Arya Atherosclerosis
Volume:12 Issue: 5, Sep 2016

The low physical activity (LPA) more or less affects every community. Because of high prevalence of cardiovascular diseases in Iran and their relationship with LPA, this study aimed to measure precisely the epidemic size of LPA and determine its relationship with six other coronary artery disease (CAD) risk factors among an urban population aged 15 to 75 years in Kerman, Iran.
Using household survey, 5895 adults were randomly recruited through single-stage cluster sampling from 250 postal codes. Demographic characteristics, blood pressure, blood glucose, cholesterol, triglyceride, smoking, opium use, mental status and physical activities at work, rest and recreation were assessed and ranked as low, moderate and intense. Adjusted odds ratio (AOR) was reported as a measure of the relationship between LPA and other CAD risk factors.
The prevalence of low, moderate, and intense physical activity were 42.1% (40.3-43.9), 45.0% (43.6-47.4) and 12.4% (11.1-13.9), respectively. LPA showed a sudden rise from 36.8% to 45.4% after the age of 25 years. On average, women had less physical activity than men (45.1% vs. 39.2%, P= 0.01). Participants with low physical activity compared to those without physical activity had significantly higher chance of anxiety [odds ratio 1.39; confidence interval (95% CI) 1.08-1.79; P = 0.01], hypertension (1.59; 1.08-2.35; P = 0.02), hyper-cholesterolemia (1.37; 1.06-1.76; P = 0.02), cigarette smoking (1.52; 1.07-2.11; P = 0.01), opium addiction (1.47; 1.07-2.02; P = 0.02) and overweight/obesity (1.34; 1.05-1.71; P = 0.02).
LPA was very common in the studied population and almost half of the adults were at risk for CAD because of insufficient level of physical activity. Such risky life-style pattern makes the emerging of CAD epidemic unavoidable, if effective interventions not being in place timely to this community.

There are a few literature data on the correlation between metabolic syndrome (MetS) and coronary disease among Iranian population. This study aimed to find relationship between MetS and severity of coronary artery disease (CAD) in presence of diabetes.
Total of 192 patients were consecutively enrolled in the study who were admitted to coronary care unit because of acute coronary syndrome (ACS) and then underwent coronary angiography. MetS was defined by Iranian criteria. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between MetS and angiographic coronary artery disease (CAD) severity or clinical presentation was compared between them after adjusting for diabetes.
Individuals with MetS (n = 125) had a higher prevalence of ST-elevation myocardial infarction (71% vs 30%, P MetS was related to the severity of CAD both clinically and by angiographic scores but diabetes was a challenging factor and may independently increase the severity of CAD.

The assessment of cardiac iron overload in thalassemia major has been considered as an important predictive factor of heart injury. The magnetic resonance imaging (MRI)-derived relaxation time parameter (T2*) varies inversely with iron level, and elevated myocardial iron levels by T2* are associated with depressed left ventricular (LV) ejection fraction (EF). We compared echocardiographic (ECHO) indices of systolic function to myocardial T2* in these patients.
A cross-sectional database review identified 200 consecutive patients with thalassemia who underwent both ECHO and MRI T2* assessment.
There was a negative correlation between T2* measurement and ECHO EF (r = −0.389, P Myocardial iron load assessed by MRI T2* is associated with deterioration of the LV function assessed by ECHO with a high specificity and moderate sensitivity. It is important to identify the thalassemic patients with a risk of iron overloaded cardiomyopathy and heart failure.

High-sensitivity C-reactive protein (hs-CRP) inflammatory biomarker is one of the best informative markers of prognosis of coronary artery disease (CAD) that has been studied. Some studies have found that hs-CRP has a direct correlation with CAD. The aim of this study was to determine the relationship between serum levels of hs-CRP and the severity of coronary artery stenosis in patients with stable and unstable angina.
In a cross-sectional study, 150 patients undergoing coronary angiography in Golestan Hospital Ahvaz, Iran in 2012, were studied in three groups of stable angina (n = 50), unstable angina (n = 50), and normal coronary angiography (n = 50). Hs-CRP levels were measured in patients before angiography by enzyme-linked immunosorbent assay method, were compared between the three groups and its correlation with the degree of stenosis was evaluated.
The mean levels of hs-CRP in the stable angina group, unstable angina group and the group with normal coronary angiography were 2.46 ± 1.79, 4.84 ± 3.38, and 2.95 ± 2.57 mg/L, respectively. The results show that the mean levels of hs-CRP in patients with unstable angina was significantly higher compared to patients with stable angina (P 0.050). A significant relationship between arterial stenosis points and hs-CRP levels in patients with stable angina was not seen (P = 0.985).
The findings suggest that it seems hs-CRP level in patients with unstable angina were significantly higher than those in patients with stable angina and patients with normal coronary angiography. It also appears that the level of hs-CRP in patients with unstable angina is associated with the severity of coronary stenosis. Given the finding of consistent results, the use of hs-CRP as a prognostic factor in these patients may be useful.

