ARYA Atherosclerosis最新文献

Background: This study aims to explore the psychosocial factors related to the severity of pain in patients with non-cardiac chest pain (NCCP), providing insights to support more comprehensive and targeted management strategies.

Methods: This cross-sectional study was conducted at two university-affiliated hospitals. Patients diagnosed with NCCP, based on physical examination and angiographic findings, completed questionnaires assessing type D personality, cardiac anxiety, fear of bodily sensations, somatization, depression, and pain severity. Univariate and multiple logistic regression analyses were conducted to identify factors influencing pain severity levels.

Results: A total of 156 males and 204 females, with a mean age of 55.76 ± 12.83 years, were divided into low-pain (N = 182) and high-pain (N = 178) groups. Higher education and being female were significantly associated with greater pain severity. Depression, type D personality, somatization, and cardiac anxiety were significantly correlated with pain severity. Multiple logistic regression analysis indicated that self-rated health (OR,: 2.14; 95% CI. :1.18-3.90), depression (OR-11.15; 95% CI-:1.09-1.22), type D personality (OR-: 1.90; 95% CI-: 1.06- 3.41), somatization (OR-: 1.03; 95% CI-: 1.01-1.06), and fear of bodily sensation (OR-: 1.90; 95% CI-: 1.06-3.41), were all associated with pain severity.

Conclusion: This study concluded that type D personality, fear of bodily sensations, depression, somatization, cardiac anxiety, and poor self-rated health were associated with increased NCCP severity. By controlling the disease and managing related pain earlier, more coherent treatment strategies can be implemented, ultimately improving patients' quality of life.

Background: Vascular adhesion molecule-1 (VCAM-1) is involved in promoting inflammation within blood vessels, activating endothelial cells, and is a key factor in the progression of diabetic vasculopathy in rats with diabetes, contributing to the underlying pathophysiological processes. This study focused on the expression level of VCAM-1 in diabetic rats subjected to a six-week schedule of aerobic training and valerian supplements.

Methods: Fifty male Wistar rats' hearts were removed under deep anesthesia and were studied using Lutgendorf's apparatus. They were divided into five groups (10 each): Healthy control (C), Diabetic control (DC), Diabetic with valerian (DV), Diabetic with exercise (DE), and Diabetic with valerian and exercise (DVE). Diabetes was induced in the animals by administering a shot of STZ (50 mg/kg) in their abdominal area. Following confirmation of diabetes in the animals, moderate exercise five days a week, combined with intraperitoneal administration of 200 mg/kg/day of valerian, was maintained for six weeks. Heart tissue was obtained from diabetic cardiac ischemia-reperfusion model (CI/RM) injury (n=40) and control rats (n=10).

Results: VCAM-1 expression and histological parameters were not observed when comparing experimental and control groups. However, the exercise/valerian treatment (E + V) notably reduced the irregularity in cardiac tissue and increased the size of cardiomyocytes.

Conclusion: These findings suggest that E + V extract could diminish the levels of diabetic cardiac complications. Also, it had a dual effect: it corrected cardiac tissue abnormalities and increased the size of cardiomyocytes, enhancing the overall structure and function of the heart. More research is needed to understand non-pharmacological complementary treatments in this area.

Stroke is a critical global health issue characterized by sudden neurological dysfunction due to disrupted blood flow to the brain. This study aims to enhance understanding of stroke by examining its risk factors, symptoms, and prevention strategies. This was a cross-sectional study conducted in Saudi Arabia; the research involved a random sample of 442 participants over two months in 2024. The findings revealed that 63% of respondents were female, with the majority (64%) aged between 20-40 years, and 76% had university education. The overall knowledge level regarding stroke was moderate, at 62%. Of the 275 participants from the Northern Border Region, 60% demonstrated knowledge regarding risk factors, 58% regarding signs and symptoms, and 60% regarding treatment options. These results highlight a significant gap in knowledge among the Saudi public, particularly in understanding stroke's general aspects, risk factors, symptoms, and treatment options. The study emphasizes the importance of early recognition of stroke symptoms, summarized by the F.A.S.T. acronym, for timely medical intervention. It underscores the necessity for improved public education and awareness campaigns to enhance understanding and potentially reduce the impact of stroke in the community. A multifaceted approach integrating awareness, lifestyle modifications, and medical management is essential for effective stroke prevention and improved quality of life for individuals at risk.

