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New cardiology research presented at CHEST 2008


(Tuesday, October 28, 10:30 AM EST)

Patients receiving donated lungs may develop arrhythmias, including atrial fibrillation. Researchers from Baylor College of Medicine in Texas reviewed the charts of all lung transplant recipients in 2006 and 2007. Of the 75 patients who underwent lung transplant, 38 percent developed arrhythmias within 30 days of transplantation. The most common arrhythmia was atrial fibrillation, followed by atrial flutter. Researchers speculate that the donor-derived tissue (atrial cuff or pulmonary vein) is a likely source of the arrhythmias passed to lung recipients.


(Tuesday, October 28, 10:30 AM EST)

New research shows that the erectile dysfunction drug, tadalafil, may be an effective adjunct therapy for patients with pulmonary arterial hypertension (PAH). Italian researchers randomized 405 patients with PAH, of whom 53 percent were taking concomitant bosentan, to two study arms. The groups received either tadalafil or placebo orally once daily as monotherapy or as add-on therapy to bosentan. Compared with placebo, tadalafil, 40 mg, increased 6-minute walk distance, delayed the time to clinical worsening, and improved six of the eight short form (SF)-36 domains. In addition, tadalafil, 40 mg, increased cardiac output and reduced pulmonary artery pressures and pulmonary vascular resistance compared with baseline. Discontinuation due to adverse events was low (11 percent for tadalafil vs. 16 percent for placebo). Researchers conclude that tadalafil may provide an effective oral, once-daily therapy that can be combined with bosentan therapy for patients with PAH.


(Tuesday, October 28, 1:00 PM EST)

Difficulty falling asleep may be associated with a lower risk of hypertension than researchers once believed. Researchers from the University of Kentucky proposed the hypothesis that insomnia would predict hypertension, particularly among African-Americans. Data were analyzed from 1,419 older individuals with a mean age of 73.4 years who were not hypertensive at baseline. Researchers found that difficulty falling asleep, alone or in combination with other sleep complaints, predicted a significantly reduced risk of incident hypertension for men who were not African-American over a 6-year period of follow up. Furthermore, insomnia complaints did not predict hypertension in women or in African-Americans, although there may not have been enough power to show a significant association for African-Americans.


(Tuesday, October 28, 1:00 PM EST)

Hospitalized patients who undergo repeated in-hospital CPR have a high mortality rate. Researchers from Western Pennsylvania Hospital in Pittsburgh reviewed the charts of 151 patients, aged 25 to 99 years, who underwent CPR as a consequence of cardiopulmonary arrest. Out of these patients, only 16 (eight men and eight women) required repeated CPR after the first successful attempt. None of these patients survived to the time of hospital discharge. Researchers suggest that patients who are seriously ill, as well as their families, should be well informed regarding the expected outcome of multiple in-hospital resuscitation events.


(Wednesday, October 29, 10:30 AM EST)

Female hospital staff members have more difficulty performing adequate chest compressions (CC) than male hospital staff. Researchers from Albert Einstein College of Medicine in New York compared the CC technique of 28 male and 30 female medical housestaff using a patient simulator, before and after CC training. Subjects also went through a posttraining endurance test where they attempted to perform adequate CC for 120 seconds or until fatigue prevented further effort. Prior to training, 50 percent of the male group performed adequate CC, while none of the female group performed adequate CC. Post-training, 89 percent of the male group performed adequate CC and 37 percent of the female group performed adequate CC. There was no correlation between body mass index and adequate CC in either group, however taller females performed better CC than shorter females. Regardless of gender, only 14 percent of subjects were able to maintain adequate CC for 120 seconds, the recommended guideline for one cycle of compressions.


(Wednesday, October 29, 1:00 PM EST)

The use of MP3 players may be an effective way for physicians to improve their recognition of the different types of heart murmurs. In a new study by researchers at Temple University School of Medicine, 255 general internists took a pretest consisting of five heart murmurs played in random order. They then listened to audio files of five basic murmurs on an MP3 player, while viewing posters with phonocardiograms of each sound. The audio files consisted of 200 repetitions of each of the five murmurs played during a single 30-minute session. All participants took a posttest consisting of the same murmurs played in a random order. The murmurs used in the training session were simulated heart sounds, while the murmurs used for both the pretest and posttest were human heart sounds. Participants' correct answers improved from 53.2 on the pretest to 78.9 on the posttest.


(Wednesday, October 29, 1:00 PM EST)

Despite increased awareness of pulmonary arterial hypertension (PAH), the disease is being diagnosed later and in women who are reaching middle age, according to research from Baylor College of Medicine in Texas. The researchers looked at data from the current REVEAL registry compared with the original National Institutes of Health registry, the French Registry, and a large, single-center US registry. The REVEAL registry confirms that in the 21st century, the US population of patients with PAH is older (mean age of 48), with a higher female preponderance of PAH (4:1) than reported previously. In addition, despite increased awareness of PAH, the time from symptoms to diagnosis has increased by 10 months.


(Wednesday, October 29, 1:00 PM EST)

Published reports have shown that Asian-Indians have a higher rate of coronary heart disease than other ethnic groups, and their small arteries may be to blame. Researchers from Jamaica Hospital Medical Center in New York explored the differences in the sizes of coronary arteries between Asian-Indians, Caucasians, and African-Americans (n=273). Results showed that ethnic group significantly predicted the diameter of all arteries. Even after controlling for other risk factors, the left anterior descending and left circumflex arteries were significantly smaller in Asian-Indians than other ethnic groups.


Contact: Jennifer Stawarz
American College of Chest Physicians

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