TAG: "Heart"

Common heart disease medication also could help asthmatics

Study indicates that statins should be explored as novel class of inhaler therapy for asthma.

Amir Zeki, UC Davis

By Karen Finney, UC Davis

A drug prescribed to prevent or stall the progress of heart disease may also relieve symptoms of asthma, according to a new study from pulmonary medicine specialists at UC Davis Health System.

The researchers demonstrated in mice that an inhalable form of pravastatin, currently only approved for oral use, could improve airway health without increasing levels of the drug in other parts of the body or causing toxic effects.

“Effective treatments for severe asthma are limited and do not address the full range of symptoms without risking significant side effects,” said Amir Zeki, assistant professor of internal medicine and lead author of the study. “This study gives us hope that when inhaled directly into the airways, statins can be delivered safely and at doses that appear to protect the cellular health of the lungs.”

Prevastatin is one of a class of drugs known as statins that regulate cholesterol production in the body. They also may modulate immune responses for a number of diseases, according to Zeki. While previous studies have shown that statins could be effective asthma therapies, this new study addresses one of the obstacles in translating the findings into patient use: how best to deliver the drug.

The investigators tested whether inhaled pravastatin, selected for the study because it is water-soluble and easily converted to an aerosol, could alleviate asthma pathology in a mouse model. Using innovative mass-spectrometry methods developed at UC Davis, they were able to measure statin levels in blood and tissues, including the lungs.

The experimental outcomes showed that pravastatin remained mostly in the lungs, with little absorbed into the rest of the body. The medication was not toxic to the lungs or overall health of the mice. In terms of asthma pathology, the treatment lowered airway over-sensitivity that can lead to bronchospasm, had some anti-inflammatory effects and reduced mucus production in the airway lining.

The optimal statin type and dose still need to be determined, the researchers wrote, but “our results indicate that statins should be explored as a novel class of inhaler therapy for airway diseases such as asthma.”

“Our ultimate goal is to reduce the onset of bronchospasms that make asthma dangerous and can lead to hospitalizations and death,” said Zeki, who specializes in treating patients with severe asthma. “While we can’t cure the disease yet, we might be able to improve symptoms and make it much easier to live with.”

The article, titled “Intratracheal Instillation of Pravastatin for the Treatment of Murine Allergic Asthma: A Lung-targeted Approach to Deliver Statins,” is published in the May issue of Physiological Reports and available at http://physreports.physiology.org/content/physreports/3/5/e12352.full.pdf.

In addition to Zeki, the UC Davis study team included Jennifer Bratt, Kevin Chang, Lisa Franzi, Sean Ott, Mark Silveria, Oliver Fiehn, Jerold Last and senior author Nicholas Kenyon.

The study was funded by the National Institutes of Health (grant numbers T32 HL07013, NCATS TR000002, KL2 RR 024144, 1K08HL114882-01A1, HL105573 and U24DK097154), an American Thoracic Society Fellows Career Development Award, the U.S. Department of Defense (grant number W81XWH-10-1-0635) and the LUNGevity Foundation.

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UC Davis Medical Center recognized for quality care for stroke patients

Receives Get With The Guidelines award.

By Karen Finney, UC Davis

UC Davis Medical Center has been recognized by the American Heart Association/American Stroke Association for using evidence-based guidelines that improve care and quality of life for stroke patients.

The medical center received the 2015 Get With The Guidelines-Stroke Gold-Plus Quality Achievement Award for consistently adhering to association-backed quality measures. UC Davis also made the Target: Stroke Honor Roll for timely use of a clot-busting drug known as tissue plasminogen activator, or tPA, which can reduce the effects of some strokes.

“The credit for this recognition truly goes to our expert team of emergency, neurology, vascular and rehabilitation specialists who are dedicated to the highest possible standards in stroke care for our patients,” said J. Douglas Kirk, chief medical officer at UC Davis Medical Center.

The medical center also meets guidelines of the Joint Commission as a Primary Stroke Center, a symbol of quality and high performance standards in stroke care.

