1. Among Noninvasive Imaging Tests, CT More Accurate Than MRI for Ruling Out Coronary Artery Disease Coronary artery disease (CAD) is a major cause of death in the United States. Typically, CAD is diagnosed through conventional coronary angiography. However, this technique is invasive and potentially risky. While several less invasive tests can be used to view the coronary arteries, computed tomography (CT) and magnetic resonance imaging (MRI) are preferred because of their superior image quality. An obvious indication for these noninvasive tests would be to reliably rule out CAD in patients with a low-to-moderate likelihood of the disease, thus avoiding an unnecessary invasive test. Researchers reviewed studies that compared CT (89 studies) or MRI (20 studies) to conventional coronary angiography in patients with suspected or known CAD. The studies were comprised of 7, 516 and 989 patients, respectively. The researchers found that for ruling out CAD, CT is a more accurate noninvasive test than MRI.
Heart disease is the single leading cause of death for American women. Nearly twice as many women in the United States die of heart disease, stroke and other cardiovascular diseases than from all forms of cancer, including breast cancer. Dr. Karla Kurrelmeyer, a cardiologist at the Methodist DeBakey Heart & Vascular Center in Houston, focuses on research and treatment of women with heart disease. Kurrelmeyer is somewhat unique among practicing cardiologists, not only because her focus is on female heart health, but also because she is a woman. Less than 20 percent of cardiologists in the U.S. are women. American Heart Month, recognized in February by the American Heart Association, gives her an opportunity to share with women on a broader scale what she shares with her patients year round. Heart Health By Dr. Karla Kurrelmeyer, cardiologist at the Methodist DeBakey Heart & Vascular Center in Houston. The most important thing I tell my female patients is to stay to as physically fit as possible.
The California Heart Center, the cardiology group that developed the nation's largest heart transplant program, has joined the Cedars-Sinai Heart Institute and Cedars-Sinai Medical Care Foundation. The California Heart Center physicians, who are nationally and internationally regarded for their expertise in treating advanced heart failure, are moving from UCLA to assume leadership roles at the Cedars-Sinai Heart Institute. Their group, which will remain in private practice, will also become part of the Cedars-Sinai Medical Care Foundation. The group is led by Jon Kobashigawa, M.D., a past president of the International Society for Heart and Lung Transplantation who has authored more than 200 scientific manuscripts. Kobashigawa also leads a number of major multi-national clinical research studies. His past medical studies have resulted in groundbreaking medical protocols, such as customized anti-rejection medications for transplant patients. At the Cedars-Sinai Heart Institute, Kobashigawa will serve as director of heart transplantation, director of advanced heart disease and as the institute's associate director for clinical affairs.
The American Heart Association (AHA) has for the first time defined "ideal cardiovascular health" and linked it to seven simple measures ("Life's Simple 7") that people can influence through diet and lifestyle changes to move from poor and intermediate to ideal health. Details of the seven health factors and lifestyle behaviors were published online before print on 20 January in Circulation: Journal of the American Heart Association in an AHA scientific statement about the new goals for defining and setting national goals for cardivascular health and disease prevention. Lead author Donald M. Lloyd-Jones, chair of the Department of Preventive Medicine and associate professor of Preventive Medicine and Medicine at Northwestern University Feinberg School of Medicine in Chicago, said that improvements in the seven health factors and lifestyle behaviors can greatly affect quality of life and life span, as well as dramatically reduce the financial burden of the Medicare-eligible population.
With scientific evidence linking high levels of copper and iron to Alzheimer's disease, heart disease, and other age-related disorders, a new report in ACS' Chemical Research in Toxicology suggests specific steps that older consumers can take to avoid build up of unhealthy amounts of these metals in their bodies. "This story of copper and iron toxicity, which I think is reaching the level of public health significance, is virtually unknown to the general medical community, to say nothing of complete unawareness of the public, " George Brewer states in the report. The article points out that copper and iron are essential nutrients for life, with high levels actually beneficial to the reproductive health of younger people. After age 50, however, high levels of these metals can damage cells in ways that may contribute to a range of age-related diseases. "It seems clear that large segments of the population are at risk for toxicities from free copper and free iron, and to me, it seems clear that preventive steps should begin now.
