ARYA Atherosclerosis[JOURNAL]
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Severe pulmonary hypertension associated with unilateral pulmonary artery hypoplasia: A case report.
Malakoutikhah M, Kalantari F, Nematollahi A … +2 more , Moradi H, Kalantari E
ARYA Atheroscler · 2025 · PMID 41473581 · Full text
BACKGROUND: Pulmonary hypertension (PH), defined as mean pulmonary arterial pressure >20 mmHg, has diverse etiologies and high morbidity and mortality, necessitating early, accurate diagnosis. METHODS: A 42-year-old woma...
BACKGROUND: Pulmonary hypertension (PH), defined as mean pulmonary arterial pressure >20 mmHg, has diverse etiologies and high morbidity and mortality, necessitating early, accurate diagnosis. METHODS: A 42-year-old woman, misdiagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) and treated with anticoagulation for four years, had a rare congenital vascular anomaly. She presented with cough, hemoptysis (~200 mL of fresh blood two hours before admission), progressive dyspnea, and chest discomfort. Examination revealed a loud P2, suggesting right ventricular strain. Echocardiography showed elevated pulmonary artery pressure with right ventricular dysfunction. Chest CT angiography revealed abnormal vascular anatomy; pulmonary angiography confirmed unilateral pulmonary artery hypoplasia (UPAH) as the cause of PH. Anticoagulation was stopped, and embolization was performed successfully. At the two-month follow-up, symptoms had resolved and hemoptysis had not recurred. RESULTS: UPAH is a rare congenital cause of PH that can mimic CTEPH, leading to misdiagnosis and inappropriate prolonged anticoagulation. Symptoms often overlap with common conditions such as pulmonary thromboembolism. In this case, lack of treatment response prompted reevaluation. Careful reassessment of prior imaging, history, and rare differential diagnoses was essential. This case highlights the importance of reconsidering the diagnosis when the course deviates from expectations and the need for individualized management in uncommon PH etiologies.
Ischemic heart disease attributable to dietary risk factors in the North Africa and Middle East (NAME) region: An analysis of data from the global burden of disease study 1990-2019.
Mohammadifard N, Mehrabani-Zeinabad K, Haghighatdoost F … +6 more , Bateni M, Mokdad A, Naghavi M, Shariful Islam SM, Sarrafzadegan N, Ihd Collaborators GN
ARYA Atheroscler · 2025 · PMID 41473580 · Full text
BACKGROUND: Diet is an important risk factor for ischemic heart disease (IHD), but its effects on IHD and trends in the North Africa and Middle East (NAME) region are unknown. We aimed to evaluate the burden of different...
BACKGROUND: Diet is an important risk factor for ischemic heart disease (IHD), but its effects on IHD and trends in the North Africa and Middle East (NAME) region are unknown. We aimed to evaluate the burden of different dietary risk factors on mortality and disability-adjusted life-years (DALYs) attributable to IHD in the NAME region from 1990 to 2019. METHODS: The data and estimations were extracted from the Global Burden of Disease (GBD) 2019 Global Health Data Exchange. The proportion of IHD burden due to dietary risks was estimated through a comparative risk assessment approach. We calculated the mortality and DALYs rate attributable to diet for IHD using disease-specific population attributable fractions. RESULTS: The age-standardized rate of IHD mortality and DALYs attributed to dietary risk in the NAME region were 102.1 (95% uncertainty interval (UI): 81.0-121.1) and 2060.6 (95% UI: 1630.7-2471.2), respectively. These rates were higher than the global estimates for mortality (62.4 [95% UI: 51.0-73.6]) and DALYs (1271.3 [95% UI: 1061.3-1473.8]) and were greater in men than in women. Suboptimal diet contributed to 46.6% of IHD mortality and 49.5% of related DALYs. Low whole-grain intake was the leading dietary risk across all countries and years, responsible for 44.5 [95% UI: 18.6-57.1] IHD mortalities and 912.8 [95% UI: 369.7-1177.8] DALYs per 100,000. CONCLUSION: Despite a decline in the burden of IHD attributable to diet in the NAME region, it remains substantially high. There exists considerable potential for enhancing dietary quality, particularly through the increased incorporation of whole grains.
Factors associated with reduced left ventricular ejection fraction as a manifestation of Trastuzumab-induced cardiotoxicity in breast cancer patients.
Alrikabi ZA
ARYA Atheroscler · 2025 · PMID 41473579 · Full text
BACKGROUND: Breast cancer is the most common malignancy in women, with 15-20% being HER2-positive, an aggressive subtype treated with Trastuzumab. Despite its survival benefits, Trastuzumab may cause cardiotoxicity, typi...