Background: The role of matrix metalloproteinases in developing ischemic heart disease has been suggested. We investigated the effect of the MMP-9 gene polymorphism rs17576 on the severity of coronary artery disease and outcomes in affected individuals.

Methods: A total of 654 patients suspected of having coronary artery disease were assessed. Real-time PCR was performed for MMP-9 (rs17576) genotyping, and ELISA was used to assess MMP-9 plasma levels. The patients were followed up for one year.

Results: Coronary angiography showed coronary artery involvement in 28% of patients. The frequencies of AA, AG, and GG genotypes of rs17576 in the group without coronary artery involvement were 5.5%, 31.4%, and 63.1%, respectively, while in those with coronary artery disease, the frequencies were 55.2%, 29.5%, and 15.3%, respectively, showing a significant difference (p < 0.001). The frequency of the major allele (G allele) in the normal group and the groups with single-, two-, and three-coronary involvement was 21.1%, 65.4%, 61.8%, and 85.0%, respectively, indicating a significant difference (p < 0.001). The mean serum level of MMP-9 was 2,963 ± 1,077 pg/ml in the group with coronary artery disease and 2,145 ± 926 pg/ml in the group without coronary involvement, with a significant difference between the two groups (p = 0.008). The presence of the A allele of rs17576 was associated with an increased hazard of one-year mortality in the coronary artery disease group (HR = 5.764, p < 0.001).

Conclusion: Tracking the rs17576 polymorphism of the MMP-9 gene can predict coronary artery disease severity and its long-term poorer outcome.

Background: Breast cancer is the most common malignancy in women, with 15-20% being HER2-positive, an aggressive subtype treated with Trastuzumab. Despite its survival benefits, Trastuzumab may cause cardiotoxicity, typically monitored by left ventricular ejection fraction (LVEF). This study assessed Trastuzumab's impact on LVEF and related factors among women with breast cancer in Baghdad.

Methods: This retrospective observational cohort study included 60 women with stage I-III HER2-positive breast cancer treated at Al-Amal National Oncology Hospital between January 2023 and May 2024. Baseline demographic, clinical, and echocardiographic parameters were collected, with follow-up assessments every three weeks during therapy and after the final cycle. Data were analyzed using SPSS version 27.

Results: A P-value <0.05 was considered statistically significant. Mean LVEF declined significantly from 64.98% ± 5.50 to 62.02% ± 6.91 post-treatment (P < 0.001). The proportion of patients with impaired left ventricular diastolic function increased from 11.7% to 26.7% (P = 0.003). An LVEF decline of ≥10% was considered clinically meaningful. Traditional risk factors were not associated with LVEF decline, whereas baseline LVDF (OR 10.80; 95% CI: 2.21-17.42; P = 0.007) and post-treatment LVDF (OR 8.20; 95% CI: 1.74-13.58; P = 0.008) were significantly linked to LVEF decline.

Conclusion: Trastuzumab can cause early cardiac function decline, which is not always detected by LVEF alone. Assessment of left ventricular diastolic function at baseline and during therapy can identify high-risk patients, enabling timely monitoring and management to balance anticancer benefits with cardiotoxic risk.

Background: The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio, Metabolic Score for Insulin Resistance (METS-IR), triglyceride-glucose (TyG) index, and triglyceride-glucose body mass index (TyG-BMI) have been associated with the occurrence and severity of coronary artery disease (CAD), although evidence remains limited.

