Hypothermia remains effective in cardiac arrest patients with preexisting cardiomyopathyNovember 15, 2011
Cardiomyopathy is common among cardiac arrest survivors. The survival and neuroprotective benefits of therapeutic hypothermia is similar in patients with preexisting cardiomyopathy, compared with those patients without cardiomyopathy, according to a scientific poster being presented Nov. 14 at the at the American Heart Association (AHA) scientific sessions in Orlando, Fla. Therefore, the researchers recommended the use of therapeutic hypothermia in patients with the preexisting condition.
"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
Is endurance training bad for you?
In 2012, Belgium scientists published a study that concluded that repeated bouts of intensive endurance exercise at the elite level may result in the pathological enlargement of the right ventricle, which, according to the article, is associated with potential health hazards including sudden cardia death.
New study uncovers mechanisms underlying how diabetes damages the heart
Cardiac complications are the number one cause of death among diabetics. Now a team of scientists has uncovered a molecular mechanism involved in a common form of heart damage found in people with diabetes.
Heart failure patients have improved outcomes following investigational stem cell treatment
An investigational stem cell therapy derived from patients' own blood marrow significantly improved outcomes in patients with severe heart failure, according to a study from the Cedars-Sinai Heart Institute.
Stem cell therapy improves outcomes in severe heart failure
A new stem cell therapy significantly improved long-term health outcomes in patients with severe and end-stage heart failure in a study presented at the American College of Cardiology's 65th Annual Scientific Session.
New device for heart failure patients fails to improve primary outcomes
A new implantable medical device intended to help patients with heart failure by stimulating the vagus nerve did not significantly reduce rates of heart failure-related hospitalization or death from any cause in a study presented at the American College of Cardiology's 65th Annual Scientific Session.
Pioneering discovery leads to potential preventive treatment for sudden cardiac death
More than 15 years ago, David Warshaw, Ph.D., and coworkers discovered the precise malfunction of a specific protein in the heart that leads to hypertrophic cardiomyopathy, a common culprit in cases of sudden death in young athletes.
Gene-editing technique successfully stops progression of Duchenne muscular dystrophy
Using a new gene-editing technique, a team of scientists from UT Southwestern Medical Center stopped progression of Duchenne muscular dystrophy (DMD) in young mice.
TGen and Barrow identify genes linked to stress-triggered heart disease
Researchers at the Translational Genomics Research Institute (TGen) and Barrow Neurological Institute have for the first time identified genetic risk factors that are linked to stress-induced cardiomyopathy (SIC), a rare type of heart disease.
Manipulating cell signaling for better muscle function in muscular dystrophy
Every heart beat and step in our daily lives is dependent on the integrity of muscles and the proteins that keep them strong and free of injury as they contract and relax.
Targeted chemotherapy shows early signs of slowing tumor growth with less toxicity
Surviving neuroblastoma as a child can come with just as many challenges as the cancer itself, mainly because of the toxic effects of chemotherapy.
More Cardiomyopathy Current Events and Cardiomyopathy News Articles