March, 2024

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ECG Blog #419 — The Cause of ECG #1?

Ken Grauer, MD

I was sent the 2 ECGs shown in Figure-1 — which were recorded from an elderly man whose heart beat "has been irregular for years". No clear history for recent chest pain — but the patient "has not been well" for the previous week. Regarding the 2 ECGs in Figure-1 : ECG #1 is the initial tracing obtained at the scene by the EMS ( E mergency M edical S ystems ) team — in association with an alert but markedly hypotensive patient.

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8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death

American Heart News - Heart News

Research Highlights: A study of over 20,000 adults found that those who followed an 8-hour time-restricted eating schedule, a type of intermittent fasting, had a 91% higher risk of death from cardiovascular disease. People with heart disease or cancer.

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Contemporary approach to cardiogenic shock care: a state-of-the-art review

Frontiers in Cardiovascular Medicine

Cardiogenic shock (CS) is a time-sensitive and hemodynamically complex syndrome with a broad spectrum of etiologies and clinical presentations. Despite contemporary therapies, CS continues to maintain high morbidity and mortality ranging from 35 to 50%. More recently, burgeoning observational research in this field aimed at enhancing the early recognition and characterization of the shock state through standardized team-based protocols, comprehensive hemodynamic profiling, and tailored and selec

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8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death

Science Daily - Heart Disease

A study of over 20,000 adults found that those who followed an 8-hour time-restricted eating schedule, a type of intermittent fasting, had a 91% higher risk of death from cardiovascular disease.

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Early Stroke Scare With Bivalent COVID Vaccines Unsupported by Large Study

Med Page Today

(MedPage Today) -- Investigation of an early signal for stroke associated with COVID-19 bivalent vaccines turned into suspicion of high-dose or adjuvanted flu shots instead, based on a large U.S. population-based study. When researchers inspected.

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Google Street View reveals how built environment correlates with risk of cardiovascular disease

Medical Xpress - Cardiology

Researchers have used Google Street View to study hundreds of elements of the built environment, including buildings, green spaces, pavements and roads, and how these elements relate to each other and influence coronary artery disease in people living in these neighborhoods.

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Boehringer Ingelheim Announces $35 Monthly Price Cap on Inhalers for Asthma, COPD Patients

HCPLive

On March 07, 2024, Boehringer Ingelheim announced it would be instituting a $35 per month out-of-pocket cost cap for its portfolio of inhaler products, with this cap going into effect on June 01, 2024.

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Spontaneous Coronary Artery Dissection: A Focus on Post-Dissection Care for the Vascular Medicine Clinician

Frontiers in Cardiovascular Medicine

Spontaneous coronary artery dissection (SCAD) is an uncommon condition which is increasingly recognized as a cause of significant morbidity. SCAD can cause acute coronary syndrome and myocardial infarction (MI), as well as sudden cardiac death. It presents similarly to atherosclerotic MI although typically in patients with few or no atherosclerotic risk factors, and particularly in women.

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Alcohol raises heart disease risk, particularly among women

Science Daily - Heart Disease

Young to middle-aged women who reported drinking eight or more alcoholic beverages per week--more than one per day, on average--were significantly more likely to develop coronary heart disease compared with those who drank less, finds a study presented at the American College of Cardiology's Annual Scientific Session. The risk was highest among both men and women who reported heavy episodic drinking, or 'binge' drinking, and the link between alcohol and heart disease appears to be especially str

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Wegovy Approved for Heart Disease Prevention

Med Page Today

(MedPage Today) -- The FDA approved semaglutide (Wegovy) to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and either obesity or overweight, the agency announced on Friday. A GLP-1 receptor.

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A humanized IL-2 mutein expands Tregs and prolongs transplant survival in preclinical models

Journal of Clinical Investigation - Cardiology

Long-term organ transplant survival remains suboptimal, and life-long immunosuppression predisposes transplant recipients to an increased risk of infection, malignancy, and kidney toxicity. Promoting the regulatory arm of the immune system by expanding Tregs may allow immunosuppression minimization and improve long-term graft outcomes. While low-dose IL-2 treatment can expand Tregs, it has a short half-life and off-target expansion of NK and effector T cells, limiting its clinical applicability.

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Wide Complex Tachycardia -- VT, SVT, or A Fib with RVR? If SVT, is it AVNRT or AVRT?

Dr. Smith's ECG Blog

A 69 y.o. male with pertinent past medical history including Atrial fibrillation, atrial flutter, cardiomyopathy, Pulmonary Embolism, and hypertension presented to the Emergency Department via ambulance for respiratory distress and tachycardia. Per EMS report, patient believes he has been in atrial fibrillation for 5 days, since coming down with flu-like illness with rhinorrhea, productive cough, SOB.

