ARYA Atherosclerosis最新文献

Background: Diet is an important risk factor for ischemic heart disease (IHD), but its effects on IHD and trends in the North Africa and Middle East (NAME) region are unknown. We aimed to evaluate the burden of different dietary risk factors on mortality and disability-adjusted life-years (DALYs) attributable to IHD in the NAME region from 1990 to 2019.

Methods: The data and estimations were extracted from the Global Burden of Disease (GBD) 2019 Global Health Data Exchange. The proportion of IHD burden due to dietary risks was estimated through a comparative risk assessment approach. We calculated the mortality and DALYs rate attributable to diet for IHD using disease-specific population attributable fractions.

Results: The age-standardized rate of IHD mortality and DALYs attributed to dietary risk in the NAME region were 102.1 (95% uncertainty interval (UI): 81.0-121.1) and 2060.6 (95% UI: 1630.7-2471.2), respectively. These rates were higher than the global estimates for mortality (62.4 [95% UI: 51.0-73.6]) and DALYs (1271.3 [95% UI: 1061.3-1473.8]) and were greater in men than in women. Suboptimal diet contributed to 46.6% of IHD mortality and 49.5% of related DALYs. Low whole-grain intake was the leading dietary risk across all countries and years, responsible for 44.5 [95% UI: 18.6-57.1] IHD mortalities and 912.8 [95% UI: 369.7-1177.8] DALYs per 100,000.

Conclusion: Despite a decline in the burden of IHD attributable to diet in the NAME region, it remains substantially high. There exists considerable potential for enhancing dietary quality, particularly through the increased incorporation of whole grains.

Background: Left main coronary artery disease (LMCAD) is a potentially life-threatening situation. The medical treatment of LMCAD can lead to critical cardiovascular events. The association between LMCAD and gender has been studied in the medical field.

Methods: This cross-sectional study was conducted at Imam Hossein Hospital in Tehran. At the beginning of the project, patient files were collected for 6,250 individuals who presented with heart complaints between 2016 and 2021 and underwent angiography examinations. These files were reviewed, and patients diagnosed with left main coronary artery disease during the angiography were identified.

Results: After reviewing 6,250 angiography results from 2016 to 2021, it was found that 274 patients had significant stenosis in the left main coronary artery, resulting in a prevalence of LMCAD of 4.38%. The mean age of the 274 patients with LMCAD was 65.98 ± 10.29 years, and 22.63% of them had premature CAD. Males constituted 75.18% of the group, with 25.18% being smokers. Common comorbidities included hypertension (51.82%), diabetes (42.70%), and chronic kidney disease (13.50%). The gender-based analysis highlighted variations, with women being older on average (P = 0.007), more likely to have premature left main involvement (P = 0.011), and exhibiting lower rates of smoking (P < 0.001) and chronic kidney diseases (P = 0.013) but higher prevalence of hypertension (P < 0.001) and diabetes (P = 0.011) compared to men.

Conclusion: Our findings showed that these gender-specific differences are crucial for tailored management strategies in patients with left main coronary artery disease. Further research is needed to optimize outcomes for this high-risk population.

Background: Congenital heart defects (CHDs) are common anomalies in children. Cardiopulmonary bypass (CPB) is widely used in cardiac surgeries, but it is associated with complications. Liver and kidney injuries frequently occur during CPB. This study aimed to evaluate liver and kidney damage in pediatric patients with CHDs undergoing cardiac surgery with CPB.

Methods: This retrospective study examined 51 patients with CHDs who underwent cardiac surgery with CPB at Vali-Asr and Razi hospitals in Birjand, Iran. The study period spanned from 2013 to 2019. Patient information was extracted from hospital records and compiled into checklists, which included demographic data, disease severity, liver function tests, cardiac ejection fraction, and serum levels of hematocrit, direct and indirect bilirubin, albumin, total protein, and creatinine.

Results: Among the patients, 52.9% were male and 47.1% were female, with a mean age of 37 months. A total of 78.4% had cyanotic CHDs.After surgery, the levels of AST, ALT, and ALKP increased significantly (P < 0.001), while the levels of indirect bilirubin, albumin, and total protein decreased (P < 0.001). The cardiac ejection fraction also improved following surgery (P < 0.001). However, changes in creatinine and direct bilirubin were not significant. Notably, AST levels were markedly higher in deceased patients compared to survivors.

Conclusion: This study revealed significant alterations in liver enzyme levels in patients undergoing cardiac surgery using CPB, potentially indicating liver damage during the procedure. Furthermore, elevated postoperative AST levels were associated with a higher risk of mortality.

