Category Archives: Cardiology

Stressful jobs are associated with a higher risk of Heart Rhythm Disorders

Having a stressful job is linked with a higher probability of suffering from a heart rhythm disorder called atrial fibrillation, the most nerve-racking jobs are psychologically insistent but give employees little control over the work condition – for example, assembly line workers, bus drivers, secretaries, and nurses. The research found that being stressed at employment was related with a 48% higher risk of atrial fibrillation, subsequent to adjustment for education, age, and sex.

Heart 2019 MEblog

We require people to do the jobs but managers can help by making sure staffs have the resources necessary to complete the allotted tasks. Bosses should programme breaks and listen to employees’ thoughts on how the work itself and the job environment can be improved.” Atrial fibrillation is the most common heart rhythm disorder (arrhythmia). Indications include palpitations, weakness, fatigue, feeling light-headed, dizziness, and shortness of breath.

Atrial fibrillation causes 20-30% of strokes overall and increases the jeopardy of dying prematurely. One in four middle-aged people in Europe and the US will be prone to atrial fibrillation. It is evaluated that by 2030 there will be 14-17 million patients suffering from atrial fibrillation in the European Union, with 120,000-215,000 new diagnosed each year.

Atrial fibrillation is a common condition with serious results and consequently it is of main public health significance to find ways of avoiding it. Little is recognized about risk factors for the disease and especially the role of the work environment.

Heart2019 ME blog

This research assessed the association between work stress and atrial fibrillation. The investigation included 13,200 members enrolled in the Swedish Longitudinal Word related Survey of Health (Slosh) in 2006, 2008, or 2010. Members were in employment and had no account of atrial fibrillation, heart attack, or heart failure. At revise inclusion, members completed postal studies on sociodemographics, lifestyle, health, and work-related factors.

Work pressure was defined as job strain, which refers to jobs with high psychosomatic demands combined with near to the ground control over the job situation. The investigation included five questions on job burden and six on controls – for example: Do you have to work very hard or very fast? Are there conflicting demands in your work? Do you have an adequate amount time to complete your work tasks? Does your work include a lot of recurrences? Can you make a decision on how and what to do at work?

 All through a median follow-up of 5.7 years, 145 cases of atrial fibrillation were acknowledged from national registers. In the universal working populace in Sweden, employees with stressful jobs were approximately 50% more likely to happen atrial fibrillation. The evaluated risk remained even later it was taken into account other factors such as smoking, leisure time physical activity, body mass index, and hypertension.” then pooled their results with two other studies on the same topic, and found that job strain was associated with a 37% increased the risk of atrial fibrillation. “Crossways studies there was a coherent pattern of work stress being a risk factor for atrial fibrillation,

Work stress has before has been linked with coronary heart disease. Work stress should be measured as an amendable risk factor for avoiding atrial fibrillation and coronary heart disease. Individuals who feel stressed at work and have palpitations or other symptoms of atrial fibrillation should see their consultant and speak to their manager about improving the condition at work.”

European guiding principle on the prevention of cardiovascular disease state that stresses at work contributes to the risk of causing cardiovascular disease and having a worse prognosis. Assessment of psychosocial risk factors is suggested in people who have or are at risk of developing cardiovascular disease.

Battling myocardial infarction by means of nanoparticle tandems

How can injured cardiac tissue resultant of heart attack be treated through replacement muscle cells? An investigation team has presented an innovative method on mice: Muscle replacement cells, which are to endure the function of the damaged tissue, are loaded by means of magnetic nanoparticles. These nanoparticle-loaded cells are then infused into the injured heart muscle and held in place by a magnet, causing the cells to engraft well onto the existing tissue. By means of the animal model, the researchers show that this leads to a considerable improvement in heart function.

In a heart attack, clots more often than not lead to diligent circulatory issues in parts of the heart muscle, which results in heart muscle cells to die. Attempts have been made for some time to revitalize the injured heart tissue with replacement cells. In spite of this, most of the cells are pushed out of the deflate channel during the infusion due to the pumping action of the beating heart. Therefore, only a few spare cells remain in the heart muscle, which implies that restoration is limited.Heart20192 28-09-2018

An interdisciplinary team tested a pioneering approach on how to ensure that the infused replacement cells continue in the desired spot and engraft onto the heart tissue. The tests were performed on mice that had earlier suffered a heart attack. In order to be able to better follow the cardiac muscle replacement EGFP expressing cells from fetal mouse hearts or mouse stem cells were utilized. These fluorescent muscle cells were loaded with small magnetic nanoparticles and infused through a fine cannula into the injured heart tissue of the mice.

