International Cardiovascular Research Journal
Volume:17 Issue: 1, Mar 2023

Hypertensive disorders of pregnancy increase neonatal and maternal mortality and morbidity. Studies have reported different seasonal patterns of these disorders during pregnancy.

We aimed to determine the seasonal prevalence of hypertensive disorders of pregnancy among women who gave birth at Ayatollah Taleghani Hospital, Ilam City, between 2017 and 2020.

This descriptive-analytical study involved 10,988 files of children born from June 2017 to May 2020 at Taleghani Hospital, Ilam City. Among them were 389 cases with hypertensive disorders during pregnancy, which were compared against 260 cases without hypertensive disorders (control group). Using a researcher-designed questionnaire, we collected data on demographics, pregnancy history, clinical information, and medical history. Data analysis was done in SPSS (V.16) using chi-squared, Fisher’s exact, Mann- Whitney U, and independent t-tests (P < 0.05).

Out of 389 cases (3.54%) of hypertensive pregnancy disorders, 254 (65.3%) were preeclampsia, 105 (27.0%) were gestational hypertension, 26 (6.7%) were chronic hypertension, and four (1%) were eclampsia. The highest prevalence of hypertensive pregnancy disorders was during winter (4.70%), specifically in February (5.46%) and January (5.05%). The minimum was in autumn (2.57%), specifically in September (2.40%) and November (2.50%). The mean age of the mothers, the mean age of the pregnancy, delivery method, history of abortion, history of stillbirth, incidents and disorders of the placenta and umbilical cord, amniotic fluid, gestational diabetes, thyroid disorders, history of preeclampsia, and history of infertility all had a significant relationship with hypertensive disorders during pregnancy.

Hypertensive disorders of pregnancy have a seasonal pattern and are more prevalent during the year’s colder months.

Iron-induced cardiomyopathy is the main cause of heart failure in patients with beta-thalassemia major (β-TM). Early diagnosis and timely cardiac iron overload (IO) therapy can improve patients’ prognosis.

This study evaluated the value of exercise test parameters and high-sensitivity C-reactive protein (hs-CRP) in detecting cardiac IO in patients with β-TM.

Forty β-TM patients (age range:18 – 48) were enrolled in this cross-sectional study. Serum hs-CRP was measured using ELISA. Echocardiography and exercise treadmill tests were performed. Cardiac IO was determined using cardiac T2* (CT2*) magnetic resonance imaging, and patients were divided into abnormal (CT2* < 20 ms; n = 22) and normal (CT2* > 20 ms; n = 18) groups. Statistical analyses were conducted using SPSS software. The Mann-Whitney U-test was used to assess differences between the groups. The correlations of variables were evaluated using Pearson’s or Spearman’s correlation analysis. Receiver operator characteristic (ROC) curves were drawn to calculate the optimum cutoff for each test.

We found a significantly higher level of hs-CRP (P = 0.011) and lower levels of the chronotropic index (CI) (P = 0.009) and heart rate recovery (HRR) at minutes 2 – 5 (P < 0.01) in the patients with abnormal CT2*. CT2* was inversely correlated with hs-CRP (r = -0.381, P = 0.022) and positively correlated with the CI (r = 0.346, P = 0.031) and HRR at minute 4 (HRR4) (r = 0.456, P = 0.005). ROC curve data showed diagnostic values of CI (AUC = 0.80, P = 0.005), HRR4 (AUC = 0.786, P = 0.008), and hs-CRP (0.711, P = 0.033) in predicting the severity of IO. These tests showed high sensitivity (CI = 84.6%, HRR4 = 84.6%, and hs-CRP = 85.7%) but low specificity (CI = 70.6%, HRR4 = 41.2%, and hs-CRP = 53.3%) in detecting the severity of cardiac IO.

We found that hs-CRP, CI, and HRRs were significantly associated with the severity of cardiac IO. Despite high sensitivity, these markers showed poor specificity in predicting cardiac iron deposition in β-TM patients.

SYNTAX scores (SS) and clinical SYNTAX scores (CSS) together are widely used in clinical practice as predictors for major adverse cardiac events (MACEs) after an elective primary percutaneous intervention (PCI).

We sought to investigate prognostic values of the combination of SS and CSS in predicting MACEs in a cohort of patients with acute myocardial infarction treated by primary PCI with a 12-month follow-up.

This prospective, longitudinal study included patients from two referral hospitals who had an acute myocardial infarction and underwent primary PCI. SS and CSS were calculated by researchers blinded to patient details using web-based software and clinical factors. SS and CSS were classified into three categories: low/SS1: < 11.75, moderate/SS2: 11.75 – 23.25, or high/SS3 > 23.25, and low/CSS1: < 22.95, moderate/ CSS2: 22.95 – 35.95, or high/CSS3: > 35.95. We followed the patients 12 months after the procedure and recorded clinical examination results and MACEs. Data analysis included the chi-squared test (c2), student’s t-test, and Cox regression analysis. Cumulative survival rates were estimated through Kaplan–Meier curve analysis.

