New device offers hope for people with heart failure

(CNN)A tiny new device is offering hope of a better life for people with severe heart failure, reducing hospitalization rates and improving mortality risk within two years of treatment, a new study finds.

Heart failure affects an estimated 5.7 million Americans and more than 26 million people globally, causing shortness of breath and tiredness among those affected as their heart struggles to pump blood around the body.

One cause of severe heart failure that currently has a poor prognosis is a leaky valve, particularly the leakage of the mitral valve, which control's blood flow in the left part of the heart. When leakage is severe, the heart can enlarge.

Estimated to affect more than two million people in the US, failure of the mitral valve causes blood to flow backward when pumped out, meaning it can't reach the rest of the body efficiently.

But a new device -- called a MitraClip -- clips the faulty valve back together, helping it work properly and pump blood out of the heart. It has now shown promising results in the study published Sunday.

Drugs are available to ease symptoms of a leaky mitral valve, but the long-term effects are unknown, the authors write. Surgery is also an option, and can be curative, but brings a significant risk of complications, as patients are often older and frailer.

Implanting the MitraClip is minimally invasive, with the device transferred up through a small incision in the groin, and has now been shown to reduce recovery time and hospitalization, according to the study.

To measure the effectiveness of the device, Dr. Gregg Stone, professor of medicine at Columbia University College of Physicians, and his team enrolled 614 patients from the US and Canada with heart failure and moderate to severe secondary mitral valve regurgitation -- a leaky mitral valve -- who continued to have symptoms despite being on drug treatment for their condition. The secondary form of the condition is when a person's left ventricle is damaged, prohibiting the valve from functioning properly.

Of the participants, 302 were given the new device and 312 acted as controls. Among those who received the MitraClip, there were 32.1% fewer hospitalizations per year within to years of follow-up.

"The annualized rate of all hospitalizations for heart failure within 24 months was 35.8% per patient-year in the device group as compared with 67.9% per patient-year in the control group," the authors wrote.

Overall mortality from any cause within those two years was also 17% lower among patients who were implanted with the device compared with the control group, at 29.1% and 46.1%, respectively.

"It's shocking how positive it is as a new therapy for patients whose hearts are very weak," said Dr. Michael Acker, the chief of the Division of Cardiovascular Surgery at Penn Medicine. Acker, who is not connected to the research, noted the study findings were far more encouraging than the results of a similar trial reported last month. "On face value, it is very exciting," he said, but he indicated that further study was necessary to understand the differences in the population groups of each study.

The MitraClip technique was first pioneered in 2003 and approved by the FDA in October 2013 to treat the primary (or degenerative) form of mitral regurgitation, according to researchers at the University of Washington.

It's used to treat the secondary form of the condition is currently under investigation and has not yet been approved by the FDA.

The new study was part of the COAPT trial for secondary mitral regurgitation and funded by American health care company Abbott, which produces the device.

Is Exercise Bad For Your Heart?

Has Research Proven That Exercise Is Bad For Your Heart?

Exercise is good for you… right? Everyone knows eating right, exercising, reducing stress and routine maintenance check-ups are the key to living up to your genetic potential. Well, a new study just found a certain type of exercise seems to be bad for your heart. Here’s the scoop: Not too long ago, researchers conducted a study on the heart health of a group of very fit older athletes — men who had been part of a National or Olympic team in distance running or rowing, or runners who had completed at least 100 marathons. All of the men had trained and competed throughout their adult lives and continued to strenuously exercise. The results were not good. Half of these lifelong athletes showed evidence of heart muscle scarring. None of the younger athletes or the older non-athletes had fibrosis in their hearts. The affected men were the ones who had trained the longest and hardest. Now, a new study done on rats has reproduced similar findings.

In this study, published in the journal, Circulation, Canadian and Spanish scientists prodded young, healthy male rats to run at an intense pace, day after day, for three months, which is the equivalent of about 10 years, in human terms. At the beginning of the study, the rats had perfectly normal hearts. At the end of the training period, heart scans showed that most of the rodents had developed diffuse scarring and some structural changes, similar to the changes seen in the human endurance athletes. A control group of rats did not develop the heart changes, but when the rats stopped running, their hearts returned to normal within 8 weeks.

