Multidisciplinary Cardiovascular Annals
Volume:12 Issue: 1, Jan 2021

Angiogenesis is very important for most strategies for regenerative damaged organs. The natural inflammatory response can be affected by the activity of different types of macrophages and their cytokines. Macrophages exist in a wide variety of phenotypes. These macrophages can range from classic M1 to M2 macrophages. M2 macrophages themselves can include different types of subgroups. These types of macrophages are usually effective in vascular regeneration while M1 or classic macrophages play a role in chronic wounds. The macrophages move toward the M2 phenotype or inhibit the polarization of the macrophages toward the M1 phenotype. On the other hand, macrophage polarization can be affected by a variety of factors, such as different types of miRNAs. The process of vascular repair and enhancing the therapeutic potential of drug regulators the treatment of vascular damage through modification of macrophage polarization. Macrophages do this by various mechanisms, which are described in detail in this study. Finally, new therapeutic mechanisms aimed at macrophages in vascular disease are discussed.

 Changes in the dosage of immunosuppressive drugs following organ transplantation, especially the heart, can be a potential predictor of long-term post-transplant outcomes. It may also be related to the degree of histopathological involvement of endomyocardium.

 We aimed to evaluate cyclosporine and tacrolimus dose changes during post-transplantation biopsies and their association with endomyocardial biopsy grades.

 This retrospective study was performed on 100 cardiac transplant patients who underwent endomyocardial biopsies to assess graft stability. In the present study, the patients were divided into two groups receiving cyclosporine (13 cases) and tacrolimus (87 cases). The data was collected by reviewing the recorded files.

 Regarding the administration of cyclosporine, at different times after biopsy, there was no significant relationship between the plasma level of the drug and the grade of biopsy. Concerning tacrolimus, there was a significant reverse association between serum concentration and biopsy grade at the first biopsy after transplantation (about one month after transplantation), although this relationship was not observed in the subsequent steps of biopsy. Also, the Quilty effect frequency was not significantly associated with biopsy grade in different biopsies for both drugs.

 There is a lack of association between endocardial biopsy grade in the heart and the serum level of cyclosporine after transplantation. However there is a significant reverse relationship between endomyocardial biopsy grade and serum Tacrolimus concentration in the first weeks after transplantation and thus monitoring serum Tacrolimus after transplantation may play an important role in predicting acute rejection.

 Congenital heart disease (CHD) is the most common congenital disorder in neonates. Many factors are associated with the occurrence of the CHD, including genetic factors, teratogenic exposure and several other unrecognized factors.

 This study aims to investigate the role of several potential factors associated with the occurrence of CHD.

 This study was conducted as a cross-sectional case-control study, in Imam Khomeini Hospital Complex, Tehran, Iran. A total of 1338 known cases of CHD, diagnosed by echocardiography or angiography and 1201 healthy children as the controls were included in this study. Factors that could have an association with CHD were investigated by a questionnaire from all participants.

 Maternal age above 30 years (P-value < 0.001), positive parents’ consanguinity (P-value < 0.001) and previous maternal history of abortion (P-value < 0.001) was significantly higher among patients with CHD; furthermore, positive history of CHD among siblings of the known cases of CHD was higher than healthy ones (P-value < 0.001). The mean birth weight in case and control group were 3 (+ 0.648) and 2.9 (+ 0.707) kilograms, respectively. The maternal age in 983 (73.4%) cases and 960 (79.93%) controls was below the 30 years, the maternal age for other participants was above the 30 years (P-value < 0.001).

 All factors except the history of stillbirth, maternal underlying disease and drug use during pregnancy in the case group were significantly different with the control group. It seems that the causes of CHD in Iran are most commonly related to the hereditary genetic factors, and the increased maternal age, drug use, and underlying diseases in the mother are a matter of less importance.

 Anemia is a predictor of no reflow with high rate morbidity and mortality particularly in patients with heart failure.

 The aim of this study was to investigate the relation between hemoglobin level and no-reflowing in patients with myocardial infarction undergoing primary PCI.

 In this retrospective cross sectional study, all patients with ST elevation myocardial infarction (STEMI) undergoing coronary angiography from 2016 till 2018 were included. According to post procedural TIMI flow, the patients were divided into two groups: patients with TIMI flow III and those with TIMI flow less than III. Patients’ demographic and laboratory data such as hemoglobin, hematocrit, platelets count, white blood cells, serum creatinine level and troponin were collected. To compare the quantitative variables chi square test and to compare qualitative variables t-test were applied by SPSS software version 19.

 In this study 1200 patients with acute ST elevation myocardial infarction (STEMI) treated with primary PCI were included. The mean Hemoglobin level in normal TIMI group and low TIMI group were 14.15 ± 1.49 and 13.66 ± 1.69, respectively (P < 0.001). Our results also showed a significant lower RBC count (P < 0.001), lower HCT level (P < 0 .001) and lower RDW (P < 0.001) in those patients with lower TIMI flow. Based on the multivariate regression analysis lower hemoglobin has a significant association with lower TIMI flow and no-reflow (OR = 0.747, CI = 0.618 - 0.888, P < 0.001).

