The Heart: Heart disease and stroke news and discussions

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Scientists identify how caffeine reduces bad cholesterol
By Michael Irving
February 15, 2022

Your morning vice might not be that guilty a pleasure after all: coffee seems to have a range of health benefits, but exactly how it affects the body to produce these results remains unknown. A new study has identified specific proteins that caffeine works on, which help the liver remove bad cholesterol from the bloodstream and protect against cardiovascular disease.

Several large-scale, long-term studies have revealed that coffee is good for you in various ways. One study tracked the coffee habits of more than half a million people across Europe for 16 years, and found that those who consumed the most had significantly lower mortality rates than those who abstained. Other research has linked coffee to reductions in prostate cancer, Parkinson’s, Alzheimer’s, and heart disease.

Observations are one thing, but scientists hadn’t identified many mechanisms for how compounds in coffee, particularly caffeine, might bestow these benefits. So for the new study, researchers at McMaster University investigated what might be behind caffeine’s apparent knack for preventing cardiovascular disease.

The team found that regular caffeine consumption was linked to lower levels of a protein called PCSK9 in the bloodstream. Lower levels of this protein boosts the liver’s ability to break down LDL cholesterol, the “bad” type that can block arteries and lead to cardiovascular disease. Not only did caffeine and derivatives of it work directly on PCSK9, but the researchers found that it also blocked the activation of another protein called SREBP2. This in turn also reduces levels of PCSK9 in the blood.

https://newatlas.com/health-wellbeing/c ... olesterol/

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315948/

The Effects of Flavonoids on Cardiovascular Health: A Review of Human Intervention Trials and Implications for Cerebrovascular Function

Whilst there is now a fairly large body of evidence for the effect of flavonoids on vascular health and blood flow in the periphery, effects of flavonoids on cerebrovascular health and blood flow in the brain is an emerging area of research. Evidence suggests that flavonoids may have a neuroprotective effect, with the potential to slow the cognitive decline typically associated with ageing

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Daily Activities Like Washing Dishes Reduced Heart Disease Risk in Senior Women

February 22, 2022

Seniors take note, running or brisk walking is not the only way to reduce the risk of heart disease. Simply being “up and about” performing routine activities, referred to as daily life movement, including housework, gardening, cooking and self-care activities like showering can significantly benefit cardiovascular health.

Compared to women with less than two hours per day of daily life movement, those women with at least four hours of daily life movement had a 43% lower risk of cardiovascular disease, 43% lower risk of coronary heart disease, 30% lower risk of stroke and notably, a 62% lower risk of cardiovascular disease death.

Reporting in the Feb. 22, 2022 online edition of the Journal of the American Heart Association, a multi-institutional team led by researchers at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego studied the impact of daily life movement to cardiovascular disease risk.

“The study demonstrates that all movement counts towards disease prevention,” said first author Steve Nguyen, Ph.D., M.P.H., postdoctoral scholar at the Herbert Wertheim School of Public Health. “Spending more time in daily life movement, which includes a wide range of activities we all do while on our feet and out of our chairs, resulted in a lower risk of cardiovascular disease.”

Researchers used a machine-learning algorithm to classify each minute spent while awake into one of five behaviors: sitting, sitting in a vehicle, standing still, daily life movement, or walking or running. Daily life movement encompasses activities occurring when standing and walking within a room or patio, such as when getting dressed, preparing meals or gardening.

https://ucsdnews.ucsd.edu/pressrelease/ ... nior-women

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Making the invisible visible: Getting a clearer 'picture' of blood vessels in health and disease
https://medicalxpress.com/news/2022-02- ... blood.html
by Johns Hopkins University School of Medicine

Johns Hopkins Medicine researchers have developed and tested a new imaging approach they say will accelerate imaging-based research in the lab by allowing investigators to capture images of blood vessels at different spatial scales. Tested in mouse tissues, the method, dubbed "VascuViz," includes a quick-setting polymer mixture to fill blood vessels and make them visible in multiple imaging techniques. The approach enables researchers to visualize the structure of a tissue's vasculature, which in conjunction with detailed mathematical models or complementary images of other tissue elements can clarify the complex role of blood flow in health and disease, say the researchers. The combined images of the blood vessels should not only enhance the study of the biology of diseases that involve abnormalities in blood flow, such as cancer and stroke, but also advance our understanding of the structures and functions of tissues throughout the body, they say.

The report published Feb. 10 in Nature Methods.

