Category Archives: Cardiology News

Mild Cortisol Increases Affect Cardiovascular Changes Linked to Heart Disease in Cushing’s

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Increases in cortisol secretion, even if mild, induce early heart and blood vessel changes that may increase the risk for cardiovascular disease, according to Italian researchers.

The findings continue to support the role of the hormone cortisol in heart disease, and demonstrate the need for carefully monitoring cardiovascular risk in patients with high levels of the hormone, including those with Cushing’s disease.

The study, “Cardiovascular features of possible autonomous cortisol secretion in patients with adrenal incidentalomas,” was published in the European Journal of Endocrinology.

While most patients with adrenal incidentalomas don’t have symptoms, nearly half have excess cortisol production. Adrenal incidentalomas are masses in the adrenal glands discovered only when a patient undergoes imaging tests for another unrelated condition.

These asymptomatic, mild cortisol-producing cases are defined as possible autonomous cortisol secretion (pACS), according to the European Society of Endocrinology Guidelines.

Excess production of the hormone, seen in Cushing’s disease patients, is associated with increased mortality, mainly due to heart diseases. Patients with asymptomatic adrenal adenomas and mild cortisol secretion also have more cardiovascular events and generally die sooner than those with normal cortisol levels.

But little is known about the causes behind cardiac and vessel damage in these patients.

To shed light on this matter, a research team at Sapienza University of Rome evaluated the cardiovascular status of patients with pACS. This allowed them to study the impact of cortisol in the heart and blood vessels without the interference of other hormone and metabolic imbalances seen in Cushing’s disease.

The ERGO trial (NCT02611258) included 71 patients. All had been diagnosed with adrenal incidentalomas, 34 of which were pACS with mildly increased levels of the hormone and 37 were defined as nonfunctioning adenoma (NFA) — adrenal masses with normal hormone levels.

The two groups were very similar, with no significant differences in metabolic and cardiovascular risk factors. Adrenal lesions in the pACS group, however, were significantly bigger, which was linked to cortisol levels.

Looking at the heart morphology, researchers found that pACS patients had a significantly higher left ventricular mass index (LVMI), which is a well-established predictive measure of adverse cardiovascular events.

Further analysis revealed that LVMI scores were associated with levels of the hormone, suggesting it has an “independent effect of cortisol on cardiac function,” the researchers wrote.

Slightly more than half of pACS patients (53%) also had a thicker left ventricle, a feature that was seen only in 13.5% of NFA patients. The performance of the left ventricle during diastole (muscle relaxation) was also affected in 82.3% of pACS patients, compared to 35.1% in those with NFA.

Patients with pACS also had less flexible arteries, which may contribute to the development of vascular diseases.

The results show that “mild autonomous cortisol secretion can sustain early cardiac and vascular remodeling” in patients who appear apparently healthy, the researchers said.

“The morphological and functional cardiovascular changes observed in pACS underline the need for further studies to correctly define the long-term management of this relatively common condition,” they added.

From https://cushingsdiseasenews.com/2018/03/13/cushings-disease-increased-cortisol-affects-cardiovascular-changes-heart-disease/

Are Exercise Recommendations Really Enough to Protect the Heart?

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When it comes to preventing heart failure, even the recommended amounts may not be enough, finds a new study

Being inactive is solidly linked to heart problems like heart attack and stroke, and exercise can help lower risk factors—such as high blood pressure and narrowed blood vessels—that are connected to those heart events.

But when it comes to another type of heart condition, heart failure, the effect of physical activity isn’t as clear. If coronary heart disease can be traced to more physical issues, such as blocked arteries or excessive pressure from blood pumping around the body, heart failure is more of a body-wide problem affecting not just the heart but almost every tissue.

In heart failure, the heart gradually loses its ability to effectively pump oxygen-rich blood to the rest of the body, and it can’t keep up with supplying muscles and cells with what they need to function properly. 5.1 million people in U.S. have heart failure.

Source: Are Exercise Recommendations Really Enough to Protect the Heart? | TIME

Don’t Ignore These Early Signs Of Heart Disease In Men | Michael Lazar

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Early Signs Of Heart Disease In Men

While many men may be unaware that they suffer from heart disease until a major incident, like a heart attack, occurs, there are several red flags that you should be aware of to better detect problems with the heart during the earliest and most treatable phases, explains WebMD.

The early stages of heart disease may have come-and-go symptoms that include:

Out of breath after moderate exercise, like climbing stairs.

A feeling of achiness or squeezing in the chest that can last 30 minutes or longer.

Pain in the upper extremities that can’t be explained.

Sometimes heart disease is caused by blood vessels. Key early signs include:

Chest pain

Shortened breath

Pain or tingling in the upper extremities

These symptoms could mean that your blood vessels have narrowed and are constricted. This can sometimes be caused by the build-up of plaque, which forces the heart to work harder to pump blood.

via Don’t Ignore These Early Signs Of Heart Disease In Men | Michael Lazar.

