Pumping Marvellous

Economic costs of Heart Failure set to Sky Rocket 

The journal “Circulation” has published today that the number of Americans with heart failure could rise 46%, from 5 million in 2012 to 8 million in 2030, new research says. This should be awake call for the UK considering similar public health profiles.

Also potentially the direct and indirect costs of treating the condition could more than double, from $31 billion to $70 billion, over the same time period.

This means that by 2030, every U.S. taxpayer could be paying $244 a year to care for heart failure patients, according to the American Heart Association policy statement. It said the findings highlight the need for strategies to prevent and treat heart failure.

Heart failure is the leading cause of hospitalisation for Americans over age 65. The rising number of people with heart failure is the result of an aging population and an increase in the rates of conditions that contribute to heart failure, such as high blood pressure, diabetes and heart disease.

“If we don’t improve or reduce the incidence of heart failure by preventing and treating the underlying conditions, there will be a large monetary and health burden on the country,” said Dr. Paul Heidenreich in an American Heart Association news release. “The costs will be paid for by every adult, not just every adult with heart failure.”

“Awareness of risk factors and adequately treating them is the greatest need,” said Heidenreich, a professor of medicine at Stanford University School of Medicine and director of a chronic heart failure research initiative at the VA Health Care System in Palo Alto, Calif.

The statement includes recommendations on how to tackle the issue. These include the following:

• More effective distribution and use of therapy recommended in guidelines to prevent heart failure and improve patient survival.
• Improving the coordination of care when hospitalised patients go home in order to help them achieve better outcomes and reduce their risk of having to return to the hospital.
• Specialised training for physicians, nurses, pharmacists and other health care professionals on advanced heart failure care.
• Improving heart failure prevention and care for minority groups and lower-income people.
• Increasing access to palliative and hospice care for patients with heart failure in advanced stages.

The statement was published online April 24 in the journal Circulation: Heart Failure.

Is Spironolcatone being questioned? 

A drug often used to treat chronic heart failure may not ease symptoms in people with one form of the disease, a new study suggests.

Spironolactone failed to improve symptoms or quality of life among 422 patients with diastolic heart failure — a form of the disease that affects about half of all people with heart failure.

The drug did, however, benefit the structure and function of patients’ hearts. And experts said it’s too early to know what to make of the results, which appear in the Feb. 27 issue of the Journal of the American Medical Association.

“It would be premature to say this is not beneficial,” said Dr. Sanjiv Shah, a cardiologist at Northwestern University Feinberg School of Medicine, in Chicago, who was not involved in the study.

Shah is involved in an ongoing study of spironolactone’s effects in people with diastolic heart failure. And that trial is focusing on the big questions: Can the drug prevent or delay hospitalizations, or prolong people’s lives?

Spironolactone is in a class of drugs called aldosterone receptor antagonists. They cause the kidneys to eliminate excess water and sodium from the body, so they can lower blood pressure and get rid of fluid build-up in some people with heart failure.

Studies have shown that spironolactone can extend the lives of some heart failure patients — namely, those with a low “ejection fraction.

The problem is that heart failure is a “syndrome”  - or a collection of signs and symptoms – rather than a disease. So a treatment that works for some patients may not work as well for others.

In systolic heart failure, the heart’s left ventricle (the main pumping chamber) cannot contract strongly enough, and many people with this form of heart failure have a reduced ejection fraction.

In the diastolic form, the left ventricle doesn’t relax enough between contractions, which means it cannot fill up with as much blood as it should. But the heart’s ejection fraction is actually normal.

Diastolic heart failure is trickier to diagnose, and doctors know less about how to best treat it, said Dr. John Cleland, a cardiologist at Hull York Medical School in Kingston-upon-Hull who co-wrote an editorial published with the study.

He agreed that it’s too soon to draw conclusions from the current findings, and that doctors will know more when Shah’s study results are in.

What is a BNP test? 

BNP ( brain natriuretic peptide ) is a hormone secreted by cardiac cells in response to increased pressure within the heart.

BNP helps to regulate the body’s salt and fluid content, and reduces blood pressure.  In patients who have heart failure, BNP levels tend to become greatly elevated during episodes of worsening shortness of breath.

