'Corkscrew' Shape Of Blood Flow In Heart's Upper Chamber May Signal Lower Stroke Risk

 Proof-of-concept study conducted in two patients

Newswise, November 7, 2016 — Using specialized CT scans of a healthy heart and one with heart disease, a team of Johns Hopkins cardiologists and biomedical engineers say they've created computer models of the "shape" of blood flow through the heart's upper left chamber that someday may help predict stroke risk.

Specifically, their computer visualizations found that blood in the diseased heart failed to flow in corkscrewlike "eddies" that most effectively moved blood out of the left atrium in the healthy heart and "showed us exactly how this motion would increase the risk of developing a blood clot," says Hiroshi Ashikaga, M.D., Ph.D., assistant professor of medicine and member of the Heart and Vascular Institute at the Johns Hopkins University School of Medicine.

The researchers say the same fluid motion analysis used in their two-heart proof-of-concept study may one day offer an accurate way to predict stroke risk in people with heart disease marked by enlargement and weakness of the cardiac muscle.

A description of the study and its results was published in the November print issue of Annals of Biomedical Engineering.

"By looking at blood flow through the atrium, we think we can accurately assess stroke risk better than such risk factors as heart size and pumping strength," says Ashikaga.

"Our study fills in a missing diagnostic link between heart function and fluid motion in our understanding of how each can affect stroke risk."

Before this study, Ashikaga notes, researchers knew that enlargement of the heart, particularly the left upper chamber, was linked to increased stroke risk, particularly in people with atrial fibrillation, an irregular and often very rapid heart rate.

Heart disease experts estimate that more than 1.6 million Americans each year are diagnosed with symptoms of atrial fibrillation that put them at risk for strokes caused by blood that pools in the heart and forms a clot, then travels to the brain.

The new study, Ashikaga says, sheds significant light on just how an enlarged and "floppy" atrium led to blood clot formation.

To collect the data needed to create the blood flow models, the Johns Hopkins team recruited two patients with a history of atrial fibrillation -- a 58-year-old woman with a healthy heart and a 68-year-old man with an enlarged heart. Each underwent a CT scan of their heart.

Using the images, the researchers then computed the movement of blood flow as it entered the left atrium from the pulmonary veins, then passed through a valve into the left lower chamber, or ventricle.

Finally, they fashioned a video representation of the fluid motion of the blood.

In visualizing the healthy heart, the researchers saw that the blood flow formed into tight, corkscrewlike motions that circled around into doughnut formations, known as vortexes.

The researchers say the vortexes helped move the blood efficiently through the atrium quicker and with less contact with the atrium's surface tissue. See blood flow modelled in a healthy heart here.

The diseased heart they chose to examine was enlarged due to overuse, muscle fatigue and scarring, all of which can promote atrial fibrillation.

In the enlarged heart, the researchers noticed that at the top of the atrium, the blood never fully forms the corkscrews that loop around into vortexes.

Instead, by the time the blood reaches the bottom of the atrium, it seems to be falling in "sheets" that coat the surface of the heart. See blood flow through a diseased heart here.

"As the blood comes in contact with the atrium's surface, it slows down due to shearing forces similar to friction, and this appears to prevent the blood from exiting the chamber as smoothly as it might," says Ashikaga.

"The slower the blood moves and the more contact it has with the atrium, the more risk there is for a clot to form."

Ashikaga says his team is currently conducting a larger long-term study looking at the blood flow of many more people with normal and ailing hearts, and monitoring the incidence of stroke and other signs of blood clots over time.

He also hopes to develop the CT scan and computer analysis into a tool to predict stroke risk.

According to the Centers for Disease Control and Prevention, an estimated 3 million to 6 million people have atrial fibrillation and nearly 800,000 people have strokes each year in the United States.

The most common symptom of stroke is numbness or weakness on one side of the body. Physicians use CT scans of the brain, blood tests, EKGs, MRI scans or other imaging test to determine if a person has suffered from a stroke. Strokes may be treated with clot-busting drugs, blood thinners and sometimes surgery to remove the clot.

Cause Of Inflammation In Diabetes Identified

Could be target for preventing related heart attacks, strokes

Too much fat in the diet promotes insulin resistance by spurring chronic inflammation. Researchers at Washington University School of Medicine have developed a way to block production of fatty acids in these immune cells in mice and protect them from diet-induced diabetes.

