ARYA Atherosclerosis最新文献

Background: Although coronary artery bypass graft (CABG) surgery has been reported to be one of the most effective internentions in terms of myocardial salvage, reperfusion itself can cause additional damage to the myocardium. Since there is strong evidence that free radicals are the principal offender in ischemia-reperfusion (I/R) injury, it has been suggested that treatment with antioxidant agents can be protective. Investigations have shown that melatonin secretion is partially disturbed in CABG patients. The aim of this study was to evaluate the protective effect of melatonin as an antioxidant agent on I/R injury.

Methods: 164 elective CABG candidates participated in this randomized clinical trial during the preoperative period. The candidates were randomized to receive 3 mg of melatonin tablets (physiologic dose) from 3 days before surgery until the day of discharge. Cardiac biomarkers [troponin and creatine kinase myocardial band (CKMB)] were assessed once before surgery (24 hours before surgery), and 8 and 24 hours after surgery.

Results: Finally, 130 patients, 65 (50%) patients in the melatonin group and 65 (50%) in the control arm finished our study. Mean age of melatonin and control groups was 59.90 ± 9.59 and 60.80 ± 8.00 years, respectively; moreover, 47 (72.30%) in melatonin and 45 (69.23%) in control group were men. No significant difference was seen in baseline cardiac biomarkers between two groups (P > 0.05). In both groups, cardiac biomarkers (CKMB and troponin) elevated after surgery in comparison to their preoperative values. There was no statistically significant difference between the control and melatonin groups regarding the 8-hour and 24-hour troponin and CKMB when adjusted for interacting factors (P > 0.05).

Conclusion: Although physiological concentration of melatonin is protective against I/R injury, substitution of endogenous melatonin with the oral supplement which creates physiologic concentration may not prevent I/R injury. In order to have antioxidant effect, pharmacologic doses of melatonin should be employed.

Background: Coronary artery calcification (CAC) is an important marker of total burden of coronary atherosclerosis. Furthermore, it is a measure of subclinical atherosclerotic disease that correlates well with the cardiovascular risk. The aim of our study was to determine the role of the different lipid parameters in prediction of calcification in coronary arteries using multidetector computed tomography (MDCT).

Methods: This study was conducted on 120 patients presenting to the clinic with typical or atypical chest pain or dyspnea on exertion, or equivocal stress test results along with standard cardiac risk factors; they all underwent computed tomography (CT) coronary angiography. A total calcium score was determined by summing individual lesion scores from each of our anatomic sites: left main (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA). The amount of calcium present in the coronary arteries was scored according to Agatston score, and patients were divided into 2 groups based on absence (group I) and presence (group II) of CAC. Clinical characteristics, lipid ratios, and a full blood count were calculated and compared between both groups.

Results: Mean and standard deviation (SD) for age of group I was 52.4 ± 8.4 years, while that of group II was 53.7 ± 7.9 (P > 0.005). Patients in group II had a higher total cholesterol (TC), low-density lipoprotein (LDL), TC/high-density lipoprotein cholesterol (HDL-C) and LDL/HDL-C ratio, and lower HDL levels. TC/HDL ratio and LDL/HDL ratio were found to be good predictors of calcium using a regression analysis model. Finally, at a cut-off value of ≥ 3.108, LDL/HDL ratio showed a sensitivity of 58.8% and specificity of 84.6% in prediction of coronary calcium, while TC/HDL ratio ≥ 4.742 showed a sensitivity of 60.3% and specificity of 88.5%.

Conclusion: Amongst the different lipid parameters, TC/HDL-C and LDL/HDL ratio were found to be good predictors of presence of CAC in coronary arteries.

Background: Coronary artery disease (CAD) is a leading cause of cardiovascular death worldwide. Therefore, assessing knowledge in patients with CAD needs a specific tool. This study aims to carry out the Persian validation of the Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV) for education of patients undergoing cardiac rehabilitation (CR).

Methods: This study was a cross-sectional study. First, the original version of the CADE-Q SV was translated from English into Farsi using the standard approach. The face validity and content validity were measured using quantitative and qualitative approaches. The confirmatory factor analysis (CFA) was done to examine the construct validity. The reliability of the questionnaire was investigated through test-retest reliability and by calculating Cronbach's alpha coefficient. SPSS software was used to analyze the data, and the R package lavaan, to approve the CFA.

