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Cardiovascular Research Journal - Volume:10 Issue: 3, Sep 2016

International Cardiovascular Research Journal
Volume:10 Issue: 3, Sep 2016

  • تاریخ انتشار: 1395/05/08
  • تعداد عناوین: 9
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  • Kamran Aeinfar, Ata Firouzi *, Hossein Shahsavari, Hamidreza Sanati, Reza Kiani, Farshad Shakerian, Ali Zahed Mehr Page 107
    Background
    No-reflow phenomenon is a serious complication of primary Percutaneous Coronary Intervention (PCI), which may increase the risk of progressive myocardial damage, profound left ventricular dysfunction, and death..
    Objectives
    This study aimed to investigate the incidence of no-reflow phenomenon and its clinical, para-clinical, and angiographic determinants in patients who underwent primary PCI for ST Elevation Myocardial Infarction (STEMI)..
    Patients and
    Methods
    This non-randomized prospective cohort study was conducted on 397 patients in a cardiovascular tertiary care center in Tehran, Iran from April 2012 to April 2014. The inclusion criteria of the study were presenting with acute STEMI of ≤ 12 h duration or having admitted between 12 and 24 hours after onset with symptoms and signs of ongoing ischemia. The participants underwent standard coronary angiography. No-reflow phenomenon was defined as a Thrombolysis In Myocardial Infarction (TIMI) flow ≤ 2 and no presence of spasm, distal embolization, or dissection after completion of the procedure. The association between no-reflow and its determinants was assessed by chi-square, student’s t-test, or Mann–Whitney U test. Logistic regression models were also used for multivariate analysis. P values
    Results
    The participants’ mean (SD) age was of 59 (12.2) years and female/male ratio was 83/314. The incidence of no-reflow phenomenon was 63 (15.9%). Besides, the results of multivariate analysis showed that only thrombus burden, lesion length, time to reperfusion, and type of occlusion had an adjusted association with this phenomenon..
    Conclusions
    The study results suggested that no-reflow phenomenon after primary PCI would be predictable. Thus, preventive measures, such as using distal protective devices or administration of platelet glycoprotein IIb/IIIa antagonists, are advised to be used in high-risk patients..
    Keywords: Myocardial Infarction, Angioplasty, Balloon, No, Reflow Phenomenon, Myocardial Reperfusion
  • Firoozeh Abtahi, Mohammad Javad Zibaeenezhad, Fatemeh Shafazadeh, Maryam Tahamtan* Page 113
    In conclusion, our results suggested that increasing degrees of pulmonary artery systolic pressure affected timing of some tissue Doppler-derived intervals within the cardiac cycle, including IVC time, time to peak systolic myocardial velocity (Sm), and time to peak strain. Therefore, tissue Doppler imaging could be used in assessment of patients with suspected pulmonary arterial hypertension..
    Background
    Pulmonary hypertension is an untreatable condition with poor prognosis and factors such as more elevated pulmonary arterial systolic pressure and right ventricular dysfunction are associated with a worse outcome..
    Objectives
    Considering the limitations of the current modalities, this study aimed to find the relationship between tissue Doppler-derived systolic and diastolic parameters and elevated pulmonary arterial pressure in order to assess the routine application of tissue Doppler imaging in evaluation of pulmonary arterial hypertension..
    Patients and
    Methods
    This study was conducted on 100 inpatient and outpatient individuals referred to the Department of Echocardiography in Shahid Faghihi hospital, Shiraz, Iran from July 2012 to March 2013. The individuals who had preserved right ventricular function in the presence of pulmonary arterial hypertension were included in the case group. On the other hand, the patients who did not have echocardiographic signs of pulmonary arterial hypertension were enrolled into the control group. All the patients underwent a complete transthoracic echocardiogram including 2-dimensional, color flow, and spectral Doppler as well as tissue Doppler imaging using a vivid E9 system, and the desired systolic and diastolic parameters were recorded. The relationship among these parameters was evaluated by independent sample t-test using the SPSS statistical software, version 16. Besides, P
    Results
    The mean time to peak strain was significantly longer in the case group (203.98 ± 47.54 milliseconds) compared to the controls (81.20 ± 25.76 milliseconds). The mean early diastolic tricuspid inflow velocity/early diastolic tricuspid annulus velocity (E/E’a) ratio was also significantly higher in the case group (10.24 ± 6.19) compared to the controls (4.70 ± 0.80). In contrast, Isovolumic Contraction (IVC) acceleration time/IVC time ratio was reduced in the case group (0.44 ± 0.09) in comparison to the control patients (0.56 ± 0.05)..
