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Arya Atherosclerosis - Volume:14 Issue: 2, Mar 2018

Arya Atherosclerosis
Volume:14 Issue: 2, Mar 2018

  • تاریخ انتشار: 1397/03/20
  • تعداد عناوین: 8
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  • Beydolah Shahouzehi, Hamid Reza Nasri, Yaser Masoumi-Ardakani Pages 46-52
    Background
    Thalassaemia is a hereditary disorder and has an economic burden on patients and the government. The most prevalent complication in these patients is iron overload which is followed by cardiomyopathy. Digoxin is considered as a treatment against heart failure in thalassaemia. The present study evaluated the effect of two digoxin concentrations on iron content and antioxidative defense in cardiac tissue of iron-overloaded rats.
    Methods
    The study was conducted on 48 rats which were divided into 6 groups. Group 1 was the control group and did not receive any treatment and group 2 was the iron overload group. In addition groups 3 and 4 were the digoxin control groups which received 1 and 5 mg/kg/day of digoxin, respectively. Groups 5 and 6 received 1 and 5 mg/kg/day of digoxin plus iron-dextran, respectively. After 1 month, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPX), and total antioxidant status (TAS) were assessed in cardiac tissues.
    Results
    Co-administration of iron-dextran and digoxin (1 and 5 mg/kg/day) significantly increased SOD and TAS levels (P
    Conclusion
    Digoxin remarkably facilitates iron uptake by cardiomyocytes by affecting other channels such as L-type and T-type Ca2 channels (LTCC and TTCC). Digoxin administration in the iron-overloaded rat model deteriorated antioxidative parameters and increased iron entry into heart tissue at higher doses. Therefore, in patients with beta thalassaemia major, digoxin must be administered with great care and serum iron and ferritin must be regularly monitored.
    Keywords: Digoxin, Iron Overload, Superoxide Dismutase, Glutathione Peroxidase
  • Fazele Atarbashi-Moghadam, Seyed Rohollah Havaei, Seyed Asghar Havaei, Nafiseh Sadat Hosseini, Gholamreza Behdadmehr, Saede Atarbashi-Moghadam Pages 53-57
    Background
    Atherosclerosis and periodontitis are both chronic inflammatory diseases. Although a strong relationship between the two has already been established, the underlying mechanism is unknown. The present study was conducted aiming to detect the deoxyribonucleic acid (DNA) of Aggregatibacter actinomycetemcomitans (A.a), Campylobacter rectus (C.r), and Porphyromonas gingivalis (P.g) in subgingival and atherosclerotic plaques of patients with both chronic periodontitis and cardiovascular disease (CVD).
    Methods
    In this cross sectional study, patients with coronary artery disease (CAD) and moderate to severe periodontitis which were scheduled for coronary artery bypass grafting (CABG) were enrolled in the study. The subgingival plaques were collected before surgery. All samples were examined for the detection of selected periopathogens using polymerase chain reaction (PCR).
    Results
    The subgingival and atherosclerotic plaque samples of 23 patients were examined. The DNA of P.g, A.a, and C.r were found to be positive in 43.47%, 43.47%, and 78.26% of subgingival plaques, and 13.04%, 17.39%, and 8.69% of atherosclerotic plaques, respectively. In all cases, the bacterial species found in atherosclerotic plaques were also found in the subgingival plaques of the same patient.
    Conclusion
    This study demonstrated the presence of periopathogens in atherosclerotic plaques of patients with chronic periodontitis. More studies are required to ascertain the exact role of these periopathogens in atherosclerotic plaque formation.
    Keywords: Atherosclerosis, Coronary Artery Disease, Chronic Periodontitis, Porphyromonas Gingivalis, Aggregatibacter Actinomycetemcomitans, Campylobacter Rectus
  • Fatemeh Nouri, Awat Feizi, Noushin Mohammadifard, Nizal Sarrafzadegan Pages 58-70
    Background
    The aim of this study was describing the sampling methods and sample size of the Isfahan Healthy Heart Program (IHHP) and its sub-studies in focus.
    Methods
    The IHHP was carried out between 2000 and 2007 in urban and rural areas in 3 districts, namely Isfahan and Najafabad (as the intervention areas), and Arak (as the reference area), Iran. It consisted of the 3 phases of baseline surveys during 2000-2001, interventions between 2002 and 2005, and post-intervention surveys during 2006-2007 on 4 target groups (adults, health professionals, cardiac patients, children, and adolescents). During 2002 to 2005, 4 evaluation studies were conducted to evaluate short-term results. An ongoing cohort study entitled the Isfahan Cohort Study was performed on those aged ≥ 35 years at baseline in 2001 to access the risk of cardiovascular disease (CVD) occurrence.
