Research in Cardiovascular Medicine
Volume:12 Issue: 45, Oct-Dec 2023

The objective is to evaluate the safety, efficiency, and clinical outcomes of Intravascular Lithotripsy Systems for treating Calcified Coronary Artery Disease (CAC) during revascularization.

Intravascular Lithotripsy (IVL) in India remains largely unexplored. Unfortunately, there is an alarming lack of sufficient data on this innovative technique, with only a handful of articles on IVL available in non-indexed journals that are not easily accessible online. This review aims to serve as a valuable source of information and promote further research on this innovative technique.

Intravascular lithotripsy systems have significantly impacted interventional cardiology, greatly improving the efficiency and safety of procedures. Coronary intravascular lithotripsy shows great promise in treating Calcified Coronary Artery Disease (CAC) during revascularization. IVL can be safely performed before stent implantation, with a high rate of procedural success and a low incidence of complications.

There is a proven link between air pollution (AP) and mortality due to cardiovascular disease and some epidemiological studies have suggested a stable association between cardiac arrest, myocardial infarction, cardiac arrhythmias, and AP. The present study was aimed to determine the relationship between AP and ventricular arrhythmias (VA) in patients with implantable cardioverter defibrillator (ICD).

The current study was conducted from April 2018 to March 2019 in Chamran Hospital of IUMS, Isfahan, Iran, on the 100 patients who had ICD and lived and worked in Isfahan. We record the residence and work of patients with ICD to be matched to the reports of the environment organization, and then detailed assessments related to VA were performed in them.

Of the patients, who did not show ventricular arrhythmia based on 6‑month analysis, 57.1% were male and 42.9% were female. In patients who showed ventricular arrhythmia, 66.7% were male and 30% were female. There was no significant difference between sex and the incidence of VA (P = 0.37). There is no significant difference between the presence of comorbidities and the incidence of VA (P = 0.89). The relationship between ventricular arrhythmia and AP was significant with spearman’s correlation coefficient of 0.26 and P = 0.008.

Increased AP is associated with an increase in the incidence of VA in patients with ICD, which increases the need for clinicians to pay attention to this issue and to explain it to patients. However, a more detailed study is needed to distinguish between the type of AP and the exact amount of each of the pollutant.

This study aimed to evaluate the association between plasma levels of high‑sensitivity cardiac troponin I (cTnI) in heart transplant patients and the grading of graft rejection.

In a cross‑sectional study, 92 biopsy samples from the patients who had undergone heart transplantation during 2022, at Rajaie Cardiovascular Medical and Research Center, the largest referral center in Tehran, Iran, were evaluated for heart transplant rejection. Transplant rejection grades, high‑sensitivity troponin I plasma levels, and the relationship between them were assessed statistically.

Forty‑two patients (mean age 37 ± 9.6 years, 26 (62%) male) were assessed. The mean transplant age was 3 ± 1.8 years. In terms of graft rejection, 30 (33%) biopsies showed Grade 1R and 4 (4%) showed Grade 2R. Quilty effect was observed in 43 (47%). The median (Q1–Q3) of the cTnI was 0.02 (0.02–0.75) and 43 (47%) had high troponin level (>0.03 ng/mL). A positive association was observed between high cTnI and rejection (P = 0.025).

The association between the troponin level and rejection grade suggested the considerable myocardial injury during the rejection process.

The worldwide prevalence of type 2 diabetes mellitus (T2DM) is rapidly increasing, and research has shown that low‑grade inflammation leads to the development and progress of T2DM. Participating in physical activities, as part of the management program, is recommended to control inflammation and prevent the complications of T2DM. Although the most effective type and intensity of exercise training are not recognized yet, aerobic training has been reported to have beneficial effects. This manuscript describes the protocol of a study, in which we compared the effectiveness of 8 weeks of high‑intensity interval training (HIIT) and moderate‑intensity continuous training (MICT) on inflammatory, metabolic, and anthropometric variables in type 2 diabetes patients.

Methods/Design:

This study was designed as a pilot randomized controlled clinical trial with three parallel groups. Twenty‑seven adults with type 2 diabetes were randomly assigned 1:1:1 to HIIT, MICT, and control groups. Participants in the HIIT and MICT groups were invited to undertake three sessions of supervised exercise each week for eight consecutive weeks. HIIT sessions consisted of seven 1‑min intervals of running exercise on a treadmill at 90%–95% heart rate reserve (HRR) separated by 2 min of active recovery at 60%–70% HRR. MICT sessions involved 30 min of continuous running on the treadmill at 60%–70% HRR. Participants were assessed 24 h before the start and 24 and 72 h after the last training session. The control group, however, continued their everyday life during the project. The primary outcomes were the alterations of plasma calprotectin, myeloperoxidase (MPO), and interleukin‑6.

Evidence shows the link between inflammation and the development of type 2 diabetes complications. Therefore, finding ways to improve inflammatory state is of vital importance to these patients. This study is the first clinical trial comparing the impact of long‑term HIIT and MICT on calprotectin and MPO for people with type 2 diabetes.

Context:

 Interleukin‑6 (IL‑6), a pro‑inflammatory cytokine, plays an important role in the pathogenesis of myocardial hypertrophy. By integrating its membrane receptor complex (gp80), IL‑6 activates the signal guidance components (gp130) and activates the hypertrophic signaling pathways. There is some evidence that 1,25 dihydroxyvitamin D exerts antihypertrophic effects, but the cellular and molecular mechanisms are not fully understood. The aim of this study was to evaluate the effect of calcitriol on the level of IL‑6 and its receptor components in hypertrophied rat heart.

Male rats were divided into control, hypertrophy, Vitamin D + hypertrophy, and propylene glycol + hypertrophy groups. The groups receiving Vitamin D and propylene glycol were treated 2 weeks before induction of hypertrophy and 2 weeks after hypertrophy. Myocardial hypertrophy was induced by abdominal aortic stenosis. Mean arterial blood pressure was measured by cannulation of the left carotid artery, and expression of genes was determined by reverse transcription‑polymerase chain reaction.

Blood pressure and heart‑to‑body weight ratio increased in hypertrophic groups compared to the control group (P < 0.01), but Vitamin D administration decreased these parameters (P < 0.05). Abdominal aortic stenosis increased IL‑6 expression levels (P < 0.001) and Vitamin‑D decreased IL‑6 mRNA levels (P < 0.01). The expression of gp80 in the hypertrophic group increased compared to the control group (P ˂ 0.05), but Vitamin D did not affect the expression of receptor subunits genes.

The data from this study suggest a possible mechanism for the antihypertrophic effects of Vitamin D through the regulation of inflammatory responses during hypertrophy. Thus, Vitamin D can reduce IL‑6 expression levels, thereby reducing hypertrophy.

Penetrating cardiac injuries are heart crises requiring immediate surgical intervention, and nail‑gun injuries have also been documented. This case report covers a 19‑year‑old male who self‑inflicted a single chest wound using a nail gun. Examination of the heart revealed a nail that touched the myocardium around the right ventricular outflow tract.