ARYA Atherosclerosis[JOURNAL]
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200 papers
Comparing outcomes of clonidine and captopril in patients with hypertensive urgency: A randomized clinical trial.
Mirdamadi A, Abrishamkar R, Kargaran A
ARYA Atheroscler · 2022 Jan · PMID 36818154 · Full text
BACKGROUND: Hypertension (HTN) is the second leading risk factor for death and disability. One fourth of healthcare in Eastern Europe and Central Asia is being spent on blood pressure (BP)-related diseases. An important...
BACKGROUND: Hypertension (HTN) is the second leading risk factor for death and disability. One fourth of healthcare in Eastern Europe and Central Asia is being spent on blood pressure (BP)-related diseases. An important situation in patients with high BP is hypertensive crisis (BP > 180/120 mmHg), which is divided to hypertensive emergency and urgency. Therefore, here, we decided to compare the effect of captopril and clonidine in patients with hypertensive urgencies, and their side effects. METHODS: This was a parallel-group randomized clinical trial. Patients, who referred to emergency ward with any symptoms of hypertensive crisis, underwent a careful history taking and clinical examination. Individuals with systolic BP (SBP) ≥ 180 mmHg or diastolic BP (DBP) ≥ 110 mmHg with no evidence of end organ damage were randomly assigned into two interventions, clonidine and captopril. 25% decrease in BP was considered as ideal relief. RESULTS: Regarding the duration of response to treatment drugs, patients who received clonidine relieved significantly faster than those who received captopril (P = 0.016). Moreover, the frequencies of side effects such as headache, dizziness/vertigo, dry mouth, and drowsiness in the clonidine group were significantly lower than captopril group (P < 0.05). CONCLUSION: Patients in clonidine group relieved sooner and experienced fewer side effects. Therefore, this study suggests clonidine as a more effective therapeutic for hypertensive urgency compared with captopril.
Iatrogenic partial diversion of inferior vena cava to left atrium after surgical closure of atrial septal defect.
Khajali Z, Nazari MS, Jorfi F … +2 more , Keshavarz-Hedayati M, Gholampour-Dehaki M
ARYA Atheroscler · 2022 Jan · PMID 36818153 · Full text
BACKGROUND: Atrial septal defects (ASDs) are one of the most common congenital cardiac abnormalities. Repair of these defects is a quite secure and routine operation. The most common complications were postoperative atri...
BACKGROUND: Atrial septal defects (ASDs) are one of the most common congenital cardiac abnormalities. Repair of these defects is a quite secure and routine operation. The most common complications were postoperative atrial arrhythmias, sinus arrhythmia, and atrioventricular (AV) blocks requiring pacemaker implantation, mediastinal bleeding, and transient ischemic attacks (TIAs) or strokes. Iatrogenic diversion of the inferior vena cava (IVC) to the left atrium (LA) during surgical closure of an ASD is a very rare complication. CASE REPORT: We reported a patient who had a history of cardiac surgery in another center at the age of seven and was introduced to our clinic with complaints of dyspnea and cyanosis of extremities on exertion. She underwent surgery in our center with diagnosis of iatrogenic diversion of IVC to LA. CONCLUSION: The most common mechanism suggested is a large eustachian valve being mistaken for the inferior rim of the ASD.
The importance of smoking cessation in follow-up protocols for cardiovascular patients.
Sadri H, Molavizadeh D
ARYA Atheroscler · 2022 Jan · PMID 36818152 · Full text
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Role of illness perception in explanation of severity of post-traumatic stress disorder symptoms after cardiovascular problems.
Komasi S, Ahmadi M
ARYA Atheroscler · 2022 Jan · PMID 36818151 · Full text
BACKGROUND: Given the role of post-traumatic stress disorder (PTSD) in morbidity and mortality of cardiac patients, the present study was conducted to determine the relationship between the perception of heart disease an...
BACKGROUND: Given the role of post-traumatic stress disorder (PTSD) in morbidity and mortality of cardiac patients, the present study was conducted to determine the relationship between the perception of heart disease and severity of PTSD symptoms. METHODS: Sampled using simple random sampling, 202 cardiovascular patients (50.5% women) were selected and included in this cross-sectional study. The patients admitted to a hospital from January to May 2017 in western Iran were selected and asked to complete the self-report demographic and cardiac risk factors inventory, Brief Illness Perception Questionnaire (Brief-IPQ), and National Stressful Events Survey PTSD Short Scale (NSESSS) checklist. The results were analyzed using the Pearson correlation coefficient and multiple regression analysis. RESULTS: The mean age of patients was 53.5 ± 11.9 years. The results of the correlation coefficient showed a significant relationship between all the components of illness perception, except personal and treatment control, with PTSD (P < 0.05). The regression model could predict 22.5% of PTSD variance and the greatest role was for the emotional representation (P = 0.002) and female sex (P = 0.008). CONCLUSION: The perception of cardiovascular patients of the cognitive and emotional components of the disease, especially in women, plays a significant role in experiencing the symptoms of PTSD. Thus, health professionals have to monitor all these components, especially the patient's perceptions and emotional reactions, and to come up with proper and timely interventions for patients at risk to control the adverse effects of PTSD after cardiovascular events.
