ARYA Atherosclerosis[JOURNAL]
Sun
200 papers
The effect of ox-LDL and platelets on macrophages, M2 macrophage polarization, and foam cell formation.
Barati F, Bashash D, Mohamadi MH … +2 more , Mehrpori M, Hamidpour M
ARYA Atheroscler · 2023 Jan · PMID 38883152 · Full text
BACKGROUND: The accumulation of oxidized LDL (ox-LDL) in macrophages in association with platelet activity leads to the formation of foam cells, which play a key role in the pathophysiology of atherosclerosis and coronar...
BACKGROUND: The accumulation of oxidized LDL (ox-LDL) in macrophages in association with platelet activity leads to the formation of foam cells, which play a key role in the pathophysiology of atherosclerosis and coronary artery diseases (CAD). Here, in this study, we aimed to investigate the simultaneous effect of ox-LDL and platelets on foam cell formation, as well as modification in cell markers. METHOD: First, the U937, a human monocytic cell line, was cultured in RPMI-1640. Then, isolated platelets were co-cultured with the U937 and exposed to ox-LDL (80 µg/ml) to evaluate the impact of ox-LDL on foam cell formation using Oil red O (ORO) staining. Also, the expression of foam cells' surface markers and and genes, which are involved in macrophage metabolism and ox-LDL uptake, was measured by flow cytometry and real-time PCR, respectively. RESULTS: Our findings suggest that platelets promoted foam cell formation (ORO-positive cells), accompanied by a higher level of CD163+ M2 macrophages. Furthermore, the expression of , and genes, which are implicated in cholesterol accumulation in macrophages, was significantly upregulated in the ox-LDL+ platelets group compared to the control (P < 0.05). Moreover, the up-regulation of and genes in the ox-LDL+ platelets group was more accentuated compared to the ox-LDL group (P < 0.05). CONCLUSIONS: Owing to the positive effector role of platelets in the formation of foam cells and CD163+ cells, it could be assumed that platelets play a dual role in the development of these cells.
Differences in gender and outcomes following isolated coronary artery bypass graft (CABG) surgery.
Sadeghi R, Miri R, Kachoueian N … +2 more , Sistanizad M, Hassanpour R
ARYA Atheroscler · 2023 Jan · PMID 38883151 · Full text
BACKGROUND: Gender impacts pre-, intra-, and postoperative parameters and outcomes following coronary artery bypass graft (CABG) with conflicting results. This study aimed to identify differences in preoperative, intraop...
BACKGROUND: Gender impacts pre-, intra-, and postoperative parameters and outcomes following coronary artery bypass graft (CABG) with conflicting results. This study aimed to identify differences in preoperative, intraoperative, and postoperative parameters. It also seeks to compare the postoperative complications and mortality between two genders who had CABG surgery. METHOD: This prospective observational study included patients who had isolated CABG and were divided based on gender. Demographic information, underlying comorbidities, drug history, clinical and laboratory data at the time of referral, operative characteristics, postoperative variables, and mortality outcomes were tracked during hospitalization and six months after discharge. RESULTS: Three hundred twenty patients were enrolled in the study during its duration. 71% were male. Women were older (62.40±9.03 vs. 59.99±9.81 years, p= 0.011) and had more dyslipidemia (p=0.003), hypertension (p=0.000), and diabetes (p=0.001), whereas men admitted with more myocardial infarction (MI) (p=0.011) and had lower Ejection fraction (EF) (p=0.001). They also had lower EF post-surgery (p <0.001) and six months after discharge (p = 0.006). However, the number of vessels involved was not different between genders (p=0.589), but the number of grafts was higher in men (p=0.008).There was no statistically significant difference in overall mortality rates between the two groups (4.42% and 6.38% in men and women, respectively, p= 0.464). CONCLUSIONS: The women had more underlying comorbidities than men. Furthermore, there were some differences in the intra-operative parameters and postoperative complications between the two genders, but there was no difference in postoperative mortality in our setting.
Report of persistent left superior vena cava associated with Ebstein's anomaly of tricuspid valve.
Khajali Z, Aliramezany M
ARYA Atheroscler · 2021 Sep · PMID 35686245 · Full text
BACKGROUND: Ebstein's anomaly is one of the challenging congenital heart diseases (CHDs) that is presented with different anatomical and clinical symptoms. For this reason, patients with this complication require exact d...
BACKGROUND: Ebstein's anomaly is one of the challenging congenital heart diseases (CHDs) that is presented with different anatomical and clinical symptoms. For this reason, patients with this complication require exact diagnostic methods and appropriate treatment approaches. In addition, multiple cardiac defects accompany this anomaly. CASE REPORT: In this study, we describe a rare associated defect in an adult patient with Ebstein's anomaly and proper surgical methods performed for her. CONCLUSION: The most important issue in adult patients with Ebstein's anomaly is to pay close attention to the presence of associated anomalies, in which careful examination and use of para-clinical methods is very helpful. Furthermore, accurate diagnosis of the associated defects determines the treatment and surgery of patients.
