Heart Beat July 2013 Issue

Heart Beat: July 2013

Of the patients who die within 30 days of percutaneous coronary intervention (PCI), only 42 percent of them do so because of complications from the procedure, according to research by Cleveland Clinic’s Director of Endovascular Services, Mehdi Shishehbor, DO, MPH, and his team of investigators. PCI is a non-surgical procedure in which a balloon and/or stents are used to open blocked or narrowed arteries. The balloons and stents are delivered with a catheter. The research, published in the Journal of the American College of Cardiology, suggests that some alternative evaluations of patient outcome results be considered. “Outcomes reporting is a vital component of our shift toward accountable care and will be extremely valuable to patients and physicians,” Dr. Shishehbor says. “But we must ensure that we are reporting the right outcomes. If we attribute mortality incorrectly to PCI complications, this may lead to risk avoidance, meaning the sickest patients who would benefit the most from interventions—those presenting with heart attack and cardiac arrest—may not get the care they need.”

Consuming more fiber may decrease your chances of having a first-time stroke, according to research published recently in the American Heart Association (AHA) journal Stroke. The study found that for every seven-gram increase in total daily fiber consumption, the risk of first-time stroke decreases by seven percent. One serving of foods such as whole-wheat pasta and two servings of fruits and vegetables are equivalent to about seven grams of dietary fiber. Researchers noted that greater fiber intake can help offset stroke risks such as obesity, smoking and having hypertension. Study results were seen with total dietary fiber only. The AHA recommends that adults consume at least 25 grams of fiber daily. Six to eight servings of whole grains and eight to 10 servings of fruits and vegetables is usually enough to reach that target.

Cleveland Clinic researchers have found a way to use exhaled breath analysis to help determine whether a patient has heart failure. This non-invasive test of a patient’s unique breathprints appears to be able to distinguish between those with heart failure from those without. The test analyzes hundreds of volatile organic compounds  in the breath. Results of the research were published recently in the Journal of the American College of Cardiology. Further research is needed to determine the potential of breath analysis for heart failure identification, but Cleveland Clinic researchers are encouraged by their findings, says Raed Dweik, MD, a pulmonologist with the Respiratory Institute at Cleveland Clinic and lead investigator in the study. He adds that one ideal goal would be to use this type of diagnostic tool to help reduce the numbers of hospital re-admissions due to heart failure complications.

Aerobic fitness lowers mortality risk, even among older adults
Supplying further proof to the notion that “you’re never too old to start,” a new study shows that older adults who maintain high levels of aerobic fitness face lower mortality risks than those who are more sedentary. Researchers presenting their study at the American Society of Hypertension 2013 Scientific Sessions found that mortality rates were 37 percent lower among men 70 and older who were determined to have high levels of aerobic fitness, and 15 percent lower among those with moderate levels of aerobic fitness. The average follow-up in the study was nine years. The study included 2,077 men age 70 and older with hypertension. Researchers note that while age is associated with declines in aerobic fitness, muscle mass, strength and endurance, regular physical activity can minimize the effects of age-related changes in health and fitness. Researchers advise individuals who don’t exercise regularly to consult with their doctors before starting an exercise program, and to begin slowly. The key is to be active daily, but not at the expense of injuring yourself or overdoing it and putting your health at risk.

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