Myths about atypical heart attack symptoms for women squashed

Quashing the myth that women tend to have 'atypical' symptoms during a heart attack, a new study has found that the women who suffer heart attacks show identical key symptoms as men.
The study published  emphasised the need for both sexes to recognise and act on the warning signs.

"Our concern is that by incorrectly labelling women as having atypical symptoms, we may be encouraging doctors and nurses not to investigate or start treatment for coronary heart disease in women," said a cardiology research nurse  and first author of the study.

"Both men and women present with an array of symptoms, but our study shows that so-called typical symptoms in women should always be seen as a red flag for a potential heart attack," she added.

Researchers recorded the symptoms of people attending the Emergency Department (ED) at Edinburgh Royal Infirmary who had a blood test called a troponin test.

This test is used when doctors suspect a person is having a heart attack and measures a protein released by damaged heart cells during a heart attack.

Between 1st June 2013 and 3rd March 2017, doctors in the ED ordered the troponin test for 1,941 people. Of these people, 274 were diagnosed as having a type of heart attack known as an NSTEMI (90 women and 184 men). This is the most common type of heart attack and occurs when the coronary artery is partially blocked.

Chest pain was the most common symptom for both men and women, with 93 per cent of both sexes reporting this symptom. A similar percentage of men and women reported pain that radiated to their left arm (48 per cent of men and 49 per cent of women).

More women had pain that radiated to their jaw or back and women were also more likely to experience nausea in addition to chest pain (33 per cent vs 19 per cent).

Less typical symptoms such as epigastric pain (heartburn), back pain, or pain that was burning, stabbing or similar to that of indigestion were more common in men than women (41 per cent in men vs 23 per cent in women).

Previous research has suggested that women and men report different heart attack symptoms. However, the symptoms were often recorded after a heart attack diagnosis was confirmed, which may introduce bias.

This study aimed to avoid this by asking an independent research nurse to interview and record the symptoms of all patients arriving at the ED with a possible heart attack before they were given a diagnosis.

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Researchers fabricates device for early diagnosis of heart attack

The microfluidic device can detect the biomarker even at low concentrations

A cardiac biomarker — cardiac troponin I — that is widely used for early diagnosis of acute heart attack can now be detected in about three minutes and even when present at very low concentration. And the detection can be done at bedside. This has become possible with the development of a microfluidic device by a team of researchers from the Indian Institute of Technology (IIT) Hyderabad.

The heart cells that get damaged during heart attack cause the expression of cardiac muscle proteins such as the biomarker cardiac troponin I, which get released into the blood. Detecting the biomaker in the blood serum helps in early diagnosis of heart attack.

Superior performance

Commercially available assays have limitations in terms of both sensitivity and time taken for detection. These assays cannot detect when the biomarker is present at concentrations below 0.02 nanogram per ml and take a long time for detection. In contrast, the microfluidic device developed by the team can detect the biomarker even when the concentration is as low as 0.005 nanogram per ml.
“Our device can detect the biomarker over a wide range — from 0.005-100 nanogram per ml,” says  the Prof. Serum samples from patients were used for testing the device. 



Commercially available assays as well the microfluidic device use the same antibody to bind to the biomarker. But the way the device has been constructed makes the difference in terms of better sensitivity and rapid detection.

Rapid detection

The researchers have successfully integrated the microfluidic device with chitosan-coated nickel vanadate nanospheres to enable rapid detection and better sensitivity.

The outer surface of the nanospheres is first coated (functionalised) with the antibody that binds to the biomarker. Since the nanospheres have greater surface area, more antibodies are present on the surface thus increasing the chances and ability to bind to the biomarker. The functionalised nanospheres are then coated on the working electrode that is present in the microfluid device chip.

“The integration of the nanospheres which detect the biomarker with the compact microfluidic device speeds up the detection process,” says one of the researcher.

“When the patient’s serum is introduced into the microfluidic device, the biomarker present in the serum binds to the antibodies present on the nanospheres. This causes a change in the current flow at a microamphere level,” explains Prof. “The electrochemical response of the sensor changes in response to a change in the concentration of the troponin I biomarker causing a change in the current flow.”

Bedside device

Since the microfluidic device can be made tiny, detection of the biomaker can be made right at bedside.

“This is a proof-of-concept work. We have to undertake large trials involving many patient samples before it can be used commercially,” says the Prof. 

