Mark Your Calendar
Focus on the Heart: Annual Cardiovascular Symposium
Feb. 26, 2016
Music City Center, Davidson Ballroom
Designed to meet the educational needs of primary care physicians, emergency room physicians, hospitalists, registered nurses and other healthcare professionals involved in the care and management of patients with cardiovascular disease. The symposium includes information and presentations that will allow participants to:
- Describe the evidence-based and emerging strategies to manage structural heart disease,
- Discuss the role of advanced cardiac imaging in the diagnosis and treatment of cardiovascular disease,
- List indications of novel pharmaceutical therapy to manage hyperlidemia and heart failure,
- Explain the clinical advantages to complex interventional cardiology and recent advances in coronary stents, and
- Describe the multi-disciplinary approach in cardio-oncology.
- Those interested in more information or registering, should go online to TriStarHealth.com/focusonheart or call 615.342.1919.
New Recs for Diagnosing Chest Pain in the ER
New recommendations from the American College of Cardiology and American College of Radiology have established appropriate use of diagnostic imaging for patients with chest pain, one of the most common reasons for emergency department visits.
The document addresses 20 fundamental clinical scenarios for emergency imaging for chest pain and assesses when imaging is useful in each case, and if so, what information is provided by the specified imaging procedure. The clinical scenarios are broken down into leading critical diagnoses: acute coronary syndrome, pulmonary embolism and acute aortic syndrome. There is a fourth category, triple rule out computerized tomography (CT), for the minority of patients for whom a leading diagnosis is not possible.
Using the well-established modified Rand methodology, an expert panel rated each of the diagnostic procedures for the 20 clinical scenarios on a scale from 1 to 9. Each procedure has a corresponding rating of “rarely appropriate,” “may be appropriate” or “appropriate.”
The paper published Jan. 22 in the Journal of the American College of Cardiology and the Journal of the American College of Radiology.
Broken UV Light Leads to Key Heart Muscle Cell Discovery
For a team of Vanderbilt investigators trying to generate heart muscle cells from stem cells, a piece of broken equipment turned out to be a good thing.
The faulty equipment pushed the researchers to try a different approach. They recently reported their new method — using a “Matrigel mattress” to rapidly generate cardiac cells suitable for heart disease studies and drug discovery — in the journal Circulation Research.
The new method addresses a problem researchers have had with cardiac muscle cells derived from human induced pluripotent stem cells. The stem cell-derived cardiac cells did not exhibit contractile properties similar to normal adult cardiac muscle cells, said Charles Hong, MD, PhD, and Björn Knollmann, MD, PhD, who collaborated to develop the new method.
The researchers believed the problem was that growing the cells on the usual glass or plastic surfaces didn’t allow them to mature into beating cardiac cells. Instead, they aimed to grow the cells on “a flexible substrate, to hopefully allow the cells to mature and contract, so that we could make measurements at the single-cell level,” said Hong, associate professor of Medicine.
The team had achieved some success toward this goal using synthetic substrates such as polyacrylamide, which requires exposure to ultraviolet light to form a gel substrate. Then the ultraviolet light was broken.
T.K. Feaster, PhD, who was a graduate student in the lab, decided to try a different type of gel — a natural matrix product called Matrigel. Matrigel is commonly used to culture cells, but it is usually diluted. Feaster decided to use undiluted Matrigel to create a cushiony “mattress” — his term — for the cells.
It worked. The stem cell-derived cardiac muscle cells grew on the Matrigel mattress with shape and contractile parameters that matched freshly isolated cardiac muscle cells, and they responded to drugs that increase the force of contraction.
The simplicity of the method makes it very attractive. “Now we can quickly and inexpensively generate these human cardiac myocytes and quantify contractile responses in single cells,” said Knollmann, professor of Medicine.
Nashville Hospitals Lead the Way on WATCHMAN™
Middle Tennessee cardiology programs have been early adopters of an implantable alternative to long-term warfarin medication for those with atrial fibrillation.
The WATCHMAN™ left atrial appendage closure device offers a stroke risk reduction option by closing off the left atrial appendage (LAA), limiting the passing of harmful blood clots from the LAA into the blood stream and potentially causing a stroke. By closing off the LAA, the risk of stroke is reduced and, over time, patients may be able to stop taking warfarin.
In early April 2015, Saint Thomas Heart cardiologist Drew Pickett, MD, performed the first WATCHMAN implant in Tennessee. When cardiologists at TriStar Centennial Heart & Vascular Center and at Vanderbilt Heart and Vascular Institute began implanting the device a couple of months later, they joined only about other 50 programs in the nation to offer the treatment option, which received FDA approval on March 13, 2015.
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