Top 5 advances in heart disease research

The American Heart Association has compiled an annual list since 1996 of the top advances in heart disease research.

The organization singled out these five for their 2010 list, choices also endorsed by cardiac specialists at the University of Florida.

1. Tailored treatment for those with diabetes: Among the more than 17 million Americans diagnosed with diabetes, heart disease death rates are two to four times higher than in the general population.

New research offers insight into what works and what doesn’t for diabetics at risk for cardiovascular disease. Aggressive blood pressure control didn’t reduce the risk for those with type 2 diabetes. A combination lipid therapy, however, shows promise for type 2 diabetics who have low HDL cholesterol and low triglycerides.

2. Alternatives for those with aortic blockage: As a minimally invasive cardiac surgeon in the University of Florida College of Medicine, Dr. Thomas Beaver puts transcatheter aortic valve implantation (TAVI) on his list of top research advances. The American Heart Association does as well.

Aortic valve disease is the most common valvular problem in old age. The aortic valve is one of four valves that control the flow of blood into and out of the heart. In particular, the aortic valve controls the flow of oxygenated blood pumped out of the heart from the left ventricle into the aorta, the main artery leading to the rest of the body.

Many patients with severe aortic blockage have other medical conditions that make open-heart surgery to replace the valve extremely risky.

The TAVI technology involves replacing the aortic valve over a wire or through a minimally invasive incision near the apex of the left ventricle, Beaver explained. The catheter-based procedure offers significant improvement in symptoms and outcomes, including quality of life. Still in clinical trials, the technology will improve over time, Beaver added.

3. Reducing stroke risk in atrial fibrillation: The heart is a strong muscular pump that contracts and relaxes to a regular beat, constantly pumping blood throughout your body. In a normal day, the average heart pumps 100,000 times, pumping 2,000 gallons of blood. In order for the heart to function properly, all four chambers of the heart must beat in a highly organized way.

An arrhythmia occurs when there is an abnormal rhythm of the heart and the four chambers don’t pump as a team.

Atrial fibrillation (A Fib) is the most common type of arrhythmia, in which the two upper chambers of the heart don’t beat the way they should. A Fib can affect both men and women and is most common in older people. A Fib creates a disorganized electrical signal that disrupts the communication between the upper and lower chambers of the heart, preventing them from working together. Instead of the body receiving a constant, regular amount of blood from the ventricles, the lower heart chambers, it receives rapid, small amounts and occasional random larger amounts, depending on how much blood has flowed from the upper to the lower chambers with each beat.

Atrial fibrillation causes blood to pool in the chambers of the heart and form clots. The clots can break loose and travel to block the arteries in the head and neck, depriving the brain of oxygen and causing a stroke. In fact, A Fib increases one’s risk for a stroke fivefold.

Dr. Jamie Conti is a UF specialist in the electrophysiology of heart disease, and she said she’s excited by the latest anticoagulant agents to prevent stroke in atrial fibrillation, along with new equipment and techniques to improve patient outcomes.

Warfarin (Coumadin) has long been the standard anti-clotting drug to reduce the risk of stroke in A Fib patients, but it has significant complications of its own. Now several new drugs have been found to work as well as warfarin and are simpler for patients to take.

For patients who must have their heartbeat regulated by an implantable cardioverter-defibrillator (or ICD), a new generation of devices promises to reduce some of the risks involved.

4. Getting “hands-on” with CPR: More than 300,000 people suffer out-of-hospital cardiac arrest each year. Many die because those around them don’t know how to perform cardiopulmonary respiration, or CPR.

The American Heart Association has updated its guidelines for CPR, based on new studies. If you’re a bystander in a heart emergency, performing “Hands Only CPR” will give the victim the best chance of survival. Call 911 and push hard and fast in the center of the chest.

For children up to the age of 8, it is still important to combine chest compressions with mouth-to-mouth breathing.

5. New hope for infants with congenital heart disease: Investigators with the Pediatric Heart Network are discovering that the type of shunt chosen for infants born with congenital heart disease can make a difference in the babies’ survival. A shunt can be created with a catheter balloon to keep blood flowing if the aorta or pulmonary artery is blocked. The choice of shunt also can make a difference in whether they must face a heart transplant early in life.

The trial offers an approach that should provide answers to other questions in the future.

source: ocala