Journal of Cardiovascular and Thoracic Research最新文献

Introduction: Atrial fibrillation (AFib) is a sustained form of cardiac arrythmia that occurs due to sympathetic overdrive, neurohumoral and electrophysiological changes. Sympatho-renal modulatory approach via miRNA-based therapeutics is likely to be an important treatment option for AFib. The study was aimed to unravel the common miRNAs as therapeutic targets involved in sympatho- renovascular axis to combat AFib.

Methods: We employed the bioinformatics approach to discover differentially expressed genes (DEGs) from microarray gene expression datasets GSE41177 and GSE79768 of AFib patients. Concomitantly, genes associated with sympathetic cardio-renal axis, from Genetic Testing Registry (GTR) of National Center for Biotechnology Information (NCBI) were also analyzed. Overlapping miRNAs that target the maximum number of genes across all three pathological conditions perpetuating AFib were shortlisted. To confirm the reliability of the identified miRNAs, differential expression analysis was performed on miRNA expression profiles GSE190898, GSE68475, GSE70887 and GSE28954 derived from AFib patient samples.

Results: ShinyGO analysis revealed enrichment in beta-adrenergic signaling, calcium signaling, as well as G protein-coupled receptor (GPCR) signaling involved in post synaptic membrane potential. The intersection of top 10 modules in miRNA-mRNA network revealed hub miRNAs having highest node degree, maximum neighborhood component (MNC), and maximal clique centrality (MCC) scores. Differential expression analysis revealed hub miRNAs identified through integrated approach were found to be significantly dysregulated in AFib patients.

Conclusion: This integrated approach identified 6 hub miRNAs, 4 reported (miR-101-3p, miR-23-3p, miR-27-3p, miR-25-3p) and 2 novel (miR-32-5p, miR-92-3p) miRNAs that might act as putative biomarkers for AFib.

Introduction: The natural course and clinical significance of moderate mitral regurgitation (MR) in patients undergoing isolated coronary artery bypass graft (CABG) surgery are still debated. This study aimed to determine the course of moderate functional MR after CABG.

Methods: In this registry-based cohort, patients who underwent isolated elective CABG at Tehran Heart Center between 2010 and 2017 were included. Transthoracic echocardiography was performed at baseline before CABG and after 12 months of follow-up. The outcomes of interest were both improvement and progression of MR during the study.

Results: Among 291 patients with moderate functional MR, the mean age was 66.1±9.6 years, and 204 (70.1%) were males. Most of the study population had extensive coronary disease (240 patients; 82.5% with thee-vessel disease). Moreover, 101 patients (34.7%) had suffered a prior myocardial infarction. The mean LVEF before CABG was 42.0±9.9 and 145 patients (49.8%) had an LVEF≤40% prior to surgery.The median follow-up duration was 10.1 months (9.0-11.2). Only four patients had improvements in MR at follow-up. Eleven patients (3.8%) in the study population showed worsening MR after isolated CABG. In this group of patients, mean LVEF dropped from 44.1±10.9 at baseline to 41.8±11.5 during follow-up Due to the low number of cases with regression and progression, an analysis of predictors of MR change was not performed.

Conclusion: This study showed that in patients with moderate functional MR, isolated CABG did not result in significant changes in the degree of MR.

Introduction: Accurate positioning of central venous catheter (CVC) tips is essential to minimize complications such as arrhythmias, thrombosis, or cardiac tamponade.

Methods: This study evaluated the reliability of the Peres formula, which estimates CVC tip placement based on patient height, within an Iranian population. A cross-sectional analysis of 100 patients undergoing cardiac surgery revealed that the Peres formula often resulted in incorrect CVC positioning, necessitating radiographic confirmation and post-insertion adjustments.

Results: The mean deviation of CVC tip placement from the ideal position near the carina was 5.13±0.78 cm. Correlation analysis highlighted significant associations between the deviation and demographic factors, including height and body mass index (BMI), suggesting the need for population-specific adjustments to the Peres formula.

Conclusion: These findings underscore the importance of tailored approaches to CVC placement to account for anatomical and physiological differences, emphasizing the need for modified guidelines for the Iranian population to enhance safety and accuracy in clinical practice due to the fact that Peres formula is not suitable for Iranian population.

Introduction: Cardiac myxomas are the most common primary cardiac neoplasm (30-50%) with clinical incident of 0.5/ million population. Tranthoracic echocardiography remains the investigation of choice. Surgical excision is curative. The present study aims to analyze demographic and clinical characteristics as well as surgical outcomes in terms of mortality and recurrence of cardiac myxoma.

Methods: Thirty patients of cardiac myxoma who met the inclusion criteria during study period study period, January-2018 to April-2024 were included. Data was analyzed for demographic characteristics, echocardiographic findings of myxoma and associated valve lesion, associated valve surgery and survival outcome.

