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Forty-seven years of Iranian cardiovascular disease scientific publication: A bibliometric and altmetric analysis.

Ouchi A, Ebrahimi F, Nemati Anaraki L … +2 more , Hoseini Ahangari SA, Ansari N

ARYA Atheroscler · 2024 · PMID 39170818 · Full text

BACKGROUND: The present study was conducted to investigate the scientific contributions of Iranians in the field of cardiovascular research, as indexed in the Scopus database, using bibliometric and altmetric methods. ME... BACKGROUND: The present study was conducted to investigate the scientific contributions of Iranians in the field of cardiovascular research, as indexed in the Scopus database, using bibliometric and altmetric methods. METHODS: This applied study was conducted with a scientometric approach, utilizing bibliometric and altmetric indicators. The research population consisted of the scientific works of Iranian researchers in the field of cardiovascular diseases, indexed in the Scopus database over a period of 47 years. For bibliometric analysis and the generation of co-citation, co-occurrence, and co-authorship maps, the authors employed VOS Viewer software and the bibliometrix package in the R programming language. In the final stage, articles mentioned on social media were analyzed and evaluated using an altmetric approach. RESULTS: The results indicated that the commencement point for the publication of documents was 1975, and there has been a steep increase in recent years. Moreover, the documents were primarily research articles out of 6853 retrieved documents, and a limited number of documents were single-authored. Other findings also revealed the co-authorship map of authors and the co-occurrence of words, highly cited authors and institutions, and highly frequent keywords, signifying the scientific collaboration of Iranian researchers with the United States and England. Altmetric analysis also demonstrated that 43.41% of documents were shared at least once on social media and had an Altmetric Attention score. Furthermore, the analysis of altmetric indices showed that Mendeley, Twitter, and News had the highest share of document mentions on social media, respectively. CONCLUSION: The findings of the study can offer valuable information to researchers, managers, and policy makers to become aware of the current state of research in the field of cardiovascular diseases and implement the necessary policies to inform society and enhance public health status.

Cardiomyopathy discovered during pregnancy: Insights from speckle tracking echocardiography in a cohort of pregnant patients.

Bahrami P, Soleimani A, Zavar R … +2 more , Masoumi H, Adelparvar F

ARYA Atheroscler · 2024 · PMID 39170817 · Full text

BACKGROUND: Heart failure (HF) is considered the leading cause of cardiac-related morbidity and mortality during pregnancy. Peripartum cardiomyopathy (PPCM) presents diagnostic challenges, often mirroring dilated cardiom... BACKGROUND: Heart failure (HF) is considered the leading cause of cardiac-related morbidity and mortality during pregnancy. Peripartum cardiomyopathy (PPCM) presents diagnostic challenges, often mirroring dilated cardiomyopathy (DCM). The aim of the study is to evaluate echocardiographic features, including global and segmental longitudinal strain values, in pregnant women with a history of newly diagnosed left ventricular systolic dysfunction (LVSD) in the third trimester of pregnancy. METHODS: This cross-sectional study, conducted in two referral cardio-obstetric clinics in Isfahan, Iran, enrolled pregnant women with newly diagnosed LV systolic dysfunction in the third trimester of pregnancy. A multidisciplinary pregnancy heart team assessed the patients. Reevaluation of patients and advanced echocardiographic investigation, including speckle tracking echocardiography (STE), were performed at least six months after delivery. RESULTS: The study included 26 pregnant women. Baseline characteristics revealed varying NYHA functional classes and etiologies, including DCM or non-dilated LV cardiomyopathy and PPCM. Undiagnosed DCM with exacerbation during pregnancy or non-dilated LV cardiomyopathy were the most probable causes for LV systolic dysfunction (65.4%). In five cases, peripartum cardiomyopathy was more relevant. The mean global longitudinal strain (GLS) was -16.94% and -13.95% in PPCM and DCM, respectively. Significantly different regional longitudinal strain numbers among different LV segments in PPCM were observed (P=.042), whereas the segmental strain in DCM patients did not differ. CONCLUSION: When LVSD is discovered late in pregnancy, it is not easy for the authors to differentiate between peripartum cardiomyopathy and other cardiomyopathies. Advanced echocardiographic techniques, particularly GLS analysis, may be valuable in differentiating between these conditions.

The prevalence of myocardial infarction in the elderly: A systematic review and meta-analysis.

