Pub Date : 2024-06-08DOI: 10.5812/intjcardiovascpract-147010
Khatereh Falamarzi, Mehdi Mokhtarian, Isa Khaheshi, M. Karvandi
Background: Patients with lone atrial fibrillation (AF) are ideal subjects for investigating the relationship between AF and genetic factors. MicroRNAs are regulatory genetic factors closely related to the pathways leading to heart diseases, including AF. Objectives: This investigation aimed to examine the expression levels of miRNAs involved in the pathogenesis of this disease as non-invasive diagnostic and prognostic biomarkers. Methods: The participants in this case-control study included 35 individuals with lone AF and 35 healthy controls. After collecting blood samples from all participants, the expression levels of miR-126 and miR-199a were evaluated using Real-Time PCR on the RNA extracted from these samples. The expression levels of these two miRNAs were then compared between the two groups. Results: Although the expression level of miR-126 in lone AF patients was significantly lower compared to healthy controls, the expression level of miR-199a did not show a significant difference between cases and controls. Additionally, the expression level of miR-126, with an AUC of 0.96, demonstrated very good prognostic power for the occurrence of lone AF. Conclusions: A decreased expression level of miR-126 was associated with lone AF and could be used as a biomarker with excellent diagnostic power. This change in expression could be proposed as a mediator that accelerates the complications of lone AF.
{"title":"Evaluating and Comparing Expression Levels of miR-199a and miR-126 in Peripheral Blood of Patients with Lone Atrial Fibrillation and Healthy Controls","authors":"Khatereh Falamarzi, Mehdi Mokhtarian, Isa Khaheshi, M. Karvandi","doi":"10.5812/intjcardiovascpract-147010","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-147010","url":null,"abstract":"Background: Patients with lone atrial fibrillation (AF) are ideal subjects for investigating the relationship between AF and genetic factors. MicroRNAs are regulatory genetic factors closely related to the pathways leading to heart diseases, including AF. Objectives: This investigation aimed to examine the expression levels of miRNAs involved in the pathogenesis of this disease as non-invasive diagnostic and prognostic biomarkers. Methods: The participants in this case-control study included 35 individuals with lone AF and 35 healthy controls. After collecting blood samples from all participants, the expression levels of miR-126 and miR-199a were evaluated using Real-Time PCR on the RNA extracted from these samples. The expression levels of these two miRNAs were then compared between the two groups. Results: Although the expression level of miR-126 in lone AF patients was significantly lower compared to healthy controls, the expression level of miR-199a did not show a significant difference between cases and controls. Additionally, the expression level of miR-126, with an AUC of 0.96, demonstrated very good prognostic power for the occurrence of lone AF. Conclusions: A decreased expression level of miR-126 was associated with lone AF and could be used as a biomarker with excellent diagnostic power. This change in expression could be proposed as a mediator that accelerates the complications of lone AF.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141370014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-05DOI: 10.5812/intjcardiovascpract-145277
Faisal Muhammad
{"title":"The Rising Burden of Cardiovascular Diseases in Somalia: Causes and Solutions","authors":"Faisal Muhammad","doi":"10.5812/intjcardiovascpract-145277","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-145277","url":null,"abstract":"<jats:p/>","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"52 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141384121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-05DOI: 10.5812/intjcardiovascpract-145138
Sidhi Laksono, Nana Maya Suryana
Context: The application of coronary computed tomography angiography (CCTA) is increasingly being recognized for its role in diagnosing and ruling out coronary artery disease (CAD). This editorial letter discusses the usefulness of CCTA in planning for chronic total occlusion percutaneous coronary intervention (CTO PCI). Evidence Acquisition: We searched for articles using Google Scholar and the PubMed Database. The keywords used were "Coronary CT Angiography (CCTA)," "Chronic Total Occlusion (CTO) intervention," "pre-procedural CTO PCI," and "post-CTO interventions." The articles included in the review were published between 2013 and 2023. Results: Regarding pre-procedural planning for the revascularization of chronic total occlusions (CTOs), there is significant interest in the ability of CCTA to visualize and analyze coronary atherosclerotic plaque. Additionally, CCTA can provide three-dimensional coronary vessel imaging. Following post-CTO intervention, CCTA is utilized to determine whether the formation of new channels and plaque remodeling will improve the chances of future successful interventions. Conclusions: CCTA allows for the precise assessment of anatomical features without invasive procedures, making the diagnosis of CAD easier. The technology is advancing rapidly, with new scanners offering higher resolution, better-quality images, and reduced radiation exposure.
