Arya Atherosclerosis
Volume:18 Issue: 6, Jun 2022

Pulmonary hypertension (PH) is a common finding in chronic kidney disease (CKD) and is associated with increased mortality and morbidity. The effect of kidney transplantation on PH is not yet well evaluated. This study aimed to compare pulmonary artery pressure (PAP) before and after kidney transplantation in CKD patients.

This longitudinal study was conducted on 33 CKD patients who were candidates for kidney transplantation in a tertiary hospital in Mashhad, Iran. Pulmonary artery pressure and ejection fraction (EF) were assessed using trans-thoracic echocardiography (TTE). Demographic and clinical findings, including age, gender, and body mass index (BMI), as well as laboratory assessments, including hemoglobin, serum calcium and phosphorus level, and parathyroid hormone, were recorded before transplantation. TTE assessment was repeated one year after transplantation. 

Mean age of the study patients (17 males and 16 females) was 30.42 ± 9.71 years. The majority of patients (85%) received hemodialysis before transplantation. Compared to before transplantation, PAP significantly decreased (from 33.67 ± 6.78 to 26.06 ± 5.78 mmHg, p<0.001) and EF increased (from 52.85 ± 7.12 to 57.03 ± 4.08, p=0.003) one year after transplantation. A significant positive correlation was found between PAP difference and EF before transplantation.

The findings of this study showed that kidney transplantation was correlated with improved PAP and EF one year after transplantation and EF before kidney transplantation was correlated with PAP changes.

Coronavirus disease 2019 (COVID-19) may lead to myocardial damage and arrhythmia. Patients with ECG changes have shown an increased risk of mortality.

We aimed to study the changes in the electrocardiogram, which may be of great significance for risk stratification of COVID-19-positive patients.

A retrospective study was conducted to compare electrocardiogram changes and disease severity markers in COVID-19-positive patients admitted to a referral hospital between February 20 and March 20, 2020.

Our study consisted of 201 cases, including 123 males and 78 females. Ages ranged between 16 and 97 years old. Fifty-two (25.9%) cases had a history of ICU admission. Multivariate logistic regression analysis showed that a low O2 saturation level (OR = 0.920, 95% CI 0.868–0.976, p=0.005), several lab tests, ECG changes (OR = 46.84, 95% CI 3.876– 566.287, p = .002) and Age (OR = 1.03, 95% CI 1.000– 1.065, p = .048) were the independent risk factors for predicting mortality rate. In addition, we utilized multivariate logistic regression analysis, demonstrating that LBBB (OR = 4.601, 95%CI: 1.357–15.600, p=0.014) is the only ECG risk factor associated with morbidity in elderly patients with ECG changes.

ECG changes are strong indicators of high mortality rates in elderly COVID-19 patients. ECG interpretations should therefore be used for risk stratification and predicting the need for ICU admission.

To investigate the effects of comprehensive, integrated interventions on dyslipidemia Knowledge and Practices (LIPOKAP) using population and high-risk approaches.

The baseline of this national, multicentric community trial was conducted on three groups: the general population (adults over the age of 18 and their children aged 6-18), patients with dyslipidemia and their caregivers, and health professionals (physicians, nurses, health providers, and health workers). The general population was selected using multi-stage random sampling, while patients and health professionals were recruited using the consecutive sampling method. The research was carried out in urban and rural areas of five Iranian counties. The sampling method and sample size were similar in baseline and post-intervention surveys. Approximately 8-month intervention programs were carried out on the target groups, which generally included educational strategies. The intervention activities addressed the management, prevention, and control and were tailored to each target group, focusing on lifestyle and self-care. 

All questionnaires’ content validity ratio, content validity index, and Cronbach’s alpha were over 0.68, 0.83, and 0.73, respectively. We enrolled 2456 adults and 850 of their children, 3331 dyslipidemia patients, 1699 caregivers, and 1800 health professionals.

The validity and reliability of all developed questionnaires that can examine knowledgeand practice  changes as a result of intervention activities were acceptable.

Various mechanisms suggest that periodontal pathogens and inflammatory processes contribute to systemic pathogenic processes such as atherosclerosis. This study investigated the possibility of a correlation between the presence of incidentally found calcifications along the course of the internal carotid artery (ICA) and tooth loss and periodontal status.

A retrospective CBCT analysis was performed on 110 patients. CBCT scans obtained as a part of the dental examinations were analyzed for missing teeth and evidence of any calcification along the ICA course. The mean age, gender, and the total number of missing teeth for all scans revealing calcifications were evaluated. 

The study sample consisted of 110 scans, with the cohort’s mean age (SD) of 50.01 (±11.6) and gender distribution of 53.4% females and 43.6% males. A total of 17% of the scans exhibited the presence of calcification. A comparison of missing teeth between the two groups revealed that the group with calcification exhibited more missing teeth, which was statistically significant with a p-value of 0.01. Comparison of the apical lesions between the two groups revealed that apical lesion was higher in the group with calcification and was statistically significant with a p-value of 0.011.

The greater the number of missing teeth, the higher the chances of calcifications being detected along the course of the ICA.

