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Cardiovascular and Thoracic Research - Volume:3 Issue: 1, Apr 2011

Journal of Cardiovascular and Thoracic Research
Volume:3 Issue: 1, Apr 2011

  • تاریخ انتشار: 1389/12/28
  • تعداد عناوین: 8
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  • Fariborz Farsad, Bahador Baharestani, Hamidreza Pouraliakbar, Farshad Hashemian, Hooman Bakhshandeh, Abbas Zavarehee, Maryam Nadermohammadi Page 1
    Background
    Pseudo aneurysm has been an increasingly common complication of catheterization procedures during the past two decades, with the greatest incidence being in the femoral artery. Treatment of the iatrogenic femoral artery pseudo aneurysm with the injection of thrombin is reported to be an efficacious and safe procedure. In this study, we evaluated the efficacy and success rate of per coetaneous ultrasonographically-guided thrombin injection and compression method for the treatment of pseudo aneurysm and to determine the effect of thrombin injection on systemic coagulation parameters.
    Methods
    This Cohort clinical trial was conducted on patients with femoral pseudo aneurysm after percutaneous intervention (PCI) in Shaheed Rajaie Cardiovascular Medical and Research Center. The patients were divided into two randomized groups and treated with either the compression method or the percutaneous ultrasonographic-guided thrombin injection method. Pseudo aneurysm size, pseudo aneurysms neck size, thrombin dose, thrombosis time, outcome of therapy, and complications were documented prospectively. Duplex sonographic follow-up examinations were performed at 0 and 24 hours afterwards. Partial thrombin time as well as the Quick test (pro thrombin time) was monitored before and after the intervention.
    Results
    Thirty patients with femoral pseudoaneurysm following catheterization between 15 and 85 years of age were enrolled in this study. The mean size of the pseudo aneurysms length was 2.45 ± 1.15cm (SD) and pseudo aneurysms width was 2.06 ± 1.07cm. In total, 13 thrombin injections were administered. The mean thrombin dose was 500-2000 IU. The success rate of thrombin injection was %92.30 (12 of 13 patients), which was significantly higher than 82.35% (13 of 17 patients) in the compression method (p value<0.05). No thrombo embolic, infectious, or allergic complications occurred.
    Conclusion
    In this study, the percutaneous ultrasonographically-guided thrombin injection method was successful and safe in the management of femoral pseudoaneurysms. Changes in coagulating factors indicated the possibility of thrombin passage into the arterial circulation.
  • Masouad Pezeshkian, Akbar Darbin, Mohammad Reza Rashidi, Amir Mansor Vatankhah, Zahra Golmohammadi, Abbas Afrasiabi, Mohammad Nouri Page 7
    Background
    PON1 (Paraoxonase – 1) is an esterase enzyme that is associated with HDL (High Density Lipoprotein). This enzyme prevents the peroxidation of LDL (Low Density Lipoprotein). It is proved that the LDL susceptibility for oxidation is a risk factor for coronary artery diseases. The aim of this study is to survey the effect of atherogenic diet with or without enzyme inhibitors on the incidence and progression of atherosclerosis in rabbits.
    Methods
    Twenty four new zealand white rabbits divided into three groups (control, under the atherogenic diet, atherogenic diet and nandrolone decanoate - paraoxonase inhibitor) and were treated for two months. At first and at the end of the treatment, 5 ml of blood was obtained to determine the levels of TAC (Total Antioxidant Capacity), HDL, MDA (Mallon Dialdehide) and PON1. After sixty days rabbits anesthetized under standard conditions and sampling carried out from heart arteries for pathological examination. Data were analyzed using statistical software SPSS/15 and one way ANOVA and paired t-test statistical tests.
    Results
    The results showed that plasma levels of TAC, HDL, MDA and PON1 had significant changes in this study (P<0.05). The results of pathological study showed that in the presence of PON1, formation and progression of atheroma is diminished.
    Conclusions
    The results of this study show that cholesterol-rich diet decreased serum level of PON1 that led to a reduction in formation and progression of atheroma. It was shown that the enzyme inhibitor helps accelerating the development of atheroma.
  • Mehrnosh Toufan, Dina Ashouri, Behzad Mohammadi, Zahra Golmohammadi Page 11
    Background
    Tissue Doppler imaging is a relatively new method that measures regional myocardial velocities on the basis of color Doppler imaging. The aim of this study was to investigate both systolic and diastolic parameters to diagnose the coronary stenosis at rest.
    Methods
    We examined 73 patients without previous myocardial infarction who underwent coronary angiography. Peak early and late diastolic velocities, systolic velocity, time to peak systolic velocities were measured at rest.
    Results
    The patients were divided to those with coronary artery disease (CAD) in the presence of stenosis of more than 50% in one coronary artery and the control group. We found no significant differences between two groups.
