theHeart.org - Heart failure

Beta blockers seen as underused before referral for ICD, clashing with guidelines

Thu, 11 Mar 2010 10:00:50 EST

Perhaps a third of patients with systolic heart failure don't take any beta blockers, and many more don't take enough, in the three months before they receive a primary-prevention defibrillator, despite guidelines requiring the drugs be "optimized" prior to any device therapy, an analysis suggests.

What's going to be hot at ACC 2010?

Fri, 05 Mar 2010 16:45:33 EST

Pack this up for your patients: program chairs say a patient-care focus means results of this year's line-up of late-breaking clinical trials will have immediate relevance to clinical practice. Highlights include two ACCORD analyses looking at blood pressure and lipids, the EVEREST II results with the MitraClip, the MM-WES study of warfarin genotyping, plus a range of DES, HF, and atrial-fibrillation studies that may help answer the question of what therapies work best and at the best price.

End-systolic volume may hold key to SVR success

Thu, 04 Mar 2010 16:00:25 EST

A single-center trial shows that left-ventricular end-systolic volume index is an independent predictor of survival in patients undergoing surgical ventricular reduction.

Most hospices ill-equipped to deal with ICDs

Thu, 04 Mar 2010 11:00:17 EST

In a nationwide US survey, few hospices routinely queried incoming patients about having implantable defibrillators. Most said at least one of their patients had recently received shocks, but only a quarter kept on hand the necessary simple tool for emergent device deactivation.

Medicare will delay paying claims for two weeks

Mon, 01 Mar 2010 12:00:47 EST

The move by Medicare is intended to blunt the effect of the 21.2% pay cut. If a fix is passed, CMS carriers will pay March claims that had been put on hold, at the current rate.

Implanted LA-pressure sensor guides HF meds, prevents decompensations in pilot study

Fri, 26 Feb 2010 17:30:39 EST

Patients with the device self-adjusted their daily diuretic intake based on left-atrial pressure readings according to instructions prepared for them by their physicians.

Medicare pay cut of 21.2% to take effect Monday

Fri, 26 Feb 2010 16:30:51 EST

Senate Democrats will not introduce legislation creating a new effective date for the reduction until next week, according to a spokesperson for Senate Majority Leader Harry Reid.

Less is more: Small changes would improve heart-disease outcomes in US

Thu, 25 Feb 2010 18:30:00 EST

Rather than concentrating primarily on medical technologies and greater use of pharmacotherapy, the US needs to seriously address lifestyle risk factors if it wants to properly tackle its heart-disease epidemic, a new Lancet editorial concludes.

ADMIRE-HF published: How imaging sympathetic nerve function can assess risk in CHF

Thu, 25 Feb 2010 11:15:20 EST

The study shows how imaging the sympathetic innervation of the heart can be used as a prognostic tool in heart-failure patients.

IOM report calls hypertension the "neglected disease"

Mon, 22 Feb 2010 18:15:00 EST

Most patients diagnosed with hypertension do not have their blood pressure adequately controlled, the report found. Physicians are also failing to adhere to guidelines for treating mild hypertension in older patients.

New Senate report puts Avandia safety in spotlight again

Mon, 22 Feb 2010 08:45:00 EST

A new Senate report has rekindled debate about the cardiovascular safety of GlaxoSmithKline's diabetes agent rosiglitazone, stating that there are "serious health risks" associated with the drug. It also severely condemns company tactics and criticizes the FDA's role in events.

Gene variants blur line between "lone" AF and typical AF presentation

Sun, 21 Feb 2010 13:00:00 EST

Yet another set of genetic mutations has been linked to atrial fibrillation; the relation appears strongest in patients with symptomatic AF but no apparent structural heart disease. The function of the affected gene, KCNN3, makes the finding especially intriguing, researchers say.

Latest Grassley letter seeks clarity on 510(k) loophole through which Myxo ring went to market

Thu, 18 Feb 2010 16:00:00 EST

The letter is the latest in a series from the senator's office probing the Myxo ETlogix annuloplasty ring—a device that made its way onto the market based on FDA guidance that Grassley has singled out as flawed.