In a significant step toward restoring healthy blood circulation to treat a variety of diseases, a team of scientists at Weill Cornell Medical College has developed a new technique and described a novel mechanism for turning human embryonic and pluripotent stem cells into plentiful, functional endothelial cells, which are critical to the formation of blood vessels. Endothelial cells form the interior "lining" of all blood vessels and are the main component of capillaries, the smallest and most abundant vessels. In the near future, the researchers believe, it will be possible to inject these cells into humans to heal damaged organs and tissues. The new approach allows scientists to generate virtually unlimited quantities of durable endothelial cells -- more than 40-fold the quantity possible with previous approaches. Based on insights into the genetic mechanisms that regulate how embryonic stem cells form vascular endothelial cells, the approach may also yield new ways to study genetically inherited vascular diseases.
Researchers at MIT and Harvard Medical School have built targeted nanoparticles that can cling to artery walls and slowly release medicine, an advance that potentially provides an alternative to drug-releasing stents in some patients with cardiovascular disease. The particles, dubbed "nanoburrs" because they are coated with tiny protein fragments that allow them to stick to target proteins, can be designed to release their drug payload over several days. They are one of the first such particles that can precisely home in on damaged vascular tissue, says Omid Farokhzad, associate professor at Harvard Medical School and an author of a paper describing the nanoparticles in the Jan. 18 issue of the Proceedings of the National Academy of Sciences. Farokhzad and MIT Institute Professor Robert Langer, also an author of the paper, have previously developed nanoparticles that seek out and destroy tumors. The nanoburrs are targeted to a specific structure, known as the basement membrane, which lines the arterial walls and is only exposed when those walls are damaged.
Rheumatic fever is an inflammatory disease that may develop as a complication of a streptococcus infection, such as strep throat or scarlet fever (caused by Streptococcus pyogenes or group A beta-hemolytic streptococcus ). If it does develop, it will usually do so two to three weeks after the Group A streptococcal infection. Rheumatic fever mainly affects children aged between 5 and 15 years; however, it can affect adults and younger children. Boys and girls have the same risk of developing the disease; girls and women tend to have more severe symptoms. The disease may cause long term effects on the skin, heart, brain and joints. Rheumatic fever may cause permanent damage to the heart valves (rheumatic heart disease). Rheumatic fever has the potential to cause heart failure, stroke and even death. Even though there is no current cure for rheumatic fever, antibiotics, anti-inflammatory drugs and anticonvulsants may be used to relieve symptoms and prevent recurrences. The disease is fairly rare in most developed nations, but is still common in many other parts of the world, particularly in sub-Saharan Africa, south central Asia, and the indigenous population of Australia and New Zealand.
Testing a patient's cardiac respiratory stress response (RSR) can quickly and accurately detect the presence of significant coronary artery disease (S-CAD), according to new research published in the current issue of Cardiovascular Revascularization Medicine. The results found patients with S-CAD had a significantly lower RSR compared to patients without (6.7% vs. 17.4%, respectively) suggesting RSR is a strong indicator for the disease. To determine cardiac respiratory stress response (RSR), Washington Hospital Center researchers used a new innovative respiratory stress test. The test uses a Pulse Oximeter (PPG) to measure blood flow in the finger in response to paced breathing over a 90 second time period. The PPG data are immediately captured and analyzed using a proprietary algorithm that determines the RSR. All findings were confirmed using Quantitative Coronary Angiography (QCA). In comparison to QCA, the test results were highly accurate, with a sensitivity and specificity of 86% and 81%, respectively.
NICE is in the process of updating its clinical guideline on the management of chronic heart failure in adults and has published its draft recommendations for public consultation.Since the original guideline was published in 2003, new high-quality evidence from randomised controlled trials in diagnosis, treatment and monitoring have been published. This partial update will ensure that the recommendations take into account the new evidence available. Heart failure is a complex clinical syndrome of symptoms and signs such as breathlessness, fatigue and fluid retention that suggest the efficiency of the heart is impaired. The most common cause of heart failure in the UK is coronary artery disease, with many patients having suffered a myocardial infarction ( heart attack ) in the past. The draft recommendations cover the diagnosis and treatment of heart failure, including defining the combination of symptoms, signs and investigations which together are most effective in confirming a diagnosis of heart failure and influencing subsequent optimum treatments.