Correlation of left ventricular ejection fraction drop and fragmented QRS with ST-segment elevation myocardial infarction.
Bordbar A, Mahmoodi K, Anasori H … +2 more , Fallah R, Azimi-Pirsaraei SV
ARYA Atheroscler · 2021 Sep · PMID 35686244 · Full text
BACKGROUND: Fragmented QRS (fQRS) is an electrocardiographic parameter, which could be assessed easily and non-invasively using surface electrocardiogram (ECG) and may have significant prognostic value. The present study...
BACKGROUND: Fragmented QRS (fQRS) is an electrocardiographic parameter, which could be assessed easily and non-invasively using surface electrocardiogram (ECG) and may have significant prognostic value. The present study aimed to evaluate the correlation between left ventricular ejection fraction (LVEF) and fQRS in surface ECG. METHODS: This study was conducted on 186 patients with acute ST-elevation myocardial infarction (STEMI). After primary percutaneous coronary intervention (PCI) and transferring the patients to the cardiac care unit (CCU), the patients were examined using echocardiography, and ejection fraction (EF) was assessed using the Simpson's method by a single cardiologist. Data analysis was performed using SPSS software. RESULTS: Among 186 eligible patients, 113 cases showed fQRS in the surface ECG. In total, 84.9% of these patients were men, and 15.1% were women (P < 0.05). No significant correlation was observed between age and fQRS (P > 0.05), as well as coronary artery disease (CAD) severity and fQRS (P > 0.05). On the other hand, a statistically significant, reverse correlation was denoted between EF and fQRS in the surface ECG (P < 0.05). In addition, significant relations were observed between the rate of ST-segment elevation and depression and fQRS (P < 0.05). CONCLUSION: According to the obtained results, EF significantly decreased in the echocardiography of the patients with STEMI and fQRS in the surface ECG. Considering the cost-efficiency and accessibility of fQRS evaluation, it could be used for the assessment of various parameters in cardiology modalities such as cardiac magnetic resonance imaging (CMRI) and computed tomography (CT).
Polymorphisms of LPA gene, rs1801693 and rs7765781, are not associated with premature myocardial infarction in the Iranian population.
Rahimi M, Khanahmad H, Gharipour M … +5 more , Roohafza H, Dianatkhah M, Khosravi E, Sadeghian L, Sadeghi M
ARYA Atheroscler · 2021 Sep · PMID 35686243 · Full text
BACKGROUND: Myocardial infarction (MI) is one of the leading causes of mortality globally. Although it is most prevalent in the elderly, it may occur in young adults (men ≤ 55 years or women ≤ 65 years) as premature MI (...
BACKGROUND: Myocardial infarction (MI) is one of the leading causes of mortality globally. Although it is most prevalent in the elderly, it may occur in young adults (men ≤ 55 years or women ≤ 65 years) as premature MI (PMI). As awareness of genetic risks may lead to effective prevention of PMI, we aim to investigate the association of two susceptible single nucleotide polymorphisms (SNPs) in the LPA gene with PMI in the Iranian population, rs1801693 and rs7765781, identified in previous genome-wide association studies (GWAS). METHODS: A total number of 85 patients with PMI and 85 healthy controls were recruited from December 2015 to March 2016 from Isfahan, Iran. Peripheral blood samples were collected from all individuals. Deoxyribonucleic acid (DNA) was extracted and genotyped at rs1181693 and rs7765781 polymorphisms, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results were statistically analyzed to find any possible association of the two polymorphisms with PMI by SPSS software and P-values less than 0.05 were considered to be statistically significant. RESULTS: Statistical analysis displayed no significant difference between rs1801693 (P = 0.815)/rs7765781 (P = 0.746) alleles in patients with PMI and healthy control subjects. CONCLUSION: There is no meaningful association between rs1801693/rs7765781 and PMI incidence in the Iranian population.
Periodontitis and cardiovascular disease: A literature review.
Rahimi A, Afshari Z
ARYA Atheroscler · 2021 Sep · PMID 35686242 · Full text
BACKGROUND: Cardiovascular diseases (CVDs) are in charge of many deaths worldwide including myocardial infarction (MI), hypertension (HTN), coronary atherosclerosis (CAS), infective endocarditis (IE), heart failure (HF),...
BACKGROUND: Cardiovascular diseases (CVDs) are in charge of many deaths worldwide including myocardial infarction (MI), hypertension (HTN), coronary atherosclerosis (CAS), infective endocarditis (IE), heart failure (HF), arterial fibrillation (AF), and peripheral artery disease (PAD). Besides, periodontitis is the sixth prevalent disease among humans and it seems that there are common risk factors between these diseases which are creating communication between prevalence and treatment. The purpose of this study is to assess the articles that reviewed the relationship between heart diseases and periodontitis. METHODS: Three databases, including PubMed, Scopus, and Web of Science were searched until November 2020. The search terms "periodontal disease, periodontitis, oral health, cardiovascular disease, atherosclerosis, myocardial infarction, hypertension, coronary heart disease, angina pectoris, arterial fibrillation, arrhythmia, and peripheral artery disease" were used in combination to identify the publications providing data. RESULTS: MI, HTN, atherosclerosis diseases for coronary artery, IE, HF, AF, and PAD were associated with periodontitis. It seems that the treatment of periodontitis may help to improve the state of mentioned heart-related diseases. However, more studies are needed to prove this relationship. CONCLUSION: The prevalence of heart diseases is more common in individuals with periodontitis.
