New pump developed for Heart Failure

New pump developed for Heart Failure For help with Heart Failure call 0800 9788133

A novel “electronic smart pump” created by scientists who say that they say will “revolutionise” the treatment of patients suffering from chronic heart failure has been developed by researchers from the Nottingham Trent University and Nottingham University Hospitals NHS Trust.

They say the smart aortic graft would be implanted in the patient’s body and is entirely self-contained, eliminating the need for the patient to be hospitalised and wired to machinery.

The device which is operated by a battery would be implanted into a section of the aorta that had previously been removed in order to improve the heart‘s efficiency. The aorta is the large artery situated in in the left ventricle of the heart. A tube is connected to the device, which is surrounded by a material that expands when a voltage is applied to it, causing it to act as a pump. The device would then create a counter blood flow by “beating out of phase with the diseased heart.”

Once the heart fills with blood, the tube contracts, therefore increasing pressure in the heart. The heart then pumps oxygenated blood around the body. This causes the tube to expand, releasing the pressure and increasing blood flow.

The researchers say they hope to have the device tailor-made to each patient using 3D printing techniques and data from MRI scans.

 

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Heart Failure and glass slippers

Heart Failure and glass slippers For help with Heart Failure call 0800 9788133

Heart failure is the ultimate “Cinderella Syndrome” but just recently Prince Charming (Pharma and Biotechs) maybe offering that glass slipper.

New treatments for heart failure have been scarce to say the least and have remained largely unchanged since the 1970s. Every year some 3.5 million people in America and Europe are admitted to hospital suffering from acute heart failure. Heart Failure equates to 5% of all AE admissions and takes 2% of the total beds in the NHS. Around 30% of patients are likely to die within a year. Drugs are given to alleviate symptoms, like breathlessness, congestion and pain. However in the past two decades only a couple of new drugs and a metamorphosing of new strains of drugs  have been approved to help patients. Now a number of treatments for heart failure are in the pipeline which is very good news for those suffering from acute and chronic heart failure. The positive line is that more people are surviving heart attacks (cardiac MI) but then they come out the other side sometimes with heart failure, this is where patients and their families need to manage this long term condition

New development amount to a “seismic shift in the clinical landscape” for acute heart failure, says Martin Cowie, professor of cardiology at the Royal Brompton Hospital in London. The new drugs being developed not only appear to reduce mortality rates, he adds, but also help to avoid long-lasting damaging effects to organs.

Some of the existing drug treatments work by impairing and dampening the body’s own response to cardiac conditions. For example, beta blockers, also given to those who suffer heart attacks, interfere with receptors on cells in the heart muscle to weaken the effect of stress hormones binding with those cells. Some of the new treatments instead exaggerate and increase the natural reactions to heart stress that occur in healthy people.

One such drug is a compound called serelaxin, which has been developed by Novartis, a Swiss. It mimics a human hormone known as relaxin. In pregnancy relaxin levels rise to help boost the blood flow for mother and child. This can also help patients whose hearts are coming under a similar sort of stress. Positive results were reported in a medical trial of serelaxin by the Lancet last year and the drug could be licensed for use next year. Serelaxin also in recent FDA trials reduced the risk of death by 37%  for those with acute heart failure in the period of 6 months after diagnosis.

Another drug that mimics a natural process is ularitide. This has been developed by Cardiorentis, also a Swiss company, as a chemically synthesised form of urodilatin—a human peptide which is produced in the kidneys and which helps them excrete waste more efficiently through manipulating hormone levels. This too can improve blood flow and further trials are planned.

Two American biotechnology companies, Amgen and Cytokinetics, reported results from a trial of a drug called omecamtiv mecarbil to a recent congress held in Amsterdam by the European Society of Cardiology. Although more tests are needed, the drug has been shown to stimulate the ability of heart muscles to contract without debilitating side-effects. Previous drugs that made the heart contract more powerfully tended to raise calcium levels, which increases the risk of life-threatening heart-rhythm problems.

In the longer term, techniques are emerging which might help repair the damaged heart itself. Celladon, another American biotechnology company, is funding a clinical trial of a gene therapy in a number of hospitals around the world. The trial, known as CUPID2, involves introducing a gene which can help the heart improve its muscle function. The gene is contained in a genetically engineered virus and inserted directly into heart muscle via a catheter. If the trial is successful, such treatment could be four or five years away from being made generally available.

More work is needed. But after such a long period of little progress acute heart failure might at last start to benefit from the sort of advances that have made heart attacks less deadly.

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Gene Therapy for Heart Failure

Gene Therapy for Heart Failure For help with Heart Failure call 0800 9788133

Around 200 patients are being enrolled on a gene therapy trial. The trial will  test whether introducing genetic material into damaged heart cells can improve the cardiac cells function.

Researchers at Imperial College London found that levels of the protein SERCA2a are lower in patients with heart failure.

Royal Brompton Hospital is one of only two British centres taking part in the international study, The Golden Jubilee National Hospital in Glasgow being the other.

Before joining the trial Mrs Gedda had baseline measurements taken for her fitne

At Royal Brompton, the gene therapy is delivered at the NIHR biomedical research unit, via a coronary angiogram under local anaesthetic.

The researchers have ‘hidden’ the gene inside a genetically modified virus which is able to latch on to heart muscle cells but is believed to be entirely harmless.

The virus delivers the extra DNA into the nucleus of the heart cells. The hope is the gene will prompt the heart cells to produce more of the SERCA2a protein and repair some of the damaged heart muscle. Half of the patients will receive the gene therapy, while the rest will get a placebo or dummy drug.

The trial, known as CUPID2, is funded by the US biotechnology company, Celladon. It will be around three years before the results are known.

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Serelaxin proves to be effective across all Heart Failure patient groups

Serelaxin proves to be effective across all Heart Failure patient groups

As a charity we think this is a very important breakthrough in drug treatment for sufferers of heart failure. This is the first big breakthrough drug that compliments the existing set of drugs that haven’t really changed since the 1970?s.

The experimental drug from Novartis to treat heart failure proved equally effective regardless of the age of patients or whether they had other medical problems, clinical trial results presented on Monday showed.

The drug, serelaxin,  is a form of a human hormone that relaxes blood vessels and eases stress on the heart and other organs.

Results from a Phase III study in November 2012 found it reduced deaths by 37% compared with a placebo – and the latest data offers further insight by showing how it performed in different patient groups.

The drug led to reduced dyspnea (breathlessness) and fewer deaths after six months in all patient groups, including those with impaired kidney function, those aged 75 or older, and those with atrial fibrillation, or irregular heartbeats.

The new findings were presented at the European Society of Cardiology congress in Amsterdam, where heart doctors have highlighted the enormous need for new treatments for acute heart failure, in which the heart is unable to pump enough blood.

Two million patients are hospitalised each year in Europe and United States as a result of heart failure, and about half of all patients die within five years of being diagnosed with the condition.

Medical treatment of heart failure has changed little since the 1970s but Novartis hopes serelaxin will soon offer cardiologists a new therapy option.

U.S. regulators in June gave serelaxin “breakthrough therapy” status, potentially fast-tracking its development and approval.

Serelaxin is currently being assessed by health authorities around the world, including the U.S. Food and Drug Administration and the European Medicines Agency.

Novartis previously disclosed that while serelaxin met one of the study’s two primary goals by reducing deaths and relieving dyspnea, it failed to hit a secondary combined objective of lowering cardiovascular death and reducing the need for patients to go back into hospitals.

Researchers view the life-saving benefit as the more important measure, although many still want to see further evidence of the drug’s performance given past disappointments in the field.

 

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Better odds for discharged Heart Failure patients

 Better odds for discharged Heart Failure patients 

One way for recently discharged heart failure patients to boost their survival odds is to see a doctor within the first month after leaving the hospital, a new study finds.

