Showing posts with label Heart. Show all posts
Showing posts with label Heart. Show all posts
Tuesday, December 24, 2013
California family celebrates 3 heart transplants
SAN MARCOS, California — Deanna Kremis remembers the exhilarating day her young sons first had the energy to race each other up a flight of stairs.
The brothers, then ages 7 and 10, could barely walk before having heart transplants just a month apart. As they flew up the steps two at a time, jostling and shouting, she recalled, “my friend turned to me and said, ‘Are YOU ready to get one now?’”
It was a joke that became prophesy. Her health, too, was slipping away because of the same inherited cardiac condition. By the time she received her own transplant in July, her heart was so weak she fainted while walking down the hall, collapsed mid-sentence and passed out in the middle of dinner at a friend’s house.
Her decline was terrifying for her sons, who were just beginning to embrace their lives with donor hearts and now saw their worst memories reflected in their mother’s struggle. All three have hypertrophic cardiomyopathy, a genetic condition that causes the heart muscle to thicken until it can’t pump properly. Kremis’ mother and brother also have it, as did her grandmother.
“We just didn’t like seeing her go through the pain and stuff,” said Trevin, now 13. “We knew what it felt like.”
The 44-year-old stay-at-home mom for this family of five now finds herself in the unusual position of getting advice on post-transplant life from her sons while coordinating a never-ending regimen of pills and doctor’s appointments that has become her fulltime job. She also homeschools Trevin, who struggles with severe osteoporosis from the anti-rejection medicine he takes daily.
In the daily whirlwind, she still worries about her sons, who are thriving but face the constant threat of organ rejection and infection. Matthew has been hospitalized once for rejection and Trevin had eight fractures in one year from his osteoporosis. A third son — her eldest — and her husband are healthy.
“It’s just really hard seeing your babies go through anything. They’re amazing,” she said, holding back tears. “My goal was to get in and out of the hospital faster than them and I didn’t quite make it. And for them not to worry. I didn’t want them to worry about me. They’re my No. 1 priority.”
It’s not unheard of to have more than one transplant in one family when a genetic condition is involved, but the triple-transplant Kremises are a rarity even in the world of advanced cardiac specialty medicine.
Hypertrophic cardiomyopathy affects up to 600,000 people in the U.S. alone and is a leading cause of sudden death among young athletes, said Dr. Gregory Perens, one of the boys’ pediatric cardiologists at Mattel Children’s Hospital UCLA.
Many don’t have symptoms until there is a strain on the heart, while others experience shortness of breath and chest pain but have a milder version that can be controlled through medication and a pacemaker. A parent who carries the gene has a 50 percent chance of passing it along.
“For most families even having one child or one parent going through a transplant is a very big deal,” Perens said. “So to have three is an extraordinary amount of work.”
Still, the family never stops thinking about the anonymous donors who gave them all a second chance. After his transplant, the family would find Trevin crying quietly, worried about the family who had lost a child so he could live.
“I’ll take anything to feel the way I feel now,” said Kremis. “We’ve been blessed, just blessed, as a family and you live every day as best you can.”
The trio’s shared cardiac history is in plain sight around their house in suburban San Diego County, from the color-coded plastic bins that hold their prescriptions to the identical chest scars. Medical bills with eye-popping sums pour in for Kremis’ recent transplant and the family is still paying off the boys’ treatment six years later.
The family moved from Arizona to live with Kremis’ parents in San Marcos so they could to be close to the pediatric cardiology team at UCLA. Kremis’ husband, Richard, landed a job with AT&T. They have decent insurance, but with a high deductible, so that the boys can stay with the same specialists who oversaw the transplants.
“Has it affected our family? Yeah, but it’s just life,” said Kremis. “It doesn’t make our problems worse than anyone else’s. It just means when it comes, you just deal with it and you move on.”
Deanna Kremis’ grandmother, a no-nonsense outdoorswoman from Alaska, wasn’t diagnosed with the condition until she was in her early 70s. When Kremis was pregnant, her grandmother told Kremis to get her children’s hearts checked before they played sports — but said nothing more.
Her first son was healthy but when Matthew was born, doctors said he wouldn’t live past age 10. The family had to learn CPR just to take him home. His lips and nail beds were blue and his skin was so pale the veins in his chest and stomach popped through “like a see-through kid,” his mother said.
