Canadian Cardiovascular Congress 2011

Canadian Cardiovascular Congress

Canadian Association of Cardiac Rehabilitation

I attended the CACR and Canadian Cardiovascular Congress this past week. Some interesting topics on atrial fibrillation and acute care and views on interventional cardiology.

If you would like to see more details about the posts please click below.

1. Chantal Smyth inspiring story with her battle with heart disease.

2. Dr. Clyde Yancy Canadian Cardiovascular Congress opening ceremonies keynote.

3. CT Angiongram vs Coventional coronary Angiogram

4. Cardiac Wellness Institute of Calgary early access clinic.

5. HDL lowering drugs

6. Heart healthy diet

7. Skipping breakfast not good for your heart

8. Stress and heart disease

9. AICD shocking normal heart rhythms

Yes there is a lot of information. Take your time to go through material that interests you.

To your success,

Diamond Fernandes

Dr Salim Yusuf

Dr. Salim Yusuf Polypill

I have been going to the CCC for many years and I always enjoy Dr. Yusuf presentations. He is a dynamic and visionary speaker with hope to reduce cardiovascular disease worldwide. His research extend to all continents of the world.

At CCC this year he presented a lot of global research. Heart disease continues to be the leading cause of death but it is a preventable disease and the numbers can go down. Part of his research is to introduce a polypill containing thiazide 12.5 mg (diuretic), atenolol 50 mg (beta-blocker), ramipril 5 mg (ACE inhibitor), simvastatin 20 mg (statin), and aspirin 100 mg per day.
Makes a lot of sense to just have one pill. However, what happens when people start to get better.

To see more on Dr. Yusuf’s research you can visit Dr. Salim Yusuf.

To your success,

Diamond Fernandes

Chantal Smyth Heart Story

Chantal Smyth Story at Canadian Cardiovascular Congress in Vancouver

Heart disease does not discriminate and it is so important to understand that life is precious and you should cease the opportunity to live a heart health life. However, in the case of Chantal Smyth there was a congenital disorder that she did not know about until she was late in pregnancy. I want to say that this story touched us all at the CCC 2011 and she gave the leaders in research an extra incentive to innovate our field of cardiology. It was a sad story being admitted to the hospital late in her pregnancy as she found out she was having cardiovascular complications. She was put under had a c section and heart surgery all within days. The doctors saved her life, providing her with hope. However, her daughter had a brief life here. Having a child is a miracle and I am grateful  every day. I cannot imagine what Chantal Smyth went through. She had an immense amount of strength and support from her husband, family and friends to persevere. Perseverance is a vital quality for success in anything that you do.
Her story provides inspiration and hope for the field of cardiovascular sciences. I would like to personally thank Chantal for her courage and perseverance to overcome heart disease.

Diamond Fernandes

CT Angiogram vs Conventional Coronary Angiography

CT Angiogram vs Catheter Angiogram

Great debates with the use of angiography and the types available. Many centres do no have the luxury of having a CT angiogram. Both procedures involve radiation and are used for patients with or potential heart problems.
The main advantage of a CT Angiogram:
1. Non-invasive
2. Fast
3. Painless
4. No hospitalization (non-invasive so no overnight monitoring required)

The big questions is: Is the angiogram for diagnostic or interventional purposes? The benefit of doing a conventional Angiogram, catheter angiogram is that the patient is already prepared to a revascularization procedure, stent.
CT angiograms can differentiate between calcified and non-calcified in the coronary artery. <br>

Contraindications:
1. Hypersensitivity to the injected contrast agent.

2. Kidney insufficiency.

3. Congestive Heart Failure

4. Atrial Fibrillation

5. Unable to hold breath for 5 seconds

CT Angiograms have their place unfortunately in Calgary, we only have private ones and use catheter Angiograms for diagnostic and interventional procedures.

There is a place for this as I feel it could possibly replace the need for thallium or MIBI scans in the future for the detection of CAD.
After all with the use of stents to open up arterial walls, cardiologists are more and more starting medical therapy and lifestyle intervention to halt, prevent or reverse the disease process vs stents. So best practice is to treat patient symptoms and incorporate a heart healthy lifestyle to reverse heart disease.

To your success,

Diamond Fernandes

Cardiac Wellness Early Access Clinic

Cardiac Wellness Institute of Calgary Early Access Clinic

Heart disease affects many people in the Calgary area. Many people after experiencing an ST elevation Myocardial Infarction are now streamed right into Cardiac Wellness Institute of Calgary. They did a good job presenting their findings at this years CCC (Canadian Cardiovascular Congress) 2011 at the Canadian Association of Cardiac Rehabilitation.
Yes it is important to get quick access to cardiac rehabilitation after a heart event. We are also at a point where cardiac rehabilitation is to be best received from the interventional cardiologists. Yet timing of delivery is difficult.
The one thing I found is that there is a difference with cardiac rehabilitation programs here in Calgary. Having worked at both for almost equal times now (5+ years) it is all about patient outcomes. Where will the patient respond best to. Patients now can have a heart attack, have a stent put in and be out of the hospital in a few days vs weeks.  Patients get back to work , back to their daily grind without even skipping a beat at times. Cardiac rehabilitation is important and sometimes going to a group program may meet their requirement or may not meet their requirements. There are other options such as the Heart Fit Clinic.

