The Heart: Heart disease and stroke news and discussions

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weatheriscool
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How pathogenic gene variants lead to heart failure
https://medicalxpress.com/news/2022-08- ... ilure.html
by Max Delbrück Center for Molecular Medicine

Cardiomyopathy is not a uniform disease. Rather, individual genetic defects lead to heart failure in different ways, an international consortium reports in Science.

The molecular and cellular mechanisms that lead to heart failure in people with cardiomyopathy are determined by the specific gene variant that each patient carries, according to newly published research based on the first comprehensive single-cell analysis of cardiac cells from healthy and failing hearts.

The work, reported in the journal Science, was conducted by 53 scientists from six countries in North America, Europe, and Asia.

The study shows that cell type compositions and gene activation profiles change according to the genetic variants. The investigators say the findings can inform the design of targeted therapies that take into account each patient's underlying gene defect responsible for their particular form of cardiomyopathy.

The team studied 880,000 single heart cells

Examining the genes activated in about 880,000 single cells from 61 failing hearts and 18 healthy donor hearts as reference was a complex endeavor which required an interdisciplinary team. The organs were procured by the Brigham and Woman's Hospital in Boston, U.S., University of Alberta in Canada, the Heart and Diabetes Center North Rhine-Westphalia in Bad Oeynhausen, Ruhr University Bochum in Germany and Imperial College London, UK.

Senior authors who spearheaded the project are Christine Seidman, professor of medicine and genetics at Harvard Medical School and a cardiologist at Brigham and Women's Hospital; Jonathan Seidman, professor of genetics at Harvard Medical School; Norbert Hübner, professor of cardiovascular and metabolic sciences at the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC) and Charité—Universitätsmedizin Berlin as well as Dr. Gavin Oudit, University of Alberta, Canada; Professor Hendrik Milting, Heart and Diabetes Center NRW, Bad Oeynhausen, Ruhr University Bochum, Germany; Dr. Matthias Heinig, Helmholtz Munich, Germany; Dr. Michela Noseda of the National Heart and Lung Institute at Imperial College London, UK and Professor Sarah Teichmann, Wellcome Sanger Institute in Cambridge, UK. Joint first authors are Dr. Daniel Reichart (Harvard), Eric Lindberg and Dr. Henrike Maatz (both MDC).
weatheriscool
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Population-based study: Autoimmune disorders increase risk of cardiovascular disease
https://medicalxpress.com/news/2022-08- ... sease.html
by KU Leuven
About 10% of the population in high income regions like Europe and the United States has been diagnosed with one or multiple autoimmune disorders. Examples are rheumatoid arthritis, psoriasis, systemic sclerosis, lupus erythematosus and type I diabetes. Although earlier research has suggested associations between some of these disorders and a higher risk of cardiovascular disease, these studies were often too small and limited to selected autoimmune or selected cardiovascular conditions to draw conclusive evidence on the necessity of cardiovascular disease prevention among patients with autoimmune disease, until now.

At the annual congress of the European Society of Cardiology, held this weekend in Barcelona, an international research team led by KU Leuven presented the outcome of a thorough epidemiological investigation into possible links between 19 of the most common autoimmune disorders and cardiovascular disease. The results of the study show that patients with autoimmune disease have a substantially higher risk (between 1.4 and 3.6 times depending on which autoimmune condition) of developing cardiovascular disease than people without an autoimmune disorder. This excess risk is comparable to that of type 2 diabetes, a well-known risk factor for cardiovascular disease. The research shows for the first time that cardiovascular risks affect autoimmune disease as a group of disorders, rather than selected disorders individually.
weatheriscool
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New type of defibrillator met safety, effectiveness goals in global clinical study

by Terri Malloy, Mayo Clinic
https://medicalxpress.com/news/2022-08- ... goals.html
A new type of extravascular implantable cardioverter-defibrillator (ICD) using a lead (thin wire) placed behind the sternum met safety and effectiveness goals for participants in a premarket global clinical study. The device effectively terminated acute and chronic life-threatening ventricular arrhythmias. The findings were presented during a late-breaking session at the European Society of Cardiology Congress and were simultaneously published in The New England Journal of Medicine.

Arrhythmias such as ventricular fibrillation and ventricular tachycardia happen in the lower heart chambers, or ventricles. They are dangerous because they interfere with the normal coordinated filling and pumping of blood through the heart. These arrhythmias can cause collapse and death if not rapidly treated. The ability of ICDs to accurately detect and terminate ventricular arrhythmias in high-risk patients saves lives.

