International Cardiovascular Research Journal
Volume:9 Issue: 4, Dec 2015

This study aimed to evaluate the risk markers of Coronary Artery Disease (CAD), so that appropriate lifestyle changes can be instituted early to prevent or delay development of the disease.. This study aimed to evaluate the risk markers of CAD based on inflammation and arterial morphology; i.e., high sensitivity C-Reactive Protein (hs-CRP) and carotid artery Intima Media Thickness (IMT), in children of patients with premature CAD..Patients and This was a case-control study with predetermined end points. It was conducted on 40 subjects randomly selected from the children of premature CAD patients and 40 age- and sex-matched healthy controls. Blood levels of hs-CRP, lipid profile, and carotid IMT were assessed for all the subjects. The relationship among these parameters was evaluated by univariate and multivariate analyses using the SPSS statistical software, version 22.0 and P < 0.05 was considered as statistically significant.. The mean values of Total Cholesterol (TC, 139.8 ± 24 vs. 111.3 ± 14.7, P < 0.05), Triglycerides (TG, 81.8 ± 15.3 vs. 63.4 ± 10.8, P < 0.05), Low Density Lipoprotein (LDL, 85.2 ± 22.2 vs. 57.5 ± 14.1, P < 0.05), hs-CRP (1.2 ± 0.77 vs. 0.79 ± 0.27, P < 0.05) and carotid artery IMT (0.49 ± 0.09 vs. 0.422 ± 0.03, P < 0.05) were significantly higher in the cases compared to the controls. Also, both LDL/High Density Lipoprotein (HDL) and TC/HDL ratios were significantly higher in the cases compared to the controls. Moreover, a significant positive correlation was found between carotid IMT and hs-CRP.. Children of patients with premature CAD showed a significantly higher incidence of dyslipidemia as well as significantly increased levels of the inflammation marker, hs- CRP, compared to the age- and sex-matched controls. This indicates that atherosclerosis is not only a disease of lipid deposition, but also an inflammatory process. This was further confirmed by demonstration of a significantly raised IMT..

Although P-wave dispersion has proven to be a reliable electrocardiographic predictor of Atrial Fibrillation (AF) in many clinical settings, its significance in patients with Constrictive Pericarditis (CP) of non-ischemic origin is to be reported.. This study aimed to find out whether p-wave dispersion is prolonged in patients with documented CP of non-ischemic origin..Patients and This study was conducted on twenty patients with CP, 16 males and 4 females, with the mean age of 39.0 ± 20.5 years and 20 age- and sex-matched healthy subjects. All the Electrocardiograms (ECGs) were scanned and the P-wave parameters were measured electronically after × 400% magnification.. Our main finding was a significantly prolonged maximum P-wave duration (P = 0.018) and P-wave dispersion (P = 0.049) in the patients with CP compared to the control group. These parameters, however, did not have any correlation with the patients’ age and disease duration.. Since AF is common in patients with CP of any etiology and may have a negative impact on their outcome, detection of individuals susceptible to development of AF could be of great clinical value..

Recently, some studies have revealed Osteonectin’s (OSN) promising role as a marker in cardiovascular diseases.. This study aimed to evaluate the prognostic value of circulating OSN for cumulative survival and hospitalization in patients with ischemic Chronic Heart Failure (CHF)..Patients and This open cohort prospective study was conducted on 154 patients with ischemic symptomatic moderate-to-severe CHF at discharge from hospital. The observation period was up to 3 years (156 weeks). Blood samples for biomarker measurements were collected at baseline. ELISA method was used for measurement of OSN circulating level. Then, Receiver Operating Characteristic (ROC) curve analysis was carried out to identify the optimal cut-off points of the OSN concentration with predicted values. Odds ratios were also calculated for all the independent predictors of patients’ survival. Kaplan-Meier survival curves were also structured for both cohorts with low and high OSN levels.. During a median follow-up of 2.18 years, 21 participants died and 106 subjects were hospitalized repetitively. The median of circulating OSN levels were 670.96 ng/mL (95% Confidence Interval [CI] = 636.53 - 705.35 ng/mL) and 907.84 ng/mL (95% CI = 878.02 - 937.60 ng/mL) in the survived and dead patients cohorts, respectively. Besides, ROC curve analysis showed that optimal cut-off point of OSN for cumulative survival function was 845.15 ng/mL. The results also revealed significant divergence of Kaplan-Meier survival curves in the patients with high (> 845.15 ng/mL) and low (< 845.15 ng/mL) concentrations of OSN.. Increased circulating OSN levels were associated with increased 3-year CHF-related death, all-cause mortality, and risk of recurrent hospitalization due to CHF..

