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Cardiovascular and Thoracic Research - Volume:8 Issue: 3, Sep 2016

Journal of Cardiovascular and Thoracic Research
Volume:8 Issue: 3, Sep 2016

  • تاریخ انتشار: 1395/07/27
  • تعداد عناوین: 9
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  • Hossein Fakhrzadeh, Shirin Djalalinia, Mojdeh Mirarefin, Tahereh Arefirad, Hamid Asayesh, Saeid Safiri, Elham Samami, Morteza Mansourian, Mostafa Qorbani* Pages 92-97
    Introduction
    Physical inactivity is one of the most important risk factors for chronic diseases, including cardiovascular disease, cancer, and stroke. We aim to conduct a systematic review of the prevalence of physical inactivity in Iran.
    Methods
    We searched international databases; ISI, PubMed/Medline, Scopus, and national databases Irandoc, Barakat knowledge network system, and Scientific Information Database (SID). We collected data for outcome measures of prevalence of physical inactivity by sex, age, province, and year. Quality assessment and data extraction has been conducted independently by two independent research experts. There were no limitations for time and language.
    Results
    We analyzed data for prevalence of physical inactivity in Iranian population. According to our search strategy we found 254 records; of them 185 were from international databases and the remaining 69 were obtained from national databases after refining the data, 34 articles that met eligible criteria remained for data extraction. From them respectively; 9, 20, 2 and 3 studies were at national, provincial, regional and local levels. The estimates for inactivity ranged from approximately 30% to almost 70% and had considerable variation between sexes and studied sub-groups.
    Conclusion
    In Iran, most of studies reported high prevalence of physical inactivity. Our findings reveal a heterogeneity of reported values, often from differences in study design, measurement tools and methods, different target groups and sub-population sampling. These data do not provide the possibility of aggregation of data for a comprehensive inference.
    Keywords: Physical Inactivity, Systematic Review, Iran
  • Ali Taghizadieh, Mahboub Pouraghaei, Payman Moharamzadeh, Alireza Ala, Farzad Rahmani*, Karim Basiri Sofiani Pages 98-101
    Introduction
    The routine and gold standard method to diagnose of acid – base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis.
    Methods
    In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated.
    Results
    Mean of ETco2 and Hco3 levels in patients with metabolic acidosis were 22.29 ± 4.15 and 12.78 ± 3.83, respectively. In all patients, the significant direct linear relationship was found between ETco2 with Hco3 (r = 0.553, P
    Conclusion
    According to the results of this study, capnography can be used for primary diagnosis of metabolic acidosis in spontaneously breathing patients who referred to the emergency wards, however, the ABG must be considered as the gold standard tool for diagnosis and guiding the treatment.
    Keywords: Metabolic Acidosis, Blood Gas, Capnography
  • Mehdi Hassanpour, Omid Cheraghi, Vahid Siavashi, Reza Rahbarghazi, Mohammad Nouri Pages 102-106
    Introduction
    A large number of cardiovascular disorders and abnormalities, notably accelerated vascular deficiencies could be related to aging changes and increased length of life. During the past decades, the discovery of different stem cells facilitates ongoing attempts for attenuating many disorders, especially in vascular beds. Endothelial progenitor cells (EPCs) are a subtype of stem cells that have potent capacity to differentiate into mature endothelial cells (ECs). However, some documented studies reported an age-related decline in proliferation and function of many stem cells. There is no data on aging effect upon proliferation and morphological feature of EPCs.
    Methods
    To show aging effect on EPCs proliferation and multipotentiality, bone marrow samples were provided from old and young cases in three different species; human, mouse and dog. After 7 days of culture, the cell morphology and clonogenic capacity were evaluated. We also calculated the mean number of colonies both in bone marrow samples from old and young subjects. To confirm the cell phenotype, isolated cells were immune-phenotyped by a panel of antibodies against Tie-2, CD133 and CD309 markers.
    Results
    Our results showed that EPCs exhibited prominent spindle form in all bone marrow samples from young cases while the cell shape became more round by aging. Notably, the number of colonies was reduced in aged samples as compared to parallel young subject samples (P
    Conclusion
    The results of this study suggest that the age-related vascular abnormalities could be presumably related to the decline in stemness capacity of EPCs.
