Breakthrough cardiac regeneration research offers hope for the treatment of ischemic heart failure

Researchers in the Michael E. DeBakey Department of Surgery at Baylor College of Medicine, the QIMR Berghofer Medical Research Institute in Brisbane, Australia, and collaborating institutions report a groundbreaking discovery in cardiac regeneration that offers new hope for the treatment of ischemic heart failure. Published in npj Regenerative Medicine, the study reveals a novel approach to promoting cardiomyocyte proliferation.

“When the heart cannot replace injured cardiomyocytes with healthy ones, it becomes progressively weaker, a condition leading to heart failure. In this study, we investigated a new way to stimulate cardiomyocyte proliferation to help the heart heal,” said co-corresponding author Dr. Riham Abouleisa, assistant professor in the Division of Cardiothoracic Surgery at Baylor.

Previous studies showed that calcium plays an important role in cardiomyocyte proliferation. In the current study, Abouleisa and her colleagues explored how modulating calcium influx in cardiomyocytes would affect their proliferation.

“We found that preventing calcium influx in cardiomyocytes enhances the expression of genes involved in cell proliferation,” Abouleisa said. “We prevented calcium influx by inhibiting L-Type Calcium Channel (LTCC), a protein that regulates calcium in these cells. Our findings suggest that LTCC could be a target for developing new therapies to induce cardiomyocyte proliferation and regeneration.”

The study demonstrates that both pharmacological and genetic inhibition of LTCC can induce cardiomyocyte replication and that this occurs by modulating the activity of calcineurin, a known regulator of cardiomyocyte proliferation. This innovative approach showed promising results both in human cardiac slices grown in the lab and in live animals.

“Abouleisa’s multi-continent collaborations led to a discovery that can revolutionize the use of current medicines that regulate calcium entry to the cells, such as Nifedipine, in heart failure patients,” said Dr. Tamer Mohamed, co-author and director of Baylor College of Medicine’s Laboratory for Cardiac Regeneration.

Co-author Dr. Todd K. Rosengart, chair and professor of the Michael E. DeBakey Department of Surgery, emphasized that, “The premise of regenerating heart tissue, which once seemed like an impossible dream, is getting closer almost daily. The work of Dr. Abouleisa and the Baylor cardiac regeneration team represents a major step toward human trials that I believe are in the not-too-distant future.”

Abouleisa and her colleagues’ research highlights the importance of targeting calcium signaling pathways to unlock the regenerative potential of the heart and opens new avenues for developing cardiac regenerative therapies, potentially transforming the treatment landscape for patients suffering from heart failure.

Reference:

Lynn A. C. Devilée, Abou bakr M. Salama, Jessica M. Miller, Janice D. Reid, Qinghui Ou, Nourhan M. Baraka, Kamal Abou Farraj, Madiha Jamal, Yibing Nong, Todd K. Rosengart, Douglas Andres, Jonathan Satin, Tamer M. A. Mohamed, James E. Hudson, Riham R. E. Abouleisa. Pharmacological or genetic inhibition of LTCC promotes cardiomyocyte proliferation through inhibition of calcineurin activity. npj Regenerative Medicine, 2025; 10 (1) DOI: 10.1038/s41536-025-00389-z

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Daily Chlorhexidine Wipes Do Not Significantly Reduce Diabetic Foot Complications, JAMA

A news study published in JAMA has determined that daily application of 2% chlorhexidine wipes for foot hygiene in diabetic veterans did not significantly decrease the risk of new foot complications compared with standard soap-and-water wipes. Diabetic foot ulcers are a severe and prevalent complication, and about 20% of them result in infections that necessitate lower extremity amputations. This study was conducted by Alison D. and fellow researchers.

