THURSDAY, Aug. 7 (HealthDay News) -- Having excess fat around your heart may be more dangerous than a high body mass index (BMI) or a thick waist in terms of your heart attack risk, according to new research.

Wake Forest University Baptist Medical Center researchers and colleagues measured fat deposits around the heart (pericardial fat) in 159 people, ages 55 to 74, and found that those with the highest levels of pericardial fat were 4.65 times more likely to have calcified coronary plaque in the arteries. While calcified coronary plaque itself isn't considered risky, it's associated with the presence of less stable fatty deposits that can lead to heart attack and stroke.

The researchers didn't find an association between volume of pericardial fat and BMI or waist circumference.

Their study is published in the August issue of the journal Obesity.

"Our findings suggest that local fat deposits, rather than total body fat, are most related to calcified coronary plaque. Inflammatory mediators released from pericardial fat may promote inflammation in local coronary arteries and lead to coronary atherosclerosis," study lead author Dr. Jingzhong Ding, an assistant professor of gerontology, said in a Wake Forest news release.

Even thin people can have fat around the heart, noted Ding, adding that he wants to find out whether the buildup of fat around the heart can be prevented.

"Because coronary heart disease kills so many people, it is imperative to find new treatments and prevention strategies," he said.

More information

The American Academy of Family Physicians outlines heart attack warning signs and risk factors  .

SUNDAY, Aug. 3 (HealthDay News) -- More accurate decisions about treatment of stroke patients in remote locations can be made using telemedicine consultations, compared with telephone consultations, according to U.S. researchers.

Telemedicine includes real-time, two-way audio and video and digital imaging and communications.

The study included 222 adult stroke patients at four remote sites in California who were randomly assigned to telemedicine (111 patients) or telephone consultation (111 patients) to assess their suitability for treatment with thrombolytic drugs.

Correct treatment decisions were made in 98 percent of telemedicine consultations and in 82 percent of telephone consultations. Thrombolytics were given to 31 percent of patients in the telemedicine group and to 25 percent of patients in the telephone group.

After three months, both groups had similar rates of stroke recurrence or death. But this could be because the study was halted early, because it was clear that telemedicine was far superior when making treatment decisions, the study authors said.

"The results of this trial show that telemedicine is efficacious for making acute medical decisions. Stroke telemedicine is widely implemented and discussed, but despite its dissemination, its efficacy has not previously been shown. Our results support the use of telemedicine to make urgent treatment decisions, such as whether to use thrombolytic therapy for acute stroke," wrote Dr. Brett C. Meyer, of the University of California, San Diego, School of Medicine Stroke Center, and colleagues.

The study was published online Sunday in The Lancet Neurology and was expected to be in the September print issue of the journal.

More information

The U.S. Food and Drug Administration has more about stroke.

FRIDAY, Aug. 1 (HealthDay News) -- Scientists have long observed a link between depression and heart disease. Now there's research to help pinpoint the symptoms of depression that may signal cardiovascular trouble.

A study suggests that people who suffer from depression, especially certain physical symptoms such as loss of appetite, sleep problems or fatigue, may be at risk of developing heart disease.

"Our findings raise the possibility that the physical symptoms of depression are particularly toxic to the cardiovascular system," said the study's lead author, Jesse C. Stewart, assistant professor in the Department of Psychology at Indiana University-Purdue University, Indianapolis. "Identifying the most harmful aspect of depression is important, because we will then know which specific components to target with our treatments."

Previous studies have linked negative emotions, including depression, anxiety and anger, to a heightened risk of heart disease. But because these emotions tend to overlap and "co-occur" within people, it's been difficult to associate a particular symptom -- or set of symptoms -- with heightened cardiovascular risk, Stewart explained.

His study, published in the Archives of Internal Medicine, is believed to be the first to tease out which emotions are key risk factors for heart disease.

"Our study is important, because it is the first to simultaneously examine the links between all of these negative emotions and sub-clinical atherosclerosis," Stewart said. "In addition, we broke depression down into physical and cognitive/emotion symptom clusters, which is uncommon."

Stewart's team measured the internal carotid artery thickness of 324 adults at the beginning of the study and three years later.

Thickening of the inside walls of the coronary arteries -- atherosclerosis -- slows or blocks the flow of blood to the heart and brain and can lead to heart attack or stroke. The carotid artery is the large vessel in the neck that supplies blood to the brain.