The effect of home-based cardiac rehabilitation on depression score in patients with ischemic heart disease: A longitudinal clinical trial study.
Jamalian M, Ansari-Moghaddam A, Roohafza H … +8 more , Mohammadi M, Vakili L, Abbasi MH, Yazdekhasti S, Masoudy G, Heidari H, Okati-Aliabad H, Sadeghi M
ARYA Atheroscler · 2022 Jan · PMID 36818150 · Full text
BACKGROUND: Depression is common in patients with cardiovascular disease (CVD). Home-based cardiac rehabilitation (HBCR) is a program that alleviates depression. This study aimed to determine and compare HBCR programs an...
BACKGROUND: Depression is common in patients with cardiovascular disease (CVD). Home-based cardiac rehabilitation (HBCR) is a program that alleviates depression. This study aimed to determine and compare HBCR programs and usual care (UC) effects on depression control in patients with ischemic heart disease (IHD). METHODS: This clinical trial study was performed on 259 patients with IHD that were randomly allocated to the HBCR and UC groups for stress management. Data were collected using the "Beck Depression Inventory" (BDI) at baseline and 6 and 12 months. Generalized estimating equation (GEE) models were applied to examine the associations between times of the groups and changes in outcomes over the study times. Data analysis was done in SPSS software at the significance level of 0.05. RESULTS: A total of 247 participants with a mean age of 55.22 ± 7.40 years participated in this study, and 209 (84.6%) of the study participants were men. Among patients, 128 patients in the UC program and 119 patients in the HBCR program attended at least one of the pre-determined visits (months 6 and 12). The patterns of change of the depression parameter were similar through the course of the study between the two groups (P = 0.04). In the HBCR group, the depression reduced continuously from baseline to 6 months, baseline to 12 months, and 6 to 12 months (P < 0.05). In the UC group, depression was significantly reduced from baseline to 6 months and from baseline to 12 months. CONCLUSION: HBCR was effective in continuous reducing of depression scores in long-term follow-up of patients with IHD. These findings suggest that HBCR can alleviate depression in patients who do not participate in hospital-based cardiac rehabilitation (CR).
Overweight and obesity: worldwide risk factors for pediatric hypertension.
Barati L, Radgoodarzi M, Vakili M … +1 more , Tabatabaizadeh M
ARYA Atheroscler · 2022 Jan · PMID 36818149 · Full text
BACKGROUND: Childhood obesity and hypertension (HTN) are among serious global health concerns. Since risk factors of cardiovascular diseases (CVDs) should be managed early in life and there is little information about ch...
BACKGROUND: Childhood obesity and hypertension (HTN) are among serious global health concerns. Since risk factors of cardiovascular diseases (CVDs) should be managed early in life and there is little information about children under the age of 6 in the community, the study was designed aiming to address these issues. METHODS: This cross-sectional study was performed on 1,091, 3-6-year-old children in Gorgan City, located in north of Iran. Height, weight, body mass index (BMI), and blood pressure were measured using standard techniques. All statistical tests were conducted using the Statistical Package for the Social Sciences (SPSS) for windows. RESULTS: Given the study, respectively 3.8 and 4.5% of the boys and girls were underweight, 17.4 and 16.5% of the boys and girls were overweight, and 20.8 and 19.3% of the boys and girls were obese. In addition, 3.4, 0.7, and 0.4% of the subjects had presystolic, systolic, and prediastolic HTN, respectively. There is a significant linear relationship between BMI and systolic and diastolic blood pressures. It was found that the risk of obesity in mothers with college education was estimated to be almost 5 times higher than in mothers with lower levels of education. CONCLUSION: Compared to the values announced by Centers for Disease Control and Prevention (CDC), the mean height, weight, and BMI of children in our study was higher. Educational interventions should be considered in society, especially for mothers with a high level of education and employed ones. It is recommended that blood pressure measurements, especially in obese children, be carefully considered at each pediatric visit so that children with HTN could be quickly identified and treated.
Comparison of the effects of the time of home-based cardiac rehabilitation program on the changes in cardiometabolic risk factors in patients with phase-IV myocardial infarction: A randomized controlled trial.
