فهرست مطالب

  • Volume:16 Issue: 4, 2020
  • تاریخ انتشار: 1399/07/19
  • تعداد عناوین: 8
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  • Hossein Babaahmadi-Rezaei, Alireza Kheirollah, Saeed Hesam, Saleh Ayashi(), Mohammad Aberumand, Mohammad Hassan Adel, Masoumeh Zamanpour, Maryam Alasvand, Zohreh Amozgari, Mojgan Noor-Behbahani, Zahra Niknam* Pages 153-160
    BACKGROUND

    Although the antioxidant properties of ginger have been revealed, there is little available information on the effectiveness of ginger on inflammatory disorders such as atherosclerosis. This study was carried out to examine the effect of ginger on improving the complication of atherosclerosis.

    METHODS

    This study was a double-blind, placebo-controlled, randomized clinical trial conducted on patients with atherosclerosis. Participants in the ginger and control groups received 1600 mg of powdered ginger or placebo (wheat flour) in capsules daily for 8 weeks. Weight, body mass index (BMI), fasting blood sugar (FBS), cholesterol, triglyceride (TG), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL), lipoprotein (a) [Lp(a)], high-sensitivity C-reactive protein (hs-CRP), and total anti-oxidant capacity (TAC) were assessed before and after the intervention.

    RESULTS

    Ginger consumption in the intervention group significantly reduced serum Lp(a) level (27.25 ± 1.30 ng/ml vs. 23.57 ± 0.97 ng/ml) (P = 0.040) and also the level of hs-CRP in the intervention group was 1.90 ± 0.33 µg/ml and 1.24 ± 0.15 µg/ml (P = 0.010) before and after intervention, respectively, but the levels of Lp(a) and hs-CRP were not decreased significantly in the placebo group. The level of TAC in the ginger group was 0.71 ± 0.05 mM and after the trial was 0.57 ± 0.04 mM (P = 0.050); no significant differences were seen in TAC when ginger was administered at 1600 mg/daily for 60 days. Also the level of Lp(a) and hs-CRP but not TAC reduced significantly in ginger group compared to placebo group after intervention.

    CONCLUSION

    This study showed that ginger had anti-atherosclerosis and anti-glycemic properties associated through a significant decreased Lp(a) and FBS in patients with atherosclerosis supplemented with ginger.

    Keywords: Atherosclerosis, Ginger, Lipoprotein (a), C-reactive Protein, Oxygen RadicalAbsorbance Capacity
  • Zahra FotokianAli Pourhabib, Nasrin Navabi, Fatemeh Ghaffari* Pages 161-169
    BACKGROUND

    Marital satisfaction is an important variable in maintaining or promoting elderly health. Therefore, identifying the effective factors can increase life expectancy and quality of life. This study aimed to determine the relationship between aging perception and demographic and clinical characteristics with marital satisfaction in the elderly patients with coronary artery disease (CAD).

    METHODS

    This was a descriptive-correlational study. The sample size was 480 elderly patients with CAD who were referred to the heart clinics of hospitals in the west of Mazandaran Province, Iran, who were recruited by convenience sampling. Data were collected by a demographic checklist, ENRICH Marital Satisfaction Inventory, and Aging Perceptions Questionnaire (APQ). The data were analyzed by structural equation model (SEM) using Goodness of Fit Index (GFI and chi-square test. P-value less than 0.050 was considered as significant level.

    RESULTS

    The mean and standard deviation (SD) of marital satisfaction was 145.16 ± 12.12, and the mean and SD of aging perception was 113.39 ± 12.74. The results of the Pearson’s correlation coefficient indicated that the highest correlation was between aging perception and marital satisfaction (r = 0.68, P < 0.001). The model fit indices of the hypothesized model met the criteria, with the GFI = 0.91, Comparative Fit Index (CFI) = 0.93, Normed Fit Index (NFI) = 0.94, and non-Normed Fit Index (NNFI) = 0.91.

    CONCLUSION

    Considering the psychological risk factors affecting marital satisfaction such as aging perception and suitable measurement can lead to marital health and improve treatment outcomes by increasing elderly motivation in self-care. Therefore, the elderly patients with CAD need more serious and long-term educational, counseling, and supportive interventions.

    Keywords: Structural Equation Modeling, Marital Status, Satisfaction, Perception, Elderly, Coronary Artery Disease
  • Maryam A. Saba, Shahin Goharpey*, Behrouz Attarbashi Moghadam, Reza Salehi, Sayed Mohammadreza Afshani Pages 170-177
    BACKGROUND

    Decision making and the quality of care provided for chronic diseases have been shown to improve through patient participation. The HeartQoL questionnaire is a core healthrelated quality of life (HRQOL) tool specifically designed for individuals with ischemic heart disease (IHD) who have undergone interventions such as cardiac rehabilitation (CR).

