Arya Atherosclerosis
Volume:14 Issue: 4, Jul 2018

Several studies have suggested that temperature may have an effect on the number of cardiovascular deaths in societies. Global warming is a concern, and cardiovascular diseases are the top cause of death worldwide. This study investigated the relation between temperature and cardiovascular mortality in Shiraz City, Iran. In this ecological study, data about temperature and cardiovascular deaths (in age and gender groups) in Shiraz City were inquired from 2006 to 2012. The simultaneous and delayed relation between monthly temperature and cardiovascular deaths was examined using Spearman and Pearson correlation tests, and crude and adjusted negative binomial regression analysis with adjustment for confounding factors such as humidity, rainfall, wind direction, wind speed, and air pollutants. Analysis was done using MINITAB and STATA software. During this period 17,167 deaths were reported in Shiraz. The lowest number of cardiovascular deaths was reported in 20 °C. No significant relation was observed between mean monthly temperature and cardiovascular deaths in the same month after adjusting for confounding factors. Although, cardiovascular death in 18- to 60-year-old people showed an inverse significant relation with minimum [Incidence rate ratio (IRR) = 0.98989, P = 0.020], maximum (IRR = 0.99046, P = 0.011), and mean temperature (IRR = 0.98913, P = 0.006) of the same month in the crude model, it was not significant in the adjusted model (IRR = 0.99848, P = 0.848, IRR = 0.99587, P = 0.584, and IRR = 0.99512, P = 0.506, respectively). It seems that there is no significant relation between temperature and cardiovascular deaths in Shiraz, which is probably due to its moderate climate, and the fact that no major heat or cold wave occurred during this time.

Matrix metalloproteinase 9 (MMP-9) is involved in extracellular matrix degradation and remodeling. An increase in MMP-9 expression by vascular component cells plays an important role in atherosclerotic plaque formation and rupture. Resveratrol, a polyphenolic substance, was suggested to play a role in preventing the progress of atherosclerotic disease. The aim of this study was to investigate the effect of resveratrol on MMP-9 and tissue inhibitors of metalloproteinases (TIMPs) in vascular smooth muscle cells (VSMCs) after treatment with H2O2. Cultured VSMCs were pre-treated with 0.2 mM of H2O2 before stimulation with different concentration of resveratrol. Expression of MMP-9, TIMP-1, and TIMP-3 genes were measured using real-time polymerase chain reaction (PCR) method, and MMP-9 protein level was detected using western blot analysis. Resveratrol at 120 μmol/l concentration reduced the elevated level of MMP-9 induced by H2O2 in VSMCs as 1.85 ± 0.35 folds (P < 0.05) and 8.70 ± 1.20 folds (P < 0.05) after 24 and 48 hours, respectively. Resveratrol increased the diminished level of TIMP-1 induced by H2O2 as 2.5 ± 0.48 folds following the treatment with 120 μmol/l after 48 hours (P < 0.05). Resveratrol as an antioxidant can decrease MMP-9 production, not only by suppressing MMP-9 expression, but also by augmenting TIMP-1 production. Altogether, resveratrol as an antioxidant can regulate the MMP-9/TIMP-1 balance, and may be considered as a preservative agent in the treatment and prevention of atherosclerosis.

Risk assessment in clinical practice plays an important role in classifying population for appropriate preventive medicine for each category. Several multivariable risk predictor algorithms and inflammatory biomarkers are developed for assessing risk for cardiovascular diseases (CVDs). We aimed to depict a picture of the cardiovascular risk profiles in the Iranian population with diabetes mellitus (DM) through three risk predictors for the first time, as the patients with DM have an increased risk for CVDs. In this cross-sectional study, the sample size consisted of 418 patients with DM from Diabetes Clinic of Shariati hospital, Isfahan, Iran, in February to July, 2014. We collected the latest information, and then calculated the 10-year CVD risk using Framingham risk score (FRS) and atherosclerotic cardiovascular disease (ASCVD) risk score; while high-sensitivity C-reactive protein (hs-CRP) was measured for them based on their physicians' prescription. Finally, all data were analyzed using SPSS software. The mean 10-year risk prediction of CVDs in the 30- to 74-year-old Iranian patients with DM was high in all three predictors based on their cut-off points, 16.31%, 12.39%, and
3.46 mg/l for FRS, ASCVD risk score, and hs-CRP level, respectively. Although the mean FRS and ASCVD risk scores were significantly higher among men than women (P < 0.0500), the mean hs-CRP level was slightly lower in men than women (P > 0.0500). Mean FRS and ASCVD risk scores and hs-CRP in patients were high, and a considerable proportion of patients with DM in our study were at intermediate and high risk for CVDs in the next 10 years. Future cohort studies would investigate the accuracy of different predictors in upcoming years, and also help to derive a specific model or recalibrate existing predictors with characteristic of Iranian populations and specific target groups.