Dehghani M, Namdari M, Rafieian-Kopaei M … +5 more , Baharvand-Ahmadi B, Mokhayeri Y, Namdari P, Dehghani M, Cheragi M
ARYA Atheroscler · 2022 Jan · PMID 36818148 · Full text
BACKGROUND: It seems that the time of performing cardiac rehabilitation is important in determining the risk of cardiac complications in patients with myocardial infarction (MI). The present study aimed to investigate th...
BACKGROUND: It seems that the time of performing cardiac rehabilitation is important in determining the risk of cardiac complications in patients with myocardial infarction (MI). The present study aimed to investigate the effects of a home-based cardiac rehabilitation program (HCRP) conducted in either the morning or evening on cardiometabolic risk factors in phase IV (maintenance) MI patients. METHODS: In this randomized controlled clinical trial, 80 patients with MI were divided into 2 groups of intervention and control (40 individuals per group). Patients in each group were categorized into morning and evening subgroups (20 individuals per subgroup). The therapeutic regimen in the intervention group included HCRP, routine medications, and exercise and walking programs for 8 weeks. Patients in the control group received routine treatments for 8 weeks. Cardiovascular risk factors comprising of cardiac troponin I (cTnI), mean platelet volume (MPV), C-reactive protein (CRP), and cardiometabolic indicators including cholesterol (Cho), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and the maximum rate of oxygen consumption (VO2 max) were measured for all patients before and after the intervention. RESULTS: Our results showed significant reductions in Cho, TG, HDL, LDL, VO2 max, CRP, and MPV (P < 0.05) in the group performing HCRP in the evening compared with the morning group. CONCLUSION: Performing HCRP in the evening, compared with morning, can be significantly more effective in improving the levels of cardiometabolic risk factors in patients with MI. Therefore, it is recommended that rehabilitation programs be implemented in these patients in evening shifts.
Does second generation n-butyl cyanoacrylate embolization really smooth in greater saphenous vein closure?
Yilmaz S, Kiziltan F, Zengin S … +2 more , Kalender M, Cam I
ARYA Atheroscler · 2022 Jan · PMID 36818147 · Full text
BACKGROUND: Cyanoacrylate (CA) has been used as an embolizing agent in the treatment of greater saphenous vein (GSV) insufficiency in recent years and the results regarding the use of this method have started to be publi...
BACKGROUND: Cyanoacrylate (CA) has been used as an embolizing agent in the treatment of greater saphenous vein (GSV) insufficiency in recent years and the results regarding the use of this method have started to be published. To the best of our knowledge, the publications in literature do not mention about a significant negative effect of endovenous CA (EVCA) embolization. We aimed to evaluate the effects and undesirable events of this relatively new treatment method and compare them with literature, using the follow-up data of our patients. METHODS: Patients who had GSV insufficiency for at least 3 months and were treated with EVCA embolization because of this disease were included in the study. Patients were excluded if they had deep vein thrombosis (DVT), excessive tortuous GSV, and peripheral neuropathy. Hospital archive records were reviewed and undesirable events like DVT, thrombophlebitis, and pain related to this treatment procedure were recorded. RESULTS: EVCA embolization procedure was performed in a total of 54 patients with an average age of 49.36 ± 13.06 years for the purpose of treating GSV insufficiency. One patient was observed to develop n-butyl CA (NBCA) extension of approximately 5 mm from saphenofemoral junction (SFJ) to the main femoral vein and painful thrombophlebitic reaction was observed in 6 extremities at the first control examination. CONCLUSION: In our opinion, while EVCA embolization is a treatment option with similar success rates to endovenous thermal ablation (EVTA), it should be kept in mind that there may be a possibility of developing thrombophlebitis and NBCA extension or thrombus extension to the deep veins.
Effects of alpha lipoic acid supplementation on serum lipid profile in patients with metabolic syndrome: A randomized, double-blind, placebo-controlled clinical trial.
Ahmadi M, Keshavarz SA, Abbasi B
ARYA Atheroscler · 2022 Jul · PMID 36817351 · Full text
BACKGROUND: Alpha lipoic acid (ALA) is considered a strong antioxidant with anti-inflammatory properties. Moreover, a number of previous studies have shown its lipid-lowering properties. Therefore, we designed this study...