Newswise, November 7, 2016 — Inflammation is one of the main reasons why people with diabetes experience heart attacks, strokes, kidney problems and other, related complications.

Now, in a surprise finding, researchers at Washington University School of Medicine in St. Louis have identified a possible trigger of chronic inflammation.

Too much fat in the diet promotes insulin resistance by spurring chronic inflammation. But the researchers discovered, in mice, that when certain immune cells can’t manufacture fat, the mice don’t develop diabetes and inflammation, even when consuming a high-fat diet.

The study is available Nov. 2 as an advance online publication from the journal Nature.

“The number of people with diabetes has quadrupled worldwide over the last 20 years,” said senior investigator Clay F. Semenkovich, the Irene E. and Michael M. Karl Professor and director of the Division of Endocrinology, Metabolism & Lipid Research at the School of Medicine.

“We have made modest progress in making it less likely for some people with diabetes to have heart attacks and strokes.

“However, those receiving optimal therapy are still much more likely to die from complications driven by chronic inflammation that is, at least in part, generated by these immune cells.

“But by blocking the production of fat inside these cells, it may be possible to prevent inflammation in people with diabetes and even in other conditions, such as arthritis and cancer, in which chronic inflammation plays a role. This could have a profound impact on health.”

Semenkovich’s team made genetically altered mice that could not make the enzyme for fatty acid synthase (FAS) in immune cells called macrophages. Without the enzyme, it was impossible for the mice to synthesize fatty acids, a normal part of cell metabolism.

“We were surprised to find that the mice were protected from diet-induced diabetes,” said first author Xiaochao Wei, PhD, an instructor of medicine. “They did not develop the insulin resistance and diabetes that normally would have been induced by a high-fat diet.”

Through a series of experiments in the animals and in cell cultures, the researchers, including Douglas F. Covey, PhD, a professor of developmental biology and biochemistry, and Daniel S. Ory, MD, a professor of medicine and of cell biology and physiology, found that if macrophages could not synthesize fat from within, the external membranes of those cells could not respond to fat from outside the cells. That prevented the cells from contributing to inflammation.

But eliminating inflammation altogether is not the answer to preventing diabetic complications because inflammation is also vital for clearing infectious pathogens from the body and helps wounds heal. Still, Semenkovich said the new findings may have profound clinical implications.

“An inhibitor of fatty acid synthase actually is now in clinical trials as a potential cancer treatment,” he explained.

“And other drugs have been developed to inhibit fatty acid synthase in diabetes, too. One possibility that our work suggests is that altering the lipid content in the cell membrane may help block cancer metastases and complications of diabetes.”

Drugs currently in use to block fatty acid synthase, as well as other developing strategies, potentially could allow for chronic inflammation to be blocked, without completely eliminating the ability of macrophages to fight infection.

The researchers also plan to take a look at existing drug compounds that change the lipid composition in cells. Such medications failed in clinical trials, but they may have an effect on the membranes of macrophages and therefore may lower the risk of diabetes complications, Semenkovich said.

Wei X, Song H, Rizzo MG, Sidhu R, Covey DF, Ory DS, Semenkovich CF. Fatty acid synthesis configures the plasma membrane for inflammation in diabetes. Nature. Nov. 2, 2016. http://www.dx.doi.org/10.1038/nature20117

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases; the National Heart, Lung, and Blood Institute; and the National Center for Research Resources of the National Institutes of Health (NIH), grant numbers DK101392, DK076729, DK088083, DK20579, DK56341, RR00954 and HL067773. Additional funds came from the Taylor Family Institute for Innovative Psychiatric Research.

Washington University School of Medicine‘s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals.

The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Earlier Alzheimer’s Diagnosis May Be Possible With New Imaging Compound

New tool detects Alzheimer’s protein, may help identify brain changes, assess treatment effects

Credit: Ping Yan and Jin-Moo Lee

Researchers at Washington University School of Medicine in St. Louis have developed a chemical compound that detects the Alzheimer’s protein amyloid beta better than current FDA-approved agents. The compound potentially may be used in brain scans to identify people in the earliest stages of Alzheimer’s disease.  In the image, the compound has passed from the bloodstream of a living mouse into its brain, where it is detected by a positron emission tomography (PET) scan. Arrows indicate clumps of amyloid beta.