“We are pleased to recognize UC Davis for their commitment to stroke care,” said Deepak L. Bhatt, national chair of the Get With The Guidelines steering committee and executive director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital. “Studies have shown that hospitals that consistently follow Get With The Guidelines quality improvement measures can reduce length-of-stay and 30-day readmission rates, and reduce disparities in care.”

A stroke occurs when one of the blood vessels that carries oxygen and nutrients to the brain is either blocked by a clot (ischemic stroke) or bursts (hemorrhagic stroke), causing parts of the brain to die. A third type of cerebrovascular event — known as a transient ischemic attack, or TIA — is caused by a temporary blood clot and is often called a “warning stroke.” Each year, nearly 800,000 Americans suffer strokes, which are leading causes of death and serious, long-term disability in adults.

More information about the medical center and its Stroke Program is at medicalcenter.ucdavis.edu.

More information about Get With The Guidelines is at heart.org/quality.

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UCLA medical center statement on behalf of Kareem Abdul-Jabbar

UCLA alum, NBA Hall of Fame member, continues recovery from quadruple bypass surgery.

This morning (April 29), Kareem Abdul-Jabbar was experiencing some dizziness following his April 16 quadruple bypass surgery. He contacted his physicians, who told him to come to the emergency department at Ronald Reagan UCLA Medical Center. He was evaluated by his surgeon and cardiologist. After a battery of tests, they found no complications. Abdul-Jabbar was discharged from the emergency department and is back home continuing his recovery. His surgeon, Dr. Richard Shemin, said it is not uncommon for patients to experience some symptoms that require ruling out serious problems following major heart surgery. Shemin added that Abdul-Jabbar did the right thing by coming in to see his doctors.

There will be no media interviews or additional information from Abdul-Jabbar, his physician or his spokesperson.

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High school students take UCLA researcher’s study to heart

Students participate in study, document experiences in school newspaper.

UCLA's Nancy Pike reviews the results of an MRI scan with a participant in her study.

By Laura Perry, UCLA

You can adopt a child,  a pet or even a stretch of highway. But students at one local high school decided recently to adopt a research project run by UCLA School of Nursing assistant professor Nancy Pike.

Pike has a grant from the National Institutes of Health to study memory loss and brain structural changes in adolescents born with single ventricle congenital heart disease, or, in other words, with only one pumping chamber instead of two. Congenital heart disease (CHD) is the No.1 birth defect in the nation, according to the March of Dimes. Twice as many children die from congenital heart defects each year than from all forms of childhood cancer combined. Children with CHD have an abnormally structured heart and/or blood vessels coming from the heart. These hearts may have incomplete or missing parts.

Since she started studying this disease two years ago, Pike has been searching for two sets of subjects — young people who have a single ventricle due to CHD and others without CHD who can serve as healthy controls. The subjects who have heart disease are, for the most part, referred to her by cardiologists or recruited from cardiology clinics that know about her study. Healthy controls are found via a wide variety of sources — fliers, word of mouth, advertising or siblings of CHD patients.

This past January, Pike tested Allison Houser, a 14-year-old high school student who was born with single ventricle heart disease. As it turned out, Leslie Miller, the girl’s mother and a teacher at an all-girls Catholic high school in La Cañada Flintridge, thought her students might be willing to participate in the study as healthy controls.

Miller told her students at Flintridge Sacred Heart Academy as well as the journalism teacher about the study and how it could really help her daughter. Miller thought students would benefit from understanding that you don’t need to be sick to participate in research and by participating, you are performing a community service.

What happened next was a researcher’s dream come true.

The student experience

Almost immediately, Pike started receiving calls from students asking to be considered for one of two studies where she is enrolling healthy controls. One student, the editor of the school newspaper, wanted to participate in the study and then write an article about the experience. Ultimately, the students decided to make Pike’s research as well as the subject of congenital heart disease their school service project for the month of February, which happened to be Congenital Heart Disease Awareness Month.

