FYI from the NHLBI Index
May 2011: Vol. 12, Issue 1
In the News
News from Capitol Hill
Science Advances from the NHLBI
- Modified Surgical Approach Benefits Infants with Congenital Heart Defects
- Study Validates Alternate Therapy for Adults with Uncontrolled Asthma
- Treatment for Depression Benefits Heart Disease Patients
News from Capitol Hill
Appropriations for Fiscal Year (FY) 2011
The fiscal year (FY) 2011 appropriations process was completed on April 15, 2011, when the President signed the Department of Defense and
Full-Year Continuing Appropriations Act, 2011 (H. R. 1473) into law (Public Law 112-10). The law provides $30.7 billion for the NIH, a 1 percent
decrease from its FY 2010 appropriation.
Pulmonary Hypertension Legislation Introduced
On April 8, 2011, Senator Robert Casey (D-PA) introduced S. 775, the Tom Lantos Pulmonary Hypertension Research and Education Act of 2011, to
encourage research and carry out an educational campaign on pulmonary hypertension. Provisions related to research would direct the Secretary of
Health and Human Services, through the NHLBI Director, to continue to encourage basic research on the causes of pulmonary hypertension, including
the relationship between scleroderma and sickle cell anemia and pulmonary hypertension, clinical research, and training of new clinicians and
investigators with expertise in pulmonary hypertension. S. 775 would also require the NIH to include information on the status of NIH pulmonary
hypertension research in the NIH biennial report. The bill was referred to the Senate Committee on Health, Education, Labor, and Pensions.
Scleroderma Research and Awareness Legislation Introduced
On March 17, 2011, Senator Kristen Gillibrand (D-NY) introduced S. 649, the Scleroderma Research and Awareness Act, to authorize the Director
of the National Institute of Arthritis and Musculoskeletal and Skin Diseases to expand, intensify, and coordinate scleroderma activities. The bill
would also require the NIH to include information about the status of scleroderma research in the NIH biennial report. The bill was referred to
the Senate Committee on Health, Education, Labor, and Pensions.
Acquired Bone Marrow Failure Disease Legislation Introduced
On February 10, 2011, Representative Doris Matsui (D-CA) introduced H.R. 640, the Bone Marrow Failure Disease Research and Treatment Act of 2011,
to enhance Federal efforts to address bone marrow failure disease. One of the bill’s provisions would establish an Advisory Committee on Acquired
Bone Marrow Failure Diseases through the CDC. The bill would require the committee to include a representative from the NHLBI. The bill was referred
to the House Energy and Commerce Committee.
Senate Recognizes Rare Disease Day
On February 17, 2011, the Senate passed by unanimous consent S. Res. 74, introduced by Senator Sherrod Brown (D-OH), to designate February 28, 2011,
as Rare Disease Day. The resolution recognizes the importance of improving awareness and encouraging accurate and early diagnosis of rare diseases
and disorders; and supports a national and global commitment to improving access to, and developing new treatments, diagnostics, and cures for
rare diseases and disorders.
Science Advances from the NHLBI
Modified Surgical Approach Benefits Infants with Congenital Heart Defects
Hypoplastic left heart syndrome and related anomalies are severe congenital heart defects that require three-stage surgical
reconstruction. The initial operation—the Norwood procedure—which is usually performed within the first week of life, carries
the highest mortality risk of all congenital heart defect surgeries. The Single Ventricle Reconstruction (SVR) trial compared
the standard Norwood procedure with a recently developed variation—the Sano modification—and found significantly higher survival
to one year of age with the newer approach. Infants who participated in the SVR continue to be followed so that researchers can
compare the long-term effects of the two surgeries. In addition, the trial collected a wealth of clinical data that will facilitate
identification of other therapeutic and supportive strategies for fragile infants with congenital heart defects and suggest new
directions for future comparative effectiveness trials.
Study Validates Alternate Therapy for Adults with Uncontrolled Asthma
Many adults with asthma experience poor symptom control with inhaled corticosteroids (ICS) alone. Increasing the dose of ICS or
adding a long-acting beta agonist (LABA) are options for “stepping-up” treatment to relieve symptoms. However, higher ICS doses
are not effective for all patients and often cause side effects, and LABAs are under FDA scrutiny for possible safety concerns.
The Tiotropium Bromide as an Alternative to Increased Inhaled Corticosteroid in Patients Inadequately Controlled on a Lower Dose
of Inhaled Corticosteroid (TALC) trial found that patients who received triotropium bromide, a drug used to treat chronic obstructive
pulmonary disease but not approved for asthma, achieved control as good as those given LABA and better than those whose ICS dose was
doubled. Adverse effects did not differ significantly among the three treatments. The TALC trial results suggest that tiotropium
bromide may be a satisfactory step-up treatment for adults whose asthma is not well controlled by low-dose ICS.
Treatment for Depression Benefits Heart Disease Patients
Two recent studies have demonstrated that innovative stepped-care approaches to depression treatment can benefit heart disease
patients. Although depression is quite common in people suffering from heart disease, past research found that standard antidepressive
treatments only modestly improved their mood and quality of life. One of the new studies, in patients who had undergone coronary artery
bypass surgery, tested an approach that involved telephone monitoring of depressive symptoms coupled with as-needed behavioral counseling
and antidepressant medication. Compared with usual care, the new approach resulted in substantial improvements in quality of life and
reductions in depressive symptoms. The second study, in people with acute coronary syndromes, found that a stepped-care treatment
focused on alleviating depressive symptoms not only reduced them but also improved cardiac prognosis. Effective methods for treating
depression in heart disease patients could lengthen survival and reduce health-care costs, while improving quality of life.
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