International Cardiovascular Research Journal
Volume:10 Issue: 1, Mar 2016

To date, not sufficient information is available regarding the effect of High Intensity Interval Training (HIIT) on diabetes-induced myocardial dysfunctions.. The present study aimed to evaluate the effect of 4-week HIIT on change in expression levels of ryanodine receptor calcium channel (RyR2) and ATPase calcium pump (SERCA2a) in diabetic rats.. This study was conducted on 24 Wistar rats with average weight of 245 ± 10 g. The rats were randomly divided into a sedentary diabetic group and a trained diabetic group. Training was started two weeks after diabetes induction by Streptozotocin (STZ) injection. The training program consisted of 4 weeks running on a treadmill and was considered to be intense for the two groups’ diabetic rats. After all, the animals’ characteristics and myocardial gene expression were compared using independent t-test.. Measurement of gene expression by Real Time-PCR revealed that cardiac mRNA expression of RyR2 was enhanced in the HIIT group. The results also revealed a significant (P = 0.03) difference between the hearts of the sedentary controls and the trained group regarding RyR2 levels. However, no significant difference was observed between the two groups with respect to SERCA2a levels (P = 0.14).. The study results showed that treatment with HIIT could prevent and/or minimize the loss in expression of RyR2 and SERCA2a..

Speckle Tracking Echocardiography (STE) is a new non-invasive method, which has been recently used as an alternative technique to assess regional and global myocardial function, especially left ventricular function. It is also considered to be a valid technique to evaluate the patients with Acute Coronary Syndrome (ACS).. The present study aimed to evaluate the capability of STE as a trustable technique to indicate ischemic parts of the heart and compare the results to the information raised from angiography. Then, decision was made about capability of STE as a valid and reliable criterion for determining the indication of performing angiography..Patients and This case-control study was conducted on 37 patients between 30 and 70 years old with clinical diagnosis of ACS and clinical indications of coronary angiography who had referred to Faghihi hospital. Also, 46 healthy volunteers were selected as the control group. STE was performed for all the participants and angiography was done for the patients.. In 20 cases (55.6%), the results of echocardiography completely matched with those of angiography. In 10 cases (27.8%), echocardiography and angiography results were partially matched. According to the results, echocardiography showed involvement of both territories, while angiography revealed involvement of one territory or vice-versa. However, the results were not matched at all in 6 cases.. Our results showed that STE, with the current quality and capacity, could be effective in diagnosis of patients with Non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS) and planning strategies for their treatment..

Evidence have shown the relationship between vitamin D deficiency and cardiovascular disease.. The present study aimed to evaluate the effect of Vitamin D deficiency treatment on the occurrence of coronary post-Percutaneous Intervention (PCI) restenosis and Major Adverse Cardiac Events (MACE)..Patients and This randomized semi-experimental non-controlled study was conducted on patients with coronary artery disease who were candidate for PCI and had referred to Baqiyatallah Hospital in a 2-month period. The patients with normal Vitamin D levels were allocated to the normal group and others were randomly assigned to treatment and non-treatment groups. All the patients were followed for 9 months. Vitamin D was measured again at the end of the 9th month and the patients were reassigned to normal and mild, moderate, and severe deficiency groups with respect to Holick classification.. This study was performed on 150 subjects with the mean age of 62.46 ± 10.80 years and male/female ratio of 94/56. The results showed no significant difference among the three groups regarding age, gender, diabetes, number of cardiovascular risk factors, and other underlying risk factors for restenosis. However, a significant difference was found between the patients with normal and abnormal vitamin D levels regarding the number of stenotic vessels and number of PCIs (both P < 0.001). Nonetheless, no significant difference was found between the treated and non-treated groups regarding the number of stenotic vessels and number of PCIs (P > 0.05). At the end of the study, 32 (55.1%) out of the 58 patients (55.1%) who were deficient reached normal vitamin D levels by consuming supplements, but 7 (12%) reached normal values without using supplements (P < 0.001).. Treatment of vitamin D deficiency could reduce restenosis of PCI. However, this protocol is efficient for patients with moderate to severe deficiency and should be changed..