Results: Of all subjects, 83.33% presented with dyspnea. Majority of myxoma, 76.67% were attached to interatrial septum. Overall survival at 1- and 3- year was 91.23%. Recurrence free survival at 1-, 3- years and end of this study were 100%, 84.71% and 84.71% respectively. Myxomas with valvular incompetence are rare entity and there is paucity of data and evidences recommending concomitant valve intervention in such cases. There were no immediate peri-operative deaths, however, in contrast to other studies; surgical site infection was the most common post operative complication. Overall survival at 1- and 3- year was 91.23%. Recurrence free survival at 1-, 3- years and end of this study were 100%, 84.71% and 84.71% respectively. Recurrence occurred in first- and third-year following surgery.

Conclusion: Study highlights decent outcomes following cardiac myxoma resection. Case specific concomitant valve intervention spiral the success of surgery.

Introduction: It is unclear whether hyperuricemia can be considered as an independent risk factor or just as a marker to represent the correlation between uric acid levels and other risk factors of MetS. In this work, we intend to study the correlation between serum uric acid (SUA) and the cardiometabolic phenotype among Tabriz University of Medical Science healthcare workers.

Methods: In this cross-sectional study, anthropometric measurements, serum fasting blood sugar (FBS), triglyceride (TG), cholesterol, high-density lipoprotein (HDL), liver enzymes, blood urea nitrogen (BUN), SUA, creatinine (Cr), and blood pressures of 1,451 healthcare workers were evaluated. MetS was diagnosed based on ATP III. We classified the participants into four cardiometabolic phenotypes: metabolically-healthy lean (MHL), metabolically-unhealthy lean (MUHL), metabolically-healthy obese (MHO), and metabolically-unhealthy obese (MUHO).

Results: MHL (26.6%) and MHO (65.8 %) had the highest prevalence rates in the first and second SUA categories, respectively (P≤0.001). Compared to the lowest SUA category, the odds of MHO and MUHO increased by 3.13 (95% CI 2.21-4.44) and 5.50 (95%CI 3.53-8.57) in the highest category, respectively. This trend was not observed regarding the association between MUHL and the SUA classification.

Conclusion: We propose using the easily-measured SUA level as a marker for early diagnosis of at-risk MUHL and MHO individuals to administer proper interventions. Further prospective studies are needed to identify the effects of SUA on the progression of MetS in various body-size subgroups.

As we know, cardiac myxoma is one of the most primary cardiac masses but laboratory findings in this type of tumor is non-specific and the diagnosis is by imaging. In this case we have reported a 61 year old man came to the emergency ward of hospital with history of recent onset dyspnea and The Laboratory finding indicates polycythemia with thrombocytopenia. Ultrasonography of abdomen and bone marrow aspiration and biopsy revealed no significant diagnosis but on echocardiography a large sized mass was detected in right atrium. After cardiologist and cardiac surgeon consultation the plan was to surgical Excision and after that the thrombocytopenia has been resolved. In this case report we want to write about a rare correlation between cardiac myxoma and thrombocytopenia and show that early diagnosis and treatment of the disease can help and totally cure complaints of patient.

The objective of present review was to assess all studies about effect of Nigella sativa (N. sativa) on vascular cell and intercellular adhesion molecules-1 (VCAM-1 and ICAM-1) under different situations. Search was performed until May 2024 using Scopus, PubMed, Web of Science, and Google Scholar databases without any restriction and alert services were utilized following the primary search. The references cited in related papers were also evaluated. Nineteen studies including human (n=4), animal (n=11), and in vitro (n=4) were eligible. All in vitro and majority of animal researches were indicative of the favorable effects of N. sativa and thymoquinone in attenuating VCAM-1 and ICAM-1 levels; however, three animal studies did not show any significant effect. Results of clinical trials were conflicting. In two clinical trials, supplementation with N. sativa oil and N. sativa powder led to significant reduction in VCAM-1 levels in coronary artery disease (CAD) and Hashimoto's thyroiditis patients, whereas no significant change occurred according to the other clinical trial involving subjects with the risk factor for cardiovascular disease (CVD). Furthermore, significant reduction in ICAM-1 levels occurred after N. sativa oil consumption in two clinical trials involving type 2 diabetic and CAD patients, whilst no significant change was noticed in subjects with the risk factor for CVD and Hashimoto's thyroiditis patients. N. sativa seems beneficial in attenuating VCAM-1 and ICAM-1 levels under different situations; however, additional long-term controlled clinical trials are needed for making concise conclusions about the effect of N. sativa on endothelial dysfunction related biomarkers.

Introduction: An angiographic finding known as "coronary slow flow phenomenon" (CSFP) occurs when there is no discernible stenosis but the contrast flow is slower than usual. Although the prognosis for the majority of CSFP cases is favorable, frequent angina significantly lowers their quality of life. Therefore, this study aimed to explore the potential contributing risk factors and prognostic implications of CSFP on long-term cardiovascular outcomes.

