Fri.Mar 01, 2024

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ECG Blog #419 — The Cause of ECG #1?

Ken Grauer, MD

I was sent the 2 ECGs shown in Figure-1 — which were recorded from an elderly man whose heart beat "has been irregular for years". No clear history for recent chest pain — but the patient "has not been well" for the previous week. Regarding the 2 ECGs in Figure-1 : ECG #1 is the initial tracing obtained at the scene by the EMS ( E mergency M edical S ystems ) team — in association with an alert but markedly hypotensive patient.

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Here’s your wake-up call: Daylight saving time may impact your heart health

American Heart News - Heart News

DALLAS, March 1, 2024 – Losing an extra hour of sleep may not be the worst thing that could happen when you “spring forward” at the start of daylight saving time. According to the American Heart Association, celebrating one hundred years of lifesaving.

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A humanized IL-2 mutein expands Tregs and prolongs transplant survival in preclinical models

Journal of Clinical Investigation - Cardiology

Long-term organ transplant survival remains suboptimal, and life-long immunosuppression predisposes transplant recipients to an increased risk of infection, malignancy, and kidney toxicity. Promoting the regulatory arm of the immune system by expanding Tregs may allow immunosuppression minimization and improve long-term graft outcomes. While low-dose IL-2 treatment can expand Tregs, it has a short half-life and off-target expansion of NK and effector T cells, limiting its clinical applicability.

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Mean platelet volume (MPV) as new marker of diabetic macrovascular complications in patients with different glucose homeostasis

Cardiovascular Diabetology

Platelets play an important role in the development of cardiovascular disease (CVD). Mean platelet volume (MPV) is considered as biological marker of platelets activity and function. The aim of the present stu.

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Increased LL37 in psoriasis and other inflammatory disorders promotes LDL uptake and atherosclerosis

Journal of Clinical Investigation - Cardiology

Patients with chronic inflammatory disorders such as psoriasis have an increased risk of cardiovascular disease and elevated levels of LL37, a cathelicidin host defense peptide that has both antimicrobial and proinflammatory properties. To explore whether LL37 could contribute to the risk of heart disease, we examined its effects on lipoprotein metabolism and show that LL37 enhanced LDL uptake in macrophages through the LDL receptor (LDLR), scavenger receptor class B member 1 (SR-B1), and CD36.

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New Studies: AI Captures Electrocardiogram Patterns That Could Signal a Future Sudden Cardiac Arrest

DAIC

Sumeet Chugh, MD. Photo by Cedars-Sinai milla1cf Fri, 03/01/2024 - 08:25 March 1, 2024 — Two new studies by Cedars-Sinai investigators support using artificial intelligence (AI) to predict sudden cardiac arrest-a health emergency that in 90% of cases leads to death within minutes. “Sudden cardiac arrest is a mostly lethal condition, and prevention will make the biggest impact, but we need to find novel clinical tools to make that possible,” said Sumeet Chugh, MD , director of the Division of A

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Dermatology Month in Review: February 2024

HCPLive

In the February edition of Dermatology Month in Review, new acne guidelines released by AAD, an FDA decision on nemolizumab, and an interview on potentially the first oral IL-23 inhibitor for psoriasis were among the major stories.

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Blanchard Valley Health cuts open-heart surgery program

Becker's Hospital Review - Cardiology

Findley, Ohio-based Blanchard Valley Health System is cutting its open-heart surgery program and will instead transfer patients to other systems as needed.

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Severe Maternal Grief Associated with Increased Risk of Heart Failure in Child

DAIC

Getty Images milla1cf Fri, 03/01/2024 - 08:32 March 1, 2024 — Prenatal stress is a potential risk factor for cardiovascular disease in offspring later in life. In a new study published in JACC: Heart Failure , maternal loss of a partner or child shortly before or during pregnancy was found to be associated with increased risk of heart failure up to middle-age in the child.

