Overcoming cardiac pacemaker "source-sink mismatch"

Instead of complication-prone electronic cardiac pacemakers, biomedical engineers at Georgia Tech and Emory envision the creation of “biological Read more

Hope Clinic part of push to optimize HIV vaccine components

Ten years ago, the results of the RV144 trial– conducted in Thailand with the help of the US Army -- re-energized the HIV vaccine field, which had been down in the Read more

Invasive cancer cells marked by distinctive mutations

What does it take to be a leader – of cancer cells? Adam Marcus and colleagues at Winship Cancer Institute are back, with an analysis of mutations that drive metastatic behavior among groups of lung cancer cells. The findings were published this week on the cover of Journal of Cell Science, and suggest pharmacological strategies to intervene against or prevent metastasis. Marcus and former graduate student Jessica Konen previously developed a technique for selectively labeling “leader” Read more

heart disease

NIH at Emory to advance women’s heart health

NIH meets at Emory to discuss women's cardiovascular health and research

The National Institutes of Health (NIH) has convened a key meeting at Emory on women’s cardiovascular health and research. The meeting, co-hosted by the Office of Research on Women’s Health and Emory School of Medicine, is focused today and tomorrow on NIH planning of the women’s health research agenda for the next decade.

Vivian Pinn, MD, associate director for research on women’s health, and director of the Office of Research on Women’s Health at NIH, opened the meeting with Emory’s conference chair, Nanette Wenger, MD, professor of medicine (cardiology), Emory School of Medicine, and chief of cardiology at Grady Memorial Hospital.

Nanette K. Wenger, MD

In a career that spans more than 50 years, Wenger’s dedication to reducing women’s disability and death from cardiovascular disease has made her one of the country’s most-respected experts on coronary heart disease in women. In 2009, Wenger received the Lifetime Achievement Award from the American College of Cardiology.

Although Wenger has earned dozens of awards in her celebrated career, she says her greatest professional achievement has been to help change a major paradigm in cardiology: the assumption that heart disease affects only men. A half a century ago heart disease was thought of as a “man’s disease.”

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Emory Heart & Vascular Center advances medicine

American Heart Month 2010

Learn about Emory Heart & Vascular Center advances during American Heart Month.

Research led by John Puskas, MD, professor of surgery and associate chief, Division of Cardiothoracic Surgery, Emory School of Medicine, has shown that off-pump bypass surgery reduces the risk of complications for high-risk patients, such as those that are especially frail or those with diabetes, obesity, kidney disease or a history of stroke.

This conclusion comes from a 10-year history of coronary bypass patients at Emory recently published in the Annals of Thoracic Surgery.

Puskas also recently presented long-term follow-up data from the first randomized U.S. trial to compare off-pump with conventional on-pump surgery.

The results from the landmark SMART (Surgical Management of Arterial Revascularization) study, which started in 2000, show that participants who had the off-pump procedure lost less blood, had less damage to their hearts during surgery and recovered more quickly than those who underwent on-pump surgery.

Beating-heart patients in the study also were able to breathe on their own sooner after surgery, spent less time in intensive care and left the hospital one day sooner, on average, than conventional coronary bypass patients.

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Managing heart disease and diabetes in South Asia

Illnesses such as diabetes and heart disease are affecting increasing numbers of young people in developing countries. In light of this worrisome trend, K. M. Venkat Narayan, MD, and his colleagues are launching a new center of excellence aimed at preventing and controlling heart disease and diabetes in India and Pakistan.

K.M. Venkat Narayan, MD

K.M. Venkat Narayan, MD

It’s essentially a center of excellence for cardiac metabolic disease prevention and control in South Asia with Emory playing a very important role in the project, says Narayan, professor of global health and epidemiology at Emory’s Rollins School of Public Health and professor of medicine in Emory School of Medicine.

The primary partner of this grant will be the public health foundation of India, New Delhi. Emory is the developed country academic partner working with other network partners, namely, the Madras Diabetes Research Foundation in Chennai, India and the Aga Khan University in Karachi, Pakistan.