"Usually, if you want to gather data on blood vessels in a given tissue and combine it with all of its surrounding context like the structure and the types of cells growing there, you have to re-label the tissue several times, acquire multiple images and piece together the complementary information," says Arvind Pathak, Ph.D., professor of radiology, biomedical and electrical engineering and member of the Sidney Kimmel Comprehensive Cancer at the Johns Hopkins University School of Medicine. "This can be an expensive and time-consuming process that risks destroying the tissue's architecture, precluding our ability to use the combined information in novel ways."

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Lipid profiling can predict risk of diabetes, cardiovascular disease decades before onset
https://medicalxpress.com/news/2022-03- ... sease.html
by Public Library of Science

Simultaneous measurement of dozens of types of fats in the blood ("lipidomics") can predict the risk of developing type 2 diabetes (T2D) and cardiovascular disease (CVD) years in the future, according to a new study publishing March 3rd in the open-access journal PLOS Biology from Chris Lauber of Lipotype, Germany, and colleagues. Such early prediction through lipidomic profiling may provide the basis for recommending diet and lifestyle interventions before disease develops.

Current assessment of risk for T2D and CVD relies largely on patient history and current risk behaviors, and the levels and ratio of two major blood lipids, high- and low-density cholesterol. But the blood contains over one hundred other types of lipids, which are thought to reflect at least in part aspects of metabolism and homeostasis throughout the body.

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Observational study finds considerable variation in performance between different artificial heart valves
https://medicalxpress.com/news/2022-03- ... alves.html
by Karolinska Institutet

Researchers at Karolinska Institutet in Sweden have studied long-term morbidity and mortality in individuals who have had different models of biological heart valves implanted. The results, which show that there are considerable differences in performance depending on model group, are published in the journal JAMA Network Open.

The aortic valve is located between the heart and the aorta and ensures that blood is pumped in the correct direction. In aortic valve disease, it is often necessary to remove the sick aortic valve and replace it with an artificial one, the most common being a biological prosthetic valve.

Using the Swedish Cardiac Surgery register (part of SWEDEHEART), researchers at Karolinska Institutet were able to identify nearly 17,000 patients who had received a bioprosthetic aortic valve in Sweden between 2003 and 2018. This information was complemented with data from the records kept by the National Board of Health and Welfare and socioeconomic data from Statistics Sweden. After adjusting for baseline factors, the risk of needing a replacement prosthetic valve after 10 years was estimated to be 3.6% for those who had received the best-performing model group (Perimount) compared with 12.2 and 11.7% for the two poorest-performing model groups (Mitroflow/Crown and Soprano, respectively).

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Scientists validate a low-risk diagnostic test for coronary artery disease
https://medicalxpress.com/news/2022-03- ... onary.html
by University of Glasgow

Led by Charité – Universitätsmedizin Berlin, researchers from 31 European clinical institutions, including a team from the University of Glasgow, worked together as part of the DISCHARGE trial. The aim of the trial was to test whether cardiac computed tomography (CT) was as reliable as catheterization—the current standard diagnostic test for intermediate-risk patients—in people with suspected coronary artery disease.

A comprehensive analysis of the study's results, which has been published in the New England Journal of Medicine, suggests that CT offers a similar level of diagnostic accuracy, in addition to being associated with a lower risk of complications.

The research team from the University of Glasgow, who included includes Professors Colin Berry and Christian Delles alongside Honorary Professor Giles Roditi, recruited 48 patients into the trial, who underwent either invasive coronary angiography or CT coronary angiography. Collaborating with colleagues in NHS Greater Glasgow and Clyde and NHS Golden Jubilee, the team followed study participants up over approximately four years, via a combination of questionnaires/surveys and remote follow-up via electronic health records.

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Identifying risk factors following ICH strokes
https://medicalxpress.com/news/2022-03-factors-ich.html
by Tim Tedeschi, University of Cincinnati

A new study led by University of Cincinnati researchers provides new insights on how different risk factors following one of the most severe types of stroke can affect patient outcomes.

Daniel Woo, MD, said intracerebral hemorrhages (ICH) are caused when a blood vessel bursts inside the brain and causes bleeding in the brain. ICH strokes are often deadly and can cause high neurological disability.

Up to this point, many different factors have been generally reported to be associated with a higher likelihood of disability or death following an ICH stroke, but Woo said there was a need for more specific data.

To learn more, Woo led a cohort study analyzing outcome data three months after an ICH event from one of the largest-ever prospectively recruited group of patients, which included 1,000 non-Hispanic white, 1,000 non-Hispanic Black and 1,000 Hispanic patients. The results of the study were recently published in JAMA Network Open.

