New therapy shows promise for treating cardiovascular disease

A new therapy being studied in non-human primates by researchers at Wake Forest Baptist Medical Center and colleagues is demonstrating promise as a potential tool for combating cardiovascular disease by increasing good cholesterol and lowering triglycerides in the blood. Supported by the National Institutes of Health and the Canadian Institutes of Health Research, the preclinical findings appear in a recent issue of the journal Nature. "The study was conducted because there is a very strong inverse correlation between the amount of HDL (good cholesterol) and heart disease," said co-principal investigator Ryan Temel, Ph.D., an assistant professor of pathology and lipid sciences at Wake Forest Baptist. "The higher your level of HDL, the lower your risk of developing cardiovascular disease. Currently, however, there are few therapies that significantly raise HDL."

Heart surgeons-in-training benefit from hands-on homework (Canada)

Residents in cardiac surgery who receive extra training on a take-home simulator do a better job once they get into the operating room, Dr. Buu-Khanh Lam today told the Canadian Cardiovascular Congress 2011, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society. Dr. Lam and a multidisciplinary surgical team developed a kit – containing sutures, forceps, and miniature tubing – that can be taken home by trainees to practice a highly technical operation called microvascular anastomosis. The procedure, which involves joining two arteries together, is the "bread and butter" of coronary artery bypass surgery and is performed hundreds of thousands of times a year in North America, says Dr. Lam, director of surgical undergraduate education at the University of Ottawa and director of the University of Ottawa Heart Institute Valve Clinic

CARG Newsletter - November 2011

The CARG Newsletter - November 2011 is now available online

Heart and Stroke Foundation appoints Bobbe Wood as President (Canada)

The Heart and Stroke Foundation of Canada (HSFC) is pleased to announce the appointment of Bobbe Wood as President. Ms. Wood is responsible for the oversight of the Foundation’s mission to eliminate heart disease and stroke in Canada through its leading edge cardiovascular research, and the advancement of health promotion, education, and advocacy initiatives. From September 2010 to June 2011, Ms. Wood served as CEO of the Heart and Stroke Foundation of Canada, leading the federation through an historic transition to a unified national organization

Ethylene Eichorn's retirement tea - October 11, 2001

A retirement tea was held for Ethylene Eichorn, pictured far left with Leslie Worth of the Saskatoon Health Region, on October 11, 2001.

Ethylene writes:

Dear CARG Members:

I want to thank you for letting me assign visitors for the hospital visitations. I have enjoyed doing it and it was hard for me to give it up, but it is always good to have younger ones have a chance to do this also.

In the years I have spent doing this, I have never met any visitor who complained about going to the hospital & visiting heart patients. In fact they wanted to do more than twice a month. The heart visitors are a group of devoted, caring people and I think they deserve a lot of praise for the many people they have talked to and given them a hope for the future.

Also, our Cardiac Nurses have been a great help to me. They are the ones who have classes to answer all the questions you have about living as a heart patient and caring for a heart patient. Having a husband who had 3 heart attacks, it sure helped me.

Again I thank you.

God Bless You All

Ethylene Eichorn

------------------------------------------

If you couldn't make it to the tea, here's what you missed:

Hospital Visitation Program at Royal University Hospital (Saskatoon)

Ruth Redden (Volunteer Visitor Program Co-ordinator) writes: Many CARG members have participated in the Hospital Visitation Program at RUH. This program began in 1986 and has been very effective in assisting patients as they adapt to a new lifestyle after experiencing a "heart event". It is also an opportunity to talk with patients and family members about the cardiac education and exercise programs.

A journal article from the Archives of Internal Medicine,(Effect of Cardiac Rehabilitation Referral Strategies on Utilization Rates, Arch Intern Med/Vol 171 (no 3), Feb. 14, 2011), looked at ways to increase cardiac rehab participation. Along with other points, they identified the benefits of visitation at the bedside and the positive effects of peers.

We know that people, after a heart event, benefit from attendance at a Cardiac Rehab Program. We also know it is best if people hear about programs from many sources. A person who has experienced a heart event and who has embraced our rehab program, is an important connection.

Our program is always interested in recruiting new volunteers to participate in the hospital visitation program currently operating at RUH.