Although some investigations have shown higher rates of successful first attempt and fewer attempts by using ultrasound-guided Internal Jugular Vein (IJV) catheterization, arterial puncture is still common.. The present study aimed to investigate US-guided catheterization of the right IJV via medial-oblique technique and also compare this technique to short-axis technique in open-heart surgery patients..Patients and In this randomized clinical trial, 80 patients referred to cardiac operating room of Namazi hospital, Shiraz, Iran from March to July 2014 were selected using census method. Block randomization with website was also done. Then, the patients were divided into two groups of 40, Short Axis Group (SAG) and Medial-Oblique Group (M-OG). For short-axis technique, patient’s head was positioned at zero degree angulation with his trunk. For medial-oblique technique, on the other hand, patient’s head was tilted to left to 45 degrees between the head and trunk. Sex, age, Body Mass Index (BMI), access time, guidewire time, cannulation time, total attempts for catheterization, first, second, and third attempt success, arterial puncture, hematoma, bleeding, and catheter malposition were recorded. The overlap between the carotid artery and IJV in zero- and 45-degree angulation was estimated through ultrasound print. After all, Kolmogorov-Smirnov test was used to assess normal distribution of the data. Then, the data were analyzed through Student’s t-test, Mann-Whitney U test, and chi-square test. P < 0.05 was considered as statistically significant.. The results showed no significant differences between the two groups regarding the duration of different catheterization steps (P = 0.376). In all the cases in both groups, accessing the vein was successful with three attempts or less. There were no clinical complications of catheterization in the two groups. The mean of overlap was 23.60 ± 33.47 in zero-degree angulation between the head and trunk and 32.72 ± 36.38 in 45-degree angulation and this difference was statistically significant (P = 0.001).. The results of the present study showed that both US-guided techniques under investigation had the same duration in different catheterization steps, total success rate, and primary mechanical complications, and could be used in clinics..

Hypertension (HTN) is a common condition with increasing prevalence rate. Hypertensive patients have a high prevalence of mental disorders, including anger.. The present study aimed to investigate the score of anger in hypertensive patients in comparison to the individuals with normal blood pressure in Shiraz..Patients and This case-control study was conducted on 100 patients with HTN and 107 normal controls with the mean age of 52.48 and 53.78 years, respectively. These patients had referred to Shiraz HTN clinic in 2013. All the patients completed the Multidimensional Anger Inventory (MAI) and the results were analyzed using the SPSS statistical software, 2010.. The participants were matched regarding age and other demographic factors which might have influenced HTN. Distributions of these factors were partly similar and the differences were not significant. The HTN group obtained higher scores in all dimensions. Besides, the differences were significant in all subscales, except for anger.. In line with the previous researches, the present study indicated that high level of aggression was correlated to high blood pressure. Therefore, it is necessary to have psychological interventions along with other interventions for hypertensive patients. Overall, this research confirmed biopsycho approach to psychosomatic diseases..

Studies have shown that Glomerular Filtration Rate (GFR) and Hemoglobin (Hb) concentrations are two predictive values for ST-elevation Myocardial Infarction (MI) mortality.. This study aimed to investigate the relationship between GFR and Hb concentrations and intra-hospital mortality and electrocardiographic (ECG) and echocardiographic abnormalities in ST-elevation MI patients admitted to a highly equipped hospital in Mashhad. The results will help define some factors to manage these patients more efficiently..Patients and This descriptive study aimed to assess the relationship between Hb and GFR concentrations and mortality and morbidity among 294 randomly selected patients with ST-elevation MI. Echocardiography, ECG, and routine laboratory tests, including Hb and creatinine, were performed for all the patients. Then, the data were entered into the SPSS statistical software, version 16 and were analyzed using chi-square, t-test, and ANOVA. P < 0.05 was considered as statistically significant.. Intra-hospital mortality rate was 10.5%. Besides, the results showed higher levels of serum blood sugar (P < 0.001), higher levels of creatinine (P < 0.001), lower levels of GFR (P < 0.001), lower ejection fraction (P < 0.001), higher grades of left ventricular diastolic dysfunction (P = 0.002), and lower mean Hb concentration (P = 0.022) in the dead compared to the alive cases. Besides, the patients with mechanical complications had lower Hb levels (P = 0.008). The results showed no significant relationship between creatinine level and mechanical and electrical complications (P = 0.430 and P = 0.095, respectively). However, ejection fraction was significantly associated with GFR (P = 0.016).. According to the results, low levels of Hb and GFR could predict mortality caused by ST-elevation MI and ECG abnormalities could notify intra-hospital death. Moreover, lower Hb levels were associated with mechanical complications and could be used as a parameter for diagnosis of high-risk patients..

Alteration of kidney function called Contrast-Induced Nephropathy (CIN) is commonly encountered in diagnostic and interventional cardiology procedures. It results in considerable morbidity and mortality besides imposing significant costs on the healthcare system. Today, it is accounted as the third cause of hospital-acquired acute renal failure..

