فهرست مطالب

Arya Atherosclerosis
Volume:15 Issue: 3, May 2019

  • تاریخ انتشار: 1398/04/26
  • تعداد عناوین: 8
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  • Majid Chinikar, Mohammad Rafiee, Mohammadreza Aghajankhah, Mahboobeh Gholipour, Tolou Hasandokht, Vali Imantalab, Ali Mirmansoori, Ali Mohammadzadeh, Nasir Nasiri, Sheikhani, Moona Naghshbandi, Mahsa Pourabdollah, Mohammad Esmaeil Rezaee, Abbass Seddighinejad, Alimohammad Sadeghi, Heidar Dadkhah* Pages 99-105
    BACKGROUND
    Coronary artery bypass grafting (CABG) surgery is widely accepted as a revascularization method for coronary artery disease (CAD). Despite survival benefit and improvement in quality of life, CABG may impose major morbidities and significant complications. Right ventricle (RV) dysfunction is an important complication that may affect patient's longevity and functional capacity. The aim of this study was to evaluate the relationship between RV dysfunction and some invisible parameters like inferior vena cava (IVC) size with physical capacity.
    METHODS
    In this prospective study, 61 eligible CABG candidates were enrolled and RV function was assessed by echocardiographic parameters before CABG and one week and six months after the procedure, using tricuspid annular plane systolic excursion (TAPSE), Tei Index (TI), peak systolic movement (Sm) (cm/s), and IVC size. Functional capacity was assessed by six-minute walk test (6-MWT) 6 months after CABG.
    RESULTS
    58 patients who did not have any perioperative RV dysfunction were remained until the end of study; mean age was 58.2 ± 7.9 years with 68.9% being men, and 3 patients died after CABG. Preoperatively, septal motion, RV indices, and IVC size were normal in all patients. The frequency of RV dysfunction according to abnormal TAPSE index, TI, and peak Sm one week after surgery was 81.0%, 79.0%, and 62.0%, respectively, and 6 months after surgery was 49.0%, 49.0%, and 37.0%, respectively. Mean walked distance in 6-MWT was significantly less in patients with RV dysfunction, older age, and higher number of involved vessels (P < 0.001).
    CONCLUSION
    The significant reduction in RV function and impairment of exercise capacity after CABG in this study suggests cardiologists to pay more attention to RV assessment in follow-up visits of patients undergoing GABG.
    Keywords: Coronary Artery Bypass Surgery, Right Ventricle, Inferior Vena Cava
  • Amir Saifipour, Amirhossein Azhari*, Ali Pourmoghaddas, Sayed Mohsen Hosseini, Tohid Jafari, Koshki, Mojtaba Rahimi, Ali Nasri, Mansour Shishehforoush, Ahmadreza Lahijanzadeh, Babak Sadeghian, Elham Moazam, Mohammad Bagher Mohebi, Victoria Ezatian, Katayoun Rabiei, Nizal Sarrafzadegan Pages 106-112
    BACKGROUND
    Many studies have shown the worst effects of air pollution on cardiovascular diseases (CVDs). Present study focused on the relationship between atrial fibrillation (AF), as one of the common arrhythmias, and air pollutants in Isfahan, Iran, an industrial city in the Middle East.
    METHODS
    A case-crossover design was used to explore the associations between air pollution and AF hospitalized patients with ventricular response (VR) > 90 beats per minute (bpm) (fast response) and those with VR ≤ 90 bpm. All patients' records were extracted from their hospital files. Air pollutants data including particulate matter less than 10 µ (PM10), PM2.5, carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) were obtained from the Correlation of Air Pollution with Hospitalization and Mortality of Cardiovascular and Respiratory Diseases (CAPACITY) study. Conditional logistic regression test was used to measure the relationship between pollutants and hospitalization due to AF.
    RESULTS
    Records of 369 patients, including 173 men (46.9%) who were hospitalized for AF during the study period and had complete data were extracted. Although a positive but not statistically significant relationship was shown between 10-unit increases in all pollutants (except PM10) and the hospitalization due to AF in patients with rapid VR (RVR), the only significant relationship was observed in case of NO2 [odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.0-2.1, P = 0.031].
    CONCLUSION
    This study showed positive significant relationships between NO2 and the hospitalization due to AF in patients with RVR. NO2 is a greenhouse gas whose levels are expected to increase due to global environmental changes. Therefore, relevant strategies should be adopted to decrease its levels, especially in industrial cities like Isfahan.
    Keywords: Air Pollution, Atrial Fibrillation, Nitrogen Dioxide
  • Fatemeh Rajati*, Mojgan Rajati Pages 113-122
    BACKGROUND
    The assessment of exercise self-efficacy in patients with cardiovascular disease (CVD) is necessary to conduct tailored interventions. The aim of the current study was to validate the Iranian version of the Cardiac Exercise Self-efficacy Scale (CESE) for patients with CVD.