In the magnetic field, the nanoparticle-loaded replacement cells remain in place

In few of the rodents treated this manner, a magnet positioned at a distance of a little millimetre from the surface of the heart guaranteed that a large part of the nanoparticle-loaded replacement cells remained at the desired spot. Devoid of a magnet, about a quarter of the added cells remained in the heart tissue, but with a magnet, about 60 percent of them remained in location, throughout the project. Ten minutes in the influence of the magnetic field was previously sufficient to keep a significant proportion of nanoparticle-loaded muscle cells at the target spot. Even days after the procedure, the injected cells remained in position and slowly attached themselves to the existing tissue.

This is remarkable; exceptionally as the infarct tissue is generally undersupplied due to reduced perfusion. In the influence of the magnet, the substitute muscle cells did not die as frequently, engrafted well again and duplicated more. The analysts investigated the reasons intended for the progressed growth: It was established that these implanted heart muscle cells were filled more densely and could stay alive better credit to the more intensive cell-cell interaction. In addition, the genetic material activity of many endurance functions, such as for cellular respiration, was higher than without a magnet in these replacement cells.

The researchers also illustrated that cardiac function significantly improved in mice that were treated with nanoparticle muscle cells in combination with a magnet. Following two weeks, seven times numerous replacement muscle cells survived, and later than two months, four times as many compared to conventional implantation technology. Known the lifespan of mice of utmost of two years, this is an amazingly lasting effect.

#cardiacarrest #nanoparticle #Stemcell #Heartregeneration

Peripartum Cardiomyopathy

Cardiology Care 2019Peripartum cardiomyopathy also known as postpartum cardiomyopathy. This condition is an uncommon form of heart failure which happens during the later stages of pregnancy. This condition weakens the heart muscle and heart gets enlarged.

Diagnosis:
PPCM may be difficult to diagnose due to mimicking symptoms of heart failure those of third trimester pregnancy, such as swelling in the feet and legs, and shortness of breath. More extreme cases emphasise severe shortness of breath and prolonged swelling after delivery.

Some of the imaging tests can also view potential lung damage. Tests may include:

  • X-ray of the entire chest
  • CT scan for precised pictures of the heart
  • Nuclear heart scan to show heart chambers
  • Echocardiogram

Peripartum cardiomyopathy is diagnosed when the following three criteria are met:

  1. Heart failure develops in the last months of pregnancy
  2. Heart pumping function is reduced, with an ejection fraction (EF) less than 45%
  3. No other cause for heart failure with reduced EF can be found

 Laboratory blood tests are a basic part of the evaluation. This includes tests to assess the functioning of kidney, liver and thyroid also tests to assess electrolytes, including sodium and potassium and a complete blood count to look for anaemia or evidence of infection. In addition, markers of cardiac injury and stress can be used to assess risk level.

 Symptoms:

  • Fatigue
  • chest pain
  • Palpitations
  • Nocturia
  • Shortness of breath
  • Swelling of the ankles
  • Swollen neck veins
  • Low blood pressure
  • Increased urination at night
  • Tiredness during physical activity

 Severity of symptoms:

Class I – Disease with no symptoms

Class II – Mild symptoms

Class III – Symptoms with minimal exertion

Class IV – Symptoms at rest

 Causes:

  • Obesity
  • History of cardiac disorders, such as myocarditis
  • Medications
  • Smoking
  • Alcoholism
  • Multiple pregnancies
  • African-American descent
  • Poor nourishment
  • being over the age of 30
  • premature delivery medications

 Medications:

  • Angiotensin converting enzyme inhibitors – Help the heart work more efficiently
  • Beta blockers – helps to reduces the pace of heart beat so it has recovery time
  • Diuretics – Reduce fluid retention
  • Digitalis – Derived from the Digitalis purpurea, to treat heart failure. Digitalis strengthens the pumping ability of the heart
  • Anticoagulants – To help thin the blood. Patients with Peripartum cardiomyopathy are at increased risk of developing blood clots, especially if the EF is very low.