This phase 2b double-blind placebo-controlled randomized clinical trial occurred from January 2019 to January 2023 at the Baltimore Veterans Affairs (VA) Medical Center. Patients had to be diabetic veterans with a risk for diabetic foot complications but without an acute foot infection. They were ambulatory and had intact feet. A total of 175 participants (97% male, mean age 68 years) were randomly assigned in a 1:1 ratio to receive either 2% chlorhexidine wipes (n = 88) or soap-and-water wipes (n = 87). The intervention lasted for one year, during which participants were instructed to use the assigned wipes daily, followed by the application of a standardized foot lotion.

Participants were supplied with lookalike wipes for blinding. The main outcome was time to first new foot complication, occurring after randomization and defined as chronic foot ulcer, foot infection, or amputation of a lower extremity. Data analysis was performed in an intention-to-treat fashion. Follow-up occurred over one year’s median duration, during which adverse effects and intervention compliance were closely observed.

Key Findings

• In a year, 12 (14%) and 14 (16%) participants in the chlorhexidine and soap-and-water groups, respectively, developed new foot complications.

• The time to the first new foot complication was 232 days (IQR: 115-315 days) in both groups.

• No significant hazard reduction of new foot complications in the chlorhexidine group was seen compared with the soap-and-water group (hazard ratio, 0.83; 95% CI, 0.39-1.80).

• 60 adverse events were documented throughout the study, but none of them resulted from the intervention. The adherence was very high with 145 participants (83%) sustaining the intervention during the entire study period.

The study authors concluded that daily use of 2% chlorhexidine wipes did not significantly influence prevention of new diabetic foot complications among diabetic veterans in comparison with soap-and-water wipes. These findings are valuable for future research regarding how to optimize preventive interventions for diabetic foot complications.

Reference:

Lydecker AD, Kim JJ, Robinson GL, et al. Chlorhexidine vs Routine Foot Washing to Prevent Diabetic Foot Ulcers: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(2):e2460087. doi:10.1001/jamanetworkopen.2024.60087

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Rituximab effective Steroid-Sparing Treatment of steroid-dependent or frequently relapsing nephrotic syndrome: BMC

A new study published in the journal of BMC Nephrology revealed rituximab to be an effective and safe steroid sparing medication in individuals with steroid dependent (SD)/frequent relapsing (FR) nephrotic syndrome (NS). Longer remission is attained when a follow-up maintenance dosage is administered following the initial course. 

According to the Kidney Disease: Improving Global Outcome (KDIGO) guidelines, glucocorticoid medication is advised as the first-line treatment for adult MCD since it has a positive prognosis. Although 75–90% of patients get a full response, up to 25% of steroid responders experience frequent relapses (FR), and 30–40% acquire steroid dependence.

Although corticosteroids are very effective in treating minimal change disease, many individuals develop steroid dependence or relapse often. Primary Focal Segmental Glomerulosclerosis (FSGS) has a lower response rate. An efficient substitute is needed as extended exposure to corticosteroids should be avoided and in this context, Rituximab is an agent with promise. Omri Feder and colleagues conducted a review to assess long-term safety and effectiveness of Rituximab therapy in adult patients with SD/FR NS.

This retrospective cohort research that assessed Rituximab-treated SD/FR NS patients at a tertiary institution. Rituximab was administered during induction, and the treating nephrologist made the choice about further dosages. Relapse frequency and time to first relapse were the main outcomes. Safety was evaluated.

There were 21 adults in total and out of these, 2 instances had no kidney biopsies, 5 (23.8%) had FSGS, and 14 (66.7%) had MCD. 54.6 years was the median age while 39.6 months was the median follow-up period. Rituximab significantly reduced the number of relapses when compared to prior therapy (median relapses were 0 versus 3, respectively, W = 3.70, p <.001). Before Rituximab, the time to first relapse was substantially shorter than after (median 11 vs. 536 days, respectively, W = 3.05, p =.002).

The patients who got a single course of Rituximab had a greater hazard ratio for recurrence than those who received further maintenance. Although the treatment was generally tolerated, severe COVID-19 and cholecystitis were among the significant side effects. Overall, in individuals with SD/FR NS, rituximab seems to be a safe and effective substitute for extended steroid therapy. Also, lengthier remission is attained when a follow-up maintenance dosage is administered following the first course. 

