Feeling lightheaded upon standing up due to initial orthostatic hypotension (IOH), or a transient decrease in blood pressure and increase in heart rate, is a common but poorly understood condition. A new study offers two simple cost- and drug-free techniques to effectively manage symptoms of IOH and improve quality of life by activating lower body muscle before or after standing. The research appears in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier.
Syncope, lightheadedness, dizziness, or loss of consciousness from IOH affects up to 40% of the general population (all ages), while presyncope is probably even more common. Despite this, the condition is relatively understudied and there is minimal information available about the underlying mechanisms or symptom management and treatment. Currently, there are very few options available to patients with IOH and no pharmacological treatments. The most common recommendations have been to stand up slowly or sit up first before standing.
“Almost everyone has probably experienced some lightheadedness at some time after standing up,” explained lead investigator Satish R. Raj, MD, MSCI, FHRS, Professor of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. “For some people this is a frequent occurrence and may happen several times a day, which can be very frightening and negatively impact their quality of life.
“We wanted to explore this further and provide novel and effective symptom management techniques with the goal of improving the IOH patient’s quality of life,” added Dr. Raj.
This study investigated physical maneuvers before or after standing and their efficacy in reducing the drop in blood pressure as well as the symptoms typically seen in IOH patients upon standing. Study participants included 24 young women (mean age 32 ± 8 years) with a high burden history of fainting immediately after standing and more than four episodes of presyncope or syncope per month. The study participants were required to have a significant drop in systolic blood pressure of at least 40mmHg upon standing to fulfill the diagnostic criteria of IOH on the study day. Two participants had inadequate heart rate recordings and were excluded from the analysis.
Twenty-two study participants completed three sit-to-stand maneuvers including a stand with no intervention (control), and two interventions. Researchers found that both lower body muscle preactivation (thighs) through repeated knee raises prior to standing (PREACT) and lower body muscle tensing (thighs and buttocks) through leg crossing and tensing immediately after standing (TENSE) effectively improve the blood pressure drop. This led to a reduction in symptoms upon standing. They found that the PREACT maneuver accomplished this by increasing cardiac output, while the TENSE maneuver did so by increasing stroke volume.
Release date: 09 February 2022
Source: Elsevier
Increased infectivity, antibody escape drive SARS-CoV-2 evolution
First announced by the World Health Organization on Nov. 26, 2021, the SARS-CoV-2 omicron variant spread rapidly around the world, becoming the dominant variant in the U.S. and elsewhere. Now, researchers report in ACS Infectious Diseases and the Journal of Chemical Information and Modeling that omicron and other variants are evolving increased infectivity and antibody escape, according to an artificial intelligence (AI) model. Therefore, new vaccines and antibody therapies are desperately needed, the researchers say.
Understanding how SARS-CoV-2 evolves is essential to predicting vaccine breakthrough and designing mutation-proof vaccines and monoclonal antibody treatments. In a recent study in ACS Infectious Diseases, Guo-Wei Wei and colleagues analyzed almost 1.5 million SARS-CoV-2 genome sequences taken from people with COVID-19. They identified 683 unique mutations in the receptor binding domain (RBD), the region of the SARS-CoV-2 spike protein that attaches to the human ACE2 receptor on the surface of human cells. Then, they used an AI model to predict how these mutations affect binding strength of the RBD to ACE2 and to 130 antibody structures, including several monoclonal antibodies used as therapies. The team found that mutations to strengthen infectivity are the driving force for viral evolution, whereas in highly vaccinated populations, mutations that allow the virus to escape vaccines become dominant. The researchers also predicted that certain combinations of mutations have a high likelihood of massive spread. Journal of Journal of Chemical Information and Modeling.
Release date: 16 February 2022
Source: American Chemical Society
Heart attack survivors may be less likely to develop Parkinson’s disease
Research Highlights:
People who have had a heart attack may be slightly less likely than people in the general population to develop Parkinson’s disease later in life, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed Journal of the American Heart Association.
Parkinson’s disease is a brain disorder characterized by progressive loss of physical movement, including tremors, slow or slurred speech, and/or stiffness or limited range of motion for walking and other physical activities. There is no cure for Parkinson’s disease, and it is also associated with behavioral changes, depression, memory loss and fatigue. Secondary parkinsonism, which has symptoms similar to Parkinson’s disease, may be caused by stroke, psychiatric or cardiovascular medications, or other illness.