For study participants, the lead of the extravascular ICD was inserted under the sternum, compared to transvenous ICD leads that are inserted through the veins into the heart, or subcutaneous ICDs that have a lead placed beneath the skin above the sternum. Patients with prior open-heart surgery, or who required pacing for a slow heart rate or had a pacemaker, were not candidates for this study.
weatheriscool
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Residential exposure to petroleum refining could be related to strokes in the southern US
https://phys.org/news/2022-09-residenti ... thern.html
by Institute of Physics
A new study has revealed that exposure to pollutants from petroleum refineries has a strong link to stroke rates across the Southern United States. The results were published today in Environmental Research Letters.

The southern United States (US) has a high concentration of petroleum production and refining (PPR). This process emits multiple pollutants which have previously been linked to diseases which lead to strokes. However, the relationship between residential exposure to PPR and their link to causing strokes was not previously well studied, until now.

"The geographic concentration of economic sectors, and their associated by-products, is an underexplored, plausible risk factor for stroke. By-products of petroleum production and refining include a mixture of pollutants that may impact the quality of adjacent air, soil, and potable water in residential areas," explains Honghyok Kim, lead author of the study, who will join the University of Illinois at Chicago as an Assistant Professor in September.

Researchers from Yale University, Brown University and Seoul National University have investigated the association between petroleum exposure and the number of strokes in adults. The team took data from the the Centers for Disease Control and Prevention of the US's Population Level Analysis and Community EStimates (PLACES) for seven southern US states and looked at areas within a 2.5 km or 5 km radius of petrol refineries. In these areas, the presence of sulfur dioxide—a chemical which may increase the risk of stroke—is high as it is a pollutant of PPR. They found that living near petrol refineries accounted for 5.6% of strokes in adults. This number differs by state with Mississippi having petrol refineries potentially explaining the prevalence of strokes to the highest degree (11.7%). This number further differs by census tract with one census tract located in Texas having the highest prevalence of strokes potentially explained by petrol refineries (25.3%).
weatheriscool
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Better screening could predict and prevent sudden cardiac death in young people
https://medicalxpress.com/news/2022-09- ... young.html
by Public Library of Science
Nearly nine in ten cases of sudden cardiac death (SCD) due to hypertrophic cardiomyopathy (HCM) in young people are preceded by symptoms, ECG abnormalities or a positive family history, according to a new study published this week in the open-access journal PLOS ONE by Erik Börjesson of Sahlgrenska University Hospital, Sweden, and colleagues. Those findings suggest that expanding cardiac screening beyond competitive athletes could aid in the prevention of SCD in the young population with HCM.

HCM is a genetic cardiovascular disease believed to affect one in 500 individuals in the general population. While sudden death due to HCM is rare, it is still a major cause of natural death in the young. Identifying at-risk patients can reduce the risk of SCD in young individuals with HCM, for example by exercise restriction and drug therapies. Implantable cardioverter defibrillators (ICDs) can also prevent deaths and improve quality of life. For instance, after suffering an on-field cardiac arrest last year, Danish footballer Christian Eriksen was able to return to playing eight months later with an ICD.
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Death rate for torn aorta drops, still five times more deadly without surgery, study finds
https://medicalxpress.com/news/2022-09- ... rgery.html
by Noah Fromson, University of Michigan
The chance of a patient living after tearing their aorta has improved significantly, but the condition remains deadly if not recognized early and repaired surgically, a study finds.

A team of researchers examined early mortality rates for over 5,600 patients admitted to the hospital and examined hourly with type A acute aortic dissection between 1996 and 2018 from the International Registry for Acute Aortic Dissection. The often-fatal dissection occurs when blood rushes through a tear in the ascending aorta, causing its layers to separate.

Findings published in JAMA Cardiology reveal that 5.8% of patients with type A acute aortic dissection died within the first two days after hospital arrival, a mortality rate of 0.12% per hour. The rate is significantly lower than that reported in the 1950s, which estimated that 37% of patients died within the first 48 hours, with an increasing mortality rate of 1-2% per hour.
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Inhibitor of lipid kinase PI3KC2a identified as potential new treatment of thrombosis
https://phys.org/news/2022-09-inhibitor ... ntial.html
by Leibniz-Forschungsinstitut für Molekulare Pharmakologie
The lipid kinase PI3KC2a is a potential pharmacological target for the treatment of thrombosis and, possibly, cancer. Researchers from the Leibniz-Forschungsinstitut für Molekulare Pharmakologie (FMP) have now identified a potent inhibitor of its activity that serves as a lead for further drug development.

