Cardiology Roundup: Breakthroughs in Research, Technology and Treatment

2017-05-16
 

The beginning of cardiology as a medical specialty arguably dates back to 1628 when William Harvey published research demonstrating how blood circulates through the body. That means cardiologists and researchers have been exploring the circulatory system for nearly four hundred years.

Perhaps more impressive than how much we have learned about the heart since William Harvey is how much there is left to learn. As technology advances, we continue to chip away at unknowns.

This month’s roundup is devoted to innovations in cardiology treatment and breakthroughs in research. Read on for new research into plaque buildup as a heart attack risk predictor, a new treatment for congestive heart failure, and more.

1. Hard, Not Soft, Plaque Buildup May Predict Risk of Heart Attack

The buildup of plaque in arteries, known as atherosclerosis, can lead to heart attack if left untreated. Existing research found that soft plaque buildup — plaque not hardened by calcification — was the most likely to rupture and trigger an attack.

Researchers at the Intermountain Medical Center Heart Institute recently presented new research, however, that indicates hard plaque may be a more reliable risk indicator. The 7-year study analyzed 224 patients with diabetes but no heart disease symptoms. It concluded that elevated levels of calcified plaque was a strong predictor for serious coronary conditions. Said Dr. Brent Muhlstein, “It is a disease marker, not a risk marker. And we think it is possibly a very important predictor.”

2. Decision Tool Helps Patients Compare SAVR, TAVR

Transcatheter aortic valve replacement (TAVR) is growing in popularity as a less-invasive option for patients who would traditionally have undergone surgical aortic valve replacement (SAVR). TAVR is now indicated for intermediate-risk patients as well as high-risk patients.

Now patients can download a smartphone app or visit valveadvice.org to guide them through the decision-making process. The app was developed by interventional cardiologists, led by Duke University’s J. Matthew Brennan, MD. The site and app draw from more than 9,000 case studies of TAVR and SAVR patients to help patients choose the appropriate procedure.

3. New Treatment for Congestive Heart Failure Tested for the First Time

Most CHF treatments are aimed at keeping patients out of the hospital, and there has been little innovation for hospitalized patients. Physicians at Ohio State University’s Richard M. Ross Heart Hospital are helping to develop a new treatment for the latter group. The procedure involves using a catheter to remove excess lymphatic fluid, reducing the possibility of heart failure from edema.

The treatment would be an alternative to diuretics or ultrafiltration, which can lower blood pressure and impair kidney function. The patient tolerated the procedure and will now undergo observation to determine the effectiveness of the treatment.

4. UCT Researchers Discover Heart-Attack Gene

Arrhythmogenic Right Ventricle Cardiomyopathy (ARVC) is a silent killer that increases the risk of sudden cardiac arrest. It strikes young people, particularly those who are athletically active, and those at risk for the disease appear perfectly healthy.

Now a team of researchers in South Africa have discovered a genetic marker for the disorder. A mutation in the CDH2 gene appears to be an underlying genetic mechanism for ARVC. The discovery may help identify those who are at risk for the condition, allowing for preventive treatment before the disorder manifests.

5. Treating Heart Failure with Muscle Stem Cell Patch

A Japanese research team has successfully completed a human trial that used cardiomyopathy patients’ own muscle stem cells — from the vastus medialis thigh muscle — to make a patch for their ailing left ventricle region. The team had previously seen success with rats, but this was the first human trial of the procedure.

The patients experienced no significant complications from the procedure, the team reports, and a year post-procedure show measurable improvement in their heart function and capacity to exercise. The report’s authors caution that larger trials are needed, and that the effect is modest, but it does demonstrate that the technique is safe for human trial and has potential for the future.

Cardiology has come a long way in the past 400 years. The pace of discovery and innovation has increased exponentially in the past century, as we explore the potential of genetic sequencing and stem-cell therapy, among a host of other new treatment possibilities. As these articles demonstrate, there are exciting discoveries to be made in the known unknown and beyond.

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