Methods: A total of 1,017 patients undergoing coronary angiography for the first time were included. Insulin resistance (IR) indices were calculated based on patients' laboratory data. Significant CAD was defined as more than 50% stenosis observed in coronary angiography¹.

Results: A positive correlation was found between CAD and the TyG index (ρ = 0.083, p = 0.008). Patients with CAD had a significantly elevated TyG index (9.02 ± 0.62) compared to those with single-vessel disease (SVD) (8.87 ± 0.59) (p = 0.012). A strong association was observed between CAD and the TG/HDL-C ratio (ρ = 0.114, p < 0.001). Patients with multi-vessel disease exhibited a considerably higher index (4.47 ± 2.46) compared to those with SVD (3.77 ± 2.45) (p = 0.003). The TyG index cut-off was 9.22 (27.5% sensitivity, 79.3% specificity, 82.2% positive predictive value (PPV), and 23.89% negative predictive value (NPV)), while the TG/HDL-C ratio cut-off was 3.6 (44% sensitivity, 65.2% specificity, 81.5% PPV, and 25.5% NPV).

Conclusion: Our findings indicate that the TG/HDL-C ratio, with a cut-off point of 3.6, and the TyG index, with a threshold of 9.22, are associated with the presence of CAD. (ClinicalTrials.gov registration number: NCT06237244).

Background: Chest pain is a common complaint among children referred to treatment centers. This study aimed to investigate the electrocardiographic changes in children aged 5-15 years with chest pain referred to Hajar and Imam Ali Hospitals of Shahrekord.

Methods: In this descriptive-analytic study, 350 children with chest pain who were referred to Hajar and Imam Ali Hospitals were included. After clinical examination, electrocardiography was performed. Echocardiography was conducted in cases with electrocardiographic changes, and CPK-MB and troponin I tests were performed if required. Data were analyzed using SPSS-22 software.

Results: The children's ages ranged from 5 to 15 years, with a mean of 10.6 ± 2.7 years. Abnormal electrocardiographic findings were observed in 28 (8%) of the 350 children. Findings included left axis deviation (2.6%), ST elevation (2.9%), ST depression (0.3%), shortened PR interval (0.9%), delta wave changes (0.06%), and cardiac hypertrophy (0.9%). Echocardiography was performed in 70 cases (23.33%), of which 28 (40%) were normal and 42 (60%) had abnormal findings. Mild changes were observed in 39 cases (55.7%), moderate changes in 2 cases (2.9%), and elevated pulmonary arterial pressure in 1 case (1.4%). Thirty girls (8.5%) and 12 boys (3.4%) experienced tachycardia, while 1 boy (0.2%) presented with bradycardia. Troponin I tests were conducted on 2 boys, with both results being negative.

Conclusion: Given the importance of heart disease, electrocardiography is recommended for all children presenting with chest pain. Electrocardiography may also serve as a valuable tool for screening heart disease in such cases.

Background: Valve replacement is an optional treatment for patients with severe aortic stenosis (AS) and is associated with a better prognosis and improved quality of life. However, surgical valve replacement may result in severe complications, especially in the elderly. Transcatheter aortic valve replacement (TAVR) for treating symptomatic aortic stenosis has expanded exponentially, becoming a therapeutic option for intermediate- and high-risk patients. To thoroughly examine and monitor its practices and improve outcomes, our TAVI center in Isfahan established a detailed registry as the primary center for the TAVI procedure.

Methods: This prospective study was conducted among all patients who underwent the TAVR procedure from September 2022 to December 2023 in Isfahan. Baseline characteristics (demographic, clinical, and procedural), 30-day outcomes, and one-year mortality data were collected.

Results: A total of 50 patients underwent the TAVI procedure in Isfahan during our registry. Of these, 56% were male, and the mean age was 77.8 ± 6.7 years. The mean calculated STS score was 5.6. Cardiac death occurred in 4 patients (8%), one (2%) experienced a major vascular complication, 5 (10%) required new pacemaker implantation, and acute kidney injury was observed in 14%. Fever/sepsis occurred in 16%, cardiac tamponade in 6%, one patient (2%) had moderate AI, two patients experienced coronary obstructions, and one suffered a major cerebrovascular accident. Additionally, 4 patients (8%) developed atrial fibrillation, 1 (2%) had ventricular tachycardia, and 6 (12%) experienced AV block.

