ARYA Atherosclerosis最新文献

Introduction: Cardiovascular disease is the principal cause of mortality and morbidity in developed countries, leading to the formation of atherosclerosis plaques and thrombosis. Apoptosis of endothelial cells is one of the primary factors in vascular thrombosis. Lipids, when oxidized by endothelial cells, result in an increased thickness of the arterial wall. Iron is also recognized as an atherogenic element that induces atherosclerosis. There remains uncertainty about the antioxidative role of vitamin E in the formation of atherosclerosis. In this study, the authors evaluated the effect of iron and vitamin E on the apoptosis of endothelial cells in the carotid arteries of hypercholesterolemic male rabbits.

Method: Thirty white male rabbits were randomly divided into five groups and fed the following diet for six weeks: Group 1: control, Group 2: cholesterol (1%), Group 3: cholesterol (1%) + vitamin E (50 mg/kg), Group 4: cholesterol (1%) + Iron (50 mg/kg), and Group 5: cholesterol (1%) + vitamin E (50 mg/kg) + Iron (50 mg/kg). Serum cholesterol, TG, HDL, and LDL levels were assessed after six weeks. Finally, the animals were sacrificed with ketamine, and carotid arteries were removed. The samples were fixed in 10% formalin, and TUNEL staining was used after the tissue processing. Cell counts were carried out under a light microscope.

Results: Vitamin E decreased Serum cholesterol and apoptotic endothelial cells in the hypercholesterolemic + vitamin E diet (P< 0.05). However, they increased significantly in the interference groups compared to the control group (P< 0.05).

Conclusion: According to our findings, vitamin E showed to have a beneficial effect on preventing cardiovascular diseases and may play a positive role in the prevention of atherosclerosis.

Introduction: This study aimed to investigate the clinical and angiographic characteristics of patients with ST-elevation myocardial infarction who experienced primary percutaneous coronary intervention failure.

Method: This retrospective observational study was derived from the Primary Angioplasty Registry of Sina Hospital (PARS). A total of 548 consecutive patients with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention between November 2016 and January 2019 were evaluated. Percutaneous coronary intervention failure was defined as Thrombolysis in Myocardial Infarction (TIMI) flow ≤ 2 or corrected TIMI frame count (cTFC) ≥ 28.

Results: The study population consisted of 458 (83.6%) males and 90 (16.4%) females with a mean age of 59.2 ± 12.49 years. TIMI flow 3 was achieved in 499 (91.1%) patients after the procedure, while 49 (8.9%) patients developed TIMI ≤ 2. The findings showed that cTFC ≥ 28 was present in 50 (9.1%) patients, while 489 (89.2%) patients had cTFC < 28. Multiple regression analysis shows that age 1.04 (1.01, 1.07), duration of pain onset to first medical contact time 1.04 (1.00, 1.18), and left anterior descending artery involvement 3.15 (1.21, 8.11) were independent predictors of TIMI ≤ 2.

Conclusion: Even though TIMI ≤ 2 was uncommon among the study population, it was associated with adverse in-hospital outcomes. The results indicate that earlier emergency medical service arrival and shorter transfer time to the referral center can dramatically reduce the primary percutaneous coronary intervention failure rate.

Introduction: A well-known and fatal complication of myocardial infarction (MI) is post-infarction ventricular septal rupture (VSR). The benefits and risks associated with coronary angiography and subsequent coronary artery bypass grafting in these patients have sparked controversy. The aim of this study was to determine the outcome of revascularization following MI.

Method: Patients aged between 55 and 78 years were considered for the post-infarction ventricular septal rupture from 2011 to 2017. Factors such as age, sex, anthropometric measurements, systolic and diastolic blood pressure (SBP and DBP), and biochemical parameters like CPK-MB, cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides were measured using standard methods.The estimated Glomerular Filtration Rate (eGFR), a measure of kidney function, was also determined. Additionally, coronary angiographic factors including ECG changes, left ventricular (LV) systolic function, right ventricular (RV) function, Pulmonary Artery Pressure (PAP), proximal coronary lesions in VSR, systolic PAP, Right Atrial Pressure (RAP), and mortality rate were determined.

Results: The study enrolled a total of 81 patients who had been surgically treated for post-infarction VSR. These patients were divided into two groups: survivors (n=35) and non-survivors (N=41). The mean systolic and diastolic blood pressure was higher in the survivor group (115.3 ± 18.7 vs. 96.3 ± 25.3 and 74.6 ± 12.2 vs. 61.2 ± 19.0, P=0.001). PCI was performed in 2.9% of survivors and 9.8% of non-survivors. Angiographic data revealed that 17 (33%) and 33 (63%) patients had single and multiple coronary artery diseases, respectively. CPK-MB levels were significantly higher in the non-survivors group (P<0.05). Echocardiographic findings, including LV ejection fraction, RV ejection fraction, systolic PAP, and the anatomic location of VSR, did not significantly differ between survivors and non-survivors.

