Cardiovascular - November 2013 Archives

JACKSONVILLE, Fla. — Thomas G. Brott, M.D., a neurologist and director for research at Mayo Clinic in Florida, has been named the recipient of the American Heart Association's 2013 Clinical Research Prize. The award recognizes and rewards an individual who is making outstanding contributions to the advancement of cardiovascular science and who currently heads an outstanding cardiovascular clinical research laboratory, according to the American Heart Association (AHA). Dr. Brott will be honored on stage during the opening ceremony of the American Heart Association's 2013 annual meeting in Dallas. He is the first Mayo Clinic investigator to receive the prestigious prize, which has been awarded annually by the American Heart Association since 2005. "This award is well deserved. Dr. Brott is a pioneer in the field of stroke and cerebrovascular disease research, and his mission to find the best therapies possible for patients has certainly saved lives," says William C. Rupp, M.D., chief executive officer at Mayo Clinic in Florida. Dr. Brott was a leading investigator in the studies that identified tissue plasminogen activator (t-PA) as an effective acute treatment for ischemic stroke. He and his team treated the very first patients using this therapy. Along with his colleagues, Dr. Brott defined the evolution of spontaneous intracerebral hemorrhage during the first hours after onset. In 1998, Dr. Brott came to Mayo Clinic's campus in Florida where he and his colleagues initiated the first NIH-funded genome-wide screen for stroke susceptibility. Dr. Brott has led federally funded national clinical trials that aim to discover best treatment for stroke and uncover risk factors for the disorder. For example, he is principal investigator for the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), a study that compares two different treatments for their ability to reduce risk for stroke. The study was supported by the National Institute of Neurological Disorders and Stroke. He also played a key role in designing the National Institutes of Health Stroke Scale (NIHSS), a tool used internationally that measures stroke-related neurologic deficits.

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.

http://www.youtube.com/watch?v=XIIATcVBdrk Contrary to results of smaller studies, two drugs tested in a larger trial did not improve kidney function in acute heart failure patients. Lead author and Mayo Clinic cardiologist Horng Chen, ...

Neurologist and director for research at Mayo Clinic in Florida Thomas Brott, M.D., has been named the recipient of the American Heart Association's 2013 Clinical Research Prize. The award recognizes and rewards an individual who is making outstanding contributions to the advancement of cardiovascular science and who currently heads an outstanding cardiovascular clinical research laboratory. Dr. Brott is the first Mayo Clinic investigator to receive the prestigious prize, which has been awarded annually since 2005. William Rupp, M.D., vice president at Mayo Clinic in Florida, says, “This award is well deserved. Dr. Brott is a pioneer in the field of stroke and cerebrovascular disease research, and his mission to find the best therapies possible for patients has certainly saved lives.” Click here for news release.

Two-year study of Plavix and Brilinta to include approximately 5,300 patients from 15 hospitals worldwide; participant DNA biobank to help elucidate genomics of coronary artery ...

ROCHESTER, Minn. — Patients with rheumatoid arthritis, lupus and other chronic forms of inflammatory arthritis can face life-threatening complications, and heart disease tops the list. People with such rheumatic diseases are twice as likely as the average person to develop heart problems. Catching heart disease early is critical. Mayo cardiologists and rheumatologists have joined forces to create the Mayo Clinic Cardio-Rheumatology Clinic to pioneer new diagnostic tools and break this dangerous disease connection. MULTIMEDIA ALERT: Video of Dr. Matteson is available for download from the Mayo Clinic News Network. Mayo Clinic has found that the traditional methods used to pinpoint heart disease risk, such as the Framingham Risk Score, do not work very well in rheumatic disease patients, because their heart disease may manifest itself in a different and more subtle way. To prevent, detect and treat heart problems as early as possible, the Cardio-Rheumatology Clinic examines a broader spectrum of risk factors. "We offer patients a more detailed assessment of their cardiovascular status and a more detailed examination of risk factors besides the usual conventional risk factors such as lipids, cholesterol and smoking," says Eric Matteson, M.D., Mayo Clinic rheumatology chair, who is moderating a presentation Saturday on "cardio rheumatology" during an American Heart Association scientific meeting in Dallas. "We also are taking into account the rheumatic disease burden, the disease activity and the treatment of the rheumatic disease as a factor for mitigating cardiovascular risk." In part based on Mayo Clinic research, Cardio-Rheumatology Clinic physicians are employing new ultrasound techniques to evaluate blood vessels for the earliest signs of heart disease. "By evaluating and educating our patients early on in their rheumatic disease processes, we hope to be able to understand the mechanisms and make a difference in the development and severity of their atherosclerotic complications," says Sharon Mulvagh, M.D., a cardiologist and director of the Mayo Clinic's Women's Heart Clinic, noting heart attack and stroke risk in particular. Because women are more commonly affected by autoimmune disorders, the Cardio-Rheumatology Clinic will be located within the Women's Heart Clinic. Physicians plan to publish their findings from the clinic as part of a long-standing Mayo Clinic effort to identify the factors driving heart disease in rheumatic disease patients, reduce risk and slow the progression of heart disease. There is some evidence that moderating inflammation through treatment reduces the risk of heart disease in patients with rheumatic diseases, Dr. Matteson says. But, physicians do not really know why there is this connection between heart problems and rheumatic diseases, he adds. "We think it must have to do with the inflammatory burden of the rheumatic disease; that is, the same process that leads to inflammation in the joints, for instance in rheumatoid arthritis, may also affect the lining of the blood vessels," Dr. Matteson says.

http://www.youtube.com/watch?v=QNBu55Zz48E People with rheumatoid arthritis, lupus and other chronic forms of inflammatory arthritis can face many life-threatening complications and now heart disease tops the list. Patients ...

