The time Anna stayed up all night

Almost precisely a decade ago, a young Atlanta lawyer named Anna was returning to work, after being treated for an extraordinary sleep disorder. Her story has been told here at Emory and by national media outlets. Fast forward a decade to Idiopathic Hypersomnia Awareness Week 2018 (September 3-9), organized by Hypersomnolence Australia. What this post deals with is essentially the correction of a date at the tail end of Anna’s story, but one with long-term implications Read more

Mini-monsters of cardiac regeneration

Jinhu Wang’s lab is not producing giant monsters. They are making fish with fluorescent hearts. Lots of cool Read more

Why is it so hard to do good science?

Last week, Lab Land put out a Twitter poll, touching on the cognitive distortions that make it difficult to do high-quality science. Lots of people (almost 50) responded! Thank you! We had to be vague about where all this came from, because it was before the publication of the underlying research paper. Ray Dingledine, in Emory’s Department of Pharmacology, asked us to do the Twitter poll first, to see what answers people would give. Dingledine’s Read more

heart failure

ACC 2016: Stem cell study sees improved heart failure outcomes

Patients with heart failure who received an experimental stem cell therapy experienced a reduced rate of death, hospitalization and unplanned clinic visits over the next year compared to a placebo group, according to results presented Monday at the American College of Cardiology meeting in Chicago.

The results of the ixCELL-DCM study were published online Monday by The Lancet. It was reportedly the largest cell therapy study done in patients with heart failure so far (58 treated vs 51 placebo).

Emory University School of Medicine investigators led by Arshed Quyyumi, MD, and their patients participated in the study, and Emory was one of the largest enrolling sites. Lead authors were Timothy Henry, MD of Cedars-Sinai Heart Institute in Los Angeles and Amit Patel, MD of the University of Utah.

“For the first time, a clinical trial has shown that administration of a cellular therapeutic results in an improvement in cardiac outcomes based on a prespecified analysis,” an editorial accompanying the paper in The Lancet says.

This study, which was sponsored by Vericel Corporation, was phase II, meaning that a larger phase III study will be needed before FDA approval. Read more

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Dealing with huff-puff? Think HFpEF

For this month’s Current Concept feature, we would like to explain a term from cardiology that is likely to become more prominent:

“Heart failure with preserved ejection fraction” (abbreviated as HFpEF and pronounced “heff-peff”).

Javed Butler, MD, an Emory expert on heart failure and deputy chief science officer for the American Heart Association, laid out in a recent seminar why this category of patients is so important. Look for more from him on this topic in the future.

Three points:

  1. The number of HFpEF patients is growing and they now make up the majority of patients with heart failure in the United States.
  2. No treatments have been proven to benefit them, in terms of reducing mortality.* In clinical studies, medications such as ACE inhibitors, angiotensin receptor blockers and beta-blockers have not helped.
  3. Once hospitalized, HFpEF patients have a high rate of readmission to the hospital within 30 days. The federal Medicare program is penalizing hospitals that have high rates of readmissions and heart failure is one of the largest contributors to readmissions.

The symptoms that drive people with HFpEF to the hospital are mainly fatigue and dyspnea, or shortness of breath, along with fluid in the lungs and swelling of the limbs. Along with heart failure, HFpEF patients often have conditions such as hypertension, anemia, diabetes, kidney disease or sleep apnea. Read more

Posted on by Quinn Eastman in Heart Leave a comment

Emory cardiologist weighs in on issue of health literacy

Javed Butler, MD, MPH

A story in yesterday’s edition of the Washington Post claims that many Americans have poor health literacy. The Post cited a 2006 study by the U.S. Department of Education that found that 36 percent of adults have only basic or below-basic skills for dealing with health material. According to the report, this means about 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower.

Emory Healthcare heart transplant cardiologist, Javed Butler, MD, MPH, was included in yesterday’s Post article citing his experience with patients who have health literacy issues. “When we say ‘diet,’ we mean ‘food,’ but patients think we mean going on a diet,” said Butler. “And when we say ‘exercise,’ we may mean ‘walking,’ but patients think we mean ‘going to the gym.’ At every step there’s a potential for misunderstanding.”