Conclusion: Based on these findings, it is recommended to avoid complete revascularization during surgical repair of post-infarction ventricular septal rupture, as it would not improve the outcome.

Tuberculous (TB) pericarditis is a well-known manifestation of tuberculosis, particularly in endemic regions. The progression to constrictive pericarditis, while under anti-tuberculosis treatment, is reported to be as high as 30%. This report presents a case of a 56-year-old female patient who complained of cough, pleuritic chest pain, night sweats, and fever, followed by orthopnea, dyspnea, and peripheral edema. Transthoracic echocardiography revealed the early stages of constrictive pericarditis and a small pericardial effusion. Chest computed tomography (CT) showed a thickened pericardium, small pericardial and pleural effusions, and multiple mediastinal lymphadenopathies. Due to a high suspicion of tuberculous pericarditis, the patient was administered empirical anti-TB treatment. A follow-up after two months showed complete resolution of symptoms and echocardiographic findings. Empirical antimicrobial treatment in endemic areas is a well-established strategy for managing tuberculous infection and proved successful in this patient. The early presentation and the significant improvement in signs and symptoms following the medical anti-TB regimen, without the need for pericardiectomy, were unique aspects of this case.

Background: Coronary Artery Diseases (CAD) are the leading cause of Myocardial Infarction (MI). However, their underlying etiology can be found in the interplay between environmental and genetic factors. On the other hand, it has been shown that Extracellular Matrix (ECM) proteins, such as Thrombospondins (TSP), play a crucial regulatory role in vascular pathologies, including atherogenesis. TSPs are extracellular proteins responsible for intercellular and cell-ECM interactions and are involved in regulating functional responses. Recently, a missense mutation in the TSP-4 gene has been reported to potentially increase the risk of CADs. The present study aimed to investigate the role of rs1866389 Guanosine to Cytosine (G/C) Single Nucleotide Polymorphism (SNP) of the TSP-4 gene on the prevalence of premature MI in southern Iran.

Method: The present case-control study included 100 patients with premature MI and 100 healthy individuals. The DNA extracted from the blood samples of the participants underwent Polymerase Chain Reaction (PCR) for the sequence of the TSP-4 gene. Afterward, the frequency of C (mutated) and G (normal) alleles of the TSP-4 gene was evaluated in the case and control groups.

Results: According to our findings, there was no significant intergroup difference in gender, age, and smoking status. However, the case group was significantly higher in the prevalence of Diabetes mellitus (DM), Hyperlipidemia (HLP), and Hypertension (HTN) compared to the control group. Moreover, 22%, 49%, and 29% of the case group had CC, GC, and GG genotypes in the TSP-4 gene, respectively, while the prevalence of CC, GC, and GG genotypes were 10%, 44%, and 46% in the control group. Also, the prevalence of allele C was significantly higher in the case group (47%) compared to the control group (33%, P=0.043), showing its significant association with the increased risk of premature MI (OR = 1.80; 95% CI = 1.01-3.19).

Conclusions: The rs1866389 G/C SNP of the TSP-4 gene significantly increased the risk of premature MI in the population of southern Iran. Thus, such mutated gene can be used as a target for gene therapy or a marker for early detection of individuals at high risk for CADs.

Stroke is one of the primary causes of morbidity and mortality worldwide, including a large proportion of cryptogenic strokes. Long-term electrocardiographic monitoring is beneficial in prospective studies for detecting atrial fibrillation in patients with cryptogenic stroke. This review aimed to evaluate the advanced echocardiographic parameters and their roles in assessing left atrial (LA) function in the incidence of cryptogenic and ischemic strokes. Main resources, including PubMed, Scopus, and ISI Web of Science databases, were evaluated for articles published in English from 2010 until May 2021. LA echocardiographic parameters such as LA strain and strain rate, isovolumetric relaxation time (IVRT), the mean left atrial volume index (LAVI), LA reservoir volume, systole strain rate (SSR) of left atrial appendage, and lack of LA function response to maximal exercise as measured by the LA ejection fraction during rest and exercise could be considered for assessing the risk of cryptogenic strokes and ischemic strokes. The results indicated that increased LA volumes and reduced LA strain rate were correlated with cryptogenic stroke. Advanced parameters of LA function, measured by speckle tracking echocardiography, such as strain and strain rate values in different parts of the cardiac cycle, in addition to standard measures of LA function such as LA ejection fraction and LAVI, will define an excellent understanding regarding LA myopathy and risk assessment of cryptogenic stroke, independent of considering conventional cardiovascular risk factors.

