ARYA Atherosclerosis最新文献

Background: Percutaneous coronary intervention (PCI) is an effective treatment for coronary artery disease. Previous studies have demonstrated the delayed effects of PCI on left ventricular diastolic and systolic function. However, the early impact on these parameters has not been systematically examined. Moreover, no study has compared the impact of revascularization on the global longitudinal (GLS) and circumferential (GCS) strains of the left ventricle. Using echocardiographic parameters, the present study aimed to investigate the reversibility of diastolic and systolic abnormalities in patients with significant coronary artery stenosis within 1 to 2 days after PCI. Additionally, this study will compare the effects on both global and longitudinal strains.

Methods: This study included 80 consecutive patients admitted to the angiography department for elective PCI with normal left ventricular function. Echocardiography was performed before PCI and 1 to 2 days post-procedure to assess left ventricular diastolic and systolic function indices in these patients.

Results: The mean age of the patients was 58.0±11.9 years, with a predominantly male cohort (65%). All the patients exhibited normal left ventricular systolic function and various degrees of diastolic dysfunction. One to 2 days after revascularization, significant improvements were observed in all diastolic function indices and GLS. However, no significant improvement was found in GCS.

Conclusion: Revascularization of a significantly stenotic coronary artery can enhance diastolic function and systolic longitudinal strain of the left ventricular myocardium as early as 1 to 2 days, with no significant impact on GCS.

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.

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.

Background: With the increase in the number of coronary artery bypass grafting (CABG) surgeries, the concern about complications after it has also increased. RV diastolic dysfunction (RVDD) is one of the post-CABG complications, and in this study, we intend to investigate its frequency and predictors.

Methods: In this cross-sectional study, eighty CABG candidate adult patients were included. A history of previous heart surgery or arrhythmia were the main exclusion criteria. After recording demographic and clinical information, echocardiography of the right ventricle (RV) was performed the day before the surgery and seven days later. The functional parameters were obtained according to the Guidelines for the Echocardiographic Assessment of the Right Heart in Adults.

Results: Eighty patients with an average age of 60.25 ± 8.93 years participated in the study. Most patients were male (72.5%). Thirteen patients had RVDD before CABG (30.8% grade I and 69.2% grade II). All these 13 patients had RVDD grade II after surgery (P=0.046). Among 67 patients with normal RV function before CABG, RV function was normal in only 20 patients (29.9%) after CABG. The incidence of grade I and grade II post-CABG RVDD (post-coronary artery bypass grafting right ventricle diastolic dysfunction) was 11.9% and 58.2%, respectively (P<0.001). Univariate logistic regression analysis showed that there was no association between pre-CABG variables, neither demographic nor echocardiographic, and the occurrence of RVDD after CABG.

Conclusion: CABG surgery is associated with a high incidence of RVDD, which cannot be predicted before surgery. The short-term and long-term consequences of this complication are still unknown.

Background: Coronary computed tomography angiography (CCTA) is a noninvasive cardiovascular imaging procedure that visualizes coronary artery calcifications (CAC), a marker of subclinical atherosclerosis. Due to different calcification patterns in patients with chronic kidney disease (CKD) compared to the general population, this study aims to present diagnostic cut-off values for CAC to detect early coronary artery disease (CAD) in CKD patients.

Methods: This cross-sectional study included 807 patients: 407 with CKD and 400 controls with normal kidney function who underwent CCTA during 2019-2021. CAC score measurements were performed for all left main coronary arteries to investigate CAD. The Coronary Artery Disease Reporting and Data System (CAD-RADS) was used as the gold standard to determine the value of CAC, and diagnostic values were measured.

Results: The number of female patients was 443 (54.9%), and 364 (45.1%) were male. The mean age in the case group was 63.95 ± 10.26 years, and in the control group, it was 53.80 ± 11.84 years. At the cut-off point of 85, the CAC score had a sensitivity and specificity of 84.7% and 83%, respectively, among patients with CKD to detect CAD (Area Under the Curve (AUC): 0.919, 95% CI: 0.89-0.94; P-value < 0.001). Considering a cut-point of 85 for CAC, the frequency of healthy subjects with CAD-RADS less than two was significantly higher than the cases (P-value = 0.012), while the two groups were similar regarding CAD-RADS 3-5 (P-value = 0.83).

Conclusion: According to this study, the CAC score is a valuable means to detect CAD among CKD subjects. There is no significant difference in CAC between patients with substantial CAD-RADS in CKD and non-CKD patients. The cut-point of 85 for the CAC score was found valuable to diagnose CAD with over 80% sensitivity and specificity.