Prevalence of pre-hypertension and hypertension, awareness, treatment, and control of hypertension, and cardiovascular risk factors in postmenopausal women.
Eghbali-Babadi M, Khosravi A, Feizi A … +3 more , Alikhasi H, Kheirollahi N, Sarrafzadegan N
ARYA Atheroscler · 2021 Sep · PMID 35686241 · Full text
BACKGROUND: Pre-hypertension (HTN) and HTN are risk factors for cardiovascular disease (CVD). Despite its importance, HTN is often underestimated and undiagnosed, especially in women. This study was designed to determine...
BACKGROUND: Pre-hypertension (HTN) and HTN are risk factors for cardiovascular disease (CVD). Despite its importance, HTN is often underestimated and undiagnosed, especially in women. This study was designed to determine the prevalence of pre-HTN and HTN among a large sample of Iranian menopausal women. METHODS: This repeated cross-sectional study was conducted on 1013 menopausal women aged 41 to 85 years in Isfahan, Iran, in the years 2001, 2007, and 2016. The participants were selected through multistage cluster random sampling. Awareness, treatment, and control of HTN were assessed using a validated researcher-made questionnaire. Blood pressure was determined via an arm digital blood pressure monitor. RESULTS: The prevalence of HTN in the years 2001, 2007, and 2016 was 52.6%, 49.0%, and 51.6%, respectively; no significant changes were observed (P > 0.05). The prevalence of pre-HTN in these years was 56.6%, 53.3%, and 42.2%, respectively. In 2001 and 2007, respectively, 28.8% and 50.4% of menopausal women had HTN controlled by medication, and in 2016, 86.6% of women were aware of their disease and 62% of them had controlled HTN (P < 0.001). CONCLUSION: The results showed that HTN and pre-HTN were highly prevalent among Iranian menopausal women and markedly increased with age. Interventional population-based approaches are needed to improve knowledge and efficient practice that may help to lower the risk of HTN and CVD in this at-risk population.
Troponin is a useful marker in clinical decision making in hospitalized patients with COVID-19 infections.
Safarnezhad-Tameshkel F, Motamed N, Karbalaie Niya MH … +17 more , Perumal D, Rezaie N, Izadi S, Ranjbar M, Yadollahzadeh M, Behdad B, Hemmasi G, Kaveh V, Anoushirvani AA, Malek M, Farahani B, Eskandari R, Panahi M, Rahimi M, Emami S, Zamani F, Farrokhpour M
ARYA Atheroscler · 2021 Sep · PMID 35686240 · Full text
BACKGROUND: COVID-19 was introduced by the World Health Organization (WHO) as a global pandemic. The disease manifestations ranges from a mild common cold to severe disease and death. It has a higher mortality rate in pe...
BACKGROUND: COVID-19 was introduced by the World Health Organization (WHO) as a global pandemic. The disease manifestations ranges from a mild common cold to severe disease and death. It has a higher mortality rate in people with a history of comorbidities, including cardiovascular disease (CVD) and can also contribute to cardiac injury. This study was conducted to evaluate the relationship between troponin levels as a cardiac marker and adverse outcomes in this disease. METHODS: The study sample included 438 patients hospitalized with COVID-19; however, the troponin data of 6 patients were not available. The need to be admitted to the intensive care unit (ICU), and death were considered the adverse outcome in patients with COVID-19. Troponin levels were checked in all patients on day 1 and day 3 of hospitalization. Multiple logistic regression analysis was performed to determine whether there was an independent association between the adverse outcomes and troponin enzyme in hospitalized patients with COVID-19. RESULTS: The mean age of patients was 61.29 ± 15.84 years. Among the 432 patients tested on day 1 of hospitalization, 24 patients (5.6%) tested positive (Troponin 1), and among the 303 patients tested on day 3, 13 patients (4.3%) tested positive (Troponin 2). Based on our results, Troponin 1 showed an independent association with both death (3.008 [95%CI = 1.091-8.290]; P = 0.033) and need for ICU admission (8.499 [95%CI = 3.316-21.788]; P < 0.001) in multiple logistic regression analysis. Moreover, the status of Troponin 2 had an independent significant association with both death (4.159 [95%CI = 1.156-14.961]; P = 0.029) and ICU admission (7.796 [95%CI = 1.954-31.097]; P = 0.004). CONCLUSION: Troponin showed a significant association with adverse outcomes in people who were hospitalized with COVID-19. The periodical assessment of this enzyme from the time of hospitalization may improve the clinical decision making of clinicians.