BACKGROUND: Breast cancer is the most common malignancy in women, with 15-20% being HER2-positive, an aggressive subtype treated with Trastuzumab. Despite its survival benefits, Trastuzumab may cause cardiotoxicity, typically monitored by left ventricular ejection fraction (LVEF). This study assessed Trastuzumab's impact on LVEF and related factors among women with breast cancer in Baghdad. METHODS: This retrospective observational cohort study included 60 women with stage I-III HER2-positive breast cancer treated at Al-Amal National Oncology Hospital between January 2023 and May 2024. Baseline demographic, clinical, and echocardiographic parameters were collected, with follow-up assessments every three weeks during therapy and after the final cycle. Data were analyzed using SPSS version 27. RESULTS: A P-value <0.05 was considered statistically significant. Mean LVEF declined significantly from 64.98% ± 5.50 to 62.02% ± 6.91 post-treatment (P < 0.001). The proportion of patients with impaired left ventricular diastolic function increased from 11.7% to 26.7% (P = 0.003). An LVEF decline of ≥10% was considered clinically meaningful. Traditional risk factors were not associated with LVEF decline, whereas baseline LVDF (OR 10.80; 95% CI: 2.21-17.42; P = 0.007) and post-treatment LVDF (OR 8.20; 95% CI: 1.74-13.58; P = 0.008) were significantly linked to LVEF decline. CONCLUSION: Trastuzumab can cause early cardiac function decline, which is not always detected by LVEF alone. Assessment of left ventricular diastolic function at baseline and during therapy can identify high-risk patients, enabling timely monitoring and management to balance anticancer benefits with cardiotoxic risk.
Assessing hemodynamic changes before and after pump in CABG surgery and its factors.
Dehghani Firoozabadi M, Mahmood SH, Shamsi A … +1 more , Sorani M
ARYA Atheroscler · 2025 · PMID 41179702 · Full text
BACKGROUND: One of the main complications after coronary artery bypass grafting (CABG) is postoperative clinical and para-clinical changes, which present a significant challenge. METHODS: This descriptive cross-sectional...
BACKGROUND: One of the main complications after coronary artery bypass grafting (CABG) is postoperative clinical and para-clinical changes, which present a significant challenge. METHODS: This descriptive cross-sectional study included 109 patients who were candidates for CABG and were admitted to the surgical intensive care unit at Tehran Heart Center Hospital, selected using random sampling and a checklist. Relationships between variables were analyzed with the Kolmogorov-Smirnov (K-S) test, paired t-test, and regression. RESULTS: The findings from the mean changes before and after the pump showed that blood sugar (28.23 ± 33.43), lactate (6.59 ± 5.63), potassium (0.75 ± 0.47), and heart rate (12.36 ± 15.46) increased significantly after the pump compared to before the pump (p < 0.05), while hemoglobin (-2.5 ± 1.28), hematocrit (-6.61 ± 3.44), pH (-0.03 ± 0.06), PaO₂ (-92.95 ± 94.01), bicarbonate (-1.83 ± 2.38), and mean blood pressure (-2.25 ± 13.01) decreased significantly (p < 0.05). Gender had a significant effect on cerebral oximetry values on both the right (β = 5.461, p = 0.002) and left (β = 4.835, p = 0.004) sides, hemoglobin (β = 0.644, p = 0.017), and hematocrit (β = 2.055, p = 0.004). In addition, patients' comorbidities also had a positive effect on PaO₂ (β = 11.340, p = 0.044). CONCLUSION: The clinical and para-clinical status in patients undergoing CABG surgery changes after on-pump surgery. In addition, comorbidities of patients have a positive and significant effect on PaO₂, as well as gender, on cerebral oximetry, hemoglobin, and hematocrit values.
Prevalence and contributing factors of nosocomial bloodstream infections in pediatric cardiac ICU patients at chamran hospital, Isfahan.
Salamati L, Mahdavi C, Amini Harandi M … +5 more , Sabri MR, Ahmadi A, Ghaderian M, Dehghan B, Hovsepian S
ARYA Atheroscler · 2025 · PMID 41179701 · Full text
BACKGROUND: Congenital heart disease (CHD) profoundly impacts pediatric health, leading to increased morbidity and complex care requirements, often resulting in prolonged hospital stays. Nosocomial infections, particular...