“I never expected that the students would get so engaged about a disease they knew so little about,” said Pike. “But seeing how CHD had impacted their teacher really motivated the students to get involved.”

Some of the participating students were asked to take a memory recall test. Others, who served as healthy controls, had both memory testing and a brain MRI scan.

As it turned out, the students got a lot more than just monetary compensation for participating. They recounted their experiences in a two-page feature in their school newspaper, Veritas Shield.

Monica Collins, who was the healthy control matched with Miller’s daughter, had a real sense of pride about being a research subject. She is interested in a career in the medical field and wanted to see how research studies are conducted as well as to learn more about CHD.

“It was interesting to take part in something that is going to help others and further the scientific research of congenital heart disease,” said Collins.

Another participant, who heard about the study from his sister, participated because CHD hit close to home. As it turned out, his older brother was born with single ventricle heart defect and died shortly after birth.

The students also decided to raise funds for CHD and donated more than $300 to Children’s Hospital, Los Angeles, where Allison had her previous heart surgeries.

A school community gives back

Pike said she was very touched by the students’ keen interest in the project and the way they rallied to support a teacher they loved.

“I hadn’t thought of this type of venue for subject recruitment because some schools do not allow study advertisement,” the researcher said. “But what worked for me and this study was the students turning this into a service project.”

What’s even better is that now she has a waiting list of healthy control subjects that she can draw on in the future. But there’s only one problem, Pike said. “It’s an all-girls school, and now I need boys!”

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Statin use in elderly would prevent disease but could carry side effects

Researchers find a tenuous balance between potential benefits and risks.

By Elizabeth Fernandez, UC San Francisco

A new study by UC San Francisco has found that statins can help prevent disease in older adults but must be weighed against potentially serious side effects.

Amid a projected cost of almost $900 billion for cardiovascular disease over the next decade in the U.S., statins are used by nearly half the elderly population in the nation. But in spite of the widespread use, there has been little systematic scrutiny of the potential risks of the drugs in older adults and whether those side effects could offset cardiovascular and other health benefits.

For the statin study, the researchers used a computer simulation model that explored whether statins should be routinely administered to adults 75 or older to prevent heart disease.

They found a tenuous balance: on the one hand, the results showed “tremendous” potential health benefits to be gained including far fewer heart attacks. On the other hand, potential side effects that may have particular consequences in the elderly – including muscle pain and weakness or mild declines in cognitive function – could offset those gains.

The study appears April 21 in Annals of Internal Medicine.

“There’s been a lot of uncertainty over the use of statins in older adults,” said senior author Kirsten Bibbins-Domingo, Ph.D., M.D., a professor of medicine, epidemiology and biostatistics at UCSF. She is also director of the UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center.

“Prior studies have favored statin use because of the clear benefits to the heart and because serious side effects are rare,” said Bibbins-Domingo. “Unfortunately, we don’t have enough studies in older adults, and as a result don’t know enough about how common or how severe the side effects are. Our study showed that in older adults, even small increases in functional limitations and mild cognitive impairments from statin use could result in net harm.”

An estimated 19 million adults 75 to 94 years old were living in the U.S., according to 2014 statistics, and of those 30 percent were diagnosed with cardiovascular disease, reported the study. Under current rates, older adults are projected to account for 2.5 million myocardial infarctions and 3.1 million deaths related to coronary heart disease over the next decade.

Statins are widely used to combat cardiovascular disease. Before patients embark on using them, typically they discuss the potential benefits and risks with their physicians. To help guide those decisions, researchers in the statin study sought to provide more precise and reliable data on the balance between benefits and harms.

They focused on two side effects that are particularly important to geriatric populations: functional limitations due to muscle pain and weakness and mild cognitive impairment. “Both of these conditions are prevalent in older adults and can have substantial impact on quality of life and ability to live independently,” the authors wrote.

The study was based on a simulation of all U.S. adults 75 to 94 years old, from 2014 through 2023. The researchers simulated the estimated impact of statin use for primary prevention, modeling the use of statins in all older adults without known heart disease.