Methods: This retrospective, cohort study was conducted between years 2014-2022 and included a total of 65 CSFP patients and 65 controls with normal coronary flow, as evidenced by coronary angiography. These two groups were examined in terms of future cardiovascular consequences due to this phenomenon, baseline demographic characteristics, and laboratory findings. A P value<0.05 was considered significant.

Results: In this study 130 people including 73 men and 57 women, who because of the typical chest pain and at least a noninvasive test took angiography, were explored. The median triglyceride (200.80±48.51 vs 131.79±34.22, P<0.001), total cholesterol (189.46±10.84 vs 103.43±8.13, P<0.001), and low-density lipoprotein (153.28±34.28 vs 103.34±19.70, P=0.01) were significantly higher in the affected people. During clinical follow-up, a higher number of major adverse cardiac events (8.97±2.95 vs 4.52±2.12, P<0.001) was observed in the CSFP cases. Moreover, a one-unit increase in body mass index raised the probability of adverse cardiac events by 0.912 in CSFP cases.

Conclusion: Our research indicated that individuals with CSFP were more likely to develop cardiac events including unstable angina. Furthermore, obesity and dyslipidemia could provoke this phenomenon.

Introduction: Premature coronary artery disease (PCAD) has an ascending trend especially in developing countries. This study have investigated the risk factors and severity of developing CAD across various Iranian ethnicities.

Methods: This case-control study was done on 3015 Iranian patients undergoing coronary artery angiography, across highly populated Iranian ethnicities including Bakhtiari, Azari, Qashqai, Arab, Fars, Kurd, Gilak, and Lur. This study was performed over three years in 14 capitals of provinces in Iran headed by Isfahan Cardiovascular Research Center, by including men≤60 years old and women≤70 years undergoing coronary artery angiography. If they had coronary stenosis above 75% (more than 50% in the left main), they were categorized as Case group.The effects of conventional risk factors as well as psychosocial ones including age, gender, weight, Body mass index (BMI), economic status, cigarette smoking, drugs of abuse, stress, anxiety, diabetes, hypertension, etc. were determined in each ethnicity using decision tree statistical method. Also, via logistic regression method, the odds of incidence of CAD in each ethnicity were specified against the Fars ethnicity (the predominant ethnicity in Iran).

Results: The most common risk factor among different ethnicities was age and male gender. Also, among the Iranian ethnicities, Kurd had the lowest chance while Gilak and Azari had the highest chance of developing PCAD as compared to the Fars ethnicity. Investigation of the behavioral and psychological dimensions indicated that stress was significantly higher among those without coronary artery involvement as compared to those with this involvement. The decision tree model could predict that among Gilakis, Fasting blood sugar (FBS) above 126 and in Lurs opium as well as diastolic blood pressure above 85, and in Kurds male gender would considerably increase the odds of developing CAD.

Conclusion: The model obtained from the decision tree indicated that although variables of age, gender, cigarette, and opium are among the main risk factors for involvement of coronary arteries among young adult patients, in different ethnicities, the risk level of each of these risk factors in incidence of PCAD is different. This means among Kurds, age, among Gilakis diabetes, and among Lurs opium are more important.

Introduction: The Evermine50^TM (Meril Life Sciences Pvt. Ltd., India) is the world's thinnest strut (50 µm) featuring a biodegradable polymer-based Everolimus-eluting stent (EES) system. We present the 3-year safety and performance outcomes of Evermine50 EES.

Methods: This was a prospective, post-marketing, single-center study of patients with native coronary artery lesions (CAL) in real-world settings. Patients with symptomatic ischemic heart disease due to de novo and in-stent restenotic lesions (lengths<44mm) in native coronary arteries with reference vessel diameters of 2.0 - 4.5 mm. and eligible for stenting procedure with percutaneous transluminal coronary angioplasty were included.

Results: A total of 251 patients (mean age: 58.20 years) were enrolled, of which 48.2% had ST-elevation myocardial infarction and 31.5% had silent ischemia. The mean lesion length was 21.81±8.14 mm, and 70.3% of patients had pre-procedure Thrombolysis in Myocardial Infarction (TIMI) flow grade III. The average and stent length was recorded as 23.50±12.21 mm. In 98% of patients, post-procedural TIMI-III flow grade was achieved. The cumulative rate of major adverse cardiac events defined as composite of cardiac death, target vessel myocardial infarction, and clinically-driven target lesion revascularization (CD-TLR) at 1, 2, and 3 years were 1.59%, 3.58%, and 3.58%, respectively. The cumulative rates of CD-TLR remained constant at 0.79% from 1 to 3 years. There were no cases of stent thrombosis until 3 years.

Conclusion: This study demonstrated favorable safety and performance of the ultrathin Evermine50 EES at 36 months in patients with native CAL.