Rajati F, Rajati M, Chegeni M … +1 more , Kazeminia M

ARYA Atheroscler · 2024 · PMID 39170816 · Full text

BACKGROUND: Myocardial Infarction (MI) refers to the destruction and death of cells in the myocardium of the heart. Its prevalence increases with age due to changes in the cardiovascular system. The aim of the present st... BACKGROUND: Myocardial Infarction (MI) refers to the destruction and death of cells in the myocardium of the heart. Its prevalence increases with age due to changes in the cardiovascular system. The aim of the present study was to combine, summarize, standardize, resolve inconsistencies in the results of studies, and investigate the impact of potential factors on the prevalence rate of MI in the elderly through a systematic review and meta-analysis. METHODS: This systematic review and meta-analysis was conducted from 1987 to March 2022. All relevant published studies were searched in PubMed, Embase, Scopus, Web of Science (WoS) databases, and Google Scholar search engine using related MeSH/Emtree and Free Text words. The heterogeneity among studies was quantified using the I index. RESULTS: In the initial search, 35453 studies were identified. After eliminating irrelevant studies, finally, 29 articles with a sample size of 3279136 subjects were included in the meta-analysis. After combining the results of the studies included in the meta-analysis, the total prevalence of MI in the elderly was estimated to be 17.6% (95% CI: 12.8 - 23.7%), 16.1% (95% CI: 11.0 - 22.8%) in males, and 12.5% (95% CI: 9.2 - 16.8%) in females. The prevalence of MI increased with the year of publication and the mean age of the elderly (P < 0.001). CONCLUSION: The results showed that due to the high prevalence of myocardial infarction (MI) in the elderly, it should be addressed within healthcare systems and policy makers should pay more attention to prevention of MI. However, considering the inclusion of heterogeneous studies, the pooled estimation should be interpreted with caution.

The association between GJB2 gene (producing Cx26 protein) and the ventricular storm: A case report.

Nikoo MH, Hatamnejad MR, Emkanjoo Z … +4 more , Arjangzadeh A, Motahari Moadab M, Bazrafshan M, Bazrafshan Drissi H

ARYA Atheroscler · 2024 · PMID 39170815 · Full text

BACKGROUND: A structural heart disease or functional electrical abnormalities can cause an electrical storm. CASE PRESENTATION: We present a young boy with an electrical storm who had no cardiac risk factors and a positi... BACKGROUND: A structural heart disease or functional electrical abnormalities can cause an electrical storm. CASE PRESENTATION: We present a young boy with an electrical storm who had no cardiac risk factors and a positive family history of sudden cardiac death. The stepwise diagnostic approach was ineffective in determining previously known causes as the origin of the electrical storm. However, whole-exome sequencing (with Next Generation Illumina Sequencing) revealed a mutation in the GJB2 (NM_004004:exon2:c.G71A:p.W24X) gene. CONCLUSION: A mutation in the GJB2 gene, which forms the connexin 26 protein, a crucial component of the myocytes' intercalated disc of gap junction complex between the myocytes, results in an abnormal electrical cell-by-cell conductance, and, eventually, ventricular storm. General anesthesia was used to control the storm, and intracardiac pacing was fruitful in ceasing the subsequent VT storms.

The assessment of no-reflow phenomenon incidence in early versus delayed percutaneous coronary intervention following a primary fibrinolysis.

Amirpour A, Behjati MA, Zavar R … +8 more , Shirvani E, Zarepour E, Hassannejad R, Sadeghi M, Janghorbanian Poodeh R, Safaei A, Sanaei S, Parvar NM

ARYA Atheroscler · 2024 · PMID 39170814 · Full text

BACKGROUND: Percutaneous coronary intervention (PCI) is the gold standard approach to ST-Segment Elevation Myocardial Infarction (STEMI). Fibrinolysis followed by PCI has been recommended. The current study aims to inves... BACKGROUND: Percutaneous coronary intervention (PCI) is the gold standard approach to ST-Segment Elevation Myocardial Infarction (STEMI). Fibrinolysis followed by PCI has been recommended. The current study aims to investigate the no-reflow phenomenon incidence in patients undergoing post-thrombolytic therapy PCI. METHODS: This cross-sectional study was conducted on 250 patients with STEMI who primarily received fibrinolytic therapy followed by early (3-24 hours) (n=231) or delayed (> 24 hours) (n=19) PCI. They were also subcategorized into four intervals: <6 hours (n=98), 6-12 hours (n=93), 12-24 hours (n=38), and ≥24 hours (n=21). The demographic and medical data of the patients were retrieved. The Thrombolysis in Myocardial Infarction score (TIMI) was assessed at baseline and at the end of PCI. A TIMI score other than 3 was defined as no-reflow. RESULTS: The incidence of the no-reflow phenomenon was not associated with any of the underlying demographic and medical characteristics of the patients (P-value>0.05). Despite the significantly higher rate of improvement in TIMI grading among those undergoing early PCI (P-value=0.04), as well as within less than 6 hours after thrombolytic therapy (P-value=0.031), the rate of the no-reflow phenomenon did not differ between the groups, neither by sorting them as early versus delayed (P-value=0.518) nor by categorizing them into four intervals (P-value=0.367). CONCLUSION: Based on the findings of the current study, early PCI after fibrinolysis led to significantly improved TIMI flow. However, the incidence of no-reflow did not differ between the groups with early versus delayed post-fibrinolysis PCI.

