In the region close to stars known as the ‘hot Neptune desert’ planets of Neptune’s size are rarely found, but this week scientists have uncovered one and are trying to untangle its mysteries. Research Article: Armstrong et al.
The infographic urges patients not to ignore symptoms, especially if they have a heart condition, and reassures them that hospitals have safety measures to protect patients from infection with the novel coronavirus.
Cardiovascular consults are way down. Is the threat of COVID-19 infection scaring people away from ED’s?
We caught up with Dr. Comilla Sasson, the American Heart Association’s VP for science and innovation. She’s an emergency physician who teaches at the University of Colorado. She’d traveled to New York City to “help with the response,” and she talked with us from a field hospital that had been set up on a tennis court in Central Park.
She had lots to say about what’s driving patients away from emergency departments these days and what’s likely to happen in medicine (hello, telemedicine!) once the pandemic abates.
From a “Circulation: Heart Failure” Journal study (Feb 25, 2020):
The study shows that wearable sensors coupled with machine learning analytics have predictive accuracy comparable to implanted devices.
We demonstrate that machine learning analytics using data from a wearable sensor can accurately predict hospitalization for heart failure exacerbation…at a median time of 6.5 days before the admission.
Heart failure (HF) is a major public health problem affecting >23 million patients worldwide. Hospitalization costs for HF represent 80% of costs attributed to HF care. Thus, accurate and timely detection of worsening HF could allow for interventions aimed at reducing the risk of HF admission.
Several such approaches have been tested. Tracking of daily weight, as recommended by current HF guidelines, did not lead to reduction of the risk of HF hospitalization, most likely because the weight gain is a contemporaneous or lagging indicator rather than a leading event. Interventions based on intrathoracic impedance monitoring also did not result in reduction of readmission risk. The results suggest that physiological parameters other than weight or intrathoracic impedance in isolation may be needed to detect HF decompensation in a timely manner. In fact, 28% reduction of rehospitalization rates has been shown with interventions based on pulmonary artery hemodynamic monitoring. More recently, in the MultiSENSE study (Multisensor Chronic Evaluation in Ambulatory HF Patients), an algorithm based on physiological data from sensors in the implantable cardiac resynchronization therapy defibrillators, was shown to have 70% sensitivity in predicting the risk of HF hospitalization or outpatient visit with intravenous therapies for worsening of HF.
Heart disease is the number one cause of death among women in the United States. It takes the lives of nearly twice as many women as all forms of cancer combined, yet many women know very little about their heart health.Heart attack symptoms in women
Women tend to have subtler symptoms, and they may begin up to a month before the heart attack. Symptoms include:
Fatigue or weakness
Pressure, or tightness in the center of the chest
Pain that spreads to the upper body, neck or jaw
Unusual sweating, nausea or vomiting
Shortness of breath
Because many of these symptoms can be associated with common illnesses such as the flu, women are more likely to brush them off or assume something less serious is going on — and that can be a serious or even fatal mistake. If you experience these symptoms, don’t ignore them. Play it safe and call 911. The sooner you get treatment, the greater the chances of recovery.
From a British Medical Journal (BMJ) Open Heart online article:
The intake of marine omega-3s has consistently been found to have antiarrhythmic effects. When marine omega-3s are consumed, there is an increase in cellular membrane fluidity, inhibition of L-type calcium channels and a reduction in the chance of arrhythmic events during susceptible times. Prospective data suggest that maintaining an omega-3 index of about 8%, which requires consuming seafood rich in omega-3 up to five times per week or consuming over 3 g of EPA and DHA per day, may provide the greatest protection against arrhythmic events.
Marine omega-3s for the prevention of arrhythmias
Omega-3s have been theorised to increase membrane fluidity by reducing compression of the acyl chains of membrane phospholipid fatty acids, which can lead to a reduction in the ‘spring-like’ tension on membrane ion channels. This spring-like tension can reduce the ability of ions to freely move in and out of the ion channel and hence reduce its conductance. This is known as the ‘Andersen membrane spring-like tension hypothesis’ and is just one way marine omega-3s may prevent arrhythmias.