 Complications associated with Peripartum cardiomyopathy

Severe complications include:

  • Arrhythmia
  • Blood clots, particularly in the lungs
  • Congestive heart failure
  • Sudden Death

Long-term outlook:

The condition depends on the severity and time frame of condition. Some women who develop the Peripartum Cardiomyopathy during pregnancy may recover and return to normal size after delivery. For others, their condition can continue to worsen. To preserve longevity, heart transplant is suggested.

Stem Cell researchers have created cells that line blood vessels

HEART2019 (1)For the first time, researchers have effectively developed the cells that line the veins – called vascular endothelial cells- – from human induced pluripotent stem cells (iPSCs), uncovering new insights about how these cells work. Utilizing a one of a kind approach, the scientists prompted the differentiation of particular cell composes by creating mechanical powers on the surface of the iPSC-determined endothelium imitating the stream of blood. For instance, cells that felt a more grounded “stream” progressed toward becoming artery cells, while those that felt a weaker “stream” moved toward becoming vein cells.

 It was particularly exciting to us to find that these cells are fundamentally reacting to biomechanical prompts. By presenting cells to atheroprone flow, they could coordinate the differentiation of these cells into cells that are available in regions of the circulatory system which are known to influence by infections like atherosclerosis. Researchers are currently taking a shot at demonstrating the arrangement of blood vessel plaques utilizing human iPSC-determined vascular endothelial cells and recognizing potential medications that may avoid plaque development.HEART2019 (2)

They found that the iPS-inferred human endothelial cells show three basic capacities completed by developing endothelium in the body: mounting incendiary reactions, shielding blood from spilling out of the vein, and counteracting blood clumps.

In light of this data, Research work has another exciting ramification – it could possibly lessen, or even dispense with the requirement for heparin use amid kidney dialysis and lung disappointment treatment- – making both especially more secure.

Generally, patients experiencing dialysis are treated with heparin, an intense medication, which keeps the blood from thickening as it’s directed through the dialysis machine. While heparin is very viable in forestalling coagulating, the fact that it significantly diminishes the blood, it can likewise cause loss of blood, interior dying, and meddle with the recuperating procedure.

The iPSC-inferred endothelial cells delightfully work as an anticoagulant surface, Later on, tissue test from a patient can be taken, create iPSCs, and after that cover, an extracorporeal gadget with the patient’s own particular endothelial cells- – so the patient can run home with the gadget without the requirement for normal heparin shots.

Steroid Hormone Imbalance Leading to Treatment-Resistant Hypertension

Heart2019Studies carried by Researchers of London, found that the steroid hormone ‘aldosterone’ makes salt amass in the circulation system. The salt aggregation happens even in patients on sensible eating methodologies, and pushes up pulse regardless of utilization of diuretics and other standard medications.

Two patients in the examination with already resistant hypertension could fall off all medications after a benign aldosterone-causing nodule formation in one adrenal and surgically removed after medical procedure.

Hypertension standouts amongst the most widely recognized and imperative preventable reasons for heart diseases, heart disappointment, stroke and sudden passing. It influences more than 1 billion individuals over the world and records for around 10 million possibly avoidable death for every year.

Most patients can be dealt with successfully with changes in accordance with their way of life and the utilization of consistent prescription. In any case, in upwards of 1 of every 10 patients, circulatory strain can be hard to control and is named ‘resistant hypertension’. These patients are at the most astounding danger of stroke and coronary illness in light of the fact that their circulatory strain stays uncontrolled.

There has been an awesome story of utilizing refined current techniques to tackle an old issue – why a few patients have clearly recalcitrant hypertension. The revelation of salt over-burden as the basic reason has empowered us to distinguish the hormone which drives this, and to treat or fix the greater part of the patients.

These outcomes are vital on the grounds that they will change clinical practice over the world and will help enhance the circulatory strain and results of our patients with resistant hypertension.

It is noteworthy when such a large number of advances in prescription rely upon costly advancement, that we have possessed the capacity to return to the utilization of medications created over 50 years prior and demonstrate that for this hard to-treat populace of patients, they work extremely well.

In past work, the group demonstrated that resistant hypertension is controlled much better by the medication spironolactone (a steroid blocker of aldosterone) than by drugs authorized for use in hypertension. Presently they have demonstrated that the prevalence of spironolactone is expected over its capacity to beat the salt overabundance in resistant hypertension.

They likewise found that spironolactone can be substituted, to great impact, by a medication, amiloride, which could be a possibility for patients unfit to endure spironolactone.

