February 15, 2000
BEEN THERE, DONE THAT
When Ruth Ann Bar, R.N., tells her patients she knows what they're going through — she really means it. After six heart surgeries, she can honestly tell her pediatric cardiology patients at UAB, "Been there, done that. You're going to be okay." Bar, an R.N. who recently began working as a pediatric cardiology nurse at UAB Hospital, was diagnosed at birth with tetralogy of Fallot with pulmonary atresia, a complex congenital anomaly in which there are multiple abnormalities in the heart. In Bar's case, one of those abnormalities was that part of her pulmonary artery, the artery that carries oxygenated blood to the lungs, was missing. Doctors told her parents she had a 10 percent chance of living. By what can only be called a miracle, she said, she survived. Now, she uses her experiences in the hospital to help others like her survive.
PICK UP THE PACE
If you are one of the more than 1 million Americans with a pacemaker, you may need to have your doctor pick up its pace before beginning an exercise regimen. Most pacemakers are designed for older people — those who typically aren't very active and whose heart rates typically don't exceed 120 beats per minute. Such a low setting can cause rapid fatigue in men who exercise, says UAB cardiologist G. Neal Kay, M.D. A pacemaker's maximum heart rate should be 220 minus your age — and a doctor can quickly adjust a pacemaker with a wireless "remote-control" type of device.
NEW THERAPY FOR HEART FAILURE
Just in time for Heart Failure Awareness Week (February 14-18), Robert C. Bourge, M.D., director of UAB's cardiovascular disease division, and UAB researchers are beginning a study on an innovative therapy for advanced heart failure intended to make a sick heart beat more effectively. If successful, the new heart resynchronization therapy — which uses a tiny, implanted device just below the skin — could augment medication in treating the debilitating symptoms of heart failure. Without major surgery, local cardiologists will use the implanted device to deliver electrical impulses that stimulate the left and right chambers of the patient's heart to beat in a synchronized fashion.
THE SKINNY ON LOW-CARB DIETS
Unfortunately, the latest low-carbohydrate fad diets are not all that they are beefed up to be. There are many health risks associated with a high-protein, low-carb diet, and an increase in the risk of heart disease is one of the biggest. A low-carb, low fiber diet is usually high in animal protein, cholesterol and saturated fat, says Kathy Hubbert, R.D., director of UAB's Eat Right program. Hubbert says all three raise serum cholesterol, particularly LDL or "bad" cholesterol. Elimination of high-carb, high-fiber plant foods that help lower cholesterol compounds this problem. High meat intake may excessively increase homocysteine levels and iron stores in the body, and there is growing evidence that high levels of both may increase the risk of heart disease.
START SMART FOR A HEALTHY HEART
With so much information on healthy hearts these days, it is sometimes hard to know where prevention begins. Antioxidants? Cholesterol? Diet? Exercise? Reduce risks? Although all of these are extremely important when it comes to adult prevention, convincing children and adolescents to lead healthy lives is the best place to start. Convincing them to avoid the smoking habit is probably the most important health message we can give, said Bonnie Sanderson, RN, Ph.D., manager of UAB's cardio-pulmonary rehabilitation facility. Teaching them to eat healthy and stay active follow in line. Primary prevention is a major priority, Sanderson said, and this is achieved by emphasizing the formulation of favorable habits from early childhood on — since it is much more difficult to change habits later in life.
STUDY TO PROBE EXERCISE BARRIERS
The availability of safe streets, walking trails, working hours and family-care responsibilities can all affect our ability to stay physically active, according to Bonnie Sanderson, Ph.D., R.N., manager of cardiopulmonary rehabilitation at UAB. She has joined other researchers in the CDC-funded Women's Cardiovascular Health Network in a study that looks in to factors that may impact physical activity among minority women. Sanderson and her team will focus on barriers to physical activity among rural, African-American women. She feels that the multi-site trial looking into physical activity patterns among minority women will provide data for potential policy and environmental changes that will help reduce the barriers. The Robert Wood Johnson Foundation (RWJF) is funding the two-year study.
SHOCKER CLEAR …
It's what you always hear on TV medical dramas just before the patient's heart is shocked back in to motion. But a recent study showed that implantable defibrillators, the tiny portable "shockers" that jolt a struggling heart back into a regular rhythm, reduce the risk of sudden cardiac death in high-risk patients with coronary disease. And, the tiny defibrillators greatly outperformed medicines in warding off cardiac arrest. The study involved 704 patients at 85 hospitals, including the University of Alabama at Birmingham. More than 1 million patients have heart problems similar to those in the study.
BEATING THE CLOCK ON HEART ATTACK
Five million adults arrive each year at the nation’s emergency departments with chest pain. Some 487,000 died of heart attacks in 1999; half within the first hour of the onset of symptoms. "'Time is muscle' is not just a medical myth,” says UAB cardiologist John Canto, M.D., medical director of the UAB Chest Pain Unit. “There is a direct relationship between time and myocardial salvage." UAB Hospital was the first in Alabama routinely to use state-of-the-art technology called myocardial nuclear perfusion imaging (MPI) in an emergency setting to help diagnose heart attacks as they occur.
HEREDITY AND HEART DISEASE
Although you can’t get around some hereditary factors that may predispose you to heart disease, you can control others by modifying your habits. “If you have a family history of cardiovascular disease or hypertension, and if you have one of the five or six genes researchers believe may contribute to hypertension, you probably will develop the condition regardless of your lifestyle,” says Suzanne Oparil, M.D., UAB cardiologist and past president of the American Heart Association. “If you have heart disease, members of your family may also be at risk. You can reduce your risk for heart disease or heart attack. Adopt a healthy lifestyle and follow your doctor’s advice. Eat low-fat, low-cholesterol foods, exercise together and stop smoking.”
MRI TO DIAGNOSE HEART DISEASE
Diagnosing heart disease can be costly, risky and time-consuming. The newest and most remarkable approach for non-invasive diagnosis is magnetic resonance imaging (MRI), according to UAB cardiologist Gerald Pohost, M.D. "MRI provides the highest quality images of the heart and blood vessels as well as information about the biochemical function of the heart. It has already replaced more conventional tests. MRI uses a sophisticated whole-body magnet to give physicians a better picture of the heart and the presence of heart disease. Within the next two years, Pohost predicts that MRI will be used to predict heart attacks, replace coronary angiograms, assess heart function and to evaluate other cardiac disorders.