The center will focus on surveillance, prevention of mortality stemming from cardiovascular disease and diabetes, and training young investigators in the field of diabetes and cardiovascular disease prevention and control.

It’s estimated that by 2030, the number of people with diabetes will reach 400 million worldwide, double today’s number, says Narayan. Cardiovascular disease is a major cause of death among people with diabetes with 80 percent of deaths from chronic diseases worldwide occurring in low and middle-income countries.

What is particularly worrying about developing countries is that diseases like diabetes are hitting younger people, says Narayan. The implications, he says, are young people who would otherwise be economically productive must leave the labor market. In addition, in India, one person having diabetes uses 25 percent of the family’s income just for his own treatment. The economic impact and the health impact are enormous, says Narayan. Read more in Emory Public Health magazine.

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Encouraging news on women and heart disease

A new study reported this week in the Archives of Internal Medicine delivers encouraging news that Americans are on the right track in the fight against heart disease among women.

The study reports that all women, especially those younger than 55, have recently experienced a greater increase than men in their chances of survival following a heart attack.

Study leader, Viola Vaccarino, MD, PhD, professor of medicine (cardiology), and director of the Emory Program in Cardiovascular Outcomes Research and Epidemiology, researched trends in the rate of in-hospital deaths following heart attack from June 1994, through Dec. 2006. Data were collected from 916,380 patients through the National Registry of Myocardial Infarction.

Between 1994 and 2006, in-hospital death rates decreased among all patients, but decreased more strikingly in women than in men. The decreased risk of death was largest in women younger than 55 years (a 52.9 percent reduction) and lowest in men of the same age (33.3 percent). The absolute reduction in the risk of death among patients younger than 55 was three times larger in women (2.7 percent) than men (0.9 percent).

Vaccarino and her colleagues say a large part (93 percent) of this sharper decrease in mortality of younger women compared with men in recent years is due to the improved risk profile of women compared with men at the time of the heart attack hospitalization, perhaps the result of better recognition and management of coronary heart disease and its risk factors in women before the acute heart event.

Whatever the reason, the improvement indicates that we are headed in the right direction, says Vaccarino. Increased and ongoing awareness to the prevention of cardiovascular risk factors—by healthy diet, regular physical activity and avoidance of smoke and smoking—is saving lives, she notes.

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National Cholesterol Month: Check your numbers

Emory’s Cheryl Williams, RD, LD, clinical nutritionist for the Emory Heart & Vascular Center and Emory HeartWise Cardiac Risk Reduction Program, says you should make it a priority to know your cholesterol levels and learn how what you eat can impact cholesterol and your heart’s health.Williams heart

Since diets high in saturated fat and trans fat have been linked to chronic disease, specifically, heart disease, this knowledge could save your life.

During National Cholesterol Month Williams notes in her blog for the Atlanta Journal-Constitution’s “Doctor Is In” that eating too many fatty foods – especially those high in saturated fat and trans fat – is the primary cause of high cholesterol. Thin, active people may not be aware of how much bad fat they consume, she says.

According to Williams, “Saturated fats are derived primarily from animal products and are known to raise cholesterol levels. They are found in common foods like butter, cheese, whole milk, pork and red meat. Lower-fat versions of these foods usually contain saturated fats, but typically in smaller quantities than the regular versions. Certain plant oils, like palm and coconut oils, are another source of saturated fats. You may not use these oils when you cook, but they are often added to commercially baked foods, such as cookies, cakes, doughnuts and pies.

Even more detrimental to cholesterol levels are trans fats, artificially created during food processing when liquid oils are converted into solid fats — a process called hydrogenation. Many fried restaurant foods and commercially baked goods contain trans fats, as well as vegetable shortening and stick margarine. Read labels and avoid foods that contain partially or fully hydrogenated oils.”

For more tips from Williams about managing for healthy cholesterol levels, visit ajc.com. To learn more about heart disease from Laurence Sperling MD, director of the Emory HeartWise Cardiac Risk Reduction Program, watch videos on health.com.