BACKGROUND: Congenital heart disease (CHD) profoundly impacts pediatric health, leading to increased morbidity and complex care requirements, often resulting in prolonged hospital stays. Nosocomial infections, particularly bloodstream infections (BSIs), pose a significant risk in the Pediatric Cardiac Intensive Care Unit (PCICU). This study aims to evaluate the prevalence of nosocomial BSIs in children with CHD within the PCICU and to identify associated risk factors. METHODS: A retrospective analysis was conducted on data recorded from patients under 18 years of age who had confirmed positive blood cultures and were hospitalized for a minimum of 48 hours from March 2019 to March 2022. Demographic, clinical, and microbiological information was collected, and statistical analyses were performed to determine the relationships between various risk factors and positive blood cultures. RESULTS: In this analysis of 510 patients evaluated, positive blood cultures were found in 16.7% of patients. Patients with positive cultures were significantly younger and had lower mean weights (P<0.05). Recovery status was a significant predictor of blood culture results (p<0.001). Device utilization, including urinary catheters and central venous lines, was notably higher in the positive culture group (P<0.05). Additionally, a higher proportion of patients with positive cultures had acyanotic CHD, with significant associations for Patent Ductus Arteriosus (PDA), Ventricular Septal Defect (VSD), and Atrial Septal Defect (ASD) (P<0.001). Improved recovery status decreased the likelihood of positive blood cultures by approximately 52.2% (odds ratio 0.478, p=0.0021). CONCLUSION: Our findings reveal a high prevalence of BSIs in the PCICU, highlighting some associated risk factors such as recovery status, use of central vein catheters, dialysis and Foley catheters, younger age, and lower weight. This study emphasizes the necessity for rigorous infection control measures, particularly regarding the management of invasive devices and prompt clinical interventions, to improve patient outcomes in this high-risk population. Enhanced surveillance and tailored guidelines are essential for reducing the risks of nosocomial infections in pediatric cardiac care settings.
How to avoid oversizing Perceval sutureless aortic valve: Technique.
Nezafati P, Yadav S
ARYA Atheroscler · 2025 · PMID 41179700 · Full text
Aortic valve replacement surgery technique has been revolutionised with the introduction of sutureless valves. Perceval sutureless aortic valve (PSV) is one of the most widely used examples. However, oversizing the PSV h...
Aortic valve replacement surgery technique has been revolutionised with the introduction of sutureless valves. Perceval sutureless aortic valve (PSV) is one of the most widely used examples. However, oversizing the PSV has been reported to be an issue. After a case of PSV stent recoil in our institution, a new technique was developed, where only the white obturator is used to size the valve. Recently, this technique was also mentioned by different authors. With this technique, we achieved low rates of paravalvular leaks and pacemaker implantation, with good transvalvular gradients. Therefore, we recommend this technique over the manufacturer's instructions.
The interplay between diabetes and atherosclerosis: A review of pathophysiological mechanisms.
Cheraghi M, Karimi A, Sedighi M … +1 more , Jabarzare S
ARYA Atheroscler · 2025 · PMID 41179699 · Full text
Atherosclerosis, characterized by lipid accumulation in arterial walls, is a leading cause of cardiovascular morbidity and mortality, with increased prevalence among individuals with diabetes mellitus. Diabetes is a chro...
Atherosclerosis, characterized by lipid accumulation in arterial walls, is a leading cause of cardiovascular morbidity and mortality, with increased prevalence among individuals with diabetes mellitus. Diabetes is a chronic condition marked by persistently high blood glucose levels, a condition that can potentially result in long-term complications, including heart, blood vessel, eye, kidney, and nerve damage. Diabetes, marked by chronic hyperglycemia, contributes to atherogenesis through mechanisms including endothelial dysfunction, oxidative stress, formation of advanced glycation end-products (AGEs), and chronic inflammation. This study provides a synopsis of the predominant characteristics of diabetes that may potentially impact the atherogenic process, including oxidative stress, altered protein kinase signaling, and the role of select microRNAs and epigenetic modifications. This review comprehensively examines literature from 1969 to 2025, focusing on the molecular and cellular pathways linking diabetes to atherosclerosis. Effective glycemic control and management of associated risk factors remain pivotal in mitigating atherosclerotic progression in diabetic patients. Understanding these interconnected mechanisms is essential for developing targeted therapies to reduce cardiovascular complications associated with diabetes.
Moderate to severe aortic stenosis: Unraveling risk factors, clinical manifestations, and one-year cardiovascular outcomes.
Soleimani A, Karimi N, Jamalian M … +1 more , Soleimani Z
ARYA Atheroscler · 2025 · PMID 41179698 · Full text
BACKGROUND: Aortic stenosis (AS), a progressively degenerative cardiac condition, poses a substantial burden on morbidity and mortality. This study responds to the scarcity of comprehensive data on moderate to severe AS,...
BACKGROUND: Aortic stenosis (AS), a progressively degenerative cardiac condition, poses a substantial burden on morbidity and mortality. This study responds to the scarcity of comprehensive data on moderate to severe AS, focusing on risk factors, clinical manifestations, and one-year outcomes. METHODS: A retrospective cross-sectional study was conducted at Chamran Hospital (2021-2022) involving 97 patients with moderate-to-severe AS. Exclusion criteria included infiltrative diseases, radiotherapy history, cardiogenic shock, ejection fraction <20%, fever, sepsis, and active infections. Data were collected using a standardized checklist with three sections: baseline demographics and risk factors, echocardiographic parameters, and outcomes (in-hospital events, surgical aortic valve replacement [AVR], and one-year mortality). RESULTS: Among the patients, 29 (29.9%) were classified as moderate AS and the remainder were severe AS. Severe AS patients exhibited higher systolic pulmonary artery pressure (sPAP) and higher prevalence of moderate to severe diastolic dysfunction and three-vessel disease (3VD). Echocardiographic parameters such as mean pressure gradient (MG), peak velocity (PV), and high sPAP were related to the severity of AS (moderate to severe) by odds ratios of 1.13, 6.09, and 1.15 folds, respectively. CONCLUSION: AS imposes a significant burden of cardiovascular risk on the population. Patients with severe AS showed higher prevalence of increased filling pressures, moderate to severe diastolic dysfunction, 3VD, and higher sPAP compared with the moderate group, with no difference in clinical presentation and one-year outcome.