What Does All This Mean For You?

According to Dr. Paul Thompson, the Chief of Cardiology at Hartford Hospital in Connecticut, and an expert on sports cardiology, in terms of exercise, unless you are going to the extreme like the elite athletes in the study, probably not much. He was one of the peer reviewers for the British athlete study. He said, “How many people are going to join the 100 Marathon club or undertake a comparable amount of training? Not many. Too much exercise has not been a big problem in America. Most people just run to stay in shape, and for them, the evidence is quite strong that endurance exercise is good [for the heart].”

So, What IS Important For You In All Of This?

One word: Moderation. Health really seems to be all about moderation. That goes for the foods you eat, the exercise you do and the stress you deal with. Not enough is not good, but too much can be just as bad. Sadly, most people think if something is good – more is better. There is an optimal level or range for everything. Above or below that level – for any length of time – leads to abnormal stress, strain, and problems. When you are looking to get in shape and be healthy, you must first discover the proper definitions of in shape and health.

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Eat an egg for breakfast, prevent a stroke?

Eating an egg a day may help protect against cardiovascular disease, according to a study published online May 21 by the journal Heart. Researchers found that people who ate an egg every day had an 18% lower risk of dying from cardiovascular disease and a 28% lower risk of experiencing a deadly hemorrhagic stroke, compared with people who didn't eat eggs.

The study included more than 400,000 adults ages 30 to 79. Participants were from 10 survey sites in China. Researchers looked at how often study subjects reported eating eggs and then tracked their health for nearly nine years using registries and other methods.

Those who reported moderate egg consumption — one a day — were far less likely than non-egg eaters both to develop cardiovascular disease, ischemic heart disease, heart attacks and related events, hemorrhagic stroke, and ischemic stroke.

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Grey Hair Linked to Heart Disease Risk in Men: Study

Men with more grey hair - irrespective of age - may be at increased risk of heart disease, warns a new research. "Our findings suggest that irrespective of chronological age, hair greying indicates biological age and could be a warning sign of increased cardiovascular risk," said Irini Samuel, a cardiologist at Cairo University, Egypt.

Atherosclerosis, the build-up of fatty material inside the arteries, and hair greying share similar mechanisms such as impaired DNA repair, oxidative stress, inflammation, hormonal changes and senescence of functional cells.

A larger study including men and women is required to confirm the association between hair greying and cardiovascular diseases in patients without other known cardiovascular risk factors.

"Atherosclerosis and hair greying occur through similar biological pathways and the incidence of both increases with age," Samuel added. 

This study -- presented at EuroPrevent 2017, the annual congress of the European Association of Preventive Cardiology (EAPC), being held at Malaga, Spain from April 6-8 -- involved 545 adult men. 

The researchers assessed the prevalence of grey hair in patients with coronary artery disease - usually caused by atherosclerosis -- and whether it was an independent risk marker of disease. 

The amount of grey hair was graded using the hair whitening score - one referring to pure black hair, two to black more than white, three to black equals white, four to white more than black, and five to pure white. 

Data was collected on traditional cardiovascular risk factors including hypertension, diabetes, smoking, dyslipidemia and a family history of coronary artery disease. 

The researchers found that a high hair whitening score (grade three or more) was associated with increased risk of coronary artery disease independent of chronological age and established cardiovascular risk factors. 

Patients with coronary artery disease had a statistically significant higher hair whitening score and higher coronary artery calcification than those without coronary artery disease.

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These four foods are proven to lower your cholesterol

Plant-based foods are known to be good for the heart. Are there any foods in particular that lower cholesterol and keep this vital organ strong and healthy? Yes, suggests a new study. In fact, there are four main foods whose heart benefits have been proven by several controlled trials.

Plant-based diets are great for cardiovascular health, but a vegetarian diet low in saturated fats may not be the best thing for keeping cholesterol in check.

Instead, it may be better to selectively eat a few foods that decrease the low-density lipoprotein (LDL) cholesterol, which is also known as the "bad" cholesterol.