    Keywords: Endothelial Progenitor Cells, Human, Mouse, Dog, Aging
  • Ramin Heshmat, Gita Shafiee, Mostafa Qorbani*, Fatemeh Azizi, Soleiman, Shirin Djalalinia, Mohammad Esmaeil Motlagh, Gelayol Ardalan, Zeinab Ahadi, Omid Safari, Saeid Safiri, Roya Kelishadi* Pages 107-112
    Introduction
    Current evidence suggests that ghrelin could contribute to the development of metabolic syndrome (MetS) in adults, but limited experience exists in adolescents. This study aims to explore the association of ghrelin levels with the MetS components among Iranian adolescents.
    Methods
    In this case-control study, 32 adolescents with MetS and 148 healthy controls were selected randomly from the childhood and Adolescence Surveillance and Prevention of Adult Non communicable disease (CASPIAN-III) study. MetS was defined according to the Adult Treatment Panel III (ATP III) criteria modified for children and adolescents. Anthropometric measures (including body mass index [BMI], waist circumference [WC] and waist to height ratio [WHtR]), blood pressure (BP) and biochemical data (including fasting blood sugar [FBS], triglyceride [TG], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC] and gerlin) were measured.
    Results
    Total ghrelin level was significantly higher in students without MetS compared to those with MetS (748.89 ± 85.04 vs. 728.72 ± 90.36 [pg/mL]; P
    Conclusion
    We observed a relationship between ghrelin concentration and MetS components in adolescents.
    Keywords: Cardiovascular Risk Factors, Adolescent, Metabolic Syndrome, Ghrelin
  • Hassanali Lotfollahi, Mustafa Mohammadi*, Samad Ghaffari*, Reza Badalzadeh, Bahram Sohrabi, Naser Aslanabadi, Ahmad Separham, Ali Golmohammadi, Ali Abbasnejad, Mehri Roshani Pages 113-118
    Introduction
    This study designed to use remote ischemic post conditioning (RIPC) as a protective strategy during percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI) to reduce myocardial cells damage due to reperfusion injury.
    Methods
    Sixty-one patients were divided into test group (32 patients) receiving RIPC and control group (29 patients). Patients were included with first MI who had 20-80 years old. The RIPC protocol was applied on patients arm in three successive episodes during the opening of infarct-related artery (IRA). Whole blood sample were taken from patients after the first episode before IRA opening and after the third episode after IRA opening. The serums were extracted and stored in the freezer -70˚C to determine the levels of glutathione peroxidase (GPX), superoxide dismutase (SOD), total antioxidant capacity (TAC) and malondialdehyde (MDA).
    Results
    The levels of GPX and SOD after the first episode of RIPC were significantly higher in test group than control group (P
    Conclusion
    The results indicated that RIPC protocol has protective properties in patients with STEMI through enhancing the antioxidant potentials and decreasing lipid peroxidation.
    Keywords: STEMI, Remote Ischemic Postconditioning, Primary Angioplasty, Oxidative Stress, MDA
  • Shabnam Mohammadi, Arya Hedjazi*, Maryam Sajjadian, Naser Ghoroubi, Maryam Mohammadi, Saeed Erfani Pages 119-125
    Introduction
    The heart is in a muscular organ in the middle mediastinum. According to our knowledge, there is no standard data about the anthropologic parameters of normal Iranian hearts. Hence, the aim of the present study was to investigate the normal heart size in Iranian cadavers.
    Methods
    In a cross-sectional study, 550 cadavers (104 female/446 male) from June 2014 to July 2015 in the Razavi Khorasan province of Iran were included in the study. After approval of the Ethical Committee, cadavers were divided into 10 groups based on age groups. Length, width, weight, chordae tendineae, papillary muscles, and heart valves were measured using vernier caliper. Finally, data were analyzed using SPSS software.
    Results
    The mean values of the demographic data were as follows: age= 42.12 ± 21.34 years; weight = 60.38 ± 15.32 kg; height = 158.14 ± 23.77 cm; and BMI = 24.66 ± 17.60 kg/m2. The mean values of the heart length, width, chordae tendineae, pupillary muscles, weight, and index of the heart were 11.41 ± 2.15 cm, 8.21 ± 4.38 cm, 19.41 ± 6.70, 5.74 ± 1.96, 247.78 ± 62.27 grams, and 5.74 ± 1.96, respectively. In addition, the circumference of the tricuspid valve, circumference of the mitral valves, and tricuspid and mitral areas were 8.80 ± 1.11 cm, 9.43 ± 1.44 cm, 4.11 ± 0.71 cm2, and 4.50 ± 0.90 cm2, respectively.
    Conclusion
    Mean values of the heart’s length and width was similar to previous reports from western population. The circumference of the tricuspid valve was less than the textbook’s data, while circumference of the mitral valves was more than it. The study findings provide valuable information about standard data of the heart in the Iranian population, which is useful for surgeons as well as anthropologists. However, multi-center studies with a larger sample size are required to complete data about anatomical characteristics of normal hearts.
