Pumping Marvellous

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

Omega 6 not too be confused with Omega 3

This is very confusing as there is so much conflicting information and Omega 6 is not to be confused with Omega 3. This information has been extrapolated from The American Journal of Clinical Nutrition, November 28, 2012.

Despite evidence suggesting omega-6 fatty acids might protect the cardiovascular system, a large new study of men finds the fats typically found in flax seeds and some vegetable oils do nothing to prevent heart failure. ”Although we know omega-6 fatty acids could influence blood pressure in a good way, we don’t see that translate into a lower risk of heart failure,” said Dr. Luc Djousse, one of the authors of the study and a professor at Brigham and Women’s Hospital in Boston.

Omega-6 fatty acids are relatively abundant in the Western diet, and are found in many cooking oils, such as sunflower and canola oils.

The effect of omega-6s on heart health has been controversial, however, according to William Harris, a professor at the University of South Dakota‘s Sanford School of Medicine and a senior scientist at Health Diagnostic Laboratory in Richmond, VA.

“Some people like me and others at the American Heart Association say higher intake of omega-6 is good for your heart from the heart attack point of view. Another group of people are saying high omega-6 is causing inflammation, so that’s a bad thing,” said Harris, who was not part of the current study.

One heart benefit linked by past research to omega-6 consumption is lower blood pressure and because high blood pressure is a risk factor for heart failure, Djousse and his colleagues wanted to see if people who ate more omega-6s also had a lower risk of heart failure.

They used data from a long-term study of 22,000 male physicians in the U.S. At the beginning of the study the men gave a blood sample, from which the researchers determined the level of omega-6 fatty acids in the men’s bodies. Over an average follow-up period of 17 years, 788 of the participants developed heart failure.

Djoussa’s group compared these men to 788 others in the study, who were otherwise similar in age and other measures but had not experienced heart failure.

They found no differences between the two groups of men in the amount of omega-6 fats in their blood. “There’s no evidence of benefit. It’s just one of those things where it doesn’t appear to be playing a role in this particular disease,”  indicated William Harris.

Djoussa said his findings suggest that researchers can shift their priorities away from looking to omega-6s as a possible way to reduce the risk of heart failure.

Another recent study by Djousse and his colleagues found that getting a lot of omega-3 fatty acids in the diet by eating fish is tied to a lower risk of heart failure.

Our Heart Failure patient toolkit is the most comprehensive patient self care programme for Heart Failure patients. Where your journey starts at A&E or even your GP through to maybe acute and then into community care, the toolkit is a guide for not only you but also your carer and family as to how to manage your new life and opportunities. Throughout the world we see different methods of engagement with patients from clinicians engaging with patients through a checklist to handing out books to read.

The difference between our toolkit and others is this -

• It is authored and put together by a Heart Failure patients experiences
• Subject matter is from patient and carer inputs from all over the world
• Specialist charities and organisations have written there own sections
• Clinicians from the NHS Trusts have provided the technical data
• Companies specialism in heart failure treatments have lent their hand
• It is geographically transferable
• It is attractive and engaging for patients
• It is digitally available to specialist heart failure nurses along with a suite of APPs for tablets therefore enriching the patient experience and self learning.

Heart Failure and memory loss link

Heart failure has been linked to detrimental changes in the brain, says new research published recently in the European Heart Journal. As heart failure has been linked to depression and cognitive impairment, Professor Osvaldo Almeida of the University of Western Australia, and colleagues investigated whether this is specifically due to the heart failure itself, or sanother factor. They analysed data on 35 heart failure patients, 56 ischemic heart disease patients without heart failure, and 64 healthy people with neither condition. All were aged 45 years or above and had no obvious cognitive impairment. MRI scans of the participants’ brains were assessed. This is the first study of cognitive changes in heart failure to include patients with ischemic heart disease.

Participants with heart failure had a lower volume of grey matter in many areas of the brain than the other two groups. These patients also had lower scores on short- and long-term memory, had longer reaction speeds, and took longer to complete a reasoning task. Professor Almeida explains, “What we found in this study is that both ischemic heart disease and heart failure are associated with a loss of cells in certain brain regions that are important for the modulation of emotions and mental activity. Such a loss is more pronounced in people with heart failure.

Health professionals and patients need to be aware that problems caused by heart disease are not limited to the heart.” In their paper, the researchers conclude, “Adults with heart failure have worse immediate and long-term memory and psychomotor speed than controls without ischemic heart disease.” This could make it more difficult for patients to comply with complicated treatment regimes, they warn, stating, “Our findings are consistent with the possibility that patients with heart failure may have trouble following complex management strategies, and, therefore, treatment messages should be simple and clear.”