Conclusion: We have shown good both 30-days outcome and one year mortality in our registry that could be a proper option in treating severe AS with comorbidities instead of surgical aortic valve replacement.

Background: Given the association between obesity and increased risks of cardiovascular diseases, the acceleration of atherosclerosis, and the significance of patient outcomes after percutaneous coronary intervention (PCI), this study aimed to investigate the relationship between abdominal obesity and the incidence of in-stent restenosis (ISR) or stent thrombosis (ST) following PCI.

Methods: This cross-sectional study included 5,980 patients who underwent angioplasty at Chamran Specialty Heart Hospital from March 2023 to February 2025. Of this population, 105 patients who developed ISR or ST and returned to the hospital were evaluated. Their demographic and clinical characteristics were recorded, and waist circumference was measured to assess abdominal obesity.

Results: The findings revealed that ISR and ST occurred in 66 (86.8%) and 10 (13.2%) cases, respectively, among patients with abdominal obesity, whereas in patients without abdominal obesity, these complications were observed in 25 (86.2%) and 4 (13.8%) cases, respectively (P > 0.050). Additionally, the incidence of ISR or ST was reported to occur over a longer period in patients without abdominal obesity, whereas it was observed within a shorter timeframe after PCI in patients with abdominal obesity (P < 0.05).

Conclusion: According to the results of this study, the prevalence of abdominal obesity was higher in patients with complications of ISR or ST after PCI. Also the incidence of ISR or ST occurred in a longer period of time in patients without abdominal obesity after PCI and in a shorter period of time after PCI in patients with abdominal obesity.

Background: Cardiovascular involvement represents a potentially serious complication associated with novel coronavirus disease 2019 (COVID-19), particularly among pediatric patients. Data regarding echocardiographic findings remain sparse, especially in low- and middle-income countries. The primary objective of this study was to investigate the echocardiographic findings of hospitalized children with COVID-19 in southeast Iran.

Methods: This was a cross-sectional study of hospitalized pediatric COVID-19 patients in Kerman, southeast Iran, between March 2020 and March 2022. Clinical records of patients who had undergone transthoracic echocardiograms were evaluated. Demographic and clinical data, as well as echocardiographic findings-including left ventricular (LV) dysfunction, coronary involvement, valvular abnormalities, and pericardial effusion-were noted. Serum inflammatory markers were also assessed.

Results: Data from a total of 188 children were analyzed. The mean age (± standard deviation) was 52.7 ± 4.9 months, and 61.4% were male. In terms of disease severity, 36.1% were categorized as moderate, 47.9% as severe, and 16.0% as multisystem inflammatory syndrome in children (MIS-C). Overall, 92.0% had abnormal echocardiographic findings-most commonly pericardial effusion (55.9%), valvular dysfunction (44.1%), coronary artery involvement (36.7%), and LV dysfunction (19.1%). Mitral regurgitation (36.2%) and tricuspid regurgitation (19.7%) were the most common valvular involvements. Moreover, coronary ectasia (19.7%) and dilatation (13.3%) were the prominent coronary abnormalities. LV dysfunction and valvular abnormalities were associated with increased mechanical ventilation, ICU admission, and mortality. Elevated erythrocyte sedimentation rate (ESR) was associated with valvular dysfunction, while higher NT-proBNP was associated with LV dysfunction.

Conclusion: Hospitalized children had a high prevalence of echocardiographic abnormalities, with LV and valvular dysfunction correlating with worse prognosis and inflammation. Echocardiography appears valuable for risk stratification in ventilator support and Intensive Care Unit (ICU) admission in pediatric patients; however, further research is needed on long-term cardiac sequelae.