Source:

Feder, O., Amsterdam, D., Ershed, M., Grupper, A., Schwartz, D., & Kliuk-Ben Bassat, O. (2025). Long-term efficacy of Rituximab in steroid dependent and frequent relapsing adult nephrotic syndrome. BMC Nephrology, 26(1), 126. https://doi.org/10.1186/s12882-025-04035-0

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High-Dose Vitamin D Reduces Disease Activity in Early Multiple Sclerosis and CIS: JAMA

France: A recent randomized clinical trial, the D-Lay MS study, has demonstrated that high-dose vitamin D supplementation may significantly reduce disease activity in individuals with clinically isolated syndrome (CIS) typical of multiple sclerosis (MS). The findings highlight the potential role of vitamin D as an adjunct therapy in managing early-stage MS. 

“High-dose vitamin D not only reduced disease activity in early MS and CIS compared to placebo but also prolonged the time to disease activity, with patients on vitamin D experiencing a delay of 432 days versus 224 days in the placebo group, without any severe adverse events associated with the supplementation,” the researchers reported in JAMA.

Clinically isolated syndrome, the first neurological episode suggestive of multiple sclerosis, requires early intervention to delay disease progression. Among potential risk factors, vitamin D deficiency has been linked to increased disease activity in MS, raising interest in its therapeutic role. However, while supplementation is considered a promising strategy, existing evidence on its effectiveness remains inconclusive.

Against the above background, Eric Thouvenot, CHU Nimes, Service de Neurologie, Univ Montpellier, Nimes, France, and colleagues aimed to assess the effectiveness of high-dose cholecalciferol as a standalone treatment in lowering disease activity in patients with clinically isolated syndrome indicative of MS.

For this purpose, the researchers conducted the D-Lay MS trial, a parallel, double-blind, randomized placebo-controlled study across 36 MS centers in France. From July 2013 to December 2020, they enrolled untreated CIS patients aged 18 to 55 years, with CIS duration under 90 days, serum vitamin D levels below 100 nmol/L, and MRI findings meeting 2010 criteria for dissemination in space or oligoclonal bands. Participants were randomized to receive either 100,000 IU of oral cholecalciferol (n=163) or placebo (n=153) every two weeks for 24 months. The primary outcome was disease activity, defined by relapses or MRI changes.

Key Findings:

• Among 316 enrolled participants (median age 34 years, 70% women), 303 (95.9%) received at least one dose, and 288 (91.1%) completed the 24-month trial.

 • Disease activity was observed in 60.3% of the vitamin D group vs. 74.1% of the placebo group (HR, 0.66).

• Median time to disease activity was longer in the vitamin D group (432 vs. 224 days).

• MRI outcomes favored vitamin D over placebo:

• MRI activity: 57.1% vs. 65.3% (HR, 0.71).

• New lesions: 46.2% vs. 59.2% (HR, 0.61).

• Contrast-enhancing lesions: 18.6% vs. 34.0% (HR, 0.47).

 • There was no significant difference in secondary clinical outcomes, including relapse (17.9% vs. 21.8%).

• There were similar results in 247 patients meeting the 2017 relapsing-remitting MS criteria.

• Severe adverse events occurred in 17 patients in the vitamin D group and 13 in the placebo group, with none linked to cholecalciferol.

“The trial demonstrated that high-dose oral cholecalciferol (100,000 IU every two weeks) effectively reduced disease activity in CIS and early RRMS with a low risk of adverse events. These findings support further research on its potential as an add-on therapy in MS management,” the researchers concluded.

Reference:

Thouvenot E, Laplaud D, Lebrun-Frenay C, et al. High-Dose Vitamin D in Clinically Isolated Syndrome Typical of Multiple Sclerosis: The D-Lay MS Randomized Clinical Trial. JAMA. Published online March 10, 2025. doi:10.1001/jama.2025.1604

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Bilateral hearing loss prevalent in children with Down syndrome: Study

A new study published in the journal of Nature Scientific Reports showed that 4.1% of children with Down syndrome had sensorineural hearing loss (SNHL), whereas almost half (48.8%) had conductive hearing loss (CHL).