Cardioprotective effects of aerobic training in diabetic rats: Reducing cardiac apoptotic indices and oxidative stress for a healthier heart.

Gharaat MA, Choobdari HR, Sheykhlouvand M

ARYA Atheroscler · 2024 · PMID 39170813 · Full text

BACKGROUND: The present study evaluated the effects of aerobic training with variable intensities on apoptotic indices of cardiac tissue in fatty diabetic rats. METHODS: Twenty-four male Wistar rats were randomly divided... BACKGROUND: The present study evaluated the effects of aerobic training with variable intensities on apoptotic indices of cardiac tissue in fatty diabetic rats. METHODS: Twenty-four male Wistar rats were randomly divided into non-diabetic (ND, n=8), trained diabetic (TD, n=8), and control diabetic (CD, n=8) groups. Following a high-fat dietary regimen, type 2 diabetes was induced by streptozotocin, with blood glucose levels above 300 mg/dL considered indicative of diabetes. The TD group underwent aerobic exercise five times a week for six weeks. Subsequently, measurements were taken for left ventricular end-diastolic (LVEDV) and end-systolic volumes (LVESV), ejection fraction (EF%), catalase, caspase-9, P53, glucose, insulin, and HOMA-IR. RESULTS: Aerobic training led to a significant decrease in blood glucose levels (P < 0.01), caspase-9 (P < 0.05), HOMA-IR (P < 0.05), and P53 expression (P < 0.001) compared with the CD group. LVEDV and LVESV decreased significantly (P < 0.05 for both), while LVEF increased significantly (P < 0.05). Catalase activation showed an insignificant increase in the TD group pre- to post-training compared to CD. CONCLUSION: Incremental aerobic exercise training (6 weeks) may exert a cardioprotective effect in diabetic rats by reducing apoptosis and oxidative stress indices, while simultaneously increasing aerobic fitness and reducing body weight.

Effects of balloon pulmonary valvuloplasty on longitudinal changes in right ventricular strain and strain rate in pediatric pulmonary stenosis.

Ahmadi A, Sabri MR, Ghaderian M … +4 more , Ramezani Nezhad D, Dehghan B, Mahdavi C, Sedighi M

ARYA Atheroscler · 2024 · PMID 39170812 · Full text

BACKGROUND: Balloon Pulmonary Valvuloplasty (BPV) is a procedure for Pulmonary Stenosis (PS) treatment. In this study, right ventricle (RV) performance was determined through 2D-Speckle Tracking Echocardiography (2D-STE)... BACKGROUND: Balloon Pulmonary Valvuloplasty (BPV) is a procedure for Pulmonary Stenosis (PS) treatment. In this study, right ventricle (RV) performance was determined through 2D-Speckle Tracking Echocardiography (2D-STE). METHODS: The study involved 25 diagnosed children with PS undergoing BPV and 25 normal children. They were examined using 2D-STE and Linear Mixed Model (LMM) approach was used to determine changes in Pulmonary Valve Peak Gradient (PVPG), Tricuspid Annular Plane Systolic Excursion (TAPSE), strain and Strain Rate (SR) for RV, and Ejection Fraction for Left Ventricle (LVEF). RESULTS: Notable differences were found between two groups in TAPSE (), global strain (), apical septal strain (), middle septal strain (), basal septal strain (), apical lateral SR (), middle lateral SR (), basal lateral SR (), and apical septal SR (). Post-BPV, there was an increase in LVEF () and TAPSE () but PVPG decreased (). Following BPV, an increase was observed in apical lateral strain (), middle septal strain (), apical septal strain (), middle septal strain (), basal septal strain (), apical septal SR (), and middle septal SR (). Gender was remarkably correlated with mean changes in basal lateral strain (), middle septal strain (), and middle septal SR (). Age of PS children was related to mean change in basal septal strain () and basal septal SR (). CONCLUSION: Strain and SR in RV improved post-BPV in children with PS. The gender and age of the children revealed remarkable effects on RV strain and SR changes after BPV.

A cross- sectional study on the association between lifestyle factors and coronary artery stenosis severity among adults living in central Iran: A protocol for the Iranian- CARDIO study.