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Folding design leads to heart sensor with smaller profile
https://techxplore.com/news/2022-03-hea ... ofile.html
by American Institute of Physics

As advances in wearable devices push the amount of information they can provide consumers, sensors increasingly have to conform to the contours of the body. One approach applies the principles of kirigami to give sensors the added flexibility.

Researchers want to leverage the centuries-old art of cutting paper into designs to develop a sensor sheet that can stretch and breathe with the skin while collecting electrocardiographic data. In Applied Physics Reviews, the sensor made by researchers in Japan uses cuts in a film made of polyethylene terephthalate (PET) printed with silver electrodes to fit on a person's chest to monitor his or her heart.

"In terms of wearability, by applying kirigami structure in a PET film, due to PET deformation and bending, the film can be stretchable, so that the film can follow skin and body movement like a bandage," said author Kuniharu Takei, from Osaka Prefecture University. "In addition, since kirigami structure has physical holes in a PET film, skin can be easily breathed through the holes."

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Novel nuclear microRNA is being developed for the treatment of cardiovascular disease
https://medicalxpress.com/news/2022-04- ... sease.html
by University of Eastern Finland

A novel angiogenic microRNA drug can be a new option for the treatment of ischemic cardiovascular disease, according to a new study published in PLOS One by researchers from the University of Eastern Finland together with international collaborators. In the study, the researchers describe a novel nuclear acting microRNA.

MicroRNAs are small RNA molecules, which regulate gene expression. Their canonical role is gene silencing by targeting messenger RNAs in cell cytoplasm. However, this novel microRNA, miR-466c, has a different mechanism of action. It upregulates the vascular endothelial growth factor A (VEGFA) by targeting the gene promoter in the cell nucleus.

In addition to expanding the academic understanding of microRNA biology, these findings have commercial relevance for the development of novel RNA drugs. Increasing the expression of VEGFA by using small RNAs offers novel options for the treatment of ischemic cardiovascular disease, where the blood supply in the tissue is compromised.

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New miniature heart could help speed heart disease cures

by Andrew Thurston, Boston University

There's no safe way to get a close-up view of the human heart as it goes about its work: you can't just pop it out, take a look, then slot it back in. Scientists have tried different ways to get around this fundamental problem: they've hooked up cadaver hearts to machines to make them pump again, attached lab-grown heart tissues to springs to watch them expand and contract. Each approach has its flaws: reanimated hearts can only beat for a few hours; springs can't replicate the forces at work on the real muscle. But getting a better understanding of this vital organ is urgent: in America, someone dies of heart disease every 36 seconds, according to the Centers for Disease Control and Prevention.

Now, an interdisciplinary team of engineers, biologists, and geneticists has developed a new way of studying the heart: they've built a miniature replica of a heart chamber from a combination of nanoengineered parts and human heart tissue. There are no springs or external power sources—like the real thing, it just beats by itself, driven by the live heart tissue grown from stem cells. The device could give researchers a more accurate view of how the organ works, allowing them to track how the heart grows in the embryo, study the impact of disease, and test the potential effectiveness and side effects of new treatments—all at zero risk to patients and without leaving a lab.

https://medicalxpress.com/news/2022-04- ... sease.html

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Researchers observe three types of hormone response to surgical disruption in cardiac patients
https://medicalxpress.com/news/2022-04- ... rdiac.html
by University of Bristol

Cardiac surgery patients may experience different levels of disruption to their body producing life-saving hormones during their operations, a new study reveals.

Major surgery and critical illness produce a potentially life-threatening systemic inflammatory response, which is counterbalanced by changes in adrenocorticotrophic hormone (ACTH) and cortisol.

The body's stress response system, known as the hypothalamic-pituitary-adrenal (HPA) axis, controls the production of these hormones as a vital part of patients' response to surgery, but researchers have found that there is no simple graded HPA response to cardiac surgery.

Research by experts at the Universities of Birmingham and Bristol, published today in Journal of The Royal Society Interface, shows cardiac surgery causes major dynamic changes in concentration of ACTH and cortisol, as well as their pattern of secretion.

Using novel mathematical techniques, researchers developed a model of HPA axis activity that predicts the physiological mechanisms responsible for different patterns of cortisol secretion.

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Targeting molecular pathway that causes pulmonary arterial hypertension
https://medicalxpress.com/news/2022-05- ... nsion.html
by Scott Lafee, University of California - San Diego

Pulmonary arterial hypertension (PAH) is a type of high blood pressure in the lungs, in which blood vessels are narrowed, blocked or destroyed, causing the heart to work harder and, in time, result in cardiac weakness and failure.