Garlic may have anti-oxidanmayti-hypertensive and anti-hyperlipidemic properties. However, the effects of its administration on cardiac function in heart failure (HF) patients impact require further investigation. We aimed to evaluate garlic prescription effects on cardiac outcomes and quality of life scores in Iranian HF patients.

From August to December 2020, a randomized, double-blind clinical trial was conducted. Individuals with heart failure (New York heart association (NYHA) functional class of II and III) referred to private clinics in Isfahan, Iran, were randomly assigned to intervention (n=80) and control (n=80) groups. They have received 500 mg of odorless garlic tablets or the same shape and dosage of placebo twice daily for three months. Laboratory data, cardiac outcomes (end-diastolic diameter, ventricular septal thickness, NYHA functional class, left ventricular ejection fraction), quality of life score (Minnesota living with HF questionnaire), and the Modified Borg Scale (MBS) were all evaluated at the baseline and the end of the trial.

The population’s mean age was 58.1±13.5 years (55% males). Patients who consumed garlic had remarkably improved functional class compared to placebo takers and their baseline (NYHA practical class of II, 79.4% vs. 50.6%, P<0.001 and 79.4% vs. 54%, P=0.006, respectively). MBS levels were significantly lower among garlic consumers (baseline: 2.52±0.5, after three months: 2.2±1.06, P= 0.040).

Garlic administration may improve cardiac function and breathe in HF patients. Complementary research is necessary to confirm our findings.

HDL has been identified as a potential new treatment for atherosclerosis. Targeting lipid metabolism via the Reverse Cholesterol Transport (RCT) pathway can improve HDL metabolism. Apolipoprotein A-I mimetic peptides (ApoA-I MPs) are able to increase HDL metabolism. Thus, this systematic review aimed to examine the potential effect of ApoA-I MPs against atherosclerosis in mice models through the RCT mechanism.

This systematic review was conducted using previous in vivo studies published in four scientific databases over the last ten years (PubMed, SCOPUS, ProQuest, and Science Direct) and was based on the Systematic Review Protocol for Animal Intervention Studies (SYRCLE) protocol. 

This study’s primary outcome was a reduction in atherosclerotic plaque, where 16 articles were qualified for this study. Based on the risk of bias analysis, these articles had a low risk of bias. Most in vivo studies (13 of 16) showed that ApoA-I MPs significantly reduced atherosclerotic plaque formation. Generally, ApoA-I MPs played an important role in regulating HDL metabolism (HDL remodeling process, increased cholesterol efflux, and stimulated RCT pathway) and anti-inflammatory agent. ApoA-I MPs may differ in their ability to reduce atherosclerotic plaque depending on the peptide sequence and administration route.

ApoA-I MPs can reduce atherosclerotic plaque formation in mice by increasing cholesterol efflux via the RCT pathway. Further investigation is required to support the development of ApoA-I MPs as a new therapy for atherosclerosis in humans.

Covid19 is still one of the major public health problems of all countries nowadays. The most common cardiac manifestations reported till now are acute coronary syndrome, myocarditis, and arrhythmia. The prevalenceof COVID-19 induced arrhythmias is different in recent reports and varies from benign sinus tachycardia tomore ominous cases of severe bradycardia or even malignant ventricular arrhythmias. Here in, we describea case of complete heart block in severe covid-19 pneumonia and review all recent relevant case reportspublished to date in order to understand the probable mechanisms and contributing factors of this rarecomplication of the disease.

Prescription of antipsychotic drugs is critical since they may cause hemodynamic changes, including hypertensive crisis,which is particularly important in patients with cardiovascular diseases. Quetiapine is an atypical antipsychotic approved for the treatment of schizophrenia, bipolar disorder, major depressive disorder, and anxietydisorder.1 The exact mechanism of action of this drug is unknown, but it is assumed that it antagonizes D2 and HT2-5 receptors. It may also have antagonizing effects on α2-5, α1, H1, D1, and HT1a receptors.2, 3Quetiapine has been reported to cause hypertension3, 4 which occurred in the case presented here. A 67-year-old married woman suffering from insomnia for about two months was referred to the psychiatrist one month ago and was prescribed Gabapentin 100/Hs and Quetiapine 12.5 mg Hs. After 24 hours, she suddenly had palpitation and high bloodpressure.Depression is common in patients with uncontrolled hypertension which may interfere with blood pressure control. Depression screening in patients with hypertension is a simple and cost-effective tool to improveoutcomes.5Both depressed and hypertensive patients experience increased sympathetic tone and increased secretion of adrenocorticotropic hormones and cortisol. Therefore, the interaction between depression and hypertension is pathophysiologically acceptable.5, 6The symptoms were controlled with sublingual captopril, but they often recurred in the afternoon. The blood pressure has been under the control for 20 years by a cardiologist and her Electrocardiogram (ECG) was normal. In the recent visit, these drugs were continued for up to 10 days; moreover, considering potential drug allergy, the drugs were discontinued and clonazepam 1 mg tablet was administered ¼ Bid.Next, the sleep state was improved, though a heart rate of up to 85 per minute and elevated blood pressure (up to systolic blood pressure of 16) occurred often in the afternoon.Biochemical tests were normal and the nephrologist didn’t report major abnormal findings (Table1). The patient was diagnosed with slightly elevated renin due to taking Losartan 50 in the morning and at night