Keeping you up to date on recent headlines in cardiovascular healthcare:
Study: 3-hour window for tPA application could be widened .... A study published in Stroke suggests that the three-hour window considered safeest for administering the stroke treatment tPA (plasminogen activator) should be widened to 4.5 hours. Researchers at Stanford University (Stanford, California) and colleagues in Germany and Belgium used data from 1,622 patients who arrived at the hospital between 3 and 4.5 hours, the treatment with tPA improving their odds of a "favorable" outcome (i.e., returning to normal or having only minimal residual symptoms) by 31%. tPA is FDA-approved for use in the three-hour window, but it can be used after that "off-label." (http://news.stanford.edu/news/2009/june3/med-tpa-060309.html)
Temporary leadless pacing successful in heart failure patients .... A new study using ultrasound-mediated leadless pacing technology, and evaluating the effects of respiration and body posture on the acoustic window, demonstrated successful pacing in human subjects with advanced heart failure. Researchers at the Queen Mary Hospital (Hong Kong) implanted in 10 heart failure patients an electrophysiology catheter incorporating a receiver-electrode delivering ultrasound-mediated pacing in the left ventricle to determine the thresholds. The approach was successful in all 10, offering the potential for avoiding the complications related to the insertion and existence of leads. The study appears in the June issue of the HeartRhythm Journal.
Joint statement on periodontal illness, heart disease .... The American Journal of Cardiology and the American Academy of Periodontology have published a consensus statement citing the link between periodontal disease and heart disease. The organizations said that the recommendations now allow cardiologists to examine a patient's mouth, and periodontists to ask questions about heart health and family history of heart disease. Besides detailing diagnostic recommendations, the consensus statement summarizes the evidence linking periodontal disease and cardiovascular disease and explains the underlying biologic and inflammatory linkage. (www.perio.org/consumer/perio_cardio.htm)
EU group supports atherosclerosis vaccine development .... AFFiRiS (Vienna) said that its vaccine development program (CETP Vaccine), in cooperation with EMC microcollections (Tuebingen, Germany), is receiving "several hundred thousand Euros" financing from the EU's Eurotrans-Bio. Project goal is to increase "good" high density lipoprotein cholesterol (HDLc) and reduce fatty deposits in the arteries. The target is a protein known as cholesteryl ester transfer protein (CETP), to reduce the activity of this protein and shift the balance of HDLc and LDLc in favor of HDLc. The project targets culmination in phase I trials. (www.affiris.com/english/news.htm)
NIH funds work on regenerating heart tissue .... Glenn Gaudette, PhD, assistant professor of biomedical engineering at Worcester Polytechnic Institute (Worcester, Massachusetts) will receive $403,000 over two years to support research using bone marrow-derived stem cells to restore function to damaged hearts. Gaudette is exploring the use of human mesenchymal stem cells (hMSCs), produced by bone marrow, to regenerate cardiac tissue. Gaudette and colleagues have developed a system for seeding biopolymer microthreads with hMSCs, stitching these threads into the heart to improve the ability to precisely place the hMSCs. The study aims to develop processes for maximizing the number of hMSCs loaded onto the threads and study the effects in rats.
Aerobic fitness link to lower risks of CHD, all-cause death .... Japanese researchers have found that poor cardio-respiratory (or aerobic) fitness increases all-cause mortality compared with those scoring high on fitness scales. Less-fit individuals also were at higher risk for coronary heart disease (CHD) and CVD. Meta-analysis of 33 observational studies evaluated all-cause mortality in 102,980 participants and 6,910 cases, and combined CHD/CVD in 84,323 participants and 4,485 cases. Assessment of low exercise tolerance was determined by identifying the speed at which a person can walk without becoming excessively fatigued. The report appears in the May 20 issue of the Journal of the American Medical Association (JAMA, 2009; 301 :1997-2004).
Potential cell therapy treatment for ischemic heart disease .... The injection of bone marrow cells into the heart of patients with chronic myocardial ischemia is associated with modest improvements in blood flow and function of the left ventricle. Researchers at the Leiden University Medical Center (Leiden, the Netherlands) assessed the effect of intramyocardial bone marrow cell injection on myocardial perfusion and left ventricular (LV) function in patients with chronic ischemia not eligible for conventional treatment. At three months, improvement in myocardial perfusion was significantly greater in the treated patients compared to placebo treatment. MRI indicated an absolute increase in LV EF in bone marrow cell-treated patients. The study appears in the May 20 issue of JAMA (2009; 301 :1997-2004).
Clinical trial tests protein to reduce angina .... University of California San Diego Medical Center is evaluating the treatment angina by injecting a protein that stimulates the growth of new blood vessels directly into the heart. The study will evaluate the safety/tolerability of three doses of human recombinant fibroblast growth factor-1. A 3D color-coded map is made of the patient's heart using the NOGA XP Cardiac Navigation System from Biosense Webster (Diamond Bar, California). The protein is injected into areas of the LV exhibiting decreased flow by using a catheter threaded through the femoral artery. (http://health.ucsd.edu/news/2009/5-20-angina-clinical-trial?intcmp=h_news)
TIA requires rapid assessment .... Researchers at the University of Oxford (Oxford, England) have published research underlining the need for rapid assessment of transient ischemic attacks (TIA) which ay signal a future major stroke. Of those who have a stroke within seven days after TIA, about half have it in the next 24 hours. In this group, 1.2% of the second strokes occurred within six hours, 2.1% within 12 hours and 5.1% within 24 hours. The researchers previously published work indicating that risk of major stroke can be reduced by up to 80% with standard drug therapy.
High BP may be programmed in womb .... Researchers at the Universities of Glasgow (Glasgow, Edinburgh) tested 278 elderly people and found those with high levels of aldosterone in their blood — a hormone increasing BP — also had low birth weights, indicating that high adult BP is programmed in the womb. High BP and low birth weight have been linked to high levels of the stress hormone cortisol in the bloodstream, but this is the first study to look specifically at levels of aldosterone, they said. The results suggest that early conditions in the womb which retard fetal growth also program the level of aldosterone production by the HPA system. The study appears in the June edition of Hypertension. (www.gla.ac.uk/news/headline_118723_en.html)
BP drug found to block breast cancer gene .... Researchers have identified a gene, called AGTR1 (analogous to HER2 or ERBB2) and over-expressed in up to 20% of breast cancers, that could be blocked in the lab by a currently available blood pressure drug, according to a study from the University of Michigan Comprehensive Cancer Center (Ann Arbor). The gene caused normal breast cells to behave like cancer cells, with this behavior reversed by treatment with the BP drug losartan, approved by the FDA. U-M has filed a patent on AGTR1 and is seeking a commercialization partner. The study appears online this week in the Proceedings of the National Academy of Sciences.
— Compiled by Don Long, MDD National Editor