Motallaei M, Darand M, Taftian M … +10 more , Beigrezaei S, Golvardi-Yazdi F, Mohyadini M, Mirjalili F, Darabi Z, Ahmadi Vasmehjani A, Seyedhosseini S, Sareban-Hassanabadi MT, Khayyatzadeh SS, Salehi-Abargouei A

ARYA Atheroscler · 2024 · PMID 39165856 · Full text

BACKGROUND: Although several studies have attempted to identify coronary artery disease (CAD) risk factors, few have explored the association between lifestyle-related factors and the severity of coronary artery stenosis... BACKGROUND: Although several studies have attempted to identify coronary artery disease (CAD) risk factors, few have explored the association between lifestyle-related factors and the severity of coronary artery stenosis. The present study was designed to assess the association between a combination of lifestyle, dietary, cardiometabolic, psychological, and mental factors, and CAD severity in adults undergoing angiography. METHODS: This cross-sectional study aimed to recruit a total of 700 patients (aged 35 to 75 years) who met the inclusion criteria and were referred for angiography between July 2020 and November 2021 to Afshar Hospital, a central heart disease hospital in Yazd city, Iran. To assess the presence and intensity of CAD, we used the Gensini and SYNTAX scores. Biochemical factors were measured using standard kits from serum samples, and extra serum and whole blood samples were retained for further analyses. Data on general information, dietary food and supplement intake, eating habits, medicinal herbs consumption, psychological and mental state, sleep quality, and other variables were gathered by trained interviewers using specific questionnaires. RESULTS: In total, 720 participants (444 males and 276 females) aged 56.57±9.78 years were included in the current study. Moderate to severe coronary artery stenosis was prevalent in 47.0% and 17.9% of participants based on Gensini and SYNTAX scores, respectively. CONCLUSION: The results of this study will enhance our understanding of the association between different risk factors and the severity of coronary artery stenosis.

Is cardiac rehabilitation after pci as effective as cabg? The first experience from the eastern mediterranean region cardiac rehabilitation registry.

Sadeghi M, Sheikhbahaei E, Hansen D … +6 more , Hassannejad R, Rouhani S, Hadavi MM, Yazdekhasti S, Behfar A, Roohafza H

ARYA Atheroscler · 2024 · PMID 39165855 · Full text

BACKGROUND: The effectiveness of cardiac rehabilitation (CR) programs following either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) has been separately studied. Few studies have comp... BACKGROUND: The effectiveness of cardiac rehabilitation (CR) programs following either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) has been separately studied. Few studies have compared the effects of similar CR programs between PCI and CABG. This study aimed to compare the effects of CR in patients recruited following either PCI or CABG on coronary heart disease risk factors, psychological variables, and functional capacity. METHODS: For this retrospective study, the documents of the CR program registry of the Isfahan Cardiovascular Research Institute were reviewed from 2008 to 2021. Patients with ischemic heart disease undergoing PCI or CABG were enrolled in an 8-week exercise-based cardiac rehabilitation program. Demographics, smoking status, clinical data, echocardiographic parameters, laboratory data, functional capacity, and psychological status were assessed. RESULTS: Patients who underwent CABG (n=557) were more likely to be referred to CR than those who underwent PCI (n=440). All variables changed significantly after the CR program compared to their baseline value in both the PCI and CABG groups. However, low-density lipoprotein and total cholesterol levels, peak systolic blood pressure, and resting and peak diastolic blood pressure did not change in any of the groups, and fasting blood sugar (p=0.01) and triglyceride (TG) (p=0.01) levels significantly decreased only in the PCI group. Between-group comparisons indicated that after adjustment, no significant difference was observed between the PCI and CABG groups except for TG, which was significantly reduced in the PCI group (p=0.01). CONCLUSION: The CR program was equally effective in patients who underwent either PCI or CABG.

Audit and quality assessment of national persian registry of cardiovascular disease(N-PROVE) in terms of comorbidities, angiography, and angioplasty characteristics in Iran.

Jazi SMH, Shirvani H, Mansouri A … +8 more , Kermani-Alghoraishi M, Bordbar A, Sattar F, Safaei A, Farshidi H, Assareh AR, Kazemi T, Khosravi A

ARYA Atheroscler · 2024 · PMID 39165854 · Full text

BACKGROUND: The National Persian Registry of Cardiovascular Disease (N-PROVE) has been established to provide a comprehensive database of cardiovascular diseases in the Iranian community for further investigations and to... BACKGROUND: The National Persian Registry of Cardiovascular Disease (N-PROVE) has been established to provide a comprehensive database of cardiovascular diseases in the Iranian community for further investigations and to develop national guidelines for the diagnosis, treatment, and prevention of cardiovascular disease (CVD). As with most clinical registries, a quality control audit is necessary to ensure a comprehensive and accurate registry; the current study aims to assess the validity and quality of the N-PROVE/Angiography/Percutaneous Coronary Intervention (PCI) registry. METHODS: The current cross-sectional quality assessment study serves as an example of data quality assessment in N-PROVE on a sample of patients registered in the N-PROVE/Angiography/PCI registry since 2020. Accordingly, data of 194 patients, including comorbidities, angiography, and angioplasty characteristics, were collected from the N-PROVE/Angiography/PCI registry as the main database and reevaluated by a panel consisting of a cardiologist and two coronary intervention fellowships as a test database. RESULTS: The quality control of the population-based healthcare database, the N-PROVE/PCI, revealed that the average error rate in terms of comorbidities, angiography characteristics, angioplasty characteristics, and in total were 3.8%, 2.3%, 3%, and 3.03%, respectively. CONCLUSION: According to the findings of this study, the N-PROVE/PCI registry had an average error of less than 4% in the assessed dimensions, including comorbidities, angiography, and angioplasty characteristics. Therefore, this registry appears valid and may be used for contemporary epidemiological studies.

