Improving treatment and averting heart failure in kids

Washington, Apr 24 (ANI): Experts are finding new strategies to improve treatment of, and ultimately to rapidly identify and prevent, the congenital cardiovascular defects and the subsequent damage acquired after birth that ultimately results in heart failure.

And the new approaches were discussed at a recent meeting of paediatric cardiovascular experts from around the world who gathered at the Indiana University School of Medicine and Riley Hospital for Children for the second annual Riley Heart Center Symposium on Cardiac Development.

The symposium focused on molecular mechanisms that implement the instructions embedded within DNA that enable cells to form a functional heart.

The key proteins studied called transcription factors regulate how other genes are turned on and off in a complicated ballet that ultimately instructs a cell to become a cardiomyocyte and where to move and how to function.

When this dance goes awry, congenital heart defects are the unfortunate result.

“Although the process by which transcription factors regulate the expression of other gene products is well understood, how the many factors coordinate their functions to precisely define a cell”s purpose is only now becoming possible to understand,” said symposium co-organizer Dr. Anthony Firulli, professor of paediatrics and member of the Riley Heart Research Centre.

“Indeed, when one considers the numerous different cell types that make up the heart and great vessels that are required to function in unison to pump blood throughout the body and that in every cell type there are complex combinatorial codes instructing each cell on how to function and how to communicate with their neighbouring cells, it provides a complex challenge for heart researchers to understand,” said Dr. Simon J. Conway, professor of paediatrics and member of the Riley Heart Research Centre, who co-organized the symposium.

Heart development is characterized by the differentiation, proliferation and movement of cardiac muscle cells, which interact with extra cardiac tissues connecting the heart with the vasculature.

Firulli presented a comprehensive overview of the role that the Hand1 and Hand2 genes play during cardiogenesis, touching on interesting aspects of their overlapping functions.

Conway presented data that directly tested whether the developing heart really requires both Hand1 and Hand2, and if one could be replaced by the other.

These data from transgenic mouse models suggest that even though the Hand proteins are very similar in structure and may be expected to fulfill similar roles, Hand1 and Hand2 are independently required for the heart to develop normally.

Dr. Tiffanie R. Johnson from Riley Hospital, presented a review of ideal imaging techniques for the most common complex congenital heart defects.

She discussed the best ways to diagnose and follow patients as they grow, both before and after surgical intervention.

Johnson believes advances in imaging techniques will lead to higher quality and safer diagnostic imaging capabilities that will continue to be needed in the field of congenital heart disease.

The details of the symposium have been published in the latest issue of the journal Pediatric Cardiology. (ANI)

Get slim with a breakfast of muesli with milk, tinned peaches and yoghurt

London, Apr 18 (ANI): Is your expanding waistline giving you nightmares? Well, take heart. Researchers have found that a breakfast of muesli with milk, tinned peaches and yoghurt can help weight loss.

Experts at the University of Nottingham suggest that the low GI breakfast with apple juice helps the body break down fat better than a high Glycaemic Index start to the day of sugary cereal and white toast, reports The Daily Express.

Scientists discovered that the type of food you eat before exercise can directly impact on your health.

A study led by Dr Emma Stevenson looked at young women after an overnight fast. In one study period they were given a breakfast of food known to cause large rises in blood glucose – those with a high GI, including cornflakes and milk, white bread and jam and a fizzy, sugary drink.

In another period, they breakfasted on food with a low GI, although both breakfasts had the same amount of calories, carbohydrate, fat and protein. The low GI breakfast was muesli, milk, tinned peaches, yoghurt and apple juice.

Three hours after eating, the women walked for an hour on a treadmill. A lunch – the same in both study periods – was then provided. Throughout the day blood samples and samples of expired air were taken.

From analyses, researchers found blood glucose levels were higher after the high GI breakfast than the low one, and had returned to normal by the time the women began to exercise.

However, plasma free fatty acids (FFA) – which show the amount of fat used up for energy – began to rise two hours after the low GI breakfast, the researchers found.

Exercise then led to a rapid increase in FFAs in both groups – but concentrations were higher in the low GI group. After lunch the concentration of FFAs was the same in both groups, but overall fat oxidation was higher in the low GI group than the high GI group.

Dr Stevenson said: “We concluded that consuming a low GI breakfast increases fat oxidation both at rest and during subsequent exercise. A low GI breakfast also had an impact on appetite, with test subjects feeling fuller for longer after they’d eaten these types of foods.” (ANI)

Screening heart patients for depression doesn’t help, says study

Screening heart patients for depression doesn’t help, says studyWashington, Testing cardiac patients for depression does not prove beneficial, reveals a new study.

Researchers at McGill University, Johns Hopkins University and six other institutions across the globe raised doubt on the American Heart Association”s insistence on the important link between depression and cardiac care.

As per Dr. Brett Thombs, a psychologist and assistant professor in the Department of Psychiatry at McGill”s Faculty of Medicine and at the affiliated Jewish General Hospital, there is not nearly enough medical evidence to support such a “massive, expensive and labour-intensive undertaking.”