Lead one ratio: A new electrocardiogram marker for cardiac resynchronization therapy response.
Raj A, Nath RK, Pandit BN … +3 more , Singh AP, Pandit N, Aggarwal P
ARYA Atheroscler · 2021 Sep · PMID 35686239 · Full text
BACKGROUND: Wider QRS duration and presence of left bundle branch block (LBBB) predict better cardiac resynchronization therapy (CRT) response. Despite strict patient selection, one-third of patients have a sub-optimal r...
BACKGROUND: Wider QRS duration and presence of left bundle branch block (LBBB) predict better cardiac resynchronization therapy (CRT) response. Despite strict patient selection, one-third of patients have a sub-optimal response. We aim to evaluate the impact of lead one ratio (LOR) on CRT response. METHODS: We enrolled 93 patients receiving CRT from August 2016 to August 2019. Pre-implant 12-lead electrocardiogram (ECG) was recorded, and LOR was derived by dividing the maximum positive deflection of QRS complex in ECG lead I by the maximum negative deflection in lead I; cut-off value of 12 was used to divide the cohort into two groups. Patients were followed for 6 months, and outcomes were compared for CRT response, New York Heart Association (NYHA) class improvement, all-cause mortality, and heart failure (HF) hospitalization events. RESULTS: At the end of 6-month follow-up, LOR ≥ 12 was associated with significantly better CRT response (75.76% vs. 51.85% in LOR < 12, P = 0.02), lower mortality per 100 patient-years (9.09 vs. 14.81 in LOR < 12, P = 0.012), and more improvement in HF symptoms (NYHA improvement) (78.79% vs. 55.56% in LOR < 12, P = 0.02). Patients with LOR < 12 had more HF hospitalization events (2.04 vs. 1.81 episodes in LOR ≥ 12, P = 0.029) and less QRS narrowing (∆5.74 ± 2.09 vs. ∆7.10 ± 3.97 ms in LOR ≥ 12, P = 0.01). QRS duration and LBBB morphology were predictors of response in both groups of patients. CONCLUSION: LOR ≥ 12 was associated with better response to CRT, less HF hospitalization, and more relief in HF symptoms. This ratio helps to identify possible sub-optimal response among patients with an indication for CRT.
Short and long-term outcomes of patients with coronary artery bypass surgery.
Soltani MH, Rasti M, Namayandeh SM … +1 more , Sarebanhassanabadi M
ARYA Atheroscler · 2021 Sep · PMID 35686238 · Full text
BACKGROUND: Coronary artery disease (CAD) is a major problem in Iran as well as throughout the globe, and coronary artery bypass grafting (CABG) surgery is an appropriate option for many patients with symptomatic and sev...
BACKGROUND: Coronary artery disease (CAD) is a major problem in Iran as well as throughout the globe, and coronary artery bypass grafting (CABG) surgery is an appropriate option for many patients with symptomatic and severe CAD. The main purpose of this study was assessment of the short and long-term outcomes of patients undergoing CABG in Yazd Province, Iran. METHODS: This historical cohort study examined the mortality rates of patients who had undergone CABG in Afshar Hospital in Yazd from 2011 to 2013. During this period, 2510 patients undergoing CABG were entered into the study and then followed for in-hospital and long-term mortality. RESULTS: Mean age of the patients was 61.37 ± 10.50 years and 34.1% were women. In-hospital mortality turned out to be 3.7% and age over 70, left ventricular (LV) dysfunction, female gender, and left main (LM) involvement induced significant higher in-hospital mortality. Of all the patients, 84.1% were followed for a period of 41 ± 20 months. The survival rate proved to be 92.4% in one year and 82.9% in five years. The patients with age over 70, diabetes mellitus (DM), and LV systolic dysfunction (LVSD) showed significant lower survival rate, whereas the patients with utilization of left internal mammary artery (LIMA) demonstrated significant higher survival rate. CONCLUSION: In-hospital and long-term mortality rate of patients undergoing CABG surgery is acceptable in comparison with other studies and more effort is needed into making this event a success.
Assessment of tissue mitral annular displacement in patients with coronary artery stenosis.
Poorzand H, Alborz H, Alimi H … +1 more , Emadzadeh M
ARYA Atheroscler · 2021 May · PMID 35685826 · Full text
BACKGROUND: The high incidence of coronary heart diseases requires early diagnosis to prevent complications. This study aims to assess the mean value of tissue mitral annular displacement (TMAD), using Speckle tracking e...
