2012 Top 10 Advances in Heart Disease and Stroke Research: American Heart Association/American Stroke Association Top 10 Research Report

DALLAS, Dec. 17, 2012 (GLOBE NEWSWIRE) -- Resuscitation, cell
regeneration, a new high blood pressure treatment and developments in
devices for treating stroke are among the key scientific findings that
make up this year's top cardiovascular and stroke research identified
by the American Heart Association and American Stroke Association.

"At this time of year, it's gratifying to reflect on scientific
progress in the prevention and treatment of cardiovascular diseases and
stroke," said Donna Arnett, PhD, president of the American Heart
Association. "Cardiovascular disease research is truly helping people
lead longer, healthier lives and the American Heart Association is
pleased to be at the forefront of supporting, promoting and translating
many important discoveries into practice."

The association has been compiling an annual list of the top 10 major
advances in heart disease and stroke research since 1996.

The association's top research advances for 2012 include:

1. Extended CPR saves lives

The effect of the duration of CPR on meaningful recovery is uncertain.
A study of hospitals using the Get With The Guidelines-Resuscitation
quality improvement program found survival was higher for cardiac
arrest patients who received CPR for a longer amount of time. Patients
at hospitals with the longest median duration of 25 minutes for
resuscitation efforts had a 12 percent higher likelihood of being
revived compared with patients at hospitals with the shortest median
time of 16 minutes. Patients who survived after longer efforts did not
appear to have substantially worse neurological function vs. patients
who responded early. This study's unique findings raise critical
questions about resuscitation duration and have the potential to change
medical practice.

Goldberger, et al: Duration of resuscitation efforts and survival after
in-hospital cardiac arrest: an observational study. Lancet
380:1473-1481, 2012. www.thelancet.com.

Funding: American Heart Association, Robert Wood Johnson Foundation and
the NIH.

2. Converting "non-beating" heart cells into "beating" heart cells

Myogenesis (methods for growing new heart muscle) is an emerging
frontier, with promise that robust approaches can be found to replace
heart muscle lost or injured in heart attacks or other disorders, or
not appropriately formed as is the case with some types of congenital
heart disease.

Two studies showed methods for reprogramming readily available
"non-beating" heart muscle cells (non-cardiomyocytes) into "beating"
heart muscle cells (cardiomyocytes) that could be used to replace heart
cells and repair scarring.

Song, et al. Heart repair by reprogramming non-myocytes with cardiac
transcription factors. Nature 485:599-604, 2012. www.nature.com.
Funding sources are listed in the article.

Qian, et al. In vivo reprogramming of murine cardiac fibroblasts into
induced cardiomyocytes. Nature 485:593-598, 2012. www.nature.com.
Funding: NIH and Gladstone Institutes.

3. Biopsied heart cells improved heart function and reduced scars

Two human trials, each using different types of cells, showed that
cells from heart biopsies could be purified and replaced into the
patient's own heart, improving heart function and reducing scarring.

Bolli, et al. Cardiac stem cells in patients with ischaemic
cardiomyopathy (SCIPIO): initial results of a randomized phase 1 trial.
Lancet 378:1847-1857, 2011. www.thelancet.com. Funding: University of
Louisville Research Foundation and NIH.

Makkar. Intracoronary cardiosphere-derived cells for heart regeneration
after myocardial infarction (CADUCEUS): a prospective, randomized phase
1 trial. Lancet 379:895-902, 2012. www.thelancet.com.

Funding: NHLBI and Cedars-Sinai Board of Governors Heart Stem Cell

4. "Disconnecting" the kidneys might be the key to treating high blood

The sympathetic nervous system controls most of the body's internal
organs. A hyperactive sympathetic nervous system is believed to be a
major contributor to hypertension. Now, four studies conclude that
renal denervation — a procedure that reduces the functional connection
between the sympathetic nervous system and the kidneys — is safe and
effective at lowering high blood pressure resistant to other
treatments. Surgery is not required; instead a catheter delivers small
bursts of radiofrequency energy to ablate, or reduce, part of the
sympathetic nervous system's connection to the kidneys.

Vink EE and Blankestijn PJ (2012) Evidence and consequences of the
central role of the kidneys in the pathophysiology of sympathetic
hyperactivity. Front. Physio. 3:29. www.frontiersin.org/Physiology.
Funding: Dutch Kidney Foundation.

Symplicity HTN-1 Investigators. Symplicity Clinical Trial
Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension
Durability of Blood Pressure Reduction Out to 24 Months. Hypertension.
2011; 57: 911-917. Funding: Ardian, Inc. http://hyper.ahajournals.org.
Funding sources are listed in the article.

Ukena, et al. Effects of renal sympathetic denervation on heart rate
and atrioventricular conduction in patients with resistant
hypertension. Int J Cardiol.

Persu, et al. Renal denervation: ultima ratio or standard in
treatment-resistant hypertension. Hypertension. 2012 Sep;60(3):596-606.

Funding: no outside funding noted.

5. Progress for children in transplant bridging and Kawasaki Disease

Two studies found significant improvements for treating children with
heart disease. A study led by U.S. researchers highlights a new
procedure that dramatically extends the life of children under age 16
who are awaiting a heart transplant. Traditionally, these children
would have been placed on ECMO, an external device that helps deliver
oxygen-rich blood through the body when the heart is unable to. But a
smaller device called VAD (ventricular assist device) may buy time for
children awaiting transplant.

A second study conducted in Japan identified a new and highly effective
treatment to prevent coronary abnormalities in children suffering from
Kawasaki disease -- a rare but deadly autoimmune disease that causes
inflammation and long-term damage to the blood vessels.

Fraser CD, et al. Berlin Heart Study Investigators.

