Sex Differences in PAD Presentation, Progression and Response to Treatment
Treatment of PAD includes medication, exercise and surgery. It aims to manage symptoms and reduce the risks of ulceration, amputation, heart attack and stroke. Women are less likely to receive recommended medications than men and respond less well to supervised exercise therapy. Women have lower rates of surgery and are more likely to die after amputation or open surgery than men.
Why Peripheral Artery Disease (PAD) Remains Underdiagnosed in Women?
Women with PAD often have no symptoms or atypical ones such as minor pain or discomfort while walking or at rest. They are less likely to have intermittent claudication and twice as likely to have CLTI. Hormones appear to play a role, as women tend to show intermittent claudication post-menopause. And ankle brachial index test is less accurate in those with no symptoms or smaller calf muscles.
Cognitive Behavioral Therapy Improves Diabetes Distress and A1C
Cognitive-behavioral-therapy improves diabetes distress and A1C among adults with diabetes. 29 adults with T1D or T2D attended 131 total sessions out of 174 sessions of cognitive-behavioral-therapy. At 3-month follow-up, significant improvements were observed in A1C values (mean = - 0.39%), diabetes distress (mean = 2.55). Improvements were also observed in diabetes self-efficacy.
Heart Roundness Identified by AI Algorithm May Predict Risk for Atrial Fibrillation & Heart Failure
In an analysis of more than 30,000 cardiac MRIs using an AI algorithm, researchers found that sphericity may predict risk for certain CV conditions, even when heart size and function are normal. Healthy adults with spherical hearts, identified through a cardiac MRI images, are 31% more likely to develop atrial fibrillation and 24% more likely to develop cardiomyopathy, researchers reported.
Apixaban May Be Superior Than Other Anticoagulants for Older Patients With AF & Dementia
Among older patients with atrial fibrillation and dementia, apixaban lowers the risk for stroke and major bleeding vs. dabigatran, rivaroxaban or warfarin, researchers reported. The association was also detected in patients with AF but no dementia, but to a lesser degree. The prescribing decisions for oral anticoagulants need to be individualized according to comorbidities and frailty.
Short Night-time Sleep May Nearly Double the Risk of Peripheral Artery Disease
Over 200 million people globally have peripheral artery disease (PAD), where arteries in the legs are clogged, increasing the risk of stroke and heart attack.Sleeping less than five hours a night is associated with a 74% raised likelihood of developing peripheral artery disease (PAD) compared with seven to eight hours. In addition PAD is associated with an increased likelihood of short sleep.
Waist-to-height Ratio Is a Better Indicator of Outcomes in Patients With Heart Failure Than BMI
In a study, both BMI and waist-to-height ratio showed that more body fat is linked with increased risk of death or hospitalisation for heart failure, but this is more evident for waist-to-height ratio. When looking at waist-to-height ratio, the top 20% of people with the most fat had a 39% increased risk of HF hospitalization compared to people in the bottom 20% who had the least fat.
Can Curcumin Supplementation be a Good Option for Weight Loss?
Meta-analyses of RCTs have shown that curcumin supplementation significantly reduced BMI, BW, and WC with mean differences (MDs) of −0.24 kg/m2, −0.59 kg, and −1.32 cm, respectively, especially in adults with obesity and diabetes. It also reduces anthropometric indices. Augmenting curcumin supplement with lifestyle modification should be an option for weight reduction.
Women Have High Risk of Long-term Anxiety After Cardiac Arrest Than Men
A study assessed the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in cardiac arrest survivors. Depression and anxiety scores were higher in women (3.3 and 6.1, respectively), vs. men (2.6 and 4.5, respectively). Anxiety scores of 8 or more were observed in 43% of women and 23% of men. Women had higher levels of PTSD vs. men (33 vs. 26, respectively).
High BP Damages Specific Regions of the Brain Causing a Decline in Mental Processes and Dementia
Researchers have found the parts of the brain affected by increase in BP. These includes 1. the putamen involved in movement and learning; 2. regions of white matter involved in planning of simple and complex daily tasks, decision-making and the management of emotions. Brain dysfunction at these location may lead to problems with cognitive function, memory, thinking and dementia.
