Hypothermia remains effective in cardiac arrest patients with preexisting cardiomyopathyNovember 15, 2011
"While it is well established that therapeutic hypothermia is neuroprotective and increases survival in resuscitated cardiac arrest patients without cardiomyopathy, we sought to determine whether catastrophic outcomes in cardiac arrest patients with preexisting cardiomyopathy are avoidable," said Michael R. Mooney, MD, a cardiologist at the Minneapolis Heart Institute® at Abbott Northwestern Hospital in Minneapolis and physician researcher with Minneapolis Heart Institute Foundation.
From February 2006 to July 2010, Mooney and his colleagues enrolled 192 consecutive cardiac arrest patients who remained unresponsive following return of spontaneous circulation in a therapeutic hypothermia protocol, regardless of initial rhythm, hemodynamic status or prior medical history. They hypothesized that there would be a high prevalence of preexisting cardiomyopathy in this patient population, and therapeutic hypothermia would confer similar neurologic and survival benefit compared to non-cardiomyopathy patients.
Of the 192 patients, 43.8 percent had preexisting cardiomyopathy, of which ischemic was the most common type (41.7 percent). Patients with preexisting cardiomyopathy were older (65.7 years vs. 61.7 years) and more likely to be male (83.3 vs. 63.9 percent).
The majority presented in ventricular fibrillation/ventricular tachycardia (75 percent and 70.4 percent) in both the cardiomyopathy and non-cardiomyopathy groups. There was a higher prevalence of concurrent STEMI in the cardiomyopathy group (27 vs. 18.5 percent), which was not statistically significantly. Cardiogenic shock was more prevalent in the cardiomyopathy group (54.8 vs. 28.7 percent).
While the cardiomyopathy groups were slightly higher, the survival between the two groups (52.4 vs. 51.9 percent) and survival with favorable neurologic outcome, defined by Cerebral Performance Category 1 or 2, (46.4 vs. 49.1 percent), were similar. They found that survival with favorable neurologic outcome in cardiomyopathy patients with cardiogenic shock was 34.8 percent, compared with 45.2 percent in non-cardiomyopathy cardiogenic shock patients.
"The incidence of preexisting heart dysfunction in this observational study is alarming. In general, we need to employ a more careful surveillance and improve our adherence to the clinical guidelines, as less than 50 percent of patients who currently qualify for automatic implantable cardioverter-defibrillators actually receive them," Mooney said. "A great deal more research is warranted in assessing this patient population."
Minneapolis Heart Institute Foundation
Related Cardiomyopathy Current Events and Cardiomyopathy News Articles
Sticky gel helps stem cells heal rat hearts
A sticky, protein-rich gel created by Johns Hopkins researchers appears to help stem cells stay on or in rat hearts and restore their metabolism after transplantation, improving cardiac function after simulated heart attacks, according to results of a new study.
Just 1 in 10 are referred for cardiac rehab after treatment for heart failure
Only 1 in 10 heart failure patients is referred to a cardiac rehabilitation program after being hospitalized, despite strong evidence that such exercise programs improve quality of life and reduce the likelihood of future hospitalizations.
Cheaper, faster, more accurate test to identify gene defects in heart patients
Stanford researchers design cheaper, faster, more accurate test to identify gene defects in heart patients
Moderate drinking in later years may damage heart
Drinking two or more alcoholic beverages daily may damage the heart of elderly people, according to research in the American Heart Association journal Circulation: Cardiovascular Imaging.
Even Olympic athletes have cardiac abnormalities and may be at risk of CVD
Even athletes whose performance and fitness are at the very highest level may have life-threatening cardiovascular abnormalities.
Gene therapy clips out heart failure causing gene mutations
Gene therapy can clip out genetic material linked to heart failure and replace it with the normal gene in human cardiac cells, according to a study led by researchers from the Cardiovascular Research Center at Icahn School of Medicine at Mount Sinai. The study is published in the April 29 edition of Nature Communications.
Oil or fat?
Olive oil is universally considered a much healthier alternative to meat fat. Plant-derived oils (such as olive oil, canola oil, and vegetable oil) largely consist of unsaturated fatty acids, whereas animal fat is richer in the saturated ones.
Heart cells regenerated in mice
When a heart attack strikes, heart muscle cells die and scar tissue forms, paving the way for heart failure. Cardiovascular diseases are a major cause of death worldwide, in part because the cells in our most vital organ do not get renewed.
Treatment outlook for adults with hypertrophic cardiomyopathy move from grim to good
Newly published research led by the Minneapolis Heart Institute Foundation (MHIF) and Tufts Medical Center in Boston shows that implantable defibrillators (ICDs), along with other modern treatments, have reduced mortality rates and are helping patients with hypertrophic cardiomyopathy (HCM) live longer, including normal life expectancy.
In chronic heart failure, monitoring calcitriol may help prevent death
In patients with chronic heart failure, the vitamin D metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D), also called calcitriol, and its ratio to parathyroid hormone (PTH 1-84) may help predict cardiovascular death; and patients with decreased calcitriol and decreased ratio of calcitriol to PTH might benefit from more aggressive supplementation, a new study finds.
More Cardiomyopathy Current Events and Cardiomyopathy News Articles