International Cardiovascular Research Journal
Volume:1 Issue: 4, Jul 2008

Vascular disease is the principal cause of morbidity and mortality in patients with diabetes. A considerable body of evidence implicates oxidative stress as an important pathogenic factor of diabetic vasculopathies. In the present study, the effect of hesperidin, a flavanone glycoside with antioxidant activity, is studied in endothelium-dependent relaxation of the rat aorta in experimental diabetes mellitus type 1 (DM1) and type 2 (DM2). Patients and Single dose intraperitoneal injection of streptozocin (60mg/kg) and subcutaneous daily injection of dexamethasone (10µg/kg for one month) were used to induce DM1 and DM2, respectively. Hesperidin (500mg/kg) was administered orally for two months in DM1 and one month in DM2. The effect of acetylcholine (Ach) on phenyl ephrine (PE) induced. PE contracted aorta was then studied and the EC50 and maximal relaxant effect of Ach were calculated and compared in the two groups. In the experimental DM1, hesperidin restored endothelium-dependent relaxation near to those of normal animals. Its effect on experimental DM2 consisted of a significant reduction of EC50 value of Ach compared to those of diabetic animals. It also showed a great but non-significant effect (P=0.07) on Ach-induced maximum relaxation compared to DM2 untreated animals. These results show that hesperidin can improve vascular endothelial dysfunction in experimental diabetes mellitus.

Evaluation of right ventricular (RV) contractility and systolic function in patients with right sided heart disease is an essential component of clinical management. The aim of this study was to assess RV systolic function by qualitative and quantitative methods and compare it to rate of ventricular pressure change during the isovolumic contraction period (dP/dt) as RV contractility index in patients with rheumatic mitral stenosis.Patients and In 56 consecutive patients with moderate to severe mitral stenosis, RV systolic function, RV dP/dt and dP/dt/Pmax, were calculated and compared. There was significant correlation between RV dP/dt and RV function (P<0.001) and between RV dP/dt and New York Heart Association (NYHA) functional capacity (P<.001). The mean of dP/dt was decreased with increasing severity of RV dysfunction (mean dP/dt was 648±159 for normal RV function, 592± 126 for mild RV dysfunction, 319±146 for moderate RV dysfunction and 166±150 for severe RV dysfunction) Severity of tricuspid regurgitation and pulmonary hypertension had no significant effect on RV dP/dt and RV function.RV dP/dt/Pmax had also significant relationship with RV function and functional capacity (P <0.001). Measurements of dP/dt and dP/dt/Pmax, are practical methods for estimating RV contractility and results have a good correlation with RV systolic function and functional capacity.

Conventional risk factors for coronary artery disease and myocardial infarction do not explain all of the clinical and epidemiological features of the disease. Periodontal disease is a common bacterial and destructive disorder of oral tissues. Many studies demonstrate close association between chronic periodontitis and development of generalized inflammation, vascular endothelial injury, and atherosclesis. Periodontal disease has been convincingly emerging as an important independent risk factor for ischemic heart disease. A case - control study was carried out to assess the prevalence of periodontitis in patients with Acute myocardial Infarction (AMI) and evaluate the possible relationship between AMI and chronic periodontitis. Patients and A number of 160 patients, aged 35 to 70 years old, enrolled in the study. Eighty patients (43 men, 37 women) were examined four days after hospitalization due to AMI. Control group consisted of 80 persons (38 men, 42 women) with normal coronary angiography. The following periodontal parameters were examined: Plaque index (PI), gingiral index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) and number of sites with CAL. The case, compared to control showed significantly worse results for some periodontal variables studied: The mean of PD and PD > 3 mm, CAL, and number of sites with CAL, had worse results compared to control despite similar oral hygiene and frequency of brushing. The confounding factors for the present study were found to be hypertension and diabetes. The association between periodontitis and acute myocardial infarction was significant after adjusting for conventional risk factors for AMI.

Post open cardiac surgery is associated with rises in fever, blood pressure and heart rate. The objective of the present study was to determine the changes in temperature, blood pressure and heart rate in first week after open cardiac surgery of non-complicated cyanotic and noncyanotic congenital heart diseases.Patients and Temperature, blood pressure and heart rate were obtained from 100 patients with different congenital heart disease after open cardiac surgery. The patients divided in two groups, 40 cyanotic CHD and 60 noncyanotic CHD. Half of patients had fever in first day after surgery. Cyanotic patients became afebrile earlier than noncyanotic group. Cyanotic patients had higher heart rate and lower blood pressure than noncyanotic group. The study suggests that post open heart surgery body temperature, blood pressure and heart rate are different in patients with cyanotic and non cyanotic congenital heart diseases.

The study was undertaken to compare the effects of small doses of sufentanil or pethidine on cardiovascular changes induced by tracheal intubation.Patients and Sixty American Soceity of Anesthesiology (ASA) physical status I-II patients, scheduled for elective abdominal surgery under general anesthesia, randomly allocated in a double- blind fashion to receive an intravenous bolus of either sufentanil 0.1 μg/kg (Group S, n = 30) or pethidine 1.5 mg/kg (Group P, n = 30) for induction of anesthesia. The heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were measured before induction of anaesthesia (baseline), at 1-min intervals for 3 min after the induction of anesthesia, at 1, 3, 5, and 7 min after start of laryngoscopy. No significant differences in SAP, DAP, and MAP were observed etween the two groups. Heart rate significantly increased 2 and 3 minutes after induction of anesthesia and 1 minute after intubation in group P compared with group S (P<0.01). However, the numbers of patients who developed a heart rate increase more than 20% of basal value were not different between two groups. At the end of the study period, systolic, diastolic, and mean arterial pressure slightly decreased from preinduction values that was transient and did not require treatment. If adequate timing in opioid administration is warranted according to the time to peak effect of each opioid drug, small doses of sufentanil or pethidine exert similar effect in controlling the inotropic response induced by the laryngoscopy and tracheal intubation.

Prospective studies confirm that microalbuminuria is predictive, independently of classical risk factor of cardiovascular diseases and all causes of mortality within groups of patients with diabetes or hypertension and in the general population. However, there are few data relating angiographic severity of coronary artery disease (CAD) to microalbuninuria (MA). We examined coronary angiograms for extent of severe CAD (luminal narrowing 50%) in patients without Diabetes Mellitus (DM) and general population.Patients and Our study consisted of 153 patients undergoing coronary angiography in Hazrat Fatemeh hospital in Iran. (M/F 80/73, mean age 57±11yrs). Urine albumin excretion was measured in 24.h urine samples by immune precipitation technique. Age-gender distribution of coronary risk factors and microalbuninuria was compared between patient with and without coronary artery disease. 70.5%(108) of patient had coronary artery disease and 29.4% (45) had no coronary lesion. Microalbuninuria was detected in 62.9% in patients with CAD and 8.8% in those without coronary artery lesion (P<0.001). The presence of 1 or 2 vessel CAD showed a linear increase between the groups without microalbuninuria. Thus, patients with microalbuninuria have more severe angiographicaly detected coronary artery disease than those without microalbuninuria, a relationship independent of other risk factor.

Transesophageal echocardiography is a useful method in cardiovascular diagnosis and preoperative care, being a safe procedure it carries significant complications. This is a report of transesophageal echocardiography complication by possible esophageal spasm in a young cardiac patients.

A 48 years old male, with porcelain ascending aorta, and diffuse and severe stenosis of great vessels who underwent coronary artery bypass graft (CABG), and the challenges surgeons may encounter in relation to these patients are discussed along with the review of corresponding literature on this challenging entity in cardiac surgery.