The Heart: Heart disease and stroke news and discussions

weatheriscool
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Identifying specific hazard patterns for emerging cardiovascular disease

by Heinrich-Heine University Duesseldorf
https://medicalxpress.com/news/2021-10- ... cular.html
Predicting when atherosclerotic changes in the arteries in a stable state will progress to acute cardiovascular disease has remained unresolved. The authors of the paper currently published in Nature Communications, led by first author Prof. Ulrich Flögel, MD, Institute of Molecular Cardiology, Faculty of Medicine, Heinrich Heine University, Düsseldorf, Germany, present an imaging technique—the targeted and multicolor nanotracer platform technology—that visualizes the hazard patterns in the development of progressive coronary disease in a mouse model.

Hazard pattern using the example of a mouse heart (top in cross-section) with a massively worn out and thus in its performance strongly impaired right heart as consequential damage to be seen in the follow-up examination (bottom right compared to bottom left).

The cascade of these vascular diseases ranges from inflammation of the vessel, thrombosis with subsequent detachment of minute particles of the vascular plaque, to vascular occlusion resulting in permanent damage due to, for example, myocardial infarction.

To show the hazard patterns, three molecules (ligands)—are coupled to different types of perfluorocarbon nanoemulsion. They are specifically directed respectively to sites of inflammation, acute and chronic thrombi. There, they embed themselves and become visible and distinguishable through the use of a specific MRI imaging technique (19F-MRI).
weatheriscool
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Cleaning the brain after ischemic stroke
https://medicalxpress.com/news/2021-10- ... hemic.html
by University of Tsukuba

It's clear that taking out the trash is an essential process in maintaining a clean and tidy home. But did you know that your body has a similar process for waste removal in which damaged cells are "thrown out"? A research team in Japan has recently shed new light on the dynamics of this process—termed efferocytosis—following ischemic stroke.

In a new study published this month in Science Immunology, researchers from the University of Tsukuba use a mouse model to identify the role of a key cell receptor, CD300a, in the process of efferocytosis after stroke.

During ischemic stroke, blockage of a blood vessel supplying the brain leads to disrupted blood flow, which can trigger cell death. Dying cells in turn trigger inflammatory responses that may worsen damage in the brain and lead to neurological impairment. Therefore, the elimination of dying cells through efferocytosis is a key part of minimizing the effects of ischemic stroke. However, the process of efferocytosis is not fully understood. The group led by researchers from the University of Tsukuba sought to further clarify the role of efferocytosis in ischemic stroke, particularly in the super-acute phase, which occurs within hours of the initial onset of stroke.
weatheriscool
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Re: Heart disease and stroke news and discussions

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Researchers find benefits and drawbacks to two-step surgical approach for 'leaky heart valves'
https://medicalxpress.com/news/2021-11- ... roach.html
by NIH/National Heart, Lung and Blood Institute

Patients with mitral and tricuspid valve regurgitation, a condition sometimes called "leaky heart valves," appeared to do better after two years if they had a tricuspid valve repair at the time of mitral valve surgery, according to a study supported by the National Heart, Lung, and Blood Institute (NHLBI), a part of the National Institutes of Health. The primary findings were released at the American Heart Association's Scientific Sessions and published in the New England Journal of Medicine.

Researchers found patients who had the mitral valve surgery with the tricuspid annuloplasty were less likely to die, need a tricuspid valve reoperation, or have tricuspid regurgitation advance to a severe stage during a two-year period after treatment, compared to those who had the mitral valve surgery alone. However, patients who had both procedures were more likely to need a permanent pacemaker.

The surgical protocol aims to prevent regurgitation, which occurs when flaps on the heart valves don't close properly and blood flows backward into the heart. This can make it harder for blood to move efficiently throughout the body. In severe cases, regurgitation can increase the risk for an irregular heart rhythm, stroke, or heart failure.
weatheriscool
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New way to identify early risks of cardiovascular disease
https://medicalxpress.com/news/2021-12- ... sease.html
by Karolinska Institutet
The risk of developing cardiovascular disease is strongly associated with the "bad" LDL cholesterol. A large study by scientists at Karolinska Institutet now shows that two proteins that transport cholesterol particles in the blood provide early and reliable risk information. The researchers now advocate introducing new guidelines for detecting cardiac risk and say the results may pave the way for early treatment, which could help lower morbidity and fatality rates.