BACKGROUND: The high incidence of coronary heart diseases requires early diagnosis to prevent complications. This study aims to assess the mean value of tissue mitral annular displacement (TMAD), using Speckle tracking echocardiography (2D STE) in patients with coronary artery stenosis. METHODS: 149 patients aged 50 to 76 years were included in this cross-sectional study who were admitted with primary diagnosis of acute coronary syndrome (ACS) to the emergency department. In all patients, the TMAD data were measured using 2D speckle tracking technology. RESULTS: 149 patients with a mean age of 61.83 ± 7.14 years old were studied. Regarding the involved coronary artery as left anterior descending (LAD), right coronary artery (RCA), or left circumflex artery (LCX), the TMAD data was reduced significantly (P < 0.001) in the relevant walls [base of anterior and anteroseptum (4.46 ± 3.53 mm), base of inferior and inferoseptum (4.91 ± 3.81 mm), and base anterolateral and inferolateral walls (5.53 ± 3.827 mm), respectively.] TMAD in anterior, inferior, and lateral ST-elevation myocardial infarction (STEMI) were 2.64 ± 0.870, 4.78 ± 3.8, and 2.80 ± 0.83 mm, respectively which were significantly reduced compared to the non-ST-elevation myocardial infarction (NSTEMI) and unstable angina (P < 0.001). TMAD in different LV function categories was only reduced in those with LAD lesion and with severe LV systolic dysfunction (2.47 ± 0.834 mm, P < 0.001). CONCLUSION: The current study describes a significant relationship between TMAD and left ventricular function, ACS type, and the culprit coronary artery. In different types of ACS, the TMAD value was worse in the subgroups of STEMI and in the walls affected by the stenosed coronary artery. This method might be helpful in defining the culprit coronary artery.
Maternal or paternal history: Which one plays more important role in developing hypertension?
Javanbakht S, Eghbali M, Bolourinejad P … +4 more , Sherafat A, Khosravi A, Hashemi M, Sarrafzadegan N
ARYA Atheroscler · 2021 May · PMID 35685825 · Full text
BACKGROUND: Hypertension (HTN) is one of the most common non-communicable diseases (NCDs), which in 2017 accounted for 1.65% of all deaths, and 0.66% of disability-adjusted life years (DALYs). About 25% of the adult popu...
BACKGROUND: Hypertension (HTN) is one of the most common non-communicable diseases (NCDs), which in 2017 accounted for 1.65% of all deaths, and 0.66% of disability-adjusted life years (DALYs). About 25% of the adult population are hypertensive in Iran. Prevalence of HTN is significantly higher in those with a family history of HTN. This study compares the impact of paternal and maternal history of HTN on the risk of HTN development. METHODS: This cross-sectional study was conducted among 2107 adults of 18-84 years old residing in Isfahan, Iran, from August 2015 to March 2016. Blood pressure (BP) measurement standards were taken from World Health Organization (WHO) guidelines. We measured BP in the right arm for three times at 1-minute intervals and considered the mean of second and third measurements. Other data were collected by questionnaire. RESULTS: Prevalence of HTN was higher in participants whose mother or both parents were hypertensive (P < 0.001). Diastolic BP (DBP) was affected by every side of parental history (P < 0.001), while systolic BP(SBP) was affected when both parents were hypertensive (P < 0.001). As a result, maternal family history increased the odds of HTN by 1.9 times [95% confidence interval (CI): 1.35-2.65] and both maternal and paternal history increased it by 3.1 times (95% CI: 2.01-4.78) compared to those with no family history. However, paternal history was not significantly related to the odds of HTN. CONCLUSION: Our study results demonstrate that maternal history of HTN doubles the odds of HTN. Besides, if both parents are hypertensive, it will be tripled.
Cardiac involvement according to echocardiographic findings in severe coronavirus disease 2019.
Tajmirriahi M, Salmasi M, Soltaninejad F … +3 more , Amra B, Sami R, Naderi Z
ARYA Atheroscler · 2021 May · PMID 35685824 · Full text
BACKGROUND: Coronavirus disease 2019 (COVID-19) has led to considerable morbidity and mortality worldwide and myocardial injury has been one of the most common findings in the affected patients. However, published eviden...
BACKGROUND: Coronavirus disease 2019 (COVID-19) has led to considerable morbidity and mortality worldwide and myocardial injury has been one of the most common findings in the affected patients. However, published evidence of cardiac evaluation by imaging techniques including echocardiography is rare. We aimed to evaluate myocardial involvement by echocardiography in patients with severe COVID-19. METHODS: We studied 64 patients with severe COVID-19 who were admitted in the intensive care unit (ICU) in Khorshid Hospital, Isfahan, Iran, from February 20, 2020 until May 20, 2020. Demographic characteristics, laboratory tests, and electrocardiography (ECG) data were collected and transthoracic echocardiography (TTE) using a focused time-efficient echocardiography protocol was performed. RESULTS: Mean age of the participating patients was 66.40 ± 14.14 years (range: 34.0-92.0 years), and 35 patients (54.7%) were men. Reduced left ventricular (LV) systolic function was seen in 20 (32%) patients. Only 4 patients had LV ejection fraction (LVEF) less than 40%. Cardiac troponin I (cTn-I) was elevated (over 15 pg/ml) in 39 (60.9%) patients and was significantly associated with higher mortality in these patients (P = 0.05). In addition, dynamic ST and T wave changes and new bundle branch blocks had a significant association with adverse clinical outcome (P = 0.05 and P = 0.02, respectively). CONCLUSION: New LV systolic dysfunction (LVSD) in patients with severe COVID-19 was mild to moderate and not uncommon and had no significant adverse effect on the prognosis of these patients, although elevation of cardiac biomarkers could predict mortality and had an adverse effect on clinical outcome.