The disease is relatively rare, but affects an estimated 100,000 persons in the United States, and results in 20,000 deaths annually. There is no cure.

In a study published May 4, 2022 in Science Translational Medicine, researchers at the University of California San Diego School of Medicine describe the underlying signaling pathway that results in PAH—and a novel monoclonal antibody therapy that blocks the abnormal blood vessel formation characterizing the disease.

At the cellular level, PAH progresses with proliferation of vascular smooth muscle cells (vSMC) that cause small arteries in the lungs to become narrowed, leading to progressively less oxygen in the blood. A research team, led by senior author Patricia A. Thistlethwaite, MD, Ph.D., professor of surgery in at UC San Diego School of Medicine and a cardiothoracic surgeon at UC San Diego Health, focused on overexpression of the NOTCH ligand JAGGED-1, a binding protein involved in cell signaling and, in this case, the development of small pulmonary vSMCs.

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Researchers develop wireless implantable vascular monitoring system
https://medicalxpress.com/news/2022-05- ... cular.html
by Georgia Institute of Technology

Vascular diseases are public enemy number one: the leading killers worldwide, accounting for nearly a third of all human deaths on the planet.

Continuous monitoring of hemodynamics—blood flow through the vascular system—can improve treatments and patient outcomes. But deadly conditions like hypertension and atherosclerosis occur in long and twisting vascular system with arteries of varying diameter and curvature, and existing clinical devices are limited by their bulk, rigidity, and utility.

Georgia Institute of Technology researcher Woon-Hong Yeo and his collaborators are trying to improve the odds for patients with development of an implantable soft electronic monitoring system. Their new device, consisting of a smart stent and printed soft sensors, is capable of wireless real-time monitoring of hemodynamics without batteries or circuits.

"This electronic system is designed to wirelessly deliver hemodynamic data, including arterial pressure, pulse, and flow, to an external data acquisition system, and it is super small and thin, which is why we can use a catheter to deliver it, anywhere inside the body," said Yeo, whose team released its study this week in the journal Science Advances.

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Haywire T cells attack protein in "bad" cholesterol
https://medicalxpress.com/news/2022-05- ... terol.html
by La Jolla Institute for Immunology

Preventing atherosclerosis, the underlying cause of heart disease, means scientists need to understand how immune cells drive inflammation in the arteries.

The challenge is that the T cells involved in atherosclerosis are very rare and extremely hard to find in the bloodstream. "This is a classic needle-in-the-haystack problem," says La Jolla Institute for Immunology (LJI) Professor Klaus Ley, M.D.

But T cells can't hide forever. In a study published recently in Nature Cardiovascular Research, Ley and his colleagues describe a group of T cells that attack a protein called apolipoprotein B (APOB).

APOB is the main protein component of LDL, or "bad," cholesterol. Dangerous plaques can form in the arteries as LDL levels increase in the bloodstream. These plaques can drive inflammation, block blood flow, and even break apart to trigger strokes and heart attacks.

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Diagnostic procedure to speed personalized treatment of acute stroke
https://medicalxpress.com/news/2022-06- ... acute.html
by Swiss Federal Laboratories for Materials Science and Technology

A blood clot in the brain that blocks the supply of oxygen can cause an acute stroke. In this case, every minute counts. A team from Empa, the University Hospital in Geneva and the Hirslanden Clinic is currently developing a diagnostic procedure that can be used to start a tailored therapy in a timely manner, as they write in the current issue of the journal Scientific Reports.

There is no warning sign: From one moment to the next, entire brain areas are blocked. When a clot occludes a blood vessel, the oxygen supply to the brain is interrupted, and the affected person suffers an acute cerebral stroke. The life-threatening condition can manifest itself in many different ways: from muscle paralysis to loss of hearing or vision to unconsciousness. But one thing is certain: This is a medical emergency, and the time span until the vascular blockage is resolved must be as short as possible in order to save as many nerve cells as possible from dying. This is the only way to prevent permanent neurological damage.

Which treatment is best suited for this purpose is not always easy to determine in the required rush. Based on X-ray analysis and electron microscopy, a team from Empa, the Hirslanden Clinic and the University Hospital in Geneva is currently developing a method that should enable the optimal therapy to be identified in the shortest possible time. A first study has been published in the scientific journal Scientific Reports. This data should provide the basis for tailored treatment in the sense of personalized medicine.