    Results
    Using stratified random cluster methods, 12514, 5891, 4793, 6096, 3012, and 9572 adults and 1946, 1999, 1427, 1223, 389, and 1992 adolescents were chosen in the 1st to 3rd phases. Furthermore, simple random sampling was used for selecting 923, 694, 1000, and 2015 health professionals and 814, 452, 420, and 502 cardiac patients. A multistage sampling method was adopted for the collection of samples from parents of preschoolers and primary school children aged 2-10 years, adolescents’ parents, and some teachers. A prospective cohort study was started on 6504 illegible individuals.
    Conclusion
    The IHHP, as a comprehensive community-based interventional trial in Iran, among the few population-based
    Keywords: Isfahan Healthy Heart Program, Cardiovascular Disease, Sample Size, Sampling Design
  • Fereshteh Asgharzadeh, Rahimeh Bargi, Mahmoud Hosseini, Mehdi Farzadnia, Majid Khazaei Pages 71-77
    Background
    Subclinical inflammation induced by persistent exposure to lipopolysaccharide (LPS) is found in some clinical conditions such as obesity or diabetes. This study aimed to investigate the effect of recurrent LPS exposure on inflammatory markers, oxidative stress balance and cardiac and renal fibrosis in male rats.
    Methods
    Male Wistar rats were divided into control and LPS-treated. LPS (10 mg/kg/week) was injected intraperitoneally. After 4 weeks, left ventricles and kidneys were homogenized and stained with hematoxylin and eosin (H&E) and Masson trichrome for histological examination. Serum levels of nitrite, interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured and total thiol, malondialdehyde (MDA), superoxide dismutase (SOD) and catalase were evaluated in the heart and kidney homogenates.
    Results
    Serum inflammatory markers were higher in LPS group than control (nitrite: 37.0 ± 2.2 vs. 25.5 ± 1.9 µmol/l; IL-6: 84 ± 3 vs. 98.0 ± 4.4 pg/ml; TNF-α: 75.5 ± 4.9 vs.
    85.3 ± 4.7 pg/ml; respectively, P
    Conclusion
    We concluded that in clinical conditions with chronic LPS, cardiac and renal fibrosis occurs even in absence of preceding tissue injury due to imbalances in oxidative stress.
    Keywords: Inflammation, Lipopolysaccharide, Oxidative Stress, Heart, Kidney
  • Javad Shahabi, Reihaneh Zavar, Afshin Amirpour, Mohammad Bidmeshki, Melinaz Barati-Chermahini Pages 78-84
    Background
    Acute pulmonary thromboembolism (PTE) is a common disease with a high mortality rate, and a variable and nonspecific clinical presentation. To detect the nonspecific signs and symptoms associated with this condition, several right ventricular (RV) echocardiographic parameters have been proposed as practical marker.
    Methods
    This cross-sectional study was performed on 93 patients with PTE diagnosed by computed tomography (CT) angiography, and 57 patients with negative PTE based on CT angiography. During the experiment, all patients underwent both transthoracic echocardiography (TTE) and multi-slice CT pulmonary angiography. Transthoracic echocardiography measurements were obtained as patients went through both experimental procedures. These measurements were later compared between the patients with and without PTE.
    Results
    Tricuspid annulus plain systolic excursion (TAPSE) (1.65 ± 0.09 vs. 2.00 ± 0.08 cm, P
    Conclusion
    TTE may be valuable as a substitute diagnostic method for patients with PTE. This technique may also assist in detecting the severity of the illness, by evaluating RV/LV in cut-off point of 0.6898.
    Keywords: Pulmonary Thromboembolism, Transthoracic Echocardiography, Computed Tomography Angiography
  • Masoumeh Sadeghi, Hossein Khosravi-Broujeni, Amin Salehi-Abarghouei, Ramin Heidari, Gholamreza Masoumi, Hamidreza Roohafza Pages 85-94
    Background
    This systematic review and meta-analysis aimed to assess the effect of cardiac rehabilitation (CR) on serum C-reactive protein (CRP) as an indicator of the inflammatory state and predictor of recurrent cardiovascular events.
