February, 2024

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ECG Blog #418 — A Single Lead Tells the Tale.

Ken Grauer, MD

The ECG in Figure-1 was obtained from a previously healthy man in his 40s — who presented to the ED ( E mergency D epartment ) with new-onset CP ( C hest P ain ) that awakened him from sleep. ECG #1 was recorded ~90 minutes after the patient was awakened from sleep. He was still having CP. QUESTIONS: In view of this history — How would YOU interpret the ECG in Figure-1 ?

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Living near pubs, bars and fast-food restaurants could be bad for heart health

American Heart News - Heart News

Research Highlights Closer proximity to and a higher number of ready-to-eat food outlets — particularly pubs, bars and fast-food restaurants — may be associated with a greater risk of developing heart failure, according to a study of half a million.

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Dementia Predicted 10 Years Before Diagnosis

Med Page Today

(MedPage Today) -- Blood protein profiles predicted future dementia in healthy adults, a large longitudinal study showed. Blood samples from over 50,000 people in the U.K. Biobank showed that four proteins -- glial fibrillary acidic protein.

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Ismail El-Hamamsy, MD, PhD, Named President of the Heart Valve Society

DAIC

Ismail El-Hamamsy, MD, performs a Ross Procedure at The Mount Sinai Hospital in New York City with Paul Stelzer, MD, and Elbert Williams, MD. Photo courtesy of Mount Sinai Health System milla1cf Thu, 02/22/2024 - 13:47 February 22, 2024 — Ismail El-Hamamsy , MD, PhD, Director of Aortic Surgery for the Mount Sinai Health System and the Mount Sinai Randall B.

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How will you save this critically ill patient? A fundamental and lifesaving ECG interpretation that everyone must recognize instantly.

Dr. Smith's ECG Blog

Written by Pendell Meyers A woman in her 30s called EMS for acute symptoms including near-syncope, nausea, diaphoresis, and abdominal pain. EMS arrived and found her to appear altered, critically ill, and hypotensive. An ECG was performed: What do you think? Extremely wide complex monomorphic rhythm just over 100 bpm. The QRS is so wide and sinusoidal that the only real possibilities left are hyperkalemia or Na channel blockade.

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Multiomic screening of invasive GBM cells reveals targetable transsulfuration pathway alterations

Journal of Clinical Investigation - Cardiology

While the poor prognosis of glioblastoma arises from the invasion of a subset of tumor cells, little is known of the metabolic alterations within these cells that fuel invasion. We integrated spatially addressable hydrogel biomaterial platforms, patient site–directed biopsies, and multiomics analyses to define metabolic drivers of invasive glioblastoma cells.

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ECG Blog #415 — The Cath showed NO Occlusion!

Ken Grauer, MD

Today’s patient is an older woman who experienced a number of fainting epiodes over the previous week. No CP ( C hest P ain ). Shortly after arrival in the ED ( E mergency D epartment ) — she suffered a cardiac arrest. The ECG in Figure-1 was obtained following successful resuscitation. Stat Echo — obtained shortly after successful resuscitation revealed anterior wall akinesis.

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Do Organ Transplants Cause Personality Changes?

Med Page Today

(MedPage Today) -- I have received some unusual phone calls in my nearly 40-year career as a psychiatrist, but Mary's* call was unique. "Dr. Liester," she began, "I don't need to see you as a patient. I just want you to tell me if I'm crazy. You.

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Double diabetes—when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

Cardiovascular Diabetology

Currently, the differentiation between type 1 diabetes (T1D) and type 2 diabetes (T2D) is not straightforward, and the features of both types of diabetes coexist in one subject. This situation triggered the ne.

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What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. After an initially narrow QRS, there is a very large abnormal extra wave at the end of the QRS complex. These are Osborn waves usually associated with hypothermia. There is also large T wave inversion and long QT.

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CTRP4/interleukin-6 receptor signaling ameliorates autoimmune encephalomyelitis by suppressing Th17 cell differentiation

Journal of Clinical Investigation - Cardiology

C1q/TNF-related protein 4 (CTRP4) is generally thought to be released extracellularly and plays a critical role in energy metabolism and protecting against sepsis. However, its physiological functions in autoimmune diseases have not been thoroughly explored. In this study, we demonstrate that Th17 cell–associated experimental autoimmune encephalomyelitis was greatly exacerbated in Ctrp4–/– mice compared with WT mice due to increased Th17 cell infiltration.

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AI tools better at predicting heart transplant rejection than standard clinical method, finds study

Medical Xpress - Cardiology

More than 4,500 heart transplants were performed in the U.S. in 2023. While the lifesaving operation improves the quality of life and longevity for most recipients, organ rejection remains a risk, with acute rejection occurring in up to 32% of recipients within the first year.