And the survival advantage is higher among patients who see their regular doctor rather than an unfamiliar one, according to the report in the Aug. 19 issue of the CMAJ (Canadian Medical Association Journal).

The researchers looked at data on more than 24,000 heart failure patients aged 20 and older who had been discharged from hospitals in Alberta, Canada. Of those patients, 22% did not see a doctor within the first month, 69% saw their regular doctor, and 9% saw an unfamiliar doctor.

Patients who saw a doctor within a month of being discharged from hospital were 3-8% less likely to die or be readmitted to the hospital within three months to one year than those who did not see a doctor, according to Dr. Finlay McAlister, of the University of Alberta, Edmonton.

The investigators also found that patients who saw their regular doctor had a significantly lower risk of death or hospital readmission than those who saw an unfamiliar doctor.

The findings show “that physicians should strive to optimize continuity with their heart failure patients after discharge, and that strategies are needed in the health care system to ensure early follow-up after discharge with the patient’s regular physician,” the study authors concluded.

It is a shame that the study didn’t calculate the effectiveness of specialist heart failure nurses. It still amazes the charity that there is still non parity of access to heart failure specialist nurses in the UK.

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The ABC’s of Heart Failure Management

The ABC’s of Heart Failure Management For help with Heart Failure call 0800 9788133

Here are some simple points to remember if you have just been diagnosed with Heart Failure.

Ejection Fraction

  • This is a measurement your doctor may use to see how well your heart is working, it is called ejection fraction or EF.
  • The ejection fraction (EF) is the amount of blood your heart pumps with each heart beat.
  • The normal EF of the pumping heart is 50% to 60%.
  • Heart failure may happen if the EF is less than 40%.

Treatment for Heart Failure

  • Eat less salt and salty type foods which are high in sodium, aim for 2 grams per day.
  • Take medicines to strengthen your heart and water pills to help your body get rid of extra fluid.
  • Balance your activity with rest. Be as active as you can each day, but also take rest periods.
  • Do not smoke
  • Reduce your Alcohol consumption

Medicines You Might Take

  • Diuretic “water pills” help your body get rid of extra fluid which accumulates when your heart is less efficient
  • Beta blockers lowers blood pressure and slows your heart rate.
  • Ace inhibitors decreases the work for your heart and lowers blood pressure.
  • Digoxin helps your heart pump better
  • ARB is an alternative to ace inhibitors, they help lower blood pressure therefore decreasing the work of the heart

Hope this makes everything a little clearer

 

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QOF allegedly not behind falling heart failure re-admissions

QOF allegedly not behind falling heart failure re-admissions

According to PULSE the publication for doctors in General Practice in the UK the QOF (Quality Outcome Framework) is not behind falling heart failure re-admissions. Hospital admissions for heart failure have dropped since the advent of the new GP contract, but are not associated with improving QOF scores for the disease, claim UK researchers.

The study

The researchers studied practice-level admissions rates in England for heart failure between 2004 and 2011. They then correlated this with population factors such as deprivation, race, smoking and CHD prevalence, as well as primary care factors such as practice size, GP supply, access and QOF scores. The heart failure hospital admission data were extracted from the Hospital Episode Statistics (HES) database. Practice level QOF data were obtained from the NHS Information Centre.

Read the rest of the article in the post from Pulse

 

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Breakfasts and a healthy heart

Breakfasts and a healthy heartFor help with Heart Failure call 0800 9788133

The BBC has reported that research conducted in the US shows that people who eat breakfast stand a chance of keeping their heart healthy.

The study of 27,000 men, in the journal Circulation, showed those skipping breakfast were at a greater risk of heart problems.

The team at the Harvard School of Public Health said missing the meal put an “extra strain” on the body.

The men, aged 45-82, were studied for 16 years. During that time there were more than 1,500 heart attacks or cases of fatal heart failure.

However, people who skipped breakfast were 27% more likely to have heart problems than those who started the day with a meal. The researchers adjusted for other lifestyle risk factors such as smoking and exercise.