Butler, a professor of medicine at the Emory School of Medicine and director of Heart Failure Research for Emory Healthcare is studying this issue and its impact on patients with heart failure. He recently reported some of his findings Nov. 17 at the American Heart Association Scientific Sessions conference in Chicago.

To read the entire Washington Post story, please click here.

Posted on by Jennifer Johnson in Uncategorized Leave a comment

Heart disease pioneer named ‘Georgia Woman of the Year’

Many people know that heart disease is currently the number one killer of women in the United States. But a little more than a half a century ago it was widely believed that cardiovascular disease only affected men. Renowned cardiologist, Nanette K. Wenger, MD, challenged this theory and thanks to her pioneering efforts over the last 50 years women today know better.

2010 Georgia Woman of the Year, Nanette K. Wenger, MD

Wenger, a professor of medicine in the division of cardiology at Emory University School of Medicine and former chief of cardiology at Grady Memorial Hospital, is being honored as the 2010 Georgia Woman of the Year for her lifetime commitment to reducing women’s disability and death from cardiovascular disease.

She joins the ranks of other distinguished Georgia women including First Lady Rosalynn Carter who was named the first Georgia Woman of the Year in 1996 by the Georgia Commission on Women. In addition to this prestigious accolade, Wenger has accumulated dozens of awards throughout her celebrated career including the Lifetime Achievement Award from the American College of Cardiology in 2009. She is a sought after lecturer for issues related to heart disease in women, heart disease in the elderly, cardiac rehabilitation, coronary prevention and contemporary cardiac care.

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Ventricular Assist Therapy Helping More Heart Failure Patients

After a long battle with congestive heart failure, former Vice President Dick Cheney this month was implanted with a left ventricular assist device (LVAD) in order to help improve the pumping function of his ailing heart.  Cheney, who has had numerous documented heart problems and hospitalizations, undoubtedly opted to have the small internal heart pump installed in order to help him live a better quality of life, and potentially reduce his hospital visits in the near future.

An LVAD is a battery-operated, mechanical pump that aids the left ventricle in pumping blood into the aorta.  Most commonly, an LVAD is installed to help patients survive the wait until a fully-functioning heart is available for transplant. However, in some cases the LVAD is used as a form of destination therapy (in place of a transplant) for patients who are not candidates for heart transplant. In 2006, surgeons at Emory University Hospital implanted Georgia’s first ventricular assist device (VAD) as destination therapy.

“When offering LVAD destination therapy, our goal is to safely integrate patients back to their respective communities and normal mode of living,” according to David Vega, MD, surgical director of the Emory Heart Transplant Program.

“Ventricular assist devices offer new hope and a much greater quality of life for individuals who are not transplant candidates, patients who do not want a transplant or those who may be transplant eligible in the future.”

According to the United Network for Organ Sharing (UNOS) there are more than 3,100 Americans – 34 in Georgia – who are currently awaiting a heart transplant. Regardless of the number of donor hearts available, many patients are not candidates for a heart transplant for a variety of reasons including cancer, personal and religious beliefs, blood clotting problems, and other debilitating health conditions.

“There are approximately five million Americans who suffer from congestive heart failure, with another half million diagnosed each year. Many of these people are limited by the severity of their heart failure, yet are not able to be transplanted for one of many reasons,” adds Dr. Vega. “These devices may be a viable option for many patients, allowing them to resume a much more normal lifestyle and improved quality of living.”

Posted on by Lance Skelly in Uncategorized Leave a comment

Predicting individual risk for heart failure

Javed Butler, MD, MPH, and colleagues

Javed Butler, MD, MPH, director of heart failure research at Emory Healthcare and associate professor of medicine at Emory University School of Medicine, says heart failure is any condition in which the heart is unable to pump enough blood for the metabolic needs of the body, but that does not mean that the heart is not pumping or the heart has stopped working.