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New heart valve replacement option under study

A new option for heart valve replacement is under study at Emory University Hospital. Cardiologists at the Emory Heart & Vascular Center are conducting groundbreaking research to study a non-surgical treatment option for patients with severe aortic stenosis, a narrowing of the aortic valve opening that affects tens of thousands of people each year. It is most common among elderly patients over 70 years of age, but can surface earlier in life in those with rheumatic heart disease or congenital abnormalities of the valve. Patients often develop symptoms of chest pain, shortness of breath, fainting spells and heart failure.

Peter Block, MD

Peter Block, MD

Emory cardiologists, led by Peter Block, MD, FACC, professor of medicine, Emory School of Medicine, are performing percutaneous aortic valve replacement as part of a clinical trial, comparing this procedure with traditional, open-heart surgery or medical therapy in high-risk patients with aortic stenosis. It provides a new way for doctors to treat patients who are too ill or frail to endure the traditional surgical approach. So far, 115 people have participated in the phase II clinical trial.

In this new procedure, doctors create a small incision in the groin or chest wall and then feed a wire mesh valve through a catheter and place it where the new valve is needed. The standard therapy, which has been used to treat aortic stenosis for more than 30 years, is to remove the diseased valve through open-heart surgery.

Block says the results seen so far in this clinical trial show great promise for this procedure. He says this is especially important since tens of thousands of Americans are diagnosed with failing valves each year and that number is expected to increase substantially in the coming years as baby boomers pass the age of 70.

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Heart care in women is key to long life

Heart care for women

Heart care for women

Many women do not realize the seriousness of heart disease – in women. Many more do not realize that some of the symptoms of heart attack for women may be different than symptoms experienced by men. Heart disease, also called cardiovascular disease (CVD), is the number one cause of death in women in the United States.

Enter Emory Heart & Vascular Center’s Michele Voeltz, MD. Her work in both the clinical setting and in research focuses on women and heart disease.

Voeltz, who practices at Emory University Hospital Midtown, says the number of women developing CVD is on the rise, with nearly 37 percent of all female deaths in the United States caused by heart disease. She is working to raise awareness about heart disease in women, and she wants to let women know about the resources available to them to take care of themselves.

With women making up 60 to 70 percent of her practice, Voeltz’s mission is to help women and men gain a greater understanding of the differences in risk factors, symptoms and treatment of heart disease in women as compared to men. She has found that women represent an underserved population with regard to cardiovascular care and hopes that her work can help bridge these gaps for women.

Voeltz conducts research in women with heart disease using percutaneous coronary intervention (angioplasty and stenting). With clinical trials to compare stents, medical devices and medications, all of which enroll both men and women, Voeltz analyzes female patients’ outcomes.

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Heart bypass surgery via a small incision

It can be daunting for a patient to hear a heart specialist say bypass surgery is needed. An image comes to mind of traditional open-heart surgery and what this would entail.

A groundbreaking advance pioneered by Emory Heart & Vascular Center doctors now means some patients can have coronary artery bypass surgery without opening up the chest cavity and without stopping the heart.

Called “Endo-ACAB,” this endoscopic surgery is the done via a small incision. In addition, the heart team can combine the Endo-ACAB with angioplasty and Ray Ban outlet stents, thus correcting all blockages a patient has while keeping the chest intact.

Most patients are able to leave the hospital within 48 hours and return to full activity, including work, in two to three weeks, versus the two to three months needed for recovery after traditional surgery. Learn more about the procedure from Thomas Vassiliades, MD, in the video below.

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Diabetes and heart disease: Not just a Western problem

As more and more people around the globe embrace the more unhealthy aspects of the Western diet and lifestyle, more and more people around the globe are developing diet- and lifestyle-related illnesses, like diabetes and heart disease. In heavily populated areas like South Asia, this means millions of new cases, including millions of young people. In light of this worrisome trend, Emory’s Dr. K. M. Venkat Narayan and his colleagues are launching a new center of excellence aimed at preventing and controlling heart disease and diabetes in India and Pakistan.

The National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health has awarded Emory University and the Public Health Foundation of India (PHFI) a $3 million, five-year contract to establish a Global Center of Excellence for Prevention and Control of Cardiometabolic Diseases in South Asia.

Crowd in India

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