“They just told us to take him home and cherish him,” she said. “He’s been on medicine since the day he was born and he’s still on meds. It’s been his whole life.”
Doctors checked Trevin for the condition in utero, at birth and then every three years. The tests were negative until he turned six.
Within a year, Trevin needed a transplant — just as Matthew’s health spiraled out of control.
“We didn’t really know the extent to what it was in our family until after. We didn’t know how it affected siblings and how many siblings would be affected. You know, we just didn’t know any of that,” Kremis said, brushing away tears.
Donor hearts don’t last forever, but doctors haven’t given the trio a life expectancy. The Kremises prefer to focus on the future.
Matthew, now a high school senior, will study auto mechanics at a trade school next year. Trevin skateboards and has a passion for rebuilding electronics and repairing motorbikes. And the boys love dirt-biking with their father and older brother — a hobby their doctors don’t like, but haven’t forbidden.
“How many people can say that they’ve been through what I’ve been through and go ride dirt bikes for fun? There’s not a lot of people like me and my family,” said Matthew Kremis.
“It’s really part of what makes my family so awesome. All we really have is each other.”
source: business.inquirer.net
Wednesday, February 22, 2012
'Biological clock' is linked to heart attacks
Ventricular arrhythmia, or abnormal heartbeat, occurs most frequently after waking in the morning -- and also to a lesser degree in the evening hours -- and causes a high number of deaths.
Reporting in the journal Nature, researchers in the United States said they had uncovered the first molecular link between this risk and circadian rhythm, the term by which biological processes vary according to a 24-hour period.
The finger points at levels of a protein called Klf15, they said.
Previous research has found Klf15 to be a circadian controller -- and, startlingly, is also lacking among some patients with heart failure.
The team created mice that had been genetically engineered to either lack Klf15 or make the protein excessively.
In both cases, the rodents had a much higher risk of arrythmias compared to normal counterparts.
"It is the first example of a molecular mechanism for the circadian change in susceptibility to cardiac arrhythmias," said Xander Wehrens of Baylor College School of Medicine in Houston, Texas.
"If there was too much Klf15 or none, the mice were at risk for developing the arrhythmia."
Klf15 is only one step in a complex molecular cascade, the researchers believe.
It controls another protein, KChIP2, which affects potassium-generated electrical current that flows though heart muscle cells called cardiac myocytes.
When levels of KChIP2 fluctuate, this causes electrical instability in the myocytes.
As a result, the heart muscle's action becomes impaired and it takes longer (or conversely, less time) to empty the ventricle -- the heart's pumping chamber. The heart loses the regularity of the beat and labours to pump blood efficiently.
Co-author Mukesh Jain of the Case Western Reserve University School of Medicine in Cleveland, Ohio said that further work could well uncover other circadian-related causes.
The discovery opens up intriguing paths of research, in pinpointing individuals at risk of nocturnal death and devising drugs to shield them, Jain added. — Agence France Presse
source: gmanetwork.com
Reporting in the journal Nature, researchers in the United States said they had uncovered the first molecular link between this risk and circadian rhythm, the term by which biological processes vary according to a 24-hour period.
The finger points at levels of a protein called Klf15, they said.
Previous research has found Klf15 to be a circadian controller -- and, startlingly, is also lacking among some patients with heart failure.
The team created mice that had been genetically engineered to either lack Klf15 or make the protein excessively.
In both cases, the rodents had a much higher risk of arrythmias compared to normal counterparts.
"It is the first example of a molecular mechanism for the circadian change in susceptibility to cardiac arrhythmias," said Xander Wehrens of Baylor College School of Medicine in Houston, Texas.
"If there was too much Klf15 or none, the mice were at risk for developing the arrhythmia."
Klf15 is only one step in a complex molecular cascade, the researchers believe.
It controls another protein, KChIP2, which affects potassium-generated electrical current that flows though heart muscle cells called cardiac myocytes.
When levels of KChIP2 fluctuate, this causes electrical instability in the myocytes.
As a result, the heart muscle's action becomes impaired and it takes longer (or conversely, less time) to empty the ventricle -- the heart's pumping chamber. The heart loses the regularity of the beat and labours to pump blood efficiently.
