Ischaemic heart disease

News in brief: Cardiac device checks; Testosterone and arterial function; COVID-19 myocarditis

Tuesday, 23 Feb 2021

Pandemic ingenuity applied to cardiac device checks

The pandemic lockdown has inspired a novel solution to the challenge of device checks of pacemakers and defibrillators for rural residents. In Victoria checks are now being conducted by pharmacists instead of the previous arrangement of having face-to-face rural clinics by visiting cardiologists and technicians from the Royal Melbourne Hospital.

Access to remote areas and social distancing restrictions have made these clinics unfeasible to operate. The Remote Device Interrogation Kiosks (ReDInK) at two locations in Shepparton and Albury has conducted satisfactory tests of devices for almost 100 patients, of whom three required follow-up for reasons including battery replacement, lead repositioning and in-person programming. The program’s has received positively by patients and clinicians and could be  expanded to other locations including metropolitan areas, its developers say in Heart Lung and Circulation.

Testosterone won’t help arterial function

Clinicians are expressing concern about the rising use of testosterone in ageing men to try improve cardiovascular health after their study showed that testosterone treatment provided no benefits to artery health and function. Scientists at the University of Western Australia examined the effect of a 12 week exercise training program and testosterone treatment on artery function in 78 men, aged between 50 and 70, who had low-to- medium testosterone levels at the start of the study. Artery function improved by 28% in the group who did exercise training without testosterone, and by 19% in men who received a combination of testosterone and exercise. There was no improvement in artery function in the group that received testosterone therapy without exercise training.

Commenting on the findings, WA endocrinologist Professor Bu Yeap noted there had been a sharp increase in sales among men with no proven pituitary or testicular disease. He attributed this to an “unproven belief that testosterone therapy was rejuvenating and might have anti-ageing effects,” and advised doctors to “apply caution when prescribing testosterone if the aim is to improve artery function and health”.

The findings are published in Hypertension.

COVID-19 patients have ‘silent’ cardiac injury

More than half of patients hospitalised with severe COVID-19 who showed raised levels of troponin, had myocarditis-like injury,  a study of 148 patients from six hospitals in London has found. The damage included myocarditis-like scar in 26%, infarction and/or ischaemia in 22% and dual pathology in 6%, was detected by MRI scans at least a month after discharge, according to findings published in  the European Heart Journal.

“While we detected only a small amount of ongoing injury, we saw injury to the heart that was present even when the heart’s pumping function was not impaired and might not have been picked up by other techniques. In the most severe cases, there are concerns that this injury may increase the risks of heart failure in the future, but more work is needed to investigate this further,” said study investigator Professor Marianna Fontana, professor of cardiology at University College London.

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