Implantable Defibrillators Help Patients With Arrhythmogenic Right Ventricular Cardiomyopathy but. . .
Implantation of cardioverter-defibrillators in high-risk patients with arrhythmogenic right ventricular cardiomyopathy benefits them, according to a report in the present issue of Circulation (Circulation. 2004;109:1503–1508OpenUrl). A high risk of disease progression or lead-related morbidity requires careful placement and long-term observation of the necessary transvenous lead performance, said researchers from the University Hospital of Münster and Institute for Arteriosclerosis Research at the University of Münster in Germany.
In this single-center study led by Thomas Wichter, MD, 60 patients with arrhythmogenic right ventricular cardiomyopathy received transvenous implantable cardioverter-defibrillator systems. Lower R-wave amplitudes were achieved in these patients compared with others chosen as controls, although more right ventricular sites were tested for adequate lead positions. At 1, 3, 5, and 7 years, the implantable cardioverter-defibrillator showed an advantage for the patients treated. However, 53 adverse events occurred in 37 patients during the period immediately after treatment or during follow-up.
Ten Honored at American College of Cardiology Scientific Sessions
NEW ORLEANS, La—Ten cardiovascular physicians were honored at the American College of Cardiology (ACC) Scientific Sessions 2004 for outstanding achievements and contributions to the organization. Those honored included:
Joseph S. Alpert, MD
Joseph S. Alpert, MD, Professor of Medicine and Chair of the Department of Medicine at the University of Arizona Health Sciences Center in Tucson, accepted the ACC Gifted Teacher Award. Dr Alpert has mentored and supervised countless fellows in cardiology, many of whom have gone on to distinguish themselves as directors or chairs of divisions of cardiology. He continues to set teaching standards as a member of the ACC Publications Committee and the ACC/American Heart Association Consensus Conference on Ethics.
George A. Diamond, MD
George A. Diamond, MD, Regional Medical Director at Cedars-Sinai Medical Center, in Los Angeles, Calif, received the ACC Distinguished Service Award. Dr Diamond’s seminal work in the clinical diagnosis of coronary artery disease advanced the concept that a test’s diagnostic accuracy depends on the prevalence of disease conditions.
Francois M. Abboud, MD
Francois M. Abboud, MD, the Edith King Pearson Professor of Medicine at the University of Iowa College of Medicine in Iowa City, received the ACC Distinguished Scientist Award for basic science. Dr Abboud has contributed basic scientific discoveries with enormous potential for effectively battling cardiovascular disease through his discovery of evolutionary conserved mechanosensitive molecules and his work on the effects of gene transfer and transgenic mutations on the baroreflex mechanism.
Robert M. Califf, MD
Robert M. Califf, MD, Professor of Medicine and Vice Chancellor of Clinical Research at Duke University Medical Center, received the ACC Distinguished Scientist award for clinical science. Dr Califf is one of the pioneers of the Duke Database for Cardiovascular Disease and has significantly contributed to the Duke Clinical Research Institute. He has also served as an advisor to the National Institutes of Health and the US Food and Drug Administration.
Raymond J. Gibbons, MD
Raymond J. Gibbons, MD, was honored as the 2004 Distinguished Fellow. Dr Gibbons is a professor of medicine and the co-director of the nuclear cardiology lab at the Mayo Clinic in Rochester, Minn. He has held numerous College positions, including key posts chairing the Cardiovascular Imaging Committee, the Task Force on Practice Guidelines, the Committee to Revise the Exercise Testing Guidelines, and the Committee to Write Guidelines for the Management of Stable Angina.
Keyur H. Parikh, MD
Keyur H. Parikh, MD, of Care Cardiology Consultants in Ahmedabad, India, was honored for international service. Dr Parikh was born in East Africa, studied medicine in the United States, and after establishing a successful cardiology practice in San Francisco, uprooted himself to move to Ahmedabad, a city devoid of cardiology programs. He funded a catheterization laboratory and established a hospital with sophisticated cardiology programs.
Costas T. Lambrew, MD
Costas T. Lambrew, MD, Director Emeritus, Division of Cardiology, and Senior Consultant at Maine Medical Center in Portland, Ore, received the designation of Master of the American College of Cardiology in recognition of his long and distinguished career in cardiovascular medicine. A former trustee of the College, Dr Lambrew served on the ACC/AHA Task Force on Performance Measures and the subsequent writing groups for acute myocardial infarction and congestive heart failure. He championed the concept of the Cardiac Care Team, a new College membership category for registered nurses, nurse practitioners, clinical nurse specialists, and physician assistants.