    Keywords: Pulmonary Arterial Hypertension, Echocardiography, Doppler, Systole, Diastole
  • Zakieh Rostamzadeh Khameneh, Alireza Rostamzadeh, Mohaddeseh Nemati, Paul M. Brown, Nariman Sepehrvand* Page 118
    Background
    The role of chronic Cytomegalovirus (CMV) infection and inflammation in the pathogenesis of atherosclerosis and Coronary Artery Disease (CAD) is still not clear..
    Objectives
    This study aimed to explore the seroprevalence of anti-CMV antibodies and inflammatory markers in patients with stable angina who had undergone diagnostic coronary angiography for clinical suspicion of CAD..
    Patients and
    Methods
    This cross-sectional, descriptive study was conducted on 181 patients with stable angina selected randomly among the patients referred to Seyyedoshohada Heart Hospital of Urmia, Iran for diagnostic coronary angiography between August 2012 and December 2013. The patients were categorized into CAD and non-CAD groups based on their angiographic findings. Then, anti-CMV IgG and IgM antibodies were tested using the Enzyme-Linked Immunosorbent Assay (ELISA) method (Diapron, Rome, Italy). Serum C-Reactive Protein (CRP) was also measured by a qualitative method (Aniston Kit).
    Results
    Based on angiographic findings, 141 patients (77.9%) had atheromatous plaques in their coronary arteries, while coronary arteries were free of any plaques in 40 cases (22.1%). Besides, 99.3% of the patients in the CAD group and all the patients in the non-CAD group were anti-CMV IgG positive. The rate of anti-CMV IgM seropositivity was 11.7% in the CAD group and 13.2% in the non-CAD group (P = 0.78). However, no significant difference was observed between the groups with and without angiographically-documented CAD in terms of CRP seropositivity (64.7% vs. 56.4%, P = 0.34).
    Conclusions
    Regardless of having angiographically-proven CAD, almost all the cases referred for coronary angiography in our study had a previous exposure to CMV infection as determined by the presence of anti-CMV IgG antibodies in their sera. In fact, the results indicated no significant associations between CMV infection and the presence of CAD.
    Keywords: Cytomegalovirus, Coronary Artery Disease, Coronary Angiography
  • Nourolhoda Fakhrzad, Reza Goudarzi*, Mohsen Barouni, Javad Kojuri, Yunes Jahani Page 123
    Background
    Cardiovascular Disease (CVD) is one of the major concerns all around the world. It is caused by mass of atherosclerotic plaques in the walls of coronary arteries, which ends in narrowing of veins, heart failure, angina, and Myocardial Infarction (MI). The growing need for therapeutic interventions in CVD patients illustrates the importance of paying special attention to these patients’ Quality of Life (QoL) and the vital interventions for their treatment..
    Objectives
    This research aimed to evaluate patients’ QoL after Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) using Seattle Angina Questionnaire (SAQ) and Short Form-36 (SF-36)..
    Patients and
    Methods
    This six-month cohort study aimed to evaluate the QoL among CAD patients in Shiraz, Iran via SAQ and SF-36. The study population included all the patients who had undergone CABG and PCI in the hospitals of Shiraz University of Medical Sciences from May to December 2014. A total of 200 patients were selected for each intervention. After gaining the patients’ consent to take part in the research, 200 patients who applied for CABG and 198 patients who applied for PCI agreed to participate in the study. Pre-intervention data were gathered through a demographic data form and two valid and reliable questionnaires for QoL. The post-intervention data were also gathered six months after the treatment using the same questionnaires. Then, the data were entered in to the SPSS statistical software, version 20 and were analyzed using paired sample t-test, Kruskal-Wallis, Mann-Whitney U, ANOVA, and Spearman and Pearson correlation coefficient..
