Few would argue that the heart is the most important organ* in the body. Without a functioning brain, we are brain dead, but without a functioning heart, we are dead.
*A purist would point out that the heart is not an organ, but rather a muscle, but let’s not quibble…
Heart disease is the leading cause of death in the world and, according to the CDC, causes 1 in 4 deaths in the US. The risks of cardiovascular death and permanent disability are increased in those who smoke, drink in excess, are diabetic, hypertensive, hypercholesterolemic, sedentary, overweight and regularly eat junk and/or fast food. The good news is that after peaking in the 1990s, the death rates from heart disease (which includes hypertension, heart failure, coronary artery disease and stroke) is falling (see graph). The value of lifestyle modification–e.g., smoking cessation, weight loss, increased exercise, and healthy eating, in reducing heart-related deaths and disease, cannot be underestimated.
Reduction of mortality in acute cardiovascular events is attributable to early administration of thrombolytics, stenting (see below image of ATAX Paclitaxel drug-eluting stent) and other permutations of percutaneous coronary intervention, all of which are intended to ensure adequate flow through a blocked coronary artery. Another factor in the falling rates of cardiovascular death is the ever-expanding war chest of preventive agents, including anti-hypertensives and lipid-lowering drugs, most of which have come to market through extensive (read, expensive) clinical research. At any point in time, hundreds of trials involving thousands of patients are ongoing in phase 3 and phase 4 (post marketing) studies.
Current medical dictionaries have largely ignored studies and clinical trials, e.g., ACADEMIC, QUIET, SMILE, etc., which form the basis for evidence-based practice in the 21st century. Nor have these lexicons formally recognized the role that defects of specific genes–e.g., ACTC1, TTN, and CALR3 and so many more–play in genetic diseases–e.g., hypertrophic cardiomyopathy, of the heart, many of which have been linked to sudden cardiac death.
I began compiling material for the Modern Medical Dictionary (MMD) database in 1984, at the dawn of the age of clinical trials. The mid-1980s preceded evidence-based practice by a decade and a link between defective genes and heart disease by two.
The MMD’s focus from the beginning has been to catalog those terms that the reader would not find in his or her medical dictionary. Then, it was easier to keep track of clinical trials; there weren’t as many. Now, not a week goes by without the report of a new and important trial in a major peer-reviewed journal. My long-term plan is to release a subdatabase containing key details on the most important clinical trials. For the short term, however, the reader can download for free, an abbreviations and acronyms app from this website which at very least, will provide a translation of many trials’ acronyms.
Regarding genes and the heart, when the human genome was fully sequenced in 2003, no one knew how many genes there were. The earliest guess was about 100,000, a number which has fallen to 23,000. A fair few of them have been linked to cardiovascular disease, in particular, inherited cardiomyopathies. In a few days, we will release the beta version of an App with important details on over 8,000 genes. By the end of this year (2017) we should have an undated beta with 15,000 genes. The upper right column showcases a handful of the cardiology terms on the www.newmedicalterms.com website.
Stay tuned for the Genes App, due out by July 2017.