International Cardiovascular Research Journal
Volume:10 Issue: 2, Jan 2016

There is an increasing need for percutaneous revascularization procedures of coronary Chronic Total Occlusion (CTO), because many patients with severe coronary artery disease have limited options for revascularization. Although the success rate of percutaneous revascularization of CTOs was unsatisfactory from the 1990s to the 2000s, recent technological advances in interventional strategies have improved the success rate to 85%. Detailed histological assessment of human autopsy studies of CTO has contributed significantly to the refinement in Percutaneous Coronary Intervention (PCI) techniques and device development. We have recently reported the pathological findings and characteristics of CTOs that occur in different clinical scenarios. In this review, we discuss the pathology of CTOs to facilitate greater understanding of revascularization strategies for CTOs.

Major Adverse Cardiac and Cerebrovascular Events (MACCE) include cardiac death, nonfatal Myocardial Infarction (MI), cerebrovascular events, and Target Vessel Revascularization (TVR) that may happen after Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft (CABG).
This study aimed to compare the incidence of MACCE between the patients who underwent PCI or CABG due to significant Left Anterior Descending (LAD) stenosis with and without other coronary arteries involvement.
Patients and This randomized mixed cohort study was conducted on 400 patients with Coronary Artery Disease (CAD), 200 with proximal LAD stenosis and 200 with non-proximal LAD stenosis, selected through census. Half of each group underwent PCI and the rest underwent CABG. The participants were followed at fixed intervals after the procedure and the incidence of MACCE was documented in their checklists. Then, relative risk index was used to compare the two groups regarding the incidence of MACCE. Statistical analysis was done using the Stata software, version 11 and P The study participants included 281 males and 119 females with the mean age of 61.36 ± 10.66 years. The results showed a significant difference between the two groups regarding the incidence of MACCE (31.58% vs. 3%, P = 0.001). However, no significant difference was found between the effects of PCI with drug eluting stent and CABG on proximal LAD (3.70% vs. 3%, P = 1.00).
Considering the incidence of MACCE, CABG had no superiority over DES for proximal LAD stenosis.

Unlike left ventricular function, less attention has been paid to Right Ventricular (RV) function after Myocardial Infarction (MI).
The current study aimed to compare RV function in patients with inferior and anterior MI.
Patients and During the study period, 60 patients consecutively presented to the Emergency Department with chest pain were divided into two groups based on their electrocardiographic findings. Accordingly, 25 patients had inferior MI (IMI group) and 35 ones had anterior MI (AMI group). Echocardiography was performed 48 hours after starting the standard therapy. Conventional echocardiographic parameters and Tissue Doppler Imaging (TDI) measurements were acquired from the standard views. Student t-test and the chi-square test were respectively used for comparisons of the normally distributed continuous and categorical variables in the two groups. Besides, P The ratio of early diastolic velocity of the tricuspid flow to early diastolic velocity of the tricuspid annulus in the lateral side (E/E’) was significantly higher in the AMI group compared to the IMI group (6.73 ± 1.64 vs. 5.68 ± 1.32, P = 0.01). In addition, abnormal E/E’ ratio of the tricuspid valve was present in 27 (77%) and 14 (56%) patients in the anterior and inferior MI groups, respectively. Besides, the RV Tei index was significantly higher in the AMI group compared to the IMI group (0.65 ± 0.11 vs. 0.58 ± 0.13, P = 0.02). Overall, 28 patients (80%) with anterior infarction and 12 patients (48%) with inferior infarction had abnormal RV Tei index. However, no significant difference was found between the two groups regarding other variables.
RV dysfunction commonly occurs after a first acute ST-elevation MI. However, RV functional changes are more pronounced in patients with anterior MI.

Dietary saturated fat and cholesterol are the cause of atherosclerosis and cardiovascular disease. This study aimed to assess diet quality after diagnosis of Coronary Heart Disease (CHD).
Patients and This descriptive study was performed on 242 patients with diagnosis of acute coronary syndrome admitted to a coronary care unit in a cardiology clinic between December 2005 and December 2006. The study questionnaire, including questions about personal information such as age, sex, and education level, was completed by face-to-face interview. Additionally, Diet Quality Index (DQI) was used to assess the subjects’ nutritonal status. Then, one-way ANOVA and chi-square tests were used where appropriated to compare the study groups. Besides, linear regression models were used to assess the associations between DQI score and the patients’ sociodemographic characteristics and lifestyle factors. P value ≤ 0.05 was considered to be statistically significant.
The patients’ ages ranged from 26 to 85 years and 68.5% of the patients were male. Considering DQI scoring, 22.7%, 75.2%, and 2.1% of the patients got “inadequate/ low”, “average”, and “acceptable/high” DQI, respectively. In addition, 28% of the patients consumed 40% of calories from total fat, while 55% consumed 30 - 40% of calories from total fat. Also, nearly 30% of the patients consumed greater than 13% of calories from saturated fat, while 64% consumed 10 - 13% of calories from saturated fat.
In this study, most of the CHD patients got low DQI scores. In general, CHD can be prevented. However, if precautions regarding lifestyle modification are not followed, CHD is expected to progress.