    METHODS
    To develop the Iranian version of the CESE scale, a forward and back translation procedure was followed. Data were collected from 260 patients with CVD who were admitted to Imam Ali Cardiovascular Hospital, Iran, using convenience sampling. Psychometric properties of the scale including validity (face and content validity, discriminant, concurrent, convergent, divergent, and construct validity) and reliability (internal consistency, and test-retest reliability) were assessed. SPSS software was used for statistical analysis.
    RESULTS
    The questionnaire had a good face and content validity and reliability, with Cronbach's alpha of 0.87 and intraclass correlation coefficient (ICC) of 0.42. The questionnaire discriminated well between subgroups according to their medical conditions and the “health transition” item in the Short-Form Health Survey (SF-36). There was a significant correlation between CESE and the physical components of the SF-36 (P < 0.001). In addition, a strong to moderate significant correlation was found between the CESE and the Exercise Self-efficacy Scale (ESES) (r = 0.77; P < 0.01) and between CESE and the Hospital Anxiety and Depression Scale (HADS) total (r = -0.45; P < 0.001). The exploratory factor analysis (EFA) identified a four-factor structure model, explaining 71.02% of the observed variance.
    CONCLUSION
    The Persian version of the CESE is a valid and reliable instrument for the evaluation of CVD patients’ exercise self-efficacy level in performing regular exercise behaviors.
    Keywords: Exercise, Self-Efficacy, Cardiovascular Diseases, Validity, Reliability, Iran
  • Firoozeh Sajjadi, Noushin Mohammadifard, Maryam Maghroun, Fatemeh Shirani, Simin Karimi, Marzie Taheri, Nizal Sarrafzadegan* Pages 123-129
    BACKGROUND
    Lifestyle modification is the most important strategy for control of obesity and overweight. Obestatin and adiponectin are the biomarkers of obesity. Thus, this study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on obesity anthropometric as well as obestatin and adiponectin levels.
    METHODS
    This semi-experimental study was conducted on a subsample of TABASSOM study. Participants were 41 overweight and obese children and adolescents aged 6-18 years old and 45 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including height, weight, waist and hip circumferences, and body fat percentage (BFP) were measured at the first and after one year at the end of study. We implemented some educational and encouragement interventions regarding dietary modification and physical activity during the study. Obestatin and adiponectin levels were measured at the first and end of study by enzyme-linked immunosorbent assay (ELISA) method.
    RESULTS
    The study did not show significant effect on anthropometric characteristics such as body mass index (BMI) and waist circumference (WC). BFP decreased significantly in boys, total children and adolescent group, and waist-to-hip ratio (WHR) decreased significantly only in adolescent boys after 1 year (P < 0.050).
    CONCLUSION
    Educational and encouraging interventions and lifestyle modifications could lead to decrease of body WHR and BFP in adolescent boys. This is helpful in controlling the increasing rate of obesity.
    BACKGROUND
    Lifestyle modification is the most important strategy for control of obesity and overweight. Obestatin and adiponectin are the biomarkers of obesity. Thus, this study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on obesity anthropometric as well as obestatin and adiponectin levels.
    METHODS
    This semi-experimental study was conducted on a subsample of TABASSOM study. Participants were 41 overweight and obese children and adolescents aged 6-18 years old and 45 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including height, weight, waist and hip circumferences, and body fat percentage (BFP) were measured at the first and after one year at the end of study. We implemented some educational and encouragement interventions regarding dietary modification and physical activity during the study. Obestatin and adiponectin levels were measured at the first and end of study by enzyme-linked immunosorbent assay (ELISA) method.
    RESULTS
    The study did not show significant effect on anthropometric characteristics such as body mass index (BMI) and waist circumference (WC). BFP decreased significantly in boys, total children and adolescent group, and waist-to-hip ratio (WHR) decreased significantly only in adolescent boys after 1 year (P < 0.050).
    CONCLUSION
    Educational and encouraging interventions and lifestyle modifications could lead to decrease of body WHR and BFP in adolescent boys. This is helpful in controlling the increasing rate of obesity.
    Keywords: Obesity, Overweight, Adults, Children, Adolescents, Obestatin, Adiponectin
  • Imran Khan*, Ahmad Shahbaz, Madeeha Iqbal, Abdul Rehman Khan, Waseem Riaz, Muhammad Sabeeh Sayyed, Kamran Khan Pages 130-135
    BACKGROUND
    Right ventricular (RV) function is a major determinant of clinical outcome, but its function indices have not been studied well in surgery for rheumatic valvular heart disease. The aim of this study was to determine the correlation of tricuspid annular plane systolic excursion (TAPSE) with outcome of rheumatic heart valve surgery.
    METHODS
    A prospective comparative study was conducted including 100 eligible patients who were divided into two groups based on RV function as assessed by TAPSE measured by two-dimensional (2D) echocardiography preoperatively. Those with TAPSE less than 15 mm were included in group 1 and those with TAPSE of 15 or more were included in group 2.