Right Ventricular (RV) functions are known to have an impact on determining the prognosis of patients with Non-Ischemic Dilated Cardiomyopathy (NICMP).. This study aimed to investigate the echocardiographic determinants of RV systolic dysfunction in patients with NICMP..Patients and This cross-sectional study was conducted on 79 patients with angiographically normal coronary arteries (mean age: 50.5 ± 12, mean Ejection Fraction (EF): 31 ± 4%) selected through purposive sampling The patients were divided into two groups based on their RV systolic function determined by tissue Doppler systolic velocities (RV-Sm): group A (RV-Sm ≥ 10 cm/s, N = 48) and group B (RV-Sm < 10 cm/s, N = 31). The two groups were compared regarding clinical, demographic, and echocardiographic variables using independent t-test and chi-square test.. The patients with RV systolic dysfunction were found to have higher Brain Natriuretic Peptide (BNP) values (P = 0.006) and worse functional status (New York Heart Association (NYHA) III-IV, P = 0.04) compared to group A. Besides, univariate analysis of the echocardiographic parameters revealed that the patients in group B had significantly (all P values < 0.05) higher Left Atrial Volume Index (LAVI), higher degree of left ventricular diastolic dysfunction (represented by LV-E/Em), higher degree of Functional Mitral Regurgitation (FMR), higher estimated Pulmonary Artery Systolic Pressure (PASP), and higher degree of RV diastolic dysfunction (represented by RV-E/Em) Moreover, multivariate logistic regression analysis showed that severe FMR (P = 0.006) and RV-E/Em (P = 0.016) predicted RV systolic dysfunction independently.. Advanced FMR and worse RV diastolic functions emerged as the independent predictors of RV systolic dysfunction in NICMP correlating to functional status and BNP levels..

Syncope is a common problem among children.. This cross-sectional study aimed to determine the epidemiological characteristics of children with syncope and clarify the outcome of managements in Imam Reza Pediatrics Cardiology Clinic affiliated to Shiraz University of Medical Sciences, the main referral center for pediatric patients with syncope in south of Iran..Patents and This cross-sectional, descriptive–analytical study was conducted on all the children referred with transient loss of consciousness and positive head up tilt test. A total of 243 children (132 girls and 111 boys) were recruited from April 2007 to April 2013. The patients’ treatment outcomes were determined through telephone interviews. All the statistical analyses were performed using the SPSS statistical software (version 16.0). Besides, P < 0.05 was considered to be statistically significant.. The majority of the patients were female (54.3% vs. 45.7%). In addition, the mean age at the first episode of syncope was 13.02 ± 3.9 years and 14.8% of the patients had positive family history of syncope. The mean duration of follow-up was 4.2 ± 3.41 years. Besides, breath holding spell history was positive in 13.6% of the patients. Medical treatment was done for 76.5% of the patients (96.7% propranolol and 3.3% atenolol). Increase of salt and fluid intake and physical maneuvers were performed for management of syncope in 75.3% and 30.9% of the patients, respectively. During follow-up, 66.7% of the patients did not experience any syncope episodes at all. Among the patients, 33.3% were referred by neurologists, while 66.7% had self-referred or referred by pediatricians or family practitioners. Moreover, 80.2%, 8.6%, and 6.2% of the syncope cases were mixed type, inodeppressive, and choronodeppressive, respectively. Furthermore, 35.8% of the tilt tests were positive with nitroglycerin consumption. Also, 11.1% of the patients had asystole > 3 seconds during syncope.. This study indicated that similar to other populations, syncope was more prevalent among girls in our area. Additionally, the most common cause was mixed type of vasovagal syncope. Medical therapy along with offering the patients to increase water and salt intake and do counter pressure physical maneuvers were effective in reduction of the recurrence of syncope..