Background: The Isfahan Twin Cohort (ITC) aims to provide a comprehensive understanding of the interplay between genetics and environment in the development of Non-Communicable Diseases (NCDs). As a type of specialized epidemiological investigation, twin studies are designed to quantify the contribution of genetics to a particular phenotype when confronted with environmental factors. In this context, the present study aims to present a detailed overview of the ITC methodology.

Method: The ITC is a prospective longitudinal study started in 2020. Data collection, including the demographics, socioeconomic status, health-related habits, medical history, and zygosity of the participants, was performed using validated questionnaires. Moreover, anthropometric measurements and blood pressure assessments were performed by a trained nurse. Also, fasting blood and morning urine samples were collected during a morning visit, and biochemical investigations were conducted at the central laboratory of the Isfahan Cardiovascular Research Institute. The participants underwent follow-up telephone interviews biannually, in which brief questionnaires were filled out on the changes in the lifestyle factors of the participants, such as diet, physical activity, psychological factors, and smoking habits. The second and final follow-up visit will include complete assessments, including blood and biological sample collections, similar to the baseline assessment.

Results: The ITR has registered a total of 112 (n=224) monozygotic and 291 (n=582) dizygotic twin pairs during two years. The age range of the participants is 1 month to 56 years. Until November 2020 / 2021, the registered twins were categorized by age and included 48 pairs (n=96) in the infant group (monozygotic: 7 pairs, dizygotic: 41 pairs); 283 pairs (n=566) in the early childhood, late childhood, and adolescent groups (monozygotic: 74 pairs, dizygotic: 209 pairs); and 72 pairs (n=144) in the adult group (monozygotic: 31 pairs, dizygotic: 41 pairs).

Conclusions: The cohort is being prospectively followed with plans to investigate the clinical utility of the newly developed biomarkers and gene-environmental interactions in the future.

Background: Carbon monoxide (CO) poisoning is the leading cause of poisoning-related deaths in the United States. In addition, myocardial infarction (MI) due to CO poisoning in a young, healthy adult is rare. On the other hand, smokeless tobacco, processed in various forms, is a controversial coronary heart disease (CHD) risk factor.

Case report: In this study, we describe a 29-year-old man who presented with acute chest pain following a night of smoking tobacco and using smokeless tobacco in the presence of carbon monoxide poisoning. ST-segment elevation was observed on an electrocardiogram, and echocardiography revealed akinesia. In addition, cardiac markers were elevated. In this particular instance, thrombolytic therapy demonstrated successful outcomes.

Conclusions: We believe the case and discussion could shed light on the emergency department management of such individuals. We advise clinicians to consider the possibility of coronary heart disease in carbon monoxide poisoning patients and to obtain a baseline electrocardiogram and cardiac markers.

Background: Acute Myocardial Infarction (AMI) is the leading cause of global mortality. Moreover, Left Ventricular Ejection Fraction (LVEF) is the most important predictor of post-AMI mortality. Thus, the present study aimed to investigate the relationship between smoking cessation and LVEF following one year from the STEMI.

Method: The present study was a part of the Kermanshah STEMI Registry and included 825 smokers admitted to Imam Ali Hospital, Kermanshah, Iran, with AMI during a 2-year study period. Data collection was performed using the standardized case report form by the European Observational Registry Program (EORP). Moreover, multiple logistic regression was used to compare LVEF between the patients who had quit smoking post-AMI and those who were still smokers after one year. Also, one-to-one Propensity Score Matching (PSM) was used to reduce the assessment error and selection bias, increase the result accuracy, and minimize the effects of confounders on the LVEF-smoking relationship.

Results: Following one year after AMI, 219 (26.55%) patients had quit smoking, while 606 (73.45%) still smoked. Using the PSM, a total of 168 ex-smokers were matched to 168 current smokers. Moreover, it was shown that LVEF was higher in current smokers compared to ex-smokers. However, the difference was not significant. Also, multiple logistic regression showed that the Odds Ratio (OR) of LVEF reduction was insignificantly higher in ex-smokers (OR=1.13; 95% CI: 0.98-1.29) compared to current smokers. Multivariate regression analysis found similar results even after the application of PSM (OR = 1.02; 95% CI: 0.82-1.22).

Conclusions: Given the low rate of smoking cessation after MI, physicians are recommended to ask about the smoking status of MI patients at each office visit or re-admission and strongly recommend quitting smoking.