This was the main takeaway of an influential study, published in 2011, that presented a "portfolio" of four foods that had each been proven to reduce cholesterol and heart disease risk. These foods are:

• nuts
• plant protein obtained either from soy-based foods such as tofu, soy milk, or other soy-based meat substitutes, or from pulses such as beans, peas, chickpeas, or lentils
• soluble fiber, such as "oats, barley, psyllium, eggplant, okra, apples, oranges, or berries"
• margarine enhanced with plant sterols, or "cholesterol-like" compounds that can be found in fruits, vegetables, nuts, and cereals

Ever since 2011, several governmental organizations have recognized the benefits of this so-called Portfolio diet.

Now, the European Association for the Study of Diabetes has commissioned a meta-analysis of all the evidence available to assess and summarize the benefits of the Portfolio diet for preventing cardiovascular disease.

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Babies born with CHD likely to have enlarged kidneys

Research out of Australia suggests newborns with congenital heart disease (CHD) are likely to have enlarged kidneys at birth—a finding that could help alert physicians to organ abnormalities before a child is born.

The work, headed by Gemma Scholes of the University of Melbourne and published this week in Pediatric Research, is reportedly the first to investigate the link between babies’ congenital heart problems and their renal development. Scholes and her colleagues said it’s an important trial since CHD is common at birth.

“It is known that the heart is not the only organ affected in CHD—there is growth restriction of both the brain and the whole body,” Scholes et al. wrote in the journal. “The protective mechanism of the ‘brain-sparing phenomenon’ redirects blood flow toward the growing brain in fetuses with CHD.”

When blood flow is prioritized to the brain in these cases, the authors said, it has adverse effects on other organs and the baby’s development.

Scholes and her team studied the phenomenon in 452 newborns, initially hypothesizing that children born with CHD would have smaller kidneys. But, after measuring ultrasounds taken before babies were operated on for the first time, the researchers found those with CHD had “significantly enlarged” kidneys, reaching an average length of 4.5 centimeters.

The extent of renal damage seemed to depend on the type of congenital abnormality, according to the study. Kids with left heart obstruction had larger kidneys than normal; children with cyanotic heart disease tended to have normal or enlarged kidneys. Even patients who suffered from a lack of amniotic fluid and were born smaller than average were likely to have larger kidneys.

“The kidneys of newborns with CHD are not reduced in size, and on average are larger than normal,” Scholes and co-authors wrote. “The nature of this size discrepancy and its subsequent clinical significance is unknown.”

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Cardiovascular disease- Facts

Cardiovascular diseases involve the blood vessels, the heart, or both.

The cardiovascular or circulatory system supplies the body with blood. It consists of the heart, arteries, veins, and capillaries.

There are several types of cardiovascular disease, but treatment, symptoms, and prevention often overlap.

Fast facts on cardiovascular disease:

• High blood pressure is a significant risk factor.
• Major cardiovascular disease related to life-threatening events include heart attack, stroke, and aneurysm.
• Prevention includes balanced diet and exercise.
  

Treatment

Treatment will depend on the type of condition the person has.

Options include:

• lifestyle adaptations, such as weight control, exercise, quitting smoking, and dietary changes
• medication, for example, to reduce LDL cholesterol
• surgery, such as coronary artery bypass grafting (CABG)
• cardiac rehabilitation, including exercise and counseling

Treatment aims to:

• relieve symptoms
• reduce the risk of the condition recurring or worsening
• prevent complications

Depending on the condition, it may also aim to stabilize heart rhythms, reduce blockages, and widen the arteries to enable a better flow of blood.

Symptoms

There are many different types of cardiovascular disease. Symptoms will vary, depending on the specific type of disease a patient has.

However, typical symptoms of an underlying cardiovascular issue include:

• pains or pressure in the chest, which may indicate angina
• pain or discomfort in the arms, the left shoulder, elbows, jaw, or back
• shortness of breath, also known as dyspnea
• nausea and fatigue
• light-headed or faint
• cold sweat

Overall, symptoms vary and are specific to the condition and the individual, but these are most common.

Prevention

Smoking is a significant risk factor for CVDs. Quitting can help reduce the risk of many other conditions.