What is involved in becoming a Hospital Volunteer Visitor?
* Interview with Ruth or one of the nurses
* Complete application form for RUH Volunteer Services
* Interview with Volunteer Services, police check and attend hospital orientation
* Buddy with an experienced volunteer and visit on the ward together

If you are interested in this area of volunteer work, please contact:
Ruth Redden (Volunteer Visitor Program Co-ordinator) at 652-6990


THANK YOU ETHYLENE EICHORN:

Ethylene Eichorn has been the program co-ordinator for the Hospital Cardiac Rehabilitation Program since 1994.
She has efficiently co-ordinated the volunteer visitation schedules and has gone above and beyond what was required to ensure this program was successful.
Ethyelene retired from this role in August of 2011 but continues to volunteer her time at RUH.
A Special THANK YOU for a job well done.

Fife cardiac patients in good heart! (Scotland)

Cardiac patients in Fife have attended an activity day at Lochore Meadows. Some 50 people who have suffered a cardiac incident turned out to take part in a range of activities including archery, kayaking, cycling, walking and kata-kanuing - paddling in canoes designed for teams. The event was organised to celebrate 11 years of community-based Fife Cardiac Rehabilitation Services - delivered by Fife Sports and Leisure Trust in partnership with NHS Fife. The annual get-together celebrates the achievement and progress of people who attend cardiac rehabilitation classes in leisure centres across the Kingdom. The service, which has been delivered by the trust since 2000, provides long-term maintenance involving gym or circuit classes led by qualified British Association of Cardiac Rehabilitation instructors. Around 12,000 people every year have taken part in Fife Sports and Leisure Trust's cardiac rehab classes held in 11 of its centres across Fife. Patients are referred to the service following a cardiac incident and progress through three phases of rehabilitation before joining phase four - the community-based service offered by the trust

Gut bacteria may affect whether a statin drug lowers cholesterol

Statins can be effective at lowering cholesterol, but they have a perplexing tendency to work for some people and not others. Gut bacteria may be the reason. A research team led by a Duke University scientist has identified three bile acids produced by gut bacteria that were evident in people who responded well to a common cholesterol-lowering drug called simvastatin. The finding, published Oct. 13, 2011, in PLoS One, demonstrates how gut bacteria can cause inherent differences in the way people digest, metabolize and benefit from substances such as drugs. The study represents the intersection of two emerging research interests: An analysis of the intestinal microflora, plus the use of a science called metabolomics, which examines the thousands of biochemical components involved in cellular metabolism and how they affect health

Citalopram: Health Canada reviewing dose-related heart risk

Health Canada is reviewing the heart-related safety of the prescription antidepressant citalopram. The review is in light of new study data suggesting that high doses (60 mg/day) can affect the electrical activity of the heart. The changes in electrical activity could potentially lead to serious, possibly fatal abnormal heart rhythms.

Health Canada is currently reviewing the available data and assessing the need for revised dosing recommendations and will take appropriate action based on the outcome of our review, including working with the companies to update the prescribing information. New safety information will be communicated to healthcare professionals and the public as soon as possible, once the review is complete.

Citalopram is used to treat depression and belongs to a family of drugs known as SSRIs (Selective Serotonin Reuptake Inhibitors). The current Canadian prescribing information recommends 20 mg/day of citalopram in adults. Some people who have not responded to this dose are prescribed 40 or even 60 mg/day.

In Canada, citalopram is available in 10, 20, 30, and 40 mg tablets. It is sold under the brand name Celexa and under several generic names (all of which contain "citalopram" in the name, except the generic products "ran-citalo" and "CTP 30")

Royal University Hospital Every Heart Matters Campaign (Saskatoon)

John Cross, Volunteer Chair Every Heart Matters Campaign writes "Chances are, you know someone with a heart rhythm disorder. It might be your grandmother or your grandson. A young athlete or a busy mom. A neighbour or a trusted friend. In fact, one in four of us will experience an abnormal heartbeat at some point in our lives. For many, an irregular heartbeat can diminish enjoyment of life. For others, it will prove fatal. In the 1950s, when Royal University Hospital opened its doors, Dr. Louis Horlick and, a few years later, his colleague Dr. José Lopez, were champions of modern, holistic cardiac care. Today, they continue that vision by joining the Royal University Hospital Foundation as Honorary Co-Chairs of the Every Heart Matters Campaign. Our goal is to advance the excellent cardiac care program at Royal University Hospital by raising $5.5 million for a laboratory and program dedicated to the treatment, research and education of heart rhythm disorders. This advanced sub-specialty is called Cardiac Electrophysiology or EP. As you will read on the following pages, a comprehensive cardiac care program - with the addition of the EP Laboratory - will make a vital difference to our patients, their families and their medical team at RUH. But we need your help. Please join me by supporting the Every Heart Matters Campaign"