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New understanding of congenital heart disease progression opens door to improved treatment options
https://medicalxpress.com/news/2022-06- ... tment.html
by Graciela Gutierrez, Baylor College of Medicine

A team of investigators from Baylor College of Medicine, Texas Heart Institute and Texas Children's Hospital uncovered new insights into the mechanisms underlying the progression of congenital heart disease (CHD)―a spectrum of heart defects that develop before birth and remain the leading cause of childhood death.

The research published in Nature represents the first reported single-cell genomics evidence of unique differences in heart muscle cells and immune systems of CHD patients. Uncovering these key differences and how these diseases progress provides an opening for researchers to devise new ways to treat CHD.

While the eventual outcome of heart failure in CHD is well documented, the underlying cause of declining heart function in these patients is still poorly understood. That knowledge gap in understanding has led to roadblocks in developing new therapies capable of extending a patient's life.

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A Major Step Forward for Organ Biofabrication
July 8, 2022

Introduction:

(EurekAlert) Heart disease — the leading cause of death in the U.S. — is so deadly in part because the heart, unlike other organs, cannot repair itself after injury. That is why tissue engineering, ultimately including the wholesale fabrication of an entire human heart for transplant, is so important for the future of cardiac medicine.

To build a human heart from the ground up, researchers need to replicate the unique structures that make up the heart. This includes recreating helical geometries, which create a twisting motion as the heart beats. It’s been long theorized that this twisting motion is critical for pumping blood at high volumes, but proving that has been difficult, in part because creating hearts with different geometries and alignments has been challenging.

Now, bioengineers from the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS) have developed the first biohybrid model of human ventricles with helically aligned beating cardiac cells, and have shown that muscle alignment does, in fact, dramatically increases how much blood the ventricle can pump with each contraction.

Read more here: https://www.eurekalert.org/news-releases/958323

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Creating an 'adult-like' mature human cardiac tissue

by Courtney Chandler, University of Connecticut
https://medicalxpress.com/news/2022-07- ... issue.html

Researchers in the Biomedical Engineering Department at UConn have developed a new cardiac cell-derived platform that closely mimics the human heart, unlocking potential for more thorough preclinical drug development and testing, and model for cardiac diseases.

The research, published in Cell Reports by Assistant Professor Kshitiz in collaboration with Dr. Junaid Afzal in the cardiology department at the University of California San Francisco, presents a method that accelerates maturation of human cardiac cells towards a state suitable enough to be a surrogate for preclinical drug testing.

"There is a very strong need to create human cardiac constructs for all sorts of applications. Small animal models just do not recapitulate human heart biology, and human samples are scarce," says Kshitiz. "This matters because all drugs need to be tested for their toxicity to heart. It is widely believed that a large number of them unnecessarily fail clinical trials because we do not have human samples to test them with."

Kshitiz and Afzal first identified the need to create a matured human cardiac tissue during their time together at Johns Hopkins Medicine.

"When methods were developed to differentiate human pluripotent stem cells to cardiac cells, it created a big hope that finally we will have human heart constructs to work with," said Afzal. "While it is straightforward to get human cardiac cells, they are similar to fetal cells. What we need is adult cells."

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Fast-acting immune cells provide powerful protection against stroke
https://medicalxpress.com/news/2022-08- ... erful.html
by University of Pittsburgh

A unique subset of white blood cells confers fast-acting and lasting protection against ischemic stroke in mice, University of Pittsburgh neurologists and immunologists reported in the Journal of Clinical Investigation today.

This study identified a novel subset of CD8+ regulatory-like T cells, or CD8+TRLs, as "first responders" to stroke. Attracted to the site of ischemic injury by a unique "homing" signal released by dying brain cells, CD8+TRLs reach the brain within 24 hours after stroke onset, where they release molecules that provide direct neuroprotective effects, as well as limit inflammation and secondary brain damage.

"The beauty of CD8+TRLs is in their fast response. They confer very potent protection to the brain, which can last a long time," said co-corresponding author Xiaoming Hu, M.D., Ph.D., associate professor of neurology at Pitt and a U.S. Department of Veterans Affairs (VA) investigator. "Most importantly, these cells are easily accessible because they circulate in the blood before they enter the injured brain."

"Creating shelf-stable and ready-to-use CD8+TRLs or developing a cocktail of neuroprotective signaling molecules released by those cells once they reach the brain could present effective future therapies against stroke and offer hope to hundreds of thousands of patients who are ineligible for treatments available to them currently," said co-senior author Jun Chen, M.D., Ph.D., professor of neurology at Pitt and a U.S. Department of VA investigator.