The majority of CVDs are preventable. It is important to address risk factors by:

• consuming less alcohol and tobacco
• eating fresh fruit and vegetables
• reducing salt intake
• avoiding sedentary lifestyles, particularly among children

Bad habits during childhood will not lead to cardiovascular disease while the individual is still young; but they can lead to the accumulation of problems that continue into adulthood, resulting in a greater probability of having a cardiovascular disease later in life.

Children who eat a lot of salt have a much higher risk of hypertension when they are adults, as well as heart disease and stroke. Parents should also keep a close eye on how much-saturated fat and sugar a child consumes.

Does aspirin protect from cardiovascular disease?

Aspirin, also known as acetylsalicylic acid (ASA), is a medication that is generally used to treat minor pains; it is also used as an antipyretic (to reduce fever) and as an anti-inflammatory.

Aspirin has become popular as an antiplatelet drug - to prevent blood clots from forming. High-risk patients take it in low doses to prevent strokes and heart attacks. Aspirin is also given to patients after a heart attack to prevent cardiac tissue death or heart attack recurrence.

A major problem posed by aspirin therapy for patients at risk of heart attack, stroke, and other cardiovascular events is major bleeding. A considerable proportion of patients with diabetes have a high rate of major bleeding, regardless of their therapeutic aspirin status.

Statistics

According to the World Health Organization (WHO), cardiovascular diseases are the leading cause of deaths globally. More people die from these diseases than from anything else.

In 2015, approximately 17.7 million people died from cardiovascular disease worldwide, and they accounted for 31 percent of all registered premature deaths.

Of these:

• 7.4 million people died from coronary heart disease
• 6.7 million people died as a result of a stroke
• Over 75 percent of deaths from cardiovascular disease occur in low and middle-income countries. They affect men and women equally.
• By 2030, it is predicted that 23.6 million people will die from cardiovascular diseases annually, mostly due to stroke and heart disease.

For women in the United States, heart disease is the leading cause of death. In 2013, there were 289,758 fatalities in women due to cardiovascular disease. One in every four female deaths were from heart disease.

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New review highlights benefits of plant-based diets for heart health

Vegetarian, especially vegan, diets are associated with better cardiovascular health, according to a new review published in the journal Progress in Cardiovascular Diseases.

Researchers with the Physicians Committee for Responsible Medicine looked at multiple clinical trials and observational studies and found strong and consistent evidence that plant-based dietary patterns can prevent and reverse atherosclerosis and decrease other markers of cardiovascular disease (CVD) risk, including blood pressure, blood lipids, and weight.

The review found that a plant-based diet:

• Reduces the risk of death from cardiovascular disease by 40 percent.
• Reduces the risk of coronary heart disease by 40 percent.
• Fully or partially opens blocked arteries in up to 91 percent of patients.
• Reduces the risk of hypertension by 34 percent.
• Is associated with 29 mg/dL and 23 mg/dL lower total cholesterol and LDL-C levels, respectively, compared with non-vegetarian diets.
• Is associated with weight loss.

"A plant-based diet has the power to not only prevent heart disease but also manage and sometimes even reverse it—something no drug has ever done," says study author Hana Kahleova, M.D., Ph.D., Physicians Committee director of clinical research.

The review notes that a healthy diet and lifestyle reduces the risk of a heart attack by 81-94 percent, while medications can only reduce the risk by 20-30 percent.

Plant-based diets benefit heart health because they're rich in fiber and phytonutrients—like carotenoids, anthocyanins, and lycopene—which reduce inflammation and oxidative stress. Animal products are packed with saturated fat, cholesterol, heme iron, and environmental pollutants and can harm heart health.

"Heart disease is the world's leading cause of death. This study proves it doesn't have to be," says Dr. Kahleova.

Around the globe, cardiovascular disease is responsible for 46 percent of non-communicable disease deaths, or 17.5 million deaths a year.

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HEALTH BENEFITS AND DISEASE PREVENTION FROM RED BEETROOT

Background: The health benefits of fruits and vegetables are becoming increasingly well known. Many of these fruits and vegetables have been used in herbal medicine for centuries, and continue to be used today. For the last few decades, the red beetroot has been scientifically researched to shed some light on its specific values as well as the mechanism of its health-promoting benefits.

