Keeping you up to date on recent headlines in cardiovascular healthcare:
Call for global action vs. heart disease, diabetes .... The International Diabetes Federation (Brussels, Belgium), International Union Against Cancer (Geneva) and World Heart Federation (WHF, Geneva) have called for international action to combat non-communicable diseases (NCDs) – primarily heart disease, diabetes, cancer and respiratory illness, causing 60% of worldwide deaths. The statement demands "substantial increases" in funding for NCDs and essential medicines to achieve the Health Millennium Development Goals. Professor Pekka Puska, president of the WHF, called for the funding applied to infectious diseases "expanded to stop the spiraling death rates from NCDs before the most vulnerable are pushed further into the poverty trap." The statement was issued to coincide with the meeting of the World Health Assembly. (www.idf.org/leading-ngos-call-international-action-combat-epidemic-ncds)
Bone marrow stem cells used to form new blood vessels .... Researchers at the Stem Cell Program of the University of California Davis Medical Center (Sacramento, California) report inducing the formation of new blood vessels in mice with limb ischemia using adult human stem cells, resulting in fully functioning limbs that showed increased blood flow to previously damaged areas and an increased number of blood vessels. The cells showed "homing" behavior that found damaged vessels, in particular the population of ALDH bright stem cells, used in the study, the researchers said. Images of mouse limbs show how the cells target the area of low oxygen and resulted in revascularization in the injured limb.
Pulmonary hypertension treated with stem cells .... Zannos Grekos, MD, a speaker at the at the 17th Annual World Congress on Anti-Aging Medicine and Regenerative Biotechnologies, reported positive one year follow-up results for a pulmonary hypertension patient treated with his own activated stem cells. "It goes against traditional theory that we should try to fix the existing pulmonary vasculature, but we are generating new blood vessels with impressive results that are lasting beyond 12 months," said Grekos, assistant clinical professor of cardiology at Nova Southeastern University (Fort Lauderdale-Davie, Florida) and head of an international team that developed the stem cell treatment protocol. A resident of Georgia received the stem cell therapy in February 2008. Ultrasounds done at the Mayo Clinic (Jacksonville, Florida) showed significant initial decrease of the pulmonary artery mean pressure from a pre-treatment high of 41mmHg (severe) to a post treatment low of 28 mmHg (mild). Wagners pulmonary pressures remained at a low of 29 mmHg even up to one year. "This is the first time medical science has successfully reversed the disease process in pulmonary hypertension ...," Grekos said.
Milestones for Paccocath Technology/drug-eluting balloon .... Medrad Interventional/Possis (Pittsburgh) reported that it has selected physician investigators for U.S. clinical trials and completed a manufacturing facility for bringing its Cotavance device, using Paccocath Technology, for treatment of peripheral artery disease (PAD). Paccocath technology is a drug matrix applied to the balloon of an angioplasty catheter which is released directly to the diseased area when the balloon is inflated. The company said that clinical results show that using the Paccocath technology during an angioplasty keeps the vessels open wider over time compared to standard angioplasty. Medrad is in the process of obtaining the CE mark and FDA approval for the Cotavance. William Gray, MD, of Columbia University (New York), a co-primary investigator, said that Paccocath is the only drug-eluting balloon technology "with positive clinical science results." (www.medrad.com/newsroom/display-press-release.html?PRid=242)
First use of near-infrared spectroscopy/ultrasound catheter .... InfraReDx (Burlington, Massachusetts) reported first use in patients of a coronary catheter that uses both light and sound to image coronary plaques in patients undergoing coronary angiography at the Thoraxcenter (Rotterdam), a combination of IVUS and NIRS imaging. NIRS was recently cleared by the FDA for the identification of lipid core plaques. The LipiScan Coronary Imaging System is a catheter-based device using laser light to detect how much fat and other substances are contained in a plaque. Dr. Ton van der Steen, a professor of biomedical engineering at the Thoraxcenter, said, "In order to determine both composition and structure of an atherosclerotic plaque, a combination catheter is necessary." (www.infraredx.com)
Enrollment completed in TTOP-AF trial .... Medtronic (Minneapolis) reported completing enrollment in the Tailored Treatment of Permanent Atrial Fibrillation (TTOP-AF) trial evaluating the use of its latest radiofrequency (RF) ablation technology, the Medtronic Ablation Frontiers Cardiac Ablation System, for the treatment of continuous atrial fibrillation (AF). The system is comprised of an RF generator and three anatomically shaped mapping and ablation catheters for targeting three areas of the heart to treat AF. Delivering customized RF energy for eliminating or isolating abnormal electrical impulses in the left atrium, the system is approved for use in Europe but not yet FDA-approved.
TOCCATA trial assesses force in catheter ablation .... Endosense (Geneva) reported the clinical results from the TOuCh+ for CATheter Ablation (TOCCATA) European clinical trial at the recent 30th Annual Scientific Sessions of the Heart Rhythm Society (Washington). It said that results of the 76-patient, multi-center study confirm efficacy/safety of the TactiCath force-sensing ablation catheter during catheter ablation, calling it "the first and only force-sensing ablation catheter." TactiCath is designed to give a real-time, objective measure of contact force during the catheter ablation procedure. The trial found high variability of contact force application across even very experienced operators, suggesting the need for a tool to measure contact force during the procedure. The TactiCath was CE-marked in May. (www.endosense.com/site/pages/news.html#may_14)
Glucocorticoid drugs found to protect heart .... Researchers at Keio University School of Medicine (Keio, Japan) have determined that synthetic glucocorticoids, besides being useful for treating asthma and allergies, can protect rodent hearts from the effects of heart attack. Specifically, glucocorticoids, acting via the glucocorticoid receptor (GR), induced mouse and rat heart muscle cells to produce PGD2, reducing the damage to their hearts in both ex vivo and in vivo models of heart attack. The authors therefore suggest that GR-selective glucocorticoids might be more beneficial to humans following heart attack than glucocorticoids that activate both GR and the MR protein, activation of which occurs in response to stress and might have unwanted consequences.
Combined ablation method improves treatment of AF .... The results of an international study offer an improved combination method for treating severe AF. The trial, Substrate vs. Trigger Ablation for Reduction of Atrial Fibrillation (STAR-AF), compared three approaches: ablation that blocks abnormal signals to the heart; a new, automated approach for ablating "hot spots" in the heart identified by electrical signals called "fractionated electrograms"; and a combination of both methods. The study found that 74% of patients receiving the combined treatment had no AF after the one-year study, compared to 47% who received only ablation of the pulmonary vein tissue and 29% who underwent only "hot spot" therapy; 94% receiving the combined therapy remained off of all anti-arrhythmic medications at 12-month follow-up. An algorithm from the EnSite System from St. Jude Medical (St. Paul, Minnesota) was used to identify these regions in the patients randomized to receive the treatment.
—Compiled by Don Long, MDD National Editor