Researcher, Dr Leah Cahill told the BBC: “The take-home message is eat in the morning when you wake up, preferably within an hour.

“The results show that something is better than nothing, but it’s always better to have something healthy and balanced.”

She said the timing of the meal seemed to be key and waiting until lunch rather than “breaking fast” may be straining the body over time.

She said this could be increasing the risk of high blood pressure, obesity and diabetes which could in turn damage the heart.

“Don’t skip breakfast,” Dr Cahill concluded.

Victoria Taylor, a dietitian with the British Heart Foundation, said: “These researchers only looked at men aged over 45, so we would need to see further research to confirm that breakfast has the same impact on the heart health of other groups of people.

“What we do know is that a healthy and filling breakfast can make that mid-morning biscuit less tempting, as well as giving you another opportunity to widen the variety of foods in your diet.

“Wholegrain toast, or cereals like porridge with low fat milk are a good way to start the day. Try a sliced banana or dried fruit on top and you’ll be on your way to five-a-day before you’ve even left the house.”

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Air Pollution and Heart Failure

Air Pollution and Heart Failure

British Heart Foundation Press Release.

In a huge study, scientists at the University of Edinburgh found that even brief exposure to air pollution increases hospital admissions and death rates among people living with heart failure. The study spanned 12 countries and nearly 4 million heart failure patients.

Dr Anoop Shah, Researcher at the University of Edinburgh’s BHF Centre of Research Excellence comments:

“We already know that air pollution is associated with an increased risk of having a heart attack. Our study suggests that air pollution also affects patients with heart failure.

“We found a strong association between exposure to air pollution and admission to hospital with heart failure or death from heart failure. The effects were strongest for particulate matter found in vehicle exhaust fumes.”

Across the UK, reducing the levels of harmful particles in the air could potentially increase the nation’s average life expectancy by up to 8 months.

Joseph Clift, Policy Manager here at the British Heart Foundation says:

“Hundreds of thousands of people in the UK are living each day with the impact of heart failure. This study reveals air pollution could be making these already vulnerable people even more unwell.

“It’s vital that the UK government meets European Commission targets to improve air quality. The benefit would not only be felt by heart failure patients, but – by reducing the cost to the NHS – our economy too.”

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More evidence around BNP screening

More evidence around BNP screening For help with Heart Failure call 0800 9788133

Parity of health development is no more evident in the BNP screening process for Left ventricular dysfunction across the UK. I know this is a little wordy but the conclusion by the research team is at the bottom of the blurb.

Screening people at risk for heart failure for certain levels of brain-type natriuretic peptide (BNP), a peptide secreted by the ventricles of the heart, followed by collaborative care reduces the risk of left ventricle dysfunction and heart failure, according to a study published in the July 3 issue of the Journal of the American Medical Association.

Mark Ledwidge, PhD, from St. Vincent’s Healthcare Group in Dublin, and colleagues randomly assigned 1,374 participants with cardiovascular risk factors to receive usual primary care or screening with BNP testing.

The researchers found that 41.6% of the screening group (263 patients) had BNP levels of ?50pg/mL and underwent echocardiography and collaborative care. Left ventricle dysfunction with or without heart failure occurred in significantly fewer patients in the screening group (5.3% vs. 8.7%; odds ratio, 0.55). Heart failure was less likely in the screening group, though non-significantly (1% vs. 2.1%; odds ratio, 0.48; P =0.12). The incidence rate of emergency hospitalization for major cardiovascular events was significantly lower in the screening group (22.3 vs. 40.4 per 1,000 patient-years; incidence rate ratio, 0.6).

“Among patients at risk of heart failure, BNP-based screening and collaborative care reduced the combined rates of left ventricle systolic dysfunction, diastolic dysfunction, and heart failure,” Ledwidge and colleagues conclude.

The study was funded by the Heartbeat Trust, an independent charity which has received unrestricted educational and research grants from multiple drug companies.

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