In their findings, the authors estimated that if all adults in the U.S. 75 to 93 years old without cardiovascular disease were to take statins over the next decade, 105,000 heart attacks and 68,000 deaths would be prevented. Because statins are available as generics and relatively inexpensive, treating all older adults without heart disease would be cost effective, the author reported.

However, the cardiovascular benefits and cost effectiveness would be offset with even a modest increased risk – by 10 to 30 percent – of cognitive impairments or functional limitations, caution the researchers.

They call for additional research to quantify both the potential benefits and harms of statin use in older adults.

The study was funded by the American Heart Association Western States Affiliate (11CRP7210088) and the National Institute on Aging (K01AG039387).

Co-authors from UCSF are Mark J. Pletcher, M.D., M.P.H., associate professor in residence; Pamela G. Coxson, Ph.D., senior statistician David Guzman, M.S., and postdoctoral fellow David Heller, M.D., M.P.H., of the UCSF Department of Medicine. The first author is Michelle Odden, Ph.D., an assistant professor of epidemiology at Oregon State University. Other co-authors are Divya Thekkethala, B.S., of Oregon State University, and Lee Goldman, M.D., M.P.H., of Columbia University in York.

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Kareem Abdul-Jabbar undergoes coronary bypass surgery

UCLA alum, NBA Hall of Fame member, has surgery at Ronald Reagan UCLA Medical Center.

UCLA Health is issuing this statement at the request of Kareem Abdul-Jabbar, the NBA’s all-time leading scorer and member of the Basketball Hall of Fame:

Kareem Abdul-Jabbar was admitted to Ronald Reagan UCLA Medical Center this week with cardiovascular disease, and he underwent quadruple coronary bypass surgery on April 16. The operation was performed by Dr. Richard Shemin, UCLA’s chief of cardiac surgery.

Shemin said the surgery was successful and he expects Abdul-Jabbar to make a full recovery.

At this time, Abdul-Jabbar would like to thank his surgical team and the medical staff at UCLA, his alma mater, for the excellent care he has received. He is looking forward to getting back to his normal activities soon.

He asks that you keep him in your thoughts and, most importantly, cherish and live each day to its fullest.

For those wanting to send well wishes, he thanks you in advance and asks that you support those in your own community who may be suffering from various health issues.

There will be no media interviews or additional information from Abdul-Jabbar, his physician or his spokesperson. However, news media planning stand-ups at the hospital must park news vans in the southbound lane of Westwood Boulevard, south of Westwood Plaza, between Le Conte Avenue and Med Plaza Circle (in the far right lane).

Media contact:
UCLA Health Sciences Media Relations
(310) 794-0777

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Genetics overlap found between Alzheimer’s, cardiovascular risk factors

Inflammation, high blood lipids may play role in dementia risk, also offer therapeutic targets.

By Scott LaFee, UC San Diego

An international team of scientists, led by researchers at the UC San Diego School of Medicine, have found genetic overlap between Alzheimer’s disease (AD) and two significant cardiovascular disease risk factors: high levels of inflammatory C-reactive protein (CRP) and plasma lipids or fats. The findings, based upon genome-wide association studies involving hundreds of thousands of individuals, suggest the two cardiovascular phenotypes play a role in AD risk – and perhaps offer a new avenue for potentially delaying disease progression.

The findings are published in current online issue of Circulation.

“For many years we have known that high levels of cholesterol and high levels of inflammation are associated with increased risks for Alzheimer’s disease,” said study co-author Paul M. Ridker, M.D., M.P.H., the Eugene Braunwald Professor of Medicine at Harvard Medical School and director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital. “The current work finds that specific genetic signals explain a part of these relationships. We now need to characterize the function of these genetic signals and see whether they can help us to design better trials evaluating inflammation inhibition as a possible method for Alzheimer’s treatment.”

The researchers used summary statistics from genome-wide association studies of more than 200,000 individuals, looking for overlap in single nucleotide polymorphisms (SNPs) associated with clinically diagnosed AD and CRP and the three components of total cholesterol: high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides (TG). SNPs are fragments of DNA sequence that commonly vary among individuals within a population.