The researchers examined health registries from the Danish National Health Service. They compared the risk of Parkinson’s disease and secondary parkinsonism among about 182,000 patients who had a first-time heart attack between 1995 and 2016 (average age 71 years old; 62% male) and more than 909,000 controls matched for age, sex and year of heart attack diagnosis. The results were adjusted for a variety of factors known to influence the risk of either heart attack or Parkinson’s disease.
Release date: 16 February 2022
Source: American Heart Association
Antibodies improve in quality for months after COVID-19 vaccination
For at least six months after COVID-19 vaccination, antibodies produced by immune cells become steadily more formidable and more precisely targeted against the virus that causes COVID-19, according to a study of the antibody response to the Pfizer-BioNTech vaccine by researchers at Washington University School of Medicine in St. Louis.
The idea that antibodies increase in quality as they decrease in quantity will come as no surprise to immunologists. The process was described in animals by Washington University immunologists Herman Eisen, MD, and Gregory Siskind, MD, in 1964. But this study, published in Nature, is the first to track the maturation of the antibody response in detail in people.
The findings suggest that declining antibody levels in the months after vaccination primarily represent a shift to a sustainable immune response. Producing vast quantities of antibodies burns a lot of energy. The immune system cannot sustain such a high level of activity indefinitely, so it gradually switches to producing smaller amounts of more powerful antibodies.
Even quite low levels of antibodies would continue to provide some protection against disease, the researchers said — as long as the virus doesn’t change.
Immune cells that produce antibodies are from the B cell family. Following the B cell response through all of its stages — from initiation through peak antibody production to the emergence of memory cells that can quickly churn out new antibodies the next time the body encounters the same virus — requires repeatedly taking samples from parts of the body that can be hard to access. At different stages in the process, key members of the B cell family are located in the blood, the lymph nodes and the bone marrow. Getting B cells from the lymph nodes is technically challenging and involves using ultrasound to locate minuscule immune structures called germinal centers within the lymph nodes. Obtaining a sample of bone marrow involves inserting a needle into the pelvic bone.
Release date: 15 February 2022
Source: Washington University School of Medicine
High levels of hazardous chemicals found in Canadian nail salons
Researchers at the University of Toronto’s Dalla Lana School of Public Health, in collaboration with Parkdale Queen West Community Heath Centre and the Healthy Nail Salons Network, have found that nail technicians in discount salons are exposed to several chemicals widely used as plasticizers and flame retardants.
The study, published this week in the journal Environmental Science & Technology, found that exposure to some hazardous chemicals was higher among nail technicians than among electronic waste workers.
The study reported higher exposures of several phthalate plasticizers, which was expected given the use of these chemicals in personal care products. One phthalate plasticizer, DEHP, which is not allowed for use in cosmetics under the Canadian Environmental Protection Act, was found at low levels.
However, the researchers did not expect to find high levels of flame retardants that are not known to be used in personal care products.
Several of the chemicals studied have some restrictions on their use (or restrictions are proposed) under the Canadian Environmental Protection Act. Yet, most of these chemicals are not explicitly regulated in Ontario workplaces. The specific source of these chemicals in nail salons was not determined in the study.
The chemicals in question have been associated with adverse health effects, including neurological and reproductive effects, with some evidence that in utero exposure may be important.
Release date: 14 February 2022
Source: University of Toronto
COVID-19 vaccination boosts mental health along with immunity
Getting vaccinated for COVID-19 measurably improved the psychological well-being of participants in the Understanding Coronavirus in America study, a large longitudinal look at the impact of the pandemic on individuals in the United States. Vaccination was associated with declines in distress and perceived risks of infection, hospitalization, and death. The study, appearing in the American Journal of Preventive Medicine, published by Elsevier, validates the intuitive but previously unanswered questions of whether becoming vaccinated reduces perceived risks associated with COVID-19, and whether the reduction of these fears leads to improvements in mental health and quality of life.
