Traci Klein (@traciklein)
Activity by Traci Klein
American College of Cardiology
Washington — March 29, 2014 — Patients who attended cardiac rehabilitation and used a smartphone-based app to record daily measurements such as weight and blood pressure had greater improvements in those cardiovascular risk factors; they also were less likely to be readmitted to the hospital within 90 days of discharge, compared with patients who only attended cardiac rehabilitation, Mayo Clinic researchers found.
Journalists: Soundbites and b-roll with Dr. Widmer are available in the downloads.
Only 20 percent of the patients who attended cardiac rehab and used the app were readmitted to the hospital or visited the emergency department within 90 days, compared with 60 percent of those in the control group, researchers discovered.
ROCHESTER, Minn. — Feb. 6, 2014 — More people who have known coronary heart disease die from other causes — such as cancer, and lung and neurological diseases — than heart disease, compared with 20 years ago, according to a Mayo Clinic study published online Feb. 10 in Circulation, an American Heart Association journal.
Journalists: Sound bites with Dr. Gulati and b-roll of a cath lab are available in the downloads.
The researchers evaluated the trends in cause-specific, long-term mortality from 1991 to 2008 in patients at Mayo Clinic in Rochester who underwent percutaneous coronary intervention (PCI), a procedure used to open clogged heart arteries. They broke the study population into three eras: 1991 to 1996, 1997 to 2002, and 2003 to 2008. Cardiac deaths predominated in the first era and were about equal with non-cardiac deaths in the middle era. In the final era — the modern-era (2003 to 2008) — non-cardiac deaths dominated.
ROCHESTER, Minn. — Jan. 21, 2014 — More people die and emergency hospital treatment takes longer for heart attack victims who arrive at the hospital during off-hours (nights and weekends), compared with patients who arrive during regular daily hours, according to a Mayo Clinic study published online in the British Medical Journal on Jan. 21.
Journalists: Sound bites with Dr. Sorita are available in the downloads.
Mayo Clinic researchers analyzed results of 48 studies published between 2001 and 2013 involving 1.8 million patients in the United States, Europe and Canada to assess the effect of off-hour hospital arrival for heart attack patients.
Low-dose dopamine or low-dose nesiritide tested in hospitalized heart failure patients
DALLAS — Two drugs tested in a larger trial did not improve kidney function in acute heart failure patients, contrary to results of smaller studies. The results were presented today at the American Heart Association's Scientific Sessions 2013 in Dallas and simultaneously published in the Journal of the American Medical Association. Previous smaller studies showed that low-dose dopamine or low-dose nesiritide could improve kidney function and reduce fluid overload that is often present in hospitalized acute heart failure patients by increasing urine production.
MULTIMEDIA ALERT: Video of Dr. Horng Chen will be available for download on the Mayo Clinic News Network.
In the Renal Optimization Strategies Evaluation in Acute Heart Failure (ROSE-AHF) randomized 26-site trial in the U.S. and Canada, researchers analyzed data on 360 hospitalized acute heart failure patients with kidney dysfunction from September 2010 to March 2013. Compared to placebo, researchers found that neither dopamine nor nesiritide, when also used with diuretic (water pills) therapy, was better at increasing urine volume or improving levels of serum cystatin-C, an indicator of kidney function, at the end of a 72-hour treatment.
"Kidney-enhancing therapies in acute heart failure continue to elude us," says Horng Chen, M.B., B.Ch., lead author and Mayo Clinic cardiologist. "In the past five years, all the major acute heart failure therapeutic clinical trials have not demonstrated beneficial effects of the therapies tested. This could be partly because the definition of acute heart failure is broad, and hence it includes a diverse group of patients."
Therefore, one take-away from the results of ROSE-AHF is that future studies in acute heart failure may need to target specific subgroups of these patients. For example, some patients have preserved ejection fraction, where the heart's lower chambers are stiff and cannot relax enough to fill fully between beats, and others may have reduced ejection fraction, where the heart is weak, Dr. Chen says.
