Keeping you up to date on recent headlines in cardiovascular healthcare:

After 5 years, coiled aneurysm better death rate than clipped .... An article published Online First and in the May edition of The Lancet Neurology by Andrew Molyneux, MD, and Richard Kerr, Neurovascular and Neuroradiology Research Unit, John Radcliffe Hospital, University of Oxford (Oxford, UK), and colleagues, reports that patients whose aneurysms are coiled instead of clipped have a better survival rate over five years according to a long-term study of the International Subarachnoid Aneurysm Trial (ISAT). The ISAT was funded by the UK Medical Research Council. In both groups, there is a slight danger of rebleeding, but in the first five years the threat is higher for coiled aneurysm. (www.thelancet.com/journals/laneur/article/PIIS1474-4422(09)70080-8/abstract)

Carbon dating shows heart cells repopulate .... By using the amount of carbon 14 in the atmosphere from above-ground nuclear testing in the 1950s and 1960, researchers at Lawrence Livermore National Laboratory (Livermore, California) and universities in Sweden have determined that cells in the human heart develop and repopulate into adulthood. But they found that the percentage of new heart cells decreases markedly with age. By age 25, renewal of heart cells gradually decrease from 1% turning over annually to .45% by the age of 75. About 50% of the heart cells a human is born with will regenerate during a lifetime. The research appears in the April 3 issue of Science. (https://publicaffairs.llnl.gov/news/news_releases/2009/NR-09-04-02.html)

AHA issues guidance on minimally invasive procedures to treat diseased brain vessels .... The American Heart Association/American Stroke Association (Dallas) have provided, in the journal Circulation, recommendations for their use, based on the best available evidence. The new statement addresses the use of stenting, coil embolization (using metal coils to close off abnormal blood vessels), in-artery delivery of clot busting drugs, and mechanical clot-removing devices for the treatment of: brain aneurysms, narrowed brain arteries, acute ischemic stroke, and arteriovenous malformations (abnormal connections between arteries and veins). (http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.109.192217)

Exercise helps after heart attack, benefits vanish when workouts stop .... Aerobic exercise, resistance training and both together safely improved blood vessel (or endothelial) function after heart attack, but quitting training quickly caused the improvements to lapse, according to a study reported in Circulation. Researchers assessed the effect of different types of exercise, as well as the effect of stopping exercise in 209 people who'd had heart attacks. They measured participants' endothelial function at the start of the study and after four weeks of training. Participants then quit their training for one month and researchers measured blood vessel function again. (http://americanheart.mediaroom.com/index.php?s=43&item=695)

UK study: gap between rich and poor post-heart surgery in England .... People from the most deprived areas of England have a far higher risk of death after cardiac surgery than people from the least deprived areas, finds a large study published online. Data on 44,902 patients, with an average age of 65 years, who underwent cardiac surgery between 1997 and 2007 at five hospitals in Birmingham and North West England showed that social deprivation was a strong independent predictor of death. People from deprived socioeconomic groups have shorter life expectancy and also spend a greater proportion of their lives affected by disability or illness, the researchers found. British Medical Journal (BMJ: bmj.com)

Improving stem cell recruitment, heart function survival post-injury .... A study in mice shows that a dual therapy can lead to generation of new blood vessels and improved cardiac function following a heart attack. The research, published by Cell Press (April 3 issue of Cell Stem Cell) explains the ineffectiveness of current stem-cell-mobilizing therapies and may drive design of future regenerative therapies for the heart, according to the authors. The researchers found that genetic or pharmacologic inhibition of CD26/DPP-IV combined with G-CSF treatment decreased DPP-IV and stabilized activated SDF-1 in the heart, thereby enhancing the recruitment of circulating blood forming precursor cells. (www.cell.com/cell-stem-cell/home)

Study: waist size predicts heart failure .... A new study, by Emily Levitan, MD, a research fellow in the Cardiovascular Epidemiology Research Unit at Beth Israel Deaconess Medical Center (BIDMC; ), and colleagues, finds that waist size is a predictor of heart failure among middle-aged and older men and women, and a risk factor even when body mass index was in the normal range. Levitan and colleagues determined that 34% of the women studied and 11% obese; and 46% of the men were overweight and 10% obese. On first analysis, they found that either BMI, waist circumference, waist to hip ratio, or waist to height ratio was linked to higher rates of heart failure. Beth Israel Deaconess Medical Center. (http://americanheart.mediaroom.com/index.php?s=43&item=705)

Teen girls catching up to boys with metabolic syndrome .... Kenn Daratha, assistant professor at the College of Nursing of Washington State University (WSU; Pullman/Spokane) and colleagues, in a paper, "Effects of Individual Components, Time, and Sex on Prevalence of Metabolic Syndrome in Adolescents," published in the April 2009 issue of the Archives of Pediatrics & Adolescent Medicine, report that while metabolic syndrome was on the rise among teens throughout the 1990s, the prevalence of metabolic syndrome in this group has remained stable over the period studied. They observed, however, that the waist circumference in teen girls has increased, while the level of HDL cholesterol has improved slightly in boys. Of concern is the fact that the fasting glucose level has nearly doubled in both boys and girls, indicating an elevated risk of early-onset diabetes. (www.vancouver.wsu.edu/marcomm/news/)

Big men more susceptible to AF .... Older men who were big during their 20s face an increased risk of suffering from atrial fibrillation (AF). New research from the Sahlgrenska Academy, University of Gothenburg (Gothenburg, Sweden), reveals that height and weight are both factors. The study reveals that the risk of atrial fibrillation increases linearly with both body size and weight gain. The larger the men were in their 20s and the more weight they gained during their life, the greater the risk. The results are published in the latest issue of the European Heart Journal. (www.sahlgrenska.gu.se/english/news_and_events/news/News_Detail?contentId=87626)

Novel imaging techniques enables prediction of treatment outcomes in patients with AF .... Researchers at the University of Utah (Salt Lake City) report that delayed-enhancement magnetic resonance imaging (DE-MRI) holds promise for predicting treatment outcomes and measuring disease progression for patients with atrial fibrillation (AF). The results indicate that DE-MRI provides a noninvasive means of assessing left atrial myocardial tissue in patients suffering from AF, and that those who do have tissue damage may be at greater risk of suffering AF recurrence after treatment with RF ablation. The study appears in the April 7 issue of Circulation. (http://healthcare.utah.edu/publicaffairs/news/current/Marrouche_Circulationstudy.html)

Compiled by Don Long, MDD National Editor

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