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 Obstructing the ‘inner eye’
07.07.2017 | Friedrich-Schiller-Universität Jena

nachricht Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington

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: Manipulating Electron Spins Without Loss of Information

Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.

For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...

Im Focus: The proton precisely weighted

What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.

To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...

Im Focus: On the way to a biological alternative

A bacterial enzyme enables reactions that open up alternatives to key industrial chemical processes

The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....

Im Focus: The 1 trillion tonne iceberg

Larsen C Ice Shelf rift finally breaks through

A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...

Im Focus: Laser-cooled ions contribute to better understanding of friction

Physics supports biology: Researchers from PTB have developed a model system to investigate friction phenomena with atomic precision

Friction: what you want from car brakes, otherwise rather a nuisance. In any case, it is useful to know as precisely as possible how friction phenomena arise –...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Closing the Sustainability Circle: Protection of Food with Biobased Materials

21.07.2017 | Event News

»We are bringing Additive Manufacturing to SMEs«

19.07.2017 | Event News

The technology with a feel for feelings

12.07.2017 | Event News

 
Latest News

NASA looks to solar eclipse to help understand Earth's energy system

21.07.2017 | Earth Sciences

Stanford researchers develop a new type of soft, growing robot

21.07.2017 | Power and Electrical Engineering

Vortex photons from electrons in circular motion

21.07.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>