CARDIOLOGY ONLINE NEWS

 Editor: Asher Kimchi, MD

Distinguished Cardiologists and Scientists Honored with 2010 International Academy of Cardiology Awards
A world-renowned panel of 125 cardiologists and scientists, members of the Faculty of the International Academy of Cardiology (IAC) announced the 2010 International Academy of Cardiology Awards during the Opening Ceremony of the 15th World Congress on Heart Disease held in Vancouver, BC, Canada. Recipients include: Professor Wilbert S. Aronow.; Professor Pawan K. Singal; Professor Elizabeth L. Barrett-Connor; Professor Gerd Heusch; and Professor Navin C. Nanda. Two faculty, Professor James. H. Chesebro and Professor Anne B. Curtis were also honored with the Distinguished Fellowship Award. Asher Kimchi, M.D., Founder and Chairman of the IAC, said, "In the past 21 years the IAC has grown from a prestigious academy to one of the world's preeminent forums for top Cardiologists and Scientists. These Faculty are the best of the best. We are proud to honor them with these well-deserved awards." MORE» Statin therapy may have a potential role in patients in the early stages of aortic stenosis to slow the progression to severe aortic stenosis
Until now all of the prospective trials testing the role of statins in aortic valve disease have been negative for the treatment of calcific aortic stenosis. These trials include SALTIRE, SEAS and Astronomer. RAAVE is the first study to evaluate the use of statins for calcific aortic valve disease in an open label study treating only patients with elevated LDL with moderate to severe aortic stenosis. The results of these studies demonstrated opposing effects of statins on the valve. In an Study by Nalini M. Rajamannan, M.D et al from Chicago, IL, USA, presented at the International Academy of Cardiology, 15th World Congress on Heart Disease, Annual Scientific Sessions 2010 in Vancouver, B.C., Canada , results combining SALTIRE and RAAVE demonstrated a positive benefit of slowing progression of aortic stenosis. MORE»

Prof. Martin Allen Samuels to deliver the fourth HJC Swan Memorial Lecture at the Opening Ceremony of the International Academy of Cardiology, 15th World Congress on Heart Disease Annual Scientific Sessions 2010
Beverly Hills, CA, (July 20, 2010) Asher Kimchi, M.D., Founder and Chairman of the International Academy of Cardiology today announced the selection of Prof. Martin Allen Samuels, Chairman of the Department of Neurology at Brigham and Women's Hospital and Professor of Neurology of the Harvard Medical School, to deliver the fourth H.J.C. Swan Memorial Lecture at the Opening Ceremony of the International Academy of Cardiology 15th World Congress on Heart Disease Annual Scientific Sessions 2010 to be held in Vancouver, B.C., from Saturday, July 24 through Tuesday, July 27, 2010. Prof. Martin Allen Samuels. Prof. Samuels will present on the topic of "Voodoo' Death Revisited: The Modern Lessons of Neurocardiology." MORE»
California Teaching Hospitals That Used More Resources Had Lower Mortality Rates
“Looking Forward, Looking Back: Assessing Variations in Hospital Resource Use and Outcomes for Elderly Patients With Heart Failure," a study published in the early online edition of the journal Circulation: Cardiovascular Quality and Outcomes, concludes that California teaching hospitals with higher resource use in caring for hospitalized heart failure patients had lower mortality rates.  Previous studies aimed at assessing how resources are used for expired elderly Medicare beneficiaries with heart failure, as a consequence of study design, have not been able to draw conclusions on health outcomes.  Dr. Michael Ong et al’s study, "Looking Forward, Looking Back” departs from assessing expenditures on deceased patients exclusively in order to circumvent limitations of previous studies, namely: inability to identify differences in health outcomes across different hospitals and assuming patterns of resource use among all patients are well represented by resource use in expired patients. MORE»
Effect of Intracoronary Streptokinase Administered Immediately After Primary Percutaneous Coronary Intervention on Long-Term Left Ventricular Infarct Size, Volumes, and Function 
A reduction in infarct size promises a substantial prognostic benefit after STEMI.  Towards this aim, Murat Sezer, MD et al from Istanbul University in Capa-Istanbul, Turkey investigated if improvements in microvascular perfusion, measured by late phase infarct size and left ventricular volume and function, were obtainable with low dose adjuvant intracoronary streptokinase treatments given immediately after percutaneous coronary intervention.  Their results, published in the September 15, 2009 issue of the Journal of the American College of Cardiology, showed that low-dose intracoronary streptokinase (ICSK) given immediately after primary percutaneous coronary intervention preserves left ventricular volumes and functions as well as significantly limits long-term infarct size.  Their study concludes that low-dose ICSK administered immediately after primary PCI improves microvascular perfusion, decreases long-term infarct size, and improves LV volume and function.  MORE»
Blocking Early Steps in Platelet Aggregation Reduces Stroke Infarct Size Without Increasing Intracerebral Hemorrhage (ICH)
Ischemic stroke is the third leading cause of death and permanent disability in industrialized countries. Currently, the anticoagulant therapies available to treat ischemic stroke offer moderate benefit on stroke progression and recurrence, but this is outweighed by a significant increase in the rate of ICH. During ischemia, platelets can adhere to hypoxic endothelial cells by binding of their glycoprotein (GP) Ib receptor to von Willebrand factor (vWF) on the endothelial surface. Additionally, subendothelial matrix proteins are exposed, allowing firm attachment of platelets to the vessel by binding of collagens to their GPVI receptor. These processes lead to activation of platelet GPIIb/IIIa and platelet aggregation. Christoph Kleinschnitz, MD et al from the University of Würzburg in Würzburg, Germany tested the hypothesis that blocking platelet aggregation and activation at various steps in these pathways may reduce infarct size following ischemic stroke. Their results, published in the May 1, 2007 issue of Circulation, showed that targeting platelet GPIb or GPVI receptors protects mice from ischemic brain injury in an experimental stroke model without increasing bleeding complications. In contrast, blockade of the final common pathway of platelet aggregation with anti-GPIIb/IIIa antibodies had no positive effect on stroke outcome and dose-dependently raised the incidence of ICH and mortality. MORE»