Hearing loss in DS patients can be caused by a number of circumstances. Otitis medium with effusion (OME) is the most frequent cause of CHL and a very common disease in children with DS. Due to the difficulty of diagnosing hearing impairment, parents and professionals face difficulties. To determine the prevalence of OME, permanent, and transitory hearing loss in children with DS who are receiving care at Mansoura University Children’s Hospital, Sohier Yahia and team carried out this study.

A total of 170 juvenile individuals with genetically proven DS are the subjects of this descriptive cross-sectional research. From October 2021 to October 2022, patients were gathered from the Mansoura University Children’s Hospital’s genetic outpatient clinic. A lateral X-ray of the nasopharynx with the mouth open and the neck extended was performed on all babies and children after a thorough history was taken.

After examination, any accumulated cerumen in the ears was removed. The tympanic membrane was examined otoscopically to determine whether middle ear pathology was present. Tympanometry was used to evaluate otitis media with effusion and eustachian tube dysfunction. Pure tone audiometry (PTA) and auditory brain stem response (ABR), among other appropriate hearing tests, were employed.

Of the children with DS in the study, 4.1% had sensorineural hearing loss and 48.8% had conductive hearing loss. Bilateral affection was observed in 86.5% of hearing-impaired individuals. 59.1% of individuals with CHL and 71.4% of patients with SNHL had minor hearing loss. Of the total CHL patients, 45.8% had stagnant HL, 15.7% had a regress from moderate to mild HL, and 38.6% had normalized HL.

All 7 afflicted individuals had persistent SNHL, with 4 showing a stable course and three showing a progressive one. In babies and children with DS, CHL was frequently linked to OME, adenoid hypertrophy, and upper respiratory tract infections (URTI). The majority of kids with DS have modest, bilateral hearing loss. The majority of HL is conductive. Overall, every newborn and youngster with Down syndrome should have their hearing evaluated. Even with a standard newborn hearing screening test, patients with DS should be monitored.

Source:

Yahia, S., Metawea, M., Megahed, A., ELshawaf, W., Wahba, Y., & Mahmoud, R. (2025). The prevalence of hearing impairment in infants and children with down syndrome a cross sectional study in a Tertiary Care Center. Scientific Reports, 15(1), 7570. https://doi.org/10.1038/s41598-025-90500-7

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Maternal cannabis use triples risk of disruptive behaviour in children: Study

Children exposed to their mother’s cannabis use during pregnancy and after birth are three times more likely to develop behavioural problems, new Curtin University research has found.

Published in Psychiatry Research, the study analysed data from more than 222,600 Australian mothers and children, revealing maternal cannabis use disorder (CUD) during pregnancy and the postnatal period significantly increased the risk of childhood disruptive behavioural disorders.

Lead researcher Abay Tadesse, from Curtin’s School of Population Health, said the findings highlighted the need for interventions targeting cannabis use among reproductive-age women.

“We found children of mothers with cannabis use disorder were at a significantly higher risk of developing behavioural issues such as oppositional defiant disorder (ODD) and conduct disorder (CD),” Mr Tadesse said.

“Our research showed maternal cannabis use during pregnancy increased the risk of disruptive behavioural disorders by 3.56 times, while postnatal use increased the risk by 2.95 times.

“With an estimated one in five Australian pregnant women using cannabis and disruptive behavioural disorders on the rise, our findings underscore the growing public health concern around cannabis use.”

Professor Rosa Alati, the Head of Curtin’s School of Population Health, said the study highlighted the lasting impact of maternal cannabis use on children’s mental health.

“Cannabinoid ingredients can cross the placenta and enter breast milk, potentially affecting brain development. This research provides critical evidence to help shape health policies aimed at minimising harm,” Professor Alati said.