They add that further studies will have to be done to uncover the process by which heart failure leads to loss of brain cells, to see whether the problems become worse over time, and to discover whether patients could benefit from cognitive rehabilitation.

Responding to the study, Dr. Christiane Angermann and colleagues at the University of Wurzburg, Germany, say that links between cardiovascular disease and dementia have been observed for decades. In fact, the label “cardiogenic dementia” was first used in 1977. Smaller studies on humans have investigated the issue, with inconsistent results. A few animal studies have also been carried out, and these studies showed changes to the brain after a heart attack. Another potential cognitive problem among heart failure patients is an inability to decide what to do if their condition changes. For example, a patient who has a cognitive problem and experiences sudden weight gain may not think to notify their physician. Their condition could worsen over time, resulting in an avoidable trip to the emergency room.

Richard S. Isaacson, MD, a neurologist at the University of Miami School of Medicine, recommends that patients bring a family member or carer to doctor appointments to help understand the treatment regime and the importance of taking medication consistently. “People with heart failure are going to have trouble understanding because their thinking skills are not as strong as they used to be,” Isaacson says. “They often have multiple medical problems and difficulty understanding what they can do to help themselves.” He supports the use of handouts to explain heart failure and its treatments, to help remind patients of what they need to do and why.

Heart Failure Conference “Cardiac Centre To Community”

Pumping Marvellous, The East Lancshire Hospital Trust, Medtronic and Servier put on a clinician led Heart Failure conference for GP’s to talk through the innovative options and solutions to Heart Failure Care in  patients.  Guest speaker is Dr David Fox, Consultant Electrophysiologist from the Northwest Cardiac Centre in Wythenshawe. Invites available from Pumping Marvellous.

New pioneering implant for Heart Failure patients 

English: Vagus nerve (Photo credit: Wikipedia)

Surgeons at Glenfield Hospital in Leicester are launching a trial into the use of an implant to treat heart failure.

How important is excercise to you as a Heart Failure patient?

Before we talk to you about this really important article it is important that you get the go ahead from a clinician before you start any exercise and especially marathon running!!

People with heart failure who are also depressed may benefit from regular, moderate exercise, a new study suggests. Researchers found patients who exercised an hour and a half to two hours per week had slightly lower depression scores, which in turn were tied to a reduced risk of re-hospitalisations and deaths related to heart problems.

Still, the effects of exercise were “modest,” researchers said. “We know that in people who have existing heart disease, including heart failure, that if they have depression on top of it, it tends to make matters worse,” said Kenneth Freedland, a psychiatrist from Washington University School of Medicine in St. Louis who wasn’t involved in the new study.

“Exercise seems to be helpful, but by itself, it’s probably not a sufficient treatment for clinical depression in somebody with heart failure,”  Still, Freeland added, “anything that can make a dent in (depression) is a good thing.”

The new findings are based on a secondary analysis of a study looking at the effects of exercise on long-term health risks in people with heart failure, which occurs when the heart can’t pump enough blood to the rest of the body.

Close to six million people in the U.S. and 1 million people in the UK have heart failure. Moderate exercise is generally considered safe in people with heart failure, as long as they have been first cleared by their doctor.

In 2003 through 2007, researchers randomly assigned 2,300 people with heart failure to a supervised and at-home exercise program or to their usual treatment. They asked participants about depression symptoms at the start of the study and tracked both those symptoms and hospitalizations and deaths over time.

Participants in the exercise group had three 30-minute workout sessions per week for three months, then were given a treadmill or stationary bike to continue exercising at home for another nine months.

About 28% of patients were clinically depressed at the start of the study, based on a questionnaire covering 21 different symptoms. Depression scores in general — and especially in people with a depression diagnosis — tended to drop with exercise. But the disparity between exercisers and non-exercisers was small, equal to participants scoring similarly on 20 out of 21 symptoms and exercisers getting a “mild” score on one symptom where the usual care group got a “moderate” or “severe” score.

“Most of the patients were not depressed,” said lead researcher James Blumenthal, a clinical psychologist at Duke University Medical Center in Durham. “To go from being not depressed to a little bit more not depressed may not be that clinically meaningful.”

