Tag: cardiology

Google Street View predicts heart disease risk based on neighborhood features

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Researchers have used Google Street View to study hundreds of elements of the built environment, including buildings, green spaces, pavements and roads, and how these elements relate to each other and influence coronary artery disease in people living in these neighborhoods.

Their findings, published in the European Heart Journal today (Thursday), show that these factors can predict 63% of the variation in the risk of coronary heart disease from one area to another.

Coronary heart disease, where a build-up of fatty substances in the coronary arteries interrupts the blood supply to the heart, is one of the most common forms of cardiovascular disease.

Researchers say that using Google Street View can help provide an overview of physical environmental risk factors in the built and natural environments that could help not only in understanding risk factors in these environments, but ultimately help towards building or adapting towns and cities to make them healthier places to live.

The study was led by Prof. Sadeer Al-Kindi and Prof. Sanjay Rajagopalan from University Hospitals Harrington Heart & Vascular Institute and Case Western Reserve University, Ohio, USA, and Dr. Zhuo Chen, a post-doctoral fellow in Prof. Rajagopalan’s laboratory.

Prof. Rajagopalan said: “We have always been interested in how the environment, both the built and natural environment, influences cardiovascular disease. Here in America, they say that the zip code is a better predictor of heart disease than even personal measures of health. However, to investigate how the environment influences large populations in multiple cities is no mean task. Hence, we used machine vision-based approaches to assess the links between the built environment and coronary heart disease prevalence in US cities.”

The study included more than half a million Google Street View images of Detroit, Michigan; Kansas City, Missouri; Cleveland, Ohio; Brownsville, Texas; Fremont, California; Bellevue, Washington State; and Denver, Colorado. Researchers also collected data on rates of coronary heart disease according to ‘census tracts’. These are areas smaller than a US zip code that are home to an average of 4,000 people. The researchers used an approach called a convolutional neural network; a type of artificial intelligence that can recognize and analyze patterns in images to make predictions.

The research revealed that features of the built environment visible on Google Street View images could predict 63% of the variation in coronary heart disease between these small regions of US cities.

Prof. Al-Kindi added: “We also used an approach called attention mapping, which highlights some of the important regions in the image, to provide a semi-qualitative interpretation of some of the thousands of features that may be important in coronary heart disease. For instance, features like green space and walkable roads were associated with lower risk, while other features, such as poorly paved roads, were associated with higher risk. However, these findings need further investigation.

“We’ve shown that we can use computer vision approaches to help identify environmental factors influencing cardiovascular risk and this could play a role in guiding heart-healthy urban planning. The fact that we can do this at scale is something that is absolutely unique and important for urban planning.”

“With upcoming challenges including climate change and a shifting demographic, where close to 70% of the world’s population will live in urban environments, there is a compelling need to understand urban environments at scale, using computer vision approaches that can provide exquisite detail at an unparalleled level,” said Prof. Rajagopalan.

In an accompanying editorial, Dr. Rohan Khera from Yale University School of Medicine, USA said: “The association of residential location with outcomes often supersedes that of known biological risk factors. This is often summarised with the expression that a person’s postal code is a bigger determinant of their health than their genetic code. However, our ability to appropriately classify environmental risk factors has relied on population surveys that track wealth, pollution, and community resources.

“The study by Chen and colleagues presents a novel and more comprehensive evaluation of the built environment. This work creatively leverages Google’s panoramic street-view imagery that supplements its widely used map application.

“… an AI-enhanced approach to studying the physical environment and its association with cardiovascular health highlights that across our communities, measures of cardiovascular health are strongly encoded in merely the visual appearance of our neighborhoods. It is critical to use this information wisely, both in defining strategic priorities for identifying vulnerable communities and in redoubling efforts to improve cardiovascular health in communities that need it most.”

https://www.msn.com/en-gb/health/other/google-street-view-predicts-heart-disease-risk-based-on-neighborhood-features/ar-BB1kFeqv

Dog ownership may improve outcomes, reduce mortality risk after cardiovascular events

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Dog ownership was linked to improved outcomes after a major CV event and with a lower risk for death in the long term, according to two studies published in Circulation: Cardiovascular Quality and Outcomes.

