ARYA Atherosclerosis最新文献

Background: The present study evaluated the effects of aerobic training with variable intensities on apoptotic indices of cardiac tissue in fatty diabetic rats.

Methods: Twenty-four male Wistar rats were randomly divided into non-diabetic (ND, n=8), trained diabetic (TD, n=8), and control diabetic (CD, n=8) groups. Following a high-fat dietary regimen, type 2 diabetes was induced by streptozotocin, with blood glucose levels above 300 mg/dL considered indicative of diabetes. The TD group underwent aerobic exercise five times a week for six weeks. Subsequently, measurements were taken for left ventricular end-diastolic (LVEDV) and end-systolic volumes (LVESV), ejection fraction (EF%), catalase, caspase-9, P53, glucose, insulin, and HOMA-IR.

Results: Aerobic training led to a significant decrease in blood glucose levels (P < 0.01), caspase-9 (P < 0.05), HOMA-IR (P < 0.05), and P53 expression (P < 0.001) compared with the CD group. LVEDV and LVESV decreased significantly (P < 0.05 for both), while LVEF increased significantly (P < 0.05). Catalase activation showed an insignificant increase in the TD group pre- to post-training compared to CD.

Conclusion: Incremental aerobic exercise training (6 weeks) may exert a cardioprotective effect in diabetic rats by reducing apoptosis and oxidative stress indices, while simultaneously increasing aerobic fitness and reducing body weight.

Background: Atrial fibrillation (AF) augments the risk of stroke by 4-5 times. Vitamin D is pivotal in numerous metabolic pathways. A handful of studies have explored the correlation between vitamin D deficiency (VDD) and AF outcomes. Hence, the authors sought to assess the relationship between VDD and AF outcomes.

Methods: From December 2021 to February 2023, 190 patients with AF were incorporated into the authors' study. Given the seasonal fluctuation of vitamin D levels, these levels were examined from the start of December until the end of March.

Results: The final analysis comprised 190 patients (55.8% male) with an average age of 46.22±15.03. Vitamin D deficiency, insufficiency, and sufficiency were noted in 77 (40.5%), 46 (24.2%), and 67 (35.3%) patients, respectively. Fatigue and syncope were significantly more prevalent in the VDD group than in other groups. Three-vessel disease was more frequent in the VDD group (p-value=0.04). Mortality was more prevalent in patients with VDD (6.31%) compared to the VDI (2.10%) and VDS (0.05%) groups (p = 0.03). Successful cardioversion was significantly more prevalent in the VDS group (p = 0.03).

Conclusion: A sufficient level of vitamin D was linked with a better response to cardioversion. However, low vitamin D levels are correlated with higher mortality in AF patients.

Background: ST-segment elevation myocardial infarction (STEMI) results from coronary artery blockage due to ruptured atherosclerotic plaque. Eosinophils play a dual role in STEMI, contributing to thrombus formation and tissue repair. This study investigates the association between eosinophil percentage, platelet counts, and in-hospital prognosis in STEMI patients.

Methods: A cross-sectional study was conducted from September 2019 to February 2020, including patients aged 18 and above with a STEMI diagnosis. In-hospital mortality, arrhythmia, and left ventricular ejection fraction (LVEF) were recorded. Demographic data, clinical manifestations, and laboratory investigations were collected. Data were analyzed using SPSS (version 25.0), with a P value of <0.05 considered significant.

Results: The study included 100 STEMI patients with a mean age of 65±13.26 years; 75% were male. The mortality rate was 13%. A significant relationship was found between eosinophil percentage and mortality (p=0.032), and platelet count also correlated significantly with mortality (p=0.008). The association between eosinophil percentage and EF was significant (p<0.001). The area under the ROC curve was 0.705 (95% CI 0.605 - 0.792) for platelet counts and 0.679 (95% CI 0.577 - 0.770) for eosinophil percentage in differentiating live and expired patients.

Conclusion: Platelet count could be a significant prognostic indicator for in-hospital outcomes in STEMI patients, suggesting an increased risk of mortality. Additionally, there is a notable relationship between eosinophil percentage and ejection fraction (EF).

Background: Heart failure is a widespread condition linked to elevated mortality rates, readmission incidents, and healthcare expenditures. Home care has emerged as a promising strategy for managing patients with heart failure. This study seeks to comprehensively review the impact of home care on individuals diagnosed with heart failure.

Methods: A comprehensive review was conducted by searching for relevant articles in Persian and English using keywords such as 'Nursing,' 'Home care,' 'Home care services,' Health Care Costs,' 'Heart diseases,' and 'Heart failure' across various databases including SID, Magiran, Ovid, Scopus, Web of Science, CINAHL, ProQuest, Embase and Medline. The search was limited to articles published between 2000 and 2023, focusing on those suitable for the study's purpose.

Results: A total of 1,260 articles were initially identified. After eliminating duplicate and irrelevant articles, evaluating the availability of full texts, and applying entry and exit criteria, as well as utilizing the CONSORT, STROBE checklist, and JBI Checklist for qualitative assessment of the studies, a total of 13 English articles were deemed suitable for inclusion in the final review. These studies utilized various study designs to investigate the effects of home care on patients with heart failure.

Conclusion: The findings of this study suggest that home care has a positive impact on the quality of life, knowledge, and self-care of patients with heart failure. Additionally, it has been shown to reduce healthcare costs, readmission rates, and mortality. Therefore, it is recommended to prioritize home care for patients with chronic heart failure following discharge.

Due to the shared risk factors between cardiovascular disease (CVD) and certain cancers such as breast cancer (BC) and colorectal cancer (CRC), our study aimed to assess the CVD risk factors among newly diagnosed patients with BC and CRC. The study utilized baseline data from the ongoing Cardiovascular Events in Breast and Colorectal Cancers (CIBC) cohort study conducted in Isfahan since 2019. Only patients who had recently been diagnosed with BC or CRC and had not undergone any treatment were included in the study. Trained interviewers administered questionnaires to collect information on the demographic, socioeconomic, and smoking status of the participants. Additionally, metabolic and physical factors were measured following established guidelines. A total of 542 patients were included in the study, with 394 (72.7%) diagnosed with BC, 147 (27.1%) with CRC, and one patient having both conditions. The average age of BC patients was 49.46±11.15 years, which was younger compared to CRC patients. The majority of patients (90.8%) were nonsmokers, and a significant proportion (91.2%) did not engage in sufficient physical activity. Less than half of the patients exhibited hypertension, while the prevalence of diabetes was comparatively lower. Obesity, particularly abdominal obesity, was more common among BC patients compared to CRC patients. In our population, we observed that patients with CRC had a higher mean age compared to those with BC, and they exhibited a higher prevalence of common metabolic risk factors. On the other hand, obesity was more prevalent among BC patients. In terms of the shared risk factors between CVD and BC, our population experienced menarche within the expected timeframe, and the mean age of menopause was also within the normal range.

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.