Posts Tagged ‘Heart & Vascular Institute’

Renowned researcher to lead transformative institute

June 25, 2010

A new initiative in translational research at Case Western Reserve University Department of Medicine and University Hospitals promises to catalyze scientific discoveries, formulate new therapies and inspire the next generation of physician-scientists.

Leading the effort will be one of the school’s newest additions: Jonathan S. Stamler, MD, who will serve as founding director of the Institute for Transformative Molecular Medicine. Dr. Stamler is also the first to hold the Robert S. and Sylvia K. Reitman Family Foundation Distinguished Chair in Cardiovascular Innovation at the Case Cardiovascular Center and University Hospitals Harrington-McLaughlin Heart & Vascular Institute.

“This newly established chair in cardiovascular investigation and its relationship to the Institute for Transformative Molecular Medicine will accelerate our scientific research to its full potential and provide new cures and therapies for the patients we serve,” says Richard A. Walsh, MD, physician-in-chief at University Hospitals and the John H. Hord Professor and chair of the Department of Medicine at Case Western Reserve University.

James Fang discusses LVADs for End-Stage Heart Failure with WebMD

April 11, 2010

More than 5 million Americans have heart failure, a progressive and often lethal condition that weakens the heart and saps its pumping power. The mainstays of treatment — including drug therapy, lifestyle modification, and surgery to implant pacemakers or defibrillators — can be quite effective at managing symptoms of mild to moderate heart failure.

But what about the estimated 150,000 Americans who suffer from chronic, severe heart failure?

Doctors traditionally have had little to offer these patients in the way of lifesaving treatment, short of a heart transplant. But with only about 2,100 donor hearts available each year, the demand for hearts inevitably outweighs the supply. And some patients are simply too old to qualify for a transplant. For them, what’s the alternative?

There’s now an option that could change the outlook for many with severe heart failure: implantable mechanical pumps called left ventricular-assist devices (LVADs or sometimes simply VADs.)

These devices were once just used as a “bridge” — a temporary stopgap to keep heart failure patients alive until they could get a heart transplant. But now, they have become so effective that doctors use them as a treatment in themselves. LVADs are now an alternative to heart transplants, permanently augmenting the action of a heart’s main pumping chamber.

In addition, the continuous-flow LVAD was associated with fewer infections and a significantly lower rate of failure.

“The continuous-flow LVAD has changed the landscape of advanced heart failure,” says James C. Fang, MD, chief medical officer of the Harrington-McLaughlin Heart and Vascular Institute at University Hospitals Case Medical Center in Cleveland and the author of an editorial on LVADs that accompanied the study in the New England Journal of Medicine.

“In addition to being more durable, the new device is a lot smaller – about the size of a D battery. It’s also quiet. You can barely hear it. With the old devices, you could hear them coming down the street.”

Find the full article on CWRUmedicine.org

Learn about the Clinical Role of Exercise Training in Management of Patients With Chronic Heart Failure

March 31, 2010

J Cardiopulm Rehabil Prev. 2010 Mar

Prior exercise research and the recently completed HF-ACTION (Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training) trial indicate that regular exercise represents an effective therapy in the management of patients with stable chronic heart failure (HF) due to left ventricular systolic dysfunction. This review summarizes the results from these studies and provides a guide for prescribing exercise. Regular aerobic-type exercise training improves exercise capacity; does not worsen and may, in fact, mildly improve cardiac function; and partially improves other physiological abnormalities that develop because of chronic HF (eg, autonomic and skeletal muscle function). Regular exercise is safe, improves health status, and modestly reduces ( approximately 15%) combined risk for cardiovascular death or HF-related hospitalization. Even greater physiological and clinical benefits appear likely in patients with HF who adhere to a higher volume of exercise (eg, 6 MET-hr per week). The exercise regimen should include an aerobic-type activity performed at least 30 minutes, 5 or more days per week, and at an intensity approximating 55% to 80% of heart rate reserve. Resistance training should be considered for patients who first demonstrate they are able to tolerate aerobic exercise training. Common to other interventions that also rely on human behavior, long-term adherence to exercise in patients with HF remains a challenge and requires additional research to determine strategies aimed at improving compliance. Areas of needed research include identifying which patient subgroup(s) benefits the most and determination of the optimal intensity, duration, and frequency of exercise needed to maximize clinical benefits and attenuate fatigue.

Read the full article on CWRUmedicine.org

No Need for High Blood Pressure Meds?

March 24, 2010

A novel treatment for drug-resistant hypertension

About 72 million adults in the United States suffer from hypertension, defined as having a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher. Of these, about 4 million adults (approximately 6 percent) suffer from drug-resistant hypertension. This is a form of the disease that does not respond to normal treatments such as reducing salt intake or using various combinations of medications. John Blebea discusses new treatment options for patients.

Electrical stimulation of “stretch receptors” surrounding the carotid arteries in the neck may prove to be the next treatment for drugresistant hypertension. Clinical researchers from the Division of Cardiovascular Medicine are part of an international research group examining the efficacy of this novel treatment. John Blebea, MD, Chief, Division of Vascular Surgery and Endovascular Therapy, University Hospitals Case Medical Center; Director, Vascular Center, UH Harrington- McLaughlin Heart & Vascular Institute; and Professor of Surgery, Case Western Reserve University School of Medicine, reports that this technique could enable patients to reduce or entirely discontinue use of their blood pressure medications.

Shocking treatment
Performed under general anesthesia, the procedure involves surgical placement of electrodes around both carotid arteries in the neck. The electrode wires are tunneled beneath the skin to an area under the collarbone where a battery and control unit are placed. “The device is very similar to a [heart] pacemaker and, indeed, has been termed a pacemaker for high blood pressure,” says Dr. Blebea. Electrical stimulation of the stretch receptors that surround the carotid arteries, known as baroreceptors, sends an electrical signal to the brain, causing it to use its natural pathways and mechanisms to relax blood vessels and lower blood pressure – the baroreflex. “The result is seen immediately after the device is turned on,”says Dr. Blebea.

Learn more at CWRUmedicine.org