Psychologic distress and anxiety increased sharply across the population following the onset of the COVID-19 pandemic. Several factors contributed, such as widespread job and income loss, food insecurity, social isolation, caregiving burdens, substance abuse, and racialized discrimination. Depressive symptoms persisted and increased into 2021 for those experiencing an accumulation of stress exposures. Not surprisingly, many individuals are also experiencing anticipatory fears that contribute to rising mental health problems.
Data from a nationally representative study of 8,090 adults who were interviewed regularly between March 2020 and June 2021 revealed declines in COVID-related risk perceptions and psychological distress following vaccination. Specifically, adults who received at least one dose of the COVID-19 vaccine between December 2020 and June 2021 reported a 7% relative reduction in mental distress, as measured using the Patient Health Questionnaire 4 (PHQ-4) distress scores, from average levels in the survey period immediately prior to vaccination.
Reductions in distress were partially explained by declining risk perceptions following vaccination. Becoming vaccinated was associated with a 7.77 percentage point decline in perceived risk of infection, a 6.91 percentage point decline in perceived risk of hospitalization, and a 4.68 percentage point decline in perceived risk of death. Adjusting for risk perceptions decreased the vaccination−distress association by 25%.
Release date: 15 February 2022
Source: Elsevier
Exercise post-vaccine bumps up antibodies
Researchers at Iowa State University found 90 minutes of mild- to moderate-intensity exercise directly after a flu or COVID-19 vaccine may provide an extra immune boost.
In the newly published study, participants who cycled on a stationary bike or took a brisk walk for an hour-and-a-half after getting a jab produced more antibodies in the following four weeks compared to participants who sat or continued with their daily routine post-immunization. The researchers found similar results when they ran an experiment with mice and treadmills.
Antibodies are essentially the body’s “search and destroy” line of defense against viruses, bacteria, fungi and parasites. Vaccines help the immune system learn how to identify something foreign and respond by bolstering the body’s defenses, including an increase in antibodies.
“Our preliminary results are the first to demonstrate a specific amount of time can enhance the body’s antibody response to the Pfizer-BioNtech COVID-19 vaccine and two vaccines for influenza,” said Kinesiology Professor Marian Kohut, lead author of the paper published in the journal Brain, Behavior, and Immunity.
The researchers said the study’s findings could directly benefit people with a range of fitness levels. Nearly half of the participants in the experiment had a BMI in the overweight or obese category. During 90 minutes of exercise, they focused on maintaining a pace that kept their heart rate around 120–140 beats per minute rather than distance.
In the study, the researchers also tested whether participants could get the same bump in antibodies with just 45-minutes of exercising. They found the shorter workout did not increase the participants’ antibody levels. Kohut said the research team may test whether 60 minutes is enough to generate a response in a follow-up study.
Release date: 11 February 2022
Source: Iowa State University
Feeling dizzy when you stand up? Simple muscle techniques can effectively manage symptoms of initial orthostatic hypotension
Feeling lightheaded upon standing up due to initial orthostatic hypotension (IOH), or a transient decrease in blood pressure and increase in heart rate, is a common but poorly understood condition. A new study offers two simple cost- and drug-free techniques to effectively manage symptoms of IOH and improve quality of life by activating lower body muscle before or after standing. The research appears in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier.
Syncope, lightheadedness, dizziness, or loss of consciousness from IOH affects up to 40% of the general population (all ages), while presyncope is probably even more common. Despite this, the condition is relatively understudied and there is minimal information available about the underlying mechanisms or symptom management and treatment. Currently, there are very few options available to patients with IOH and no pharmacological treatments. The most common recommendations have been to stand up slowly or sit up first before standing.
“Almost everyone has probably experienced some lightheadedness at some time after standing up,” explained lead investigator Satish R. Raj, MD, MSCI, FHRS, Professor of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. “For some people this is a frequent occurrence and may happen several times a day, which can be very frightening and negatively impact their quality of life.
“We wanted to explore this further and provide novel and effective symptom management techniques with the goal of improving the IOH patient’s quality of life,” added Dr. Raj.