Subcutaneous monitor 96% sensitive for AF in study

Wed, 17 Feb 2010 11:30:56 EST

A small prospective study shows the Medtronic Reveal XT to be highly accurate in detecting and ruling out atrial fibrillation.

New overview of 9p21 gene variants show significant but modest link with heart disease

Wed, 17 Feb 2010 10:00:59 EST

The results also suggest this association varies with age but less so with race.

Broad genetic score adds nothing above traditional CV risk factors

Tue, 16 Feb 2010 16:00:00 EST

Combining all known single nucleotide polymorphisms for heart disease—or at least all of the ones discovered by June of last year—results in a score that's no better than traditional risk factors at predicting women who'll go on to have a cardiovascular event. Researchers say their "brute-force" approach may yet yield results.

ACC backs cardiologist for Congress, tests political clout at pivotal time for US healthcare

Sun, 14 Feb 2010 16:30:00 EST

The college's political action committee recently donated $5000 to the campaign of Georgia Republican Chris Cates. The conservative candidate has set his sights on blocking some of the proposed changes to US healthcare, something he sees as "the biggest power grab in the history of our country."

Study shows weight loss improves ventricular structure

Fri, 12 Feb 2010 13:45:58 EST

Ventricular remodeling associated with obesity may be at least partially reversible with weight loss, a new study shows.

Authors of case report on a rare defibrillator problem clash with company over claims

Fri, 12 Feb 2010 09:30:36 EST

A new report describes a single case of inappropriate shocks that the authors believe stemmed from a wobbly defibrillator head. The manufacturer rejects the theory and says the writers should have held off on publishing while the company did a proper analysis; the authors say they did.

Possible link between H1N1 flu and myocarditis

Thu, 11 Feb 2010 15:30:15 EST

Within a recent 30-day period, four cases of fulminant myocarditis, an atypical number compared with usual experiences, were documented, raising suspicions that the virus is more commonly associated with myocarditis than other flu strains.

Changing times: New approach needed in PAH trials

Wed, 10 Feb 2010 11:30:00 EST

A new review concludes that current treatments for pulmonary arterial hypertension have "uncertain" effects on long-term survival and concludes that a novel approach is needed for future clinical trials. One expert not involved in the review says change is coming.

Novel biomarker-guided strategy hastens optimal dosing in highest-risk HF patients

Wed, 10 Feb 2010 10:30:34 EST

Once higher-risk patients are identified by natriuretic-peptide testing, the assays can be used to accelerate their beta-blocker uptitration and optimize dosing of other drugs, researchers say.

Aspirin's US REACH: 25% of secondary-prevention patients not treated

Tue, 09 Feb 2010 16:30:15 EST

A new registry analysis should remind physicians to step up use of aspirin in patients proven to benefit but also gives a snapshot of aspirin use in primary prevention that may prove helpful when results come in from the large trials in this group.

African Americans have highest risk of peripartum cardiomyopathy

Mon, 08 Feb 2010 17:00:00 EST

African American women have much higher odds of developing peripartum cardiomyopathy than non-African Americans, a new US study shows; the findings illustrate that race is by far the largest risk factor for this disease, say the researchers.

From the heart: Call for better African CV research

Mon, 08 Feb 2010 17:00:00 EST

Two doctors from Mozambique are calling for concerted efforts to foster multidisciplinary research into neglected cardiovascular diseases that predominantly occur in Africa. These include newly emerging cardiac manifestations of infectious diseases, say the authors.

Thomas recalls SafeSheath CSG introducers

Fri, 05 Feb 2010 10:30:31 EST

Thomas Medical is recalling certain lots of its SafeSheath CSG lead introducers in response to reports of fragmentation and embolization of the tip.

A good report card for laser-assisted pacemaker/ICD lead extraction

Fri, 05 Feb 2010 09:30:44 EST

Non-procedure-related clinical issues, such as diabetes or device-related infection, are a major cause of poor procedural and clinical outcomes; still, the overall success rate is high, and complication rate is very low, suggests a multicenter experience of >1400 cases.

Procedure volume is a close proxy for popular hospital quality rankings

Wed, 03 Feb 2010 14:30:51 EST

A study comparing cardiovascular outcomes at the "best hospitals," according to two popular hospital ranking systems, shows that the systems do identify high-quality hospitals, but not all of them.