Either way it is important to get quick access and decide for yourself where you will get the attention you deserve and your goals achieved.

To your success

Diamond Fernandes

HDL drugs for heart health

HDL Raising Drugs 

 

A new class of drugs are emerging for targeting low HDL cholesterol. Statins have been commonly prescribed for lowering LDL cholesterol but now they are making room for HDL raising drugs. HDL is the good cholesterol in your blood stream and if you have poor LDL cholesterol you may have been prescribed a statin. The concern is that statins do a great job at lowering LDL cholesterol however do not have any effect on HDL cholesterol. At this years Canadian Cardiovascular Congress, The latest research is under way to present next year the benefits of bringing a HDL raising drug to market.

Dal Plaque 2 study by Roche is being released next year and we will see if this will the next chain of HDL lowering drugs. They are using carotid intima media thickness and ivus imaging to track the results. Yes Carotid IMT is a good surrogate end point for trials. My personal concern is that if people have poor cholesterol profile start to reverse heart disease with intense lifestyle change may be more beneficial than any drug. Never have I seen, nor can I foresee, a drug competing against aggressive lifestyle changes. Yes medications are important to treat heart disease but sometimes it is not the only answer. I have seen many people lower cholesterol, reverse heart disease focusing on nutrition, exercise and stress management. It is just sometimes easy to just take a pill. What is easy to do is also easy not to do. Medications have their place but the fact is that many people just taking medication after heart disease thinking this is going to prolong their life are solely mistaken. Exercise has been proven to help decrease mortality and morbidity after heart disease.

Find your why power and start your cardiac rehabilitation program today.

To your heart health success,

Diamond Fernandes

Heart Healthy Diet- Top 10 Things you can Do for Eating Healthy

This year at the Canadian Association of Cardiac Rehabilitation (CACR) we had a nice debate as to which is the best heart healthy diet. Yes there are important things but some of the common diets.

1. South Beach Diet
2. Mediterranean Diet
3. Dash Diet
4. Dean Ornish Diet
5. National Cholesterol Education Program (NCEP) Diet
6. Portfolio Diet

Yes there are lots of diets and it really depends on what your goals are (lower cholesterol, lower blood pressure, lose weight). All of these have been clinically proven and are effective. The fact is what you are going to do. We all know kind of what we should eat. This is where it is important to talk to your heart health expert.

Top 10 Diet Recommendations:

1. Fruits and vegetables. Make this your priority. Every fruit = 4% decreased risk in heart attacks.
2. Have Healthy Grains.
3. Increase Fibre intake.
4. Stay away from trans fats. Every gram of trans fat increases risk of heart disease 20%.
5. Stay away from hydrogenated or vegetable iols
6. Have healthy unsaturated fats. This includes oils, nuts, avacodo, fish
7. Stay away from high Glycemic indexed foods
8. Stay away from fructose, corn syrup. Fructose gets metabolised by the liver which produces uric acid. This then decreases Nitric Oxide. Nitric oxide is important to dilate the blood vessels.
9. Keep a Journal
10. You have to change your mindset. Enjoy vs tolerate. There is a difference between dieting and lifestyle change.

For more information you can get our DVD program to reverse and prevent heart disease or book an appointment with your heart health dietitian.  The DVD program will provide everything you have to know to reverse heart disease .

To your heart health success,

Diamond Fernandes

Skipping Breakfast can lead to poor Heart health

Skipping Breakfast is not good for your Heart Health

Yes we know this may be obvious. But it will affect your heart health. Heart disease is the number one cause of death it is preventable and even reversible. Skipping breakfast does not help your heart. In a lecture at CACR (Canadian Association of Cardiac Rehabilitaton) this year, kelloggs sponsored breakfast talks about skipping breakfast leads to increased weight, increased waist girth, and of course poor glycemic control.

Having a quick breakfasts and/or even skipping breakfast can lead to a decrease in folate and other essential vitamins such as calcium, magnisium, potassium and of course decreased fiber.
Yes fibre is important and we all hear about it, but having whole grains is not always high in fiber.

Have nutrient dense foods that are high in fibre and essential vitamins and minerals. Establish a routine for breakfast, make it a part of your heart health. Even if you find yourself rushing you can prepare the night before.

Skipping has no benefits on your heart health and yes you may save time skipping breakfast but the time saved can be lost elsewhere in your heart health. “Small disciplines yield multiple returns” (Jim Rohn).

To your success,

Diamond Fernandes