Heart disease is not a disease but a syndrome, so a whole family of different diseases can precede this condition. Diabetes, obesity, heart valve problems, lung disease, heart attack and irregular heartbeats are only some factors that can cause heart failure. “Pinning down the roots of heart failure can be confusing,” says Butler, who serves as deputy chief science advisor for the American Heart Association. “Unlike some heart problems, heart failure is not one disease. It has a few common causes, and a few less common, even rare, causes.”

Finding new ways to identify people at risk for developing heart failure—before damage is done—is his raison d’etre and primary research focus, according to Emory Medicine magazine.

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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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Ventricular assist devices offer hope for heart failure

Emory doctors are leaders in a “destination” therapy program using ventricular assist devices for failing hearts.

The United Network for Organ Sharing says there are more than 2,900 Americans, 43 in Georgia, who are awaiting a heart transplant. Regardless of the number of donor hearts available, however, many patients are not candidates for a heart transplant for a variety of reasons including cancer, personal and religious beliefs, blood clotting problems, and other debilitating health conditions.

Right now there are about 5 million Americans who suffer from congestive heart failure, with another half million diagnosed each year. Many individuals are limited by the severity of their heart failure, yet are not able to be transplanted for one of many reasons.

With so many people awaiting precious few donor hearts, doctors are working to provide access to Ventricular Assist Devices (VADs). VADs are small pumps that are implanted into the chest cavity and help pump a heart that is no longer able to function properly on its own. This offers new hope and a greater quality of life for individuals who are not transplant candidates, patients who do not want a transplant or for people who may be transplant eligible in the future.

Many patients use VADs as a bridge to transplant – meaning they rely on the device temporarily until a donor heart can become available. Others are candidates for VADs as destination therapy, which means a patient is not a candidate for heart transplant or simply does not want a heart transplant – often because of religious or personal ethical reasons.

David Vega, MD

David Vega, MD

David Vega, MD, professor of surgery, Emory University School of Medicine, and director of Heart Transplantation/Mechanical Circulatory Support at Emory University Hospital, leads the pioneering VAD program. He says VAD destination therapy allows patients to resume many basic activities that they were unable to perform before the VAD.

Recently, Emory University Hospital’s VAD program recently the “Gold Seal of Approval” from The Joint Commission, which accredits nearly 16,000 health care organizations and programs in the United States. Emory’s VAD program is the only certified program of its kind in Georgia. Learn more about Emory’s heart transplant program and its 500th patient.

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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.

Posted on by Jennifer Johnson in Uncategorized 1 Comment

New ways to pinpoint heart failure risk

Javed Butler, MD, MPH

Javed Butler, MD, MPH

An aging U.S. population, an increase in the prevalence of obesity and improved cardiovascular therapies for acute problems are boosting the number of people living with the condition of heart failure.

Javed Butler, MD, MPH, director of heart failure research at Emory Healthcare and associate professor of medicine at Emory University School of Medicine, is looking for new ways to prevent and treat heart failure.

According to Butler, heart failure is any condition in which the heart is unable to pump enough blood for the metabolic needs of the body, but that does not mean that the heart is not cheap oakleys pumping or the heart has stopped working. Heart failure is not a disease but a syndrome, so there’s a whole family of different diseases that can precede this condition. These are known collectively as heart failure.

In the clinic, Butler treats patients already diagnosed with heart failure. His research focuses on prevention through life style changes as well as models pinpointing who is at risk for heart failure.

Butler and his colleagues recently created the Health ABC Heart Failure Model for predicting risk of new onset heart failure in the elderly. That model has now been strengthened by validating it via a library of patient data from an earlier cardiovascular study. The results suggest the Health ABC risk model can be used to identify high-risk individuals for whom interventions can be cost-effectively targeted to prevent heart failure.

To hear Butler’s own discussion about heart failure, access the podcast from Emory’s Sound Science series.

Posted on by Holly Korschun in Heart Leave a comment