Mayo Clinic Studying Genomics of Antiplatelet Heart Medication http://www.youtube.com/watch?v=DheqVPuMro0 Each year in the United States, 600,000 to 800,000 heart stents are placed to restore blood flow through coronary arteries. Patients are then given medication to keep blood clots from forming near the surgical site. Such clots can be deadly, causing heart attack and stroke. But, which antiplatelet medication is best? The answer may lie in your genes. “The current standard of care after angioplasty is to prescribe clopidogrel for one year, regardless of a person’s individual genotype, even though we have known for several years that variation in the CYP2C19 gene may diminish the benefit from the drug,” says Naveen Pereira, M.D., a Mayo Clinic cardiologist and principal investigator. Click here to read the full news release. Journalists: Sound bites with Dr. Pereira and animation of a heart stent placement are available in the downloads.

http://www.youtube.com/watch?v=AReHTIVuCbA&feature=youtu.be&hd=1 The U.S. Food and Drug Administration (FDA) has made a preliminary determination that "partially hydrogenated oils (PHOs), the primary dietary source of artificial trans fat in processed foods, are ...

http://www.youtube.com/watch?v=GsmTRjwTfgo&feature=youtu.be&hd=1 It's an epidemic spreading steadily and painfully, joint by joint. Arthritis now afflicts nearly 1 in 4 American adults, the Centers for Disease Control and Prevention (CDC) reported Thursday. [CDC news release] It found that 22.7 percent of U.S. adults -  52.5 million people - have arthritis, and that 22.7 million of them say arthritis is limiting their daily activities. In all, the number of adults with arthritis rose 2.5 million during the 2010-12 period studied, compared with the previous analysis, covering 2007-09. Mayo Clinic rheumatologist Shreyasee Amin, M.D., offers these comments on the CDC statistics: “The aging population in general is increasing, and osteoarthritis, which is the most common form for arthritis and which doesn’t get a lot of attention in the media, is probably one of the things that’s contributing to that increase.” “The fact that obesity is certainly an increasing problem in the country and obesity contributes to a higher risk of osteoarthritis in the knees in particular, that might be one of the reasons that we’re seeing this increase.” “It’s sort of a catch-22 or a vicious circle that people run into: If you’re in pain you aren’t physically active, it puts you at risk for other conditions like osteoporosis, it may make you more prone to falling and breaking a bone. If you’re overweight because you’re not active enough anymore, you’re more likely to get diabetes and its complications maybe further aggravate heart disease, and some forms of obesity have been linked to cancer. So I think it really is important for us to recognize arthritis, do what we can and study it better so that we can improve the health of people before they get to that point where they’re into that level of pain and injury.” “I think because arthritis is so linked to other diseases, and physical inactivity that can result from arthritis can contribute to other complications like obesity, leading to diabetes and  further problems with heart disease, I think more attention needs to be drawn to preventing arthritis, understanding the mechanisms that contribute to osteoarthrtis in particular, which is so common, and I hope that helps spur our research dollars to better understand this condition and prevent it.” Journalists: Sound bites with Dr. Amin are available in the downloads. To interview Dr. Amin, Dr. Krych or other Mayo Clinic experts on arthritis, please contact Sharon Theimer in Mayo Clinic Public Affairs at newsbureau@mayo.edu or 507-284-5005. There are more than 100 forms of arthritis: Osteoarthritis, also known as wear-and-tear arthritis, is the most common.

DEAR MAYO CLINIC: I was recently put on medication for high blood pressure. Does it matter what time I take it? I thought I was supposed to take it before I go to bed. But when I do, I’m up all night using the bathroom. Also, is this medication something I will have to take for life? ANSWER: It usually is not necessary to take your blood pressure medication at night, unless your doctor has told you to do so. Whether or not you have to take the medication for the rest of your life depends on a variety of factors. In some cases, lifestyle changes can lower or eliminate the need for blood pressure medication. What you eat and how much you exercise can help control blood pressure. Lowering the amount of salt in your diet and eating plenty of fruits and vegetables, along with whole grains and low-fat dairy foods, can have a positive effect. Regular physical activity can also help lower blood pressure and keep your weight at a healthy level. Weight is a big factor in high blood pressure. Research has shown that, in people who are overweight, lowering one’s weight by just 10 percent can lower blood pressure.