FDA OKays combo pill for diabetes, cholesterol

The FDA has approved a fixed-dose combination tablet that combines the diabetes drug sitagliptin with simvastatin, under the brand name Juvisync. It's the first product with drugs for diabetes and high cholesterol in a single pill, the agency noted. Sitagliptin is a DPP-4 inhibitor sold as Januvia, first approved in 2006 as an adjunct to diet and exercise. Simvastatin (Zocor) is one of the most popular statin drugs for reducing total and LDL cholesterol. In the short term, the combination product will come in three strengths, all with 100 mg of sitagliptin and 10, 20, or 40 mg of simvstatin. The FDA advised physicians to consider other drugs that patients may be taking when deciding which strength to prescribe. The product's manufacturer, the Merck subsidiary MSD International GmbH Clonmel, of Tipperary, Ireland, has committed to develop additional strengths with 50 mg of sitagliptin and 10, 20, and 40 mg of simvastatin, according to the agency. "Pending availability of the fixed-dose combination tablets containing 50 mg of sitagliptin, patients who require this dose should continue to use the single ingredient sitagliptin tablet," the FDA said. Sitagliptin is also sold in a 25-mg dose, but it is seldom prescribed and there are no plans to develop Juvisync tablets with that dose, the agency added. The FDA noted that statins can exacerbate hyperglycemia in patients with type 2 diabetes. "This risk appears very small and is outweighed by the benefits of statins for reducing heart disease in diabetes," the agency said. "However, the prescribing information for Juvisync will inform doctors of this possible side effect. The company will also be required to conduct a post-marketing clinical trial comparing the glucose-lowering ability of sitagliptin alone compared to sitagliptin given with simvastatin." Common side effects associated with the combination include upper respiratory infections, rhinitis, sore throat, headache, muscle and stomach pain, constipation, and nausea. (You may wish to consult your own medical expert about this)

Canada's emergency doctors push to improve rate of "bystander" CPR assistance

Canadians who suffer cardiac arrest outside of a hospital are three to four times more likely to survive if they receive cardiopulmonary resuscitation (CPR). According to the Canadian Association of Emergency Physicians, such assistance is provided in only about one-quarter of cases. In a position statement on "bystander" CPR to be published in the Canadian Journal of Emergency Medicine, CAEP says it is not acceptable that vast numbers of witnessed cardiac arrest victims do not receive bystander CPR. More than 20,000 people suffer out-of-hospital cardiac arrests in Canada each year, with 85 per cent of cases occurring in residential dwellings. Currently, less than 10 per cent of these people survive. Every Canadian should be trained in CPR and all Canadians should respond and provide chest compressions, with or without mouth-to-mouth ventilation, whether they are trained or not, CAEP says

EP lab to eliminate need for out-of-province travel (Saskatoon)

After several years of relative good health, Terry York (CARG member) was told last summer that he needed a second implantable cardioverter-defibrillator implanted in his heart to help it pump. He had already traveled to Calgary for an ICD several years ago, however, it wasn't doing the full job York needed. Prior to April 21, the procedure couldn't be completed in Saskatoon, so he was put on a list for Calgary. He almost didn't make it. While golfing one day, he realized he was in trouble.

"My breath was so short, I lost control of my breathing. I was admitted to RUH, put on oxygen and an aortic heart pump," he says. "I survived, but was in the hospital for a week and a half before taking the air ambulance to Calgary for the other implant."

Heart health is important to everyone, however to those with heart conditions like York, it's the difference between life and death. For that reason, Royal University Hospital, already a leader in cardiac care, is moving forward with construction on its much anticipated cardiac electrophysiology (EP) lab. The lab will allow patients in Saskatchewan to receive procedures here instead of leaving the province.

Two EP cardiologists, Dr. Carlo Stuglin and Dr. Kelly Coverett, currently conduct EP procedures out of the cardiac catheterization lab at RUH one day a week. That's possible through equipment purchased in 2009 by the Royal University Hospital Foundation and Saskatoon Health Region. As of April 21 they began implanting ICDs in the operating room. "I can't tell you how grateful I am for the program Dr. Coverett has developed," said York at the RUH Foundation Donor Grand Rounds on May 17, 2011. "My son and his wife are both med-school grads and they both said that if I hadn't been at RUH and had access to the kind of care they provide, I would have died. No question."

The two-phase construction of the EP lab begins this month (June 2011). The full lab is expected to be operational in spring 2012. The EP lab will share the same space at RUH as the cardiac catheterization lab. With support from the RUH Foundation, it is expected that the new EP lab will be as good as or better than any other lab in North America. With a dedicated lab, a wait list of 18 months will be shortened and patients can have these surgeries in Saskatoon.