Successful percutaneous closure of a large ventricular septal defect (VSD) in a 9-month-old Infant: A case report.
Derakhshan R, Doost Mohammadi F
ARYA Atheroscler · 2025 · PMID 41179697 · Full text
Ventricular septal defect (VSD) is a common congenital heart defect. In large VSDs with significant left-to-right shunting, percutaneous closure can be an effective alternative to surgical repair. In some cases, percutan...
Ventricular septal defect (VSD) is a common congenital heart defect. In large VSDs with significant left-to-right shunting, percutaneous closure can be an effective alternative to surgical repair. In some cases, percutaneous closure of septal defects is a successful treatment. Our main objective in this case report is to discuss the transcatheter closure of ventricular septal defects in a low-birth-weight infant. We are presenting the case of a 9-month-old male infant who is experiencing failure to thrive (FTT) alongside a significant ventricular septal defect (VSD). The patient successfully underwent percutaneous closure of the VSD using an antegrade approach with a symmetric device. Follow-up evaluations after the procedure confirmed that the closure was effective, the device was in the correct position, and pulmonary hypertension had resolved. As far as we know, this case represents one of the youngest and lowest-weight infants reported in Iran for successful percutaneous VSD closure instead of open surgery.
Developing in hospital mortality prediction model tools for patients with acute myocardial infarction (STEMI) using Yazd cardiovascular disease registry, YCDR data.
Namayandeh SM, Mohammadi M, Mirzaei M … +3 more , Askarishahi M, Dehghani H, Sadr Bafghi SM
ARYA Atheroscler · 2025 · PMID 41179696 · Full text
BACKGROUND: An acute ST-elevation myocardial infarction (STEMI) is a medical event characterized by transmural myocardial ischemia that leads to myocardial injury or necrosis. This study was undertaken to develop, evalua...
BACKGROUND: An acute ST-elevation myocardial infarction (STEMI) is a medical event characterized by transmural myocardial ischemia that leads to myocardial injury or necrosis. This study was undertaken to develop, evaluate, and compare models for assessing the risk of hospital mortality in patients with acute myocardial infarction. METHODS: The study made use of data from the Yazd Cardiovascular Diseases Registry (YCDR), which is a cohort study of inpatient records of ischemic heart disease in Yazd province, Iran. A total of 1,861 patients who had experienced a STEMI were included in the analysis. Decision tree analysis was conducted using R software with the package. Additionally, to analyze the data and adjust for any confounding variables, logistic regression was performed using the package. To compare the effectiveness of the two models, accuracy measures were used, and the Receiver Operating Characteristic (ROC) curve was applied. RESULTS: In this study, three clinical, laboratory, and clinical-laboratory models were created. In a clinical-laboratory model, variables such as blood sugar (BS), triglycerides, HDL cholesterol, peak myocardial band (MBpick), CVA history, and low ejection fraction (EF) were found to increase the risk of in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI). Conversely, higher levels of hemoglobin, low HDL-C, and previous myocardial infarction (MI) were associated with a protective effect against the risk of in-hospital mortality from acute myocardial infarction.The performance of the models in terms of Receiver Operating Characteristic (ROC) curve was 86.5%, 79.5%, and 90.2% for logistic regression model in three different models: clinical, laboratory, and combined clinical-laboratory. The accuracy of these models was calculated to be 88.3%, 81.3%, and 93%, respectively. Important variables influencing the prediction of in-hospital mortality in STEMI patients included Killip class, triglycerides, blood sugar, creatinine levels, the need for treatment due to ventricular fibrillation or ventricular tachycardia (VF/VT), age, and hemoglobin (HB). In the ROC curve analysis of the decision tree algorithm across the clinical, laboratory, and combined clinical-laboratory models, the performance levels were 74.6%, 69.8%, and 81.7%, respectively. The accuracy of the decision tree was 93.0%, 92.5%, and 95.8%. CONCLUSION: The findings of this study indicated that the decision tree algorithm had higher accuracy across all three models: clinical, laboratory, and combined clinical-laboratory compared to logistic regression. However, logistic regression showed higher sensitivity and better ROC curve performance than the decision tree algorithm.
Serum levels of C1q/TNF-related protein-1 (CTRP1) and CTRP3 in patients with coronary artery disease.
Namazi G, Mehranian M, Mafi A … +2 more , Salami R, Raygan F
ARYA Atheroscler · 2025 · PMID 41179695 · Full text
BACKGROUND: Research suggests that C1q/TNF-related proteins (CTRPs) play a role in inflammation and may impact coronary artery disease (CAD). This study aimed to measure their levels in CAD patients and assess their corr...