Vitamin D deficiency and atrial fibrillation: A cross sectional single center study.

Askarinejad A, Bakhshandeh H, Heidarali M … +3 more , Adimi S, Ghaemmaghami Z, Haghjoo M

ARYA Atheroscler · 2024 · PMID 39165853 · Full text

BACKGROUND: Atrial fibrillation (AF) augments the risk of stroke by 4-5 times. Vitamin D is pivotal in numerous metabolic pathways. A handful of studies have explored the correlation between vitamin D deficiency (VDD) an... BACKGROUND: Atrial fibrillation (AF) augments the risk of stroke by 4-5 times. Vitamin D is pivotal in numerous metabolic pathways. A handful of studies have explored the correlation between vitamin D deficiency (VDD) and AF outcomes. Hence, the authors sought to assess the relationship between VDD and AF outcomes. METHODS: From December 2021 to February 2023, 190 patients with AF were incorporated into the authors' study. Given the seasonal fluctuation of vitamin D levels, these levels were examined from the start of December until the end of March. RESULTS: The final analysis comprised 190 patients (55.8% male) with an average age of 46.22±15.03. Vitamin D deficiency, insufficiency, and sufficiency were noted in 77 (40.5%), 46 (24.2%), and 67 (35.3%) patients, respectively. Fatigue and syncope were significantly more prevalent in the VDD group than in other groups. Three-vessel disease was more frequent in the VDD group (p-value=0.04). Mortality was more prevalent in patients with VDD (6.31%) compared to the VDI (2.10%) and VDS (0.05%) groups (p = 0.03). Successful cardioversion was significantly more prevalent in the VDS group (p = 0.03). CONCLUSION: A sufficient level of vitamin D was linked with a better response to cardioversion. However, low vitamin D levels are correlated with higher mortality in AF patients.

Investigation of flow-mediated vasodilatation (FMD) and comparison with carotid intima-media thickness (CIMT) in children with cyanotic congenital heart disease.

Ghaderian M, Ahmadi A, Navabfar N … +3 more , Sabri MR, Dehghan B, Mahdavi C

ARYA Atheroscler · 2024 · PMID 39165852 · Full text

BACKGROUND: There is a high mortality rate in cyanotic patients with congenital heart disease (CHD) due to cardiovascular complications. The cardiovascular prognosis is negatively affected by endothelium dysfunction, inc... BACKGROUND: There is a high mortality rate in cyanotic patients with congenital heart disease (CHD) due to cardiovascular complications. The cardiovascular prognosis is negatively affected by endothelium dysfunction, increased arterial stiffness, and impaired vascular system. This study aimed to determine carotid intimal mean thickness (CIMT) and flow-mediated dilatation (FMD) in a group of children with cyanotic CHD (CCHD). METHODS: FMD and CIMT were evaluated for 45 children with CHKD and 38 patients who did not have CHKD over the period 2021 to 2022, as part of this case-control study. In terms of age and gender, the case group has been compared to controls. RESULTS: Men accounted for 61.3% of the participants, with a mean standard deviation age of 7.8 5.39 years. In subjects with CCHD, CIMT increased non-significantly and FMD decreased significantly, but systolic blood pressure was significantly higher in patients than in the healthy group. (P=0.003). CONCLUSION: FMD was reduced in children with CCHD, but in controls, systolic blood pressure and CIMT were lower. The risk of developing atherosclerosis in CCHD patients may be increased by an increase in CIMT and systolic blood pressure.

Importance of ECG findings in COVID-19 patients: Predictor of in-hospital prognosis.