BACKGROUND: Alpha lipoic acid (ALA) is considered a strong antioxidant with anti-inflammatory properties. Moreover, a number of previous studies have shown its lipid-lowering properties. Therefore, we designed this study to investigate the effects of ALA on lipid profile in patients with metabolic syndrome (MetS), which can lead to an increased risk of cardiovascular disease (CVD) and premature mortality. METHODS: A total 46 patients with MetS were randomly divided into two groups. They received either 600 mg ALA (n = 23) or 600 mg placebo (n = 23) for 12 weeks. The body weight, height, body mass index (BMI), waist circumference (WC), fasting blood sugar (FBS), hemoglobin A1C (HbA1c), and blood pressure (BP) were assessed at baseline of the study. Physical activity level and dietary intake were assessed at baseline and end of the study. Serum lipid profile including triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were measured before and after 12 weeks of intervention. RESULTS: Baseline characteristics were similar in the ALA and placebo groups (P > 0.05). However, there were statistically significant differences in plasma levels of TG (-36.82 ± 42.48 versus 6.15 ± 25.04 mg/dl, P = 0.001) and TC (-8.91 ± 20.65 versus 10.84 ± 22.97 mg/dl, P = 0.01) after 12 weeks between the ALA group and the placebo group. Yet, there were no statistically significant differences in plasma levels of HDL-C and LDL-C after 12 weeks between the ALA group and the placebo group. CONCLUSION: The results suggest that daily supplementation of 600 mg ALA for 12 weeks may improve the lipid profile in patients with MetS.
Investigation of the effect of 8 weeks of high-intensity interval training and berberine supplementation on some echocardiography and electrocardiogram indices following myocardial ischemia-reperfusion in rats.
Banaei P, Nazem F, Sedighi M
ARYA Atheroscler · 2022 Jul · PMID 36817350 · Full text
BACKGROUND: Myocardial ischemia leads to left ventricular (LV) dysfunction and cardiac arrhythmia. The present research was conducted with the aim to explore echocardiography changes and electrocardiogram parameters of t...
BACKGROUND: Myocardial ischemia leads to left ventricular (LV) dysfunction and cardiac arrhythmia. The present research was conducted with the aim to explore echocardiography changes and electrocardiogram parameters of the hearts of rats with ischemia-reperfusion injury (IRI). METHODS: The study subjects included 50 male Wistar rats) 8-10 weeks), which were divided into 5 groups (1: trained, 2: supplemented, 3: combined (training and supplementation), 4: sham, and 5: control). High-intensity interval training ý(HIIT) was performed for 8 weeks, 5 sessions per week. Rats belonging to groups 2 and 3 received 10 mg/kg berberine. Finally, after 48 hours, electrocardiogram and echocardiography were performed on all rats. Moreover, myocardial ischemia was performed by descending coronary artery ligation for 30 minutes. RESULTS: There were significant differences between the 5 groups in terms of the volumes and dimensions of LV end-systolic dimension (LVSD), LV end-diastolic dimension (LVDD)ý, fractional shortening cardiac output, ejection fraction (EF), stroke volume (SV), ventricular tachycardia (VT), and ventricular ectopic beats (VEBs) episodes, duration of VTs, and ECG parameters (P ≤ 0.05). CONCLUSION: Berberine supplementation and HIIT, as preconditioning agents, can possibly prevent the elevation of EF and fractional shortening, the reduction of cardiac output and SV, and arrhythmia improvement after myocardial IRI. Finally, these changes result in increased LV function and decreased mortality in rats with myocardial IRI.
Unusual trifurcation of left main coronary artery in a patient with hypertrophic obstructive cardiomyopathy: Issues in management strategy.
Sinha S, Aggarwal P, Samrat S … +3 more , Razi M, Sharma A, Pandey U
ARYA Atheroscler · 2022 Jul · PMID 36817349 · Full text
BACKGROUND: Hypertrophic cardiomyopathy (HCM) and anomalous coronary artery arising from the opposite sinus are independently associated with increased risk of sudden cardiac death (SCD). Their coexistence in a single pa...
BACKGROUND: Hypertrophic cardiomyopathy (HCM) and anomalous coronary artery arising from the opposite sinus are independently associated with increased risk of sudden cardiac death (SCD). Their coexistence in a single patient further complicates the issue by affecting management strategy and increasing the risk of sudden death. CASE REPORT: A 21-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) having strong family history of SCD presented with exertional fatigue and palpitation. Cardiac catheterization and computed tomography (CT) coronary angiography revealed single left coronary artery where left main trunk was trifurcating into left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA). The course of RCA was retro-aortic. There were no appreciable septal arteries to be ablated by alcohol injection. The patient was managed with implantable cardioverter-defibrillator (ICD) and metoprolol. CONCLUSION: Single coronary artery (SCA) and HOCM are of great clinical significance as both of these conditions are independently associated with SCD. Medical management in form of beta blocker and ICD is an acceptable treatment strategy in appropriately selected symptomatic obstructive HCM. To the best of our knowledge, this is the first ever case report of RCA following a retro-aortic course arising from left main in a patient with obstructive HCM.