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Serum amyloid A expression in liver promotes synovial macrophage activation and chronic arthritis via NFAT5

Journal of Clinical Investigation - Cardiology

Nuclear factor of activated T-cells 5 (NFAT5), an osmo-sensitive transcription factor, can be activated by isotonic stimuli, such as infection. It remains unclear, however, whether NFAT5 is required for damage-associated molecular pattern–triggered (DAMP-triggered) inflammation and immunity. Here, we found that several DAMPs increased NFAT5 expression in macrophages.

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Multimodal AI Chatbot Presents Mixed Results in Ophthalmic Imaging Analysis

HCPLive

The newest version of ChatGPT accurately responded to most multiple-choice questions on ophthalmic cases but performed better on non-image–based questions.

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Targeting mitochondrial dynamics of morphine-responsive dopaminergic neurons ameliorates opiate withdrawal

Journal of Clinical Investigation - Cardiology

Converging studies demonstrate the dysfunction of the dopaminergic neurons following chronic opioid administration. However, the therapeutic strategies targeting opioid-responsive dopaminergic ensembles that contribute to the development of opioid withdrawal remain to be elucidated. Here, we used the neuronal activity-dependent Tet-Off system to label dopaminergic ensembles in response to initial morphine exposure (Mor-Ens) in the ventral tegmental area (VTA).

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"Seizure" in a 60 year old male

Dr. Smith's ECG Blog

This 60 yo male had an apparent tonic clonic seizure. He had no history of seizures. He was unconscious for 8 minutes and slowly awoke in the ambulance, complaining of nausea only. First responders found him to be very tachycardic , confused, perserverating and with no memory of the event. There was tongue biting. Lightheadedness continued. The tachycardia was gone by the time paramedics arrived.

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APOL1-mediated monovalent cation transport contributes to APOL1-mediated podocytopathy in kidney disease

Journal of Clinical Investigation - Cardiology

Two coding variants of apolipoprotein L1 (APOL1), called G1 and G2, explain much of the excess risk of kidney disease in African Americans. While various cytotoxic phenotypes have been reported in experimental models, the proximal mechanism by which G1 and G2 cause kidney disease is poorly understood. Here, we leveraged 3 experimental models and a recently reported small molecule blocker of APOL1 protein, VX-147, to identify the upstream mechanism of G1-induced cytotoxicity.

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Esta es su señal de alerta: El horario de verano puede afectar la salud del corazón de los hispanos

American Heart News - Heart News

DALLAS, 1 de marzo de 2024 – Es posible que perder una hora extra de sueño no sea lo peor que podría pasar cuando se “adelanten los relojes” al comienzo del horario de verano. Según la American Heart Association (la Asociación Americana del Corazón), que.

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Mechanosensitive channels TMEM63A and TMEM63B mediate lung inflation–induced surfactant secretion

Journal of Clinical Investigation - Cardiology

Pulmonary surfactant is a lipoprotein complex lining the alveolar surface to decrease the surface tension and facilitate inspiration. Surfactant deficiency is often seen in premature infants and in children and adults with respiratory distress syndrome. Mechanical stretch of alveolar type 2 epithelial (AT2) cells during lung expansion is the primary physiological factor that stimulates surfactant secretion; however, it is unclear whether there is a mechanosensor dedicated to this process.

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HCV Recurrence Unlikely Post-Renal Transplant After DAA Treatment Response

HCPLive

Results showed 95.8% of patients who were treated for HCV with DAA therapy and underwent renal transplantation did not experience HCV recurrence.

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TRIM56 protects against nonalcoholic fatty liver disease by promoting the degradation of fatty acid synthase

Journal of Clinical Investigation - Cardiology

Nonalcoholic fatty liver disease (NAFLD) encompasses a disease continuum from simple steatosis to nonalcoholic steatohepatitis (NASH). However, there are currently no approved pharmacotherapies for NAFLD, although several drugs are in advanced stages of clinical development. Because of the complex pathophysiology and heterogeneity of NAFLD, the identification of potential therapeutic targets is clinically important.