Cardiovascular disease is the most common cause of death globally and includes a wide range of conditions, such as stroke and myocardial infarction with atherosclerosis in different organs of the body. In many cases the disease can be prevented and arrested with lifestyle changes and lipid-lowering treatments using statins and other methods.

The data generally used to assess elevated cardiac risk are reference values for the "bad" LDL cholesterol. In some medical conditions, other types of fat particles are also measured along with apolipoproteins, which transport cholesterol in the blood. International guidelines for cardiovascular disease recommend using the apolipoprotein apoB, which transports the "bad" cholesterol, as an alternative risk marker for people with type 2 diabetes, overweight (high BMI) and very high levels of blood lipids.
weatheriscool
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'Pop-up' electronic sensors could detect when individual heart cells misbehave
https://phys.org/news/2021-12-pop-up-el ... heart.html
by University of California - San Diego
Engineers at the University of California San Diego have developed a powerful new tool that monitors the electrical activity inside heart cells, using tiny "pop-up" sensors that poke into cells without damaging them. The device directly measures the movement and speed of electrical signals traveling within a single heart cell—a first—as well as between multiple heart cells. It is also the first to measure these signals inside the cells of 3D tissues.

The device, published Dec. 23 in the journal Nature Nanotechnology, could enable scientists to gain more detailed insights into heart disorders and diseases such as arrhythmia (abnormal heart rhythm), heart attack and cardiac fibrosis (stiffening or thickening of heart tissue).

"Studying how an electrical signal propagates between different cells is important to understand the mechanism of cell function and disease," said first author Yue Gu, who recently received his Ph.D. in materials science and engineering at UC San Diego. "Irregularities in this signal can be a sign of arrhythmia, for example. If the signal cannot propagate correctly from one part of the heart to another, then some part of the heart cannot receive the signal so it cannot contract."
weatheriscool
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Researchers identify how red meat increases cardiovascular disease risk
https://medicalxpress.com/news/2021-12- ... sease.html
by Cleveland Clinic
A Cleveland Clinic-led study has revealed new insights into how a diet rich in red meat increases risk for cardiovascular disease. The findings were published in Nature Microbiology and build on more than a decade of research by lead author Stanley Hazen, MD, Ph.D..

In a previous series of landmark studies, Dr. Hazen found that a byproduct that forms when gut bacteria digest certain nutrients abundant in red meat and other animal products—called TMAO (trimethylamine N-oxide)—increases the risk of heart disease and stroke.

The latest findings offer a more comprehensive understanding of the two-step process by which gut microbes convert the nutrient carnitine into TMAO, an atherosclerosis- and blood clot-promoting molecule, following the ingestion of a red meat-rich diet.

"These new studies identify the gut microbial gene cluster responsible for the second step of the process that links a red meat-rich diet to elevated cardiac disease risks," said Dr. Hazen, who directs the Cleveland Clinic Center for Microbiome & Human Health. "This discovery helps point us towards new therapeutic targets to prevent or reduce diet-associated cardiovascular disease risk."
weatheriscool
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Computer model of blood enzyme may lead to new drugs for cardiovascular disease
https://phys.org/news/2022-01-blood-enz ... sease.html
by University of California - San Diego

Membrane-associated proteins play a vital role in a variety of cellular processes, yet little is known about the membrane-association mechanism. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is one such protein with an important role in cardiovascular health, but its mechanism of action on the phospholipid membrane was unknown. To address this, researchers at University of California San Diego School of Medicine used state-of-the-art experimental and computational tools to show exactly how the enzyme interacts with the membrane and extracts its specific substrates.

The findings are publishing Jan. 3, 2022 in the online issue of Proceedings of the National Academy of Sciences.

Lp-PLA2 works on lipoproteins in the bloodstream, including common forms like low- and high-density lipoprotein (LDL and HDL). These lipoprotein particles are made up of a spherical layer of phospholipids surrounding a drop of fat and cholesterol esters. Over time, the phospholipids in this outer layer become oxidized, attracting free radicals and further oxidation, which contributes to plaque buildup and cardiovascular disease.
weatheriscool
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Innovative approach brings cell-reprogramming therapy for heart failure closer to reality
https://medicalxpress.com/news/2022-01- ... ilure.html
by Ana María Rodríguez, Ph.D., Baylor College of Medicine
Not too long ago, the idea of taking—for instance—a skin cell and transforming it into a muscle cell was unthinkable. About 10 years ago, however, revolutionary research showed that it is indeed possible to reprogram differentiated adult cells into other types fully capable of conducting new functions.