High Salt Diet Is Linked to Hardening of the Arteries Even in People With Normal Blood Pressure
Eating excessive salt is linked with clogged arteries of the heart and neck which is known to be linked with raised risks of heart attack and stroke. The association was linear, meaning that each rise in salt intake was linked with more atherosclerosis. The findings applied even at normal blood pressure levels, suggesting that salt could be damaging even before the development of hypertension.
AI Can Translate Polygenic Risk For Coronary Artery Disease Into Clinically Actionable Information
A polygenic score (PGS) measures a person’s inherited risk for coronary artery disease (CAD). Causal AI algorithm can translate PGS for CAD into clinically useful information by quantifying how much each person must lower their LDL or SBP to overcome their inherited polygenic risk for CAD. The polygenic risk for CAD was overcome with small lifetime reductions in LDL and SBP.
Cardiac Team Must Have a Trained Interventional Echocardiographer (IE)
IE is an integral part of the multidisciplinary cardiac team including a cardiac surgeon, interventional & HF cardiologist. The imager must have specific knowledge and technical skills in all aspects of structural heart disease. In a study, it was seen that after mitral valve surgery or interventions, the RR of mortality was 61% lower for patients in the heart team compared to no heart team.
Imaging techniques in Transcatheter Therapies
Interventional echocardiography (IE) has an integral role in a plethora of heart interventions such as in heart valves including transcatheter mitral valve replacement, transcatheter tricuspid valve-in-valve (ViV), electrophysiology assessment, LAO ablation, TAVR, etc. Imaging techniques have also evolved in parallel, such as Live 30 MPR, 4D intra-cardiac echo, and Live T fusion.
Statin Prescribing In Patients With Atherosclerotic Cardiovascular Disease
High-intensity statin (HIS) use is low in patients with atherosclerotic cardiovascular disease despite guideline recommendations. A trial showed that baseline HIS/statin use at intervention and usual-care sites was 52.6% / 81% and 55.6% / 82.2%, respectively. Algorithm identified statin-associated side effects in 23% patients; individualized reminders on 5156 patients have been delivered to date.
Efficacy And Safety Of Macitentan-Tadalafil FDC In Pulmonary Arterial Hypertension
187 PAH pts were randomized to fixed dose combination of macitentan 10 mg + tadalafil 40 mg (MT FDC), macitentan or tadalafil. Pulmonary vascular resistance reduction with MT FDC was significantly greater vs macitentan (29%) and vs tadalafil (28%). MT FDC significantly improved hemodynamics vs monotherapies, with a safety and tolerability profile consistent with that of the loose combination.
Pulsed Field Ablation (PFA): A Novel Technology for AF Ablation
PFA is a very novel cardiac ablation technology which utilizes electrical pulses to cause irreversible electroporation and induce nonthermal cardiac cell death. Pre-clinical studies show that PFA can selectively ablate cardiac tissue effectively and rapidly while avoiding damage to structures surrounding the pulmonary veins (esophagus, phrenic nerve). This should enhance safety.
The Benefits Of Microcor (μCor™) In Ambulatory Decompensated Heart Failure (BMAD) Trial
In BMAD trial, subjects were asked to wear μCor system for 90 days and were assigned to a control group with investigators were blinded to thoracic fluid index (TFI) and a treatment group using TFI to guide HF therapy. There were 42 treatment subjects with a HF event compared to 63 control subjects. HF management using TFI results in a 36% reduction in HF ER visits, hospitalizations or death.
Mitral and Tricuspid TEE: Guideline-Based Screening for Structural Heart Disease (SHD)
Carpentier classification divides mitral valve regurgitation as: Type I: normal leaflet motion, Type II: excessive leaflet motion, and Type III: restricted leaflet motion. Finding the intended gripping zones by locating the tricuspid regurgitation (TR) on color Doppler and imaging the leaflets during systole and diastole to determine length and gaps are the screening's objectives.
Usefulness of H2FPEF Score for Predicting New Atrial Fibrillation
H2FPEF score consists of six factors: heavy, hypertension, atrial fibrillation (AF), pulmonary hypertension, elder, and high filling pressure. These factors are known to be associated with left ventricular diastolic dysfunction. A recent study showed that H2FPEF score can predict new AF development in patients without clinically significant cardiac disease.