The study examined a collection of more than 1,500 clinical studies from around the world and after reviewing 17 of these in detail, Dr. Roy Ziegelstein, of Johns Hopkins added screening for depression would not held patients in a cardiac care environment.

Thombs said: “We discovered that screening alone or screening and referral doesn”t help most patients. Moreover, we found no connection at all between getting treated for depression and cardiovascular outcomes, like having a subsequent heart attack.

“That said, in no sense are we saying that depression doesn”t matter. We”re just saying we don”t have the tools in cardiovascular care settings to identify and improve the lives of people who aren”t already being treated for depression.

The study is to be published in the Nov. 12 special edition of the Journal of the American Medical Association (JAMA). (ANI)

Bypass heart surgery doesn’t affect IQ levels in kids

Bypass heart surgery doesn’t affect IQ levels in kidsWashington: Bypass surgery in children with less complex heart defects doesn’t lead to low IQ levels, say researchers from the Children”s Hospital of Philadelphia.

The study involving 41 patients, aged five to 18 showed that the use of cardiopulmonary bypass does not cause short-term neurological problems in children and teenagers after surgery.

“This is good news for school-aged children who receive surgery for these less complex heart defects,” said study leader Michael D. Quartermain, M. D., a pediatric cardiologist at The Children”s Hospital of Philadelphia.

All the patients had milder forms of congenital heart disease usually characterized by an abnormal heart valve or by a hole between the heart”s chambers.

Previous studies of survivors of more complex heart surgery have found neurological problems, such as impaired motor development, lower I. Q. scores and reduced language skills.

In the current study, researchers compared 41 pediatric heart patients who underwent CPB to a control group receiving non-heart-related surgery without CPB.

Neurological and developmental testing were performed two weeks before and six months after surgery in both groups.

The researchers found no significant difference between the two groups in I. Q. scores and tests of memory, motor skills or attention. Neither of the surgical groups showed a decline in neuropsychological scores after surgery.

“It is often challenging for the cardiologist to determine the optimal time to refer a child without symptoms to the operating room for repair of an underlying congenital heart defect,” said Quartermain.

“It is now clear that the potential neurodevelopmental sequelae of cardiopulmonary bypass in this group of school-aged patients should not be a major factor in this important decision,” he added.

The study was presented at the American Heart Association”s Scientific Sessions in New Orleans. (ANI)

Five proteins may pave way for highly accurate blood test to predict heart attack

Five proteins may pave way for highly accurate blood test to predict heart attack Washington : Johns Hopkins researchers have uncovered a set of five proteins in blood, which they believe may lay the basis for a highly accurate early warning test to predict heart attack in people with severely reduced blood flow, a condition medically known as ischemia.

The team comprising over a dozen scientists revealed that it took them a year to perform the study. They believe that theirs is the largest protein analysis ever done at Hopkins.

According to the researchers, their study was based on 76 arterial blood samples from 19 men and women, which had been taken immediately before and after a period of medically induced ischemia lasting as long as 45 minutes.

They called their method of selecting proteins from tens of thousands present in the blood “a pipeline approach”.

“From the start, we knew that we were looking for rare, almost unique biomarkers that bore some direct relationship with ischemia,” says study senior investigator Dr. Jennifer Van Eyk, whose first step was to remove from the analysis common blood proteins, such as albumin and globulins.

Presenting their work at the American Heart Association”s (AHA) annual Scientific Sessions in New Orleans on November 9, the researchers said that only five proteins were present in significantly increased amounts after ischemia occurred, with at least a doubling in the blood concentration, compared with those recorded during healthy blood flow.

They said that the five proteins were lumican, semenogelin, angiogenin, extracellular matrix protein, and so-called long palate, lung and nasal epithelium carcinoma-associated protein 1.

While all of them are believed to originate in the heart, they can also be found in other tissues varying from the corneas of the eyes (lumican) to semen.

The researchers also revealed that semenogelin had not been seen in the heart ever before, while others like angiogenin are more predictably found in growing blood vessels and muscle tissue, and are actively involved in tissue repair.

They further said that little was known about the remaining two, which ironically have the longest names: extracellular matrix protein, secreted in a rare inflammatory disease; and long palate, lung and nasal epithelium carcinoma-associated protein 1, thought to play a role in innate immunity.

The Johns Hopkins team believe that the presence of all or even a selected set of these proteins in a simple, rapid blood test could aid emergency paramedics and physicians during the critical 12- to 24-hour window before ischemia causes substantial heart tissue damage or death from heart attack.

“Our results lay the foundation for a first-of-a-kind, early-warning system that could save tens of thousands of people on the brink of a heart attack,” says Van Eyk, a professor at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute.

The researchers are currently planning to further analyse the five proteins to map their molecular structures, so that an antibody can be identified to bind to one or several of the proteins, laying the basis for a blood test for ischemia. They will also conduct tests to verify that their study findings also apply to ischemia in stroke. (ANI)