Dietary omega-3s are mainly consumed as triglycerides, which are absorbed as free fatty acids and monoglycerides. These fats then get rapidly resynthesised in the intestine and liver back to triglycerides with subsequent integration into chylomicrons, very low-density lipoprotein and low-density lipoprotein (LDL) (LDL can actually deliver omega-3s to tissues via LDL receptors).
From a Wall Street Journal online article (01/14/20):
Americans are dying of heart disease and strokes at a rising rate in middle age, normally considered the prime years of life. An analysis of U.S. mortality statistics by The Wall Street Journal shows the problem is geographically widespread.
Death rates from cardiovascular disease among people between the ages of 45 and 64 are rising in cities all across the country, including in some of the most unlikely places.
In the Journal’s analysis, three metro areas east of Colorado’s Rocky Mountains—Colorado Springs, Fort Collins and Greeley—recorded some of the biggest increases. Death rates in each rose almost 25%. The three cities boast robust access to exercise and health care. There are bike trails, good heart-disease treatment-and-prevention programs and nearby skiing and hiking.
“This is an entirely new approach with no current treatments able to change scar in this way,” says Associate Professor James Chong who led the research. “By improving cardiac function and scar formation following heart attack, treatment with rhPDGF-AB led to an overall increase in survival rate in our study.”
The research centers on a protein therapy called recombinant human platelet-derived growth factor-AB (rhPDGF-AB), which had previously been shown to improve heart function in mice that had suffered a heart attack. In a new study aimed at bringing the treatment closer to human trials, a team set out to discover if it produced similar results in large animals, namely pigs.
The researchers from the Westmead Institute for Medical Research (WIMR) and the University of Sydney found that when pigs that had suffered a heart attack received an infusion of rhPDGF, it did indeed prompt the formation of new blood vessels in the heart and led to a reduction of potentially fatal heart arrhythmia.
Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation.
January 2, 2020 Atrial fibrillation is the most common sustained arrhythmia,1 and alcohol is consumed by a majority of U.S. adults.2 The current study showed that among regular drinkers, a substantial reduction in alcohol consumption by patients with symptomatic atrial fibrillation was associated with a reduction in recurrence of atrial fibrillation and a reduced proportion of time spent in atrial fibrillation. Earlier meta-analyses showed that alcohol was associated with a dose-related increased risk of incident atrial fibrillation, with increased risk observed even among drinkers who consumed as few as 7 drinks per week.8 Current trends show a rise in alcohol consumption among adults older than 60 years of age,2coupled with greater prevalence of atrial fibrillation in this age group. The present study, with participants having an average intake of approximately 17 drinks per week at baseline, suggests that consumption at these levels may contribute to atrial fibrillation.
It was all horribly familiar — a rerun of an episode 15 months earlier, when she was with her family in River Vale, N.J. Back then, the burning pressure sent her to the emergency department, and she was told the same thing: She was having a heart attack. Immediately the cardiologist looked for blockages in the coronary arteries, which feed blood and oxygen to the hardworking muscles of her heart. That was the cause of most heart attacks. But they found no blockage.
Since childhood, she had frequent terrible canker sores that lasted for weeks. Sometimes it was hard to eat or even talk. Her mother, a nurse, told her everybody got them and thought she was being dramatic when she complained. So she had never brought them up with her doctors. Now the woman saw that her answer somehow made sense to the rheumatologist.
Indeed, that was the clue that led the rheumatologist to a likely diagnosis: Behcet’s disease. It’s an unusual inflammatory disorder characterized by joint pains, muscle pains and recurrent ulcers in mucus membranes throughout the body. Almost any part of the body can be involved — the eyes, the nose and lungs, the brain, the blood vessels, even the heart. Behcet’s was named after a Turkish dermatologist who in 1937 described a triad of clinical findings including canker sores (medically known as aphthous ulcers), genital ulcers and an inflammatory condition of the eye.