{"title":"The Role of Coronary CT Angiography in Chronic Total Occlusion Coronary Intervention","authors":"Sidhi Laksono, Nana Maya Suryana","doi":"10.5812/intjcardiovascpract-145138","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-145138","url":null,"abstract":"Context: The application of coronary computed tomography angiography (CCTA) is increasingly being recognized for its role in diagnosing and ruling out coronary artery disease (CAD). This editorial letter discusses the usefulness of CCTA in planning for chronic total occlusion percutaneous coronary intervention (CTO PCI). Evidence Acquisition: We searched for articles using Google Scholar and the PubMed Database. The keywords used were \"Coronary CT Angiography (CCTA),\" \"Chronic Total Occlusion (CTO) intervention,\" \"pre-procedural CTO PCI,\" and \"post-CTO interventions.\" The articles included in the review were published between 2013 and 2023. Results: Regarding pre-procedural planning for the revascularization of chronic total occlusions (CTOs), there is significant interest in the ability of CCTA to visualize and analyze coronary atherosclerotic plaque. Additionally, CCTA can provide three-dimensional coronary vessel imaging. Following post-CTO intervention, CCTA is utilized to determine whether the formation of new channels and plaque remodeling will improve the chances of future successful interventions. Conclusions: CCTA allows for the precise assessment of anatomical features without invasive procedures, making the diagnosis of CAD easier. The technology is advancing rapidly, with new scanners offering higher resolution, better-quality images, and reduced radiation exposure.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"331 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-12DOI: 10.5812/intjcardiovascpract-142347
Sepideh Jafari Naeini
Context: Despite advances in the treatment of heart failure, mortality and morbidity remain high. Novel medical and surgical treatments have attempted to reduce the burden of disease. Evidence Acquisition: In this review, we discussed newly proposed strategies for the treatment of heart failure based on the recent European Society of Cardiology (ESC) congress. Results: Recent advances in heart failure treatment may play a pivotal role in prognosis and lead to significant changes in guideline-based recommendations. Conclusions: Recent trials have demonstrated the effectiveness of several adjuvant treatments for heart failure.
{"title":"Novel Issues in the Treatment of Heart Failure, Based on the European Society of Cardiology (ESC) 2023 Congress","authors":"Sepideh Jafari Naeini","doi":"10.5812/intjcardiovascpract-142347","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-142347","url":null,"abstract":"Context: Despite advances in the treatment of heart failure, mortality and morbidity remain high. Novel medical and surgical treatments have attempted to reduce the burden of disease. Evidence Acquisition: In this review, we discussed newly proposed strategies for the treatment of heart failure based on the recent European Society of Cardiology (ESC) congress. Results: Recent advances in heart failure treatment may play a pivotal role in prognosis and lead to significant changes in guideline-based recommendations. Conclusions: Recent trials have demonstrated the effectiveness of several adjuvant treatments for heart failure.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"15 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-28DOI: 10.5812/intjcardiovascpract-141366
Sidhi Laksono
Context: An important development in the percutaneous management of coronary artery disease was the creation of the drug-eluting stent (DES). The DES reduces the high incidence of target lesion revascularization associated with balloon angioplasty and bare metal stents by overcoming vessel recoil and restenosis. Despite these advantages, DES carries a persistent risk of stent-related problems due to the permanent implantation of a foreign body and the limitation of arterial vasomotion. Similar to DES, bioresorbable vascular scaffolds (BRS) are intended to distribute drugs and offer mechanical support before completely degrading over the years. Evidence Acquisition: This study was a review article. The data were acquired from PubMed and Google Scholar. Medical Subject Headings (MeSH) terms were used when available, and only English articles were included in the review. Results: Recent studies have shown that the BRS is not inferior to modern DES clinically, although some clinical results are worrying, particularly the greater rates of scaffold thrombosis. Early studies showed that BRS was superior to DES; nevertheless, larger-scale applications and longer observations revealed serious problems with their use, such as reduced radial strength and a higher risk of thrombosis, which led to a higher rate of serious adverse cardiac events. Conclusions: The position of DES was not directly challenged by additional attention to procedural details and research on the second generation of BRS with innovative features. Bioresorbable vascular scaffolds still have an opportunity to demonstrate their supremacy in standout indicators.