Heart failure occurs when the heart doesn't pump blood as well as it should. Acute heart failure — when heart failure patients require hospitalization — is the most common cause of hospitalization in patients 65 years and older in the U.S., according to the American Heart Association.
Mayo Clinic study examines costs following operating room and recovery improvement efforts
ROCHESTER, Minn. — Sept. 30, 2013 — The total hospital cost of mitral valve repair surgery — from the time a patient is admitted to the hospital until release — is similar, whether performed through small port incisions using robotic equipment or via the conventional open-chest method, a Mayo Clinic study of 370 patients found. Importantly, robotic surgeries were just as safe as conventional open procedures, but patients who underwent robotic mitral valve repair recovered more rapidly and returned home earlier than patients who had open-chest surgery, the study found. The results of the study also reflect systems innovation efforts designed to reduce the cost of high-technology cardiac care. The findings will be published online Oct. 1 in Mayo Clinic Proceedings.
MULTIMEDIA ALERT: Video of Dr. Rakesh Suri will be available for download on the Mayo Clinic News Network.
"These results reflect an important opportunity to decrease cost and improve quality of U.S. health care when technologically complex procedures are performed by well-trained, high-volume teams capable of leveraging the potential of less invasive approaches for patient benefit," says lead author Rakesh Suri, M.D., D.Phil., a cardiovascular surgeon at Mayo Clinic in Rochester.
Physicians, nurses at Mayo Clinic in Minnesota also monitor patients by computerized system
ROCHESTER, Minn. — Sept. 5, 2013 — Critically ill patients are benefiting from a new program designed to improve care and shorten hospital stays. Mayo Clinic's Enhanced Critical Care program offers 24/7 remote monitoring of the sickest patients at six Mayo Clinic Health Systemhospitals.
MULTIMEDIA ALERT: Click here to retrieve video and photography from the Mayo Clinic News Network.
Patients will continue to receive care from the local care team, but physicians and nurses in an operations center in Rochester will monitor patients' vital signs and other health data on a computerized system able to detect subtle changes in a patient's condition. High definition video cameras and computer screens will allow operations center staff to communicate with patients, their families and the care team.
ROCHESTER, Minn. — Aug. 8, 2013 — Patients with severe mitral valve regurgitation who are otherwise healthy should have mitral valve repair surgery sooner rather than later, even if they feel no symptoms, a Mayo Clinic-led study by U.S. and European researchers found. The results challenge the long-held belief that it is safer to "watch and wait" until a patient has symptoms, such as shortness of breath. This is the largest study to show that patients who undergo surgery early after diagnosis have improved long-term survival and lower risk of heart failure.
MULTIMEDIA ALERT: Video of Drs. Rakesh Suri and Maurice Enriquez-Sarano will be available for download on the Mayo Clinic News Network.
ROCHESTER, Minn. — August 27, 2012. People who are of normal weight but have fat concentrated in their bellies have a higher death risk than those who are obese, according to Mayo Clinic research presented today at the European Society of Cardiology Congress in Munich. Those studied who had a normal body mass index but central obesity — a high waist-to-hip ratio — had the highest cardiovascular death risk and the highest death risk from all causes, the analysis found.
"We knew from previous research that central obesity is bad, but what is new in this research is that the distribution of the fat is very important even in people with a normal weight," says senior author Francisco Lopez-Jimenez, M.D., a cardiologist at Mayo Clinic in Rochester. "This group has the highest death rate, even higher than those who are considered obese based on body mass index. From a public health perspective, this is a significant finding."
The study included 12,785 people 18 and older from the Third National Health and Nutrition Examination Survey, a representative sample of the U.S. population. The survey recorded body measurements such as height, weight, waist circumference and hip circumference, as well as socioeconomic status, comorbidities, and physiological and laboratory measurements. Baseline data were matched to the National Death Index to assess deaths at follow-up.
Those studied were divided by body mass index into three categories (normal: 18.5–24.9 kg/m2; overweight: 25.0–29.9 kg/m2; and obese: >30 kg/m2) and two categories of waist-to-hip ratio (normal:
The mean age was 44; 47.4 percent were men. The median follow-up period was 14.3 years. There were 2,562 deaths, of which 1,138 were cardiovascular related.