The examination originates from the PATHWAY-2 contemplate, some portion of a progression of concentrates intended to grow more powerful methods for treating hypertension. It explored the theory that resistant hypertension was fundamentally caused by an imperfection in taking out salt and water and that the hypertension in these patients would be best treated by extra diuretic treatment to advance salt and water discharge by the kidneys.

Minimally invasive surgeries: Greatest innovation to overcome the pain in traditional surgeries

1The word minimally invasive surgeries or laparoscopic surgeries have become predominant nowadays since it offers the patients with smaller incisions, faster recovery times, reduced pains and the scarring. The probability of accuracy was also high in the case of the minimally invasive surgery when compared to the traditional open surgery.

Laparoscopy has got its name from the instrument which it uses called the laparoscope, a slender tool that has a tiny video camera and light on the end. Whenever a surgeon inserts it through a small cut, they can look through the video monitoring and see what is happening inside. If this technique had not been present, they require the larger cutting which would have been more painful. At the starting stages minimally invasive surgeries have been used for the gynecological surgeries and now its use has become predominant in all the cases of surgery.

Key benefits of having this kind of surgery is that we have smaller scars, shorter hospital stays and less pain.

When a robot helps?

In robotics assisted version of laparoscopic surgery, the surgeons first cut through the skin and inserts the camera as usual and later they use the robot’s mechanical arms to perform the surgery. Most of the surgeons think robotics assisted surgery is helpful in treating the people who weigh a lot, and for the gynecological and the urological surgery. The robotic surgery, the monitor gives the surgeon 3-D, high-resolution, magnified images inside the body. While they are watching the screen, they use the hands to control the robot and the surgical instruments. This helps the surgeon to be more successful and it causes the less discomfort to the body after the operation and has the very less bleeding.

The next level of advancement in the case of surgery is the gaming technology and the virtual augmentation in surgeries.

Sports Cardiology the Advancing Subject of Concern

Sports Cardiology the Advancing Subject of Concern.The field of sports cardiology has progressive appreciably over current times. It has integrated with clinical and research progresses in cardiac imaging, electrophysiology and exercise physiology to facilitate improved diagnostic and therapeutic organization of patients. One important attempt has been towards   better differentiate athletic cardiac remodelling from hereditary cardiomyopathies and other pathologies. At the same time as the diagnostic tools have enhanced, there have also been errors follow-on from assumptions that the pathological characteristics observed in the universal population would be generalizable to athletic populations.

Conversely, we know, athletes with hypertrophic cardiomyopathy, for instance, have many exceptional characteristics when compared among non-athletic patients with hypertrophic cardiomyopathy. We are learning the limitations of cross-sectional perceptions and a larger number of prospective studies have been started which ought to allow us towards more certainly examine the associations connecting exercise, cardiac remodelling and clinical results. The field enables some of the world’s specialists in sports cardiology to indicate on where there is a necessary for research focus to evolve knowledge and clinical care in sports cardiology.

Cardiology is an exclusive branch of learning in internal medicine, it uses exercise as part of both the diagnosis and treatment of disease. The result of exercise on cardiovascular function has long been a deliberation in medicine but the sub-specialty of sports cardiology speaks to a comparatively novel discipline focussing on the clinical issues relating to athletes and exercise devotees. The domineering subjects of concern have correlated to the classification of structural heart disease and the management of cardiac arrhythmias, predominantly aimed at deterrence of abrupt cardiac death and disintegration of cardiovascular function. Serious dispute has encompassed the issue of pre-participation screening of athletes and this has subjugated much of the sports cardiology agenda in the recent decade. The goal of the commentary is to mirror the current subjects of interest in sports cardiology and to identify vague issues that are likely to receive attention in the decades to come.

Ways hospitals can improve surgical training through technology: Nurturing the fields of surgery and surgical instrumentation

1

Improving the standard of surgery to be performed has became one of the key roles for the growing and developed hospitals and here are the some of the steps carried are adopted by them to improve the fields of surgery. The first and foremost thing to be monitored is quality. Generally outcomes are partly measured with the quality of care surgery patients receive throughout their hospital stays. Importantly technical quality of surgical procedures is also the major factor for the positive outcomes. Advances in technology and analytics have created opportunities for evaluating surgeons techniques.

 Digital trail:
The digital trail includes real-time information on a patient’s history, vital signs, imaging and other parameters. It’s also increasingly feasible to collect and synthesize information from surgical instruments and clinical workflows to drive surgical performance. Through analyzing such data, surgeons can find the root causes for the complications that put a patient and hospital at risk.