{"title":"Bioresorbable Vascular Scaffolds: Should We use Them Again?","authors":"Sidhi Laksono","doi":"10.5812/intjcardiovascpract-141366","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-141366","url":null,"abstract":"Context: An important development in the percutaneous management of coronary artery disease was the creation of the drug-eluting stent (DES). The DES reduces the high incidence of target lesion revascularization associated with balloon angioplasty and bare metal stents by overcoming vessel recoil and restenosis. Despite these advantages, DES carries a persistent risk of stent-related problems due to the permanent implantation of a foreign body and the limitation of arterial vasomotion. Similar to DES, bioresorbable vascular scaffolds (BRS) are intended to distribute drugs and offer mechanical support before completely degrading over the years. Evidence Acquisition: This study was a review article. The data were acquired from PubMed and Google Scholar. Medical Subject Headings (MeSH) terms were used when available, and only English articles were included in the review. Results: Recent studies have shown that the BRS is not inferior to modern DES clinically, although some clinical results are worrying, particularly the greater rates of scaffold thrombosis. Early studies showed that BRS was superior to DES; nevertheless, larger-scale applications and longer observations revealed serious problems with their use, such as reduced radial strength and a higher risk of thrombosis, which led to a higher rate of serious adverse cardiac events. Conclusions: The position of DES was not directly challenged by additional attention to procedural details and research on the second generation of BRS with innovative features. Bioresorbable vascular scaffolds still have an opportunity to demonstrate their supremacy in standout indicators.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"5 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136158786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-28DOI: 10.5812/intjcardiovascpract-140879
Akif Bayyigit, Mustafa Genco Erdem, Erdal Belen, Mehmet Kucuk
Background: Warfarin is a drug most commonly used for anticoagulation. Its efficiency depends on remaining in the demanded therapeutic range. Objectives: In this study, the relation between the time in therapeutic range (TTR) and sociodemographic characteristics, comorbidities, and drugs used was investigated for the patient’s use of warfarin. Methods: Among patients admitted to the Internal Diseases Polyclinic or taking inpatient treatment in internal diseases service, 50 female and 50 male patients using warfarin were selected starting from the closest date based on their admittance dates. Using patient files and hospital automation system data, TTR levels were calculated with the Rosendaal method, and sociodemographic characteristics, comorbidities, and drugs used were recorded. Patients were separated into 2 groups, TTR > 60% and TTR < 60%, and relations between sociodemographic characteristics, comorbidities, and drugs used were investigated among these groups. Results: Time in therapeutic range was found to be over 60% in 34% of the patients. It was observed that gender, occupation and education level, body mass index, smoking ratios, comorbid diseases, drugs used, serum creatinine, and alanine aminotransferase (ALT) levels were similar among TTR groups. The use of drugs lowering the warfarin effect was found to be similar among TTR groups. Conclusions: It was observed that sociodemographic characteristics, comorbid diseases, used drugs, serum creatinine, and ALT levels of the patients didn't affect the time in the therapeutic range.