Depression is common among patients with heart disease. Depression is also associated with worse outcomes among patients with heart disease. Fewer studies have shown whether or not baseline depressive symptoms predict subsequent heart disease in general population.. This study aimed to investigate whether depressive symptoms at baseline predict risk of developing heart disease during the next 20 years in the United States..Patients and The data were extracted from the Health and Retirement Study (HRS), 1992 - 2012. The study was conducted on 8,375 individuals who were older than 50 years at entry, did not have heart disease at baseline, and had data on heart disease over the next 20 years. High depressive symptoms (modified Center for Epidemiologic Studies Depression Scale [CES-D]) were considered as the independent variable. Self-reported data on physician diagnosis of heart disease were measured on a biannual basis. Baseline demographic data (i.e., age and gender), socioeconomic status (i.e., race, marital status, and education level), health behaviors (i.e., drinking, smoking, and exercise), and body mass index were controlled. Cox proportional hazard model was used for data analysis.. Cox proportional hazard model revealed a link between high depressive symptoms at baseline and time to developing heart disease (Hazard ratio = 1.439, 95% CI = 1.253 - 1.652), suggesting that individuals with high depressive symptoms at baseline developed heart disease sooner than others. The association between baseline depressive symptoms and risk of heart disease was significant after controlling for all the covariates.. Individuals with depressive symptomatology are at higher risk of development of heart disease over time. Thus, individuals with depressed mood may need more rigorous evaluation for heart disease..

Endomyocardial Biopsy (EMB) is the gold standard test for diagnosis of acute allograft cardiac rejection.. The present study aimed to assess the role of echocardiographic parameters in discriminating patients with and without evidence of acute cardiac allograft rejection.. In the present cross-sectional study, using convenience sampling, 63 EMB specimens were collected from the patients who had undergone biatrial orthotropic cardiac transplantation. The mean age of the recipients and donors was 30.46 ± 9.49 and 24.55 ± 7.64 years, respectively. There were 51(81%) male recipients and 39(62%) male donors. Echocardiographic examination was performed within the 24 hours of EMB. The data were entered into the SPSS statistical software, version 19 and were analyzed by chi-square test, student’s t-test, and one-way ANOVA as appropriated. All the data were two-tailed and P < 0.05 was considered to be statistically significant.. Among the 63 EMB specimens evaluated in the present study, mild and moderate acute rejections were seen in 19(30%) and 5(8%) cases, respectively. On Doppler examination, the three groups (without rejection, with mild rejection, and with moderate acute rejection) were significantly different only regarding trans-tricuspid E wave (P = 0.040). Pulsed-wave Tissue Doppler Imaging (TDI) also revealed a significant difference between the patients with and without allograft rejection regarding early diastolic tricuspid and mitral annular motion velocities (P = 0.005 and P = 0.02, respectively).. It seems that echocardiographic parameters, including TDI, might be adjunct to, rather than substitution for, EMB findings for early diagnosis of acute allograft rejection..

Coronary artery embolism is an uncommon cause of Acute Myocardial Infarction (AMI). Herein, we reported a 24-year-old male who was admitted with acute infero-posterior myocardial infarction and cerebral Transient Ischemic Attack (TIA). He had undergone mechanical Aortic Valve Replacement (AVR) surgery 6 years ago. Surprisingly, the patient had decided to stop taking his medication (warfarin) 20 days earlier without any medical advice. Coronary angiography revealed a thrombus located at the distal part of the left circumflex artery. Discontinuation of anticoagulant therapy in the presence of mechanical valve prosthesis, clinical evidence of coincidental TIA, and lack of atherosclerotic risk factors were highly suggestive of coronary thromboembolism as the cause of AMI. Overall, this case report emphasized the necessity of continuous education in patients with mechanical heart valves to prevent such undesired events..

Iatrogenic aortocoronary dissection and ostial coronary avulsion are rare and devastating complications of Percutaneous Coronary Intervention (PCI), which mandate a challenging management. Herein, we described a case of right coronary ostial avulsion in a dwarf woman with chronic total occlusion of the vessel during PCI and discussed about the results and pitfalls..