Pulse Pressure is a Risk Factor for New-Onset Atrial Fibrillation (AF)
Atrial fibrillation is associated with an increased risk of mortality and stroke, and every one in four people will develop AF at some point in their lifetime. Already recognized clinical risk factors for AF include advancing age, increased systolic blood pressure, diabetes, hypertension, heart failure, valvular disease, myocardial infarction, and obesity. Echocardiographic risk factors for AF include left atrial enlargement, increased left ventricular wall thickness, and impaired left ventricular systolic function. Gary F. Mitchell, MD et al from the Cardiovascular Engineering Inc. in Waltham, MA investigated whether pulse pressure, a reflection of aortic stiffness, could be a potentially easily modifiable risk factor for AF. Their study, published in the February 21, 2007 issue of The Journal of the American Medical Association, found that pulse pressure is in fact an important risk factor for incident AF in a community-based sample. MORE»

Intensive Treatment with Atorvastatin in Patients with Stable Coronary Artery Disease Significantly Reduces Hospitalizations for Heart Failure (HF)
Statins are known to reduce the rate of major cardiovascular events through their lipid lowering effects, but their potential benefit as treatment for HF is largely unexplored. Kiran K. Khush et al from University of California, San Francisco School of Medicine compared the effects of two doses of the same statin formulation to determine their impact on the incidence of hospitalization for HF among the two treatment arms. This study, which was published in the February 6, 2007 issue of Circulation, found that intensive treatment with atorvastatin in patients with stable coronary artery disease significantly reduces subsequent hospitalizations for HF compared with low-dose therapy. This benefit was most pronounced in patients with a history of HF. MORE»

Decontamination of Nasopharynx and Oropharynx with Chlorhexidine Gluconate Appears to Reduce Nosocomial Infection After Cardiac Surgery
Nosocomial infections after open-heart surgery are recognized as an important cause of complications and mortality. Patrique Segers, MD et al from the University of Amsterdam set out to determine the efficacy of perioperative decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate for reduction of nosocomial infection after cardiac surgery. Their study, published in the November 22/29 issue of the Journal of the American Medical Association found that decontamination with chlorhexidine gluconate appears to be an effective method to reduce nosocomial infection after cardiac surgery. MORE»

Radiofrequency Catheter Ablation Should Be Considered a First-Line Therapy After the First Episode of Symptomatic Atrial Flutter
Until now, there have been no studies comparing amiodarone therapy and radiofrequency catheter ablation (RFA) for patients who have had one episode of atrial flutter (AFL). Antoine Da Costa, MD, PhD et al from the University Jean Monnet in Saint-Etienne, France did a study comparing the efficacy and safety of first-line RFA versus AFL therapy. The study found that RFA should be considered a first-line therapy even after the first episode of symptomatic AFL due to better long-term success rate, the same risk of subsequent AF and fewer secondary effects. The study was published in the October 17, 2006 issue of Circulation. MORE»

Mutations in the Connexin 40 Gene, GJA5, Predisposes Patients to Idiopathic Atrial Fibrillation
Atrial Fibrillation is the most common type of cardiac arrhythmia characterized by erratic electrical activation of the atrial myocardium, resulting in loss of effective contractility and an increase in clot formation. Michael H. Gollob et al from the University of Ottawa Heart Institute studied the genetic basis of atrial fibrillation as it relates to mutations in the connexin 40 gene, GJA5. Their results, published in the June 22, 2006 issue of The New England Journal of Medicine, found that mutations in GJA5 may predispose patients to idiopathic atrial fibrillation by impairing gap-junction assembly or electrical coupling. MORE»