“While intervention strategies are essential, further genetic research is also needed to better understand the link between maternal cannabis use and childhood behavioural disorders.”

This study identifies maternal cannabis use as a significant risk factor for childhood disruptive behavioural disorders, acknowledging that these associations are also likely to be influenced by a range of genetic, environmental and social factors.

Reference:

Abay Woday Tadesse, Berihun Assefa Dachew, Getinet Ayano, Kim Betts, Rosa Alati, Maternal cannabis use disorder and offspring behavioral outcomes: findings from a linked data cohort study, Psychiatry Research, https://doi.org/10.1016/j.psychres.2025.116404.

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Diabetes drug could help cancer patients make better recovery, suggests study

A common type of diabetes medication could help cancer patients make a better long-term recovery, according to new research from the University of East Anglia.

Many cancer patients go on to develop heart failure-because of the cancer itself and also due to chemotherapy. This can lead to a reduced quality of life, multiple admissions to hospital or even death.

But a new study published today shows that a type of diabetes medication, called an SGLT2 inhibitor, may help protect the heart during and after cancer treatment.

This is the first time that any medication has been shown to be beneficial in reducing heart failure or heart failure hospitalisation in cancer patients and survivors.

The medication appears to lower the risk of heart failure and unplanned hospital visits related to heart failure by more than 50 per cent.

And the benefits were found to be particularly promising for breast cancer patients receiving a common chemotherapy type called anthracycline chemotherapy, which can affect heart health.

Lead researcher Prof Vassilios Vassiliou, from UEA’s Norwich Medical School and Consultant Cardiologist at the Norfolk and Norwich University Hospital, said: “Cancer is currently one of the leading causes of premature death worldwide​.

“Chemotherapy has played an instrumental role in improving patient outcomes. But up to 20 per cent of cancer patients who have had chemotherapy go on to develop heart problems, with up to 10 per cent having heart failure.

“We know that a type of diabetes medication called SGLT2 inhibitors are recognised for their cardiovascular benefits. They can improve the symptoms of heart failure such as breathlessness and tiredness, and also reduce people’s risk of becoming frail.

“We wanted to see whether SGLT2 inhibitors could help protect the heart during and after cancer treatment.”

Analysing 13 studies with a total of 88,273 cancer patients and survivors, the team found that hospital admissions for heart failure were reduced by half.

The effect was especially striking in breast cancer patients undergoing anthracycline chemotherapy, offering a promising breakthrough in patient care

The number of new heart failure cases appeared to fall by more than two-thirds (71 per cent), suggesting these pills might help protect the heart during and after cancer treatment, though the research team say that more research is needed to confirm these findings. 

Prof Vassiliou said: “What we found is that SGLT2 inhibitors may help protect the heart during and after cancer treatment.

“These medications significantly lowered the risk of heart failure and reduced hospital visits related to heart failure.

“The benefits are particularly promising for breast cancer patients receiving a common type of chemotherapy called anthracycline chemotherapy,” he added.

“We hope that this type of medication could in future be used as routine for cancer patients.”

Reference:

U Bhalraam, Rathna B Veerni, Sophie Paddock, James Meng, Massimo Piepoli, Teresa López-Fernández, Vasiliki Tsampasian, Vassilios S Vassiliou, Impact of sodium–glucose cotransporter-2 inhibitors on heart failure outcomes in cancer patients and survivors: a systematic review and meta-analysis, European Journal of Preventive Cardiology, 2025;, zwaf026, https://doi.org/10.1093/eurjpc/zwaf026.

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SGLT2 Inhibitors May Lower Risk of Atopic Dermatitis in Diabetics: Study

Researchers have identified in a new study that sodium-glucose cotransporter-2 inhibitors (SGLT2i) could diminish the risk for the development of atopic dermatitis (AD) in patients with type 2 diabetes. Atopic dermatitis, characterized as a metabolic inflammatory skin condition, is recognized to have associations with the metabolic syndrome. Given SGLT2i’s ability to promote glucose and sodium excretion through urine, their impact on skin conditions has gained interest. The study was published in The British Journal of Dermatology by Yuan-Liang and colleagues.

