Experts explain why heart failure should be a public concern

Agencies
April 8, 2018

New Delhi, Apr 8: Heart Failure is a progressive, debilitating and potentially life-threatening condition, which is responsible for silently killing one-third of patients during hospital admission and one-fourth within 3 months of diagnosis.

On World Health Day 2018, the Cardiological Society of India (CSI) has urged the people to prioritise heart failure as a public health priority. The need of the hour is to develop a comprehensive approach to combat heart diseases in India which is on its way to becoming an epidemic in the country.

Focusing on the 'Health for all' theme of World Health Day 2018, the CSI calls for introducing programmes concentrating on screening and detection of symptoms of heart diseases amongst the rural population as such initiatives need to be scaled up across the country.

It is important that the growing incidence of heart failure should be seen as a public health challenge to further reduce mortality and morbidity due to heart failure.

'Heart failure' doesn't mean that the heart is about to stop working, but it is a potentially life-threatening condition where the heart cannot pump enough blood around the body. This, in most cases, happens because the heart muscle, which is responsible for the pumping action, weakens or stiffens over time.

According to the Non-Communicable Diseases Country Profiles released by the WHO, of the estimated 98.16 lakh deaths in India, NCDs led to nearly 6 million, which is 60 percent of the total mortality reported annually in the country.

Cardiovascular diseases (CVDs) are the leading cause of mortality, accounting for more than half of all deaths resulting from NCDs. The burden of CVDs is rising at a significantly high rate amongst middle-income and lower-income geographies.

According to Dr. K. Sarat Chandra, President, Cardiological Society of India, "Indians have all the reasons to be alarmed over matters of the heart. With the burden of heart failure snowballing in India and the associated high death rates, it is necessary to recognize heart failure as a public health priority in the country. The disease has socio-economic and emotional implications for the patient and his family, impacting the overall quality of life. The need of the hour is for all stakeholders to come together to develop a community-level approach to raise awareness about this condition."

The increased prevalence of heart diseases in India can be attributed mainly to lifestyle factors like tobacco use, unhealthy diet, physical inactivity and psychosocial stress. Heart failure is a global health problem, affecting about 26 million people worldwide. The disease burden of heart failure is around 10 million in India.

Dr Ambuj Roy, Additional Professor of Cardiology, AIIMS, New Delhi, said, "Untreated Heart Failure is a rapidly progressive and potentially fatal condition, so it is important to recognize the symptoms promptly and get treated at the earliest to prevent a rapidly downhill course. This is especially critical, since there is no way to reverse the damage already done, and treatment helps in containing further damage to the heart and other body organs. Simple medicines and in some cases implantable devices are known to benefit these patients and prolong their survival."

Data from low-income and middle-income countries like India suggested that mortality in patients with heart failure in these countries is greater than that in high-income countries. It is estimated to have cost about US$100 billion in 2012. The marked variation in mortality is attributed to low awareness, economic disparity, and ease of access to high-quality healthcare facilities, environmental and genetic factors.

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News Network
February 21,2020

Washington, Feb 21: The fat around arteries may play an important role in keeping the blood vessels healthy, according to a study in rats that may affect how researchers test for treatments related to plaque buildup, as seen in conditions leading to heart attack.

The study, published in the journal Scientific Reports, noted that the fat, known as perivascular adipose tissue, or PVAT, helps arteries let go of muscular tension while under constant strain.

According to the researchers, including Stephanie W. Watts from the Michigan State University in the US, this feature is similar to how the bladder expands to accommodate more liquid, while at the same time keeping it from spilling out.

"In our study, PVAT reduced the tension that blood vessels experience when stretched," Watts said.

"And that's a good thing, because the vessel then expends less energy. It's not under as much stress," she added.

According to Watts and her team, PVAT has largely been ignored by researchers believing its main job was to store lipids and do little more.

Until now, she said, scientists only divided blood vessels into three parts, the innermost layer called the tunica intima, the middle layer called the tunica media, and the outermost layer called the tunica adventitia.

Watts believes PVAT is the fourth layer, which others have called tunica adiposa.

Tunica, she said, meant a membranous sheath enveloping or lining an organ, and adiposa is a synonym for fat.

"For years, we ignored this layer -- in the lab it was thrown out. In the clinic it wasn't imaged. But now we're discovering it may be integral to our blood vessels," Watts said.

"Our finding redefines what the functional blood vessels are, and is part of what can be dysfunctional in diseases that afflict us, including hypertension. We need to pay attention to this layer of a blood vessel because it does far more than we originally thought," she added.