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Vipul Jairath, MBChB, DPhil: The ‘Evolving Concept’ of Disease Clearance in Ulcerative Colitis

HCPLive

Jairath discusses disease clearance and optimal treatment targeting in UC, highlighting what the ongoing VERDICT trial hopes to add to our understanding of improving patient outcomes.

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PIEZO1 is a distal nephron mechanosensor and is required for flow-induced K+ secretion

Journal of Clinical Investigation - Cardiology

Ca2+-activated BK channels in renal intercalated cells (ICs) mediate luminal flow–induced K+ secretion (FIKS), but how ICs sense increased flow remains uncertain. We examined whether PIEZO1, a mechanosensitive Ca2+-permeable channel expressed in the basolateral membranes of ICs, is required for FIKS. In isolated cortical collecting ducts (CCDs), the mechanosensitive cation-selective channel inhibitor GsMTx4 dampened flow-induced increases in intracellular Ca2+ concentration ([Ca2+]i), whereas th

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From the Member Sections | WIC Section: A History of Driving Change

American College of Cardiology

The history behind the ACC Women in Cardiology (WIC) Member Section reaches back 30 years and is a captivating narrative of empowerment, innovation, resilience and, ultimately, progress.

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Glucocorticoid receptor-dependent therapeutic efficacy of tauroursodeoxycholic acid in preclinical models of spinocerebellar ataxia type 3

Journal of Clinical Investigation - Cardiology

Spinocerebellar ataxia type 3 (SCA3) is an adult-onset neurodegenerative disease caused by a polyglutamine expansion in the ataxin-3 (ATXN3) gene. No effective treatment is available for this disorder, other than symptom-directed approaches. Bile acids have shown therapeutic efficacy in neurodegenerative disease models. Here, we pinpointed tauroursodeoxycholic acid (TUDCA) as an efficient therapeutic, improving the motor and neuropathological phenotype of SCA3 nematode and mouse models.

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Rheumatology Month in Review: February 2024

HCPLive

The rheumatology month in review highlights cognitive dysfunction in patients with fibromyalgia, explores the impact of obesity on treatment response in rheumatoid arthritis, and evaluates work-related challenges faced by patients with psoriatic arthritis.

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Stromal Pbrm1 mediates chromatin remodeling necessary for embryo implantation in the mouse uterus

Journal of Clinical Investigation - Cardiology

Early gestational loss occurs in approximately 20% of all clinically recognized human pregnancies and is an important cause of morbidity. Either embryonic or maternal defects can cause loss, but a functioning and receptive uterine endometrium is crucial for embryo implantation. We report that the switch/sucrose nonfermentable (SWI/SNF) remodeling complex containing polybromo-1 (PBRM1) and Brahma-related gene 1 (BRG1) is essential for implantation of the embryonic blastocyst on the wall of the ut

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Feature | Honoring Excellence: Recognizing AHA, ABC Achievements in Improving Heart Health

American College of Cardiology

The ACC isn't the only cardiovascular society celebrating a milestone anniversary in 2024. Both the American Heart Association (AHA) and Association of Black Cardiologists (ABC) are celebrating 100 years and 50 years, respectively.

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Reversible synaptic adaptations in a subpopulation of murine hippocampal neurons following early-life seizures

Journal of Clinical Investigation - Cardiology

Early-life seizures (ELSs) can cause permanent cognitive deficits and network hyperexcitability, but it is unclear whether ELSs induce persistent changes in specific neuronal populations and whether these changes can be targeted to mitigate network dysfunction. We used the targeted recombination of activated populations (TRAP) approach to genetically label neurons activated by kainate-induced ELSs in immature mice.