Behnemoon M, Mehrno M, Alinejad V

ARYA Atheroscler · 2024 · PMID 39165851 · Full text

BACKGROUND: Cardiac injury in COVID-19 patients confers a worse prognosis. The interpretation of electrocardiography can be beneficial in the early diagnosis of probable cardiac involvement. After adjusting for other var... BACKGROUND: Cardiac injury in COVID-19 patients confers a worse prognosis. The interpretation of electrocardiography can be beneficial in the early diagnosis of probable cardiac involvement. After adjusting for other variables, we sought to determine if the initial ECG on admission could add additional prognostic value. METHODS: In this single-center cross-sectional study, 1165 patients with a positive COVID-19 PCR between Feb 2020 and Nov 2021 were enrolled in our study. Patients were grouped according to their admitted units, and survivors to hospital discharge or non-survivors. Predictors of ICU admission and in-hospital mortality were determined using univariate analysis and a logistic regression model. RESULTS: The mean age was 55.6 ± 16.2 years and 52% were male. Out of 1165 patients, 149 deaths (12.8%) were recorded during hospitalization. Sinus tachycardia was the most common dysrhythmia, followed by premature atrial and ventricular beats, sinus bradycardia, and atrial fibrillation (28.6%, 5.6%, 3.9%, and 2.1%, respectively). Age (p<0.001), sex (p=0.006), history of diabetes mellitus (p=0.002), hypertension (p=0.018), ischemic heart disease (p=0.004), and cancer (p<0.001) were more frequent among non-survivors. Among ECG findings, tachycardia, low voltage QRS, ST-T changes, and dysrhythmia were related to an increased mortality risk. However, in regression analysis, only sex (OR 1.89, 95% CI 1.2 to 2.9, p=0.004), age (OR 1.03, 95% CI 1.02 to 1.05, p<0.001), and initial tachycardia (OR 1.02, 95% CI 1.01 to 1.03, p<0.001) were independent predictors of in-hospital mortality. CONCLUSION: Our data suggest that initial electrocardiographic findings could be helpful in distinguishing patients with an increased risk for ICU admission or in-hospital death.

Intramyocardial dissecting hematoma: A systematic review and pooled analysis of available literature.

Zavar R, Soleimani A, Tajmirriahi M … +3 more , Amirpour A, Mahmoudiandehcordi S, Farhang F

ARYA Atheroscler · 2024 · PMID 39165850 · Full text

BACKGROUND: The current systematic review and pooled analysis were conducted to answer several questions using findings from case reports and case series as follows: (1) Demographic characteristics; (2) clinical findings... BACKGROUND: The current systematic review and pooled analysis were conducted to answer several questions using findings from case reports and case series as follows: (1) Demographic characteristics; (2) clinical findings; (3) management approach; and (4) prognosis of individuals diagnosed with intramyocardial dissecting hematoma. METHODS: Electronic databases, including PubMed (Medline), Scopus, and Web of Science, were systematically searched from the earliest available date up to February 2023 using selected keywords. All analyses were performed using SPSS software version 27 (IBM Corp, Armonk, NY, USA), and a P-value less than 0.05 was considered statistically significant. RESULTS: A total of 77 patients diagnosed with Intramyocardial dissecting hematoma (IDH) comprised the study population, with a mean (standard deviation) age of 58.72 (13.99) years, of which 22.1% were women. Patients of higher age experienced a higher risk for mortality compared to younger subjects (OR=1.05, 95% CI: 1.01, 1.10; P=0.014). In addition, the implementation of angiography (OR=0.25, 95% CI: 0.08, 0.71; P=0.010) and cardiac magnetic resonance (OR=0.19, 95% CI: 0.06, 0.60; P=0.004) in the context of diagnosis reduced the risk of death compared to those who did not receive these interventions. Similarly, the diagnosis of pericardial effusion significantly increased the risk of mortality compared to those without pericardial effusion (OR=3.92, 95% CI: 1.27, 12.07; P=0.017). CONCLUSION: The authors found that older patients experience a poor prognosis compared to younger ones. In addition, the utilization of angiography and cardiac magnetic resonance improves the prognosis of individuals. Likewise, the diagnosis of pericardial effusion in patients with IDH increases the odds of mortality.

Does Adjunctive Prophylactic Intracoronary Infusion of Low Dose Alteplase Prevent No-Reflow Phenomenon During Primary Percutaneous Coronary Intervention?

