Several studies exploring smartphone technology, diet and exercise, drug use and cardiac infection, hyperlipidemia in pregnancy, and cardiovascular disease in cancer patients will be presented during ACC.19 in New Orleans, LA.

Smartphone Technology

Robert Avram, MD, et al., correctly identified diabetes using a deep learning algorithm with a smartphone app that measures heart rate with the phone’s camera, in >72 percent of 54,269 participants. Combining the app-based screening with common diabetes risk factors, diabetes detection rose to 81 percent.

Meanwhile, Bimal R. Shah, MD, FACC, et al., reported that using a smartphone app to monitor blood pressure (BP) in 708 participants resulted in 5.4 mm Hg systolic BP decrease and 3.5 mm Hg diastolic BP decrease. With each reading, the app provided healthful living tips and connection with a health coach. “With longer follow-up and further coaching, we expect more participants will see durable blood pressure reductions,” said Shah.

Diet and Exercise

Xiaodong Zhuang, MD, PhD, et al. analyzed data from 14,000 people without atrial fibrillation (AFib) and identified 1,900 who developed AFib during 22 years follow-up. Participants who ate a low carbohydrate diet were 18 percent more likely to develop AFib than those with moderate carbohydrate intake and 16 percent more likely than those with high carbohydrate intake. “Low carbohydrate diets were associated with increased risk of incident AFib regardless of the type of protein or fat used to replace the carbohydrate,” Zhuang noted.

Another study found that people who ate an energy-rich breakfast and watched less TV had less plaque and arterial stiffness, according to Sotirios Tsalamandris, MD, MSc, et al. Arterial stiffness and more plaque were found in 15 and 28 percent of participants skipping breakfast, 9.5 and 26 percent of those eating a low energy breakfast and 8.7 and 18 percent of those eating a high-energy breakfast. Participants who watched >21 hours of TV per week were twice as likely to have plaque buildup.

Seamus P. Whelton, MD, MPH, et al., demonstrated that physical fitness is a better predictor of a longer lifespan than the number of cardiovascular risk factors among people >70. Fitness was assessed with an exercise stress test in >6,500 participants, who were followed for 10 years. “People who aren’t exercising or are sedentary would likely benefit from starting a routine of low- to moderate-intensity exercise, though they should talk with their physician first,” Whelton said.

In a study of 1,172 former National Football League players, approximately 12 percent had left ventricular hypertrophy (LVH), which appeared to be associated with hypertension. Players with severe LVH had significantly higher blood pressure. “The findings underscore the need for former players and their doctors to keep an eye on any cardiovascular risk factors and work to keep blood pressure in a healthy range,” said Genevieve Smith, PhD.

Yaoshan Dun, MD, PhD, et al., found that cardiac rehabilitation patients who practiced high-intensity interval training (HIIT) gained significant benefits over those performing moderate exercise. After 12 weeks, patients performing HIIT lost four more pounds of body fat, gained a pound and a half more lean muscle mass, and trimmed an inch more off their waists. “These findings support the use of HIIT as an essential treatment tool to improve body composition in heart attack patients enrolled in early outpatient cardiac rehabilitation,” Dun said.

Hyperlipidemia in Pregnancy

A retrospective analysis by Dipika J. Gopal, MD, et al., of 5,100 women who gave birth and attended a postpartum visit within 180 days of delivery, found that only 22 percent had lipid screening before the visit. Of those, 7 percent had elevated total cholesterol and 13 percent had elevated triglycerides. According to the investigators, these results demonstrate a missed opportunity to counsel and treat women at high risk of long-term complications from maternal hyperlipidemia and address possible effects on fetal health.

Drug Use and Heart Infection

Serena Day, MD, et al., reported a 436 percent increase in a medical center’s admissions for infective endocarditis related to intravenous drug use from 2012 to 2017. “As a nation, we need to be aware of these other complications of injection drug use,” Day said. “Treatment for this condition has to include rehabilitation or we will continue to lose lives and precious health care resources.”

Cardio-Oncology

Computed tomography scans, commonly performed before cancer therapy, can provide valuable information on the presence of coronary artery calcium (CAC). Matthew C. Hooks, MD, et al., found that 35 percent of 1,001 patients with cancer had CAC, which was noted on the CT report in just half of cases. Only five patients were started on aspirin and three on statins, suggesting that some doctors missed the opportunity to identify patients with cardiovascular risk.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Dyslipidemia, Noninvasive Imaging, Prevention, Sports and Exercise Cardiology, Atrial Fibrillation/Supraventricular Arrhythmias, Homozygous Familial Hypercholesterolemia, Hypertriglyceridemia, Lipid Metabolism, Nonstatins, Diet, Hypertension, Sports and Exercise and ECG and Stress Testing, Sports and Exercise and Imaging

Keywords: ACC19, ACC Annual Scientific Session, Cardiac Rehabilitation, Blood Pressure, Risk Factors, Heart Rate, Exercise Test, Hypertrophy, Left Ventricular, Aspirin, Atrial Fibrillation, Vascular Stiffness, Breakfast, Retrospective Studies, Coronary Vessels, Physical Fitness, Hypercholesterolemia, Hyperlipidemias, Hypertension, Myocardial Infarction, Diabetes Mellitus, Adipose Tissue, Diet, Carbohydrate-Restricted, Postpartum Period, Endocarditis, Algorithms, Triglycerides, Cholesterol, Tomography, Lipids

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