This nationwide, active-comparator cohort study used data from the Taiwan National Health Insurance Database. Adult type 2 diabetes patients who started either SGLT2i or DPP4i between May 2016 and December 2018 were included, as long as they had no previous prescriptions for these drugs in the 12 months prior to recruitment. The study group consisted of 148,354 SGLT2i users, and the comparator group consisted of 322,703 DPP4i users. The main outcome was AD incidence, which was measured with Cox proportional hazards regression models. To control for confounders, inverse probability of treatment weighting (IPTW) was used to balance variables like baseline parameters, medical history, and prior medication use. Other analyses, such as sensitivity tests, subgroup analysis, and gender analysis, were also carried out for cross-validation.

Key Findings

  • Reduced Rate of AD: The incidence of AD in SGLT2i users was 9.742 per 1,000 person-years and in DPP4i users was 12.070 per 1,000 person-years.

  • Substantial Risk Reduction: SGLT2i users, after IPTW adjustment, presented with a 16% lower risk of AD compared to DPP4i users (HR = 0.847).

  • Persistent Protective Effect: All SGLT2i classes experienced a persistent reduced risk for AD.

  • Dose-Dependent Benefit: The highest dose of SGLT2i was linked with the lowest AD risk (IPTW-adjusted HR = 0.647), which lends support to a hypothetical dose-response relationship.

  • Gender Differences: Male SGLT2i users exhibited a greater protective effect against AD (IPTW-adjusted HR = 0.750) compared to female users.

The research implies several mechanisms through which SGLT2i could decrease AD risk. Through glucose excretion, these drugs could decrease systemic inflammation, a central mechanism in AD pathogenesis. The sodium loss caused by SGLT2i could have immunomodulatory effects, perhaps affecting skin barrier function and inflammatory processes.

The study authors concluded that SGLT2i markedly decreases AD risk in patients with diabetes versus DPP4i, and the highest efficacy is achieved at higher doses. These findings confirm that SGLT2i can be utilized not only to manage diabetes but also as a measure to prevent AD, especially in men. More research should investigate the mechanisms and long-term skin effects of SGLT2i.

Reference:

Wen, Y.-L., Hsu, W.-T., Chen, Y.-H., Kao, H.-H., Liao, C.-C., To, S.-Y., Yang, H.-W., & Kao, L.-T. (2025). Sodium-glucose cotransporter 2 inhibitors and inverse risk of new-onset atopic dermatitis in diabetic population: A nationwide, active-comparator study. The British Journal of Dermatology. https://doi.org/10.1093/bjd/ljaf086

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Levels of select vitamins & minerals in pregnancy may be linked to lower midlife BP risk: Study

Women with higher levels of essential minerals circulating in their blood during pregnancy, particularly copper and manganese, along with vitamin B12, had a lower risk of developing high blood pressure in middle age, about 20 years later, according to research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2025. The meeting will be held in New Orleans, March 6-9, 2025, and offers the latest science on population-based health and wellness and implications for lifestyle. According to the study authors, it is the first to explore the associations of pregnancy metal levels with women’s midlife blood pressure and hypertension risk, and the full manuscript is simultaneously published today in the American Heart Association’s peer-reviewed journal Hypertension.