{"title":"Which Factors Determine the Success of Anticoagulation with Warfarin","authors":"Akif Bayyigit, Mustafa Genco Erdem, Erdal Belen, Mehmet Kucuk","doi":"10.5812/intjcardiovascpract-140879","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-140879","url":null,"abstract":"Background: Warfarin is a drug most commonly used for anticoagulation. Its efficiency depends on remaining in the demanded therapeutic range. Objectives: In this study, the relation between the time in therapeutic range (TTR) and sociodemographic characteristics, comorbidities, and drugs used was investigated for the patient’s use of warfarin. Methods: Among patients admitted to the Internal Diseases Polyclinic or taking inpatient treatment in internal diseases service, 50 female and 50 male patients using warfarin were selected starting from the closest date based on their admittance dates. Using patient files and hospital automation system data, TTR levels were calculated with the Rosendaal method, and sociodemographic characteristics, comorbidities, and drugs used were recorded. Patients were separated into 2 groups, TTR > 60% and TTR < 60%, and relations between sociodemographic characteristics, comorbidities, and drugs used were investigated among these groups. Results: Time in therapeutic range was found to be over 60% in 34% of the patients. It was observed that gender, occupation and education level, body mass index, smoking ratios, comorbid diseases, drugs used, serum creatinine, and alanine aminotransferase (ALT) levels were similar among TTR groups. The use of drugs lowering the warfarin effect was found to be similar among TTR groups. Conclusions: It was observed that sociodemographic characteristics, comorbid diseases, used drugs, serum creatinine, and ALT levels of the patients didn't affect the time in the therapeutic range.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"4 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-07DOI: 10.5812/intjcardiovascpract-141066
Mohammad Rahmanian, Isa Khaheshi, Mohammad Khani, Reza Bayati, Mohammadamin Ataee, Nasim Sohrabifar
: Atrial fibrillation (AF), considered the most common tachyarrhythmia, is associated with severe complications, such as ischemic stroke and heart failure. Mitochondria are organelles that supply cells energy by converting various forms of molecules into adenosine triphosphate. Mitochondria has a double-stranded, independent DNA (mtDNA), the copy number of which in peripheral blood is associated with the oxidative stress status in the patient. Oxidative stress is also regarded as a potential factor contributing to AF. This study reviews the association between the cell-free circulating mitochondrial DNA (Cfc-mtDNA) in peripheral blood and AF. We searched for studies on AF and mtDNA; four investigations were included. The three of these studies revealed that the level of Cfc-mtDNA in serum appears to be associated with AF, but there are no similar results about Cfc-mtDNA and Per-AF. In addition, the age and gender of patients do not affect Cfc-mtDNA levels. However, further research is necessary in the future.
{"title":"Is the Cell-Free Circulating Mitochondrial DNA a Potential Biomarker for Atrial Fibrillation?","authors":"Mohammad Rahmanian, Isa Khaheshi, Mohammad Khani, Reza Bayati, Mohammadamin Ataee, Nasim Sohrabifar","doi":"10.5812/intjcardiovascpract-141066","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-141066","url":null,"abstract":": Atrial fibrillation (AF), considered the most common tachyarrhythmia, is associated with severe complications, such as ischemic stroke and heart failure. Mitochondria are organelles that supply cells energy by converting various forms of molecules into adenosine triphosphate. Mitochondria has a double-stranded, independent DNA (mtDNA), the copy number of which in peripheral blood is associated with the oxidative stress status in the patient. Oxidative stress is also regarded as a potential factor contributing to AF. This study reviews the association between the cell-free circulating mitochondrial DNA (Cfc-mtDNA) in peripheral blood and AF. We searched for studies on AF and mtDNA; four investigations were included. The three of these studies revealed that the level of Cfc-mtDNA in serum appears to be associated with AF, but there are no similar results about Cfc-mtDNA and Per-AF. In addition, the age and gender of patients do not affect Cfc-mtDNA levels. However, further research is necessary in the future.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"11 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135254582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-26DOI: 10.5812/intjcardiovascpract-141032
Mohammad Khani, Mohammad Hasan Namazi, Saeed Alipour Parsa, Ramin Baghaei, Saeed Nourian, Alireza Ramandi, Isa Khaheshi
Background: Bio-prosthesis is the method of choice in managing aortic valve stenosis due to THE lesser probability of coagulation, even though higher valve replacement rates are undeniable. Valve-in-Valve Surgical Valve Replacement (ViV-SAVR) is shown to have lower rates of mortality than reoperation. We have reported a patient undergoing a ViV-SAVR procedure with exceptionally better results than in the literature. Case presentation: A 73-year-old Caucasian female was admitted with dyspnea and pulmonary edema with a bioprosthetic Mitroflow valve stented 10 years before admission. The echocardiography showed ejection fraction = 30%, left ventricular end-diastolic volume = 135 mL, LVEDV index = 72.9 mi∕m2, degenerated aortic valve with severe transvalvular aortic regurgitation, and mild aortic stenosis (mean gradient = 19 mmHg, peak gradient = 36 mmHg). The prosthetic valve was positioned on the previous Mitroflow bioprosthetic valve strut, followed by aortography. The patient was followed up for one month using transesophageal echocardiography, with no paravalvular leakage. Aortic transvalvular mean gradient of 16 mmHg and EOA of 1.3 cm2. Conclusion: ViV-SAVR is a method of treating aortic valve stenosis, which, if performed correctly, can enhance the survival and quality of life of the patients.