Central obesity is a common health disorder, and the main objective of this study was to compare its changings among rural women in the north of Iran, between the years 2004 and 2013. Two cross-sectional studies were established on the 2839 and 2478 subjects in 2004 (first stage) and 2013 (second stage), respectively. Among 118 villages, 20 were selected using random sampling; they were the same in two studies. Central obesity was defined as waist circumference (WC) > 88 cm, waist-to-hip ratio (WHR) > 0.8, and waist-to-height ratio (WHtR) > 0.5. The prevalence of central obesity in 2013 based on WC, WHR, and WHtR were 37.4%, 73.5%, and 67.8%, respectively. Compared with 2004, the prevalence of central obesity based on WHR increased as 5.4% (68.1% vs. 73.5%) (P = 0.001), whereas morbid obesity (WHtR > 0.6) based on WHtR decreased as 3.7% in 2013 (28.8% vs. 25.1%) (P = 0.004). Central obesity based on WHR significantly decreased in less or equal 24-year-old group (76.6% vs. 70.1%) (P = 0.003), while it increased in 25-34- (65.1% vs. 74.0%) and in equal or more than 35-year-old group (54.1% vs. 78.9%) (P = 0.001 for all). Moreover, morbid obesity decreased in all age, economic, and education groups (except uneducated one) (P < 0.050 for all). Despite the decrease in central obesity based on WC and WHR indices in 2004-2013 duration, we found the evidence of a decline in sever obesity based on WHtR in that period. These trends have an alarm for health policy makers, not only in this area but also in same communities. Comprehensive studies are recommended to determine the best obesity indicator related to health in future

Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases (CHD) in children. Various surgical procedures including palliative shunts and TOF total correction (TFTC) were done with some complications, of which, the most common is pulmonary valve regurgitation (PR). Tadalafil is a phosphodiesterase 5 inhibitor which reduces pulmonary vascular resistance, and improves right ventricular function and vascular endothelium, and may have some beneficial effects after TFTC. We studied 18 patients with TOF and PR, with some impaired right ventricular function after TFTC. Tadalafil tablets at a dose of 1 mg per kg (maximum 40 mg) per day as a single dose was administered orally for 8 weeks. In all patients, before and after taking tadalafil, functional class assessment, electrocardiography (ECG) changes, some echocardiographic and endothelial function parameters [flow-mediated dilation (FMD) and intima-media thickness (IMT) of carotid artery], and exercise test were determined. The patient’s mean age was 10.11 ± 4.03 years, and the mean age of operation was 2.52 ± 1.12 years. The effect of tadalafil on different echocardiographic parameters and also on tricuspid valve regurgitation (TR) and PR severity and gradient was not significant. Moreover, it had no effects on QRS duration. Tadalafil had a significant effect on improving FMD and exercise test (P = 0.01). The effect of tadalafil on echocardiographic parameters, carotid artery IMT, and ECG parameters was not significant (P > 0.05). Tadalafil was tolerated well, and the most common side effects were headache and myalgia. This study showed that tadalafil is a safe and well-tolerated drug. It might improve exercise performance, endothelial function, and functional class, and possibly could allow patients a longer period of well-being and could possibly delay the need for pulmonary valve replacement (PVR).

Cardiovascular diseases are a major cause of morbidity and mortality. Chronic inflammation is an important risk factor for atherosclerosis, and viral infections can cause cardiovascular disease by developing inflammation. Infection with human T-lymphotropic virus (HTLV) is endemic in some parts of the world such as Japan, Africa, Caribbean islands, South America, and Iran. HTLV-1 is an oncogenic retrovirus, and can cause adult T-cell leukemia/lymphoma (ATL or ATLL). It also causes HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). A number of inflammatory diseases such as uveitis, arthritis, and Sjogren's syndrome are also associated with the virus. A few case reports have shown the direct involvement of the heart in HTLV-1-positive patients who develop ATLL. The purpose of this study was to review the literature relevant with the role of HTLV in cardiovascular diseases.