    RESULTS
    50 patients were included in group 1 and 50 patients in group 2. Mean age of the patients was 56.78 ± 15.21 years in group 1 and 54.46 ± 15.03 years in group 2 (P = 0.444). 34 (34%) patients underwent aortic valve replacement (AVR), 35 (35%) underwent both aortic and mitral valves replacement, and 31 (31%) ones had mitral valve replacement (MVR). A significant difference was found between the duration of ventilation (5.15 ± 2.80 hours in group 1 vs. 3.72 ± 2.71 hours in group 2, P = 0.001), postoperative inotropic requirement [more than 24 hours in 18 (36%) patients in group 1 vs. 7 (14%) patients in group 2, P = 0.003], total intensive care unit (ICU) stay (8.92 ± 3.62 days in group 1 vs. 5.20 ± 2.06 days in group 2, P = 0.001), and mortality [7 (14%) in group 1 vs. 2 (4%) in group 2, P = 0.038].
    CONCLUSION
    TAPSE less than 15 mm in patients undergoing surgical correction for rheumatic valvular heart disease leads to poor outcomes. These patients need special attention perioperatively.
    Keywords: Rheumatic Heart Diseases, Right Ventricle, Cardiac Surgery
  • Soudabe Motamed, Mohsen Mazidi, Mohammad Safarian, Majid Ghayour, Mobarhan*, Mohsen Mouhebati, Mahmoud Ebrahimi, Mahmoudreza Azarpazhouh, Alireza Heidari, Habibollah Esmailie, Ahmadreza Baghestani, Andre Pascal Kengne, Gordon AA Ferns Pages 136-145
    BACKGROUND
    We aimed to compare dietary macronutrient intake and physical activity level (PAL) between community-based samples of Iranian adults with metabolic syndrome (MetS+) and without metabolic syndrome (MetS-).
    METHODS
    This cross-sectional study was conducted among 3800 men and women aged
    35-65 years. The International Diabetes Federation (IDF) criteria were used to define MetS. A 24-hour recall was used to evaluate dietary intake. The James and Schofield human energy requirements equations were used to calculate PAL and questions were categorized into time spent on activities during work (including housework), during non-work time, and in bed.
    RESULTS
    The mean ± standard deviation (SD)age of the MetS+ and MetS- subjects was, respectively, 48.8 ± 7.8 years (521 men and 1178 women) and 47.6 ± 7.5 years (714 men and 1222 women) (P = 0.93). The mean energy intake was higher in the MetS+ men compared with MetS- men (1977.4 ± 26.6 vs. 1812.7 ± 21.7 Kcal; P < 0.001). Crude and energy-adjusted intake from total fat was lower in MetS+ women compared with MetS- women (both P < 0.01). PALs were lower in MetS+ compared with MetS- participants (P < 0.001). After adjusting for confounders, no significant association was observed between the intake of individual macronutrients and MetS. In contrast, PAL was inversely associated with the incidence of MetS (OR = 0.34 [95% CI: 0.17-0.57]; P < 0.001).
    CONCLUSION
    In the current study, there was an inverse relationship between PAL and the risk of MetS, but no association between individual dietary macronutrients intake and the incidence of MetS.
    Keywords: Nutritional Assessment, Basal Metabolic Rate, Physical Activity
  • Mohammad Akbari, Masoumeh Sadat Mousavi, Farimah Shirani*, Gholamreza Massoumi, Mohammadreza Shafeie, Reyhaneh Niknejad, Parvaneh Khourasani, Mousa Alavi, Ahmad Ghadami Pages 146-151
    BACKGROUND
    Low health literacy can act as a barrier to effective disease self-management. The study aimed to promote heart health literacy in Iranian society.
    METHODS
    This study was conducted as a participatory action research (PAR) based on Zuber-Skerritt Model to design and implement a program for promoting heart health literacy in Iranian society. Participants were selected among adults with heart diseases and their family members, as well as their health care providers in Chamran Hospital, Isfahan Heart Friends association and researchers, and Isfahan Cardiovascular Research Institute, Isfahan, Iran. Data collection was conducted using interviews. Content analysis was used to analyze the data to promote heart health literacy. Promoting of heart health literacy was implemented in different levels in Isfahan from March 2017 to October 2017. The effect of the program was evaluated based on interviews, feedback, and focus groups at the individual level.
    RESULTS
    Finally, at the World Heart Week, a healthy heart campaign was formed with the slogan "Share the power". At the end of this program, participants experienced significant empowerment during the project to promote heart health literacy. The three main themes indicating this feeling of empowerment were “Being worried about the hearts of others”, “Sensitization to the care of the heart”, and “General understanding of heart health”.
    CONCLUSION
    PAR can be an effective way to promote heart health literacy in Iranian society. It integrates the voices of the marginalized group promoting heart health literacy in Iranian society.
    Keywords: Heart, Health Literacy, Action Research, Iran
  • Behzad Heydarpour, Maryam Ahmadi, Saeid Komasi Pages 152-153