The relationship of the changes in lateral leads I and aVL in electrocardiogram with echocardiography and coronary angiography findings in patients with acute coronary syndrome.
Shemirani H, Mir-Amirkhani F, Mansouri MH … +2 more , Zavar R, Mansouri P
ARYA Atheroscler · 2021 May · PMID 35685823 · Full text
BACKGROUND: Electrocardiographic (ECG) study is a principle for the symptoms contributed to the acute myocardial infarction (AMI)/acute coronary syndrome (ACS). The diagnosis of involved coronary artery based on ECG chan...
BACKGROUND: Electrocardiographic (ECG) study is a principle for the symptoms contributed to the acute myocardial infarction (AMI)/acute coronary syndrome (ACS). The diagnosis of involved coronary artery based on ECG changes is still a challenge. This study is aimed to evaluate the association of mere changes in I and aVL leads with the involved region found through echocardiography and involved coronary artery through angiography. METHODS: This cross-sectional study was conducted on 100 patients referred with AMI/ACS symptoms that had mere ECG changes in I and aVL leads (ST elevation + Q wave/ST depression + inverted-T). Transthoracic echocardiography (TTE) and coronary angiography (CAG) were performed for the patients. The correlation of ECG with echocardiography and angiography was assessed. RESULTS: Among the studied population, 39 patients (39%) were women with the mean ± standard deviation (SD) of age of 64.60 ± 9.39 years. There was no significant association between ECG changes in leads I and aVL with neither the stenosis of first diagonal (D1) coronary artery found through angiography (P = 0.580) nor the mid-anterior wall dyskinesia found through echocardiography (P = 0.380). A remarkable association between the echocardiographic findings representing mid-anterior wall ischemic dyskinesia with the stenosis of D1 coronary artery was detected (P < 0.001). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100%, 54.54%, 94.68%, and 100% were respectively found as the diagnostic values of mentioned factors. CONCLUSION: Our findings showed significant association between D1 involvement and mid-anterior dyskinesia in echocardiography, while the changes in ECG were associated neither with echocardiographic nor angiographic outcomes.
One-year survival cohort of patients with reduced ejection fraction heart failure in Iranian population: A single center study.
Abdollahi-Karizno M, Partovi N, Noferesti V … +3 more , Ravanbakhsh N, Kazemi T, Khosravi-Bizhaem S
ARYA Atheroscler · 2021 May · PMID 35685822 · Full text
BACKGROUND: Cardiovascular diseases (CVDs) are one of the main concerns of health care systems. The aim of this study was to investigate the most important prognostic factors of heart failure (HF) and their survival outc...
BACKGROUND: Cardiovascular diseases (CVDs) are one of the main concerns of health care systems. The aim of this study was to investigate the most important prognostic factors of heart failure (HF) and their survival outcomes in patients in Birjand, East of Iran. METHODS: A total of 194 systolic HF patients hospitalized in Birjand Valiasr hospital were followed up for 12 months in 2016, and those with reduced left ventricle ejection fraction (LVEF < 50%) were included in this study. Kaplan-Meier and Cox proportional hazard analysis were used to determine the association of each factor with events. RESULTS: The mean age of patients was 68.23 ± 13.40 (27-95) years, and 57.2% (111 out of 194) were women. Mean survival time was 294.7 ± 9.924 days. Pervious history of myocardial infarction (MI) [2.141 (1.101-4.161)] increased the risk of cardiovascular hospitalization. Elevated blood levels of potassium [2.264 (1.438-3.564)] was found to be a risk factor for all-cause and cardiovascular mortality. Moreover, there was a reverse relationship between body height [0.942 (0.888-0.999)] and cardiovascular death. Patients with opium addiction [4.049 (1.310-12.516)] are at a higher risk of cardiovascular mortality. Lower levels of LDL-C [0.977 (0.960-0.996)] and living in rural areas [3.052 (1.039-8.964)] increased all-cause mortality levels. Lack of pervious history of chronic obstructive pulmonary disease (COPD) decreased cardiovascular hospitalization [0.265 (0.062-1.122)]. CONCLUSION: In our study, serum potassium, LDL-C, and uric acid levels in patients with HF were identified as prognostic factors. The height of patients, which can be an indicator of the functional state of their respiratory system, and the history of COPD were also recognized as prognostic factors. Opium use and rural living were identified as social factors influencing patients' prognosis.
Isolated pneumopericardium; An extremely rare complication following active resuscitation in a term neonate.