CoQ10 and your Heart

Human cardiac muscle

We are having a lot of questions asked at the moment surrounding Q10 so we thought it would be a good idea to put more information on the website so that people could reference it against the other pieces of information we have on what seems to be an ever popular topic for discussion. It has always been a popular topic with us so we are pleased it is being referenced more by patients.Coenzyme Q10 (Ubiquinone / Ubiquinol which is synthesised from Ubiquinone and is highly absorbent and more potent than Ubiquinone) is a mitochondrial coenzyme that is essential for the production of adenosine triphosphate (ATP), the body’s form of chemical energy. The human body has approximately 100 trillion cells, and each one must produce its own energy to carry out its biological functions. The cells produce this energy by burning (oxidizing) carbohydrates, fats and proteins. This controlled burning or oxidation process (catabolic reactions) occurs as a result of oxygen combining with foodstuffs to produce energy, carbon dioxide and water. More than 95 percent of the oxygen we inhale is used solely for the purpose of making energy through this process. The result of these chemical reactions is converted into chemical energy in the form of ATP molecules. These ATP molecules supply the energy needed for the various cellular chemical and biological reactions necessary for life to occur (termed: bioenergetics). ATP is the fuel used to provide cellular energy, making life possible.CoQ10 was discovered by Frederick L. Crane, Ph.D., in the late 1950s, during his research on the biochemistry of the mitochondrial electron transport chain. The substance was sent to Karl Folkers, Ph.D., for identification and identity of its structure. It was designated “coenzyme Q10″ because of its quinone structure and the 10 isoprene unit side chain. During this time, another group of scientists led by R. A. Morton, Ph.D., isolated the same substance from mitochondria and designated it ubiquinone (from ubiquitous, meaning everywhere) because of its widespread occurrence in nature. The role of CoQ10 in the electron transport chain was first described by Peter Mitchell, Ph.D., who was awarded the Nobel Prize for that work.

So how does this fit into a heart failure patients profile?

Cells that require the most energy contain a higher number of mitochondria. The more work required, the more energy needed. The cells of the brain, the skeletal muscle, the heart and the eye contain the highest number of mitochondria (as many as 10,000 per cell), while the skin cells, which do not require much energy, contain only a few hundred mitochondria. Cardiac cells are muscle cells whose function is to contract repeatedly, pumping blood continuously around the body. This means these cells need a large and continuous supply of energy to in order to function efficiently, so no surprise they have a large number of mitochondria within them. CoQ10 (being at the center of the creation of cellular energy) assumes significant importance in cells with high energy requirements, such as the cardiac cells.

Much of the research in support of CoQ10 supplementation has been focused on CHF. These patients’ hearts have been shown to have increased oxidative stress, as well as decreased concentrations of CoQ10.^1,2 We already know heart muscle cells have a remarkably high-energy requirement. Consistent correlation between the level of CoQ10 and the severity of CHF appears to be a well-documented. Low levels of CoQ10 have been linked to decreased heart muscle function (poor myocardial function).^3,4 The more severe the heart failure, the more the deficient the CoQ10 level is. Recently, it has been found that CoQ10 levels can be used as a predictor of mortality in CHF.

CoQ10 has a potential role for the prevention and treatment of heart ailments by improving cellular bioenergetics. Supplementation can help correct energy depletion and oxidative stress, which are inherent in these cardiac conditions; this can result in helping to restore the energy and efficiency of the heart. Significant improvement has been observed in exercise tolerance in patients given adjunctive CoQ10.⁷

Supplementation has been shown to cause sustained clinical improvement in the heart muscle contraction (improved ejection fraction, heart wall motion and heart size), and progress in improving other related symptoms (fatigue, chest pain, shortness of breath, exercise ability and palpitations).⁸ Some studies have showed significant development with NYHA class improving from a mean of IV to a mean of II.⁹ CoQ10 supplementation can also protect against ischemia and reperfusion injury.¹⁰ The improvement in some patients can be rather significant, with the heart size and heart function returning to near normal.

As we all know every patient is different  and CoQ10 supplementation should be used as a parallel therapy, supporting traditional medical treatment and not in place of it. As with all supplements it is vital that you speak to your doctor or nurse before starting on a self prescribed course. CoQ10 reacts with warfarin therefore may affect your INR levels.

Eplerenone  / Inspra approved for Heart Failure in Scotland

Patients with chronic heart failure are to be offered a new drug which reduces their risk of being hospitalised by almost 40%.

June 12th 2012 was the day we staged our very succesfull heart failure charity patient conference. We had guest speakers from -

Talking about cardiomyopathy – Cardiomyopathy Association – CEO Robert Hall

Devices and what do they do – Medtronic – Emma Nardo

What is Tai Chi – Jason Hacking

Heart failure update – East Lancashire Hospital Trust – Angela Graves

Pumping Marvellous update – Nick Hartshorne-Evans

First Aid for heart failure patients and their carers – Eric Lee – British Red Cross

We received some positive feedback and some developmental feedback from the conference so for the next conference which will be Winter 2012 it has already been decided that technical content will be limited to a minimum.

Here are some pictures of the event -

Angela Graves speaking for the East Lancashire Hospital Trust

Heart failure charity conference

Nick Hartshorne-Evans presenting at heart failure conference

Pumping Marvellous Tai Chi Team