Newswise, November 7, 2016 — By the time unambiguous signs of memory loss and cognitive decline appear in people with Alzheimer’s disease, their brains already are significantly damaged, dotted with clumps of a destructive protein known as amyloid beta. For years, scientists have sought methods and clues to help identify brain changes associated with Alzheimer’s earlier in the disease process, so they can try to stop or even reverse the changes before they severely affect people’s lives.

Now, researchers at Washington University School of Medicine in St. Louis have developed a chemical compound, named Fluselenamyl, that detects amyloid clumps better than current FDA-approved compounds.

If a radioactive atom is incorporated into the compound, its location in a living brain can be monitored using positron emission tomography (PET) scans.

The compound, described in a paper published Nov. 2 in Scientific Reports, one of the Nature journals, potentially could be used in brain scans to identify the signs of early-stage Alzheimer’s disease or to monitor response to treatment.

“Fluselenamyl is both more sensitive and likely more specific than current agents,” said Vijay Sharma, PhD, a professor of radiology, of neurology and of biomedical engineering, and the study’s senior author.

“Using this compound, I think we can reduce false negatives, potentially do a better job of identifying people in the earliest stages of Alzheimer’s disease and assess the effects of treatments.”

Amyloid plaques are one of the most telltale findings in the brains of people with Alzheimer’s disease. The neurons near such plaques are often dead or damaged, and this loss of brain cells is thought to account for difficulty with thinking, memory loss and confusion experienced by Alzheimer’s patients.

Amyloid plaques can be either diffuse or compact. The compact kind has long been associated with the disease, but conventional wisdom has held that diffuse plaques are benign, since they can be found in the brains of elderly people without any symptoms of Alzheimer’s disease, as well as the brains of those with Alzheimer’s. Sharma believes that diffuse plaques may mark the earliest stages of the disease.

“It is a relatively underexplored area in the development of Alzheimer’s pathology,” Sharma said.

“Since current approved agents don’t detect diffuse plaques, there is no reliable noninvasive imaging tool to investigate this aspect in animal models or in patients. Our compound could be used to study the role of diffuse plaques.”

Using human amyloid beta proteins, Sharma and colleagues showed that Fluselenamyl bound to such proteins two to 10 times better than each of the three FDA-approved imaging agents for detecting amyloid beta.

In other words, Fluselenamyl detected much smaller clumps of the protein, indicating that it may be able to detect the brain changes associated with Alzheimer’s disease earlier.

To determine whether Fluselenamyl can detect plaques in the brain, the researchers used the compound to stain brain slices from people who had died of Alzheimer’s disease and, as controls, people of similar ages who had died of other causes.

The brain slices from the Alzheimer’s patients, but not the controls, were identified as containing plaques.

When a radioactive atom was incorporated into the compound, the researchers found very little interaction between Fluselenamyl and the healthy white matter in the human brain slices.

“A huge obstacle with existing state-of-the-art PET agents approved for plaque detection is that they tend to bind indiscriminately to the brain’s white matter, which creates false positives on the scans,” Sharma said.

Nonspecific binding to other parts of the brain creates “noise,” which makes it difficult to distinguish samples with plaques from those without.

A similar experiment comparing mice genetically predisposed to develop amyloid plaques with normal control mice showed the same pattern of high sensitivity for amyloid beta and low binding to healthy white matter.

Furthermore, Sharma and colleagues showed that when Fluselenamyl with the radioactive atom is injected intravenously into mice, the compound can cross the blood-brain barrier, bind to any plaques in their brains and be detected by PET scan.

In mice without plaques, the compound is quickly flushed from the brain and then excreted from the body.

The next step is to move to testing in patients. Sharma already has submitted an application to the National Institutes of Health (NIH) for a phase 0 trial, to establish whether Fluselenamyl is safe for use in humans and behaves in the human body the same way it behaves in mice.

Phase 0 trials involve a low dose given to a small number of people to learn how a molecule is processed in the body and how it affects the body.

“Ideally, we’d like to look at patients with very mild symptoms who are negative for Alzheimer’s by PET scan to see if we can identify them using Fluselenamyl,” Sharma said.

 “One day, we may be able to use Fluselenamyl as part of a screening test to identify segments of the population that are going to be at risk for development of Alzheimer’s disease. That’s the long-term goal.”