The study found that depressive symptoms, but not anxiety and anger, were associated with greater thickening of the arteries over time. Further analyses indicated that only the physical symptoms of depression were associated with thickening arteries, while the cognitive and emotional symptoms of depression, such as sadness, pessimism, and indecisiveness, were not related.

Scientists have not yet established whether depression causes heart disease or whether some other factor, such as diet, affects depression and heart disease. In a review of the epidemiologic data, published in 2007, Dr. Francois Lesperance, a professor in the Department of Psychiatry at the University of Montreal in Canada, noted that the evidence supports each theory.

While it might be useful to identify depression as a marker for future heart trouble, it's still not a proven tool. "No secondary prevention trial has successfully reduced cardiovascular risk by targeting depression," Lesperance wrote.

Robert M. Carney, a professor of psychiatry and director or the Behavioral Medicine Center at Washington University School of Medicine in St. Louis, agreed. "There currently exists no evidence that treating depression will help prevent heart disease," he said. "The biggest reason is that studies that would be needed to draw that conclusion would have to be large and therefore very expensive."

Still, Carney thinks it's important for patients to know that depression is a risk factor for developing heart disease. What's more, the potential benefits of recognizing and treating depression, such as improved quality of life, are well known and sufficient reason to get treatment, he noted. "Hopefully, an added bonus will be to reduce the risk of developing or suffering from heart disease," he said.

Stewart is planning other studies examining the relationships between depression and hostility, and various measures of cardiovascular risk. He also plans to investigate whether positive emotions -- happiness, for example -- and related factors, such as optimism, are associated with reduced cardiovascular risk and therefore protective against heart disease.

"Ultimately, we plan to use the data from this study and similar investigations to develop a psychological treatment for adults at risk for cardiovascular disease," Stewart said. "We hope that our treatment, when combined with standard treatments, will help to prevent the development of cardiovascular disease."

More information

For more on depression and related health risks, visit the National Institute of Mental Health.

WEDNESDAY, July 30 (HealthDay News) -- A mesh patch designed to regenerate cardiac muscle damaged by a heart attack or heart failure has done well in animal studies and preliminary human trials.

The patch is made of vicryl, a material used for suturing injured tissue that is later absorbed by the body, explained Jordan J. Lancaster, a predoctoral fellow at the Southern Arizona VA Medical Center in Tucson, who reported on the animal studies Wednesday at an American Heart Association meeting in Keystone, Colo.

"The mesh is grown in a bioreactor with human dermal fibroblast cells," Lancaster said. When the patch is placed on the heart, it delivers cells that grow to strengthen the heart muscle.

"We evaluated this patch in two studies," Lancaster said. "One was in an acute situation, immediately after a heart attack, the other was in chronic heart failure."

After a heart attack, he explained, there is abnormal enlargement of the left ventricle, which pumps blood to the body. The ventricle also works harder, which can ultimately lead to heart failure.

Applying the patch to rats after a heart attack, "we were able to prevent the negative functioning and the negative remodeling," Lancaster said. Blood flow to the heart muscle increased by 37 percent for rats who got the patch immediately after a heart attack, and the blood-pumping ability of the heart increased by 40 percent.

A second series of experiments applied the patch to rats three weeks after a heart attack to study its effect on heart failure. Blood flow was improved by 116 percent, and blood-pumping ability improved by 21 percent.

The animal studies were sponsored by Theregen Inc., a San Francisco company that has started human studies of the patch. A first study, primarily to test the safety of the patch, was done last year by Dr. Bartley P. Griffith, chief of cardiac surgery at the University of Maryland.

"We were very pleased," Griffith said of the trial, which included 12 heart attack patients. "In our patients, the application of the patch was not associated with any complications. The application of the patch is quite simple. Four stitches are enough to attach the patch."

One of the people given the patch died, and a study of the heart showed "remarkable new blood vessel formation," Griffith said. "We had generally very positive outcomes."

A second round of human trials has begun, said Dr. Gary Gentzkow, chief medical officer of Theregen. One trial is designed to study the effect of the patch on heart function. The second trial is intended to get a detailed look at heart tissue after the patch is applied. The subjects are people with heart conditions severe enough to require implanted heart-assist devices.

The trials are being done at several medical centers in the United States, Gentzkow said. "Enrollment is finished in the studies," he said. "We are in the follow-up phase. We expect complete follow-up results this year."

Further human studies depend on the results of those trials, Gentzkow said.

More information

Current heart attack treatments are described by the U.S. Heart, Lung, and Blood Institute.