Association of plasma visfatin with epicardial fat thickness and severity of coronary artery diseases in patients with acute myocardial infarction and stable angina pectoris.
Avesta L, Doustkami H, Zamani B … +3 more , Nejati A, Mousavy S, Aslani MR
ARYA Atheroscler · 2022 Jul · PMID 36817348 · Full text
BACKGROUND: Elevated serum visfatin levels have been reported in some chronic inflammatory diseases such as cardiovascular diseases (CVDs) and rheumatoid arthritis. The purpose of the present study was to investigate the...
BACKGROUND: Elevated serum visfatin levels have been reported in some chronic inflammatory diseases such as cardiovascular diseases (CVDs) and rheumatoid arthritis. The purpose of the present study was to investigate the correlation between visfatin and interleukin-6 (IL-6) and anthropometric, angiographic, echocardiographic, and biochemical parameters in patients with acute myocardial infarction (AMI). METHODS: In this case-control study, 90 patients who were candidates for angiography were divided into the following 3 groups: non-coronary artery disease group (non-CAD; n = 30) with a history of chest pain without angiographic changes, stable angina pectoris group (SAP; n = 30), and AMI group (n = 30). Anthropometric, angiographic, echocardiographic, and biochemical parameters were measured in all subjects. RESULTS: The mean age of patients in the non-CAD, SAP, and AMI groups was 62.26 ± 13.24, 62.93 ± 8.35, and 52.83 ± 10.26 years (P < 0.001) respectively. The results showed that the median [interquartile range] of visfatin level was higher in the AMI group [7 (6.30-9.30), pg/ml] compared with the SAP [5.85 (5.20-6.60); P < 0.001] and non-CAD [5.20 (3.30-5.70); P < 0.001] groups. In addition, median [interquartile range] IL-6 levels were higher in the AMI group [17.5 (16-21), pg/ml] compared with the SAP [15.50 (14-18); P < 0.01] and non-CAD [14 (11-17); P < 0.001] groups. Furthermore, there was a positive association between plasma level of visfatin, and epicardial fat thickness (EFT) and the Gensini score in the SAP and AMI patients. The results of multivariate linear regression analysis revealed that white blood cell ý(WBC) count and IL-6 were independently associated with plasma visfatin level. CONCLUSION: The current study showed an association between visfatin and EFT in AMI patients. Increased visfatin levels in patients with AMI may contribute to atherosclerosis; however, further studies should be conducted to confirm this finding.
An evaluation of the effects of Pistacia atlantica gum hydro-alcoholic extract on the phagocytosis ability of macrophages and atherosclerosis development in hypercholesteremic rats.
Ghalavand M, Esmaeili-Gouvarchin-Ghaleh H, Mirzaei-Nodooshan M … +2 more , Vazifedost S, Mohammadi-Yeganeh S
ARYA Atheroscler · 2022 Jul · PMID 36817347 · Full text
BACKGROUND: Atherosclerosis is an inflammatory disease that various factors affect the onset and its progression, including free radicals, hypertension, diabetes, genetic changes, hypercholesterolemia, and even some micr...
BACKGROUND: Atherosclerosis is an inflammatory disease that various factors affect the onset and its progression, including free radicals, hypertension, diabetes, genetic changes, hypercholesterolemia, and even some microorganisms such as herpes viruses and chlamydia. Therefore, compounds that can be effective in any of the above cases may be considered as a useful therapeutic agent in the process of atherosclerosis. The aim of the present study was to evaluate the effects of Pistacia atlantica gum hydro-alcoholic extract on macrophage phagocytosis ability and development of atherosclerosis in hypercholesterolemic rats. METHODS: The statistical population of the present study consisted of 25 rats that were randomly divided into 5 groups (one control group under standard diet, 4 treatment groups under high-fat diet). After consumption of high-fat food for 45 days, the treatment groups orally received 100, 200, and 400 mg/kg of Pistacia atlantica gum hydro-alcoholic extract for 30 days. Then, peritoneal macrophages were isolated and blood samples were collected to measure the level of nitroblue tetrazolium (NBT), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG). P ˂ 0.05 was considered significant in all evaluations. RESULTS: The level of cholesterol (503.66 ± 17.15), TG (436.66 ± 16.80), LDL-C (343.66 ± 11.59), HDL-C (54.33 ± 7.02), and NBT (0.64 ± 0.02) decreased in the treatment groups. Besides, exactly in a concentration-dependent manner, plant extract significantly reduced the level of respiratory potential level in macrophages. CONCLUSION: Hydro-alcoholic extract of Pistacia atlantica gum could effectively decrease hypercholesterolemia and increase phagocytic ability of macrophages. Therefore, it can be suggested for more investigation as a blockage of atherosclerosis.