BACKGROUND: Research suggests that C1q/TNF-related proteins (CTRPs) play a role in inflammation and may impact coronary artery disease (CAD). This study aimed to measure their levels in CAD patients and assess their correlation with disease severity. METHODS: This study involved 88 individuals (50 men and 38 women) who underwent coronary angiography. Among them, 47 patients had significant coronary obstruction and were selected as the case group, and 41 individuals without significant obstruction were considered as the control group. Serum levels of CTRP1 and CTRP3 were quantified using the ELISA method, whereas other parameters were assessed by standard laboratory techniques. Multiple logistic regression analysis was used to examine the association between CTRP1 and CTRP3 levels with CAD. RESULTS: The mean age of CAD patients was 62.1 ± 11.5 years. Thirty-one patients were male and sixteen were female. The control group comprised nineteen men and twenty-two women, with a mean age of 62.3 ± 12.7 years. The concentrations of CTRP1 and CTRP3 proteins were significantly higher in individuals with CAD relative to controls. Except for serum HDL levels, which were lower in the CAD group than in the control group, there were no significant differences in the demographic or clinical features between the studied groups. A direct and significant association was discovered between the amounts of assessed adipokines and the severity of CAD. CONCLUSION: A greater concentration of both CTRP1 and CTRP3 was strongly associated with the presence and severity of CAD, indicating that these adipocytokines may serve as markers for CAD.
Investigation the effects of Rivaroxaban on oxidative stress and antioxidant capacity in patients heart failure.
Dilanchian G, Rezvani Sichani Z, Nayeri H … +1 more , Asgary S
ARYA Atheroscler · 2025 · PMID 40893721 · Full text
BACKGROUND: Rivaroxaban, a direct Factor Xa inhibitor, primarily acts by disrupting the coagulation cascade. However, it may also influence oxidative stress. This effect likely stems from its ability to reduce thrombin-m...
BACKGROUND: Rivaroxaban, a direct Factor Xa inhibitor, primarily acts by disrupting the coagulation cascade. However, it may also influence oxidative stress. This effect likely stems from its ability to reduce thrombin-mediated reactive oxygen species (ROS) production and mitigate inflammation. The major aim of the present investigation was to assess the effects of Rivaroxaban on oxidative stress and antioxidant capacity in patients with heart failure. METHODS: This study included 39 patients (17 males and 22 females, aged 30-95 years) with Stage B heart failure (HF) who had never previously received Rivaroxaban. Patients were enrolled from Chamran Cardiovascular Hospital in Isfahan after providing written informed consent, approved by the Falavarjan University Ethical Committee (IR.IAU.FALA.REC.1398.029). All patients had structural cardiac abnormalities, including reduced left ventricular ejection fraction (LVEF < 40%) or diastolic dysfunction, but no clinical symptoms of HF. Rivaroxaban (20 mg/day) was administered orally to all patients for two months using a pre-post design. Blood samples were collected before and after treatment to assess oxidative stress and antioxidant biomarkers, including total antioxidant capacity (TAC), malondialdehyde (MDA), homocysteine (Hcy), and the enzymatic activities of paraoxonase-1 (PON1) and arylesterase. TAC, MDA, and enzyme activities were measured spectrophotometrically, while homocysteine levels were determined using ELISA. RESULTS: The results showed a significant reduction in MDA levels (P < 0.001), indicating reduced oxidative stress after Rivaroxaban treatment. However, no statistically significant changes were observed in other biomarkers, including homocysteine, arylesterase, paraoxonase, and TAC (P > 0.05). CONCLUSION: In conclusion, Rivaroxaban appears to effectively reduce oxidative stress, as evidenced by decreased MDA levels.
Echocardiographic findings of hospitalized children with covid-19: A cross-sectional study in southeast Iran.
Bagheri MM, Sinaei R, Dortaj F … +2 more , Ilaghi M, Aboutalebi S
ARYA Atheroscler · 2025 · PMID 40893720 · Full text
BACKGROUND: Cardiovascular involvement represents a potentially serious complication associated with novel coronavirus disease 2019 (COVID-19), particularly among pediatric patients. Data regarding echocardiographic find...