    Methods
    PubMed, SCOPUS, Cochrane library, and Google Scholar databases were searched up to January 2014 for original articles which investigated the effect of CR on CRP among adult patients with previous cardiovascular events. The random effects model was used to assess the overall effect of CR on the variation in serum CRP levels.
    Results
    In the present systematic review and meta-analysis, 15 studies were included. The analysis showed that CR might significantly reduce hs-CRP levels [Difference in means (DM) = -1.81 mg/l, 95% confidence interval (CI): -2.65, -0.98; P = 0.004). However, the heterogeneity between studies was significant (Cochran's Q test, P
    Conclusion
    Both short and long term CR has resulted in improvement in serum hs-CRP levels. CR can be perceived as a beneficial tool to reduce inflammatory markers among patients with previous cardiac events.
    Keywords: Cardiac Rehabilitation, Inflammation, C-Reactive Protein
  • Farshad Roghani-Dehkordi, Omid Hashemifard, Masoumeh Sadeghi, Rohollah Mansouri, Mehdi Akbarzadeh, Asieh Dehghani, Mojtaba Akbari Pages 95-100
    Background
    Trans-radial and trans-ulnar accesses have been practiced and recommended as default and alternative techniques for coronary angiography and angioplasty in recent years. In this study, we present new innovative approaches using more distal access points, i.e. trans-snuff box and trans-palmar approaches.
    Methods
    We conducted dorsal hand access (trans-snuff box) for angiography and/or angioplasty on 235 patients, and trans-palmar access (superficial palmar branch of ulnar artery) on 175 patients in 3 hospitals in Isfahan City, Iran.
    Results
    In 221 patients out of 235 ones (94.1%) (men: 76.5%, age: 57.4 ± 10.4 years; women: 23.5%, age: 62.4 ± 9.5 years), our procedure through snuff box (dorsal hand) was successfully performed. In 159 patients out of 175 ones (90.8%) [men: 76.0%, age: 58.1 ± 10.5 (years); women: 24.0%, age: 61.2 ± 9.6 (years)], our procedure through palmar artery was successfully performed. In total, the evaluated patients had mild pain (3.4% for snuff box, and 4.5% for palmar), ecchymosis in distal forearm (5.1% for snuff box, and 2.8% for palmar), with no major complications even one (amputation, infection, thrombosis, need for surgery, hand dysfunction, nerve palsy, and so forth). In addition, percutaneous coronary intervention (PCI) was done in 28.9% and 18.2% of cases via snuff box and palmar approaches, respectively. Meanwhile, hemostasis was very fast and easy with discharge time equivalent to other upper limb accesses.
    Conclusion
    Although our procedures are at their early stages with about a follow-up period of 3-15 months, more researches are recommended to be conducted in forthcoming months and years, and this new innovative approaches could be suggested safe, feasible, and reliable with low complications.
    Keywords: Trans-Palmar Approach, Trans-Snuff Box Approach, Coronary Angiography, Coronary Angioplasty, Distal Aaccesses, Novel Accesses
  • Mohsen Yaghubi, Hossein Dinpanah, Fahimeh Ghanei- Motlagh, Samaneh Kakhki, Reza Ghasemi Pages 101-104
    Background
    Amyloidosis is a severe systemic disorder produces by the accumulation of inappropriately amyloid deposition in tissues. Cardiac involvement, as a main type of amyloidosis, has a major impact on prognosis. We describe a biopsy-proven cardiac amyloidosis in an old man with unexpected presentation.
    CASE REPORT: A 70-year-old man, with a complaint of severe weakness, lightheadedness, and lower limb paresthesia, was admitted to the emergency department. Electrocardiography revealed right bundle branch block and Trifascicular block. Echocardiography study showed a moderately increased thickness of left ventricular wall with concentric pattern as well. Laboratory investigations including serum and urine electrophoresis, and serum free light chain examination as immunofixation assay revealed that κ chains predominated over λ chains in a ratio of 3:2. Our patient with final diagnosis of amyloid light-chain (AL) amyloidosis underwent chemotherapy with melphalan combined with high-dose dexamethasone, CPHPC and monoclonal antibodies for 2 weeks.
    Conclusion
    It shows that rapid diagnosis of AL amyloidosis can enhance the prognosis. Applying an optimal strategy for the treatment leads to effective therapy, too.
    Keywords: Amyloidosis, Bundle branch block, Echocardiography