Sinha SK, Aggarwal P, Samrat S … +2 more , Pandey U, Krishna V
ARYA Atheroscler · 2021 May · PMID 35685821 · Full text
BACKGROUND: Pneumopericardium, presence of air in pericardial cavity, is rare entity with potentially severe complications and mortality. In the neonatal period, it is associated with prematurity, low birth weight, and a...
BACKGROUND: Pneumopericardium, presence of air in pericardial cavity, is rare entity with potentially severe complications and mortality. In the neonatal period, it is associated with prematurity, low birth weight, and assisted ventilation, but in full term neonates its occurrence after resuscitation is exceedingly rare. CASE REPORT: Our patient was a 2-day old full term neonate who developed respiratory distress following active resuscitation which was carried out at the time of birth in lieu of perinatal asphyxia. He was immediately put on mechanical ventilatory support. Chest x-ray showed a "halo sign"- rim of air completely surrounding the heart, and echocardiography confirmed pneumopericardium with cardiac tamponade. Pericardiocentesis was performed as a life saving measure. CONCLUSION: He was successfully discharged on the tenth day following sheath removal, and is doing fine on follow up.
Background and design of a 5-year ST Elevation Myocardial Infarction Cohort in Isfahan, Iran: SEMI-CI study.
Sadeghi M, Soleimani A, Sarrafzadegan N … +5 more , Askari M, Nouri F, Masoumi G, Hassannejad R, Roohafza H
ARYA Atheroscler · 2021 May · PMID 35685820 · Full text
BACKGROUND: Cardiovascular disease (CVD) is one of the most important causes of mortality and morbidity in Iran. Secondary prevention of acute myocardial infarction (AMI) is necessary. The main aim of this cohort is eval...
BACKGROUND: Cardiovascular disease (CVD) is one of the most important causes of mortality and morbidity in Iran. Secondary prevention of acute myocardial infarction (AMI) is necessary. The main aim of this cohort is evaluating clinical, paraclinical, management, and 5-year major events of the participants in Isfahan, Iran. METHODS: All consecutive patients with AMI hospitalized in Chamran Hospital, Isfahan, during 1 year from march 2015 were recruited and followed for 5 years. ST-Elevation Myocardial Infarction Cohort Study (SEMI-CI) has been initiated as a longitudinal study to evaluate course of patients with AMI in Iran, adherence to evidence-based secondary prevention drug, and five-year events such as death, re-myocardial infarction (REMI), re-hospitalization, congestive heart failure (CHF), and referring to another procedure [percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), and resynchronization therapy]. RESULTS: A total of 867 patients with ST-elevation myocardial infarction (STEMI) with mean age of 60.91 ± 12.76 years were recruited. 705 (81.3%) subjects were men with mean age of 59.63 ± 12.59 years. 470 (54.2%) patients had anterior AMI (ant-AMI) and the rest had other types of AMI. The ejection fraction (EF) mean was 37.80 ± 11.74 percent. A total of 30 (3.5%) cases of AMI had not received reperfusion. 445 (51.4%) had primary PCI and 392 (45.2%) had thrombolysis at first revascularization strategy. In-hospital death occurred in 72 participants (8.3%). Drug during hospital included: at discharge, 767 (88.5%) received aspirin, 787 (90.7%) statin, 697 (80.4%) beta-blocker, and 480 (55.4%) angiotensin-converting enzyme (ACE) inhibitor. CONCLUSION: According to the best of our knowledge, it is among few cohorts in Eastern Mediterranean Region (EMR) in patients with AMI. This paper showed methodology of this study in patients with STEMI and its follow-up protocol. We can use this result in policy-making for improving secondary prevention strategies.
The effect of vitamin D therapy in the improvement of cardiac performance and exercise capacity in patients with heart failure: A double-blind, randomized, placebo-controlled trial.
Garakyaraghi M, Siavash M, Kerdegari M
ARYA Atheroscler · 2021 May · PMID 35685819 · Full text
BACKGROUND: Low vitamin D status may contribute to the pathogenesis of heart failure (HF), but therapeutic roles of vitamin D on cardiac performance are not well known. We evaluated vitamin D effects on left ventricular...
BACKGROUND: Low vitamin D status may contribute to the pathogenesis of heart failure (HF), but therapeutic roles of vitamin D on cardiac performance are not well known. We evaluated vitamin D effects on left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) functional class in patients with HF for the first time. METHODS: This study was a double-blind, randomized, placebo-controlled trial. 110 patients with HF admitted to Shahid Chamran and Khorshid Hospitals, Isfahan, Iran, randomly received 500 mg calcium daily plus either 50000 IU vitamin D3 per week (case group) or placebo (control group) for 6 months. Biochemical variables, LVEF, and NYHA functional class were assessed at baseline and after 6 months. RESULTS: 81 patients completed the study. Vitamin D supplementation increased mean serum 25-hydroxyvitamin D [25(OH)D] concentration in the case group by 33.9 ng/ml (P < 0.001). After 6 months of treatment, both groups showed improvement in LVEF, but the extent of improvement was significant only in the case group (5.48% versus 0.44%, P < 0.001). The NYHA functional class improved in the case group but remained constant in the control group (P < 0.001). CONCLUSION: Vitamin D3 improved LVEF and NYHA functional class in patients with HF and might serve as a new agent for the future treatment of this disease.
