International Cardiovascular Research Journal
Volume:17 Issue: 2, Jun 2023

In acute myocardial infarction (MI), hypoxia, through the hypoxiainducible factor pathway, increases the level of apelin, protecting the myocardium from ischemia-reperfusion injury.

We aimed to evaluate the level of apelin-12 in the early and late phases of MI.

In this prospective observational study, 98 patients were randomly included with the following criteria: chest pain lasting for more than 30 minutes, a 12-lead ECG with ST-segment elevation, a rise of cardiac troponin I, and a primary percutaneous coronary intervention (PCI) within 12 hours. Blood samples were collected on the first day (early phase) and the seventh day (late phase) after reperfusion therapy. Continuous variables are expressed as mean ± standard deviation or median (range), while categorical variables are expressed as percentages. We compared the variables using the Wilcoxon test and evaluated the variability of apelin values with the Kruskal-Wallis test. We checked the degree of association and correlation between two variables with the Mann-Whitney test and Pearson correlation, respectively.

On the first day of the early phase after MI, the median apelin-12 level was 2.73 (0.46 –15.24), which was significantly higher than the seventh-day value of 2.32 (0.25 – 10.89) (P = 0.003 on Wilcoxon test). With the Kruskal-Wallis test, variability in apelin-12 values was noted on the first day relative to segmental wall motion abnormalities (P = 0.043) and on the seventh day relative to the number of coronary stenoses (P < 0.001). The Mann-Whitney test of the post-PCI final thrombolysis in MI (TIMI) flow grade (patients without reperfusion injury: TIMI 3; patients with reperfusion injury: TIMI ≤ 2) and the apelin-12 levels during the early phase of MI revealed a statistically significant difference (P = 0.002).

Differences in apelin-12 between the early and late phases may reflect the activity of the apelin-angiotensin receptor-like axis in patients with MI.

Vitamin D and parathyroid hormone (PTH) are related but impact cardiovascular functions differently.

This study investigated the roles of PTH and vitamin D serum levels in the severity of coronary artery disease and left ventricular systolic function (LVSF).

This cross-sectional study was conducted on 271 participants who underwent elective coronary angiography at Dr. Heshmat Hospital, selected by convenience sampling over four months. 25-hydroxyvitamin D (25 (OH) D) and PTH levels were obtained from patients’ blood samples. Vitamin D levels were categorized into three categories. The SYNTAX score was used to evaluate the severity of coronary artery disease (CAD), classified across three categories. The chi-squared test, independent samples t-test, and multivariable logistic regression were used for statistical analysis. Data were analyzed by SPSS ver.21.

Diabetes, hypertension, dyslipidemia, and lower vitamin D levels were independent variables affecting patients’ high-risk conditions. The highest SYNTAX score was in patients with vitamin D deficiency (P < 0.001). Patients with different ejection fractions did not have statistically significant differences in vitamin D (25.38 ± 14.23) and PTH levels (66.62 ± 17.39) (P = 0.4). The severity of CAD in patients with PTH > 40 was higher than in patients with PTH ≤ 40, but this was not statistically significant (P = 0.06).

Our results showed an inverse relation between CAD and vitamin D. However, the CAD risk did not change with PTH levels.

Subclinical left ventricular dysfunction is an important predictor of cardiovascular death, detected via the global longitudinal strain (GLS) echocardiographic parameter. While T2DM is associated with a worse GLS, it is not cost-effective to perform 2D speckle tracking echocardiography for all asymptomatic T2DM patients to screen for early signs of subclinical left ventricular dysfunction.

We aimed to investigate the association of possible risk factors with subclinical left ventricular dysfunction assessed by 2D speckle tracking echocardiography in T2DM patients with normal ejection fraction, excluding patients with comorbidities associated with left ventricular dysfunction such as hypertension or any cardiovascular disease.

This cross-sectional study involved patients aged >18 with type 2 diabetes mellitus (T2DM) and EF ≥ 50% referred to Shohada-e-Tajrish Hospital, Tehran, Iran, from May 2, 2023, to June 21, 2023. Patients with any history or signs and symptoms of heart disease and hypertension were excluded. The correlation of GLS with age, BMI, duration of diabetes, systolic (SBP) and diastolic blood pressure (DBP), and laboratory parameters was assessed using Pearson’s correlation test, with P < 0.05 denoting significance.