Comparison of the effect of 1:1 and 1:2 frequencies of intra-aortic balloon pump on hemodynamics of the patients undergoing coronary artery bypass graft surgery.
Mirmohammadsadeghi A, Afzali Arani M, Zavar R
ARYA Atheroscler · 2022 Jul · PMID 36817346 · Full text
BACKGROUND: Some patients require intra-aortic balloon pump (IABP) after coronary artery bypass graft (CABG) surgery. IABP can be adjusted to different frequencies such as 1:1, 1:2, or 1:3. In this study, we tried to com...
BACKGROUND: Some patients require intra-aortic balloon pump (IABP) after coronary artery bypass graft (CABG) surgery. IABP can be adjusted to different frequencies such as 1:1, 1:2, or 1:3. In this study, we tried to compare the effect of 1:1 and 1:2 frequencies of IABP on hemodynamic status of the patients after CABG surgery. METHODS: In this experimental study, all patients using IABP after CABG surgery were entered the study as pretest and posttest groups. The study could not be blinded because of the clearness of posttest group for the same echocardiographist. The pretest group included patients using a 1:1 frequency of IABP device. The posttest group included patients in the pretest group who were exposed to a 1:2 frequency for 20 minutes. In both groups, on the moderate dose of inotropic support, hemodynamic parameters of patients including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI), stroke volume (SV), and velocity time integral (VTI) in the aorta during systole were measured. Both groups were compared using Wilcoxon signed rank test. SPSS software was used for analysis and P < 0.05 was considered to be statistically significant. RESULTS: Twelve patients were entered into the study. Three patients were excluded because of open chest and instability of vital signs. Nine patients completed the study. 3 patients were men and 6 were women. The mean age was 58.32 ± 13.18 years. MAP in 1:1 frequency was significantly higher than 1:2 (P = 0.043); however, there was no significant difference between 1:1 and 1:2 in other hemodynamic parameters, namely CO, CI, SV, HR, and VTI. CONCLUSION: In patients on moderate dose of inotropes, IABP frequencies of 1:1 and 1:2 have the same effect on hemodynamic parameters such as CI, SBP, DBP, HR, and left ventricular outflow tract (LVOT) VTI; meanwhile, MAP remains higher in 1:1 frequency.
The experiences of home care team members regarding the needs of family caregivers of heart failure patients in home health care services in Iran: A qualitative study.
Hashemlu L, Esmaeili R, Bahramnezhad F … +1 more , Rohani C
ARYA Atheroscler · 2022 Jul · PMID 36817345 · Full text
BACKGROUND: Home healthcare guidelines emphasize the engagement of family caregivers of heart failure (HF) patients in patient care at home. Thus, this study was conducted with the aim to explore the deep experiences of...
BACKGROUND: Home healthcare guidelines emphasize the engagement of family caregivers of heart failure (HF) patients in patient care at home. Thus, this study was conducted with the aim to explore the deep experiences of home care team members regarding the needs of family caregivers of HF patients in home healthcare services in Iran. METHODS: The present qualitative study was performed with a conventional content analysis approach. Data were collected through in-depth, semi-structured interviews with 23 participants who were recruited through purposive sampling. The Data were analyzed using the Graneheim and Lundman method for conventional content analysis in MAXQDA Software. RESULTS: The participants included 14 women and 9 men with the mean age of 46.21 ± 11.44 years. After analyzing the interviews, 3 main categories and 15 subcategories were extracted. The main categories were "family caregiver's unmet needs" (with 5 subcategories), "Empowering Informal Caregivers" (with 3 subcategories), and "access to a standard home healthcare system" (with 7 subcategories). CONCLUSION: Deep understanding of the needs of family caregivers of HF patients in home health care services increases the quality of services, the quality of life (QOL) of the family, and prevents patients' hospital readmissions. Moreover, it will contribute to our next project of the home healthcare guideline for HF patients in the health care system of Iran. Identifying the training needs of caregivers within the home health care services has an important role in the designing of education strategies in policy making programs at the level of the Ministry of Health or planning at lower levels of the health network.
Comparison of midazolam versus captopril in patients with uncomplicated hypertensive urgency in emergency ward: Double-blind randomized clinical trial.