Can fractional excretion of sodium predict worsening of renal function, in-hospital mortality, and length of hospital stay in acute decompensated heart failure?
Ahmadi F, Torfi E, Afshani SM … +2 more , Kazemi-Mansourabad S, Hayati F
ARYA Atheroscler · 2021 Nov · PMID 35685452 · Full text
BACKGROUND: Fractional excretion of sodium (FENa), the reflection of sodium (Na) handling by the kidney during natriuresis, is influenced by exo- and endogenous factors that have a powerful impact on renal function. We p...
BACKGROUND: Fractional excretion of sodium (FENa), the reflection of sodium (Na) handling by the kidney during natriuresis, is influenced by exo- and endogenous factors that have a powerful impact on renal function. We performed this study to define the correlation between FENa and worsening renal function (WRF) and assess the value of FENa in the length of hospital stay and in-hospital mortality in the patients with acute decompensated heart failure (ADHF). METHODS: This prospective observational study was performed in two tertiary governmental heart centers located in Ahvaz, Iran, from March 2019 to March 2020. Any individual suffering from ADHF who had no renal failure, received only loop diuretics, and was on a low Na diet was eligible for recruitment in this study. The urine sample used to calculate FENa was a 24-hour sample. RESULTS: Over the one year, 56 patients met the inclusion criteria. The total study population had a mean age of 61.46 ± 14.22 years with the dominance of women (51.8%). The mean age of men and women was 58.59 ± 14.35 and 64.13 ± 13.80 years, respectively. During hospitalization, 13 (23.2%) patients experienced WRF. In patients who experienced WRF during hospitalization, FENa of < 1% was mostly observed compared to FENa of 1%-2% (42.9% vs. 0%, P < 0.05). Post-hoc test of data on mean hospitalization days indicated that those with lower FENa had longer admission periods than those with other FENa groups (< 1%: 3.04 ± 1.02 days vs. 1%-2%: 1.58 ± 0.66 days, P < 0.001 and < 1%: 3.04 ± 1.02 days vs. > 2%: 2.30 ± 0.92 days, P = 0.02). There was no significant relation in terms of in-hospital death across different categories of FENa (P = 0.69). CONCLUSION: Our data suggested that FENa less than 1% was associated with WRF and could be associated with a longer hospitalization period. We did not find any association between FENa and in-hospital mortality. Further studies with a larger number of patients are required to determine the cut-off value.
Serum interleukin-18 and its relationship with subclinical atherosclerosis in systemic lupus erythematosus.
Rezaieyazdi Z, AkbariRad M, Saadati N … +7 more , Salari M, Orang R, Sedighi S, Esmaily H, Azarpazhooh MR, Firoozi A, Akbarpour E
ARYA Atheroscler · 2021 Nov · PMID 35685451 · Full text
BACKGROUND: Interleukin-18 (IL-18) is a pro-inflammatory and pro-atherogenic factor, and its blood level has shown a direct correlation with atherosclerosis. We aimed to evaluate the serum IL-18 level in patients with sy...
BACKGROUND: Interleukin-18 (IL-18) is a pro-inflammatory and pro-atherogenic factor, and its blood level has shown a direct correlation with atherosclerosis. We aimed to evaluate the serum IL-18 level in patients with systemic lupus erythematosus (SLE) and its relationship with the intima-media thickness (IMT) of the carotid artery in these patients, as an indicator of atherosclerosis. METHODS: In this cross-sectional study, 60 patients as the patient group and 30 healthy volunteers as the control group [matched sex, age, and body mass index (BMI)] were selected, and their disease status and general data were gathered using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) form. A blood sample was also obtained from all participants to determine the serum level of IL-18 and other metrics, including high-sensitivity C-reactive protein (hs-CRP), cholesterol, triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), anti-double stranded deoxyribonucleic acid (anti-dsDNA), complement 3 (C3), and C4. The IMT of the carotid artery was calculated in both groups. We also evaluated the clinical cardiovascular manifestations. RESULTS: The serum IL-18 levels in patients were significantly higher than in the control group (P ˂ 0.005). It had no significant correlation with disease activity (P = 0.10). The patients with SLE with high IL-18 serum levels (> 280 pg/ml) had higher SLEDAI-2K (P = 0.02) than the patients with a low level (< 280), where 280 was the median of the IL-18 levels. The serum IL-18 level had no significant correlation with the carotid artery IMT. CONCLUSION: A high level of IL-18 reflects the disease activity, but it was not significantly correlated with subclinical atherosclerosis, denoted by the carotid artery IMT.
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