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Century of progress sets stage for future scientific advances in cardiovascular health

American Heart News - Heart News

Embargoed until 4 a.m. CT/5 a.m. ET Monday, Feb. 12, 2024 DALLAS, Feb. 12, 2024 — Dramatic advances in the understanding and treatment of cardiovascular diseases have saved millions of lives in the 100 years since the founding in 1924 of the American.

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Even With Alzheimer's Pathology, Healthy Lifestyles May Preserve Cognition

Med Page Today

(MedPage Today) -- Cognitive function was better for older adults with healthy lifestyles even if they had Alzheimer's or other dementia-related pathologies, autopsy data showed. A 1-point increase in a healthy lifestyle score was associated with.

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Occupational Noise Linked to Rheumatoid Arthritis, Osteoarthritis Prevalence

HCPLive

Results of a multivariate logistic regression analysis showed previous exposure to occupational noise was positively associated with both rheumatoid arthritis and osteoarthritis.

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A young man with persistent palpitations

Dr. Smith's ECG Blog

Written by Pendell Meyers A teenager was playing basketball when he suddenly developed palpitations and lightheadedness. He presented soon afterward at the Emergency Department with ongoing symptoms. Mentation and blood pressure were normal. He had no chest pain or shortness of breath. Heart rates on the monitor fluctuated from 180-250 bpm. Here is his triage ECG: What do you think?

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Piezo1 agonist restores meningeal lymphatic vessels, drainage, and brain-CSF perfusion in craniosynostosis and aged mice

Journal of Clinical Investigation - Cardiology

Skull development coincides with the onset of cerebrospinal fluid (CSF) circulation, brain-CSF perfusion, and meningeal lymphangiogenesis, processes essential for brain waste clearance. How these processes are affected by craniofacial disorders such as craniosynostosis are poorly understood. We report that raised intracranial pressure and diminished CSF flow in craniosynostosis mouse models associate with pathological changes to meningeal lymphatic vessels that affect their sprouting, expansion,

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Researchers explore whether gut microbes cause some COVID-19 patients to have higher blood clot risk

Medical Xpress - Cardiology

A gut microbial metabolite called 2-methylbutyrylcarnitine (2MBC) plays a role in exacerbating thrombosis—the formation of blood clots—researchers report February 23 in the journal Cell Metabolism. The results also revealed that 2MBC is accumulated in individuals with COVID-19, potentially explaining why these patients are at increased risk of thrombosis.

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New weight loss medication may help lower blood pressure in adults with obesity

American Heart News - Heart News

Research Highlights: The weight loss medication tirzepatide significantly lowered the systolic blood pressure of nearly 500 adults who had obesity and took the medication for 36 weeks, or about eight months, in a subset of an international clinical.

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Cannabis Singled Out for Cardiovascular Risk

Med Page Today

(MedPage Today) -- Cannabis use was independently linked to adverse cardiovascular outcomes in the general population even after accounting for tobacco cigarette and e-cigarette use, a large national study found. Using data from the CDC's Behavioral.

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Immune genes are altered in Alzheimer's patients' blood

Science Daily - Stroke

A new study has found the immune system in the blood of Alzheimer's patients is epigenetically altered. That means the patients' behavior or environment has caused changes that affect the way their genes work. Many of these altered immune genes are the same ones that increase an individual's risk for Alzheimer's. Scientists now theorize the cause could be a previous viral infection, environmental pollutants or other lifestyle factors and behaviors.

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Tachycardia and hyperkalemia. What will happen after therapy with 1 gram of Ca gluconate and some bicarbonate?

Dr. Smith's ECG Blog

A 20-something type, 1 diabetic presented by EMS with altered mental status. Blood pressure was 117/80, pulse 161, Resp 45, SpO2 100 on oxygen. Here is the 12-lead ECG: Wide complex tachycardia What do you think? The providers thought that this wide QRS was purely due to (severe) hyperkalemia. They treated with 4 ampules (200 mL) of bicarb and 1 gram of calcium gluconate.

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KIBRA repairs synaptic plasticity and promotes resilience to tauopathy-related memory loss

Journal of Clinical Investigation - Cardiology

Synaptic plasticity is obstructed by pathogenic tau in the brain, representing a key mechanism that underlies memory loss in Alzheimer’s disease (AD) and related tauopathies. Here, we found that reduced levels of the memory-associated protein KIdney/BRAin (KIBRA) in the brain and increased KIBRA protein levels in cerebrospinal fluid are associated with cognitive impairment and pathological tau levels in disease.