They found up to a 50-fold enrichment of AD SNPs for different levels of association with CRP, LDL, HDL and TG, which then lead to identification of 55 loci – specific locations on a gene, DNA sequence or chromosome – linked to increased AD risk. The researchers next conducted a meta-analysis of these 55 variants across four independent AD study cohorts, encompassing almost 145,000 persons with AD and healthy controls, revealing two genome-wide significant variants on chromosomes 4 and 10. The two identified genes – HS3ST1 and ECHDC3 – were not previously associated with AD risk.

“Our findings indicate that a subset of genes involved with elevated plasma lipid levels and inflammation may also increase the risk for developing AD. Elevated levels of plasma lipids and inflammation can be modified with treatment, which means it could be possible to identify and therapeutically target individuals at increased risk for developing cardiovascular disease who are also at risk for developing Alzheimer’s disease,” said Rahul S. Desikan, M.D., Ph.D., research fellow and radiology resident at the UC San Diego School of Medicine and the study’s first author.

If so, the research may have significant ramifications. Late-onset AD is the most common form of dementia, affecting an estimated 30 million persons worldwide – a number that is expected to quadruple over the next 40 years. The societal costs, from medical to lost productivity, are staggering. The 2010 World Alzheimer Report estimated total annual costs at $606 billion.

“Currently, there are no disease modifying therapies and much attention has been focused upon prevention and early diagnosis,” said Ole A. Andreassen, M.D., Ph.D., a senior co-author and professor of biological psychiatry at the University of Oslo in Norway. “Delaying dementia onset by even just two years could potentially lower the worldwide prevalence of AD by more than 22 million cases over the next four decades, resulting in significant societal savings.”

Senior author Anders M. Dale, Ph.D., professor of neurosciences and radiology and director of the Center for Translational Imaging and Precision Medicine at UC San Diego, said further research will be needed: “Careful and considerable effort will be required to further characterize the novel candidate genes detected in this study and to detect the functional variants responsible for the association of these loci with Alzheimer’s risk. It will also be important to understand whether these genes, in combination with other known markers such as brain imaging, cerebrospinal fluid measurements and APOE E4 status, can improve the prediction of disease risk in AD.”

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1 in 4 atrial fibrillation patients receives unnecessary blood thinners

Researchers believe cardiology specialists may be unaware of risk.

An electrocardiogram reading traces irregular, rapid and chaotic atrial activity, seen in lead V1 (the top squiggly line).

By Heather Buschman, UC San Diego

About one quarter of all atrial fibrillation patients at the lowest risk for stroke receive unnecessary blood thinners from cardiology specialists, according to a new study by researchers at the UC San Diego School of Medicine and UC San Francisco, and these health care providers must be made aware of the resulting potential health risks. The findings are published online today (April 13) by JAMA Internal Medicine.

“Clinicians who prescribe blood thinners need to be diligent about weighing the risks and benefits of these medications,” said lead author Jonathan C. Hsu, M.D., cardiologist and assistant clinical professor of medicine at UC San Diego. “In those who have no risk factors for stroke, the risk of bleeding likely outweighs the benefit of stroke reduction. The fact that blood thinners were prescribed to so many patients with no risk factors for stroke is a wakeup call that we need to do better for our patients.”

In atrial fibrillation, electrical impulses are triggered from many areas in and around the upper chambers of the heart instead of just one area. This activity is chaotic, and the atrial walls quiver rather than contract normally in moving blood to the lower chambers.

For atrial fibrillation patients at risk for blood clots, anticoagulation therapies such as warfarin or other drugs reduce the risk of illness and death. But because their use carries a bleeding risk, they are not recommended for atrial fibrillation patients at a particularly low risk for stroke.

In fact, current guidelines do not recommend oral anticoagulation in patients under age 60 without heart disease or other known risk factors for blood clots or in atrial fibrillation patients without any established risk factor for stroke. What’s more, the previous guidelines, which were in place at the time the data for this study were collected, contained a very strong recommendation specifically to avoid anticoagulants in that population.