"Our campaign for 2011-2012 will focus on raising $5.5 million to build a dedicated EP lab," says Arla Gustafson, CEO of the RUH Foundation. "Patients like Terry and their families will be able to stay in province for surgery and procedures, which is always a better option for them and their families." The Kinsmen Telemiracle Foundation has already donated $1.5 million for the equipment that will be installed in the EP lab. (Reprinted from SHR, Region Reporter)

Mayo Clinic finds estrogen may prevent younger menopausal women from strokes

Estrogen may prevent strokes in premature or early menopausal women, Mayo Clinic researchers say. Their findings challenge the conventional wisdom that estrogen is a risk factor for stroke at all ages. The study was published in the journal Menopause. Researchers combined the results from a recent Mayo Clinic study with six other studies from across the world and found that estrogen is protective for stroke before age 50. That is roughly the average age when women go through menopause. "We were very surprised because these results were unexpected," says study author Walter Rocca, M.D., an epidemiologist and neurologist at Mayo Clinic. "The old idea that estrogen is always a problem in the brain has to be corrected." Estrogen can be a problem in older women, he explains, but in younger women, estrogen may be important to protect the brain from strokes. The study has implications for women who experience premature (before age 40) or early menopause (before age 45) from natural causes or from ovary removal. Women in these groups should consider taking estrogen up to approximately age 50 to prevent stroke, Dr. Rocca says. Ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. According to the American Stroke Association, these types of strokes account for 87 percent of all stroke cases

Einstein College of Medicine given $6.7 million to study congenital heart defect genetics

The Eunice Kennedy Shriver National Institute of Child Health & Human Development, part of the National Institutes of Health, has awarded researchers at Albert Einstein College of Medicine of Yeshiva University and collaborators at the Children's Hospital of Philadelphia a five-year, $6.7 million grant to study the genetics of both rare and common congenital heart abnormalities known as conotruncal defects. CTDs account for more than one-third of all heart defects. They can involve a faulty connection between the heart's chambers or an abnormality affecting a major blood vessel leaving the heart. Some of the more common CTDs include ventricular septal defects and tetralogy of Fallot

Increasing cardiovascular disease in China: urgent need for prevention

At over 40%, the mortality rate due to cardiovascular disease in China is amongst the highest in the world and has been rightly described as an epidemic. Its population faces a catalogue of CVD risk factor statistics that expose high levels of obesity, diabetes, cholesterol and blood pressure, and a smoking habit within males that is proving stubborn to address. To support efforts to implement a series of treatment and prevention strategies that can help reverse these worrying trends, the European Society of Cardiology announces that it will deliver an educational programme at the 22nd Great Wall International Congress of Cardiology. The ESC has been invited for the second time by its affiliate, the Chinese Society of Cardiology, to co-host a special symposium during the congress, which runs from 15 October in Beijing

Researchers make older beta cells act young again

As a person ages, the ability of their beta cells to divide and make new beta cells declines. By the time children reach the age of 10 to 12 years, the ability of their insulin-producing cells to replicate greatly diminishes. If these cells, called beta cells, are destroyed - as they are in type 1 diabetes - treatment with the hormone insulin becomes essential to regulate blood glucose levels and get energy from food. Now, longtime JDRF-funded researchers at Stanford University have identified a pathway responsible for this age-related decline, and have shown that they can tweak it to get older beta cells to act young again - and start dividing. The work, to appear in the October 12 issue of Nature, provides the most complete picture to date of the molecular and biochemical mechanisms that bring beta cell regeneration to a near halt as beta cells age. These findings may help pave a path for developing strategies to restore beta cell number to treat both type 1 and type 2 diabetes

High cholesterol might be linked to Alzheimer's Disease

New research suggests that high cholesterol levels could boost the risk of Alzheimer's disease by creating more brain-clogging bits known as plaque. The finding doesn't directly prove that high cholesterol causes Alzheimer's disease or that lowering it would reduce the risk. Also, researchers didn't find any link between high cholesterol and tangles, which also clog the brain in those with Alzheimer's. Still, the findings add to previous research that has linked insulin resistance to Alzheimer's disease, said study author Dr. Kensuke Sasaki. Better control of both cholesterol levels and insulin resistance, both risk factors for heart disease, "might contribute to a strategy for the prevention of Alzheimer's disease," said Sasaki, an assistant professor of neuropathology at Kyushu University in Japan

Raw vegetables and fruit 'counteract heart risk genes'

People who are genetically susceptible to heart disease can lower their risk by eating plenty of fruit and raw vegetables, a study suggests. It says five or more daily portions should be enough to counteract culprit versions of a gene on chromosome 9, thought to be possessed by a fifth of people of European ancestry. Healthy diets appeared to weaken its effect. The US researchers investigated more than 27,000 people for their work. The findings were published in Plos Medicine journal. These participants came from from around the globe, including Europe, China and Latin America.