Funding: Prospective trial of a pediatric ventricular assist device. N
Engl J Med. 2012 Aug 9;367(6):532-41. www.nejm.org. Funding: Berlin
Heart and the FDA.

Kobayashi T, et al. RAISE study group investigators. Efficacy of
immunoglobulin plus prednisolone for prevention of coronary artery
abnormalities in severe Kawasaki disease (RAISE study): a randomised,
open-label, blinded-endpoints trial. Lancet. 2012 Apr
28;379(9826):1613-20. Epub 2012 Mar 8. PubMed PMID: 22405251.

Funding: Japanese Ministry of Health and Labour Sciences Research

6. Why children and adolescents should "just say no" to sugary drinks

Although we've known for years about the association between consuming
sugar-sweetened beverages and overweight and obesity, two clinical
trials this year provided definitive evidence. Both independently
concluded that reducing the consumption of sugar-sweetened beverages
reduces weight gain in children and adolescents. The studies are the
first-ever randomized controlled trials showing that calories from
sugar-sweetened beverages can harm children's health.

De Ruyter, Janne C. et al. A Trial of Sugar-free or Sugar-Sweetened
Beverages and Body Weight in Children, N Engl J Med 2012;
367:1397-1406October 11, 2012DOI: 10.1056/NEJMoa1203034. www.nejm.org.
Funding: Netherlands Organization for Health Research and Development,
the Netherlands Heart Foundation and the Royal Netherlands Academy of
Arts and Sciences.

Ebbeling Cara B. et al. A Randomized Trial of Sugar-Sweetened Beverages
and Adolescent Body Weight September 21, 2012, at NEJM.org. N Engl J
Med 2012;367:1407-16. DOI: 10.1056/NEJMoa1203388. www.nejm.org.

Funding sources are listed in the article.

7. Global impact: ECHO screening for rheumatic heart disease

Rheumatic heart disease is a major global health problem, especially in
Africa, Asia and the Pacific, affecting more than 15 million people. A
clinical trial done in Ugandan children showed that an echocardiogram
(ultrasound of the heart) is highly effective at screening for
rheumatic heart disease -- an inflammation of the heart valves that
occurs as a result of certain types of Streptococcus infections. In
this largest-ever screening trial of African children, the
echocardiogram detected three times as many cases of rheumatic heart
disease as the traditional use of the stethoscope only.

Beaton A, et al. Echocardiography screening for rheumatic heart disease
in Ugandan schoolchildren. Circulation. 2012 Jun 26;125(25):3127-32.
Epub 2012 May 24.

Funding: partial support from the World Bank.

8. Devices for stroke

This year marked several important developments in the use of medical
devices for treating stroke. The SOLITAIRE and TREVO devices were found
to more effectively clear blocked blood vessels in the brain than the
MERCI device, benefitting a significantly greater percentage of
patients. On the other hand, the CLOSURE trial found that devices that
closed small holes between the upper chambers of the heart (patent
foramen ovale) in certain stroke patients did not prevent subsequent
strokes any better than standard medical treatment.

Saver et al. Solitaire flow restoration device versus the Merci
Retriever in patients with acute ischaemic stroke (SWIFT): a
randomised, parallel-group, non-inferiority trial. Lancet
380:1241-1249. www.thelancet.com.

Funding: Covidien/ev3.

Nogueira, et al. Trevo versus Merci retrievers for thrombectomy
revascularisation of large vessel occlusions in acute ischaemic stroke
(TREVO 2): a randomised trial. Lancet 380:1231-1240, 2012.

Funding: Stryker Neurovascular.

Furlan, et al. Evaluation of the STARFlex Septal Closure System in
Patients with a Stroke and/or Transient Ischemic Attack due to Presumed
Paradoxical Embolism through a Patent Foramen Ovale (CLOSURE I). N Engl
J Med 2012;366:991-9. www.nejm.org.

Funding: NMT Medical, Boston.

9. Ideal cardiovascular health practices lead to longer life, lower

Two notable studies this year highlighted the huge impact lifestyle
factors can have in lowering heart disease and stroke risk and in
helping people extend their lives. People with "ideal cardiovascular
health," as measured by seven components -- health behaviors (not
smoking, regular exercise and healthy diet) and health factors (ideal
body mass index, cholesterol, blood pressure and blood glucose) had the
lowest risk.

Ford, et al. Ideal Cardiovascular Health and Mortality From All Causes
and Diseases of the Circulatory System Among Adults in the United
States. Circulation 2012, 125:987-995. www.circ.ahajournals.org.
Funding: Centers for Disease Control and Prevention.

Berry, et al. Lifetime Risks of Cardiovascular Disease. N Engl J Med
2012;366:321-9. www.nejm.org.

Funding: NHLBI.

10. Bypass surgery vs. drug-coated stents for diabetes patients

A large clinical trial found that patients with diabetes who had
multiple clogged heart arteries fared significantly better when treated
with bypass surgery vs. drug-coated stents. These patients were less
likely to die or have a heart attack within five years if they
underwent bypass surgery compared to treatment with drug-coated stents.
Patients like the ones studied represent about a quarter of all
patients undergoing heart procedures in catheterization labs. The study
suggests that bypass surgery should be considered an important
treatment option for such patients.

Farkouh, et al; the FREEDOM Trial Investigators. Strategies for
multivessel revascularization in patients with diabetes. N Engl J Med.
2012 Nov 4. [Epub ahead of print]. www.nejm.org.

Funding: NHLBI.

The American Heart Association/American Stroke Association receives
funding primarily from individuals; foundations and corporations
(including pharmaceutical, device manufacturers and other companies)
also make donations and fund specific association programs and events.
The association has strict policies to prevent these relationships from
influencing science content. Revenues from pharmaceutical and device
corporations are available at www.heart.org/corporatefunding.