Objective: The aim of this study was to discuss the bioavailability of beetroot as well as its effect on oxidative stress, inflammation, endothelial function, and cognitive function.

Methods: This study was a literature review. Studies which examined the effect of beetroot supplementation on conditions such as oxidative stress, inflammation, endothelial function, and cognitive function were included.

Results: Studies related to cellular oxidative stress showed that beetroot can have an antioxidant effect, thereby reducing oxidative stress which can be a precursor to many chronic diseases. Studies indicated that supplementing through a juice form seemed to have the most powerful effects. Beetroot seems to interfere with pro-inflammatory pathways, thereby providing an anti-inflammatory effect in the body.

These results are mostly shown in vitro (outside of the body), and there are few which have shown this effect in vivo (inside the body). Some of these initial in vivo studies do show promise for an effect on cancer tumor growth.

Preliminary studies examining cognitive decline in older adults suggest that beetroot supplementation through juice over 14 days had significantly improved reaction time in comparison to a control group.

Conclusion: Although the body of literature is still young, beetroot appears to have the potential to be a powerful source of health-promoting factors such as antioxidants, anti-inflammatories as well as having a vascular–protective effect. This makes it increasingly popular in the nutritional approach to managing cardiovascular disease and cancer. Beetroot juice also seems to have a positive effect on cognitive function in the elderly.

Findings in Perspective: Based on the findings of the limited number of studies, beetroot seems to be a promising area of research. Beetroot supplementation could be beneficial in cancer, as well as a cardiovascular disease because of its anti-oxidative and anti-inflammatory effects.

Because of its relatively low cost, it could have economic benefits as well. Other possible benefits of beetroot which are still unexplored but promising are in the areas of pain reduction, cognitive function, insulin resistance, cancer, and inflammation.

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What 5 Facts Should You Know About The Aorta?

If you didn’t know…

Your aorta is the largest artery in the body.  It starts at the top of the heart’s main pumping chamber, the left ventricle, and extends down to the abdomen.  Blood is pumped from the left ventricle into the aorta through the aortic valve, which is a tri-leaflet heart valve for 98% of the population.

As many people in this patient community are aware, the aorta can weaken and expand.  This bulge in the aorta is called an aneurysm.  In worse case scenarios, an aortic aneurysm can rupture (or dissect).  Together, we have learned that many patients with heart valve disease – especially bicuspid aortic valves – also have aortic aneurysms.

In a recent newsletter, I referenced an educational post by Dr. Thomas Gleason about timing the surgical intervention for an aortic aneurysm and bicuspid aortic valve.  In the post, Dr. Gleason referenced the guidelines that doctors use to determine when to operate.  Shortly after mentioning this article, Dr. Paul Fedak, a Calgary-based heart surgeon and long-time supporter of HeartValveSurgery.com, sent me an email.  In his note, Dr. Fedak informed me that the guidelines had changed and that we should update our community.

I thought it was a great idea.

Dr. Fedak’s Top 5 Facts About Your Aorta

I asked Dr. Fedak, who is an incredibly nice guy, what should patients know about the aorta.

In response, he sent me these “Top 5 Fact About Your Aorta”.

1. You are not a ticking time bomb. Research is showing that the risk of the aorta rupturing or dissecting is not as high as we once believed;
2. Surgery to remove an enlarged aorta is recommended for most people with Bicuspid Aortic Valve at 5.5 cm (based on a CT scan or MRI test);
3. Surgery to remove an enlarged aorta is recommended for some people with Bicuspid Aortic Valve at 5.0 cm (if they have other high-risk features as determined by your physicians);
4. Surgery to remove an enlarged aorta is recommended for most people with Bicuspid Aortic Valve at 4.5 cm if they are already having a valve or other heart surgery;
5. Surgery to remove an enlarged aorta is NOT recommended if the size of the aorta is under 5.0 cm if the valve is still working well and the patient is of average height/body size.
6. 
   