Hashemi M, Ostovan J, Sadeghi M … +3 more , Shirvani E, Safaei A, Sanaei S

ARYA Atheroscler · 2023 · PMID 38883855 · Full text

INTRODUCTION: Primary percutaneous coronary intervention (PPCI) is the gold standard approach to restore blood flow in ST-segment elevation myocardial infarction (STEMI); however, the no-reflow phenomenon as a potential... INTRODUCTION: Primary percutaneous coronary intervention (PPCI) is the gold standard approach to restore blood flow in ST-segment elevation myocardial infarction (STEMI); however, the no-reflow phenomenon as a potential complication of PPCI can worsen the outcomes. It has been hypothesized that adjunctive prophylactic intracoronary infusion of low-dose fibrinolytic might improve the PPCI outcomes; however, this theory is a matter of debate. The current study aims to investigate the value of adjunctive prophylactic intracoronary low-dose alteplase to prevent the no-reflow phenomenon in patients with STEMI. METHOD: This case-control study was conducted on 80 STEMI patients who underwent PPCI. The patients were assigned into the case group who were intervened by 10 mg adjunctive intracoronary alteplase immediately at the end of the balloon angioplasty (n=40) and controls (n=40) who underwent conventional PPCI only. The angioplasty-associated outcomes including final TIMI score, need for no-reflow treatment, ST-segment resolution, post-PPCI complications, and death were compared between the groups. RESULTS: Alteplase use was accompanied by significantly improved final TIMI flow scores (P-value<0.001) and fewer requirements for no-reflow treatments (P-value<0.001); however, it did not improve the ST-segment resolution (P-value=0.491). The mortality rate and post-angioplasty complications did not differ between the groups (P-value>0.05). CONCLUSION: Based on the findings of this study, adjunctive infusion of low-dose intracoronary alteplase during PPCI could not efficiently prevent the no-reflow phenomenon. Although the final TIMI flow and need for post-stenting no-reflow treatment improved, ST-segment resolution did not occur dramatically. Given that, this approach requires further investigations and should be considered cautiously.

Air Pollution, a Case of Neglect in Cardiovascular Disease.

Hashemi F, Jafari E, Modares B … +2 more , Shokri K, Sadeghi M

ARYA Atheroscler · 2023 · PMID 38883854 · Full text

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Frequency of Asymptomatic Intracranial and Extracranial Arterial Stenosis in a Group of Healthy General Papulation in Kerman (South of Iran).

Iranmanesh F, Shafiei K, Bagheri F

ARYA Atheroscler · 2023 · PMID 38883853 · Full text

INTRODUCTION: This study aimed to investigate the frequency of asymptomatic intracranial and extracranial artery stenosis in healthy volunteers in Kerman, Iran, in 2019 using Doppler ultrasound imaging. METHOD: This cros... INTRODUCTION: This study aimed to investigate the frequency of asymptomatic intracranial and extracranial artery stenosis in healthy volunteers in Kerman, Iran, in 2019 using Doppler ultrasound imaging. METHOD: This cross-sectional study was conducted on healthy volunteers in Kerman in 2019 following a public elicitation. After the general examination, 138 healthy volunteers who had no history of any disease and were not treated with any medication underwent cerebrovascular evaluation with Doppler ultrasound. Demographic information, history of addiction, and sonographic findings were recorded in a checklist and then analyzed using SPSS 22. RESULTS: Stenosis was found in 14.4% of volunteers. The mean age of participants was 45.8±10.12 years, and 74 (54%) of them were male. In volunteers with stenosis, a significant correlation was found between age (P = 0.03) and addiction (P = 0.04) with the involved artery. There was also a significant correlation between addiction and intracranial and extracranial artery stenosis (P = 0.04). Logistic regression analysis showed a significant relationship between being female, addiction, and age with stenosis, as well as between addiction and intracranial artery stenosis (P <0.05). CONCLUSION: The majority of healthy residents of Kerman have asymptomatic cerebrovascular stenosis, and this is more prevalent in the elderly, addicts, and women.

Refractory Atrial Flutter, the Unusual Presentation of Covid-19 Infection in a Neonate: A Case Report and Review of Literature.

Saadat SH, Tariverdi M, Kargarfard Jahromi M … +2 more , Sharma D, Farahbakhsh N

ARYA Atheroscler · 2023 · PMID 38883852 · Full text

INTRODUCTION: The accurate incidence of different cardiovascular consequences of COVID-19 in the pediatric population has been inadequately defined due to ongoing genotype changes in the virus. Although COVID-19 is known... INTRODUCTION: The accurate incidence of different cardiovascular consequences of COVID-19 in the pediatric population has been inadequately defined due to ongoing genotype changes in the virus. Although COVID-19 is known to increase inflammatory markers associated with atrial arrhythmias, the contemporary literature has poorly described new onset arrhythmias as a complication in previously healthy neonates with COVID-19. CASE PRESENTATION: A twenty-day-old female term neonate, born by caesarean section with immediate cry, developed labored breathing, cyanosis, and tachycardia after having close contact with a confirmed case of COVID-19. The neonate developed atrial flutter, which was refractory to cardioversion and drugs, namely Amiodarone, Flecainide, and Propranolol. The authors treated the neonate with IVIG. This is the first reported case of atrial flutter in the neonatal period secondary to COVID-19. CONCLUSION: Since the start of the SARS-CoV-2 pandemic, all attention and concerns have been mainly on respiratory manifestations and complications. The cardiovascular complications and treatment have been neglected. This case reports tachyarrhythmia (Atrial Flutter) as an unusual presentation of acute COVID-19 in the neonatal population and shows the role of IVIG in the treatment of refractory arrhythmias.

