Cardiology News: January 2021
DMS Cardiology news is a curated collection of interesting articles, posts & studies related to general & interventional cardiology, cardiovascular & heart health that may be of help or interest to others. All articles are sourced from reliable and respected sources cited with links to read the original full article.
DISCLAIMER: Dr. Dalawari shares interesting and relevant medical news and articles in the press. He has no professional or personal relationship to sources other than in some cases as a member of the organization.
Heart Transplant 'Liquid Biopsy'; PCSK9 CRISPR; More SGLT2 Drugs Try FDA in HF
Jan 19, 2021 - MedPageToday
A blood test showed promise as a "liquid biopsy" for detection of acute heart transplant rejection. (Circulation)
Early efforts to use CRISPR to edit PCSK9 genes in severe heterozygous familial hypercholesterolemia are moving forward. (Endpoints News)
In a study of 145 student athletes with no more than moderate COVID-19 symptoms, cardiac MRI a median 15 days after the positive test was consistent with myocarditis in two (1.4%). (JAMA Cardiology)
Each extra serving of fried foods per week was linked to 3% more major cardiovascular events, 2% more coronary heart disease, and 12% more heart failure risk. (Heart)
Unusual Case of Cardiac Arrest
Jan 19, 2021 - JAMA Network
A patient in their 40s with a history of remote coronary artery bypass grafting, heart failure with reduced ejection fraction, and poorly controlled insulin-dependent diabetes was admitted to the cardiac intensive care unit with acute decompensated heart failure.
The patient’s baseline electrocardiogram (ECG) demonstrated normal sinus rhythm, with normal PR and QRS intervals at 132 and 82 milliseconds, respectively. With poor response to intravenous (IV) diuretics, the patient underwent right heart cardiac catheterization, which demonstrated a low cardiac index, high left ventricular filling pressure, and elevated systemic vascular resistance.
The patient’s outpatient use of metoprolol was discontinued, and IV dobutamine (5.0 µg/kg/min) was initiated with continuing aggressive IV diuresis...
New Training Statement Defines Core Competencies For Vascular Medicine Specialists
Jan 15, 2021 - American College of Cardiology
At a glance:
A new advanced training statement from the ACC, American Heart Association, Society of Vascular Medicine and American College of Physicians defines core competencies required of Level III vascular medicine specialists. The 2021 ACC/AHA/SVM/ACP Advanced Training Statement on Vascular Medicine was published Jan. 15 in the Journal of the American College of Cardiology.
A new advanced training statement from the ACC, American Heart Association, Society of Vascular Medicine and American College of Physicians defines core competencies required of Level III vascular medicine specialists. The 2021 ACC/AHA/SVM/ACP Advanced Training Statement on Vascular Medicine was published Jan. 15 in the Journal of the American College of Cardiology.
Does the Ketogenic Diet Benefit Patients With Heart Failure?
Jan 13, 2021 -
Medscape & American College of Cardiology Editorial Collaboration
At a glance:
The ketogenic ("keto") diet, originally developed in the 1920s as an alternative treatment for pediatric epilepsy, remains a therapeutic strategy for a variety of conditions, including neurodegenerative diseases, diabetes, nonalcoholic fatty liver disease, cancer, and, most notably, weight loss.
However, conflicting study results fuel the ongoing debate regarding the role of the ketogenic diet in patients with heart failure (HF). Is the ketogenic diet beneficial in HF in the long term, and how does it affect cardiovascular risk factors?
Ketones and the Failing Heart
The daily caloric intake for people on the ketogenic diet is, approximately, 70%-80% from fats, 10%-20% from proteins, and 5%-10% from carbohydrates. Reducing carbohydrate intake while increasing fat intake results in a metabolic shift in the body called ketosis. In this state, blood ketone levels are increased due to the restriction of carbohydrates, decreased circulating insulin (and consequently, decreased insulin-mediated inhibition of lipolysis and ketogenesis), and a subsequent increase in the mobilization of adipose tissue fatty acids, which are used by the liver for ketogenesis...
CMS unleashes innovation to ensure our nation’s seniors have access to the latest advancements
Jan 11, 2021 - ACC.org
At a glance:
Today, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that propels innovative technology so Medicare beneficiaries have access to the latest, most advanced devices.
Today’s action represents a step forward that will help smooth the Medicare coverage pathway for innovative products, resulting in faster access to new devices for America’s seniors. This action delivers on CMS’s Unleashing Innovation and Patients Over Paperwork Initiative.
Today’s action represents a step forward that will help smooth the Medicare coverage pathway for innovative products, resulting in faster access to new devices for America’s seniors. This action delivers on CMS’s Unleashing Innovation and Patients Over Paperwork Initiative.
The Medicare Coverage of Innovative Technology (MCIT) (CMS-3372-F) final rule will provide the nation’s more than 60 million Medicare beneficiaries access to the latest medical technology faster than ever.
Under current rules, FDA approval of a device is followed by an often lengthy and costly process for Medicare coverage. The lag time between the two results in innovators first spending time and resources on FDA approval, and then subsequently on the Medicare coverage process. This causes an undue burden for innovators and could delay access to these potentially life-saving technologies during the existing Medicare coverage determination process.
Under current rules, FDA approval of a device is followed by an often lengthy and costly process for Medicare coverage. The lag time between the two results in innovators first spending time and resources on FDA approval, and then subsequently on the Medicare coverage process. This causes an undue burden for innovators and could delay access to these potentially life-saving technologies during the existing Medicare coverage determination process.
Impact of COVID-19 on Diagnosis of Heart Disease Worldwide
Jan 11, 2021 - ACC.org
At a glance:
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COVID-19 pandemic was associated with a rapid reduction in cardiovascular diagnostic procedures across the world.
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Additional studies are indicated to assess the impact of these reductions in cardiovascular diagnostic care related to COVID-19, as they raise serious concerns for long-term worsening of cardiovascular health outcomes from lack of timely diagnosis.
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Multiple stakeholders will need to work together to improve timely patient access to cardiovascular diagnosis and therapeutics in this ongoing and in future pandemics.
Study Questions:
What has been the impact of coronavirus disease 2019 (COVID-19) on global cardiovascular diagnostic procedural volumes and safety practices?
Conclusions:
The authors concluded that COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world’s economically challenged.
Effect of Machine Learning on Dispatcher Recognition of Out-of-Hospital Cardiac Arrest During Calls to Emergency Medical Services
Jan 6, 2021 - JAMA Network
At a glance:
Importance Emergency medical dispatchers fail to identify approximately 25% of cases of out-of-hospital cardiac arrest (OHCA), resulting in lost opportunities to save lives by initiating cardiopulmonary resuscitation.
Question Can a machine learning model help medical dispatchers improve recognition of out-of-hospital cardiac arrest?
Findings In this randomized clinical trial of 5242 emergency calls, a machine learning model listening to calls could alert the medical dispatchers in cases of suspected cardiac arrest. There was no significant improvement in recognition of out-of-hospital cardiac arrest during calls on which the model alerted dispatchers vs those on which it did not; however, the machine learning model had higher sensitivity than dispatchers alone.
Meaning These findings suggest that while a machine learning model recognized a significantly greater number of out-of-hospital cardiac arrests than dispatchers alone, this did not translate into improved cardiac arrest recognition by dispatchers.
Objective To examine how a machine learning model trained to identify OHCA and alert dispatchers during emergency calls affected OHCA recognition and response.
Conclusions and Relevance This randomized clinical trial did not find any significant improvement in dispatchers’ ability to recognize cardiac arrest when supported by machine learning even though artificial intelligence did surpass human recognition.
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