{"title":"Valve In Valve Transaortic Valve Replacement (ViV-TAVR) in a Patient with Recurrent Pulmonary Edema: A Novel Procedure That Could Be Effective and Life-Saving in High-Risk Patients","authors":"Mohammad Khani, Mohammad Hasan Namazi, Saeed Alipour Parsa, Ramin Baghaei, Saeed Nourian, Alireza Ramandi, Isa Khaheshi","doi":"10.5812/intjcardiovascpract-141032","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-141032","url":null,"abstract":"Background: Bio-prosthesis is the method of choice in managing aortic valve stenosis due to THE lesser probability of coagulation, even though higher valve replacement rates are undeniable. Valve-in-Valve Surgical Valve Replacement (ViV-SAVR) is shown to have lower rates of mortality than reoperation. We have reported a patient undergoing a ViV-SAVR procedure with exceptionally better results than in the literature. Case presentation: A 73-year-old Caucasian female was admitted with dyspnea and pulmonary edema with a bioprosthetic Mitroflow valve stented 10 years before admission. The echocardiography showed ejection fraction = 30%, left ventricular end-diastolic volume = 135 mL, LVEDV index = 72.9 mi∕m2, degenerated aortic valve with severe transvalvular aortic regurgitation, and mild aortic stenosis (mean gradient = 19 mmHg, peak gradient = 36 mmHg). The prosthetic valve was positioned on the previous Mitroflow bioprosthetic valve strut, followed by aortography. The patient was followed up for one month using transesophageal echocardiography, with no paravalvular leakage. Aortic transvalvular mean gradient of 16 mmHg and EOA of 1.3 cm2. Conclusion: ViV-SAVR is a method of treating aortic valve stenosis, which, if performed correctly, can enhance the survival and quality of life of the patients.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135720310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-10DOI: 10.5812/intjcardiovascpract-134780
Mehrdad Jafari Fesharaki, F. Samadian, Marjan Sharifzadeh
Introduction: Infective endocarditis is a serious disease with high morbidity and mortality, especially when associated with renal failure. Anemia is a common finding in chronic kidney disease. Here, we present a case of renal failure and severe anemia with a complicated mechanical heart valve infection with a Delayed diagnosis. Case Presentation: A 68-year-old male patient with a history of chronic kidney disease and metallic aortic valve surgery presented with fever, severe anemia, and about 10-kg weight loss that eventually revealed infective endocarditis in echocardiography with significant valvular leakage, pseudoaneurysm of mitral-aortic intervalvular fibrosa and a fistula to left ventricular outflow tract and sinus Valsalva of the aorta. Conclusions: This case report indicates that anemia, renal failure, and fever of unknown origin can be one of the diagnostic signs of endocarditis. It is important to consider infectious endocarditis in high-risk patients because late diagnosis greatly increases mortality, serious complications, and morbidity.