Cardiovascular diseases have various etiologies. Previous studies have come to contradictory results regarding the effects of Oral Contraceptive Pills (OCPs) on the risk of myocardial infarction, angina pectoris, and venous thrombosis. Thus, further investigation is required in this area. This study aimed to determine the relationship between cardiovascular diseases and some risk factors in the women with a history of contraceptive pills consumption.
Patients and The present case-control study was conducted on 317 women with cardiovascular diseases (myocardial infarction, angina pectoris, and deep venous thrombosis) selected through simple purposive sampling from CCU, ICU, post-ICU, and neurology departments of Nemazee, Faghihi, and Al-Zahra heart hospitals. Also, 371 controls were selected among 20 – 60 year-old women without cardiac diseases. The data were collected through questionnaires, interviewing the patients and their firstdegree relatives, and the patients’ medical records. The main variables studied in both groups included the history of OCPs consumption, weight gain, blood sugar level, and hypertension. Then, the data were analyzed using chi-square test, correlation coefficient, and odds ratio. Besides, P The mean age of the study population was 49.2 ± 13.4 years. Besides, 10.6%, 4%, and 2.7% of the women had used OCPs for 6 - 10, 11 - 15, and more than 16 years, respectively. There were no significant differences between the two groups in terms of history of using OCPs (47.3% vs. 51.5%, P = 0.8). In addition, no significant relationship was observed between consumption of OCPs and incidence of myocardial infarction (P = 0.202), angina pectoris (P = 0.260), and thrombosis (P = 0.389). However, a significant difference was found between the two groups regarding the frequency of hyperlipidemia, hyperglycemia, and hypertension (P The results showed no significant association between the use of OCPs and cardiovascular diseases. Nevertheless, other risk factors of cardiovascular diseases were higher among the patients with a history of contraceptive pills consumption.

Coronary Slow Flow (CSF) is described as delayed opacification of the distal vasculature and angiographically Normal Coronary Arteries (NCA). Numerous studies have suggested that the interval from the peak to the end of electrocardiographic T wave (Tp-e) may correspond to transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias.
The present study aimed to evaluate ventricular repolarization in patients with CSFby using Tp-e interval and Tp--e/QT ratio.
Patients and This study was conducted on electrocardiographic parameters of 100 patients with angiographically proven NCA with CSF in all three coronary arteries and 100 patients with NCA without CSF. The patients were followed up for arrhythmias and clinical events.
Tp–e tail interval (120 ± 5.5 msn, 101 ± 3.9 msn; P Tp-e interval and Tp-e/QT ratio were significantly higher in the patients with CSF compared to the NCA group.

Hypertrophied hearts are susceptible to ischemic injury. Besides, cardiac vulnerability could be changed in the presence of diazepam.
The current study aimed to investigate the effect of diazepam on hypertrophied rats’ hearts in ischemia-reperfusion conditions.
Male Wistar rats (body weight 210 - 270 gr) were administered with isoproterenol (4 mg/kg body weight, intraperitoneally for 7 days) alone or along with diazepam (1 and 5 mg/kg body weight, intraperitoneally for 5 days). The control rats received normal saline intraperitoneally. The animal s’ hearts were isolated according to langendorff setup and were passed through baseline, ischemia, and reperfusion stages. Then, cardiac mass index (ratio of heart weight to body weight) was measured. Cardiac functional parameters, including left ventricular developed pressure and rate pressure product, were also assessed at baseline and following ischemia. The data were analyzed using ANOVA and P Isoproterenol-induced cardiac hypertrophy was significantly reduced by both doses of diazepam compared to the group only treated with isoproterenol (P Diazepam relatively prevented the isoproterenol–induced cardiac hypertrophy in the animal model. This effect could be probably explained by the modification of oxidative stress and preservation of intracellular calcium concentration. Considering the common clinical usage of diazepam, as a peripheral benzodiazepine ligand, antihypertrophic effects of diazepam are recommended to be investigated in clinical trials.

Using Electrocardiographic criteria is usual for determining the best site for ablating accessory pathways. Many algorithms are present in this regard, but there are still many facts to be found. The present study aimed to reduce fluoroscopic time by using a special electrocardiographic sign. This study was performed on a young lady with palpitation, negative delta wave in V1 and V3, and positive delta wave in V2. Positive delta in V2 intervened with negative delta in V1 and V3 localized in the crux area for accessory pathway. This might help reduce the procedure time and increase the success rate. This exceptional electrocardiography could be used to locate the site of ablation, increase the rate of success, and reduce radiation exposure.

Cleft in the anterior mitral leaflet is an infrequent congenital anomaly most often encountered in association with other congenital heart defects. The importance of the lesion is that it is often a correctable cause of Mitral Regurgitation (MR).