This study investigated physical maneuvers before or after standing and their efficacy in reducing the drop in blood pressure as well as the symptoms typically seen in IOH patients upon standing. Study participants included 24 young women (mean age 32 ± 8 years) with a high burden history of fainting immediately after standing and more than four episodes of presyncope or syncope per month. The study participants were required to have a significant drop in systolic blood pressure of at least 40mmHg upon standing to fulfill the diagnostic criteria of IOH on the study day. Two participants had inadequate heart rate recordings and were excluded from the analysis.
Twenty-two study participants completed three sit-to-stand maneuvers including a stand with no intervention (control), and two interventions. Researchers found that both lower body muscle preactivation (thighs) through repeated knee raises prior to standing (PREACT) and lower body muscle tensing (thighs and buttocks) through leg crossing and tensing immediately after standing (TENSE) effectively improve the blood pressure drop. This led to a reduction in symptoms upon standing. They found that the PREACT maneuver accomplished this by increasing cardiac output, while the TENSE maneuver did so by increasing stroke volume.
Release date: 09 February 2022
Source: Elsevier
Poor sleep can triple risk for heart disease
Individual aspects of poor sleep can be detrimental to heart health. But if you combine them, the risk of heart disease can increase by as much as 141 percent. That’s the finding of a new study published in the journal Scientific Reports.
The University of South Florida-led study reviewed sleep data of 6,820 U.S. adults with an average age of 53 who self-reported their sleep characteristics and heart disease history. Among the participants, 633 also wore a research device (actigraphy) around their wrist that captured sleep activity.
Researchers focused on multiple aspects of sleep health, such as regularity, satisfaction, alertness during waking hours, timing of sleep, sleep efficiency and sleep duration and linked them to physician-diagnosed heart disease. They found that each additional increase in self-reported sleep health problems was associated with a 54 percent increased risk of heart disease. The estimated risk of heart disease associated with an increase in sleep health problems was much higher for those who provided sleep data by both self-report and the research device. They had a 141 percent increase – a figure that could be perceived to be more accurate.
Release date: 07 February 2022
Source: University of South Florida (USF Innovation)
COVID-19 infections increase risk of heart conditions up to a year later
An in-depth analysis of federal health data indicates that people who have had COVID-19 are at increased risk of developing cardiovascular complications within the first month to a year after infection. Such complications include disruptive heart rhythms, inflammation of the heart, blood clots, stroke, coronary artery disease, heart attack, heart failure or even death.
Such problems occur even among previously healthy individuals and those who have had mild COVID-19 infections, according to the study, from researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System.
The research is published Feb. 7 in Nature Medicine.
“We wanted to build upon our past research on COVID’s long-term effects by taking a closer look at what’s happening in people’s hearts,” said senior author Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University. “What we’re seeing isn’t good. COVID-19 can lead to serious cardiovascular complications and death. The heart does not regenerate or easily mend after heart damage. These are diseases that will affect people for a lifetime.”
Release date: 04 February 2022
Source: Washington University in St. Louis
Alzheimer’s-like Changes in Some COVID Patients’ Brains
A study from researchers at Columbia University Vagelos College of Physicians and Surgeons reports that the brains of a small sample of patients who died of COVID display some of the same molecular changes found in the brains of people with Alzheimer’s disease.
The findings could help explain the memory problems reported by sufferers of “long COVID,” though the researchers caution that the study is small—with data from only 10 patients—and needs to be replicated by others.
The study was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s & Dementia.
Early reports of “brain fog” and persistent cardiac symptoms in COVID survivors prompted the Columbia researchers to investigate how certain molecules called ryanodine receptors were affected in this new disease.
Inside neurons, defective ryanodine receptors have previously been linked to an increase in phosphorylated tau, a well-known hallmark of Alzheimer’s.
In the new study, the Columbia researchers found high levels of phosphorylated tau in the brains of the COVID patients in addition to defective ryanodine receptors.
Phosphorylated tau was found in areas where tau is typically located in Alzheimer’s patients, as well as in areas where tau is not typically located in Alzheimer’s patients. That suggests that phosphorylated tau in the COVID patients could be a sign of early-stage Alzheimer’s and also contribute to other neurological symptoms observed in COVID-19 patients.
Increased levels of phosphorylated tau in the brain are believed to be linked to memory problems in Alzheimer’s and could be causing similar issues in people with long COVID, Marks says.
Release date: 03 February 2022
Source: Columbia University Irving Medical Center