Smartphones can become health monitors (USA)

Researchers at Worcester Polytechnic Institute in Worcester, Mass., have expanded the medical reach of smartphones, developing an application that can turn the ubiquitous devices into vital sign monitors. Led by Ki H. Chon, PhD, professor and head of biomedical engineering at WPI, a team of researchers created an app that can measure the heart rate, rhythm, respiration rate and blood oxygen saturation using a phone's built-in camera. The researchers reported that the software can read vital signs as accurately as standard medical monitors currently in clinical use. "This gives a patient the ability to carry an accurate physiological monitor anywhere, without additional hardware beyond what's already included in many consumer mobile phones," the authors wrote. "One of the advantages of mobile phone monitoring is that it allows patients to make baseline measurements at any time, building a database that could allow for improved detection of disease states."

Defibrillators in Scottish shops

A scheme which will see life-saving devices installed in 40 stores in Scotland has been hailed by Health Secretary Nicola Sturgeon. The Semichem shop in Kirkcaldy is the first to have its staff trained to use the automated defibrillators which can help save the lives of heart attack victims. As part of the programme the devices, which give the heart an electric shock, are being installed in Scotmid, Semichem and Fragrance House shops. The Scottish Ambulance Service is helping Scotmid to purchase and install the in-store defibrillators, training staff to ensure they can use them quickly if needed. The ambulance service also worked closely with the company to identify those stores where the defibrillators are likely to save the most lives

Researchers seek patients for diabetes 'dating agency' (UK)

A massive recruitment drive is under way to match up thousands of diabetes patients with research projects aimed at finding a cure for the disease. The scheme is being likened to a kind of "dating agency" that puts researchers and patients in contact. Researchers say about 30% of cancer patients may be taking part in clinical trials, but for diabetes that figure is less than 1%. About 2.8 million people in the UK are known to have diabetes. But the charity Diabetes UK believes another 800,000 people may not know they already have the disease

Windsor's Hotel-Dieu Grace recruits star heart doctor (Canada)

Meet Dr. Nisar Huq. The new star recruit of Hotel-Dieu Grace Hospital's cardiology department could serve as poster boy for Canada's reversal of the medical brain drain to the U.S. Huq, a highly trained and successful interventional cardiologist has the professional profile that the Canadian medical profession would have lamented losing just a few years ago. Born in Ottawa and trained in Ontario and Quebec, Huq was eventually lured to the U.S. to pursue more challenging professional opportunities there. The last five years, he worked in Michigan, Illinois and, most recently, Texas. Now he has returned home. "I always hoped to come back," said the 44-year-old specialist, who trained at the Ottawa Heart Institute and Montreal's McGill University. "I enjoyed my time in the U.S. but I love Canada and I'm proud to practise here." He joins Dr. Roland Mikhail and Dr. Amr Morsi to give the local hospital three interventional cardiologists able to perform angioplasties - Windsor Star

Why cardiac rehab saves lives

Cardiac rehabilitation can be extremely effective, yet most people choose to avoid it. New research may make them think twice. Cardiac rehabilitation can improve the ability of the heart to return quickly to a normal rate after exercise, and that in turn can double the chances of survival. "Time and time again, cardiac rehabilitation has been shown to improve survival, to improve quality of life, and of course improve exercise capacity," says researcher Leslie Cho, MD, section head of preventive cardiology and rehabilitation at the Cleveland Clinic. However, experts debate whether it's possible to reverse an abnormally slow return to a normal heart rate, and if doing so can lengthen life. The new research sheds light on both points. "For the first time, we have shown that cardiac rehabilitation can train the heart to return to its normal rate quickly after exercise and improve survival. This is better than any medicine," Cho says. The study is published in Circulation: Journal of the American Heart Association

Men 'more prone to type 2 diabetes'

Researchers say they have discovered why men may be more likely than women to develop type 2 diabetes - they are biologically more susceptible. Men need to gain far less weight than women to develop the condition, study findings suggest. The Glasgow University team found men developed the disease at a lower Body Mass Index than women. They believe distribution of the body fat is important - men tend to store it in their liver and around the waist