Earlier studies, Watts said, had shown that PVAT plays a role in the functioning of blood vessels, finding that it secretes substances that can cause blood vessels to relax as well as substances that can cause it to contract.

In the current study, the researchers decided to test whether PVAT provides a structural benefit to arteries by assisting the function of stress relaxation.

They tested the thoracic aorta in rats, and found those with intact PVAT had more stress relaxation than those without.

The study revealed that the pieces of artery with surrounding fat had measurably relaxed more than those without.

Watts and her colleagues then tested other arteries, and were able to duplicate the same response.

"It's not something you see only in this particular vessel or this particular species or this particular strain. But that maybe it's a general phenomenon," she said.

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Agencies
February 10,2020

Washington D.C, Feb 10: Children's vulnerability towards depression, anxiety, impulsive behaviour, and poor cognitive performance could be determined by considering the hours of sleep they manage to get.

Sleep states are active processes that support the reorganisation of brain circuitry. This makes sleep especially important for children, whose brains are developing and reorganising rapidly.

In a study by researchers from the University of Warwick -- recently published in the journal Molecular Psychiatry -- cases of 11,000 children aged between 9 and 11 years from the Adolescent Brain Cognitive Development dataset were analyzed to find out the relationship between sleep duration and brain structure.

The study was carried out by researchers Professor Jianfeng Feng, Professor Edmund Rolls, Dr. Wei Cheng and colleagues from the University of Warwick's Department of Computer Science and Fudan University.

Measures of depression, anxiety, impulsive behaviour and poor cognitive performance in the children were associated with shorter sleep duration. Moreover, the depressive problems were associated with short sleep duration one year later.

The reduced brain volume of areas such as orbitofrontal cortex, prefrontal, and temporal cortex, precuneus, and supramarginal gyrus was found to be associated with the shorter sleep duration.

Professor Jianfeng Feng, from the University of Warwick's Department of Computer Science, comments: "The recommended amount of sleep for children 6 to 12 years of age is 9-12 hours. However, sleep disturbances are common among children and adolescents around the world due to the increasing demand on their time from school, increased screen time use, and sports and social activities."

A previous study showed that about 60 per cent of adolescents in the United States receive less than eight hours of sleep on school nights.

Professor Jianfeng Feng further added: "Our findings showed that the total score for behavior problems in children with less than 7 hours sleep was 53 per cent higher on average and the cognitive total score was 7.8 per cent lower on average than for children with 9-11 hours of sleep. It highlights the importance of enough sleep in both cognition and mental health in children."

Professor Edmund Rolls from the University of Warwick's Department of Computer Science also commented: "These are important associations that have been identified between sleep duration in children, brain structure, and cognitive and mental health measures, but further research is needed to discover the underlying reasons for these relationships."

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Agencies
May 2,2020

Clinician-scientists have found that Irish patients admitted to hospital with severe coronavirus (COVID-19) infection are experiencing abnormal blood clotting that contributes to death in some patients.

The research team from the Royal College of Surgeons in Ireland found that abnormal blood clotting occurs in Irish patients with severe COVID-19 infection, causing micro-clots within the lungs.

According to the study, they also found that Irish patients with higher levels of blood clotting activity had a significantly worse prognosis and were more likely to require ICU admission.

"Our novel findings demonstrate that COVID-19 is associated with a unique type of blood clotting disorder that is primarily focussed within the lungs and which undoubtedly contributes to the high levels of mortality being seen in patients with COVID-19," said Professor James O'Donnell from St James's Hospital in Ireland.

In addition to pneumonia affecting the small air sacs within the lungs, the research team has also hundreds of small blood clots throughout the lungs.

This scenario is not seen with other types of lung infection and explains why blood oxygen levels fall dramatically in severe COVID-19 infection, the study, published in the British Journal of Haematology said.

"Understanding how these micro-clots are being formed within the lung is critical so that we can develop more effective treatments for our patients, particularly those in high-risk groups," O'Donnell said.

"Further studies will be required to investigate whether different blood-thinning treatments may have a role in selected high-risk patients in order to reduce the risk of clot formation," Professor O'Donnell added.

According to the study, emerging evidence also shows that the abnormal blood-clotting problem in COVID-19 results in a significantly increased risk of heart attacks and strokes.

As of Friday morning, the cases increased to 20,612 cases in Ireland, with 1,232 deaths so far, according to the Johns Hopkins University.

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