Background: A structural heart disease or functional electrical abnormalities can cause an electrical storm.

Case presentation: We present a young boy with an electrical storm who had no cardiac risk factors and a positive family history of sudden cardiac death. The stepwise diagnostic approach was ineffective in determining previously known causes as the origin of the electrical storm. However, whole-exome sequencing (with Next Generation Illumina Sequencing) revealed a mutation in the GJB2 (NM_004004:exon2:c.G71A:p.W24X) gene.

Conclusion: A mutation in the GJB2 gene, which forms the connexin 26 protein, a crucial component of the myocytes' intercalated disc of gap junction complex between the myocytes, results in an abnormal electrical cell-by-cell conductance, and, eventually, ventricular storm. General anesthesia was used to control the storm, and intracardiac pacing was fruitful in ceasing the subsequent VT storms.

Background: The present study was conducted to investigate the scientific contributions of Iranians in the field of cardiovascular research, as indexed in the Scopus database, using bibliometric and altmetric methods.

Methods: This applied study was conducted with a scientometric approach, utilizing bibliometric and altmetric indicators. The research population consisted of the scientific works of Iranian researchers in the field of cardiovascular diseases, indexed in the Scopus database over a period of 47 years. For bibliometric analysis and the generation of co-citation, co-occurrence, and co-authorship maps, the authors employed VOS Viewer software and the bibliometrix package in the R programming language. In the final stage, articles mentioned on social media were analyzed and evaluated using an altmetric approach.

Results: The results indicated that the commencement point for the publication of documents was 1975, and there has been a steep increase in recent years. Moreover, the documents were primarily research articles out of 6853 retrieved documents, and a limited number of documents were single-authored. Other findings also revealed the co-authorship map of authors and the co-occurrence of words, highly cited authors and institutions, and highly frequent keywords, signifying the scientific collaboration of Iranian researchers with the United States and England. Altmetric analysis also demonstrated that 43.41% of documents were shared at least once on social media and had an Altmetric Attention score. Furthermore, the analysis of altmetric indices showed that Mendeley, Twitter, and News had the highest share of document mentions on social media, respectively.

Conclusion: The findings of the study can offer valuable information to researchers, managers, and policy makers to become aware of the current state of research in the field of cardiovascular diseases and implement the necessary policies to inform society and enhance public health status.

Background: Percutaneous coronary intervention (PCI) is the gold standard approach to ST-Segment Elevation Myocardial Infarction (STEMI). Fibrinolysis followed by PCI has been recommended. The current study aims to investigate the no-reflow phenomenon incidence in patients undergoing post-thrombolytic therapy PCI.

Methods: This cross-sectional study was conducted on 250 patients with STEMI who primarily received fibrinolytic therapy followed by early (3-24 hours) (n=231) or delayed (> 24 hours) (n=19) PCI. They were also subcategorized into four intervals: <6 hours (n=98), 6-12 hours (n=93), 12-24 hours (n=38), and ≥24 hours (n=21). The demographic and medical data of the patients were retrieved. The Thrombolysis in Myocardial Infarction score (TIMI) was assessed at baseline and at the end of PCI. A TIMI score other than 3 was defined as no-reflow.

Results: The incidence of the no-reflow phenomenon was not associated with any of the underlying demographic and medical characteristics of the patients (P-value>0.05). Despite the significantly higher rate of improvement in TIMI grading among those undergoing early PCI (P-value=0.04), as well as within less than 6 hours after thrombolytic therapy (P-value=0.031), the rate of the no-reflow phenomenon did not differ between the groups, neither by sorting them as early versus delayed (P-value=0.518) nor by categorizing them into four intervals (P-value=0.367).

Conclusion: Based on the findings of the current study, early PCI after fibrinolysis led to significantly improved TIMI flow. However, the incidence of no-reflow did not differ between the groups with early versus delayed post-fibrinolysis PCI.

Background: Heart failure (HF) is considered the leading cause of cardiac-related morbidity and mortality during pregnancy. Peripartum cardiomyopathy (PPCM) presents diagnostic challenges, often mirroring dilated cardiomyopathy (DCM). The aim of the study is to evaluate echocardiographic features, including global and segmental longitudinal strain values, in pregnant women with a history of newly diagnosed left ventricular systolic dysfunction (LVSD) in the third trimester of pregnancy.