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FDA Approves AGENT DCB for In-Stent Restenosis

HCPLive

The approval of the AGENT Drug-Coated Balloon is based on the AGENT IDE trial and was announced by Boston Scientific on March 01, 2024.

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Comprehensive Overview of GLP-1 RAs in Cardiometabolic Care

Cardiometabolic Health Congress

The not-so-sudden rise of weight loss ”wonder” drugs for T2D and obesity This World Obesity Day, March 4, 2024, weight loss drugs dominate discussions and raise new questions for clinicians. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) have been used to treat type 2 diabetes (T2D) since the approval of Byetta (exenatide) in 2005.

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Hormone Therapy for Menopause May Also Help Depressive Symptoms

HCPLive

A new study found menopausal hormone therapy was associated with a significant reduction in depressive symptoms over time with a greater reduction combined with antidepressants.

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Tipping the balance toward transplantation tolerance: in vivo therapy using a mutated IL-2

Journal of Clinical Investigation - Cardiology

Immune tolerance to allogenic transplanted tissues remains elusive, and therapeutics promoting CD4+FOXP3+ Tregs are required to achieve this ultimate goal. In this issue of the JCI, Efe and colleagues engineered an Fc domain fused to a human mutein IL-2 (mIL-2–Fc) bearing mutations that confer preferential binding to the high-affinity IL-2 receptor expressed on Tregs.

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Substantial Site-Level Variation in Pacemaker Implantation Rates Post TAVR

American College of Cardiology

Despite decreasing rates of permanent pacemaker implantation (PPI) after TAVR, substantial site-level variation persists, suggesting the need for quality improvement initiatives like replicating best practices from high-performing sites and increased guideline-based education, according to a recent study published in JACC: Cardiovascular Interventions.

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Efficiency Frontier Method: Reducing Psoriasis Drug Prices Based on Clinical Benefits

HCPLive

These findings suggest much lower prices can be achieved for medications, with better alignment to the benefits of different biological psoriasis treatments

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Cancer neoepitopes viewed through negative selection and peripheral tolerance: a new path to cancer vaccines

Journal of Clinical Investigation - Cardiology

A proportion of somatic mutations in tumors create neoepitopes that can prime T cell responses that target the MHC I–neoepitope complexes on tumor cells, mediating tumor control or rejection. Despite the compelling centrality of neoepitopes to cancer immunity, we know remarkably little about what constitutes a neoepitope that can mediate tumor control in vivo and what distinguishes such a neoepitope from the vast majority of similar candidate neoepitopes that are inefficacious in vivo.

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Seniors Have Increased Hospital Readmission Risk Within 180 Days of Major Surgery

HCPLive

Older adults who are ≥ 90 years old, have dementia, are frail, and are undergoing vascular surgery have greater hospital readmission rates within 180 days.

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How Healthcare Employers Can Embrace Data as Collaborative Ally | NHA

Learning + Leading

The healthcare sector is evolving rapidly, with staffing and retention at the forefront of many organizations' strategic planning. In response, data-driven approaches are increasingly being adopted to refine recruitment and training processes. The National Healthcareer Association ® (NHA) provides valuable resources that align with these data-centric strategies, aiding healthcare employers in their quest to build resilient and skilled teams.

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Biosimilars Month in Review: February 2024

HCPLive

This month’s biosimilars month in review highlights the evolving landscape of biosimilars, emphasizing their potential benefits in terms of safety, cost-effectiveness, and increased treatment options, while recognizing the importance of addressing challenges in adoption and perception.

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A Robotic Radiation Shielding Device for Electrophysiologic Procedures

Cassling

Fluoroscopy-guided procedures are the leading source of occupational ionizing radiation exposure for electrophysiologic (EP) personnel. High cumulative doses of X-ray radiation might increase the risk for malignancies, early development of cataracts and orthopedic problems due to the heavy weight of lead aprons. Reducing high scatter radiation exposure during medical procedures is the principal task of many professional societies and advisory groups.