 Our study showed that in patients with STEMI undergoing primary PCI, hemoglobin level had a significant association with post procedural low TIMI flow and no-reflow. Our results emphasize the need for randomized control trials to evaluate the importance of pre-simultaneous blood transfusion in patients with anemia undergoing PPCI.

 Congestive Heart Failure (CHF) is a debilitating disorder that affects 1-2% of the general population. Despite recent advances in the management of heart failure, symptomatic heart failure still has a poor prognosis, so the importance of evaluating these patients is emphasized. The micronutrients are not produced in the body, but they should be taken in the required amount of diet, and their required amount is generally less than 100 mg per day. Copper deficiency leads to hypertrophic cardiomyopathies in several experimental models, which ultimately leads to systolic and diastolic cardiac function impairment. Copper deficiency is the only nutritional factor that increases cholesterol, blood pressure, homocysteine, and uric acid, leads to glucose intolerance, and increases thrombotic and oxidative damage.

 The aim of this assessment is to examine the serum copper level in patients with Heart failure hospitalized in Rajaie Cardiovascular, Medical and Research Center and its related factors in the period of 2017-18.

 This as a prospective descriptive study conducted on patients with heart failure hospitalized in Rajaee Cardiovascular, Medical and Research Center. Research variables included serum copper level, Pro-BNP serum level, heart failure etiology, Seattle Heart Failure Model (SHFM), age, gender, BMI, history of diabetes, history of airway disease, duration of heart failure diagnosis, smoking, presence of shortness of breath, the amount of ejection fraction (EF), initial blood pressure, serum hemoglobin levels, white blood cell count, creatinine, cholesterol, sodium and uric acid. Accordingly, 80 patients with heart failure have been evaluated and the results of the evaluation of patients have been put together based on the aims of the study.

 Of the evaluated cases, there were 52 (65%) male and 35 (28%) female. The mean and standard deviation of the patients' age was 49.9 ± 16.2 years, also the mean and standard deviation of serum copper was 189.28 ± 58.3 (range:80-150). The evaluated indices in this study included severe NYHA (P = 0.90), ejection fraction (EF) in echocardiography (P = 0.40), serum Pro BNP (P = 0.45) and prognosis of disease according to Seattle Heart Failure Model (P = 0.63), because non of the patients copper serum level were under the baseline we could not found statistically significant relationship between serum copper level and EF, pro BNP, NYHA function class and prognosis of the disease according to Seattle Heart failure model, while there was a significant statistical relationship between serum copper levels and etiology of heart failure (P = 0.02).

 Copper does not have a significant effect on the status of patients with heart failure, and only some differences were observed in the etiology of heart failure.

 A critical, therapeutic interference that develops the opportunity of survival is cardiopulmonary resuscitation (CPR). One of the practical factors resulting from resuscitation is the presence or absence of underlying disorders in patients.

 This experiment aims to evaluate the primary disease and success rate of resuscitation.

 This study was an observational retrospective study; the therapeutic histories of all patients who sustained CPR were collected. A total of 587 patient case histories, who were supported with in Hospital CPR within two years from January 2017 to June 2018, were enrolled in the current investigation. The association of CPR success rate with underlying disease, the first cardiac rhythm observed after monitoring, and the use of cardiac defibrillator was investigated.

 Overall, the success valuation of CPR in this investigation was 26.3%. There was no notable correlation between the success rate of CPR, and the early detection of cardiac rhythm after monitoring and using a cardiac defibrillator. Past medical histories reported a difference among the success rates of CPR in patients with hypertension, diabetes, and cardiac and renal disease.

 The current study revealed a significant difference in past medical histories and CPR outcomes.
 

 Cardiopulmonary resuscitation (CPR) has been a frequently performed medical intervention that increases the chance of survival of a person stricken by cardiac arrest, and there is an excellent value of diversity in the rate of successful rehabilitation in societies.

 A retrospective observational study was carried out. The medical records of all in-hospital and out-hospital cardiac arrest patients who underwent CPR were collected. A total of 587 people with who underwent CPR during two years between January 2017 and June 2018, using a designed form were enrolled. Demographic information, the ward which CPR was committed, hospitalization, the delay before the onset of CPR and time of the day were recorded.

 The overall success rate of CPR in this study was 25.89%. There was no significant difference in the success rate of CPR between men and women. A comparison of age groups revealed a difference between the success rates of CPR in 14 - 64 years group compared with the group above 64. Analysis of the data revealed no difference between CPR success rates in various seasons. Investigating the occurrence of cardiac arrest and its success rate at the hospital shifting showed a significant difference between the success rate of CPR in the morning shift with the evening shift and night. The dual comparison revealed a significant difference in the success rate of CPR only between the emergency department and intensive care units.

 The current study revealed a significant difference in age group and location, and did not show any significant success rate of CPR in the presence of witnesses, location of cardiac arrest, season and gender.