Manganese, selenium, magnesium and copper are among the essential metals important for a healthy body because their anti-oxidation and anti-inflammatory properties may help protect against cardiovascular disease. Previous researchhas found that higher levels of manganese were associated with a lower risk of preeclampsia (high blood pressure during pregnancy). However, it is not known whether higher levels of essential metals during pregnancy may influence the risk of developing high blood pressure later in life. Additionally, chronic exposure to the non-essential metals lead, cadmium and arsenic is associated with an increased risk of cardiovascular disease, according to the Association’s 2023 scientific statement “Contaminant Metals as Cardiovascular Risk Factors.“

“People are constantly exposed to heavy metals and trace elements, and much research has shown that exposure to those metals and elements may have an impact on cardiovascular health, especially hypertension,” said lead study author Mingyu Zhang, Ph.D., M.H.S., an epidemiologist and instructor in medicine at Beth Israel Deaconess Medical Center and Harvard Medical School, both in Boston. “In our study, we wanted to examine how levels of essential metals and elements during pregnancy may affect blood pressure and hypertension risk in midlife.”

The researchers analyzed data from Project Viva, an ongoing, long-term study that began in 1999 of women and their children who live in eastern Massachusetts. Nearly 500 women enrolled in the study during early pregnancy, between 1999 and 2002. Researchers measured concentrations of non-essential metals (arsenic, barium, cadmium, cesium, mercury and lead), essential minerals (copper, magnesium, manganese, selenium and zinc), folate and vitamin B12 in blood samples collected during study enrollment.

After nearly twenty years of follow-up, researchers conducted a “midlife” study visit between 2017 and 2021 with the same study participants, who were now at a median age of 51.2 years. Researchers measured blood pressure to assess potential associations of individual metals with blood pressure and high blood pressure risk. Participants were categorized as having high blood pressure if blood pressure measures were greater than 130/80 mm Hg or if participants confirmed taking anti-hypertensive medication. In addition, the potential collective effects of all eleven metals and two micronutrients on blood pressure were analyzed.

The study found:

  • After researchers adjusted for sociodemographic factors, as levels of copper and manganese doubled in the blood during pregnancy, the risk of high blood pressure in midlife was 25% and 20% lower, respectively.
  • As blood levels of vitamin B12 doubled during pregnancy, women had an average 3.64 mm Hg lower systolic blood pressure and 2.52 mm Hg lower diastolic blood pressure almost two decades later. About 95% of the study participants had vitamin B12 levels within the normal range, the researchers noted.
  • Blood levels of the mixture of copper, manganese, selenium and zinc were also associated with lower blood pressure in a relationship that increased with dose. Nonessential metals did not have a significant impact on blood pressure.

“Circulating levels of these metals and minerals in blood were measured, however, the sources of exposure, such as food or dietary supplements, were not quantified so these findings should not be interpreted as recommendations,” Zhang said. “Optimizing these essential metals, minerals and vitamins, particularly copper, manganese and vitamin B12, during pregnancy may offer protective benefits against hypertension in midlife, an especially critical time period for women’s future cardiovascular risk in later life.”

“More research including clinical trials is needed to determine the optimal dietary intake of these minerals and micronutrients,” he added. The researchers hope to ultimately identify women at high risk for developing high blood pressure later in life and intervene during pregnancy, either with enhanced nutrition or supplements.

Study details, background and design:

  • The analysis included 493 women enrolled in Project Viva, a prospective study examining the effects of environmental and lifestyle factors during pregnancy on the short and long-term health of women and their children.
  • Project Viva enrolled women in early pregnancy between 1999 and 2002. The women had a median age of 32.9 years at enrollment. Participants were followed for 18.1 years, through 2021.
  • 72% of participants self-identified as white women; 11% were self-identified as Black women; and 17% self-identified as Hispanic or Latina, Asian or Pacific Islander, American Indian or Alaskan Native, or selected “Other” race, more than one race or “do not know.”
  • Blood samples were collected at study enrollment and stored in freezers for subsequent analyses. The researchers accessed blood samples and analyzed them for this study in 2018. Folate and vitamin B12 were also measured in blood plasma samples during pregnancy.
  • Blood pressure was measured in study participants during a “midlife” (median age of 51 years) study visit between 2017 and 2021. During this visit, trained research assistants measured participants’ blood pressure up to five times, at one-minute intervals. Blood pressure measurements were then averaged.
  • The analyses were adjusted for maternal age at study enrollment, pre-pregnancy body mass index, race and ethnicity, education, household income, parity (the number of pregnancies carried to term), use of anti-hypertensive medication, DASH diet score in early pregnancy and multivitamin intake.