The risk of cardiovascular death was 2.75 times higher, and the risk of death from all causes was 2.08 times higher, in people of normal weight with central obesity, compared with those with a normal body mass index and waist-to-hip ratio.
"The high risk of death may be related to a higher visceral fat accumulation in this group, which is associated with insulin resistance and other risk factors, the limited amount of fat located on the hips and legs, which is fat with presumed protective effects, and to the relatively limited amount of muscle mass," says Karine Sahakyan, M.D., Ph.D., a cardiovascular research fellow at Mayo Clinic in Rochester.
ROCHESTER, Minn. — August 16, 2012. Each year, hundreds of thousands of X-rays are performed across the country to help detect and treat common cardiovascular conditions such as coronary artery disease, valve disease and other heart problems. However, concern is growing within the medical community about the potential risks of radiation exposure from this imaging technology. Now, researchers at Mayo Clinic have been able to dramatically cut the amount of radiation that patients and medical personnel are exposed to during invasive cardiovascular procedures. The solution: targeted modifications to the use of standard X-ray equipment, coupled with intensive radiation safety training. The efforts are detailed in a paper published online Aug. 20 in the Journal of the American College of Cardiology: Cardiovascular Interventions.
MULTIMEDIA ALERT: Video of Dr. Ken Fetterly is available for journalists to download on the Mayo Clinic News Network
"Through our efforts, we were able to quickly cut the overall radiation exposure to patients by nearly half using simple but effective methods," said Charanjit Rihal, M.D., chair of Mayo's Division of Cardiovascular Diseases. "We think this program could serve as a useful model for other cath labs in the U.S."
Cardiologists rely on X-ray images to identify heart problems and provide real-time guidance for procedures such as implanting stents to open narrowed arteries and aortic valve replacement. However, radiation from X-rays can be harmful. It can injure the skin if not administered judiciously, and can also damage DNA, which can increase the risk of certain cancers.
The amount of radiation used in a procedure should not exceed the minimum necessary, Dr. Rihal says. Recognizing this, Mayo instituted a broad-based program that has raised awareness about radiation safety and changed the way standard X-ray systems are used in the cath lab. For example, medical staff now set the radiation output of their systems to a very low setting, minimizing the radiation dose to their patients. They only increase the radiation dose if higher-quality images are needed, such as temporarily during a critical portion of a procedure. As a result, they can obtain useful images while lowering radiation exposure.
In addition, practice-wide radiation safety is now included when training fellows and junior faculty. The cath lab teams also are informed of the radiation dose delivered to patients during each procedure. Radiation exposure is routinely reported in the patient's medical record.
"The reductions in the radiation dose administered to patients occurred practice-wide and across diverse procedures," says Kenneth Fetterly, Ph.D., Division of Cardiovascular Diseases. Dr. Fetterly says the initiative is part of Mayo's ongoing commitment to patient safety.
The changes implemented by Mayo go well beyond standard procedures used in hospitals across the country. Buy-in across the practice is needed for such programs to succeed, Dr. Fetterly says. Success also requires physicians to shift their expectations from attaining the highest image quality to focusing on lower radiation exposure and accepting adequate image quality.
CORRECTION: We are revising the statement to clarify the type of surgery Congressman Jackson had. Here is the revision to information in the second paragraph below:
Congressman Jackson underwent bariatric surgery in 2004, specifically a duodenal switch. This type of surgery is increasingly common in the US and can change how the body absorbs food, liquids, vitamins, nutrients and medications.
ROCHESTER, Minn. — August 13, 2012. Following extensive evaluation, Congressman Jesse Jackson, Jr. is undergoing treatment for Bipolar II depression at Mayo Clinic in Rochester, Minn. Congressman Jackson is responding well to the treatment and regaining his strength.
Many Americans have bipolar disorder. Bipolar II disorder is a treatable condition that affects parts of the brain controlling emotion, thought and drive and [...]