harmless' EKG irregularity linked to arrhythmia ... First-degree atrioventricular (AV) block, a PR interval longer than 200 milliseconds, is associated with a greater risk of atrial fibrillation (AF), pacemaker implantation, and all-cause mortality, according to Thomas Wang, MD, of the Massachusetts General Hospital (Boston) and colleagues. Previous studies, mostly conducted in young healthy men in the military, suggested that a finding of first-degree AV block on an electrocardiogram does not have serious consequences. the researchers turned to 7,575 participants (mean age 47) in the Framingham Heart Study who underwent routine EKg. In follow-up of four decades 481 participants developed AF, 124 received a pacemaker, and 1,739 died. Each 20-millisecond increase in PR interval was associated with an increased risk of each of the three outcomes: AF, pacemaker implant, and all-cause death. The study appears in JAMA. (http://jama.ama-assn.org/cgi/content/short/301/24/2571)
Higher mortality for heart failure patients with cognitive impairment ... A team of French and Italian researchers has analyzed data from three studies of 896 patients suffering from cardiac insufficiency, half of them cognitively impaired. They found heart failure associated with a high mortality rate, even among patients not cognitively impaired: 17.9 % (at 6 months), 25.6 % (at 12 months) und 68,2 % (at 60 months). The mortality rate was even higher in heart failure patients with cognitive impairment, with rates of 35.6 %, 40 % and 96.3 %. Clotilde Balucani, MD, from Perugia, Italy, said this data are "too scarce to identify whether this is just the result of an increased morbidity in patients with cognitive impairment or if there is a direct causal relationship due to under-treatment or poor compliance" and that more research is needed. Researchers presented the findings at the current meeting of the European Neurological Society (ENS; Basel, Switzerland). (ENS abstract O119: Balucani et al, "Does cognitive impairment influence outcome in congestive heart failure? A systematic review")
Overweight a health concern, BMI only part of story ... Overweight is a health concern, and Body Mass Index (BMI) is part of a larger picture, according to a new advisory from the American Heart Association (Dallas). Cora Lewis, MD, professor of medicine and public health at the University of Alabama at Birmingham, said, "This larger picture includes important relationships between BMI and other health outcomes, such as cardiovascular disease and its risk factors. Arguably, the most important relationship among the cardiovascular disease risk factors is diabetes, which is significantly more common in overweight than in normal-weight people." Lewis and colleagues conclude: Being overweight increases the risk of cardiovascular disease, Type 2 diabetes and other health conditions but more research is needed on the links between overweight and health and this should go beyond looking only at BMI and risk of death. "Meanwhile, we cannot afford to wait for this research to begin addressing the problem of overweight in our patients and in our society." The advisory is published June 8, online, by Circulation (DOI: 10.1161/CIRCULATIONAHA.109.192574).
Weekly stroke clinics can't meet minimum standards ... According to an audit published by the Royal College of Physicians (London), outpatient clinics in District General Hospitals operating on a weekly basis are not able to reach minimum standards for treating patients who have suffered a stroke. The study, published in Clinical Medicine journal, assessed the timeliness with which an urgent access neurovascular clinic was able to evaluate possible stroke victims between 2000 and 2006. Data showed that the clinic was not able to reach the UK National Clinical Guideline for Stroke's recommendation that patients who may have suffered a minor stroke or transient ischemic attack receive urgent evaluation within one week. Researchers at Stoke Mandeville Hospital surveyed GPs and found that high-risk patients were seen sooner than those who had been categorized as low or intermediate risk. But, in 2006, the average wait for high risk patients was still 17 days. The report appears in the June edition of Clinical Medicine. Royal College of Physicians.
Inflammation markers linked to more fatal than non-fatal events in elderly ... The presence of inflammatory markers in the blood can identify that an elderly individual is at higher risk for fatal rather than a non-fatal heart attack or stroke, according to a new study. Naveed Sattar of the University of Glasgow (Glasgow, Scotland) and colleagues used data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) trial, of participants ages between 70 and 82 who had or were at risk of cardiovascular disease. They examined if three inflammatory markers-interleukin-6 (IL-6), C-reactive protein (CRP) and fibrinogen-were each more strongly associated with fatal cardiovascular events than with non-fatal cardiovascular events over three years.The researchers found that in this group of elderly patients increased levels of all three inflammatory markers, and in particular IL-6, were more strongly associated with a fatal heart attack or stroke than with a non-fatal heart attack or stroke. The findings appear this week in the open access journal PLoS Medicine.
— Compiled by Don Long, MDD National Editor