To examine the prevalence of inappropriate anticoagulant prescriptions in young and healthy patients at the lowest risk for blood clots, Hsu and team used a large national registry of cardiovascular patients. From this, they reviewed nearly 11,000 patients age 60 and under and found that roughly 25 percent were prescribed oral anticoagulant therapy contrary to contemporary guideline recommendations. Further, they found that males with atrial fibrillation at the lowest risk of stroke were more likely to be prescribed oral anticoagulation than females, as were older patients and overweight patients without stroke risk factors.

“The irony is that there is a general push to get providers to prescribe these drugs, and they are also generally under-prescribed among many atrial fibrillation patients who actually need them,” said senior author Gregory Marcus, M.D., director of clinical research at UC San Francisco. “Our study suggests people are trying to do the right thing but, due to a lack of understanding of some of the critical nuances, go too far in that direction in low-risk patients.”

Co-authors of this study also include Paul S. Chan, Fengming Tang, St. Luke’s Mid America Heart Institute and the University of Missouri, Kansas City; and Thomas M. Maddox, Veterans Affairs Eastern Colorado Health Care System/University of Colorado School of Medicine.

This research was funded, in part, by the National Heart, Lung and Blood Institute, part of the National Institutes of Health, (grant K23HL102224), U.S. Department of Veterans Affairs, Medtronic and SentreHeart Inc.

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Patients with heart stents face similar risks from bleeding, heart attacks

Results show importance of treating cardiac patients based on personalized risk factors.

By Scott Maier, UC San Francisco

In patients who received a stent to treat coronary artery blockage, those who experienced bleeding requiring hospitalization in the years after the procedure faced an increased risk of death that was similar to the risk faced by those who subsequently had heart attacks, according to a study of nearly 33,000 patients by UC San Francisco and Kaiser Permanente.

“Every year, 600,000 patients in the United States receive a coronary stent and are given drugs that prevent the formation of clots within the stent. These drugs prevent heart attacks but increase the risk of internal bleeding,” said lead author Dhruv Kazi, M.D., M.Sc., M.S., an assistant professor of medicine at UCSF. “These bleeds are often written off as a side effect, but it turns out that they may be just as bad for patients as the heart attacks we’re trying to avoid.”

The study in the April 14 issue of the Journal of the American College of Cardiology is the first to show that the two risks are of comparable magnitude.

Kazi said that the results underline the importance of treating cardiac patients based on personalized risk factors, instead of using what he called a “one-size-fits-all” approach based on population statistics. This study points toward the possibility of using other information about patients that may help identify the antiplatelet drug that is most likely to be the most safe and effective for individual patients in the long run.

The study authors analyzed the records of 32,906 patients in the Kaiser Permanente Northern California health care system who received stents between 1996 and 2008 and were followed for four years. They found that both post-procedure heart attack and episodes of bleeding requiring hospitalization were associated with a greater relative risk of death (91 percent and 61 percent, respectively) over the same time span. The risks in the two groups were not different statistically, so the researchers could not say the risk for one was greater than the other.

Senior author Alan S. Go, M.D., of the Kaiser Permanente Division of Research, noted that the study results “highlight the need for and value of high-quality outcomes research using data from patients treated in the real world to inform patients and doctors about the consequences of treatments.”

Randomized trials, Go observed, “can tell us whether or not a drug, such as an antiplatelet medication, works. But patients enrolled in these trials are highly selected and may not really be like the patients we treat in the clinical practice and are usually followed for a short period of time.”

In contrast, Go said, when rigorously evaluated, data collected in everyday clinical practice can yield valuable insights about long-term effectiveness and safety that complement what is learned from randomized clinical trials.

“We’ve known for some time that bleeds that occur during the stent procedure are bad for the patient, so we increasingly take steps to reduce those bleeds, such as giving drugs with lower bleeding risk and using the radial artery to perform the procedure instead of the femoral artery,” Kazi said. “This is the first study to show that bleeds that occur in the months and years after discharge are also bad for the patient, emphasizing the need for long-term strategies that reduce a patient’s risk of bleeding.”