Measuring BNP levels in the blood through a blood test can help doctors to determine whether a patient’s shortness of breath is due to heart failure, or to some other cause. If the elevated figure is above 400 then NICE guidelines say that the patient should have an echocardiogram within three weeks which is the gold standard of diagnosis for heart failure in the UK.

We feel the BNP test is one of the most under utilised tools in primary care and would if used more assist clinicians with the early symptons and treatment of Heart Failure.

BNP tests can also be used to monitor the severity of heart failure once diagnosed.

The chief utility of BNP measurement is that it can be helpful in diagnosing whether or not heart failure is the cause of a patient’s dyspnea.

Once heart failure has been diagnosed, some doctors believe that following repeated measurements of BNP can help guide their therapy (for instance, by helping them decide whether they have given enough diuretic medication). But clinical trials have failed to demonstrate that treatment guided by serial BNP measurements is useful in improving the outcome of therapy, so most doctors use BNP blood tests only if they need help with the diagnosis.

Heart Skips a beat with the new Pumping Marvellous Toolkit

The BHF have got staying alive and now Pumping Marvellous have got “heart skips a beat” by Olly Murs. We would like to thank everybody for their hardwork and dedication in making this video such a success and we really hope it energises people who have been newly diagnosed with heart failure to have some attitude, belief and success in managing their heart failure symptoms. Also remember this video is also good for carers / caregivers and families to learn about how to help.

This video accompanies the Patient Heart Failure toolkit that has been developed by Pumping Marvellous for the NHS in England and Wales to support self management.

Molecular ‘calcium sponge’ to tackle heart failure 

Sounds a bit peculiar, interested read on…

Researchers at the University of Minnesota’s and the Lillehei Heart Institute have utilised molecular genetic engineering to optimise heart performance in models of diastolic heart failure by creating an optimized protein that can aid in high-speed relaxation similar to fast twitching muscles.

Within heart cells, calcium plays a major role in helping normal heart pump function. However, in diastolic failure the calcium signaling process is slowed; calcium levels rise to the peak needed for the squeezing action of the heart but don’t then drop quickly enough for an efficient relaxation period – the condition known as diastolic heart failure. University researchers were able to pinpoint a specific protein, parvalbumin – which aids in high-speed relaxation of fast twitching muscles in nature – and optimize it to become a calcium sponge for heart muscle. As a result, the optimized protein, ParvE101Q, soaks up excess calcium at a precise instant, allowing the heart to relax efficiently after contraction. Still with us…

The advance offers a solid conceptual step forward in solving the puzzle of diastolic heart failure. The next step will be determining the best possible delivery mechanism for the protein, which should allow the discovery to be used in clinics.

“In nature, there are unique organisms known to be able to contract and relax muscles quickly,” said Joseph M. Metzger, Ph.D, a University of Minnesota Medical School professor and chair of the Department of Integrative Biology and Physiology. “We hoped research and discovery could help identify what was promoting this highly efficient activity so we could harness it for use in the heart. We’ve discovered that our optimised variation of parvalbumin can fulfill that role by treating diastolic heart failure.”

If they can develop an ideal delivery system for the optimized protein, the researchers believe they may have found a unique clinical application to treat diastolic heart failure.

I suppose we will all have to wait and see. We apologise for the level detail we sometimes go into but it generally cannot be described in any other way.

The Jigsaw – Self Management Support for Heart Failure

Self Management support for Heart Failure

Self Management support for Heart Failure

Heart Failure Toolkit Launch

We have confirmed that Pumping Marvellous will be handing over it’s first Heart Failure toolkits to the NHS on 14th February 2013 on the cardiology wards at the Royal Blackburn. the HEart Failure toolkit has 42 components and is a complete self care patient management system. We believe that this is the most comprehensive discharge and educational coaching tool for heart failure patients. If you have any questions about our toolkit or would like to have the toolkit for your trust then please email us.