Contrast-induced nephropathy (CIN) is a major concern following procedures with applying iodinated contrast media. The basis prevention of CIN is hydration and to avoid hypovolemia. We aimed to evaluate the efficacy of pentoxifylline (PTX) for the prevention of CIN in patients with myocardial infarction (MI) undergoing coronary angioplasty.
This prospective, single-blind, randomized clinical trial study was performed on 175 (127 men) of MI patients undergoing routine treatment. Patients were assigned randomly to the control (n = 84) and study groups (n = 91). In our study group, patients received 400 mg/3 times a day from 24 hours before to 24 hours after coronary angiography. In addition, before the procedure and after 48 hours from the procedure, serum creatinine was measured.
CIN occurred in 14 patients (8.0%); 8 controls (9.5%) and 6 patients (6.6%) in the PTX group )P = 0.475) showing PTX to have no significant effect on CIN [P = 0.750, odds ratio = 0.82 (confidence interval = 0.24-2.8)] though a significantly different volume of contrast was used between the groups (231.29 ± 105.10 mm3 and 190.88 ± 75.82 mm3; P = 0.005, respectively).
There was no significantly different occurrence of CIN on patients with MI, undergoing coronary angioplasty, but its relatively lower rate in PTX group would recommend the prophylactic oral use of PTX for CIN prevention.

Although isolated left ventricular noncompaction (ILVNC) has been described almost two decades ago, our knowledge about its diagnosis, presentation, echocardiographic features and clinical outcome is sparse. We aimed to assess the echocardiographic and clinical characteristics of ILVNC in a group of patients referred to our center.
Patients who were referred to a tertiary referral center, affiliated with Mashhad University of Medical Sciences, with primary diagnosis of dilated cardiomyopathy underwent comprehensive echocardiographic evaluation. The diagnosis of ILVNC was made based on the presence of two-structural layer in myocardium; ratio of noncompacted to compacted layers more than 2, and excessive trabeculation in the left ventricle.
Final diagnoses of ILVNC were made in 42 patients. Mean age of patients was 32.9 ± 15.6 years (ranging from 9 to 70 years). Females comprised a higher proportion of patients (61.9%) and shortness of breath was the most reported symptom among patients (47.6%). Non-compacted layers were detected in inferior and lateral segments of apex in 97.6% of patients. A total of 26 (61.9%) patients had left ventricle (LV) dysfunction (defined as ejection fraction less than 50%). The only factor that showed significant association with LV dysfunction was the number of affected segments with noncompaction (P = 0.008). Reduced ejection fraction was not associated with either age or sex (P = 0.437 and P = 0.206, respectively).
Based on the result of the current study, it can be suggested that apex of the heart is the most common site of noncompaction and increasing numbers of affected segments might be associated with LV dysfunction.

Apium graveolens is one of the well-known herbs used for the treatment of different; however, allergic reactions have been reported after its use. This report aimed to demonstrate the A. graveolens induced hyperthyroidism after its oral consumption for weight loss.
CASE REPORT: Mr. A, 48-year-old, with no history of any thyroid diseases, was diagnosed with hyperthyroidism due to daily consumption of 4 g of dried celery leaves for 45 days. After cessation of consumption and treatment with methimazole, the symptoms remitted. Then, the medication was discontinued when the lab tests and ultrasound were normal and indicated the patient’s definite recovery. In 2 months follow up of, he was normal and thyroid-stimulating hormone (TSH), T4, T3, anti-TSH receptor, anti thyroperoxidase and antithyroglobulin were in normal ranges.
Hyperthyroidism may be induced by consumption celery. Although many studies have reported side effects such as allergic reactions for this herb, this is the first report of hyperthyroidism induced by celery in which the patient recovered after discontinuing the medication. Therefore, it can be assumed that celery induces hyperthyroidism as a side effect of this herb if it is used for a long term.

The races show different cerebrovascular involvements, for example, the involvement of intracranial arteries are higher among Asians than Caucasians. The aim of this study was to investigate the cerebrovascular stenosis pattern by computed tomography angiography (CTA), which is unprecedented in Iran.
In this study, patients with brain stroke (thrombosis), confirmed by CT scanning and cardiac assessments, who referred to Shafa Hospital in Kerman, Iran, underwent brain and cervical arteries CT angiography to assess involved cerebrovascular territories and also its risk factors from June 2012 to June 2013.
We did CTA for 100 patients. Eighty-four cases had cerebral artery stenosis. Intracranial vessel involvement alone was observed in 47.6% of patients, simultaneous intracranial and extracranial artery stenosis in 26.2%, and extracranial artery stenosis in 26.2%. Posterior cerebral artery territory showed the highest degree of vascular stenosis. Posterior cerebral artery stenosis alone was observed in 51.3% of the cases; 27.4% of the cases suffered from anterior artery stenosis, and 21.6% had simultaneous anterior and posterior cerebral artery stenosis. Smokers showed higher extracranial artery involvement compared to non-smokers; 44% of smokers and 14% of non-smokers had extracranial vertebral involvement
Our findings showed that intracranial artery involvement was the most prevalent finding in patients with thrombotic stroke in Kerman. Also posterior cerebral artery stenosis was more prevalent than anterior artery stenosis. Hypertension was the most common risk factor. Furthermore, smoking was considered as an important risk factor for extracranial artery stenosis, especially in the posterior cerebral artery.