Cardiology News: May 2021
DMS Cardiology news is a curated collection of articles, posts & studies related to general & interventional cardiology, cardiovascular & heart health that I found interesting and may be of help or interest to others. All articles are published on reliable and respected sources cited with links to read the original full article.
Human Engineered Heart Tissue Patches Remuscularize the Injured Heart in a Dose-Dependent Manner
18 May, 2021 - Circulation - ahajournals.com
EXCERPT:
Background:
Human engineered heart tissue (EHT) transplantation represents a potential regenerative strategy for patients with heart failure and has been successful in preclinical models. Clinical application requires upscaling, adaptation to good manufacturing practices, and determination of the effective dose.
Conclusions:
EHT patch transplantation resulted in a partial remuscularization of the injured heart and improved left ventricular function in a dose-dependent manner in a guinea pig injury model. Human-scale patches were successfully transplanted in pigs in a proof-of-principle study.
Clinical Perspective
What Is New?
- Human engineered heart tissue patches can be generated under good manufacturing practice–compatible conditions and in human scale (5×7 cm, 450×106 cells).
- Engineered heart tissue patch transplantation remuscularizes the injured heart in a dose-dependent manner.
- Cardiomyocyte proliferation after transplantation participates in graft development.
What Are the Clinical Implications? - Engineered heart tissue transplantation might provide a new therapeutic strategy for patients with heart failure.
- Stimulation of cardiomyocyte proliferation after transplantation could represent a strategy to improve transplantation success.
Introduction
Heart disease is the number one cause of death worldwide.1 Although mortality from acute myocardial infarction has decreased substantially over the past 2 decades,2 heart failure as its main sequela remains a major disease burden.3 Cardiomyocyte renewal is limited to ≈1% per year, and, even though there is evidence that cardiomyocyte proliferation increases slightly after injury, this is by far too little to form a physiologically relevant number of new cardiomyocytes.4
Regenerative strategies that aim to generate new myocardium are currently being evaluated in preclinical5 and first clinical trials.6,7 Pluripotent stem cell-derived cardiomyocytes have repeatedly demonstrated their potential to regenerate injured hearts in preclinical models.8–11 We have recently shown that transplantation of 2 strip-format human engineered heart tissues (EHTs) improved left ventricular function in a guinea pig model.9 Yet, hurdles toward clinical translation remain. Upscaling from small-animal models to humans and adaptation to good manufacturing practices (GMPs) represent challenges. In addition, the optimal dose has not yet been defined. The present study describes the generation of EHT patches under GMP-compatible conditions that can be scaled to a clinically relevant size, evaluated the effect of EHT-patch transplantation in a dose-finding study in guinea pigs, and assessed the possibility to transplant human-scale EHT patches in pigs.
Eight Things to Know About the Surgical Left Atrial Appendage Occlusion (LAAOS III) Trial
15 May, 2021 - Medscape
EXCERPT:
In the Left Atrial Appendage Occlusion (LAAOS III) trial, slightly more than 4800 patients with atrial fibrillation (AF) scheduled for open-heart surgery were randomly assigned to add-on surgical closure of the left atrial appendage or heart surgery alone.
Both groups remained on standard medical therapy, including anticoagulation. Concomitant left atrial occlusion resulted in a statistically significant reduction in ischemic stroke or systemic embolism. No safety issues were observed.
Here are eight things to know about this practice-changing trial.
Reflections on Mother’s Day From Women in Cardiology
07 May, 2021 - American College of Cardiology
Mother's Day engenders a wide variety of emotions, thoughts and feelings in women. New mothers have different feelings than mothers of adult children. Women who have decided not to have children, women who were adopted or women who have adopted children feel differently than women fighting the biologic time clock or going through infertility treatments. Mother's Day is a reminder of loss and pain for women who have lost children, experienced miscarriages or lost their own mothers. And it is a joyful day for women who can still share it with their mother and children.
In 2015, the ACC Women in Cardiology (WIC) Leadership Council conducted a Physician Life Survey (PLS) to assess the changes in the landscape of cardiology over the previous two decades. In this survey, women reported being less likely to be married (75% women vs. 89% men), less likely to have children (72% vs. 87%) and more likely to be older at the time of their first child [1]. In addition, an online survey published in 2019 under the direction of ACC WIC Leadership Council was conducted to assess fellows in training (FIT) perspectives regarding professional and personal elements that influenced cardiology subspecialty choices. Female interventional cardiology fellows were more likely to not have children (78% women vs. 58% men), though both male and female fellows planned to have children in the future. Radiation exposure concerns during childbearing was one of the negative attributes against choosing interventional cardiology[2].
We asked four WIC mothers to give us their reflections on Mother's Day.
Empagliflozin Evaluation by Measuring the Impact on Hemodynamics in Patients With Heart Failure - EMBRACE-HF
04 May, 2021 - American College of Cardiology
Description:
The goal of the trial was to assess the efficacy of empagliflozin in reducing pulmonary artery pressures (PAPs) among patients with heart failure (HF).
Study Design
Eligible patients were randomized in a 1:1 fashion to either empagliflozin 10 mg daily (n = 33) or placebo (n = 32).
Total screened: 93
- Total number of enrollees: 65
- Duration of follow-up: 12 weeks
- Mean patient age: 66 years
- Percentage female: 37%
The results of this small trial indicate that empagliflozin significantly reduced average PA diastolic pressures at 8-12 weeks compared with placebo among patients with an implanted CardioMEMS PAP sensor due to difficult-to-manage HF (with either HFrEF or HFpEF). No difference in patient-reported or clinical outcomes was noted.
Dr. Joel Kahn: Best To Test, Not Guess, About Your Artery Health
30 April, 2021 - Deadlinedetroit.com
EXCERPT:
It would seem obvious that examining the health of the approximately 50,000 miles of arteries in the body provides key information on heart and overall aging.
As Dr. Thomas Sydenham, a famous 17th-century physician in England said: “A man is as old as his arteries.” This, of course, is true for women too.
Evaluating the health of the vascular system is not a common part of clinical examinations of patients and may be limited to checking blood pressure and assessing the appearance and circulation in the hands and feet. When is the last time your physician said: “I am worried your arteries are silently aging.” That should be a common comment.
There are actually a wide range of options for accurate vascular health assessments to spot potentially life-endangering risks.
DMS Cardiology news is a curated collection of articles, posts & studies related to general & interventional cardiology, cardiovascular & heart health that I found interesting and may be of help or interest to others. All articles are published on reliable and respected sources cited with links to read the original full article.
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