Other co-authors are Thomas K. Leong, M.P.H., and Matthew D. Solomon, M.D., Ph.D., of Kaiser Permanente, and Tara I. Chang, M.D., M.S., and Mark A. Hlatky, M.D., of Stanford University.

The study was supported by funds from the American Heart Association, Kaiser Permanente Northern California Division of Research, Stanford University and UCSF.

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Heart pouch may explain potentially important cause of strokes

UC Irvine findings could lead to new therapeutic strategies for preventing stroke.

By Tom Vasich, UC Irvine

A pouchlike structure inside the heart’s left atrial chamber in some people may explain strokes that otherwise lack an identifiable cause, according to UC Irvine School of Medicine researchers.

Dr. Mark Fisher, a professor of neurology and pathology & laboratory medicine, and colleagues evaluated 75 stroke patients at UC Irvine Medical Center to learn whether this left atrial septal pouch could be a potent source of stroke-causing blood clots.

Of the 23 patients who had experienced a stroke of undetermined origin (a “cryptogenic” stroke), 30 percent possessed the left atrial septal pouch. It was present in only 10 percent of the 52 patients who’d had a stroke with an identifiable trigger.

Stroke is the leading cause of long-term severe disability and the fourth-most-common cause of death in the U.S. About 80 percent of the 700,000-plus strokes that occur annually in this country are due to blood clots blocking a brain artery. In up to a third of these cases, the clots’ origin cannot be determined.

UC Irvine cardiologists first discovered this pouchlike structure inside the heart’s left atrial chamber in a 2010 study.

“The cul-de-sac nature of this heart pouch may promote stagnation of the blood, forming clots that can travel into the brain and cause a stroke,” Fisher said.

“This finding points to a potentially important cause of strokes,” he added. “The presence of this pouch could change how neurologists treat these patients and lead to new therapeutic strategies for preventing strokes.”

Fisher said that large-scale studies are necessary to verify the results of this study, which appears online in Frontiers in Neurology at http://journal.frontiersin.org/article/10.3389/fneur.2015.00057/abstract.

The research was conducted at UC Irvine Medical Center by members of the Department of Neurology (Fisher and Dr. Annlia Paganini-Hill), the Division of Cardiology (Drs. Dawn Lombardo, Nathan Wong, Ailin Barseghian, Jashdeep Dhoot, Harkawal Hundal and Jonathan Salcedo) and the UCI School of Medicine (Dr. Jonathan Wong, who is now with the California Pacific Medical Center). It was supported by the American Heart Association.

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Necklace and smartphone app can help people track food intake

UCLA-developed app could help battle obesity, heart disease and diabetes.

WearSens rests loosely above the sternum and uses highly sensitive sensors to capture vibrations from the action of swallowing.

By Bill Kisliuk, UCLA

A sophisticated necklace developed by researchers at the UCLA Henry Samueli School of Engineering and Applied Science can monitor food and drink intake, which could help wearers track and improve their dietary habits.

The inventors of the WearSens device say it could help battle obesity, heart disease, diabetes and other problems related to nutrition.

Majid Sarrafzadeh, a distinguished professor of computer science and co-director of UCLA’s Wireless Health Institute, led a team that created the device and an algorithm that translates data from the necklace, and tested it on 30 people who ate a variety of foods.

The researchers found that WearSens can differentiate between solids and liquids with 87 percent accuracy, between hot drinks and room-temperature drinks with 90 percent accuracy, and between food items with different textures with 80 percent accuracy. Researchers say those figures will improve as users calibrate the device based on their eating habits.

The research was published online by the IEEE Sensors Journal.

“Today, many people try to track their food intake with journals, but this is often not effective or convenient,” Sarrafzadeh said. “This technology allows individuals and health care professionals to monitor intake with greater accuracy and more immediacy.”