Apixaban, a Novel Oral Anticoagulant, Use to Resolute Arterial Patency in Radial Artery Occlusion Due to Cardiac Catheterization; A Pilot Randomized Clinical Trial.

Amirpour A, Zavar R, Seifipour A … +10 more , Sadeghi M, Shirvani E, Kermani-Alghoraishi M, Sanei H, Hashemi Jazi SM, Pourmoghaddas A, Khosravi Farsani A, Zarepour E, Safaei A, Hassannejad R

ARYA Atheroscler · 2023 · PMID 38883851 · Full text

INTRODUCTION: In recent years, transradial cardiac catheterization has become the preferred method. However, it can result in a significant complication known as radial artery occlusion (RAO). The medical management of R... INTRODUCTION: In recent years, transradial cardiac catheterization has become the preferred method. However, it can result in a significant complication known as radial artery occlusion (RAO). The medical management of RAO remains controversial, especially with the emergence of novel oral anticoagulants. Nevertheless, there is limited data on the use of these agents for treating RAO, which is the focus of this study using apixaban. METHOD: This pilot double-blinded randomized clinical trial involved 30 patients who developed RAO following transradial coronary angiography. The patients were randomly assigned to receive either apixaban (2.5 mg twice daily) or a conservative approach for 30 days. Doppler ultrasonography was performed at baseline and at the end of the intervention to assess radial artery diameter and the resolution of arterial patency. Demographic, medical, medication, and clinical characteristics were collected. RESULTS: The mean age of the studied population was 59.43±12.14 years, and the majority were males (60%). Radial artery resolution was observed in 21 (70%) patients, independent of medication use. There was no significant association between resolution and age (P-value=0.62), gender (P-value=0.74), body mass index (P-value=0.23), smoking (P-value=0.64), diabetes (P-value=0.999), hypertension (P-value=0.74), statins (P-value=0.999), antiplatelet therapy (P-value=0.999), length of angiography (P-value=0.216), or follow-up arterial diameter (P-value=0.304). Recanalization occurred in 13 (86.7%) cases in the apixaban treatment group, compared to 8 (53.3%) individuals in the control group, indicating a significant difference (P-value=0.046). CONCLUSION: The study findings suggest no demographic, medical, medication, or clinical factors were associated with arterial recanalization. However, a one-month treatment with apixaban at a dose of 2.5 mg twice daily appeared to be effective.

Impact of Allopurinol Pretreatment on Coronary Blood Flow and Revascularization Outcomes after Percutaneous Coronary Intervention in Acute STEMI Patients: A Randomized Double Blind Clinical Trial.

Kermani-Alghoraishi M, Sanei H, Heshmat-Ghahdarijani K … +3 more , Ghahramani R, Honarvar M, Sadeghi M

ARYA Atheroscler · 2023 · PMID 38883850 · Full text

INTRODUCTION: The generation of reactive oxygen species, which is induced by the activation of the xanthine oxidase (XO) enzymatic system, is one of the primary causes of ischemia-reperfusion injury for an ischemic heart... INTRODUCTION: The generation of reactive oxygen species, which is induced by the activation of the xanthine oxidase (XO) enzymatic system, is one of the primary causes of ischemia-reperfusion injury for an ischemic heart. Allopurinol, as an XO inhibitor, plays an inhibitory role in free radical production in ST-elevation myocardial infarction (STEMI) patients. The aim of this study is to evaluate the impact of allopurinol pre-treatment on post-revascularization outcomes in patients admitted with STEMI. METHOD: Ninety patients with acute STEMI were enrolled in this randomized double-blind clinical trial and divided into two equal groups. The allopurinol group received a 600 mg allopurinol loading dose before the emergency PCI, and the control group received a placebo medication of the same shape. Thrombolysis in Myocardial Infarction (TIMI) flow, ECG changes, troponin level, and the occurrence of major cardiac events (MACE) during a 1-month follow-up were assessed. RESULTS: In the end, 81 patients were analyzed. The mean age of the patients was 59.52(11.31) and 61.3(9.25) in the allopurinol and control groups, respectively (p = 0.49). The troponin level 48 hours after the PCI and ST-elevation regression showed no significant difference between the groups [(p = 0.25) and (p = 0.21), respectively]. TIMI flow had improved in the allopurinol group compared to the placebo (p = 0.02). The PCI success rate was 78.6% and 61.5% in the case and control groups, respectively (p = 0.09). MACE and other clinical outcomes were similar between the groups (p > 0.05). CONCLUSION: This study revealed that allopurinol pre-treatment could improve TIMI flow in patients undergoing primary or rescue PCI in an acute STEMI setting.
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