Methods: This cross-sectional study, conducted in two referral cardio-obstetric clinics in Isfahan, Iran, enrolled pregnant women with newly diagnosed LV systolic dysfunction in the third trimester of pregnancy. A multidisciplinary pregnancy heart team assessed the patients. Reevaluation of patients and advanced echocardiographic investigation, including speckle tracking echocardiography (STE), were performed at least six months after delivery.

Results: The study included 26 pregnant women. Baseline characteristics revealed varying NYHA functional classes and etiologies, including DCM or non-dilated LV cardiomyopathy and PPCM. Undiagnosed DCM with exacerbation during pregnancy or non-dilated LV cardiomyopathy were the most probable causes for LV systolic dysfunction (65.4%). In five cases, peripartum cardiomyopathy was more relevant. The mean global longitudinal strain (GLS) was -16.94% and -13.95% in PPCM and DCM, respectively. Significantly different regional longitudinal strain numbers among different LV segments in PPCM were observed (P=.042), whereas the segmental strain in DCM patients did not differ.

Conclusion: When LVSD is discovered late in pregnancy, it is not easy for the authors to differentiate between peripartum cardiomyopathy and other cardiomyopathies. Advanced echocardiographic techniques, particularly GLS analysis, may be valuable in differentiating between these conditions.

Background: Balloon Pulmonary Valvuloplasty (BPV) is a procedure for Pulmonary Stenosis (PS) treatment. In this study, right ventricle (RV) performance was determined through 2D-Speckle Tracking Echocardiography (2D-STE).

Methods: The study involved 25 diagnosed children with PS undergoing BPV and 25 normal children. They were examined using 2D-STE and Linear Mixed Model (LMM) approach was used to determine changes in Pulmonary Valve Peak Gradient (PVPG), Tricuspid Annular Plane Systolic Excursion (TAPSE), strain and Strain Rate (SR) for RV, and Ejection Fraction for Left Ventricle (LVEF).

Results: Notable differences were found between two groups in TAPSE (P=0.001), global strain (P=0.001), apical septal strain (P=0.024), middle septal strain (P=0.001), basal septal strain (P=0.001), apical lateral SR (P=0.001), middle lateral SR (P=0.007), basal lateral SR (P=0.001), and apical septal SR (P=0.001). Post-BPV, there was an increase in LVEF (P=0.001) and TAPSE (P=0.001) but PVPG decreased (P=0.001). Following BPV, an increase was observed in apical lateral strain (P=0.004), middle septal strain (P=0.001), apical septal strain (P=0.003), middle septal strain (P=0.001), basal septal strain (P=0.048), apical septal SR (P=0.025), and middle septal SR (P=0.023). Gender was remarkably correlated with mean changes in basal lateral strain (P=0.019), middle septal strain (P=0.037), and middle septal SR (P=0.020). Age of PS children was related to mean change in basal septal strain (P=0.031) and basal septal SR (P=0.018).

Conclusion: Strain and SR in RV improved post-BPV in children with PS. The gender and age of the children revealed remarkable effects on RV strain and SR changes after BPV.

Background: Myocardial Infarction (MI) refers to the destruction and death of cells in the myocardium of the heart. Its prevalence increases with age due to changes in the cardiovascular system. The aim of the present study was to combine, summarize, standardize, resolve inconsistencies in the results of studies, and investigate the impact of potential factors on the prevalence rate of MI in the elderly through a systematic review and meta-analysis.

Methods: This systematic review and meta-analysis was conducted from 1987 to March 2022. All relevant published studies were searched in PubMed, Embase, Scopus, Web of Science (WoS) databases, and Google Scholar search engine using related MeSH/Emtree and Free Text words. The heterogeneity among studies was quantified using the I² index.

Results: In the initial search, 35453 studies were identified. After eliminating irrelevant studies, finally, 29 articles with a sample size of 3279136 subjects were included in the meta-analysis. After combining the results of the studies included in the meta-analysis, the total prevalence of MI in the elderly was estimated to be 17.6% (95% CI: 12.8 - 23.7%), 16.1% (95% CI: 11.0 - 22.8%) in males, and 12.5% (95% CI: 9.2 - 16.8%) in females. The prevalence of MI increased with the year of publication and the mean age of the elderly (P < 0.001).

Conclusion: The results showed that due to the high prevalence of myocardial infarction (MI) in the elderly, it should be addressed within healthcare systems and policy makers should pay more attention to prevention of MI. However, considering the inclusion of heterogeneous studies, the pooled estimation should be interpreted with caution.