WearSens rests loosely above the sternum and uses highly sensitive piezoelectric sensors to capture vibrations from the action of swallowing. Piezoelectric sensors produce voltage based on the mechanical stress — or movement or pressure — that is applied to them.

When the wearer eats or drinks, skin and muscle motion from the lower trachea trigger the sensors, and the necklace transmits the signals to a smartphone, where the UCLA-developed algorithm converts the data into information about the food or beverage. The phone displays data about the volume of food or liquid consumed and can offer advice or analysis; for example, that the wearer is eating more than in previous days or that the person should drink more water.

With the WearSens device, the sensor information is translated using a spectrogram, which offers a visual representation of vibrations picked up by the sensors. Spectrograms are often used in speech therapy and seismology, among other applications.

“The breakthroughs are in the design of the necklace, which is simple and does not interfere with daily activity, and in identifying statistical measures that distinguish food intake based on spectrogram images generated from piezoelectric sensor signals,” said Nabil Alshurafa, a graduate student researcher at UCLA who is a co-inventor of the device and the first author of the research.

The study’s other authors are co-inventor Haik Kalantarian, a graduate student researcher; Shruti Sarin and Behnam Shahbazi, also graduate student researchers; Jason Liu, who was a UCLA graduate student at the time he worked on the research; and postdoctoral researcher Mohammad Pourhomayoun.

The team is continuing to refine the algorithms and the necklace’s design. The researchers hope WearSens will be available to the public later this year.

The technology is available for licensing via the UCLA Office of Intellectual Property and Industry-Sponsored Research, which facilitates the conversion of UCLA research to benefit the public.

The research was supported by the National Science Foundation.

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Infant leaves UCLA’s Mattel hospital for home with a transplanted heart

Drayvn is the hospital’s second youngest heart transplant recipient.

Drayvn Johnson got a heart transplant when he was 23 days after he was born with a heart defect and only one coronary artery. Now 5 weeks old, he left Mattel Children's Hospital UCLA for home today with his mother, Nicole Eggleston. (Photo by Reed Hutchinson, UCLA)

By Amy Albin, UCLA

Staff at Mattel Children’s Hospital UCLA witnessed a happy ending today (March 11) instead of what could have easily been a tragic one  when they bid farewell to 5-week-old Drayvn Johnson, who went home with his mother, Nicole Eggleston, and two older brothers after becoming the hospital’s second youngest heart transplant recipient. He was only 23 days old when he received his new heart, which was the size of a strawberry.

“All of our heart transplant patients are special, but I think this one was special because we knew there was a risk we might not find a donor in time,” said Dr. Juan Alejos, professor of pediatric cardiology and director of the Pediatric Heart Transplant Program at Mattel Children’s Hospital UCLA

Dravyn was born with a condition called pulmonary atresia in which the pulmonary valve does not form properly. It was discovered during Eggleston’s pregnancy in a sonogram performed at 22 weeks. Doctors had thought initially that his heart could be repaired with a series of corrective surgeries performed over the first few years of Dravyn’s life.

However, when he was born in early February at an Orange County hospital, doctors found that he had only one coronary artery instead of two and determined that surgery would be too risky for the baby.

At 5 days old, Drayvn was airlifted to Mattel where doctors confirmed that the only hope for his survival was an urgent heart transplant. Miraculously, within two days after Drayvn’s name went on a list for a transplant, a donor was found. And Drayvn got his new heart. The hospital’s youngest heart recipient was a 16-day-old infant who received a transplanted heart in 1994.

The UCLA Pediatric Heart and Heart-Lung Transplant Program is one of the major referral centers for the western United States. The team has performed more than 300 pediatric heart transplants since 1984 when it did its first such surgery. The program is a coordinated effort among pediatric cardiologists, cardiothoracic surgeons, dentists, nurse practitioners, transplant coordinators, nutritional specialists, social workers and child developmental specialists. For more information, visit http://transplants.ucla.edu/heart.

The family has set up a website to help raise funds for Drayvn’s care.

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