BACKGROUND: Cardiovascular involvement represents a potentially serious complication associated with novel coronavirus disease 2019 (COVID-19), particularly among pediatric patients. Data regarding echocardiographic findings remain sparse, especially in low- and middle-income countries. The primary objective of this study was to investigate the echocardiographic findings of hospitalized children with COVID-19 in southeast Iran. METHODS: This was a cross-sectional study of hospitalized pediatric COVID-19 patients in Kerman, southeast Iran, between March 2020 and March 2022. Clinical records of patients who had undergone transthoracic echocardiograms were evaluated. Demographic and clinical data, as well as echocardiographic findings-including left ventricular (LV) dysfunction, coronary involvement, valvular abnormalities, and pericardial effusion-were noted. Serum inflammatory markers were also assessed. RESULTS: Data from a total of 188 children were analyzed. The mean age (± standard deviation) was 52.7 ± 4.9 months, and 61.4% were male. In terms of disease severity, 36.1% were categorized as moderate, 47.9% as severe, and 16.0% as multisystem inflammatory syndrome in children (MIS-C). Overall, 92.0% had abnormal echocardiographic findings-most commonly pericardial effusion (55.9%), valvular dysfunction (44.1%), coronary artery involvement (36.7%), and LV dysfunction (19.1%). Mitral regurgitation (36.2%) and tricuspid regurgitation (19.7%) were the most common valvular involvements. Moreover, coronary ectasia (19.7%) and dilatation (13.3%) were the prominent coronary abnormalities. LV dysfunction and valvular abnormalities were associated with increased mechanical ventilation, ICU admission, and mortality. Elevated erythrocyte sedimentation rate (ESR) was associated with valvular dysfunction, while higher NT-proBNP was associated with LV dysfunction. CONCLUSION: Hospitalized children had a high prevalence of echocardiographic abnormalities, with LV and valvular dysfunction correlating with worse prognosis and inflammation. Echocardiography appears valuable for risk stratification in ventilator support and Intensive Care Unit (ICU) admission in pediatric patients; however, further research is needed on long-term cardiac sequelae.
The thrill is vanished: Percutaneous exclusion of post trans radial arteriovenous fistula using stent graft through transbrachial approach.
Sinha SK, Jha MJ, Pandey U … +2 more , Razi M, Sharma AK
ARYA Atheroscler · 2025 · PMID 40893719 · Full text
Radial arteriovenous fistula (AVF) following radial intervention is exceedingly scarce. Here, we report a case of a 73-year-old man who was admitted with acute myocardial ischaemic syndrome and underwent transradial angi...
Radial arteriovenous fistula (AVF) following radial intervention is exceedingly scarce. Here, we report a case of a 73-year-old man who was admitted with acute myocardial ischaemic syndrome and underwent transradial angioplasty of the proximal left anterior descending and circumflex artery. Fourteen months later, he presented with progressive swelling, dilated superficial veins, a palpable thrill, continuous bruit, and tingling at the local site. Doppler ultrasonography (DUS) diagnosed radial AVF with multiple fistulous communications draining into the cephalic vein, confirmed by contrast-enhanced computed tomography (CECT). Local compression using a prolonged compressive bandage (>12 hours) and a DUS probe was attempted but remained ineffectual. A 2.8 × 26 mm Graftmaster stent graft (Abbott Vascular, USA) was deployed into the radial artery across the fistula neck via a transbrachial approach, slowly expanded over 60 seconds at 12 atm pressure, and post-dilated with a 3 × 15 mm noncompliant balloon at 15 atm pressure. A post-procedure angiogram displayed complete closure of the fistula with restoration of palmar arch perfusion. This is the first reported case of successful exclusion of RAVF through transbrachial approach using a ever covered stent, and only the second case overall of percutaneous exclusion using a stent graft.
The mechanism of vascular adhesion molecule-1 in an ischemia-reperfusion cardia model.
Zarei S, Nazari A, Chehelcheraghi F … +2 more , Birjandi M, Karbaschi R
ARYA Atheroscler · 2025 · PMID 40893718 · Full text
BACKGROUND: Vascular adhesion molecule-1 (VCAM-1) is involved in promoting inflammation within blood vessels, activating endothelial cells, and is a key factor in the progression of diabetic vasculopathy in rats with dia...
BACKGROUND: Vascular adhesion molecule-1 (VCAM-1) is involved in promoting inflammation within blood vessels, activating endothelial cells, and is a key factor in the progression of diabetic vasculopathy in rats with diabetes, contributing to the underlying pathophysiological processes. This study focused on the expression level of VCAM-1 in diabetic rats subjected to a six-week schedule of aerobic training and valerian supplements. METHODS: Fifty male Wistar rats' hearts were removed under deep anesthesia and were studied using Lutgendorf's apparatus. They were divided into five groups (10 each): Healthy control (C), Diabetic control (DC), Diabetic with valerian (DV), Diabetic with exercise (DE), and Diabetic with valerian and exercise (DVE). Diabetes was induced in the animals by administering a shot of STZ (50 mg/kg) in their abdominal area. Following confirmation of diabetes in the animals, moderate exercise five days a week, combined with intraperitoneal administration of 200 mg/kg/day of valerian, was maintained for six weeks. Heart tissue was obtained from diabetic cardiac ischemia-reperfusion model (CI/RM) injury (n=40) and control rats (n=10). RESULTS: VCAM-1 expression and histological parameters were not observed when comparing experimental and control groups. However, the exercise/valerian treatment (E + V) notably reduced the irregularity in cardiac tissue and increased the size of cardiomyocytes. CONCLUSION: These findings suggest that E + V extract could diminish the levels of diabetic cardiac complications. Also, it had a dual effect: it corrected cardiac tissue abnormalities and increased the size of cardiomyocytes, enhancing the overall structure and function of the heart. More research is needed to understand non-pharmacological complementary treatments in this area.