Co-author Mukesh Jain of the Case Western Reserve University School of Medicine in Cleveland, Ohio said that further work could well uncover other circadian-related causes.
The discovery opens up intriguing paths of research, in pinpointing individuals at risk of nocturnal death and devising drugs to shield them, Jain added. — Agence France Presse
source: gmanetwork.com
Wednesday, February 15, 2012
Paris study: Air pollution tied to higher heart attack risk
Breathing in dirty air may be linked to a higher chance of suffering a heart attack a few days afterward, according to a French analysis of past studies.
Researchers led by Hazrije Mustafic from the Paris Cardiovascular Research Center found that heart attacks were slightly more common at high levels of every main pollutant except ozone, the group reported in the Journal of the American Medical Association.
They looked at 34 studies comparing the risk of suffering a heart attack, or myocardial infarction, at various levels of inhaling industrial and traffic-related air pollutants including carbon monoxide, nitrogen dioxide and very small soot-like particles.
The reports included anywhere from about 400 to more than 300,000 people, with heart attacks that were confirmed in hospital records and disease and death registries.
"All the main air pollutants, with the exception of ozone, were significantly associated with a near-term increase in myocardial infarction risk," they wrote.
For most of the pollutants, an increase in concentration of 10 micrograms per cubic meter of air – the typical standard used to assess harm, and barely noticeable to a person breathing the air – was associated with a one to three percent increase in the chance of having a heart attack in the next week.
"Even if the relative risks are low compared with traditional risk factors such as smoking status or hypertension or diabetes, in fact everybody is exposed to air pollution in industrialized countries," Mustafic told Reuters Health, so even small effects can add up.
When people inhale polluted air, small particles can reach the tiny sacs in the lungs and be carried in the bloodstream to the heart, she said.
Pollutants may also affect blood vessels' ability to expand and contract in order to keep blood pressure constant -- an effect that researchers blame for increasing evidence that high-pollution days are also tied to a person's risk of suffering a stroke.
"If you put together the evidence, clearly day-to-day changes in particle concentration do make a very small but significant difference in terms of increasing susceptibility for cardiovascular events," said Sanjay Rajagopalan, who studies pollution and cardiovascular health at The Ohio State University in Columbus.
"This seems to be particularly so for individuals with pre-existing heart disease," he told Reuters Health, adding that at-risk people should minimize exposure to pollutants as much as possible. — Reuters
source: gmanetwork.com
Researchers led by Hazrije Mustafic from the Paris Cardiovascular Research Center found that heart attacks were slightly more common at high levels of every main pollutant except ozone, the group reported in the Journal of the American Medical Association.
They looked at 34 studies comparing the risk of suffering a heart attack, or myocardial infarction, at various levels of inhaling industrial and traffic-related air pollutants including carbon monoxide, nitrogen dioxide and very small soot-like particles.
The reports included anywhere from about 400 to more than 300,000 people, with heart attacks that were confirmed in hospital records and disease and death registries.
"All the main air pollutants, with the exception of ozone, were significantly associated with a near-term increase in myocardial infarction risk," they wrote.
For most of the pollutants, an increase in concentration of 10 micrograms per cubic meter of air – the typical standard used to assess harm, and barely noticeable to a person breathing the air – was associated with a one to three percent increase in the chance of having a heart attack in the next week.
"Even if the relative risks are low compared with traditional risk factors such as smoking status or hypertension or diabetes, in fact everybody is exposed to air pollution in industrialized countries," Mustafic told Reuters Health, so even small effects can add up.
When people inhale polluted air, small particles can reach the tiny sacs in the lungs and be carried in the bloodstream to the heart, she said.
Pollutants may also affect blood vessels' ability to expand and contract in order to keep blood pressure constant -- an effect that researchers blame for increasing evidence that high-pollution days are also tied to a person's risk of suffering a stroke.
"If you put together the evidence, clearly day-to-day changes in particle concentration do make a very small but significant difference in terms of increasing susceptibility for cardiovascular events," said Sanjay Rajagopalan, who studies pollution and cardiovascular health at The Ohio State University in Columbus.
"This seems to be particularly so for individuals with pre-existing heart disease," he told Reuters Health, adding that at-risk people should minimize exposure to pollutants as much as possible. — Reuters
source: gmanetwork.com
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