Coronary Artery Disease Risk among Obese Metabolically Healthy Young Men.

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Eur J Endocrinol. 2015 Jun 3. pii: EJE-15-0284. [Epub ahead of print]

Coronary Artery Disease Risk among Obese Metabolically Healthy Young Men.

Twig G1, Gerstein H2, Ben-Ami Shor D3, Derazne E4, Tzur D5, Afek A6, Tirosh A7.

Abstract

OBJECTIVE:

The aim of this study was to assess CAD risk among obese young men without metabolic risk factors.

DESIGN:

longitudinal study in a historical cohort Methods: Incident CAD during a median follow-up of 6.1 years was assessed among 31,684 young men (mean age 31.2±5.7 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. Participants were categorized by BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI≥30 kg/m2 in the presence of normal blood pressure and normal levels of fasting glucose, triglyceride and HDL-cholesterol levels (n=599; 1.9%). Cox proportional hazard models were applied.

RESULTS:

There were 198 new cases of CAD that were diagnosed during 209,971 person-years of follow-up, of which 6 cases occurred among MH obese. The incidence of CAD among MH lean, overweight and obese participates was 0.23, 0.45 and 1.0 per 1,000 person-years, respectively. In a multivariable model adjusted for clinical and biochemical CAD risk factors, a higher CAD risk was observed among MH-obese (HR=3.08; 95%CI=1.10-8.68, p=0.033), compared to MH-normal weight subjects. This risk persisted when BMI was treated as a time-dependent variable, or when fasting glucose, HDL-cholesterol, triglycerides or blood pressure were added to the model. Similar results were also obtained when a more permissive definition of metabolic health was used.

CONCLUSIONS:

Obesity may continue to contribute to increased risk for incident CAD in young men even in the presence of a healthy metabolic profile.

PMID: 26041076 [PubMed – as supplied by publisher]

via Coronary Artery Disease Risk among Obese Metabolically Healthy Young Men. – PubMed – NCBI.

Snow shoveling: How to avoid a heart attack – WTOP

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“Shoveling snow can, in fact, precipitate a heart attack, and it does for thousands of Americans every year,” says Dr. Warren Levy, chief medical officer of Virginia Heart, one of the largest cardiology practices in the region.

He says shoveling snow involves a level of exertion that most of us just are not used to and don’t do on a daily basis.

“It is the same sort of trouble people get into [when they] have never exercised and decide to suddenly train for a marathon,” Levy explained.

People most likely to have problems while shoveling snow are those already diagnosed with heart disease, or who have significant risk factors, such as high blood pressure, obesity, diabetes, cigarette smoking, a strong family history or a sedentary lifestyle.

Read more at Snow shoveling: How to avoid a heart attack – WTOP.

Heart failure symptoms easy to miss for unsuspecting patients – Chicago Tribune

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“I have hardly been sick a day in my life. I take vitamins, try homeopathic remedies and have a great immune system,” says Kilian, 53.However, little did she know while treating her flu/bronchitis symptoms at home in November 2013, that she would end up in the hospital for nearly three weeks.”

Over the winter, I just wasn’t getting better,” says Kilian. “I was having trouble breathing and was starting to feel like I was gaining weight from eating healthy foods to keep my strength up. But, in reality, I was retaining fluid from heart failure.”

Kilian said that her water retention started out slowly, but it became more rapid as her symptoms progressed. Eventually, her brother, who lives in Naperville, brought her to the Elmhurst Memorial Hospital Emergency Department.”

The doctors were shocked at the amount of fluid that I had around my heart. I ended up with a pacemaker in the process,” says Kilian.

Read the entire article at Heart failure symptoms easy to miss for unsuspecting patients – Chicago Tribune.

Big Step in regenerating the heart muscle

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A remarkable discovery in heart research was made by scientists at the Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB in Stuttgart: they found the surface markers of cardiovascular functional living progenitor cells CPCs. This discovery is extremely important for heart research because it demonstrates that the cardiovascular progenitor cells CPCs can be derived from induced pluripotent stem cells, iPS cells. Investigation results were recently published in the journal PLoS ONE.

Progenitor cells are cells that are normally found only in the fetus and have the ability to develop into all cell types of the heart: cardiomyocytes, etc. The goal of the study led by Prof. Dr. Katja Schenke-by Layland from the Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB in Stuttgart, was to produce functional cardiomyocytes from progenitor cells. Cardiomyocytes are heart muscle cells that play an essential role in contraction. Myocardial infarction leads to loss of functional cardiomyocytes. As a result of a blockage of a coronary artery, myocardium served by that artery will not be supplied with oxygen anymore, thus it will die. A frequent consequence of patients who suffer a heart attack is heart failure, which means decreased ability of the heart contraction.

Read more at Big Step in regenerating the heart muscle.

Heart Of The Matter: Treating The Disease Instead Of The Person : Shots – Health News : NPR

Posted on by MaryO

Many times patients and doctors see the same hospital visit through different eyes.

This NPR article discusses the importance of seeing things from both sides…

 

Heart Of The Matter: Treating The Disease Instead Of The Person : Shots – Health News : NPR.

A Good Night’s Sleep Increases the Cardiovascular Benefits of a Healthy Lifestyle

Posted on by MaryO
sleep

sleep (Photo credit: Sean MacEntee)

A good night’s sleep can increase the benefit of exercise, healthy diet, moderate alcohol consumption and non-smoking in their protection against cardiovascular disease (CVD), according to results of a large population follow-up study.(1) Results showed that the combination of the four traditional healthy lifestyle habits was associated with a 57% lower risk of cardiovascular disease (fatal and non-fatal) and a 67% lower risk of fatal events.(2) But, when “sufficient sleep” (defined as seven or more hours a night) was added to the other four lifestyle factors, the overall protective benefit was even further increased — and resulted in a 65% lower risk of composite CVD and a 83% lower risk of fatal events.

“If all participants adhered to all five healthy lifestyle factors, 36% of composite CVD and 57% of fatal CVD could theoretically be prevented or postponed,” the authors report. “The public health impact of sufficient sleep duration, in addition to the traditional healthy lifestyle factors, could be substantial.”

The study is published today in the European Journal of Preventive Cardiology, and is the first to investigate whether the addition of sleep duration to the four traditional healthy lifestyle factors contributes to an association with CVD.

The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN) is a prospective cohort study in the Netherlands from which 6672 men and 7967 women aged 20-65 years and free of CVD at baseline were followed up for a mean time of 12 years. Details of physical activity, diet, alcohol consumption, smoking and sleep duration were recorded between 1993 and 1997, and the subjects followed-up through a cross-link to national hospital and mortality registers.

As expected, results showed that adherence to each of the four traditional lifestyle factors alone reduced the risk of CVD. Those at baseline who recorded sufficient physical activity, a healthy diet and moderate alcohol consumption reduced their risk of composite CVD from 12% for a healthy diet to 43% for not smoking; and risk reduction in fatal CVD ranged from 26% for being physically active to 43% for not smoking.

However, sufficient sleep duration alone also reduced the risk of composite CVD by about 22% (HR 0.78) and of fatal CVD by about 43% (HR 0.57) when compared with those having insufficient sleep. Thus, non-smoking and sufficient sleep duration were both strongly and similarly inversely associated with fatal CVD.

These benefits were even greater when all five lifestyle factors were observed, resulting in a in a 65% lower risk of composite CVD and an 83% lower risk of fatal CVD.

As background to the study, the investigators note that poor sleep duration has been proposed as an independent risk factor for CVD in two other (non-European) studies, but without adding the effect of sleep to other healthy lifestyle benefits. This study — in a large population — now suggests that sufficient sleep and adherence to all four traditional healthy lifestyle factors are associated with a lower CVD risk. When sufficient sleep duration is added to the traditional lifestyle factors, the risk of CVD is even further reduced.

As an explanation for the results, the investigators note that short sleep duration has been associated with a higher incidence of overweight, obesity and hypertension and with higher levels of blood pressure, total cholesterol, haemoglobin A, and triglycerides, effects which are “consistent with the hypothesis that short sleep duration is directly associated with CVD risk.”

The study’s principal investigator, Dr Monique Verschuren from the National Institute for Public Health and the Environment in the Netherlands, said that the importance of sufficient sleep “should now be mentioned as an additional way to reduce the risk of cardiovascular disease.” “It is always important to confirm results,” she added, “but the evidence is certainly growing that sleep should be added to our list of CVD risk factors.”

Dr Verschuren noted that seven hours is the average sleeping time that “is likely to be sufficient for most people.” An earlier study from her group in the Netherlands, which included information on sleep quality, found that those who slept less than seven hours and got up each morning not fully rested had a 63% higher risk of CVD than those sleeping sufficiently — although those who woke rested, even from less than seven hours’ sleep, did not have the increased risk.(3)

Story Source:

The above story is reprinted from materials provided byEuropean Society of Cardiology (ESC).

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

  1. Hoevenaar-Blom M, Spijkerman AMW, Kromhout D, Verschuren WMM. Sufficient sleep duration contributes to lower cardiovascular disease risk in addition to four traditional lifestyle factors: the MORGEN study. Eur J Prevent Cardiol, 2013 DOI: 10.1177/2047487313493057
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