Get Your Flu Shot, Or We All Pay The Price!

Unvaccinated Adults are a Costly Economic Burden Ever Year in the U.S.

LabelsNewswise, October 31, 2016 -- Many of us have seen the signs at work, gotten the emails from our health care insurer, or heard the ads on the radio telling us that it is flu season, and thus time to get an annual flu shot.

Many Americans will comply with this yearly health edict, but many will challenge medical wisdom and opt to face their impending exposure to an onslaught of sneezes, coughs and sniffles without the shield of vaccination. In fact, the CDC estimates that only 42% of adults ages 18 and older received the flu vaccine for the 2015-2016 flu season.

This results in many adults getting sick, causing lost days from work, health care expenses, and even death for those highly susceptible, such as the elderly.

Vaccines are available for prevention of many illnesses, and most Americans get a thorough course of vaccinations as children.

There are also vaccines that the CDC recommends for adults, such as those for influenza (flu), HPV, hepatitis A and B, and meningococcal disease. As we age, our susceptibility to certain illnesses increases, so the CDC urges older adults to get immunized against pneumonia, shingles, and influenza, which are particularly dangerous to the elderly.

Younger adults in late teens to early twenties are strongly urged to get vaccinated against human papilloma virus (HPV), which is sexually transmitted and so common that most American adults will contract a strain of it at some point in their lives.

College-aged adults are also urged to get the meningococcal vaccine, which protects against a potentially deadly infection that causes swelling of the protective coverings surrounding the brain. Many universities require this vaccine for incoming students prior to allowing them to register or move in to on-campus housing.

Despite the proven efficacy and minimal risks associated with vaccines, many American adults continue to forgo getting vaccinations, usually due to doubt of effectiveness, concerns of the safety of the vaccines, or just a lack of consistent follow-up on their personal health care needs.

The result is costly health and economic losses, both to themselves and to the general public.

A recent studyrevealed that illnesses attributable to vaccine-preventable diseases in the U.S. caused a $9 billion economic burden in 2015. Ninety-five percent of these costs ($8.3 billion) were health care expenses, with the remaining 5% ($700 million) representing productivity losses, such as lost income during treatment.

The majority of these costs, approximately $5.8 billion, was attributed to influenza illnesses alone, even though flu shots are readily available at low or no cost to both the insured and uninsured in the U.S.

Many employers offer shots free of charge to employees during flu season, and many health care providers and pharmacies make the vaccine available at convenient times by holding special flu shot clinics in evenings and weekends and at community-based locations during flu season.

In addition to the personal health toll vaccine-preventable illnesses can make on the individual, unvaccinated adults put others at greater risk of illness through exposure to the diseases.

Children, the immune-compromised, or others who have health conditions that preclude them from receiving certain vaccinations are put at unnecessary risk of exposure to illness by the unvaccinated who become sick.

 In a place such as Washington, DC, where there is close contact with many people in crowded public venues or through the use of public transportation, these risks of exposure and disease spread are amplified and further illustrates the need for all those who can to get properly vaccinated.

Vaccines are available to adults for the following 14 illnesses: HPV, Herpes zoster (shingles), varicella (chicken pox), pneumococcal disease (pneumonia), meningococcal disease (meningitis), influenza (flu), Measles, Mumps, and Rubella, Tetanus, Diphtheria, Pertussis (whooping cough), and hepatitis A and B.

To find a location where flu shots are available, use this link. Many locations also offer vaccinations for the other 13 diseases for low cost, and health insurance will cover most or all of these shots as well.

You can also test your Flu I.Q. by taking this CDC quiz.

The O’Neill Institute for National and Global Health Law at Georgetown University is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure.

The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives. 

Experimental Drug Shows Promise In Treating Alzheimer’s Disease

Newswise, October 31, 2016--An experimental drug shows promise in treating Alzheimer’s disease by preventing inflammation and removing abnormal protein clumps in the brain that are associated with the disease, suggests a study in mice presented at the ANESTHESIOLOGY® 2016 annual meeting.

A key characteristic of Alzheimer’s disease is the development of abnormal protein clumps called amyloid plaques and tangled bundles of fibers in the brain. These changes cause inflammation in the brain and damage to the neurons.