In this cross-sectional study, 118 patients consisting of 70 women (59.32%) and 48 men (40.68%) with T2DM were enrolled. The mean age of the participants was 49.61 ± 5.10 years. The mean GLS was -16.71 ± 2.14%. The GLS correlated positively with BMI (P = 0.038 and r = 0.197), SBP (P = 0.003 and r = 0.268), DBP (P = 0.023 and r = 0.209), homocysteine (P = 0.001 and r = 0.310), HbA1C (P = 0.046 and r = 0.184), LDL (P = 0.034 and r = 0.203), and TG (P < 0.001 and r = 0.375), and negatively with GFR (P < 0.001 and r = -0.363).

BMI, SBP, DBP, homocysteine, HbA1C, LDL, TG, and GFR correlated with subclinical left ventricular dysfunction assessed by GLS in patients with T2DM; these markers may offer value in selecting T2DM patients for cost-effective 2D speckle tracking echocardiography screening of subclinical left ventricular dysfunction.

Coronary artery disease (CAD) and its numerous consequences significantly reduce the quality of life for millions of people worldwide.

This study investigated the differential expression of let-7 microRNA between CAD patients and healthy peers, which can be used as an early diagnostic, therapeutic, and preventive tool.

In this case-control study, participants were selected through convenient sampling and categorized into CAD-positive (n = 25) and CAD-negative (n = 25) groups. Blood samples were obtained, and the level of let-7 miRNA was measured. Various other parameters, including demographic variables, blood pressure, and results of routine blood tests besides smoking status, educational level, overweight, diabetes status, and history of coronary atherosclerosis, were recorded. Familial history of hypertension, diabetes, atherosclerosis, and sudden death were also registered. Different statistical methods including independent sample t, Mann-Whitney, and chi-squared tests were used to compare variables. A P value of less than 0.05 was considered significant.

Patients with CAD were older, with a higher frequency of the male sex. Fasting blood sugar (P = 0.002), triglyceride (P < 0.001), HDL-cholesterol (P = 0.038), triglycerideglucose index (P < 0.001), TG/HDL-cholesterol ratio (P < 0.001), and LDL/HDL ratio (P = 0.011) were significantly higher in the case group. Also, smoking (P = 0.001), illiteracy (P = 0.005), dyslipidemia (P = 0.048), and a history of coronary atherosclerosis (P = 0.022) were more prevalent in the CAD patients. Differential expression of let-7 microRNA between groups was at the borderline of statistical significance (P = 0.058).

Let-7 microRNA was expressed higher in patients with CAD, which may be helpful in the early diagnosis of atherosclerotic plaques and can possibly be used in designing therapeutic and preventive approaches.

Acute myocardial infarction (AMI) is one of the leading causes of death worldwide. Contradictory findings are available regarding the effects of changes in electrolytes in patients with an AMI.

We aimed to investigate the effect of electrolyte changes on the 3-month outcome.

A total of 168 patients with AMI managed at Dr. Heshmat Hospital in Rasht, Iran, were investigated in this prospective cohort study by a census method. AMI was confirmed by biochemical, electrocardiographic, or angiographic evidence. Electrolyte serum levels, demographic characteristics, myocardial infarction type, ejection fraction (EF), and underlying diseases were collected in a checklist in the early hours after each patient entered the hospital. Information about patients’ outcomes and echocardiographic data were collected after three months. All data were analyzed using SPSS software version 22.

Out of 162 patients with AMI, most (44%) were aged between 50 to 59 years, and 76.8% were men. In all models, the odds of non-recovery remained constant with increasing electrolytes. On uni-variable and multi-variable models, sodium showed a significant positive association with initial EF (unstandardized coefficient = 0.8 in both uni-variable and multi-variable models, approximately), and phosphorus displayed a significant negative association with initial EF (unstandardized coefficient = -4.5 in both uni-variable and multi-variable models, approximately). There was no significant association of electrolytes with follow-up EF in all models.

In this study, the phosphorus and sodium serum levels were significantly related to the initial EF. However, none of the studied electrolytes impacted the 3-month outcome in AMI patients.

Tricuspid valve stenosis (TS) is often combined with tricuspid regurgitation and most cases of TS have a rheumatic origin. TS is usually associated with other valvopathies when occurring in a rheumatic context. Rheumatismal tricuspid stenosis typically occurs with concomitant mitral and/or aortic involvement. Other causes are rare, including congenital, carcinoid, and drug-induced valve disease, Whipple`s disease, endocarditis, and large right atrial tumor.

Here, we present a 42-year-old symptomatic woman with isolated TS due to rheumatic heart disease.

Patients suffering from rheumatic heart disease should be on regular followups and periodically assessed with echocardiography. In the present case, the tricuspid valve was involved in isolation.