Among 296 subjects, those with a MACE predominated in the SS3 (16.8%) and CSS3 (14.0%) categories. SS had a significant relationship with all-cause mortality (P = 0.015), re-infarction (P = 0.019), cardiovascular death (P = 0.03), and MACE (P = 0.04). CSS had a significant relationship with all-cause mortality (P < 0.001), re-infarction (P = 0.02), cardiovascular death (P = 0.016), and MACE (P = 0.045). The risk of death by 12-month follow-up of the SS3 patient group was 2.99 times higher than that of the SS1 group (HR = 2.99; 95% CI: 1.11 – 7.84; P = 0.029). The CSS3 patient group had a 4.23 times higher risk of death than the CSS1 group (HR = 4.23; 95% CI: 1.94 – 9.36; P < 0.001). According to Kaplan-Meier curve analysis, the difference in survival rates of the three patient groups categorized by SS or CSS was significant. The SS1 group had the highest survival rate of 91.8%, followed by the SS2 (85.0%) and SS3 (77.9%) groups. Regarding CSS, the CSS1 group had the highest survival rate of 93.0%, followed by the CSS2 (85.1%) and CSS3 (73.8%) groups.

The classification of SS (low SS1, moderate SS2, high SS3) and CCS (low CSS1, moderate CSS2, high CSS3) has important roles in the risk assessment of patients with ACS treated by primary PCI.

Smoking is a preventable cause of human death. While the chronic effects of smoking on cardiovascular health are well known, its acute effects remain obscure.

This study aimed to assess the acute effects of smoking on left ventricle (LV) diastolic and systolic cardiac function and right ventricle (RV) systolic function in healthy smokers.

In this before-after (quasi-experimental) study conducted at Modarres and Shohada-e-Tajrish hospitals in Tehran, Iran, healthy smokers were asked to discontinue smoking and caffeine for half an hour. Then, they underwent echocardiography by the same echo-cardiologist at baseline and 10 minutes after smoking a single cigarette with 10 mg of nicotine. The 2D speckle tracking mode illustrated the diastolic and systolic ventricular functions.

Among 80 participants were 54 males (67.5%) and 26 females (32.5%). The mean age was 36.8 ± 13.6 years. The mean smoking history was 7.3 ± 7.5 pack years. Significant changes occurred after smoking in the global longitudinal strain (GLS), E/A ratio, and pulmonary artery systolic pressure (P = 0.001). No changes occurred in other factors including ejection fraction (EF), S wave velocity of septum, tricuspid annular plane systolic excursion (TAPSE), and right ventricular systolic function (SRV) (P > 0.05).

This study was carried out as a pilot for larger clinical studies to demonstrate the acute effects of smoking on heart function and cardiovascular health. Our findings indicate that smoking acutely affects both right and left ventricular parameters on echocardiography.

Cardiac surgery plays a vital role in human health. Hypothyroidism is a common disorder that affects 4 - 10% of the world’s population. One of the important challenges of cardiac surgery in hypothyroid patients is their perioperative management.

In this study, we determined the effects of hypothyroidism on complications after cardiac surgery.

In this retrospective cohort study, patients who underwent cardiac surgery in Birjand, Iran, during 2016 - 2021 and had TSH > 5 μU/mL in adults ≤ 50 and TSH > 10 μU/mL in adults > 50 years old were included as the case group. Also, adults ≤ 50 with TSH 0.3 – 5 μU/mL and adults > 50 years old with TSH 0.3 – 10 μU/mL were included as the control group. The complications and outcomes of cardiac surgery were extracted from the patient files.

This study involved 30 patients with hypothyroidism and 90 controls. The two study groups were comparable regarding gender, type of cardiac surgery, history of diabetes, hypertension, heart failure, myocardial infarction (MI), and dyslipidemia (P > 0.05). The frequency distribution of cardiac and pulmonary complications, delirium, acute kidney injury (AKI), sepsis, and mortality ratio was not significantly different between the two groups (P > 0.05); the mean systolic and diastolic blood pressure before and after the surgery, duration of mechanical ventilation, cardiopulmonary bypass time, aortic clamp time, duration of ICU hospitalization, and amount of use of dopamine, epinephrine, and norepinephrine were also similar (P > 0.05).

Hypothyroidism did not affect the frequency of complications and outcomes after cardiac surgery. Thus, achieving a euthyroid status in hypothyroid patients is unnecessary before cardiac surgery, and there is no need to postpone elective cardiac surgery until hypothyroidism is corrected.