{"title":"Severe Anemia in a Case with Chronic Kidney Disease and Mechanical Heart Valve","authors":"Mehrdad Jafari Fesharaki, F. Samadian, Marjan Sharifzadeh","doi":"10.5812/intjcardiovascpract-134780","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-134780","url":null,"abstract":"Introduction: Infective endocarditis is a serious disease with high morbidity and mortality, especially when associated with renal failure. Anemia is a common finding in chronic kidney disease. Here, we present a case of renal failure and severe anemia with a complicated mechanical heart valve infection with a Delayed diagnosis. Case Presentation: A 68-year-old male patient with a history of chronic kidney disease and metallic aortic valve surgery presented with fever, severe anemia, and about 10-kg weight loss that eventually revealed infective endocarditis in echocardiography with significant valvular leakage, pseudoaneurysm of mitral-aortic intervalvular fibrosa and a fistula to left ventricular outflow tract and sinus Valsalva of the aorta. Conclusions: This case report indicates that anemia, renal failure, and fever of unknown origin can be one of the diagnostic signs of endocarditis. It is important to consider infectious endocarditis in high-risk patients because late diagnosis greatly increases mortality, serious complications, and morbidity.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75650290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-16DOI: 10.5812/intjcardiovascpract-128956
V. Eslami, Z. Alipour, Azin Gheimati, Somaye Farokhnejad, L. Gachkar
Background: One of the pitfalls of primary percutaneous coronary intervention (PPCI) is myocardial reperfusion injury caused by several pathophysiological mechanisms. Melatonin has been shown to be effective against this condition in various organs. Some of the biological effects of melatonin are associated with its capability to scavenge free radicals and reinforce the activity of antioxidant enzymes. Methods: The study population included 128 patients admitted with a diagnosis of acute ST-elevation myocardial infarction (STEMI) to the Emergency Department of Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, who subsequently underwent PPCI. The patients were randomly assigned to two groups, each consisting of 64 cases, with those receiving 3 mg of melatonin in the emergency department before adding PPCI to the standard treatment (test group) and those receiving the standard therapy alone (control group). The myocardial blush grade (MBG) and thrombolysis in myocardial infarction frame count were assessed visually on the angiogram to evaluate microvascular integrity. Results: In the study as a whole and in subgroup analysis, the MBG showed a significant difference with melatonin prescription (2.8 ± 0.3 and 2.3 ± 0.7 in the test and control groups, respectively; P < 0.001). In patients with coronary risk factors, no difference was observed between the two groups. Nevertheless, melatonin significantly improved the MBG in patients without such risk factors. Melatonin had significant protective effects in both the right coronary and left anterior descending culprit arteries. Conclusions: This study demonstrated the effect of melatonin on preventing reperfusion injury in patients with STEMI undergoing PPCI.
{"title":"Cardioprotective Effects of Melatonin in Patients Undergoing PPCI","authors":"V. Eslami, Z. Alipour, Azin Gheimati, Somaye Farokhnejad, L. Gachkar","doi":"10.5812/intjcardiovascpract-128956","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-128956","url":null,"abstract":"Background: One of the pitfalls of primary percutaneous coronary intervention (PPCI) is myocardial reperfusion injury caused by several pathophysiological mechanisms. Melatonin has been shown to be effective against this condition in various organs. Some of the biological effects of melatonin are associated with its capability to scavenge free radicals and reinforce the activity of antioxidant enzymes. Methods: The study population included 128 patients admitted with a diagnosis of acute ST-elevation myocardial infarction (STEMI) to the Emergency Department of Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, who subsequently underwent PPCI. The patients were randomly assigned to two groups, each consisting of 64 cases, with those receiving 3 mg of melatonin in the emergency department before adding PPCI to the standard treatment (test group) and those receiving the standard therapy alone (control group). The myocardial blush grade (MBG) and thrombolysis in myocardial infarction frame count were assessed visually on the angiogram to evaluate microvascular integrity. Results: In the study as a whole and in subgroup analysis, the MBG showed a significant difference with melatonin prescription (2.8 ± 0.3 and 2.3 ± 0.7 in the test and control groups, respectively; P < 0.001). In patients with coronary risk factors, no difference was observed between the two groups. Nevertheless, melatonin significantly improved the MBG in patients without such risk factors. Melatonin had significant protective effects in both the right coronary and left anterior descending culprit arteries. Conclusions: This study demonstrated the effect of melatonin on preventing reperfusion injury in patients with STEMI undergoing PPCI.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79774037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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