7. More Insights About Bicuspid Aortic Valves & Aortic Aneurysms

   As you can see above, there is a direct connection between aortic aneurysms and Bicuspid Aortic Valves.  Bicuspid aortic valves have two valve leaflets instead of three.  And, Bicuspid Aortic Valves are the most common congenital cardiac disorder.  If you would like to read more about this topic, you can review the American Association for Thoracic Surgery Consensus Guidelines on Bicuspid Aortic Valve-Related Aortopathy, by clicking here.
   Many thanks to Dr. Fedak for keeping me and our patient community up-to-speed on the guidelines that help clinicians determine the best and most appropriate time for an operation!!!

Reference: https://www.heart-valve-surgery.com/heart-surgery-blog/2018/07/11/top-5-facts-aorta-aneurysm-bicuspid/

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Importance Of A Healthy Heart

A healthy heart is important for the body to function properly and remove waste products that are not needed. South Asians, especially, are at high risk of heart diseases due to lifestyle choices and high-risk genes. To end this statistic, it is first important to understand the disease and what we can do to minimize the risk:

Cardiovascular diseases result from an abnormal function of the heart and blood vessels. Age and gender are two important risk factors and it is estimated that 87 percent of people with heart diseases are 55 and older and men are at a higher risk.

Research suggests doing the following for managing your health to reduce your risk of cardiovascular disease:
Follow a healthy eating pattern: Follow the Healthy Thali portion plate.

Reduce salt and sodium in your diet: Limit the use of table salt to no more than 6 grams a day.
Maintain a healthy weight: Weight loss of 10 pounds reduces the blood pressure in overweight or obese individuals with hypertension.
Exercise: It is important to remain very active and exercise every day. Aerobic exercise for at least 30 minutes or walking for 1 hour.
Limit alcohol intake: Drinking too much alcohol can raise blood pressure. It can harm the liver, brain, and heart.

Knowing what it takes to maintain a healthy lifestyle, what can you do today?

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The Importance of Monitoring Your Heart Rate During Exercise

What’s your heart rate got to do with your training and fitness goal? Apparently, everything! Read more to learn the importance of monitoring your heart rate during exercise.

Why should you monitor your heart rate?

In our gadget-oriented era where all kinds of cutting-edge devices and technology are rampant and rife, now you can find out how much calories you’re burning or how many steps you’ve taken in a day. But do you know how hard you’re actually training? This is where monitoring your heart rate becomes handy!

When the intensity of your activity increases, your heart will beat faster to meet the demands of blood and oxygen from your muscles. The harder the activity, the more blood and oxygen your muscles require to function, thus the higher your heart rate will be. Therefore, your heart rate can be a good indicator of your exercise intensity. There’s a certain range of exercise intensity that’s considered safer and more effective in promoting cardiovascular benefits. So, by knowing your heart rate during the workout, you can better monitor your exercise.

What does the number mean?

The maximum heart rate (HRmax) can be estimated by subtracting your age from the number 220. This number is highly dependant on age. The older you are, the slower your heart rate will be.

During aerobic exercise, you should aim to have your heart rate within the target heart rate zone. The zone is shown in terms of percentage of the maximum heart rate (%HRmax). This number serves as a guideline for how hard you should be exercising. For example, the target heart rate zone for healthy adults who are just beginning their aerobic program is 50% - 60% HRmax. Those who have better fitness or who are undergoing a conditioning training can aim to be at higher end of the zone.

This is in line with the training principle of specificity: specific training yields a specific result. This works the other way around as well: if you want a specific result, it requires a specific kind of training. You can make your training more specific by manipulating the intensity of your workout and using the target heart rate zone as a guideline. As an example, at a lower end of the target heart rate zone where exercise intensity is lower, the energy source used is mostly fat.

HOW & WHERE can you monitor your heart rate?

Immediately after exercise, check your pulse either from the radial artery at the base of your thumb on your wrist or the carotid artery at the side of your neck. For a more accurate number, you should count the number of beats in 60 seconds. For a shortcut, you can also count the number of beats in a 10-second period and then multiply the number by 6.

Take Note!

The numbers are only estimations, based and only intended to be used for average adults with no health conditions. Hence, this should only be a guideline. Always consult with your physician for a more in-depth and accurate analysis and recommendation of exercise intensity based on your health condition.

Reference: https://www.goldsgym.co.id/knowledge/details/the-importance-of-monitoring-your-heart-rate-during-exercise

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