“The findings in these two well-done studies and analyses build upon prior studies and the conclusions of the 2013 American Heart Association Scientific Statement ‘Pet Ownership and Cardiovascular Risk’ that dog ownership is associated with reductions in factors that contribute to cardiac risk and to cardiovascular events,” Glenn N. Levine, MD, professor of medicine at Baylor College of Medicine in Houston, director of the cardiac care unit at Michael E. DeBakey Medical Center in Houston and chair of the writing group of the AHA’s scientific statement on pet ownership, said in a press release. “Further, these two studies provide good, quality data indicating dog ownership is associated with reduced cardiac and all-cause mortality.”

Study on Swedish patients

Mwenya Mubanga, MD, PhD, assistant undergoing research training in the department of medical sciences, molecular epidemiology at Uppsala University in Sweden, and colleagues analyzed data from 181,696 patients with MI (mean age, 71 years; 64% men) and 154,617 patients with stroke (mean age, 73 years; 55% men) between 2001 and 2012 from the Swedish National Patient Register. Patients were aged 40 to 85 years and did not have an event between 1997 and 2001. Information on dog ownership was collected from two dog registers, as dogs are required to be registered in Sweden since 2001.

Death was the main outcome that was assessed in this study. A secondary outcome included rehospitalization for the same event after 30 days.

Dog ownership accounted for 5.7% of patients with MI and 4.8% of those with stroke.

During 804,137 person-years of follow-up for patients with MI, dog owners had a reduced risk for death after hospitalization, which was seen in those who lived alone (adjusted HR = 0.67; 95% CI, 0.61-0.75) and those who lived with a partner or child (aHR = 0.85; 95% CI, 0.8-0.9).

Similar results were seen for patients with ischemic stroke during 638,219 person-years of follow-up. The adjusted HR for patients who owned a dog and lived alone was 0.73 (95% CI, 0.66-0.8) and 0.88 for those who owned a dog and lived with a partner or child (95% CI, 0.83-0.93).

Dog ownership was also associated with a reduced risk for hospitalization for recurrent MI (HR = 0.93; 95% CI, 0.87-0.99).

“One mechanism may be an increased motivation for engagement in consistent physical activity in dog owners, a factor regarded important in post-event recovery of cognition, arm function, balance and gait,” Mubanga and colleagues wrote. “Another explanation is reduced risk of depression, an important risk factor for death after myocardial infarction.”

Systematic review, meta-analysis

In another study from the same publication, Caroline K. Kramer, MD, PhD, assistant professor in the division of endocrinology and metabolism at University of Toronto, and colleagues performed a systematic review and meta-analysis of data from 3,837,005 participants from 10 studies published between 1950 and May 24, 2019.

Studies were included if they included original data of prospective observational studies, included patients older than 18 years, reported CV mortality or all-cause mortality and evaluated dog ownership at baseline.

During a mean follow-up of 10.1 years, there were 530,515 deaths.

There was a 24% risk reduction for all-cause mortality in participants who owned a dog compared with those who did not (RR = 0.76; 95% CI, 0.67-0.86). Six studies showed a significant reduction in the risk for death in participants who owned a dog.

Participants with prior coronary events who lived in a home with a dog had an even more pronounced reduction in the risk for all-cause mortality (RR = 0.35; 95% CI, 0.17-0.69; I2 = 0%). When the analyses were restricted to studies that evaluated CV mortality, there was a 31% risk reduction for CV death in participants who owned a dog (RR = 0.69; 95% CI, 0.67-0.71; I2 = 5.1%).