Cell reprogramming is a main interest of the lab of Dr. Todd Rosengart, chair and professor of the Michael E. DeBakey Department of Surgery at Baylor College of Medicine, whose research focuses on finding innovative therapeutic approaches for heart failure.

"Heart failure remains the leading cause of death from heart disease," said Rosengart, DeBakey-Bard Chair in Surgery and professor of molecular and cellular biology at Baylor. "Nearly 5 million Americans can be expected to develop advanced congestive heart failure, and heart transplant or mechanical circulatory support implantation currently are the only options for patients with end-stage heart disease. However, these options are limited. We need to improve how to treat this devastating condition."

After a heart attack, the parts of the heart muscle that die do not regenerate into new heart tissue; instead, they are replaced by a scar that does not help the heart to beat. "The idea behind cell reprogramming is to coach the heart to heal itself by inducing the scar tissue, which is made mostly of fibroblasts, to change into functional heart muscle," said Rosengart, professor of heart and vascular disease at the Texas Heart Institute.

Researchers have succeeded at reprogramming fibroblasts from small animals to become heart muscle, with dramatic improvements in heart function. The challenge has been to apply this technology to human cells—human fibroblasts are more resistant to reprogramming. In this study, Rosengart and his colleagues explored a novel strategy to enhance the reprogramming efficiency of human fibroblasts.
weatheriscool
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Using the eye as a window into heart disease
https://medicalxpress.com/news/2022-01- ... sease.html
by University of Leeds
Scientists have developed an artificial intelligence (AI) system that can analyze eye scans taken during a routine visit to an optician or eye clinic and identify patients at a high risk of a heart attack.

Doctors have recognized that changes to the tiny blood vessels in the retina are indicators of broader vascular disease, including problems with the heart.

In the research, led by the University of Leeds, deep learning techniques were used to train the AI system to automatically read retinal scans and identify those people who, over the following year, were likely to have a heart attack.

Deep learning is a complex series of algorithms that enable computers to identify patterns in data and to make predictions.

Writing in the journal Nature Machine Intelligence, the researchers report that the AI system had an accuracy of between 70% and 80% and could be used as a second referral mechanism for in-depth cardiovascular investigation.

The use of deep learning in the analysis of retinal scans could revolutionize the way patients are regularly screened for signs of heart disease.
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caltrek
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Neighborhood Socioeconomic Status May Impact Patient Outcomes After Heart Surgery
January 30, 2022

https://www.eurekalert.org/news-releases/941694

Introduction:
(EurekAlert) CHICAGO (January 30, 2022) — Patients with mitral valve disease who live in disadvantaged communities are more likely to experience complications and are at higher risk for death after surgery than those with higher socioeconomic status (SES), according to research presented at the 58th Annual Meeting of The Society of Thoracic Surgeons.

“We collaboratively undertook this work with The Society of Thoracic Surgeons to better understand the impact of socioeconomic status on mitral valve surgery in the US,” said Amit Iyengar, MD, MSE, from the University of Pennsylvania in Philadelphia. “The STS Adult Cardiac Surgery Database was linked with a very robust composite metric that evaluates average SES based on census block tract groups, and showed it relates to mortality and rate of achieving a successful repair, independent of all other demographic or hospital and surgeon-level characteristics we had available.”

Using data from the STS Adult Cardiac Surgery Database, Dr. Iyengar and colleagues identified 46,831 adult patients who underwent—for the first time—isolated mitral valve repair or replacement for degenerative mitral disease from 2012 to 2018. Socioeconomic status was calculated using the 2018 Area Deprivation Index (ADI), a geographically-derived measure used to assess average income, education, employment, and housing quality for a given region. For this research, the group queried the ADI at a single city block level or rural equivalent.

“We confirmed the effect of ADI by looking at it more closely in smaller bootstrapped subsets,” said Dr. Iyengar. “We did this thoughtfully, trying to shed some light on the mechanisms by which socioeconomic status would affect outcomes.”

The researchers determined that low SES patients—who more commonly received health care under government payor programs such as Medicare and Medicaid (63% vs. 49%)—had more urgent/emergent surgery (21% vs. 13%), with minimally-invasive approaches used less often (24% vs. 39%).
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