    Results
    Intervention was proved to be the most effective factor in changing the patients’ QoL (P = 0.04, mean ± SD = 4.65 ± 22.02 for PCI and 8.25 ± 22.97 for CABG using SF36; P = 0.002, mean ± SD = 10.54 ± 17.14 for PCI and 15.47 ± 16.81 for CABG using SAQ). Moreover, both intervention types boosted the patients’ QoL (P
    Keywords: Quality of Life, Questionnaires, Coronary Artery Bypass, Percutaneous Coronary, Intervention
  • Ansar Karimian, Safar Farajnia*, Morteza Ghojazadeh, Fatemeh Khaki, Khatibi * Page 129
    Background
    Coronary Artery Disease (CAD) is caused by atherosclerosis. Studies have shown that a number of factors, including cellular binding molecules such as Plasminogen Activator Inhibitor-1 (PAI-1), lipid peroxidation, inflammation, and hemostasis, are closely related to development and progression of CAD..
    Objectives
    The present case-control study aimed to evaluate the association between Plasminogen Activator Inhibitor-1 (PAI-1) 4G/5G polymorphism and oxidative stress markers and Coronary Artery Disease (CAD)..
    Patients and
    Methods
    Blood was drawn and DNA was extracted from 90 subjects (46 patients with angiographically diagnosed CAD and 44 age- and sex-matched healthy controls). The 4G/5G polymorphism of PAI-1 was detected by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) analysis. Besides, the risk factors, serpin E1, Malondialdehyde (MDA), high-sensitivity C-Reactive Protein (hs-CRP), and lipid profile serum levels were measured by standard methods and were compared between the two study groups using independent samples t-test, one-way ANOVA, and Mann-Whitney U test as appropriated..
    Results
    The frequency of 4G/4G genotype of PAI-1 gene was higher in the CAD patients than in the controls (28/46 (60.87%) vs. 8/44 (18.18%), P
    Conclusion
    The findings of this study suggested that 4G/4G PAI-1 polymorphism was associated with cholesterol, triglyceride, LDL, and HDL levels and could be regarded as a biomarker for risk of CAD..
    Keywords: Plasminogen Activator Inhibitor 1, Malondialdehyde, C, Reactive Protein, Coronary Artery Disease
  • Daryoosh Javidi, Marjan Ladan*, Amin Vahdani, Azar Nazar, Ali Zarin Ara, Yousef Alimohamadi Page 135
    Background
    Impaired cardiac performance is a frequent presentation after Coronary Artery Bypass Graft (CABG) surgery. Intra-Aortic Balloon Pump (IABP), as a mechanical support, is lifesaving in many cases of low cardiac output state. IABP is needed to be in place from a few hours to a few days. Weaning is usually done according to patients’ hemodynamic response. Up to now, many studies have addressed the withdrawal methods, but few are related to predict the support time..
    Objectives
    This study aimed to evaluate whether high serum lactate levels are early predictors of IABP dependency after CABG surgery..
    Patients and
    Methods
    This prospective cohort study was performed on 843 patients who underwent CABG surgery from April 2009 to January 2014 in Pars hospital. Among these patients, 47 ones required IABP support and were all entered into our study. Arterial blood samples were collected by 2-hour intervals during the first 12 hours after the operation. Serum lactate levels were compared according to IABP dependency. The data were analyzed using chi-square, t-test, and correlation coefficient and α = 0.05 was considered to be the significance level..
    Results
    Based on the results, 97.8% of the patients (n = 46) were successfully weaned from IABP support and 95.7% (n = 45) survived to discharge from the hospital. Two patients with persistent serum lactate levels > 15 mmol/L in the first 12 hours of IABP support had the worst prognosis. A significant association was found between the mean serum lactate levels ≥ 6 mmol/L in the first 12 hours after the surgery and ≥ 48 hours dependency on IABP (P = 0.030)..
    Conclusions
    Prediction of IABP dependency may be possible by measuring serum lactate levels in the first 12 hours after CABG surgery..
    Keywords: Surgery, Intra, Aortic Balloon Pumping, Serum Lactate
  • Filippo Maria Cauti, Andrea Radinovic, Patrizio Mazzone*, Damiano Regazzoli, Fabrizio Guarracini, Simone Sala, Marco Ancona, Nicola Trevisi, Paolo Della Bella Page 140
  • Ilias A. Kouerinis*, Mathew Benjamin, Ioannis Karathanasis, George Peskesis, Charilaos Kantsos, Georgia Sarri, Grigorios Karagkiouzis, Uday Trivedi Page 143