This progressive damage leads to memory loss, confusion and dementia. The new drug, known as NTRX-07, appears to decrease this inflammation in the brain, while preserving neurons and regenerative cells in the brain.

“This drug may reduce inflammation in the brain, which is linked to Alzheimer’s disease,” said lead researcher Mohamed Naguib, M.D., a physician anesthesiologist in the Department of General Anesthesiology at the Cleveland Clinic and professor of anesthesiology at the Cleveland Clinic Lerner College of Medicine.

“NTRX-07 uses a different mechanism than many other Alzheimer’s drugs currently available, as it targets the cause of the disease, not just the symptoms.”

The authors discovered NTRX -07’s memory-restoring abilities while studying the drug’s potential to treat a complex, chronic pain condition called neuropathic pain.

“Patients who have neuropathic pain have chronic neuroinflammation,” said Dr. Naguib. “This is a compound that blunts that inflammation.”

Researchers tested NTRX -07 on mice bred to have similar brain neurodegenerative issues as seen in Alzheimer’s. They found that inflammation produced in response to the disease caused changes in the brain’s microglia cells – immune cells that typically remove dangerous amyloid plaques (protein clumps) in the brain.

As the amyloid plaques accumulated in the mice, the microglia (immune cells) were unable to remove them, leading to inflammation and damage to nerve cells, which caused decreased cognitive ability.

Microglia cells have receptors on the surface called CB2 receptors, which when activated can produce an anti-inflammatory response. NTRX -07 targets CB2 receptors, which leads to decreased inflammation and prevents damage to the brain tissue.

The new drug improved removal of abnormal amyloid plaques and improved memory performance and other cognitive skills.

The drug also increased levels of a protein called SOX2, which has been shown to help new brain cells develop and protect the brain in people with Alzheimer’s disease.

The study found in mice treated with NTRX-07, the levels of SOX2 were restored to normal levels. In contrast, mice treated with a placebo showed decreased levels of SOX2, active inflammation in the brain, poor removal of amyloid plaques, and poor memory performance.

Joseph F. Foss, M.D., director, of clinical research for general anesthesiology at Cleveland Clinic, and Dr. Naguib are co-founders of NeuroTherapiaTM, a spin-off company created by Cleveland Clinic Innovations to develop NTRX -07. NeuroTherapiaTM recently received a $1.7 million investment from the Alzheimer’s Drug Discovery Foundation to advance NTRX-07 toward human clinical trials.

The company also has received $700,000 from the Alzheimer’s Association to support the proposed Phase I human studies. They anticipate initiating the human clinical studies in 2017.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGY® 2016 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES16.

November is Diabetes Awareness Month

Mount Sinai Experts Weigh In on Self-Management, Treatment Options,

Reversing the Disease and the Newest Advances in Diabetes Research

Newswise, New York, October 31, 2016–Diabetes is the seventh leading cause of death in the United States. Today, 29.1 million people in the United States have been diagnosed with diabetes, according to the U.S. Centers for Disease Control and Prevention (CDC). 

November is Diabetes Awareness Month and Mount Sinai Health System experts are sharing tips on self-management, treatment options, reversing the disease, and the newest advances in diabetes research.

Mount Sinai Experts

• Jeanine Albu, MD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease), Icahn School of Medicine at Mount Sinai
• Carol Levy, MD, Clinical Director, Mount Sinai Diabetes Center, The Mount Sinai Hospital
• Maria Rodriguez, RD, Certified Diabetes Educator, The Diabetes Alliance, Mount Sinai Health System
• Ronald Tamler, MD, PhD, Medical Director, Clinical Diabetes Institute, Icahn School of Medicine at Mount Sinai
• Jerome Tolbert, MD, Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease), Icahn School of Medicine at Mount Sinai
• Andrew Stewart, MD, PhD, Director, Mount Sinai Diabetes, Obesity, and Metabolism Institute, Icahn School of Medicine at Mount Sinai

Mount Sinai Artificial Pancreas (AP) Research Program:

Dr. Carol Levy and her team of researchers at the Icahn School of Medicine at Mount Sinai are studying the safety and efficacy of AP systems to improve the blood glucose control and reduce the burden of disease for people with type 1 diabetes.