Considering anti-oxidant and free radical scavenging properties of selenium and the role of free radicals in CIN, the present study aimed to investigate the effects of oral selenium (in the form of Se-yeast capsule) on preventing or decreasing the rate of CIN in patients undergoing angiography and angioplasty..Patients and

This prospective, non-randomized, single-blind, single-center clinical trial was conducted on 175 consecutive patients admitted for elective coronary angiography (N = 105) or angioplasty (N = 70). Selenium was prescribed as a single dose of 200 micrograms the day before and after the procedure. Routine hydration based on the ward protocol was administered for all the patients. For the control group, the researchers made use of the data of another survey performed in the same hospitals for determining the prevalence of CIN a year before. The data were analyzed using student’s t-test and logistic regression analysis and P < 0.05 was considered as statistically significant..

Based on the results of student’s t-test, the mean difference between the two groups was significant only in hematocrit levels. The incidence of CIN was 9% in the selenium group compared to 22% in the control group (P = 0.027). There was no case of in-hospital mortality and none of the CIN patients required renal replacement therapy during hospitalization..

Prophylactic selenium administration may significantly reduce the incidence of CIN..

Metabolic Syndrome (MetS) is defined as a group of cardiovascular risk factors and is an important health threat.. This study aimed to determine the role of gender in the prevalence of MetS among Shiraz Healthy Heart Center population..Patients and This study was performed on 350 adults aged 20 - 65 years from Shiraz Healthy Heart Center, Shiraz University of Medical Sciences. Individuals with obesity secondary to medication and genetic or endocrine disorders were excluded from the study. Weight and height were measured for calculating Body Mass Index (BMI). Waist circumference and blood pressure were measured, as well. Plasma glucose, serum High Density Lipoprotein-cholesterol (HDL-c), and Triglyceride (TG) were also analyzed. The presence of MetS was determined using Adult Treatment Panel-III (ATP-III) criteria.. The results showed significant correlations between age and waist circumference, Fasting Blood Sugar (FBS), Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP). Moreover, statistically significant relationships were found between waist circumference and TG, SBP, DBP, and BMI. Significant correlations were also observed between FBS and TG, SBP, and DBP. Besides, there were strong correlations between TG and HDL-c, SBP, DBP, and BMI. Moreover, BMI, SBP, and DBP were significantly correlated. In addition, serum HDL-c was negatively associated with most of the variables. The prevalence of pre-diabetes, pre-hypertension, and hypertriglyceridemia was higher among males. On the other hand, the prevalence of hypertension, diabetes, high waist circumference, and MetS was significantly higher among the female participants.. A better understanding of the role of gender in the prevalence of MetS is important in developing prevention and treatment strategies..

In major orthopedic surgery, prevention of venous thromboembolism has been based on Unfractionated Heparins (UFHs) over the past decades, then on Low-Molecular Weight Heparins (LMWHs), and on New Oral Anticoagulants (NOACs) more recently. To summarize the comparative effectiveness of UFHs, LMWHs, and NOACs in this clinical indication, we applied Bayesian network meta-analysis to the clinical material (randomized studies) published in two previous reviews focused on this issue.. Our end-point was a composite of venous thromboembolism and pulmonary embolism.. Our analysis was based on standard Bayesian network meta-analysis (random-effect model).. The analysis included 21 randomized trials for a total of 21,805 patients. Our results showed that the degree of effectiveness did not differ among UFHs, LMWHs, and NOACs. Although some trends emerged from an in-depth analysis of these data (e.g. according to the histogram of rankings), no significant differences were found (P > 0.05). Moreover, two agents among LMWHs proved to be adequately supported by randomized trials (enoxaparin and dalteparin), while limited evidence was available for other agents of this class.. Our synthesis of the effectiveness data can be useful as an overall reference in this area and can also contribute to defining the place of further innovative treatments for this clinical indication..

Bacterial pericarditis caused by Streptococcus Milleri Group (SMG) strains is a particularly exceptional pathology. All the eight previous reported cases were under the care of medical teams and the seven existed reports in medical journals were more or less from this perspective..Herein, we reported a unique case of a pericardial-cutaneous fistula resulting from a recurrent purulent pericardial effusion caused by SMG strains, which had been treated with open surgical drainage two months before. A thorough review of the surgical treatment options and the results has also been presented..

Prosthetic Valve Obstruction (PVO) is a serious complication which is associated with increased morbidity and mortality. This could result from thrombus formation, development of pannus, or a combination of both. Patients with this complication often present with symptoms and signs of heart failure, systemic embolism, acute cardiovascular collapse, and sudden death. Transesophageal echocardiography and cine fluoroscopy play a vital role in diagnosis of this potentially lethal condition. Herein, we reported a 56-year-old male patient who presented with severe heart failure and was found to have obstructed ATS27 bileaflet mitral prosthetic valve. Thrombolysis and redo surgery are two important options for treating this condition although guidelines for choosing between the two are not very definite..