Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Columbia research suggests need to rethink causes of heart failure

13.04.2005


Research at NYPH/Allen pavilion shows more than half of patients may be affected by factors external to heart



New research from Columbia University Medical Center is challenging the traditional explanation for the causes of the most common type of heart failure, traditionally called diastolic heart failure. The study of 145 patients at NewYork-Presbyterian Hospital/The Allen Pavilion suggests that the most common type of heart failure is caused by health problems outside the heart.

The study, published in the April issue of the Journal of Cardiac Failure, suggests the majority of heart failure cases might be better treated with drugs to target specific disorders that are causing the heart failure - e.g. anemia, obesity, hypertension and diabetes - rather than the treatments currently prescribed specifically for heart failure.


Heart failure is the currently the number one reason for hospital admission in patients over the age of 65. With the growing elderly population this condition is expected to increase exponentially. Current estimates are that of the more than 5 million people in the United States with heart failure, more than half have heart failure despite the heart having normal pumping function.

"Our data suggests that the classic definition of heart failure fails to take into account the wide range of health problems that can be associated with the disease," said Mathew S. Maurer, M.D., Irving Assistant Professor of Medicine at Columbia University College of Physicians and Surgeons and Director of the Clinical Cardiovascular Research Laboratory for the Elderly at the NewYork Presbyterian Hospital/The Allen Pavilion, who was the study’s principal investigator. "A broader view of heart failure is necessary to understand its causes and treat these patients."

Heart failure patients have been routinely classified into one of two groups - those with hearts that are pumping abnormally, considered systolic heart failure, and those with hearts that pump blood out normally but have trouble filling with blood, which was typically called diastolic heart failure.

The patients who were the subject of the study have heart failure but normal ejection fractions – the measurement of the heart’s ability to pump blood. It was previously believed that heart failure patients with a normal ejection fraction had small, thick-walled hearts that made it exceedingly difficult for them to fill with enough blood. The Columbia study showed, however, that many patients with heart failure and normal ejection fractions had hearts that were bigger than average.

Unique 3-D Imaging System Allows Unprecedented Accuracy

Previous studies failed to account for the shape of the heart, but a one-of-a-kind three-dimensional imaging system developed by Columbia University Medical Center’s Donald King, professor emeritus of radiology, provided an accurate measurement of heart shape. The other studies just measured heart width, but Dr. King’s 3-D echocardiography system also measured heart length, proving that these patients did not have smaller hearts, as previously believed.

Prior to this study researcher had also compared the cardiac failure patients’ hearts to a standardized heart size similar to that of a healthy 25 year old, rather than taking into account that this disease predominantly affects elderly women, who have smaller hearts.

"By accurately measuring patient heart size and comparing it to the hearts of healthy elderly women, we showed for the first time that not only were the heart failure hearts not smaller, but in many cases they were larger, meaning we need to look elsewhere to discover the roots of this problem," said Dr. Maurer.

The Columbia researchers measured left ventricular end-systolic and end-diastolic volumes in 35 heart failure patients with normal ejection fractions and hypertension, as well as 11 patients with heart failure and no high blood pressure and 99 asymptomatic normal controls. While all of the subjects had normal pumping function of the heart, the subjects with heart failure and a normal ejection fraction and low blood pressure had trouble filling their small to normal sized hearts, and wall thickening that was out of proportion to their ventricular volume. However, for the majority of elderly subjects with heart failure and a normal ejection with concomitant hypertension, there was a concomitant increase in ventricular volume and mass, suggesting that the ventricle had no difficulty filling.

According to Dr. Maurer, the heart may not be the proximate cause of the syndrome, but rather it could be responding to conditions outside heart failure in patients with normal ejection fractions.

Craig LeMoult | EurekAlert!
Further information:
http://www.columbia.edu

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Challenging European Research Project to Develop New Tiny Microscopes

The Institute of Semiconductor Technology and the Institute of Physical and Theoretical Chemistry, both members of the Laboratory for Emerging Nanometrology (LENA), at Technische Universität Braunschweig are partners in a new European research project entitled ChipScope, which aims to develop a completely new and extremely small optical microscope capable of observing the interior of living cells in real time. A consortium of 7 partners from 5 countries will tackle this issue with very ambitious objectives during a four-year research program.

To demonstrate the usefulness of this new scientific tool, at the end of the project the developed chip-sized microscope will be used to observe in real-time...

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Researchers shoot for success with simulations of laser pulse-material interactions

29.03.2017 | Materials Sciences

Igniting a solar flare in the corona with lower-atmosphere kindling

29.03.2017 | Physics and Astronomy

As sea level rises, much of Honolulu and Waikiki vulnerable to groundwater inundation

29.03.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>