Symptoms of Diabetes:
• Frequent urination and blurry vision
• Unusual thirst and sensations of hunger and fatigue
• Unintended weight loss
• Recurrent infections, like skin, gum, or bladder infections

Tips for Diabetes Prevention:
• Make smarter food choices
• Increase physical activity
• Maintain a healthy weight
• Reduce salt and sugar intake

Risk Factors for Prediabetes:
• Elevated blood glucose levels
• Family history of diabetes
• Having hypertension, high cholesterol, or high triglycerides
• Sedentary lifestyle and obesity and a history of cardiovascular disease

About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.

Queen Latifah And UCLA Cardiologist Discuss Why Heart Failure Is A Family Affair

Queen Latifah and UCLA's Dr. Karol Watson joined together on World Heart Day to educate the public on living with heart failure. Latifah's mother suffers from the condition.

 Newswise, October 31, 2016 — More than 6 million Americans live with heart failure. Including Queen Latifah’s mother.

That’s why the award-winning actress, singer, songwriter and producer recently joined UCLA cardiologist Dr. Karol Watson and the American Heart Association on World Heart Day for a Facebook Live event held at UCLA.

The goal? Raise awareness of the AHA’s “Rise Above Heart Failure” campaign and talk about how patients and caregivers can help manage the disease.

Heart failure is a condition in which the heart can’t pump efficiently to get enough blood to the organs. Symptoms include difficulty breathing, fatigue and swelling of the feet, ankles and legs.

“Once we got over the shock of my mom’s diagnosis, we started to learn that there are a lot of things we could do,” said Latifah, whose mother, Rita Owens, was in her early 50’s when she was diagnosed with heart failure ten years ago.

“We learned about medications she could take and how we could make simple lifestyle changes. We became educated and changed our entire family’s lifestyle and her heart began to improve.”

Watson, a professor of medicine/cardiology at the David Geffen School of Medicine at UCLA, noted that heart failure doesn’t affect just one person, it affects the whole family.

“But the good thing is that there are so many proactive steps that patients can take, like managing salt, diet and activity. Having family rally around the patient to support them is important,” said Watson, who is also co-director of the UCLA Program in Preventive Cardiology, and director of the UCLA Barbra Streisand Women’s Heart Health Program.

Whether it’s a family member or yourself, here are some key things about managing heart failure that Latifah and Watson discussed:

Notice a change? Get it checked out by your doctor.

People don’t always notice the signs of heart failure or they may mistake them as signs of other conditions or simply old age.

“A lot of people mistake the signs of heart failure as just getting older; I know my mom did,” Latifah said.

“But if you have symptoms like feeling short of breath when you bend down to put on your shoes, or have trouble sleeping at night without a bunch of pillows – don’t think ‘old age’. Think ‘heart failure’ and be sure to talk to your doctor.”

Watson added that if you see a definite change in your activity or if you’re not able to do the things you used to do, then definitely get it checked out.

“We are all at-risk for heart failure,” said Watson. “No one is untouched by this disease and we have to consider ourselves potentially at risk.”

Low-salt diet is important.

One of the biggest contributors to hear failure is too much salt in the diet, and it’s one of the first things a doctor will advise patients to cut back on.

“Too much salt makes us retain water and makes our heart have to work harder to try and get rid of it,” explained Watson.

For most heart failure patients, salt intake should be limited to one teaspoon, or no more than 1,500 milligrams, daily.

Latifah said she and her family had learned to use less salt.

“We find the flavor is in the food. Once you start to adjust, if you start putting salt on your food, everything will taste salty to you,” she said.

Watson noted the UCLA preventative cardiology program has a motto that encompasses the essential components to healthy heart and lifestyle: Move frequently, eat thoughtfully, connect deeply.

“We should all be physically active, including those with heart failure. We should strive to think about what we eat—we won’t always be perfect, but we can try to eat the right things and limit the bad,” said Watson, “And, it’s so important to maintain strong social connections with family and friends.”

Latifah summed it up by saying, “Our heart is our life and we need this thing to beat so we can live.”

Watch the video of the Facebook Live event with Latifah and Dr. Watson.

AHA’s Rise Above Heart Failure is nationally supported by Novartis Pharmaceuticals Corp. Latifah and her mother have joined the initiative to spread the word about heart failure and help others understand the symptoms and how to manage it.

Visit www.heart.ucla.edu for more information on UCLA Health’s heart services.