Results: The result of quantitative face validity showed that the minimum score was 4.42. The minimum scores for quantitative content validity were 0.83 for content validity index (CVI) and 0.66 for content validity ratio (CVR); therefore, all the items were approved. According to the results of the CFA, the comparative fit index (CFI) was reported to be 0.969, indicating a good fit for the items. The Cronbach's alpha coefficient for the whole instrument was 0.679, and the test-retest correlation was measured to be > 0.4, after a 2-week interval.

Conclusion: In total, it can be concluded that the CADE-Q SV has good psychometric properties and proper reliability. It can be utilized in medical and CR centers.

Background: The important role of lipoproteins, particularly low-density lipoprotein (LDL) and high-density lipoprotein (HDL), has been highly regarded among the known causes of cardiovascular disease (CVD). A wide range of risk factors may cause structural and functional changes in lipoprotein particles, resulting in deposition and formation of atherosclerotic plaques. Homocysteine is one of the most important risk factors in heart disease, and its atherosclerotic properties appear to be related to its intermediate metabolite called homocysteine thiolactone (HCTL). The major aim of the present investigation was to study the effect of HCTL in different concentrations (10, 50, and 100 μM) on paraoxonase and aryl esterase activities of purified human serum paraoxonase 1 (PON1) antioxidant enzyme related to HDL, as an extracellular hydrolyzing enzyme of HCTL.

Methods: In order to purify PON1 enzyme from human serum, three-step chromatographic methods including DEAE Sephadex A50, Sephadex G100, and DEAE Sephadex A50 were used. Protein concentration and paraoxonase and aryl esterase activities of each fraction were measured separately and the highest activities fractions were collected and subsequently pooled together for the next steps. Ultimately, both activities of PON1 in the presence of different concentrations of HCTL were measured in triplicate by spectrophotometry technique.

Results: HCTL at concentrations of 50 and 100 μM decreased both paraoxonase and aryl esterase activities (P < 0.05) in comparison with the control group, which is directly related to the increase in HCTL concentration. However, at a concentration of 10 μM HCTL, no significant difference was observed in both paraoxonase and aryl esterase activities compared to the control group.

Conclusion: HCTL is a highly toxic and reactive compound that is produced in all cells. Extracellular enzyme PON1 causes its hydrolysis with high efficiency. The results obtained from the present study showed that paraoxonase and aryl esterase activities decreased in vitro in the presence of HCTL and therefore, HCTL may cause changing in the protein structure of this enzyme. Previous in vivo studies have also shown decrease of PON1 activity in patients with hyperhomocysteinemia.

Background: Obesity is associated with several metabolic disorders and myocardial apoptosis. The aim of this study was to determine the effect of high-intensity interval training (HIIT) and coenzyme Q10 (CoQ10) supplementation on myocardial apoptotic proteins in obese male rats.

Methods: Forty-eight male Wistar rats were randomly assigned to 6 groups including non-obese control (NOC), baseline obese control (BOC), HIIT, CoQ10, HIIT + CoQ10, and control. NOC and BOC groups were sacrificed at the beginning of the study. Exercise groups were subjected to a HIIT program over 12 weeks. Rats in CoQ10 group were gavage-fed with 500 mg/kg-1 CoQ10 supplement throughout the study. The heart muscle was removed 48 hours after the last training session. The B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), cytochrome c, BH3-interacting domain death agonist (Bid), caspase-8, and caspase-3 protein expressions were analyzed using western blotting. Data were analyzed using independent t-test and two-way analysis of variance (ANOVA).

Results: The Bax, Bid, cytochrome c, caspase-8, caspase-3 proteins, and Bax/Bcl-2 were significantly higher in BOC group compared to NOC (P = 0.025, P = 0.0001, P = 0.013, P = 0.017, P = 0.010, P = 0.180, respectively). Moreover, Bcl-2 protein was lower in BOC compared to NOC group (P = 0.025). HIIT program decreased Bax/Bcl-2 ratio (P = 0.012), Bid (P = 0.0001), cytochrome c (P = 0.003), caspase-8 (P = 0.006), and caspase-3 (P = 0.002) proteins and increased Bcl-2 (P = 0.001) proteins in heart muscle. CoQ10 supplementation significantly increased Bcl-2 protein content (P = 0.001).