The study’s limitations include that it was an observational study, meaning other confounding factors that were not measured in the study may have affected the results; the researchers only included a subset of the original Project Viva participants; and there were demographic differences between participants included and excluded. In addition, the researchers did not have measurements for metal levels between delivery and midlife; and participants were predominantly white women who resided in Eastern Massachusetts, which may limit the generalizability of the study’s findings.

Reference:

Levels of select vitamins & minerals in pregnancy may be linked to lower midlife BP risk, American Heart Association, Meeting: AHA Epidemiology Lifestyle Scientific Sessions 2025.

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Collagenase Injection More Effective Than Needle Fasciotomy for Primary Dupuytren Contracture: study

Collagenase Clostridium histolyticum (CCH) and percutaneous needle fasciotomy (PNF) are two treatment options for Dupuytren disease. Ingi Thor Hauksson et al conducted a study was to compare these 2 methods in terms of clinical and patient reported outcomes. It was performed at Akershus University Hospital, Lørenskog, Norway

Eighty patients (median age, 72 years; 83% male) with a single-digit primary metacarpophalangeal (MCP) joint contracture of more than 30degree were randomized to either CCH or PNF and followed for 5 years.

Collagenase (0.58 mg) was injected into the palpable cord in the proximal zone 2 of the involved digit, followed by an extension manipulation 24 hours later under use of a local finger anesthetic block. PNF was performed according to the Lermusiaux multiple perforation technique.

The primary outcome was the difference in flexion-contracture reduction at the MCP joint from baseline to 2 years, with additional analysis examining the effect of the primary endpoint variable up to 5 years. Secondary outcomes included complications, grip strength, scores on the visual analogue scale (VAS) for pain, the shortened version of the Disabilities of the Arm, Shoulder and Hand, the brief Michigan Hand Questionnaire, Unit´e Rhumatologique des Affections de la Main, and a VAS for treatment satisfaction as well as recurrence and retreatments.

The main findings of the study were:

• The mean MCP joint contracture was 48deg at baseline and 2deg at 5 years in the CCH group, and 50deg at baseline and 7deg at 5 years in the PNF group.

• The reduction in MCP contracture at 2 years was larger in the CCH group than in the PNF group, with a mean difference between the groups of 12deg (95% confidence interval [CI], 1.5deg to 22.3deg; p = 0.026).

• At 5 years, this mean difference was reduced to 6deg (-1.5deg to 12.8deg; p = 0.1).

• There was no difference between the groups in any patient reported outcome scores or grip strength beyond 4 weeks, with the exception of the brief Michigan Hand Questionnaire at 5 years.

• Ten (25%) of the patients in the PNF group compared with no patient in the CCH group had recurrence (contracture of more than 30) at the MCP joint at 2 years.

• At 5 years, 17 (42.5%) of 40 patients in the PNF group had been retreated compared with 4 (10%) of 40 in the CCH group (p < 0.001).

• The CCH group experienced more transient complications (stiffness and

• hematoma) during the first week and were more satisfied (VAS satisfaction) from 1 year to the 5-year follow-up.

The authors concluded that – “Our study supports the use of CCH as a more durable treatment for primary Dupuytren disease MCP joint contracture. It reduced the need for further treatment for a large proportion of patients for at least 5 years. However, PNF treatment is a safe and effective initial option, which delays more costly treatments (CCH) or invasive surgical procedures.”

Level of Evidence: Therapeutic Level I.

Further reading:

Collagenase Clostridium histolyticum Versus Needle Fasciotomy for Primary Metacarpophalangeal Dupuytren Contracture Five-Year Results from a Randomized Controlled Trial Ingi Thor Hauksson et alJBJS Open Access 2024:e24.00038. http://dx.doi.org/10.2106/JBJS.OA.24.00038

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