Background: Coronary air embolism (CAE) is a complication that can lead to catastrophic outcomes, including myocardial infarction, stroke, and death. It is reported to occur during cardiac catheterization, within a few hours after cardiac surgery, or as a result of chest trauma. This is a case report of delayed coronary air embolism following cardiac surgery.

Case presentation: A 58-year-old female presented with New York Heart Association (NYHA) Class II symptoms resulting from severe, highly eccentric anterior mitral regurgitation from a bio-prosthetic valve. She had preserved ejection function and a total calcium score of zero. This patient underwent a re-do mechanical mitral valve replacement. Two days post-surgery, she was brought to the catheterization laboratory with signs and symptoms suggestive of an inferior myocardial infarction (MI) and complete heart block (CHB). Her symptoms and ST changes resolved immediately after the introduction of angiographic contrast. Angiography revealed no occlusion in the right coronary artery (RCA).

Background: Sudan has a high prevalence of hypertension or high blood pressure, a key risk factor for cardiovascular illnesses. Therefore, this study aimed to investigate the socio-demographic characteristics, antihypertensive medication adherence, lifestyle changes, and the relationships between these factors and blood pressure control.

Methods: A cross-sectional study was conducted from March to August 2023 in tertiary care hospitals in Sudan. A structured questionnaire was used to gather information from 385 hypertensive individuals who participated in the study.

Results: The results estimated a positive correlation between the independent variables measuring medication adherence. Diet, stress management, and exercise also moderately correlated with each other and the independent variables. Systolic and diastolic blood pressure levels had a high correlation at 0.93, and most variables correlated moderately with the dependent variable of blood pressure control. The regression model (R = 0.698) using the dependent variable (blood pressure control) as the outcome strongly correlated with the independent variables, explaining almost 49% of the variance in hypertension control. It was observed that blood pressure control was significantly predicted by adherence to antihypertensive medication, proper diet, exercise, and stress reduction among the participants.

Conclusion: The study emphasizes the significance of lifestyle changes for effective hypertension control, specifically adherence to antihypertensive medication, diet, exercise, and stress management. Hypertensive patients in Sudan experienced much better blood pressure control and a decreased risk of cardiovascular problems after changing their lifestyle.

Background: Atrial fibrillation (AF) is a prevalent arrhythmia, and predicting its occurrence plays a crucial role in reducing its complications. This study aimed to investigate the relation between simple P wave parameters and paroxysmal AF (pAF).

Methods: In this case-control study, demographic and laboratory data were gathered by a checklist. P wave parameters were measured in electrocardiography (ECG). The relationship between these parameters and AF in groups was analyzed.

Results: Eighty individuals were included (40 patients with pAF (57.5% female, mean age = 64.9 ± 2.04) and 40 individuals without AF (57.5% female, mean age = 60.3 ± 2.01)). The P wave peak time (PWPT) in leads D2 (p = 0.003) and V1 (p = 0.001) were longer in the case group. In addition, the prolongation of the PR interval (PR) in lead D2, P wave duration (PWD) in lead D2, and P terminal force (PTF) in V1 were associated with an increase in the occurrence of pAF. Adjusted regression analysis showed that two variables, PWPT in V1 (OR, 95% CI: 1.04 (1.01-1.07), p = 0.005) and PWD in D2 (OR, 95% CI: 1.03 (1.00-1.05), p = 0.018), were predictors for AF.

Conclusion: Our results underscore the potential utility of simple ECG parameters, especially PWD in lead D2 and PWPT in V1, in predicting and assessing the risk of pAF. These findings provide valuable insights for clinical practice and risk stratification in patients without structural cardiac disease. Additionally, these findings may potentially contribute to the prevention of complications and injuries associated with pAF.

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.

Background: Cardiovascular disease (CVD) is a global health challenge. Various studies have shown that genetic and environmental factors play roles in the development and progression of CVD. Small non-coding RNAs, namely microRNAs (miRs), regulate gene expression and have key roles in essential cellular processes such as apoptosis, cell cycle, differentiation, and proliferation. Currently, clinical studies highlight the critical role of platelets and miRs in coronary thrombosis, atherosclerosis, and CVD.

Methods: Using search engines such as PubMed and Scopus, articles studying platelet miRs and their effects on atherosclerosis and cardiovascular disease were reviewed.

Results: This article presents a comprehensive analysis of the association of platelet-related miRs as prognostic, diagnostic, and therapeutic biomarkers with the pathogenesis of atherosclerosis and cardiovascular disease.

Conclusion: Taken together, data show that platelet-related miRs not only play important roles in the initial development of atherosclerosis and cardiovascular disease (CVD), but they are also considered prognostic and diagnostic biomarkers in CVD.