Pumping Marvellous Heart Failure Toolkit

East Lancashire Heart Failure Nurse talks to the BBC

Listen to Angela Graves, Heart Failure Nurse Manager for the East Lancashire Hospital Trust and Nick Hartshorne-Evans, the Founder of Pumping Marvellous talking on the Sally Naden show on BBC Radio Lancashire on Angela’s nomination for the Claire Rayners Patient’s Choice Award and heart failure.

Listen to them

Key times

Angela – 32mins
Nick – 1hr 9min
Angela -1hr 24min

Careful about Coffee and Heart Failure

English: A photo of a cup of coffee. Esperanto: Taso de kafo. Français : Photo d’une tasse de caffé Español: Taza de café (Photo credit: Wikipedia)

There is a lot in the press about coffee and it’s effect on Heart Failure. We would ask you to tread carefully and use common sense before acting on press reports as the important word used by the clincian in the report below is “association”. Remember coffee has caffeine that is a stimulant and definitely makes your rate increase which is not what we are trying to do when we have a Heart Condition.”Drinking coffee moderately may reduce the risk of heart failure, but drinking  too much makes this benefit disappear, according to a new review.

People who drank two cups of coffee a day were 11 percent less likely to have  heart failure, compared with people who drank no coffee. Heart failure occurs  when the heart cannot pump enough blood to meet the demands of the body, and can  be caused by factors ranging from high blood pressure to pregnancy.

Constantly drinking too much coffee, however, negates this benefit: no  difference in heart failure risk was seen between non-coffee drinkers’ and those  who drank more than three cups a day.

“As with so many things, moderation appears to be the key here,” said study  author Dr. Murray Mittleman, director of the Cardiovascular Epidemiology  Research Unit at Beth Israel Deaconess Medical Center in Boston.

The study showed an association, not a cause-and-effect link.

Still, there is reason to think coffee lowers heart failure risk, the  researchers said. Moderate coffee consumption may increase drinkers’ caffeine  tolerance, which could in turn limit their susceptibility to high blood  pressure. Additionally, coffee drinking has been shown to lower the risk of type 2 diabetes.  Diabetes and hypertension are major risk factors for heart failure, Mittleman  said.

People who have already have heart failure should consume no more than one to  two cups of coffee per  day, according to the American Heart Association.

The finding “is good news for coffee drinkers,  of course, but it also may warrant changes to the current heart failure  prevention guidelines, which suggest that coffee drinking may be risky for heart  patients,” said study author Elizabeth Mostofsky, a research fellow at the  center.

The researchers looked at data collected on 140,220 people in Sweden and  Finland who participated in five previous studies. There were a total of 6,522  cases of heart failure between 2001 and 2011. The causes of heart failure often  cannot be reversed, but the condition can be treated.

The researchers took into account the differing serving sizes between Europe  and the United States (European servings are generally smaller), however, they  did not account for coffee’s strength or whether the coffee was caffeinated,  though they noted that in northern Europe, it typically is.

The study was published yesterday (June 26) in the journal Circulation Heart  Failure.

Lancashire Telegraph – written by Catherine Pye

FUNDING has been secured for a new heart failure ‘tool kit’ for patients leaving the Royal Blackburn Hospital.

The Hapton-based charity Pumping Marvellous applied for £22,000 from NHS North West to produce 1,500 tool kits — parcels of information on how to live with the condition after discharge — and hope  to launch them at the end of September.

Nick Hartsthorne-Evans, 42, set up Pumping Marvellous after he suffered heart failure, aged 39, from picking up a virus.   He said: “Hospitals do their best to give leaflets that are clinically correct, but is that what the patient needs, to read about how morbid it is?

“What they give you satisfies your needs for about six months. It’s not a life-long thing.

“What we’re doing is based on the ‘bounty bag’ that new mums get after giving birth. It will give patients all the information they need throughout their lives on how to manage the condition. “There will be information in there for the employer, about smoking cessation and alcohol management, information for carers, and how make sure someone is getting benefits they’re entitled to.

“For the cost of each tool kit — about £15 — it will have a great impact on reducing hospital admissions and will make people less symptomatic

After an 18 month trial period, Nick hopes to be able to secure more funding to roll the scheme out regionally and then nationally.