Thrombosis including venous thrombosis and pulmonary embolism with an annual incidence of about 1 in 1,000 adults is a major threat for human health, in particular during old age. To counteract blood clotting, patients take blood thinning medication, which, however, often display severe side-effects such as bleeding (hemorrhage).
weatheriscool
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Stopping aspirin when on a blood thinner lowers risk of bleeding, study finds
https://medicalxpress.com/news/2022-09- ... owers.html
by University of Michigan
If you're already taking one blood thinner, mounting research suggests you might not need to take a second one.

In fact, when patients who are on a commonly prescribed blood thinner stop taking aspirin, their risk of bleeding complications drops significantly, a Michigan Medicine study finds.

Researchers analyzed over 6,700 people treated at anticoagulation clinics across Michigan for venous thromboembolism, or blood clots, as well as atrial fibrillation, an irregular heart rhythm that can cause stroke. Patients were treated with the common blood thinner warfarin but also took aspirin despite not having history of heart disease.

"We know that aspirin is not a panacea drug as it was once thought to be and can in fact lead to more bleeding events in some of these patients, so we worked with the clinics to reduce aspirin use among patients for whom it might not be necessary," said Geoffrey Barnes, M.D., senior author of the study and a cardiologist at the University of Michigan Health Frankel Cardiovascular Center.

Over the course of the study intervention, aspirin use among patients decreased by 46.6%. With aspirin used less commonly, the risk of a bleeding complication dropped by 32.3%—amounting to one major bleeding event prevented per every 1,000 patients who stop taking aspirin. Results are published in JAMA Network Open.
weatheriscool
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Large study of thoracic aortic aneurysm backs guidelines
https://medicalxpress.com/news/2022-10- ... lines.html
by Kaiser Permanente
A large, new Kaiser Permanente study provides high-quality evidence that most of the 33,000 patients diagnosed each year in the U.S. with a thoracic aortic aneurysm—a bulge in the part of the main artery that runs through the chest—are not likely to experience an aortic dissection and may not need open-heart surgery.

"We built the largest-ever cohort of patients with thoracic aortic aneurysm to study their natural history," said lead author Matthew D. Solomon, MD, Ph.D., a physician researcher at the Kaiser Permanente Division of Research and a Kaiser Permanente cardiologist.

"This research was critical because of the lack of evidence to guide clinicians and the ongoing debate in the field as to how large an aneurysm should be before recommending a patient undergo a very high-risk surgery."

The study, published October 5 in JAMA Cardiology, is the largest to date to support the current consensus guidelines that recommend surgery for most patients with a thoracic aneurysm that is 5.5 centimeters or larger. These guidelines are specific to patients who do not have certain genetic conditions that increase their risk of experiencing an aortic aneurysm or dissection.

The study included 6,372 Kaiser Permanente patients in Northern California who were identified as having a thoracic aortic aneurysm between 2000 and 2016. Of these, 6,092 (96%) were diagnosed with an aneurysm that was initially less than 5.5 centimeters, and 280 (4%) were initially diagnosed with an aneurysm 5.5 centimeters or larger.

All the patients were enrolled in a computerized population management system to ensure they received appropriate, ongoing imaging to assess the size and growth of their aneurysm. None had a genetic syndrome known to increase risk for an aortic aneurysm or dissection.
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AI-enabled eye scan delivers stroke and heart disease risk scores
By Rich Haridy
October 06, 2022
https://newatlas.com/health-wellbeing/a ... sk-scores/

A team of researchers in the UK has developed a fully automated artificial intelligence-enabled system that can scan retinal images for vascular health, helping identify those at high risk of heart disease and stroke.

The old adage "the eyes are windows to the soul" isn’t that far off when considering how much one can infer about a person’s general health by studying their eyes. Diseases such as rheumatoid arthritis and hyperthyroidism can be detected in the eyes, and recent innovations suggest neurodegenerative diseases like Alzheimer’s and Parkinson’s could be diagnosable through retinal scanning.

Considering how sensitive blood vessels in the eye can be to general cardiovascular changes, researchers have long studied the relationship between retinal features and conditions such as diabetes or coronary artery disease. With the advent of computerized systems that can automatically identify minute differences in a person’s retinal vasculature researchers are now closing in on a new kind of diagnostic tool.

The AI system is dubbed QUARTZ ((QUantitative Analysis of Retinal vessels Topology and siZe) and a new study put the algorithm to the test on more than 88,000 retinal images from two large ongoing population health studies. Each person included in the study had an average of seven to nine years of follow-up data, allowing the researchers to evaluate the predictive capacity of the system.
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