Multidisciplinary Cardiovascular Annals
Volume:13 Issue: 2, Jul 2022

Thyroid hormones play an important role in cardiac tissue function. Therefore, it is important to understand the relationship between thyroid hormone levels and cardiac disorders.

The present study aimed to assess the relationship between normal serum level of thyroid hormones and left ventricular systolic and diastolic dysfunction.

In this cross sectional descriptive retrospective study, 391 patients were selected. They were referred to the Rajaie Cardiovascular Research Center, Tehran, Iran from 2019 to 2021. After extracting echocardiographic and laboratory data from the clinical records, the parameters affecting the left ventricular systolic and diastolic dysfunction were analyzed using statistical software.

The mean age of patients was 41 ± 12.8 years. Among them 58.1% of all patients were female. Tricuspid regurgitation (TR) severity had a significant relationship with thyroid stimulating hormone (TSH) level (P = 0.02). End diastolic interventricular septum thickness (IVSD) was inversely associated with thyroxin4 (T4) level (P = 0.04). Mitral valve inflow deceleration time (MVDT) was inversely correlated with thyroxin3 (T3) (P = 0.04). Left ventricular ejection fraction (LVEF) was inversely related to TSH level and end diastolic right ventricular internal diameter (RVIDd) was directly related to TSH (P = 0.05).

Thyroid hormone levels in the normal range can be associated with the tricuspid regurgitation severity, end diastolic right ventricular internal diameter (RVIDd), mitral valve inflow deceleration time (MVDT), and. end diastolic interventricular septum thickness (IVSD). Due to the high prevalence of heart disorders, information on thyroid hormone levels can be helpful in the identification and timely treatment of these disorders.

 There are many surgical methods used to treat sinus of Valsalva aneurysms, and these methods vary depending on the surgical team's expertise and the patient's health, which has an impact on the surgical outcomes.

 In our study, we evaluated the midterm outcomes of a single center's highly skilled surgical team.

 In this retrospective cohort study the clinical data of 42 consecutive patients from November 1, 2005 to 21 august 2018 were reviewed and early and mid-term results were assessed. Twenty-two patients (53%) were presented with ruptured aneurysms; 8 of these patients (28.5%) had their aneurysms repaired with a double patch and an AV repair; nonetheless, 20 patients (46.6%) required valve replacement.

 It was found that there was no bicuspid valve in our patients, no correlation between the presence of VSD and the severity of aortic insufficiency in our series (P = 0.89), and the severity of aortic insufficiency increased when the Valsalva aneurysm ruptured into the heart chambers. There was a strong association between female gender and ruptured sinus of Valsalva aneurysms (P = 0.02, AI severity, P = 0.05, aortic valve surgery, P = 0.03, and total AV replacement, P = 0.001). RSOV and the likelihood of a heart block did not correlate in our series (P = 0. 29).

 Results from one surgical team, particularly when the same specialist is making decisions, are more trustworthy. Excellent long-term outcomes are obtained, and rupture of the SOV is linked to an increase in AI and, ultimately, to aortic valve surgery, primarily AV replacement. Using patch technique for closing fistulas does not increase the post op arrhythmia.

 Acute coronary syndrome (ACS) is a major cause of morbidity and mortality all over the world. Despite substantial efforts that have been made over the last decades, ACS management still remains challenging in most of the regions.

 This study describes the characteristics and trends of outcomes for ACS patients in a decade in north-east of Iran.

 In this cross-sectional study, two tertiary academic hospitals of Mashhad University of Medical Sciences in Iran were investigated during a 10-year period starting from January 1, 2007. Patients were identified according to their final diagnosis at discharge using the international classification of diseases 10th revision (ICD-10). The ten-year trend of prevalence of ACS was plotted. The outcomes (alive, death) were compared between the two types of myocardial infarction (MI) (ST-elevation myocardial infarction (STEMI), and non-ST elevation myocardial infarction (NSTEMI)/unspecific).

 During the study period, there were a total of 9068 admissions for acute MI or unstable angina. The mean age of admitted patients was 61.6 ± 13.7 years and the majority (67.8%) was male. The in-hospital mortality rate was 12.3% (927), which was significantly higher in NSTEMI/unspecific AMI compared to STEMI patients (15.3% vs. 9.8%, P < 0.001). Females were significantly older than males (65.7 ± 12.5 vs. 59.6 ± 13.8, P < 0.001) and have higher mortality rates compared to males (16.7 vs. 10.1, P < 0.001). The prevalence rate of all MI categories had an increasing secular trend, though the mortality rate was decreased.

 Although the prevalence rate of AMI has slightly increased, the mortality rate has decreased. Close cooperation between general practitioners, health providers and cardiologists are of great importance in this field.

 Inadequate nutritional status has been linked to poor outcomes in heart failure patients. Generally, high protein intake is recommended for sarcopenic and malnourished patients. On the other hand, protein restriction is recommended in patients with renal damage. We found no clinical trial considering protein intake in HF patients with renal insufficiency.

 The present study is a randomized, parallel-arm, controlled pilot study. The effect of a high protein diet versus glomerular filtration rate (GFR)-based protein intake in non-obese advanced HF patients will be assessed. Muscle mass will be assessed as the main outcome. Re-hospitalization, quality of life, renal function, physical performance, appetite and mortality are the second outcomes.

 In the present clinical trial, for the first time, we will evaluate the effect of high protein diet in patients with advanced HF who have pre-existing renal impairment. The result of the present trial may shed light on the methods for the nutritional intervention in this group of patients.

 Overally the anomaly of the coronary arteries are rare. Its incidence according to angiographic, autopsy and echocardiographic findings, are about 1%, 0.29% and less than 0.1% respectively. Usually these are the incidental finding during angiography without clinical presentation. These anomalies may be accompanied by myocardial ischemia, arrhythmia, syncope and sudden death.

 We present a 14-year-old Iranian boy who experienced chest pain and shortness of breath after engaging in physical activity. The right coronary artery (RCA) had an intramural and inter-arterial course and was proven to have originated from the left sinus of Valsalva by computed tomographic coronary angiography (CTCA). The RCA began adjunct to the ostium of the left main coronary artery and coursed intramural at first and then continued between the aorta and pulmonary artery. The patient underwent corrective surgery. The RCA was cut from origin and reanastomosd to the right coronary sinus after preparing the sinus. The patient recovered well and he was discharged with the ability to perform sports activity. One year Follow up of the patient was uneventful.

 Even though single ostium coronary artery abnormalities are uncommon, they have become more frequently identified in recent years using non-invasive techniques such transthoracic echocardiography, which is then followed by CT angiography or conventional angiography. These patients are susceptible to sudden death, so attention to symptoms of the patients and comprehensive approach to them can be lifesaving.