Health Rounds: Clues to heart risk from COVID uncovered

Milestone Pharmaceuticals

28/09/2023 19:37

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    By Nancy Lapid
       Sept 28 (Reuters) - 
    Hello Health Rounds Readers! Today we return to the
mysteries of COVID-19 with research that yields new clues as to
why the risk for serious heart problems is elevated after an
infection. We also feature a study that found certain types of
carbohydrates promote less weigh gain in middle age than others.
And we highlight a promising experimental drug delivered by
nasal spray that helps control dangerously rapid heartbeats.
        
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    New clues to rise in heart attack risk after COVID-19
        Scientists have uncovered new clues to explain the
elevated risk of heart attack and stroke during the year after a
bout of COVID-19.
    The coronavirus appears to induce a dangerous immune
response in fatty deposits, or plaques, lining the arteries,
according to a report published on Thursday in Nature
Cardiovascular Research. 
    “The virus creates a highly inflammatory environment that
could make it easier for plaque to grow, rupture, and block
blood flow to the heart, brain, and other key organs,” study
leader Natalia Eberhardt of NYU Langone Health said in a
statement.
    Eberhardt and colleagues studied 27 heart artery tissue
samples from autopsies of eight patients with known heart
disease who died of COVID-19 in 2020 and 2021. 
    In addition to infecting the artery tissues, the virus also
invaded immune cells called macrophages, which normally protect
the heart by engulfing fatty molecules.
    In response to the virus, the macrophages released high
amounts of inflammatory proteins, including interleukin-1 beta
and interleukin-6, which are known to be associated with heart
attacks, the researchers found.
    They also found higher levels of inflammation in the
plaque-covered artery tissue from the autopsied individuals than
in plaque-covered tissue collected during heart procedures on
patients without COVID-19. 
    Moreover, macrophages rich in engulfed fat were invaded more
frequently by the virus, and for longer periods, than those
containing less fat, researchers found.
    “These results shed light onto a possible connection between
preexisting heart issues and long COVID symptoms,” study senior
author Dr. Chiara Giannarelli, also of NYU Langone, said in a
statement. 
    “The immune cells most involved in atherosclerosis may serve
as a reservoir for the virus, giving it the opportunity to
persist in the body over time.”
    
    Some carbs are better than others for weight control
        Not all carbohydrates are the same when it comes to
weight gain in middle age, new findings suggest.
    While increased consumption of carbs from refined grains,
starchy vegetables, and sugary drinks was linked with greater
weight gain, researchers found more fiber and carbohydrate from
whole grains, fruit, and non-starchy vegetables was associated 
to less weight gain.
    For their study, the researchers tracked 136,432 healthcare
professionals under age 66 for 24 years.
    On average, study participants gained 1.5 kilograms (3.3
pounds) every four years.
    During those four-year periods, a 100 grams-per-day increase
in starch was associated with 1.5 kg of weight gain, while a
similar increase in sugar intake led to a gain of 0.9 kg (2 lb).
    By comparison, the same 100 g/day increase in fiber was
associated with 0.8 kg less weight gain, according to a report
published on Wednesday in The BMJ.
    For every 100 g/day increase in intake of carbs from
non-starchy vegetables such as broccoli, carrots, and spinach,
participants gained 3 kg (6.6 lb) less weight. For the same
amount of grains it was 0.4 kg less weight gained and 1.6 kg for
fruit.
    The associations were stronger among participants with
excessive body weight and among women, the researchers said.
However, they noted, observational studies in which participants
self-report their food intake, are not always reliable.
    Still, they said, the findings “highlight the potential
importance of carbohydrate quality and source for long-term
weight management, especially for people with excessive body
weight.”

    Experimental nasal spray controls rapid heart rate
    An experimental self-administered nasal spray developed by
Milestone Pharmaceuticals  MIST.O  could safely and quickly
allow patients to control abnormally rapid, irregular heartbeats
without medical supervision, a new study suggests.
    In most cases, the calcium-channel blocking drug etripamil
normalized heart rates within 30 minutes after the onset of a
condition in which heart beats more than 100 times per minute,
known as paroxysmal supraventricular tachycardia (PSVT),
researchers reported on Wednesday in the Journal of the American
Heart Association. 
    The typical treatment for PSVT involves performing physical
actions known as vagal maneuvers to slow the heart rate. For
example, patients are instructed to attempt to exhale while
keeping their nose and mouth closed. In cases where vagal
maneuvers are not effective, etripamil may be used to reduce the
need for emergency medical services, the researchers said.
    “This is a potential new and exciting option for patients to
safely self-treat their rapid heartbeat ... (and) avoid
emergency room visits and medical interventions,” study leader
Dr. James Ip of Weill Cornell Medicine at New York-Presbyterian
Hospital said in a statement.
    His team tested the spray in 169 adults who had experienced
an average of 9.7 PSVT episodes in the previous year and were
taking medication to prevent rapid heartbeats. Many had gone to
emergency departments for this problem in the past.
    During the study, when symptoms began, patients applied a
patch that monitored their heart rate for the next five hours. 
    Overall, 105 patients self-medicated with the nasal spray at
least once. Among 181 treated episodes, heart rates normalized
within 30 minutes in about 60% and within an hour in 75%.
    The most common side effects were mild-to-moderate nasal
congestion, discomfort, or a runny nose. 
    Based on feedback from the U.S. Food and Drug
Administration, Milestone Pharmaceuticals has said it expects to
file it application seeing approval for etripamil next month.
     


 (Reporting by Nancy Lapid; Additional reporting by Shawana
Alleyne-Morris; Editing by Bill Berkrot)
 ((Nancy.Lapid@thomsonreuters.com;))