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TAVI Matches SAVR in Lower Risk Aortic Valve Patients: 10 year outcomes

Cardiology Update

The NOTION trial, a pioneering study, sought to compare the long-term clinical and bioprosthesis outcomes of Transcatheter Aortic Valve Implantation (TAVI) versus Surgical Aortic Valve Replacement (SAVR) in patients with severe aortic valve stenosis (AS) at lower surgical risk. The study, spanning a decade, enrolled 280 patients, randomly assigned to either TAVI with the CoreValve bioprosthesis or SAVR.

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Patients with Behavioral Health Disorders Less Likely to Have Surgery for Cancer

HCPLive

Cancer patients with behavioral health disorders, such as substance abuse, eating disorders, and sleep disorders have a 7.76% increase in health care costs, a new study found.

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Could Niacin Actually Induce Heart Disease?

Med Page Today

(MedPage Today) -- Niacin metabolism was associated with incident major adverse cardiovascular events (MACE) and may be linked to the pathogenesis of heart disease via inflammatory pathways, researchers said. In a metabolomics study of stable.

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Blood thinners added to clot-busting medication did not improve stroke outcomes

American Heart News - Stroke News

Research Highlights: Although giving blood thinners along with clot-busting medication may help in treating heart attacks, it did not improve 90-day outcomes in people with clot-caused strokes. Enrollment in a large clinical trial, which had been.

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DNA methylation risk score for type 2 diabetes is associated with gestational diabetes

Cardiovascular Diabetology

Gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) share many pathophysiological factors including genetics, but whether epigenetic marks are shared is unknown. We aimed to test whether a.

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Dynamic metabolism of endothelial triglycerides protects against atherosclerosis in mice

Journal of Clinical Investigation - Cardiology

Blood vessels are continually exposed to circulating lipids, and elevation of ApoB-containing lipoproteins causes atherosclerosis. Lipoprotein metabolism is highly regulated by lipolysis, largely at the level of the capillary endothelium lining metabolically active tissues. How large blood vessels, the site of atherosclerotic vascular disease, regulate the flux of fatty acids (FAs) into triglyceride-rich (TG-rich) lipid droplets (LDs) is not known.

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Valvular and perivalvular thrombus after TAVR: Risks and Outcomes

Cardiology Update

Transcatheter aortic valve replacement (TAVR) is the standard treatment for severe aortic stenosis, but post-TAVR leaflet thrombus, identified by hypoattenuated leaflet thickening (HALT), poses potential risks like cerebral thromboembolic events. Perivalvular thrombus has also been reported. The ADAPT-TAVR study compared edoxaban with dual antiplatelet therapy (DAPT) to prevent leaflet thrombus and associated risks post-TAVR.

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Heart disease risk factors in women highlight need for increased awareness, prevention

American Heart News - Heart News

Statement Highlights: The new scientific statement highlights heart disease as the leading cause of death for women and emerging evidence that has identified several gender-specific risk factors for heart disease in women, including complications.

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Even Modest Lp(a) Elevations Bode Poorly for Cardiovascular Health

Med Page Today

(MedPage Today) -- Lipoprotein(a), or Lp(a), at levels well below currently accepted risk thresholds correlated with increased cardiovascular risk in a large registry study, suggesting a wider patient pool that could benefit from future preventive.

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Scientist shows focused ultrasound can reach deep into the brain to relieve pain

Science Daily - Heart Disease

Scientists have found soundwaves from low-intensity focused ultrasound aimed at a place deep in the brain called the insula can reduce both the perception of pain and other effects of pain, such as heart rate changes.

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Crisis Response Planning Can Reduce Suicide Risk for PTSD Among Veterans

HCPLive

A new study found crisis response planning for PTSD among military veterans had lower onset of suicidal ideation than veterans with self-guided safety planning.

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Biofilm-derived oxylipin 10-HOME–mediated immune response in women with breast implants

Journal of Clinical Investigation - Cardiology

This study investigates a mechanistic link of bacterial biofilm–mediated host-pathogen interaction leading to immunological complications associated with breast implant illness (BII). Over 10 million women worldwide have breast implants. In recent years, women have described a constellation of immunological symptoms believed to be related to their breast implants.

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Ohio State First in Central Ohio to Use Novel Heart Failure Therapy

DAIC

milla1cf Mon, 02/26/2024 - 12:40 February 26, 2024 — More than 6 million Americans live with heart failure , and about half have an enlarged left ventricle, which causes stress on the heart and less blood pumped with each heartbeat. The Ohio State University Wexner Medical Center is the first in central Ohio to take part in a global clinical trial to use a novel therapy to reduce the size of the left ventricle without open-heart surgery.

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AI-based system to guide stroke treatment decisions may help prevent another stroke

American Heart News - Stroke News

Research Highlights: An artificial intelligence (AI) system to help guide treatment decisions for stroke patients led to improved stroke care quality and fewer recurrent strokes, heart attacks and vascular death among stroke survivors three months.

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