ARYA Atherosclerosis最新文献

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: Liver X receptors (LXR) play an essential role in the regulation of cholesterol metabolism, and their activation increases ABCG5 and ABCG8 gene expression for the improvement of cholesterol excretion from the body during reverse cholesterol transport (RCT). The aim of this study was to investigate the effects of high-intensity interval (HIT) and low-intensity continuous (LIT) trainings on gene expression of these substances after a high-fat diet in Wistar rats.

Methods: Fifteen male Wistar rats were divided into 3 groups: control group (n = 5), HIT exercise group (n = 5), and LIT exercise group (n = 5). All groups were fed a high-fat diet for 13 weeks, and the HIT and LIT groups performed the specific training program. The expression of LXRβ, ABCG5, and ABCG8 genes was measured after the training period.

Results: Data analysis showed significantly higher levels of LXRβ, ABCG5, and ABCG8 gene expression in the HIT and LIT groups compared to the control group (P ≤ 0.05).

Conclusion: HIT and LIT trainings after a high-fat diet have beneficial effects on RCT, preventing heart attacks. Additionally, HIT training may have a greater effect on cholesterol excretion during the reverse cholesterol transport mechanism than LIT.

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: The purpose of this study was estimate and identify in hospital mortality predictors factors for patients with acute ST elevation myocardial infarction (STEMI).

Methods: This study is a retrospective cohort study based on data from the Yazd Cardiovascular Diseases Registry (YCDR) from 2015-2018 in Yazd Province, Iran, focusing on hospitalized patients with ST-elevation myocardial infarction (STEMI). The primary outcome was in-hospital mortality in STEMI patients. A total of 1861 patients with STEMI were analyzed. Multivariable logistic regression was used to determine death predictive factors for in-hospital mortality in STEMI patients. The significance level of the model was considered to be 5% and the software was used for analysis.

Results: The study included 1,861 patients with STEMI. Among them, 103 (5.5%) individuals died during admission the hospital. After multivariable logistic regression, the following variables were identified as death predictive factors for in-hospital mortality of STEMI: having a history of CVA (OR: 5.6, 95% CI: 2.2-20.3), killip class IV (OR: 6.4, 95%CI: 1.5-11.2), lower ejection fraction (OR: 3.6, 95% CI: 1.2-9.8), lower HDL cholesterol (OR: 1.2, 95% CI: 1.01-2.3), and lower hemoglobin (OR: 1.4, 95% CI: 1.3-2.9).

Conclusion: This study found that lower ejection fraction, lower hemoglobin levels, Killip class IV, having a history of CVA, and low HDL cholesterol levels are important death predictive factors for hospital mortality in patients with STEMI. Health policy in STEMI management must consider these factors to improve hospital prognosis.

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: Patients with cardiovascular disease need to adhere to their treatment and care recommendations to prevent the progression of their condition and improve their quality of life. In this regard, this study was conducted to develop a mobile application and test its effectiveness in improving medication adherence among persons with cardiac disease.

Methods: The study was conducted in two stages. The first stage involved the preparation of the "Mobile Application for Persons with Cardiac Disease" using the cascade model. In the second stage, 121 patients who were hospitalized in the cardiac intensive care unit of Ayatollah Taleghani Medical Education Center of Tehran from March to August 2023 were enrolled. The participants were randomly assigned to either the control group (63 people) or the intervention group (58 people). The study collected data using a medication adherence questionnaire on the 7th, 14th, and 21st day after discharge and compared the results with the control group. The data were analyzed using SPSS 20.

Results: The average age of the control group was 56.75 ± 11.38 years, and the average age of the intervention group was 57.03 ± 11.55 years. The comparison of the average medication adherence with independent t-tests showed a significant difference between the intervention and control groups on the 7th, 14th, and 21st day after discharge (P<0.01). The results of the repeated measures test in each group also showed that the difference between the groups increased over time (P<0.001).

Conclusion: The results of the study showed that the mobile application is effective in improving medication adherence among heart patients.

Background: The present post-marketing clinical study was conducted over a 12-month follow-up period to monitor the clinical outcomes of patients treated with the Vector® Percutaneous Transluminal Coronary Angioplasty (PTCA) Balloon Catheter for the dilatation of coronary lesions. The semi-compliant balloon improves balloon-to-vessel wall apposition and minimizes balloon slippage during PTCA, which could reduce complications and improve clinical outcomes. This investigation aimed to assess the safety and effectiveness of the Vector® PTCA Balloon Catheter in real-world settings.

Methods: A retrospective study was conducted to investigate the safety and efficacy of the Vector® PTCA Balloon Catheter in 125 patients who underwent pre-dilatation and post-dilatation. The primary outcome of the study was major adverse cardiac events (MACE), a composite endpoint encompassing target-lesion revascularization (TLR), cardiac death, and myocardial infarction (MI).

Results: The Vector® PTCA Balloon Catheter has shown promising results in a small group of patients undergoing dilatation of normal and intricate coronary artery lesions, reflecting a 100% procedural success rate. The successful delivery to the target lesion, deployment, and subsequent retrieval of the device during the index procedure led to a 100% device success rate without any technical issues. A total of 3.2% (4) patients experienced MACE during the 12-month follow-up, with 1.6% (2) MI, 1.6% (2) TLR, and no cardiovascular deaths..

Conclusion: This study demonstrated the favorable safety and reliability of the Vector® PTCA Balloon Catheter in patients with angina, MI, and a history of coronary artery disease in a real-world setting.

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.

Background: Patients with ischemic heart disease often exhibit various psychological factors that increase the risk of future cardiovascular events. Therefore, in addition to rehabilitation programs, there is a need for more interventional psychotherapy. Bioenergy Economy-based Health Improvement (BEHI) is a mind-body intervention that may address these issues. This study aimed to evaluate the effectiveness of the BEHI program on laboratory, clinical, and psychological factors in post-myocardial infarction (MI) patients.

Methods: In this study, 52 post-MI patients were randomly divided into two groups. One group received cardiac rehabilitation combined with the BEHI program, while the other group received only cardiac rehabilitation. Laboratory data, clinical characteristics, and psychological variables were evaluated at baseline, immediately after the intervention, and four months post-intervention (follow-up).

Results: Among the participants, the mean age was 59.97 ± 6.32 years, and 98.07% were male. The results showed a significant improvement in the mean scores of metabolic equivalents (METs), depression, and anxiety in participants who received the BEHI program and the rehabilitation program (p values: 0.006, 0.038, and 0.028, respectively).

Conclusion: These findings suggest that incorporating mind-body interventions like the BEHI program into cardiac rehabilitation can enhance physical and psychological outcomes for patients recovering from MI.