Public awareness and knowledge of stroke risk factors and symptoms in Saudi Arabia: A cross-sectional study.
Alrawili NKA, Alanazi SN, Alanazi SN … +3 more , Rikabi HA, Abdulkareem EM, Eltaib L
ARYA Atheroscler · 2025 · PMID 40893717 · Full text
Stroke is a critical global health issue characterized by sudden neurological dysfunction due to disrupted blood flow to the brain. This study aims to enhance understanding of stroke by examining its risk factors, sympto...
Stroke is a critical global health issue characterized by sudden neurological dysfunction due to disrupted blood flow to the brain. This study aims to enhance understanding of stroke by examining its risk factors, symptoms, and prevention strategies. This was a cross-sectional study conducted in Saudi Arabia; the research involved a random sample of 442 participants over two months in 2024. The findings revealed that 63% of respondents were female, with the majority (64%) aged between 20-40 years, and 76% had university education. The overall knowledge level regarding stroke was moderate, at 62%. Of the 275 participants from the Northern Border Region, 60% demonstrated knowledge regarding risk factors, 58% regarding signs and symptoms, and 60% regarding treatment options. These results highlight a significant gap in knowledge among the Saudi public, particularly in understanding stroke's general aspects, risk factors, symptoms, and treatment options. The study emphasizes the importance of early recognition of stroke symptoms, summarized by the F.A.S.T. acronym, for timely medical intervention. It underscores the necessity for improved public education and awareness campaigns to enhance understanding and potentially reduce the impact of stroke in the community. A multifaceted approach integrating awareness, lifestyle modifications, and medical management is essential for effective stroke prevention and improved quality of life for individuals at risk.
Clinical insights into nonbacterial thrombotic endocarditis in cancer patients: A case-based systematic review.
Torkan A, Dehghan H, Tajmirriahi M … +1 more , Zavar R
ARYA Atheroscler · 2025 · PMID 40893716 · Full text
BACKGROUND: Nonbacterial thrombotic endocarditis (NBTE) is a rare yet critical complication in cancer patients, with high embolic risk and poor prognoses. This systematic review investigates the clinical presentation, va...
BACKGROUND: Nonbacterial thrombotic endocarditis (NBTE) is a rare yet critical complication in cancer patients, with high embolic risk and poor prognoses. This systematic review investigates the clinical presentation, valve involvement, embolic risk, vegetation management, and prognostic variability across cancer types in NBTE cases. METHODS: Adhering to PRISMA guidelines, we conducted a comprehensive literature search in PubMed, Scopus, and Embase for studies from 2000 to September 2024. Extracted data included demographics; cancer type and site; NBTE diagnosis timing; valve characteristics; embolic events; and patient outcomes. Chi-square and regression analyses evaluated associations among clinical variables and outcomes. Quality was appraised using the Joanna Briggs Institute tool. RESULTS: From 38 studies comprising 40 cases, the mean patient age was 50.5 years (±12.5), with equal gender distribution (20 males, 20 females). Pancreatic adenocarcinoma (17.5%) and lung adenocarcinoma (15.0%) were most frequently associated with NBTE. Mortality rates varied significantly by cancer type, with gastrointestinal and urogenital cancers showing the highest rates. A significant association was found between cancer type and vegetation management strategy (χ² = 24.41, p = 0.018). Further correlations indicated that longer cancer histories necessitated more invasive management, and concurrent embolic events correlated with poorer prognoses. Quality assessment reinforced the findings' reliability (65% high quality). CONCLUSION: NBTE in cancer patients shows distinct clinical and prognostic patterns, with cancer type impacting both management and outcomes. These insights highlight the importance of tailored management approaches and provide a basis for future research to enhance care and prognostic assessments in NBTE cases within oncology.
Evaluating the association of ischemic ECG changes and CBC parameters in normal population.
Yaghooti-Khorasani M, Varasteh N, Hatamzadeh H … +13 more , Saffar Soflaei S, Darroudi S, Sahranavard T, Allahyari M, Mosa Farkhani E, Heidari-Bakavoli A, Alimi H, Izadi-Moud A, Hosseinzadeh F, Ferns GA, Esmaily H, Ghayour-Mobarhan M, Moohebati M
ARYA Atheroscler · 2025 · PMID 40893715 · Full text
BACKGROUND: Finding the relation between complete blood count (CBC) parameters and ischemic electrocardiogram (ECG) changes among a large normal population, for the first time. METHODS: Participants of the first phase of...