Conclusion: HIIT exerts an anti-apoptotic effect in heart muscle of obese rats. Although the administration of CoQ10 increased Bcl-2 anti-apoptotic protein, it did not show a potent synergistic effect along with HIIT to reduce obesity-related myocardial apoptosis.

Background: Vascular injuries during inguinal hernia repair are rarely reported. Especially in children, we have little information about vascular management.

Case report: In this article, we present a 6-year-old girl with right iliac vein ligation during inguinal hernia repair who was referred to our center and managed at the day of surgery. We recommended prior surgeon to order therapeutic heparin in dispatch time. The patient was treated with primary anastomosis of iliac vein and was admitted to pediatric intensive care unit (PICU). On the day following the operation, she had minimal dyspnea with low oxygen saturation and the investigations revealed pulmonary micro-embolization. Blood flow in lower extremity was normal and after a few days, she was discharged with good health and oral anticoagulation.

Conclusion: Any unusual bleeding at the time of inguinal hernia repair should be considered as major vascular injury by the surgeon, and to prevent more injuries, minimum attempt must be performed to control the bleeding.

Background: Depression is common in patients with cardiovascular disease (CVD). Home-based cardiac rehabilitation (HBCR) is a program that alleviates depression. This study aimed to determine and compare HBCR programs and usual care (UC) effects on depression control in patients with ischemic heart disease (IHD).

Methods: This clinical trial study was performed on 259 patients with IHD that were randomly allocated to the HBCR and UC groups for stress management. Data were collected using the "Beck Depression Inventory" (BDI) at baseline and 6 and 12 months. Generalized estimating equation (GEE) models were applied to examine the associations between times of the groups and changes in outcomes over the study times. Data analysis was done in SPSS software at the significance level of 0.05.

Results: A total of 247 participants with a mean age of 55.22 ± 7.40 years participated in this study, and 209 (84.6%) of the study participants were men. Among patients, 128 patients in the UC program and 119 patients in the HBCR program attended at least one of the pre-determined visits (months 6 and 12). The patterns of change of the depression parameter were similar through the course of the study between the two groups (P = 0.04). In the HBCR group, the depression reduced continuously from baseline to 6 months, baseline to 12 months, and 6 to 12 months (P < 0.05). In the UC group, depression was significantly reduced from baseline to 6 months and from baseline to 12 months.

Conclusion: HBCR was effective in continuous reducing of depression scores in long-term follow-up of patients with IHD. These findings suggest that HBCR can alleviate depression in patients who do not participate in hospital-based cardiac rehabilitation (CR).

Background: Childhood obesity and hypertension (HTN) are among serious global health concerns. Since risk factors of cardiovascular diseases (CVDs) should be managed early in life and there is little information about children under the age of 6 in the community, the study was designed aiming to address these issues.

Methods: This cross-sectional study was performed on 1,091, 3-6-year-old children in Gorgan City, located in north of Iran. Height, weight, body mass index (BMI), and blood pressure were measured using standard techniques. All statistical tests were conducted using the Statistical Package for the Social Sciences (SPSS) for windows.

Results: Given the study, respectively 3.8 and 4.5% of the boys and girls were underweight, 17.4 and 16.5% of the boys and girls were overweight, and 20.8 and 19.3% of the boys and girls were obese. In addition, 3.4, 0.7, and 0.4% of the subjects had presystolic, systolic, and prediastolic HTN, respectively. There is a significant linear relationship between BMI and systolic and diastolic blood pressures. It was found that the risk of obesity in mothers with college education was estimated to be almost 5 times higher than in mothers with lower levels of education.

Conclusion: Compared to the values announced by Centers for Disease Control and Prevention (CDC), the mean height, weight, and BMI of children in our study was higher. Educational interventions should be considered in society, especially for mothers with a high level of education and employed ones. It is recommended that blood pressure measurements, especially in obese children, be carefully considered at each pediatric visit so that children with HTN could be quickly identified and treated.