William C. Roberts, MD, DSc
William C. Roberts, MD, DSc, Director of the Baylor Heart and Vascular Institute at Baylor University Medical Center in Dallas, Tex, was designated a Master of the American College of Cardiology. Dr Roberts has made extensive contributions to the ACC and other leading cardiovascular institutions. He is a leading advocate of aggressive measures to slow the atherosclerotic process.
David J. Sahn, MD
David J. Sahn, MD, Director of the Clinical Care Center for Congenital Heart Disease at the Oregon Health and Sciences Center in Portland, received the designation of Master of the American College of Cardiology in recognition of his long service as a fellow, educator, and thought leader. Dr Sahn is best known for advancing the collaboration between adult and pediatric cardiovascular specialists and working at the frontiers of physics and engineering to advance diagnostic imaging.
L. Samuel Wann, MD
L. Samuel Wann, MD, of the Wisconsin Heart and Vascular Clinic in Milwaukee, received the designation Master of the American College of Cardiology. In addition to his clinical and academic achievements, Dr Wann founded the Foundation for International Medical Exchange to improve cardiac care abroad. His leadership in advocacy has increased visibility of key issues and the need for long-term strategies. He also has served as a volunteer in the care of uninsured patients.
A Stem Cell Warning
Two reports appearing online March 21, 2004, in the journal Nature (www.nature.com) failed to find evidence that hematopoietic stems—the source of blood-related cells in the body—can become heart cells after injection in the myocardium. In one report, the researchers cautioned that ongoing studies using such cells may be premature and place patients at risk.
In one study, Charles E. Murry, MD, of the Department of Pathology at the University of Washington in Seattle, along with researchers from Indiana University, used cardiomyocyte-restricted and ubiquitously expressed reporter transgenes to track the fate of the stem cells after they had been transplanted 145 times in normal and injured mouse hearts.
In the second study (www.nature.com), Leora B. Balsam, MD, and colleagues from Stanford University School of Medicine in California isolated cells from transgenic mice expressing green fluorescent protein and injected them into the blood-starved myocardia of wild-type mice. After 10 days, the scientists found many cells lit by green fluorescent protein, but the cells disappeared after 30 days.
“These GFP1 cells did not express cardiac tissue–specific markers, but rather, most of them expressed the haematopoietic marker CD45 and myeloid marker Gr-1,” they wrote. They saw similar results when they studied the role of circulating cells in the repair of ischemic myocardium.
“Again, we found no evidence of myocardial regeneration from blood-borne partner-derived cells,” they wrote. “Our studies are a logical extension to previous studies suggesting that BM [bone marrow] cells contribute to myocardium after cardiac injury. . . . Our data are of particular importance given the fact that a variety of groups worldwide have initiated clinical trials of BM transplantation into ischaemic myocardium. Without additional preclinical experimental data, these studies are premature and may in fact place a group of sick patients at risk. At the very least, many more preclinical experimental data should be collected before such phenomena can be fully understood or clinically exploited.”
Weekly and Daily Alcohol Use May Protect Men With High Blood Pressure
Drinking lightly or moderately may reduce the risk of cardiovascular deaths among men with high blood pressure, said researchers from the University of Massachusetts Medical School at Worcester after an analysis of the data from 14 125 male physicians with high blood pressure but no history of cardiovascular diseases enrolled in the 20-year-old Physicians’ Health Study.
In a report that appears in the March 22, 2004, issue of the Archives of Internal Medicine, Maciej K. Malinski, MD, and colleagues noted that 1108 deaths, including 579 from cardiovascular disease, had occurred during follow-up, which averaged 5.4 years. In the study, 17% of men reported drinking alcohol only rarely or never; 11% reported drinking 1 to 3 drinks per month; 40% reported 1 to 6 drinks per week; and 32% reported drinking 1 or 2 drinks per day.
The authors noted that when compared with nondrinkers, the weekly and daily drinkers had a 28% and 27% reduced risk of death, respectively. There was a similarly reduced risk of death from cardiovascular disease, they wrote. Compared with those who drank rarely or were nondrinkers, those who drank weekly had a 39% lower risk of dying from cardiovascular disease, and those who drink daily had a 44% lower risk of cardiovascular disease death.
Although the researchers felt that the study results appeared clear, they cautioned, “In light of major clinical and public health problems associated with heavy drinking, recommendations regarding alcohol use must be made on an individual basis after carefully assessing cardiovascular risk profile and the risks and benefits of any changes in drinking behavior. However, patients with hypertension who are able to maintain light to moderate alcohol intake have no compelling reason to change their lifestyle and eliminate a possibly beneficial habit.”