Articles related to Cardiology, Interventional

The FDA has granted clearance for Casana’s Heart Seat™ toilet seat to be used in homes for monitoring heart rate and oxygen saturation (SpO2) in adults aged 22 and above, weighing between 90 and 350 pounds. The toilet seat is equipped with sensors that can measure these vital signs and transmit the data to the Casana Cloud automatically. Healthcare providers can then access the data generated by three sensors: a ballistocardiogram, which measures heart mechanical activity; an electrocardiogram, which measures heart electrical activity; and a photoplethysmogram, which detects blood volume changes. A study assessing the accuracy of the seat demonstrated consistent measurements of blood pressure, stroke volume, and blood oxygenation compared to a hospital-grade vital signs monitor. Casana intends to conduct further testing and plans to submit an application to the FDA this year to include additional clinical measurements, such as blood pressure monitoring. The Heart Seat is expected to be available by the end of 2023.

In this video, Zack Shinar, MD, discusses the future of cardiac arrest and the role of extracorporeal membrane oxygenation (ECMO) in the emergency department (ED). Dr. Shinar is a leading expert in ECMO and has been instrumental in developing new protocols for its use in the ED. Dr. Shinar begins by discussing the current state of CPR. He notes that CPR is only effective in about 10% of cases, and that even when it is successful, patients often suffer significant brain damage. He then discusses ECMO, which is a life-support machine that can oxygenate the blood outside of the body. ECMO has been shown to be effective in saving the lives of patients with cardiac arrest, and Dr. Shinar believes that it should be used more widely in the ED. Dr. Shinar then discusses the challenges of using ECMO in the ED. He notes that ECMO is a complex procedure that requires specialized training and equipment. He also notes that ECMO can be expensive, and that it is not always available in all hospitals.

Clinicians are directed to the American College of Cardiology/American Heart Association pooled cohort equation, which takes into account age, gender, blood pressure, lipids, diabetes mellitus, and tobacco use but not family history. The USPSTF now advises against starting aspirin therapy in individuals 60 and older since there is no net benefit and the risk of damage may outweigh the benefit. The USPSTF guidelines are based on evidence from 13 trials, which show that aspirin has a slight advantage for select adults aged 40 to 59, but no net benefit (with the potential for harm) for patients aged 60 and older.

Phosphodiesterase-5 inhibitors (PDE5i) have been found to reduce the risk of major adverse cardiovascular events in men with both coronary artery disease (CAD) and erectile dysfunction (ED), with tadalafil showing greater cardiac benefits compared to sildenafil, according to a study presented at the American Urological Association’s annual meeting. The retrospective study analyzed over 41,000 men with CAD and ED and found that those who took tadalafil or sildenafil had significantly lower 5-year risks of heart failure, myocardial infarction, and overall mortality compared to those who received no PDE5i treatment. Tadalafil recipients had even lower risks than sildenafil recipients across all categories. The study suggests that understanding the specific differences among PDE5i medications is crucial for addressing cardiac outcomes in patients with ED and CAD, with tadalafil potentially offering superior benefits due to differences in pharmacokinetics and longer duration of efficacy. However, further research is needed before definitive conclusions can be made regarding preferential prescription of tadalafil over other PDE5i medications.

In a randomized, double-blind, repeated crossover trial that involved almost 1,500 individuals with stage II hypertension, researchers found significant variation in individual responses to different antihypertensive treatments, particularly for lisinopril versus hydrochlorothiazide, lisinopril versus amlodipine, candesartan versus hydrochlorothiazide, and candesartan versus amlodipine. The study highlights the need for personalized antihypertensive therapy as there is substantial heterogeneity in blood pressure response to drug therapy for hypertension. The researchers recommend further studies to identify the mechanisms behind these individual differences to enable personalized antihypertensive therapy in routine clinical practice. This study’s findings underscore the importance of considering individualized treatment approaches for hypertension management to achieve optimal outcomes.

The Organ Transplant and Procurement Network (OTPN) is set to undergo modernization and improvement after being criticized for lack of transparency, long waits, mishandling of organs, and the number of people who die on the waitlist each year. The Health Resources and Services Administration (HRSA) has launched the OTPN modernization project, which will focus on accountability. The current system is outdated and has been responsible for 70 deaths between 2010 and 2020, according to a 2022 senate report. The HRSA plans to take steps, such as creating a new dashboard, to provide transparency and better serve patients and their families. Additional modernization will focus on overhauling the operations of the OTPN system to ensure higher compliance and a greater focus on patient safety. Organ transplants and the OTPN disproportionately affect the Black community in the US. About 30% of the ONTP waitlist is Black Americans, and about 90% are waiting for kidney transplants. The HRSA’s plan hopes to address the inequality by improving accountability, transparency, and systems of organ retrieval and matching. The changes will benefit patients, and physicians might be able to see more of their patients receive the life-saving transplants they need.