    METHODS

    In this cross-sectional and multicenter study, 150 patients were recruited. The participants completed the HeartQoL, MacNew Heart Disease Questionnaire, and Short Form Health Survey (SF-36) on entering CR for validity assessment. The HeartQoL along with a Global Rating of Change (GRoC) scale (for responsiveness measurement) were completed by 100 participants 3 months later.

    RESULTS

    The mean age of all participants in validity assessment was 61.87 ± 8.13 years. Cronbach’s alphas of the total scales ranged from 0.70 to 0.81 and of the subscales from 0.70 to 0.82. The Pearson correlation coefficient was used to determine construct validity; similar constructs were confirmed with correlation coefficients ranging from 0.50 to 0.69 and dissimilar constructs with correlation coefficients ranging from 0.28 to 0.29 (P < 0.010). The assessment of the responsiveness of the questionnaire indicated that the area under curve (AUC) was greater than 0.70 (range: 0.74 to 0.91) and the optimal cut-off point was 0.65.

    CONCLUSION

    The Persian version of the HeartQoL questionnaire demonstrated satisfactory psychometric properties in the sample of participants admitted to CR after coronary artery bypass grafting (CABG). The present study results showed that the HRQOL can be used by clinicians and researchers in conjunction with other outcome measures to gain additional information about symptoms relevant to HRQOL in patients referred to CR and to evaluate change over time.

    Keywords: Health-Related Quality of Life, Outcomes Assessment, Validity, CardiacRehabilitation
  • Alireza Khosravi, Hamid Reza Rajabi, Mehrbod Vakhshoori, Katayoun Rabiei, Sayed Mohsen Hosseini, Asieh Mansouri, Farshad Roghani-Dehkordi, Jamshid Najafian, Mojtaba Rahimi, Tohid Jafari-Koshk, Babak Sadeghian, Mansour Shishehforoush, Ahmadreza Lahijanzadeh, Marzieh Taheri, Nizal Sarrafzadegan* Pages 178-184
    BACKGROUND

    The relation between air pollution and cardiovascular diseases (CVDs) risk factors, especially blood pressure (BP) levels, has been less frequently assessed. The aim of this study was evaluating the association between air pollutants of less than 2.5 µm [particulate matter (PM2.5)] and BP indices among individuals admitted with CVDs and pulmonary diseases.

    METHODS

    This cross-sectional study was in context of air pollution associated with hospitalization and mortality of CVDs and respiratory diseases (CAPACITY) study. Data of 792 Iranian patients referring to two hospitals in Isfahan, Iran, for cardiovascular or respiratory problems from March 2011 to March 2012 were used for analysis. BP indices including systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were obtained from patients’ medical forms and mean PM2.5 concentrations during 24 hours prior to admission of each patient were obtained from Isfahan Department of Environment (DOE).

    RESULTS

    Mean ± standard deviation (SD) of participants’ age were 62.5 ± 15.9 years. All BP indices on admission were significantly higher in women compared with men. Adjustment of all potential confounders including age, sex, temperature, wind speed, and dew point revealed that increasing one quartile in PM2.5 concentrations had been associated with 1.98 mmHg raising in SBP at the time of admission [95% confidence interval (CI) = 0.41-3.54, P = 0.010]. Women with cardiac diseases had higher all BP indices with increased PM2.5 concentration [SBP: β: 4.30, 95% CI = 0.90-7.70, P = 0.010; DBP: β: 1.89, 95% CI = 0.09-3.69, P = 0.040; MAP: β: 3.09, 95% CI = 0.68-5.51, P= 0.010, respectively).

    CONCLUSION

    Our findings suggest that increasing PM2.5 concentration has been positively associated with raising SBP in total population and all BP indices among women with cardiac problems at admission time. Several comprehensive studies are required for confirming these relations.

    Keywords: Particulate Matter, Blood Pressure, Air Pollutants, Air Pollution
  • Heidar Dadkhah-Tirani, Arsalan Salari, Asieh Ashouri, Azam Nouri-Saeed, Arezoo Javadzadeh-Moghtader* Pages 185-191
    BACKGROUND

    Depression is closely related to coronary artery disease (CAD). However, the association of depression before angiography with major adverse cardiovascular event (MACE) is still unknown.