Khorsand MR, Enayatrad M, Yekesadat SM … +2 more , Khodayar M, Noyani A
ARYA Atheroscler · 2022 Jul · PMID 36817344 · Full text
BACKGROUND: The urgency of uncomplicated blood pressure (BP) is known as a sudden rise in BP. The aim of this study was to evaluate the intravascular administration of midazolam as an emergency care to control BP against...
BACKGROUND: The urgency of uncomplicated blood pressure (BP) is known as a sudden rise in BP. The aim of this study was to evaluate the intravascular administration of midazolam as an emergency care to control BP against captopril in patients with uncomplicated hypertension (HTN). METHODS: The present study was a double-blind parallel randomized clinical trial (RCT) study that was performed on patients with urgent HTN referred to Imam Hossein Hospital in Shahroud, Iran, in 2018. Patients with BP higher than 180/110 mmHg and with healthy vital organs were selected randomly and allocated into three groups of 43 participants. All patients' BP in both arms, and after a period of 10 minutes in the left arm, was checked and after administering the medication was checked again for 4 times of 15 minutes till 1 hour complete. RESULTS: There were significant differences between systolic (P = 0.024), diastolic (P = 0.001), and mean BP (P = 0.009) in the midazolam group before and after treatment. The group of midazolam and captopril showed the greatest reduction of BP before, in the middle, and after carrying out the treatment methods. As such, systolic, diastolic, and mean BP showed 23.5% (P = 0.047), 17.4% (P = 0.021), and 20.5% (P = 0.031) reduction, respectively. CONCLUSION: Midazolam can be used as an effective and low-risk drug for lowering BP. Midazolam also has a faster effect on lowering BP.
Precision medicine and metabolic syndrome.
Gharipour M, Nezafati P, Sadeghian L … +3 more , Eftekhari A, Rothenberg I, Jahanfar S
ARYA Atheroscler · 2022 Jul · PMID 36817343 · Full text
Metabolic syndrome (MetS) is one of the most important health issues around the world and a major risk factor for both type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The etiology of MetS is determined by th...
Metabolic syndrome (MetS) is one of the most important health issues around the world and a major risk factor for both type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The etiology of MetS is determined by the interaction between genetic and environmental factors. Effective prevention and treatment of MetS notably decreases the risk of its complications such as diabetes, obesity, hypertension, and dyslipidemia. According to recent genome-wide association studies, multiple genes are involved in the incidence and development of MetS. The presence of particular genes which are responsible for obesity and lipid metabolism, affecting insulin sensitivity and blood pressure, as well as genes associated with inflammation, can increase the risk of MetS. These molecular markers, together with clinical data and findings from proteomic, metabolomic, pharmacokinetic, and other methods, would clarify the etiology and pathophysiology of MetS and facilitate the development of personalized approaches to the management of MetS. The application of personalized medicinebased on susceptibility identified genomes would help physicians recommend healthier lifestyles and prescribe medications to improve various aspects of health in patients with MetS. In recent years, personalized medicine by genetic testing has helped physicians determine genetic predisposition to MetS, prevent the disease by behavioral, lifestyle-related, or therapeutic interventions, and detect, diagnose, treat, and manage the disease. Clinically, personalized medicine is providing effective strategies for the prevention and treatment of MetS by reducing the time, cost, and failure rate of pharmaceutical clinical trials. It is also eliminating trial-and-error inefficiencies that inflate health care costs and undermine patient care.
Atrioventricular (AV) block and sinus arrest associated with dipyridamole infusion.
Khalili M, Jahani M
ARYA Atheroscler · 2022 May · PMID 36815960 · Full text
BACKGROUND: The use of dipyridamole for thallium-201 imaging has proved very successful in demonstrating coronary arterial disease, and a combination of dipyridamole and dynamic exercise is becoming widely used. Dipyrida...
BACKGROUND: The use of dipyridamole for thallium-201 imaging has proved very successful in demonstrating coronary arterial disease, and a combination of dipyridamole and dynamic exercise is becoming widely used. Dipyridamole is safe when given intravenously, although transient noncardiac side effects are common; side effects such as chest pain, headache, and dizziness. These side effects are mostly mild, and can be treated with aminophylline. CASE REPORT: We describe a 45-year-old woman with normal baseline electrocardiography (ECG) and unremarkable physical examination, referred for myocardial thallium scan with dipyridamole. A few seconds after infusion of dipyridamole, her ECG developed first-degree atrioventricular (AV) block, then, 2:1 AV block, complete heart block (CHB), and sinus arrest. After aminophylline infusion, junctional escape rhythm was seen, and a few seconds later, rhythm changed to sinus rhythm. Thallium scan was negative for ischemia. CONCLUSION: High-grade AV block after dipyridamole has been described in few case reports, and mostly was associated with transient myocardial ischemia; it seems that the presence of conduction abnormalities at baseline is a risk factor. But in our case, the sinus arrest and AV block occurred without evidence of ischemia in myocardial perfusion imaging, and we think it can be an unwanted complication of dipyridamole; clinicians should be aware of bradyarrhythmia as a possible complication of dipyridamole. An alternative explanation is that this arrhythmia can be caused by vagal activity; and another possibility is that the imaging study was false negative.