Opportunity lost: 400�000 US CHD deaths predicted for 2010, as risk-reduction goals fall short

Tue, 02 Feb 2010 16:15:45 EST

The number of deaths predicted would be half as high, if the US population met goals set out 10 years ago in the Healthy People 2010 report, researchers say. Obesity and diabetes have proved to be the major obstacles.

Herbal heartache: New review reminds cardiologists to query supplement use

Mon, 01 Feb 2010 17:00:00 EST

More than 15 million people in the US alone take herbal remedies and/or vitamins at doses that may be interacting with their cardiovascular medications, potentially putting them at risk.

Ripe for change: US ponders populationwide salt-reduction policies

Fri, 29 Jan 2010 14:15:00 EST

Messages to limit the amount of salt added to food have had little impact on sodium intake in the West, where more than 75% of salt in the diet there is contained in readily prepared foods. The UK has recently gotten tough with the food industry and cut salt intake by 10%; is it time the US and others took a similar stance? heartwire examines the issues.

How to get "clinically significant" randomized trials

Mon, 25 Jan 2010 17:00:00 EST

A new review notes that unlike well-established standards for statistical significance, no guidelines exist for deciding what magnitude of difference is clinically meaningful or practically important. Composite end points and subgroup analyses also pose problems for clinicians trying to understand trial results.

Serial natriuretic-peptide testing unmasks shifts in CV risk in the elderly

Mon, 25 Jan 2010 17:00:00 EST

The findings in a community-based cohort of people aged >65 highlight the dynamic nature of cardiovascular risk in that population; a substantial jump in levels from the first to the second test significantly increased the adjusted risks of both heart failure and CV death.

FDA adds contraindication to sibutramine; Europe moves to yank it altogether

Fri, 22 Jan 2010 08:45:06 EST

The FDA's Medwatch sent an alert yesterday announcing that the diet drug labeling will now include contraindications for people with a history of CVD. Meanwhile, Europe's EMEA announced it plans to withdraw the drug from the market altogether.

Canadian transcatheter-valve series offers insights into highest-risk patients

Thu, 21 Jan 2010 13:30:02 EST

While it is impossible to compare the transfemoral and transapical outcomes from the nonrandomized, multicenter study, investigators note that the survival rates for both groups were similar at one and two years.

Mild emphysema tied to subclinical LV diastolic dysfunction in population-based study

Thu, 21 Jan 2010 10:30:55 EST

The findings have implications for the workup of patients presenting with dyspnea for whom heart failure with preserved ejection fraction is one potential diagnosis, according to researchers.

FDA approves Thoratec's HeartMate II LVAD for destination therapy

Wed, 20 Jan 2010 15:00:02 EST

FDA approves Thoratec's HeartMate II continuous-flow left ventricular assist device for severe heart-failure patients who are not eligible for a heart transplant.

A-bomb survivor data affirm radiation/CVD risk link

Tue, 19 Jan 2010 10:00:21 EST

The latest data from Japanese atomic-bomb survivors show that even moderate radiation-dose levels may increase the risk of stroke and heart disease.

DNA methylation observed for first time in heart failure

Mon, 18 Jan 2010 13:15:00 EST

UK scientists have shown for the first time that cardiac tissue from patients with end-stage heart failure shows signs of DNA methylation, a process that is thought to explain why cells with the same genes can develop into different tissues.

Court declines to hear ACC Medicare payment lawsuit

Fri, 15 Jan 2010 16:30:29 EST

A Florida judge has slammed the door on the lawsuit, citing jurisdictional grounds. The ACC vows to fight on.

US healthcare reform bills inspire fear and hope in cardiologists

Fri, 15 Jan 2010 13:30:44 EST

Cardiologists hope US health reform will improve patient access to life-saving therapies but fear good intentions could shift costs onto hospitals and providers, without fully tackling the thorny issues underpinning comparative-effectiveness decisions and end-of-life care.

Panel to FDA: Nebivolol shouldn't be approved for chronic heart failure

Wed, 13 Jan 2010 09:00:03 EST

UPDATED WITH COMMENTARY // Submitted in support of the beta blocker's approval: only one randomized trial, and that showing only a marginally significant clinical benefit. The advisory committee voted the application down by 8 to 0.