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Sweetened drinks linked to atrial fibrillation risk

American Heart News - Heart News

Research Highlights: An analysis of health data in the UK Biobank found a 20% higher risk of irregular heart rhythm, known as atrial fibrillation, among people who said they drank two liters or more per week (about 67 ounces) of artificially sweetened.

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Cardiac amyloidosis: New AI system developed for early diagnosis

Medical Xpress - Cardiology

Cardiac amyloidosis is a serious disease in which abnormal proteins (amyloids) accumulate in the heart muscle and impair heart function. As the disease leads to serious complications such as heart insufficiency and, in many cases, death if left untreated, early diagnosis is essential in order to start treatment in good time.

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Eggs may not be bad for your heart after all

Science Daily - Heart Disease

Whether you like your eggs sunny-side up, hard boiled or scrambled, many hesitate to eat them amid concerns that eggs may raise cholesterol levels and be bad for heart health. However, results from a prospective, controlled trial show that over a four-month period cholesterol levels were similar among people who ate fortified eggs most days of the week compared with those who didn't eat eggs.

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Sotatercept's FDA Approval a New Chapter for Pulmonary Arterial Hypertension

Med Page Today

(MedPage Today) -- The FDA approved sotatercept (Winrevair) for treating pulmonary arterial hypertension (PAH) in adults, Merck announced on Tuesday. A novel activin signaling inhibitor, sotatercept is indicated to increase exercise capacity.

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Evidence that tirzepatide protects against diabetes-related cardiac damages

Cardiovascular Diabetology

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are effective antidiabetic drugs with potential cardiovascular benefits. Despite their well-established role in reducing the risk of major adverse cardiovas.

Diabetes 124
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Transcutaneous Pacing: Part I

EMS 12-Lead

TCP In Transit: A case reviewing transcutaneous pacing, false electrical capture, and re-arrest. Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the first installment of a blog series showing how transcutaneous pacing (TCP) can be difficult, and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.

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Semaglutide (Wegovy) Receives FDA Label Expansion to Include Cardiovascular Risk Reduction

HCPLive

On March 08, 2024, the FDA approved semaglutide 2.4 mg (Wegovy) to reduce cardiovascular risk in adults with obesity or overweight and heart disease based on the SELECT trial.

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Study suggests earlier puberty onset may affect adult cardiometabolic health

Medical Xpress - Cardiology

Experiencing puberty earlier, compared to same-age peers, may be one of the mechanisms through which childhood risk factors influence adult cardiometabolic health issues, according to a study published March 27, 2024 in the open-access journal PLOS ONE by Maria Bleil from the University of Washington and colleagues.

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Small amounts of licorice raise blood pressure, study finds

Science Daily - Heart Disease

It is known that large amounts of licorice cause high blood pressure. A new study now shows that even small amounts of licorice raise blood pressure. The individuals who react most strongly also show signs of strain on the heart.

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CVD Risks Tied to Teeny-Tiny Plastics Lodged in Atherosclerotic Plaque

Med Page Today

(MedPage Today) -- It was common for tiny plastic particles from the environment to infiltrate people's vascular lesions, foreshadowing future cardiovascular disease in patients who underwent carotid endarterectomy, an observational study showed.

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Case report of belt electrode-skeletal muscle electrical stimulation for acute heart failure with severe obesity: a novel therapeutic option for acute phase rehabilitation

Frontiers in Cardiovascular Medicine

Background Belt electrode skeletal muscle electrical stimulation (B-SES) is an emerging therapy anticipated to yield more favorable outcomes than conventional neuromuscular electrical stimulation (NMES), owing to its larger stimulation area. However, information on its efficacy and safety in patients with heart failure remains limited. Case presentation A 43-year-old man with a body mass index of 41 kg/m 2 was admitted to our hospital for acute heart failure due to dilated cardiomyopathy.

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Impact of Diabetes on Outcomes in Left Main Coronary Revascularization: PCI vs. CABG

Cardiology Update

Left main coronary artery disease (CAD) and diabetes pose significant challenges in cardiovascular care, often leading to adverse outcomes. However, the comparative long-term efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with these conditions remains unclear. Despite efforts to address this question, previous studies have been hampered by limitations, including inadequate statistical power and inherent biases in registry-based anal

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Young man with Gunshot wound to right chest with hemorrhagic shock, but bullet path not near heart

Dr. Smith's ECG Blog

A young man presented with a gunshot wound to the right chest, with hemo-pneumothorax and hemorrhagic shock. He got a chest tube and intubation and massive transfusion and stabilized. CT of chest showed the bullet path through his right lung but nowhere near his heart. But he did get an EKG: What is this? There were times when it would be usurped by sinus tachycardia, then return to this rhythm.