    Keywords: Human Heart, Cadaver, Gross Anatomy, Morphometry
  • Naser Aslanabadi, Samad Ghaffari, Naser Khezerlouy Aghdam*, Masoumeh Ahmadzade, Babak Kazemi, Babak Nasiri, Ahmad Separham, Bahram Sohrabi, Mohamadreza Taban, Arash Aslanabadi Pages 126-131
    Introduction
    Atrial fibrillation (AF) is the most common arrhythmia in patients with mitral stenosis (MS) and it may increase complications and decreases success rates of percutaneous balloon mitral valvotomy (PBMV). This study aimed to investigate the short and long term results of PBMV in patients with AF compared to sinus rhythm (SR).
    Methods
    In this cross sectional study, 1000 patients with MS who had undergone PBMV between 1999 and 2013 were enrolled including 585 and 415 patients with AF and SR respectively. Patients were followed for a mean of 7.27 ± 3.16 years. Clinical, echocardiographic and hemodynamic data were collected. Procedure success, in-hospital and long-term outcome were evaluated.
    Results
    Patients with AF were older and had greater symptoms, mitral regurgitation, mitral echocardiographic score, and mitral pressure gradient before PBMV. PBMV success rate were significantly lower in AF group (P
    Conclusion
    AF leads to worse in-hospital and long-term outcome and lower PBMV success rate. Repeated assessment and early decision to PBMV in patients with MS to reduce AF and AF related complication seems necessary.
    Keywords: Mitral Stenosis, Balloon Mtral Valvotomy, Atrial Fibrillation
  • Ruben Kevin Arnold Tapia Orihuela*, Jorge Huaringa Marcelo, David Loja Oropeza Pages 132-136
    Introduction
    Situs inversus totalis is an uncommon anomaly which exist a complete transposition of organs and it’s occasionally associated with congenital heart diseases, such as tetralogy of fallot. Pheochromocytoma is a rare neuroendocrine tumor with an annual incidence of 2-8 cases per million people and for years has been studied its relationship with the hypoxic pathway.
    Case Report: A 29 year old male with a history of tetralogy of fallot corrected at 10 years and situs inversus totalis. He was admitted to hospital with a progressive story of four months of constipation, palpitations, headache, dyspnea and sweating. Physical examination revealed a thinned man with peripheral cyanosis, clubbing and signs of decompensated congestive heart failure as hepatomegaly, legs edema, multifocal systodiastolic murmurs, abdominal distension and jugular venous distention. The echocardiogram shows severe right ventricular dysfunction and severe pulmonary hypertension. Furthermore, abdominal computed tomography shows right adrenal mass. Elevated metanephrines and catecholamines confirmed the diagnosis of pheochromocytoma. Surgical removal is decided and preoperative management begins with alpha-adrenergic blockade, however the patient had a hemodynamic decompensation with an unfavorable evolution.
    Discussion
    In conclusion, there are few reports of cyanotic congenital heart disease with pheochromocytoma. Several studies show a significant association between both of them due to chronic hypoxia leads sustained hyperresponsiveness in adrenal medulla and it would cause the tumor. Special preoperative management of pheochromocytoma is recommended when there underlying heart disease and congestive heart failure. We present the first international report of tetralogy of fallot and pheochromocytoma in a patient with situs inversus totalis.
    Keywords: Tetralogy of Fallot, Pheochromocytoma, Congenital Heart Defects, Situs inversus, Hypoxia
  • Mohammad Ali Ostovan, Mahdi Sajedi Khanian, Sahand Hamidi, Mostafa Fattahi, Pooyan Dehghani* Pages 137-139
    Spontaneous coronary artery vasospasm is one of the important causes of acute chest pain syndromes. The diagnosis of diffuse multifocal spasm can be quite challenging and it could be easily mistaken for diffuse coronary artery disease. The use of intracoronary nitroglycerin can relieve spasm and reveal the real extent of coronary artery disease. Herein we present a case presenting with acute myocardial infarction due to severe coronary artery spasm that had even received fibrinolytic therapy. Multiple narrowing was shown during coronary angiography and the patient was scheduled for percutaneous coronary intervention (PCI). But after intracoronary (IC) injection of nitroglycerin, all of lesions disappeared completely and the diagnosis of coronary spasm was confirmed.
    Keywords: Coronary Spasm, Intracoronary Nitroglycerin, Myocardial infarction