The effect of heparin administration time on thrombolysis in myocardial infarction flow grade in patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.
Fakhr-Mousavi A, Cheshmkhorooshan S, Vakilpour A … +1 more , Mousavi SM
ARYA Atheroscler · 2022 May · PMID 36815959 · Full text
BACKGROUND: In the clinical setting of patients with ST-elevation myocardial infarction (STEMI), there are controversies about the role of early heparin administration on the patients' outcome and the patency of the infa...
BACKGROUND: In the clinical setting of patients with ST-elevation myocardial infarction (STEMI), there are controversies about the role of early heparin administration on the patients' outcome and the patency of the infarct-related artery (IRA). In this randomized clinical trial, we sought to investigate the effect of heparin administration time on the thrombolysis in myocardial infarction (TIMI) flow grade of patients with STEMI treated with primary percutaneous coronary intervention (PPCI). METHODS: Eligible individuals were randomly assigned to two groups: early heparin administration (90 IU/kg) in the emergency department (group A, n = 92) and late heparin administration in the Cath lab (group B, n = 77). All demographic and clinical information and on admission examinations were documented. Clinical outcomes, 40-day mortality, and left ventricular (LV) function improvement in follow-up were also collected. RESULTS: The mean age of patients was 57.1 ± 8.8 and 57.5 ± 7.5 years in groups A and B, respectively (P = 0.232). The history of hypertension (HTN) (34.8% vs. 53.2%, P = 0.016) and diabetes (14.1% vs. 29.9%, P = 0.013) was significantly lower in group A. The LV ejection fraction (LVEF) changes were significant before and after the intervention within each group. However, this change was not significantly different between the groups (P = 0.592). Post-intervention complications did not differ between the two groups (P > 0.05). In the proportion of cases with TIMI flow grade less than 2 in the IRA, no significant differences were observed between the groups. [P = 0.092 for left anterior descending (LAD) and P = 0.086 for left circumflex artery (LCX)]. CONCLUSION: Although heparin administration in patients with STEMI undergoing PPCI is safe and effective, the effect appears not to be time-dependent.
Cut-off values of obesity indices to predict coronary heart disease incidence by time-dependent receiver operating characteristic curve analysis in 10-year follow-up in study of Yazd Healthy Heart Cohort, Iran.
Hozhabrnia A, Jambarsang S, Namayandeh SM
ARYA Atheroscler · 2022 May · PMID 36815958 · Full text
BACKGROUND: The current study aimed to determine the optimal cut-off of obesity indices for detecting coronary heart disease (CHD) in 10-year study of Yazd Healthy Heart Cohort (YHHC) in Iran. METHODS: A total of 2000 in...
BACKGROUND: The current study aimed to determine the optimal cut-off of obesity indices for detecting coronary heart disease (CHD) in 10-year study of Yazd Healthy Heart Cohort (YHHC) in Iran. METHODS: A total of 2000 individuals aged 20-74 years were enrolled. All participants without cardiovascular disease (CVD) had a full medical check-up at the start of the study. At the start of the study, a variety of obesity indices were assessed and calculated, including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), A Body Shape Index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), and body roundness index (BRI). Coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), myocardial infarction (MI), Rose Angina Questionnaire (RAQ) (chest pain) greater than 3, and electrocardiographic (ECG) changes in favour of the coronary artery disease (CAD) were considered as the CVD risks. A time-dependent receiver operating characteristic (ROC) curve with right-censored data and naive estimator was used to estimate the time-dependent sensitivity and specificity and the best cut-off of the anthropometric indices for CHD risk. RESULTS: Overall, 1623 participants (818 men and 805 women) with mean and standard deviation (SD) of weight of 71.21 ± 12.94 kg were included. In a 10-year follow-up, 101 [59 (58.42%) men and 42 (41.58%) women] developed CVD event. WHpR demonstrated the largest area under the time-dependent ROC curve (AUC) of 0.65 and 0.63 as well as 95% confidence interval (CI) of 58.64-72.66 and 50.74-75.55 for men and women, respectively, in predicting CVD. Optimal WHpR cut-off was 0.93 and 0.92, respectively, for men and women. CONCLUSION: WHpR index was superior to other obesity indices in predicting CHD.
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