    METHODS

    In a prospective cohort study, 410 patients underwent angiography for the first time between 2016 and 2017 in Dr. Heshmat Hospital, Rasht, Iran. Demographic and medical information were collected and depressive symptoms were assessed using Beck Depression Inventory-II (BDI-II). The patients were followed for one year after angiography. Chi-square test and analysis of variance (ANOVA) were performed to compare demographic and clinical characteristics of patients between different levels of depressive symptoms. Multiple Cox regression analysis was performed to assess the association between depression symptoms before angiography and MACE rate controlled for the effect of confounders.

    RESULTS

    Of 410 patients, follow-up data were available for 380 (95%) patients. the MACE occurred in 134 (35%) patients. Depressive symptoms were observed in 42% of patients. Based on multivariable Cox regression analysis, adjusted for CAD severity, the risk of one-year MACE occurrence in patients with mild, moderate, and severe depressive symptoms was 1.96 [95% confidence interval (CI) for hazard ratio (HR): 1.30-2.94], 1.88 (95% CI for HR: 1.15-3.09), and 2.81 (95% CI for HR: 1.56-5.06) times that of patients without depressive symptoms, respectively. Depression in patients before angiography increased the risk of MACE up to 2.045 times.

    CONCLUSION

    The results showed that MACE in patients with depression was more than patients without depression. MACE in different levels of depression (mild, moderate, severe) was not significantly different.

    Keywords: Depression, Angiography, Coronary Artery Disease
  • Mohammad Javaherian, Narges Dabbaghipour, Zinat Mohammadpour, Behrouz Attarbashi Moghadam* Pages 192-207
    BACKGROUND

    The current study aimed to update prior systematic review and meta-analyses (SRMA) in order to determine the effects of supervised exercise-based cardiac rehabilitation (EBCR) and introduce a suitable exercise protocol for management of lipid profile abnormalities in patients with cardiovascular disease (CVD).

    METHODS

    PubMed, Scopus, and Web of Science databases were searched from 1980 to December 2018. All published, randomized controlled trials (RCTs) reporting the efficacy of supervised EBCR in patients with CVD and measuring at least 1 component of lipid profile were included. The quality of articles was assessed based on the Physiotherapy Evidence Database (PEDro) scale. Random effect model was used to calculate the effect size of post-intervention data.

    RESULTS

    Initially 774 RCTs were reviewed, 14 of them were included in the study. In comparison with the control group, supervised EBCR was associated with higher serum levels of high-density lipoprotein (HDL) [weight mean difference (WMD): 1.297; 95% confidence interval (CI): -1.620, 4.214] and lower serum level of low-density lipoprotein (LDL) (WMD: -7.797; 95%CI: -14.005, -1.588), total cholesterol (TC) (WMD: -11.029; 95%CI: -20.716, -1.342), and triglyceride (TG) (WMD: -14.602; 95%CI: -28.992, -0.212).

    CONCLUSION

    It seems that EBCR is correlated with an insignificant increase in HDL serum level and a significant decrease in LDL, TC, and TG serum levels. Considering subgroup analysis results, it is suggested that long duration, moderate exercise volume (EV), and combination of aerobic exercise (AE) and resistance exercise (RE) be used to improve HDL and TG serum levels. Short duration, high EV, and AE+RE seem to significantly reduce LDL serum level. Moreover, moderate EV is associated with a significant reduction in TC level.

    Keywords: Cardiac Rehabilitation, Cardiovascular Diseases, Exercise, Lipids, Meta-Analysis
  • Mohammad Reza Sabri, Chehreh Mahdavi*, Hamid Bigdelian, Ali Reza Ahmadi, Mehdi Ghaderian, Bahar Dehghan Pages 208-210
    BACKGROUND

    Atrial septal defect (ASD) is one of the most common congenital heart defects (CHDs) with prevalence of 8% to 10% in children with CHD and incidence of 56 per 100000 live births. It is categorized according to the defect site in which the most common form is secundum ASD (ASD2) with the defect in the central part of the atrial septum.

    CASE REPORT

    In our case series, we evaluated five children aged under one year old with ASD2 and pulmonary hypertension (PH). All the patients were referred for surgical ASD closure. Their PH was improved and the size of right atrium (RA) and right ventricle (RV) became normal during the follow-up and one year after the surgery all of them had normal pulmonary artery pressure (PAP) with normal RA and RV size.

    CONCLUSION

    According to our study and those done by others, the prevalence of PH in infants with ASD is low, but when this combination is found without any other CHD, ASD closure should be considered.

    Keywords: Atrial Septal Defect, Pulmonary Hypertension, Congenital Heart Defects, Infant