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Genetic therapy heals damage caused by heart attack

Scientists have developed a gene therapy that can induce heart cells to regenerate and repair the damage caused by a heart attack.

Myocardial infarction, more commonly known as a heart attack, caused by the sudden blocking of one of the cardiac coronary arteries, is the main cause of heart failure.
 

The condition affects over 23 million population in the world, according to the WHO.

At present, when a patient survives a heart attack, they are left with permanent structural damage to their heart through the formation of a scar, which can lead to heart failure in the future, according to the researchers.

"It is a very exciting moment for the field. After so many unsuccessful attempts at regenerating the heart using stem cells, which all have failed so far, for the first time we see real cardiac repair in a large animal," said a researcher.

In the study,  researchers delivered a small piece of genetic material, called microRNA-199, to the heart of pigs, after a myocardial infarction which resulted in the almost complete recovery of cardiac function at one month later.

This is the first demonstration that cardiac regeneration can be achieved by administering an effective genetic drug that stimulates cardiac regeneration in a large animal, with heart anatomy and physiology like that of humans.

"It will take some time before we can proceed to clinical trials," the researcher said in a statement.

"We still need to learn how to administer the RNA as a synthetic molecule in large animals and then in patients, but we already know this works well in mice," he said.

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Heart cells can be monitored with minimal disruption now

Engineers have demonstrated an electronic device to closely monitor beating heart cells, or cardiomyocytes, without affecting their behaviour. Inside each of us beats a life sustaining heart. 

Unfortunately, the organ is not always perfect and sometimes goes wrong. One way or another research on the heart is fundamentally important to us all.

When researchers study cardiomyocytes in action they culture them on hard petri dishes and attach rigid sensor probes. These impede the cells’ natural tendency to move as the sample beats, so observations do not reflect reality well,” said one of the researcher.

Our nanomesh sensor frees researchers to study cardiomyocytes and other cell cultures in a way more faithful to how they are in nature. The key is to use the sensor in conjunction with a flexible substrate, or base, for the cells to grow on, he said. For this study, researchers used a healthy culture of cardiomyocytes derived from human stem cells.

 

 

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The fine mesh sensor is difficult to place perfectly. This reflects the delicate touch necessary to fabricate in the first place, he said. The researcher believe that the device could aid the study of other cells, organs and medicines.

neers have demonstrated an electronic device to closely

Read more at:
https://ahmedabadmirror.indiatimes.com/others/you/heart-cells-can-be-monitored-with-minimal-disruption-now/articleshow/67340650.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Engineers have demonstrated an electronic device to closely

Read more at:
https://ahmedabadmirror.indiatimes.com/others/you/heart-cells-can-be-monitored-with-minimal-disruption-now/articleshow/67340650.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Scientists control heart cells with laser

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In a first, scientists have found a way to control the behaviour of heart muscle cells using laser radiation - paving the way to develop better understanding of the heart's mechanisms to treat conditions like acute arrhythmia which is responsible for causing one in eight deaths globally.

 "Right now, this result may be very useful for clinical studies of the mechanisms of the heart and in the future, we could potentially stop attacks of arrhythmia in patients at the touch of a button," said study co-author Konstantin Agladze from the Moscow Institute of Physics and Technology.

In order to study the heart disorder, Agladze's team created "arrhythmia in vitro", using azoTAB (azobenzene trimethylammonium bromide) whose molecule consists of two benzene rings connected by a bridge of two nitrogen atoms. 
If the molecule is irradiated with UV light, the benzene rings change position relative to one another, they "fold" and under the influence of visible light, the rings return to their original configuration. 

An azoTAB molecule can, therefore, exist in two states -- switching between them under the influence of radiation.

The team "taught" the azoTAB molecules to control cardiomyocytes so that one configuration did not prevent voluntary contractions (passive), and the other (active) "deactivated" contractions. 

Using a device similar to a projector, but with a laser instead of a lamp, the scientists created at each point the required concentration of the active form of azoTAB. 

This enabled them to control the cardiomyocytes in each specific point of the heart. 

The experiment, detailed in the journal PLOS ONE, showed that the effect of azoTAB on a cell is reversible. 

This means that the results of the experiments can be used in research and clinical practice, which could potentially lead to an effective treatment for arrhythmia.