“Taken together, our meta-analysis suggests the need for further investigation of the potential for dog ownership as a lifestyle intervention that may offer significant health benefits, particularly in populations at high risk for cardiovascular death,” Kramer and colleagues wrote.

https://www.healio.com/cardiology/vascular-medicine/news/online/%7B32f1f7e0-a796-4e8b-8a0d-75c32fa1de7d%7D/dog-ownership-may-improve-outcomes-reduce-mortality-risk-after-cv-events?utm_source=selligent&utm_medium=email&utm_campaign=cardiology+news&m_bt=1162769038120

Tragic Loss to Medicine as Celebrated Cardiologist Bongani Mayosi Commits Suicide

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The 51-year-old University of Cape Town researcher had been suffering from depression, and his death has prompted reflection on being a black academic in South Africa.

Bongani Mayosi, a prominent cardiologist and dean of the Faculty of Health Sciences at the University of Cape Town in South Africa, died of suicide on July 27. He was 51.

“In the last two years he has battled with depression and on that day [Friday] took the desperate decision to end his life,” his family said in a statement at the time, News24 reports. “We are still struggling to come to terms with this devastating loss.”

Born in 1967, Mayosi grew up under apartheid in the Transkei region of South Africa. Homeschooled by his mother as a child, he later studied medicine at the University of KwaZulu-Natal, incorporating a year of research to qualify for a BMedSci degree. In 1998, he won a fellowship to join the PhD program in the department of cardiovascular medicine at the University of Oxford.

Upon returning to South Africa a few years later, Bongani worked on a number of projects, including searching for the genetic mutations underpinning arrhythmogenic cardiomyopathy to identifying risk factors involved in cardiovascular disease. In 2006, at 38 years old, he became the first black person to chair the Department of Medicine at the University of Cape Town (UCT).

His career over the next decade would be marked by several awards recognizing his contributions to cardiology. In 2007, he was named one of the top 25 “influential leaders in healthcare in South Africa,” and, two years later, received the Order of Mapungubwe, South Africa’s highest honor. In 2017, he was elected to the US National Academy of Medicine.

Becoming dean in 2016, Mayosi was responsible for handling part of the university’s response to a tumultuous period of student unrest across the country. In a letter published on News24, the university’s vice chancellor Mamokgethi Phakeng writes that during that period, Mayosi’s “office was occupied for about two weeks in 2016. He had to manage pressure coming from many different directions, including from staff and students.” Over the next two years, Mayosi suffered from depression and took time off from his position; he resigned twice, but was persuaded to change his mind.

Mayosi’s death has led colleagues to examine the external forces that might have contributed to his desperation. In early August, Johannesburg’s City Press and other outlets reported that UCT had instigated an inquiry into the circumstances surrounding Mayosi’s death following calls from concerned colleagues and the university’s Black Academic Caucus. In a statement on Facebook on August 2, the Caucus wrote that “it is hard for us to exclude the UCT working environment from the tragic death of our colleague, and indeed others, including students.” Many researchers and activists also highlighted challenges Mayosi faced as a black academic in South Africa.

Matshidiso Moeti, the African regional director for the World Health Organization—where Mayosi had chaired the African Advisory Committee on Health Research & Development—was one of many health officials and researchers to send condolences after news of Mayosi’s death. “We will always cherish him for his diligence and immense contribution to the development of the WHO strategy for strengthening the use of evidence, information and research for policy-making in the African Region,” she wrote.

Cardiologists Hugh Watkins of the University of Oxford and Ntobeko Ntusi of UCT write in a memorial published yesterday (September 11) in Circulation that “one of the most striking impressions from his funeral, attended by thousands of mourners who remembered him with awe and love, was the abundant evidence of his commitment to bring others with him, nurture talent, and provide the sorts of opportunity from which he had benefited. . . . We speak for many in saying that we are in awe of what Bongani achieved.”

https://www.the-scientist.com/news-opinion/celebrated-cardiologist-bongani-mayosi-dies-64787?utm_campaign=TS_DAILY%20NEWSLETTER_2018&utm_source=hs_email&utm_medium=email&utm_content=65896990&_hsenc=p2ANqtz-_Xn_C3066EAlU479N7jk9yk0YpvAneSzSm7Ae9hwdounQSXC6y1NB1SlSwEHpKfuJXV3J_nz64REq0mTIGy6GuyMPE0Q&_hsmi=65896990