 Interactions among the surgeons:
Surgical units where other healthcare professionals have clearly defined roles within the team in delivering surgical care. We need to build on interactions and work with these colleagues to learn from these examples and encourage this recent trend in the field of surgery to develop.

 Data Analysis of the surgical results:
Data analysis at all levels could improve our understanding of surgical results and help develop ways to improve surgical techniques outcomes. Outcomes should be as simple as possible, so that it could have the wide range of understanding and take necessary steps to overcome the negative analysis.

 Virtual Imaging techniques: Big view through the small window:
In any situation with unexpected anatomy this virtual reality techniques will be very helpful for both the pediatric and the adult patient care. Virtual reality augmented surgical procedures will help to achieve better results in the field of surgery than the normal conventional procedures.

Study reveals that Cardiomyopathy mutation reduces heart’s ability to vary pumping force

HEART2019_meblogRecently, the Researchers have found how a genetic mutation is associated to hypertrophic cardiomyopathy (HCM) disrupts the heart’s normal function. The study reveals that the mutation prevents the heart from increasing the amount of force it produces when it needs to pump additional blood around the body.

Inherited genetic mutations can cause in the heart muscle which can abnormally thick and reduce the pumping of enough blood around the body. Studies have identified a mutation in the heart muscle protein troponin T that seem to pose a particularly high risk of sudden death in children and adults, despite it having only a mild thickening of the heart muscle wall. The mutation, known as F87L, alters a single amino acid in the central region of troponin.

Troponin complex component Troponin T which allows muscle fibers to contract in response to calcium released upon electrical stimulation. One of the significant features of cardiac muscle filaments is: they become more sensitive to calcium and hence contract more strongly, because they are stretched to longer lengths. Hence, when heart is filled with more blood, especially during carrying out physical activity, the muscle walls stretches and the heart contracts with high force to pump out extra blood. This phenomenon, which is known as the Frank-Starling mechanism is mainly due to Troponin action.

A professor along with a graduate student carried out research and introduced an equivalent mutation in the cardiac troponin T gene of guinea pigs and analyzed how it can affects the guinea pigs cardiac muscle fibers ability to contract and produce force. They found that the mutation: F87L in troponin T destroys the length-dependent increase in calcium sensitivity. the same response to calcium was observed in short, unstretched muscle fibers expressing mutant troponin T showed just as longer, stretched fibers.

The data resulted demonstrate that the length-mediated increase in force is significantly decreased by this hypertrophic cardiomyopathy (HCM)-associated mutation, which suggested that the mutation may direct muscle length-mediated increase in force production in the heart.. The effect of the Frank-Starling mechanism may have severe consequences for any individual as it decreases the heart’s ability to increase output when it needs to pump additional blood around the body.

For more visit: https://heart.cardiologymeeting.com/

Carotid Endarterectomy: An advancement in Vascular Surgery

surgeon

Carotid endarterectomy is the surgical procedure we commonly have to reduce the risk created as the result of stroke by generally rectifying the stenosis in the carotid artery of our body. The concerned vascular surgeon may recommend one to have this kind of surgical procedure under the following conditions.

  • When there is the moderate blockage of carotid artery and are experiencing the following symptoms like stroke, ministroke or ischemic attack.
  • A severe blockage is found, and we do not have any symptoms.

A carotid endarterectomy procedure is usually carried out with the sterile surgical suite or standard operating theatre. The victims may generally go home the same day or after the 1-2 nights of the surgical procedures.

Generally, the anesthetic is given, and the vascular surgeon makes the incision at the front of the neck. After removing the plaque from the artery, the vascular surgeon generally repairs the artery with the help of the veins from the elsewhere in the body and after it the incision is generally closed. As one of the advancement in the field of surgery the carotid stenosis is usually clubbed with the ultrasound doppler imaging of the neck arteries and magnetic resonance angiography or CTA. Generally, the surgeons try to avoid this procedure when the patient has,

  • Complete internal carotid artery obstruction.
  • Compete hemispheric stroke.
  • Patient seemed to be unfit due to comorbidities.

The complications after the procedure may include hemorrhage of the wound which is sometimes may be life threatening, because the swelling occurs at the neck due to the hematoma which could compress the trachea. But the surgeons generally try to avoid this discomfort. One of another serious problem is the hyper fusion syndrome.