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FDA Approves Aprocitentan (Tryvio) for Treatment-Resistant Hypertension

HCPLive

Idorsia Ltd. announced the FDA's approval of aprocitentan (Tryvio) for treatment-resistant hypertension on March 20, 2024.

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For younger women, mental health now may predict heart health later

Science Daily - Heart Disease

Younger women are generally thought to have a low risk of heart disease, but new research urges clinicians to revisit that assumption, especially for women who suffer from certain mental health conditions. A new study found that having anxiety or depression could accelerate the development of cardiovascular risk factors among young and middle-aged women.

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Our Brains Are Getting Bigger, MRIs Show

Med Page Today

(MedPage Today) -- Human brains appeared to be getting bigger, temporal trends showed. From the 1930s to 1970s, brain volumes and cortical surface area of people who had neither dementia nor stroke became progressively larger, reported Charles.

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Young adults with migraine, other nontraditional risk factors may have higher stroke risk

American Heart News - Heart News

Research Highlights: Nontraditional risk factors for stroke were significantly associated with the development of strokes in adults younger than ages 35 to 45. Migraine was the most important nontraditional risk factor for stroke among both men and.

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Questioning Intermittent Fasting’s Cardiovascular Impact

CardiacWire

A new AHA study shocked the world this week, suggesting that intermittent fasting might significantly increase people’s risk of cardiovascular death, sparking a wave of media coverage, and a frenzy of criticisms from the cardiologist and scientific communities. Time-restricted eating, which is a type of intermittent fasting, involves limiting eating to a specific number of hours per day (e.g. 4 or 8 hours) and fasting for the rest of the day.

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Treating anxiety, depression in people with heart disease reduced ER visits, hospitalizations

Medical Xpress - Cardiology

Treating anxiety and depression reduced emergency room visits and rehospitalizations among people with heart disease, according to new research published today in the Journal of the American Heart Association.

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Tapinarof Cream for Atopic Dermatitis: An Interim Analysis of Results in Adults, Children

HCPLive

A new analysis of the phase 3 ADORING 3 extension trial involved a large, diverse population and the analysis showed that 91% of eligible participants from previous phases rolled over into this trial.

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Understanding Childhood Cardiomyopathies: Insights from the First European Registry

Cardiology Update

Childhood-onset cardiomyopathies represent a rare and poorly understood subset of cardiac disorders. In a recent study published in the European Heart Journal, investigators delved into the demographics and prognosis of pediatric cardiomyopathy patients within the inaugural European Cardiomyopathy Registry. Data were prospectively gathered from individuals aged 1 to under 18 years participating in the European Society of Cardiology EURObservational Research Programme Cardiomyopathy and Myocardit

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Medicare to Cover Weight-Loss Drug Wegovy for Certain Patients

Med Page Today

(MedPage Today) -- Medicare will cover the weight-loss drug semaglutide (Wegovy) under its Part D drug program for patients with overweight or obesity who have preexisting heart disease and need the drug to prevent heart attacks or strokes, the.

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Increased LL37 in psoriasis and other inflammatory disorders promotes LDL uptake and atherosclerosis

Journal of Clinical Investigation - Cardiology

Patients with chronic inflammatory disorders such as psoriasis have an increased risk of cardiovascular disease and elevated levels of LL37, a cathelicidin host defense peptide that has both antimicrobial and proinflammatory properties. To explore whether LL37 could contribute to the risk of heart disease, we examined its effects on lipoprotein metabolism and show that LL37 enhanced LDL uptake in macrophages through the LDL receptor (LDLR), scavenger receptor class B member 1 (SR-B1), and CD36.

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Microplastics, Nanoplastics, and Major Cardiac Events

CardiacWire

A landmark NEJM study revealed that many patients with carotid artery disease might have microplastics and nanoplastics (MNPs) embedded in their carotid plaque, and those patients have a massive 4.5-fold greater risk of heart attack, stroke, or death within three years. The researchers examined carotid plaque specimens from 257 patients with asymptomatic carotid artery disease, analyzing their plaque for the presence of 11 MNPs, and tracking the patients’ cardiovascular outcomes over 34 months.

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Microplastics linked to heart attack, stroke: Study

Becker's Hospital Review - Cardiology

We all have microplastics in our bodies , but if they show up in carotid artery tissues, patients are nearly two times as likely to experience a stroke, heart attack or related death, according to a study published March 7 in The New England Journal of Medicine.