American Heart Association

New Technologies Presented at the American Heart Association Meeting

November 13, 2008
by Lynn Shapiro, Writer
Synvista Therapeutics (Montvale, NJ) finds vitamin E is extremely helpful for some diabetics and has marketed a test to identify them.

Researchers Andrew Levy, MD and Shany Blum, MD, from the Technion Institute in Haifa, Israel, had already found that if a diabetic person tests positive for the HP-22 genotype, then taking 400 units of natural Vitamin E reduces that patient's risk for cardiovascular disease, Dr. Noah Berkowitz, CEO of Synvista, tells DOTmed News.

That is established science, Dr. Berkowitz says. The newest study says that if these patients stop taking Vitamin E, their risk of heart attack rises dramatically.

In a prospective study called CARE, individuals with diabetes who were age 55 or over, from 47 primary-care clinics in Israel underwent haptoglobin genotype testing and were randomized to receive either Vitamin E or placebo. (Haptoglobin in humans exists as three different proteins that arise from one of three haptoglobin gene combinations in the population.)

The patients were followed for three years to track heart attack, stroke and death (from cardiovascular disease and all causes). During the study, it was determined that those who had the Hp2-2 genotype and who also received Vitamin E had a drastically reduced incidence of MI compared to placebo. HDL function was also improved.

However, after only two months of stopping Vitamin E, HDL function had deteriorated to its level of dysfunction prior to the initiation of the study. Furthermore, in the 15-month period following the termination of the study, there was little difference in the incidence of heart attack in those Hp2-2 individuals who had received vitamin E (and stopped taking it at the end of the study) and those who received placebos.

Speaking of marketing his company's haptoglobin genotyping test, Dr. Berkowitz told DOTmed that, "right now, there is only one lab in the US that we have offered a license to, ARUP Laboratories in Salt Lake City.

"We're developing a kit that can be mass produced, which any hospital in the country can use, or that doctors can send a sample of, to many different labs. The kit is expected to receive FDA clearance in the next six months," Dr. Berkowitz says.

Patients who test positive for the haptoglobin HP-22 gene and are diabetic have up to a fivefold risk of having a heart attack or stroke over a long period of time compared to other diabetic patients, Dr. Berkowitz says. He adds that these patients should aggressively keep their diabetes under control. About 36 percent of diabetes patients in the US have the HP-22 genotype, he says.

Meanwhile, Synvista has another test in development that uses genotyping to assess the risk of cardiovascular disease and kidney disease.

Other highlights of this week's American Heart Association meeting follow:

GE Healthcare

Meanwhile, three new ultrasound devices are making their US debut this week, the company told AHA members. The Vivid E9 offers 4D imaging, opening the door to full cardiac studies. Vivid q adds quantitative analysis to portable excellence, bringing even more diagnostic confidence into the equation; while its intravascular ultrasound (ICE) imaging probe opens up an entirely new care area. All of these products are ready to take users and their patients in directions they can only dream of, the company says.

Diagnostic Cardiology

Among the new releases from GE's Diagnostic Cardiology business exhibited at AHA is EMR Gateway, an innovation that delivers electrocardiogram results and patient demographic data to virtually any electronic medical records (EMR) system. In addition, the company will unveil a new electrocardiograph system in MAC 1600, which will provide recording for advanced arrhythmia assessment. This advancement is designed to aid healthcare providers in appropriate treatment.

Cardiovascular Services

GE's Ultrasound Service team is set to announce the availability of AccoustiCare, a package including as many as four, fully covered, and transesophageal ultrasound probe repairs per year.

Each repair consists of genuine, upgraded OEM parts and results in a like-new, remanufactured transducer probe. GE's Interventional Service team for Hemodynamics and EP Recording Equipment, including Mac-Lab IT, CardioLab IT and ComboLab IT, will provide Proactive System Check-up and Patch Management coverage for hospitals needing optimal efficiency and security. This system check-up can improve network performance, prevent workflow interruption and keep the system performing at optimal levels, the company said.

Royal Philips Electronics

Philips unveiled a cardiograph technology that helps improve detection of heart problems, including specific coronary artery obstructions, damaged heart muscle and abnormal rhythms.

On display at the AHA meeting, the new Philips PageWriter TC70 cardiograph, featuring Philips unique DXL16-Lead ECG Algorithm, may help clinicians deliver faster diagnosis and treatment during heart attacks, while also supporting door-to-balloon (speed) and hospital quality products.

12-Lead EKG is Upgraded

While limb and chest leads have been traditional components of the 12-lead ECG, it has long been recognized that additional electrodes can provide information that is poorly or not seen at all on a traditional 12-lead ECG, says Joris van den Hurk, vice president of cardiology programs for Philips Healthcare.

The standard 12-lead ECG has a blind spot on the right side of the patient's chest that limits the ability to detect right ventricular myocardial infarction. (MI), which Philips may not have detected with a 12-lead ECG, says Debbie Heinecke, RN, manager of non-invasive cardiology at Blessing Hospital in Quincy, IL, an early user of the new technology. Philips' new DXL Algorithm technology addresses this issue by using electrodes placed on the right side to provide incremental capabilities not available with previous programs.

Gender-specific Criteria for Women's Heart Health

Women often present cardiac symptoms differently from men and have a higher mortality rate from cardiovascular disease.

Confirming Philips' commitment to developing technologies for women's health, the DXL algorithm applies new gender, age and lead-specific STEMI (ST-segment Elevation Myocardial Infarction) criteria to detect acute MI in women as well as men.

A widespread pattern of ST depression often reflects global ischemia due to left main coronary obstruction, multi-vessel obstructions, or microvascular disease, which is more prevalent in women.

The DXL Algorithm incorporates new criteria for these conditions and provides a "Critical Value of Global Ischemia" to highlight when prompt intervention may be needed. The new algorithm also builds upon Philips' long use of gender and age-specific criteria, left ventricular hypertrophy and prolonged QT interval.

Philips PageWriter TC70 Cardiograph provides innovative platform for new DXL Algorithm

In addition, the PageWriter TC70 cardiograph not only incorporates the new DXL Algorithm, but also improves workflow and enables faster clinical decision-making making.

ECG reports are quickly taken and transferred to the TraceMasterVue ECG management system with the click of a single button. Bedside decision-making is enhanced with the automatic retrieval of the previous ECG, allowing for immediate clinical serial comparison.

The new PageWriter includes technologies that are especially useful in the Emergency Room, where ECG reports can highlight test results that may warrant immediate clinical attention. When used with the DXL 16-Lead Algorithm, the PageWriter TC70 provides a powerful tool to reduce a hospital's door-to-balloon times.

Improved Technology for STEMI Diagnosis and Management

There is increasing interest within the Emergency Room in managing STEMI often seen in the early stages of a heart attack. Incorporating new criteria based on recent scientific discoveries, the Philips DXL Algorithm's STEMI-CA criteria examines the lead distribution for ST elevation to identify the artery that is most likely to harbor an obstruction (the culprit artery). Patented ST Maps that show the spatial orientation of STEMI provide an easier perception of the ischemic areas. Using these data, clinicians can quickly decide which treatments are in order.

In addition to being available within the PageWriter TC70 cardiograph, the DXL Algorithm will also be integrated into additional Philips products to help improve diagnosis, Philips said.

Read other news and abstracts from the meeting: