ARYA Atherosclerosis最新文献

Background: One of the most severe problems that patients with Hypertension (HPN) face are lack of medication adherence, which is influenced by psychological factors. Thus, the current survey sought to compare medication beliefs, cognitive defusion and valued living in hypertensive patients with varying medication adherence.

Method: A cross-sectional study with 162 HPN patients from three clinics at Isfahan University of Medical Sciences was conducted in 2019. Participants completed the BMQ (Beliefs about Medicines Questionnaire), MMAS (Morisky Medication Adherence Scale), CFQ (Cognitive Fusion Questionnaire), and VLQ (Valued Living Questionnaire). The data were analyzed using descriptive statistics, chi-square, and analysis of variance (ANOVA).

Results: Only 22.2% of patients scored high in medication adherence (MA). MA levels increased with age in a significant correlation (P=0.03). ANOVA results revealed that the three MA levels (low, medium, and high) had substantial differences in both VLQ subscales (importance of person-valued living and allotted time for values; P=0.002 and P=0.023). However, no significant differences in MA levels were found in the CFQ (cognitive defusion and cognitive fusion) and BMQ subscales (specific necessity, specific concern, general overuse, and general harm).

Conclusions: This study discovered that a higher MA is associated with increasing age. In addition, patients with HPN who value living and devote more time to their values have higher MA.

Background: Elevated serum visfatin levels have been reported in some chronic inflammatory diseases such as cardiovascular diseases (CVDs) and rheumatoid arthritis. The purpose of the present study was to investigate the correlation between visfatin and interleukin-6 (IL-6) and anthropometric, angiographic, echocardiographic, and biochemical parameters in patients with acute myocardial infarction (AMI).

Methods: In this case-control study, 90 patients who were candidates for angiography were divided into the following 3 groups: non-coronary artery disease group (non-CAD; n = 30) with a history of chest pain without angiographic changes, stable angina pectoris group (SAP; n = 30), and AMI group (n = 30). Anthropometric, angiographic, echocardiographic, and biochemical parameters were measured in all subjects.

Results: The mean age of patients in the non-CAD, SAP, and AMI groups was 62.26 ± 13.24, 62.93 ± 8.35, and 52.83 ± 10.26 years (P < 0.001) respectively. The results showed that the median [interquartile range] of visfatin level was higher in the AMI group [7 (6.30-9.30), pg/ml] compared with the SAP [5.85 (5.20-6.60); P < 0.001] and non-CAD [5.20 (3.30-5.70); P < 0.001] groups. In addition, median [interquartile range] IL-6 levels were higher in the AMI group [17.5 (16-21), pg/ml] compared with the SAP [15.50 (14-18); P < 0.01] and non-CAD [14 (11-17); P < 0.001] groups. Furthermore, there was a positive association between plasma level of visfatin, and epicardial fat thickness (EFT) and the Gensini score in the SAP and AMI patients. The results of multivariate linear regression analysis revealed that white blood cell ý(WBC) count and IL-6 were independently associated with plasma visfatin level.

Conclusion: The current study showed an association between visfatin and EFT in AMI patients. Increased visfatin levels in patients with AMI may contribute to atherosclerosis; however, further studies should be conducted to confirm this finding.

Background: Home healthcare guidelines emphasize the engagement of family caregivers of heart failure (HF) patients in patient care at home. Thus, this study was conducted with the aim to explore the deep experiences of home care team members regarding the needs of family caregivers of HF patients in home healthcare services in Iran.

Methods: The present qualitative study was performed with a conventional content analysis approach. Data were collected through in-depth, semi-structured interviews with 23 participants who were recruited through purposive sampling. The Data were analyzed using the Graneheim and Lundman method for conventional content analysis in MAXQDA Software.

Results: The participants included 14 women and 9 men with the mean age of 46.21 ± 11.44 years. After analyzing the interviews, 3 main categories and 15 subcategories were extracted. The main categories were "family caregiver's unmet needs" (with 5 subcategories), "Empowering Informal Caregivers" (with 3 subcategories), and "access to a standard home healthcare system" (with 7 subcategories).

Conclusion: Deep understanding of the needs of family caregivers of HF patients in home health care services increases the quality of services, the quality of life (QOL) of the family, and prevents patients' hospital readmissions. Moreover, it will contribute to our next project of the home healthcare guideline for HF patients in the health care system of Iran. Identifying the training needs of caregivers within the home health care services has an important role in the designing of education strategies in policy making programs at the level of the Ministry of Health or planning at lower levels of the health network.

Background: Alpha lipoic acid (ALA) is considered a strong antioxidant with anti-inflammatory properties. Moreover, a number of previous studies have shown its lipid-lowering properties. Therefore, we designed this study to investigate the effects of ALA on lipid profile in patients with metabolic syndrome (MetS), which can lead to an increased risk of cardiovascular disease (CVD) and premature mortality.

Methods: A total 46 patients with MetS were randomly divided into two groups. They received either 600 mg ALA (n = 23) or 600 mg placebo (n = 23) for 12 weeks. The body weight, height, body mass index (BMI), waist circumference (WC), fasting blood sugar (FBS), hemoglobin A1C (HbA1c), and blood pressure (BP) were assessed at baseline of the study. Physical activity level and dietary intake were assessed at baseline and end of the study. Serum lipid profile including triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were measured before and after 12 weeks of intervention.

Results: Baseline characteristics were similar in the ALA and placebo groups (P > 0.05). However, there were statistically significant differences in plasma levels of TG (-36.82 ± 42.48 versus 6.15 ± 25.04 mg/dl, P = 0.001) and TC (-8.91 ± 20.65 versus 10.84 ± 22.97 mg/dl, P = 0.01) after 12 weeks between the ALA group and the placebo group. Yet, there were no statistically significant differences in plasma levels of HDL-C and LDL-C after 12 weeks between the ALA group and the placebo group.

Conclusion: The results suggest that daily supplementation of 600 mg ALA for 12 weeks may improve the lipid profile in patients with MetS.

Background: Hypertrophic cardiomyopathy (HCM) and anomalous coronary artery arising from the opposite sinus are independently associated with increased risk of sudden cardiac death (SCD). Their coexistence in a single patient further complicates the issue by affecting management strategy and increasing the risk of sudden death.

Case report: A 21-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) having strong family history of SCD presented with exertional fatigue and palpitation. Cardiac catheterization and computed tomography (CT) coronary angiography revealed single left coronary artery where left main trunk was trifurcating into left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA). The course of RCA was retro-aortic. There were no appreciable septal arteries to be ablated by alcohol injection. The patient was managed with implantable cardioverter-defibrillator (ICD) and metoprolol.

Conclusion: Single coronary artery (SCA) and HOCM are of great clinical significance as both of these conditions are independently associated with SCD. Medical management in form of beta blocker and ICD is an acceptable treatment strategy in appropriately selected symptomatic obstructive HCM. To the best of our knowledge, this is the first ever case report of RCA following a retro-aortic course arising from left main in a patient with obstructive HCM.

Background: The urgency of uncomplicated blood pressure (BP) is known as a sudden rise in BP. The aim of this study was to evaluate the intravascular administration of midazolam as an emergency care to control BP against captopril in patients with uncomplicated hypertension (HTN).

Methods: The present study was a double-blind parallel randomized clinical trial (RCT) study that was performed on patients with urgent HTN referred to Imam Hossein Hospital in Shahroud, Iran, in 2018. Patients with BP higher than 180/110 mmHg and with healthy vital organs were selected randomly and allocated into three groups of 43 participants. All patients' BP in both arms, and after a period of 10 minutes in the left arm, was checked and after administering the medication was checked again for 4 times of 15 minutes till 1 hour complete.

Results: There were significant differences between systolic (P = 0.024), diastolic (P = 0.001), and mean BP (P = 0.009) in the midazolam group before and after treatment. The group of midazolam and captopril showed the greatest reduction of BP before, in the middle, and after carrying out the treatment methods. As such, systolic, diastolic, and mean BP showed 23.5% (P = 0.047), 17.4% (P = 0.021), and 20.5% (P = 0.031) reduction, respectively.

Conclusion: Midazolam can be used as an effective and low-risk drug for lowering BP. Midazolam also has a faster effect on lowering BP.

Background: Some patients require intra-aortic balloon pump (IABP) after coronary artery bypass graft (CABG) surgery. IABP can be adjusted to different frequencies such as 1:1, 1:2, or 1:3. In this study, we tried to compare the effect of 1:1 and 1:2 frequencies of IABP on hemodynamic status of the patients after CABG surgery.

Methods: In this experimental study, all patients using IABP after CABG surgery were entered the study as pretest and posttest groups. The study could not be blinded because of the clearness of posttest group for the same echocardiographist. The pretest group included patients using a 1:1 frequency of IABP device. The posttest group included patients in the pretest group who were exposed to a 1:2 frequency for 20 minutes. In both groups, on the moderate dose of inotropic support, hemodynamic parameters of patients including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI), stroke volume (SV), and velocity time integral (VTI) in the aorta during systole were measured. Both groups were compared using Wilcoxon signed rank test. SPSS software was used for analysis and P < 0.05 was considered to be statistically significant.

Results: Twelve patients were entered into the study. Three patients were excluded because of open chest and instability of vital signs. Nine patients completed the study. 3 patients were men and 6 were women. The mean age was 58.32 ± 13.18 years. MAP in 1:1 frequency was significantly higher than 1:2 (P = 0.043); however, there was no significant difference between 1:1 and 1:2 in other hemodynamic parameters, namely CO, CI, SV, HR, and VTI.

Conclusion: In patients on moderate dose of inotropes, IABP frequencies of 1:1 and 1:2 have the same effect on hemodynamic parameters such as CI, SBP, DBP, HR, and left ventricular outflow tract (LVOT) VTI; meanwhile, MAP remains higher in 1:1 frequency.

Background: Myocardial ischemia leads to left ventricular (LV) dysfunction and cardiac arrhythmia. The present research was conducted with the aim to explore echocardiography changes and electrocardiogram parameters of the hearts of rats with ischemia-reperfusion injury (IRI).

Methods: The study subjects included 50 male Wistar rats) 8-10 weeks), which were divided into 5 groups (1: trained, 2: supplemented, 3: combined (training and supplementation), 4: sham, and 5: control). High-intensity interval training ý(HIIT) was performed for 8 weeks, 5 sessions per week. Rats belonging to groups 2 and 3 received 10 mg/kg berberine. Finally, after 48 hours, electrocardiogram and echocardiography were performed on all rats. Moreover, myocardial ischemia was performed by descending coronary artery ligation for 30 minutes.

Results: There were significant differences between the 5 groups in terms of the volumes and dimensions of LV end-systolic dimension (LVSD), LV end-diastolic dimension (LVDD)ý, fractional shortening cardiac output, ejection fraction (EF), stroke volume (SV), ventricular tachycardia (VT), and ventricular ectopic beats (VEBs) episodes, duration of VTs, and ECG parameters (P ≤ 0.05).

Conclusion: Berberine supplementation and HIIT, as preconditioning agents, can possibly prevent the elevation of EF and fractional shortening, the reduction of cardiac output and SV, and arrhythmia improvement after myocardial IRI. Finally, these changes result in increased LV function and decreased mortality in rats with myocardial IRI.

Background: Atherosclerosis is an inflammatory disease that various factors affect the onset and its progression, including free radicals, hypertension, diabetes, genetic changes, hypercholesterolemia, and even some microorganisms such as herpes viruses and chlamydia. Therefore, compounds that can be effective in any of the above cases may be considered as a useful therapeutic agent in the process of atherosclerosis. The aim of the present study was to evaluate the effects of Pistacia atlantica gum hydro-alcoholic extract on macrophage phagocytosis ability and development of atherosclerosis in hypercholesterolemic rats.

Methods: The statistical population of the present study consisted of 25 rats that were randomly divided into 5 groups (one control group under standard diet, 4 treatment groups under high-fat diet). After consumption of high-fat food for 45 days, the treatment groups orally received 100, 200, and 400 mg/kg of Pistacia atlantica gum hydro-alcoholic extract for 30 days. Then, peritoneal macrophages were isolated and blood samples were collected to measure the level of nitroblue tetrazolium (NBT), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG). P ˂ 0.05 was considered significant in all evaluations.

Results: The level of cholesterol (503.66 ± 17.15), TG (436.66 ± 16.80), LDL-C (343.66 ± 11.59), HDL-C (54.33 ± 7.02), and NBT (0.64 ± 0.02) decreased in the treatment groups. Besides, exactly in a concentration-dependent manner, plant extract significantly reduced the level of respiratory potential level in macrophages.

Conclusion: Hydro-alcoholic extract of Pistacia atlantica gum could effectively decrease hypercholesterolemia and increase phagocytic ability of macrophages. Therefore, it can be suggested for more investigation as a blockage of atherosclerosis.

Metabolic syndrome (MetS) is one of the most important health issues around the world and a major risk factor for both type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The etiology of MetS is determined by the interaction between genetic and environmental factors. Effective prevention and treatment of MetS notably decreases the risk of its complications such as diabetes, obesity, hypertension, and dyslipidemia. According to recent genome-wide association studies, multiple genes are involved in the incidence and development of MetS. The presence of particular genes which are responsible for obesity and lipid metabolism, affecting insulin sensitivity and blood pressure, as well as genes associated with inflammation, can increase the risk of MetS. These molecular markers, together with clinical data and findings from proteomic, metabolomic, pharmacokinetic, and other methods, would clarify the etiology and pathophysiology of MetS and facilitate the development of personalized approaches to the management of MetS. The application of personalized medicinebased on susceptibility identified genomes would help physicians recommend healthier lifestyles and prescribe medications to improve various aspects of health in patients with MetS. In recent years, personalized medicine by genetic testing has helped physicians determine genetic predisposition to MetS, prevent the disease by behavioral, lifestyle-related, or therapeutic interventions, and detect, diagnose, treat, and manage the disease. Clinically, personalized medicine is providing effective strategies for the prevention and treatment of MetS by reducing the time, cost, and failure rate of pharmaceutical clinical trials. It is also eliminating trial-and-error inefficiencies that inflate health care costs and undermine patient care.