BACKGROUND: Finding the relation between complete blood count (CBC) parameters and ischemic electrocardiogram (ECG) changes among a large normal population, for the first time. METHODS: Participants of the first phase of the MASHAD cohort study were enrolled in this cross-sectional study. Twelve-lead ECGs were taken from participants. According to the Minnesota codes, we divided the ischemic ECG changes into major and minor. Major ischemic changes included major Q-wave changes, minor Q-wave plus ST-T changes, and major isolated ST-T changes. Minor changes included minor isolated Q/QS waves, minor ST/T changes, and ST-segment elevation. The mean of the CBC parameters was compared between individuals with and without ischemic changes. The backward stepwise logistic regression model was implemented to estimate the odds ratios of ECG changes and eliminate confounders. Data were analyzed using SPSS version 20, with significance set at p < 0.05. RESULTS: Among 9,106 participants, 510 individuals (5.6%) had minor and major ischemic changes, with a preference for males. Major ischemic changes were not associated with CBC parameters. However, the odds of having minor ischemic changes increased 1.96-fold with increasing red blood cell (RBC) count (OR = 1.96 [1.31-2.94], p = 0.001); though, they decreased by 0.18 units with increasing hemoglobin (OR = 0.81 [0.73-0.92], p = 0.001). Additionally, high mean corpuscular volume (MCV) increased the odds of minor ischemic changes (OR = 1.05 [1.01-1.08], p = 0.004). CONCLUSION: Among Mashhad's normal population, major ischemic changes were not associated with CBC parameters. Also, minor and major ischemic changes were positively associated with WBC count.
Localized dissection of ascending aorta and arch rupture due to fire suppressant blast: A rare mechanism of injury successfully managed by urgent surgical intervention.
Grant R, Iyer A, Nezafati P
ARYA Atheroscler · 2025 · PMID 40625823 · Full text
BACKGROUND: Traumatic aortic injuries are predominantly caused by high-impact motor vehicle collisions, often due to sudden deceleration. This report presents a rare case of localized dissection and partial aortic arch r...
BACKGROUND: Traumatic aortic injuries are predominantly caused by high-impact motor vehicle collisions, often due to sudden deceleration. This report presents a rare case of localized dissection and partial aortic arch rupture resulting from a fire suppressant explosion. CASE PRESENTATION: A 36-year-old male was transferred following a fire suppressant explosion at a copper smelter. He presented with central chest pain and stable hemodynamics, with no signs of external chest trauma. Computed tomography (CT) imaging revealed a localized dissection of the ascending aorta and a partial rupture of the aortic arch, in addition to fractures in the hand and foot caused by suppressant debris. The patient subsequently became hemodynamically unstable and required urgent surgical intervention. He underwent ascending aortic and aortic arch repairs. Postoperatively, his course was complicated by a pulmonary embolism, which was managed medically. He was eventually discharged after recovering from his injuries. CONCLUSION: Aortic injuries resulting from small-scale blasts can occur. Successful management relies on a high index of suspicion and timely surgical intervention.
Determinants of severity of pain in non-cardiac chest pain patients: A cross sectional study.
Roohafza H, Heidari D, Feizi A … +7 more , Khani A, Shokri K, Bagherieh S, Yavari N, Saneian P, Karami A, Sadeghi M
ARYA Atheroscler · 2025 · PMID 40625822 · Full text
BACKGROUND: This study aims to explore the psychosocial factors related to the severity of pain in patients with non-cardiac chest pain (NCCP), providing insights to support more comprehensive and targeted management str...
BACKGROUND: This study aims to explore the psychosocial factors related to the severity of pain in patients with non-cardiac chest pain (NCCP), providing insights to support more comprehensive and targeted management strategies. METHODS: This cross-sectional study was conducted at two university-affiliated hospitals. Patients diagnosed with NCCP, based on physical examination and angiographic findings, completed questionnaires assessing type D personality, cardiac anxiety, fear of bodily sensations, somatization, depression, and pain severity. Univariate and multiple logistic regression analyses were conducted to identify factors influencing pain severity levels. RESULTS: A total of 156 males and 204 females, with a mean age of 55.76 ± 12.83 years, were divided into low-pain (N = 182) and high-pain (N = 178) groups. Higher education and being female were significantly associated with greater pain severity. Depression, type D personality, somatization, and cardiac anxiety were significantly correlated with pain severity. Multiple logistic regression analysis indicated that self-rated health (OR,: 2.14; 95% CI. :1.18-3.90), depression (OR-11.15; 95% CI-:1.09-1.22), type D personality (OR-: 1.90; 95% CI-: 1.06- 3.41), somatization (OR-: 1.03; 95% CI-: 1.01-1.06), and fear of bodily sensation (OR-: 1.90; 95% CI-: 1.06-3.41), were all associated with pain severity. CONCLUSION: This study concluded that type D personality, fear of bodily sensations, depression, somatization, cardiac anxiety, and poor self-rated health were associated with increased NCCP severity. By controlling the disease and managing related pain earlier, more coherent treatment strategies can be implemented, ultimately improving patients' quality of life.
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