    Conclusion
    Tissue Doppler Imaging is not a reliable tool for diagnosis of CAD at rest. Systolic and diastolic velocities by pulsed-wave tissue Doppler imaging were not sensitive for diagnosing the coronary stenosis.
  • Majid Malaki, Shamsi Ghaffari, Mohammad Reza Ghaffari, Mahmood Samadi, Bahman Rastkar, Anoosh Azarfar Page 17
    Background
    The relationship between congenital heart disease and nephropathy has been known for a long time although its mechanism has not been understood thoroughly. Furthermore such studies have been performed in older populations.
    Methods
    74 children aged between two months to 168 months (20 normal as control group,20 cyanotic and 34 acyanotic patients with congenital heart disease were investigated for their renal function and protein excretion. the measurements compared by T independent test in SPSS 16 program.
    Results
    Creatinine and glomerular filtration rate in cyanotic was lower than acyanotic group but these were not significant while both protein excretion incidence (65% vs 24%) and quantity (1.2 vs 0.2; measured as urine protein to creatinine ratio) were higher significantly in cyanotic group (P< 0. 001).
    Conclusion
    In cyanotic children with congenital heart disease proteinuria is more common and more severe compared with acyanotic patients; this is not related to age factor in children as it may occur to the same degree as nephrotic range in infants with cyanotic congenital heart disease.
  • Sepideh Sokhanvar, Mohammad Kiani, Nouraddin Mousavinasab, Zahra Golmohammadi Page 23
    Background
    Hyperhomocysteinemia is accompanied by many cardiovascular risk factors. However it’s relation with other cardiac risk factors and with extent of coronary artery disease (CAD) is still a controversial issue. This study was designed to investigate the relationship between total plasma homocysteine (tHcy) levels and other cardiovascular risk factors and the severity of CAD.
    Methods
    Plasma fasting tHcy levels were measured in 60 patients with angiographically documented CAD and compared to 56 age-sex-smoking habit matched control subjects. Also patients were classified into two risk groups according to their major risk factors as low risk (with two or few risk factor) and high risk (with three and more risk factor).
    Results
    Mean of tHcy levels were significantly higher in high risk patients compared to low risk patients (p=0.013).Also hyperhomocysteinemia rate was higher in the high risk patients compared to low risk patients, OR=5 (CI 95%=1.6-16).There were relationship between coronary risk factors and severe coronary artery disease (three vessels disease) but only in smokers (P=0.012) and diabetic patients (P=0.035) were statistically significant.
    Conclusion
    Plasma tHcy level was an independent risk factor for high risk patients.
  • Moussa Mirinazhad , Mohammad Chavoshinazhad, Nasser Ghorbanian Page 29
    Background
    To evaluate the epidemiology and etiology of acquired urinary tract infections in cardiac surgery ICU patients at Madani Hospital, Tabriz.
    Methods
    In this descriptive cross-sectional study, 500 patients in the cardiac surgery ICU in Tabriz Madani Hospital were evaluated for a period of 1 year. The acquired UTI was diagnosed by the positive urine culture result (number of microorganisms < 105/mL) 48 hours after hospitalization or 48 hours after discharge from ICU. In patients with positive culture results, anti-bacterial sensitivity test was carried out by modified Kriby-Bauer method in relation to Amikacin, Gentamicin, Co-Trimoxazole, Ciprofloxacin and Ceftazidime.
    Results
    A total of 500 patients, 309 males and 191 females, with a mean age of 48.95±22.83 years were included in the study. All the patients had urinary catheters. Acquired UTI was diagnosed in 8 subjects (1.6%), 7 males and 1 females, with a mean age of 62.88 years (mean standard error=40.7; age range=41-78 years). All the subjects were married. From each patient one microorganism was isolated: Enterobacter aerogenes (37.5%); Candida albicans (25%); Escherichia coli (25%) and Klebsiella pneumoniae (12.5%). Anti-microbial sensitivity test revealed only one case of E coli resistant to Co-Trimoxazole.
    Conclusion
    The results of the present study showed a low prevalence of acquired UTI in the ICU under study. Although the microorganisms isolated were similar to those reported in other studies, a low rate of resistance to commonly used antibiotics was observed.
  • Sepideh Sokhanvar, Rezvan Rohi Sephid Mazaki, Nouraddin Mousavinasab, Zahra Golmohammadi Page 35
    Background
    Several meta-analyses have provided support for an association between lipoprotein (a) [Lp (a)] and coronary disease, but the correlation of Lp (a) and other coronary risk factors with severity of coronary artery disease are ambiguous.
    Methods
    In this case control study, plasma Lp (a) concentration, lipid profile, diabetes, hypertension, smoking were evaluated in 108 patients with and without CAD (Case: 55 and Control: 53, respectively) who were admitted at heart center in Shahid Beheshti hospital of Zanjan in 2009.Also patients were classified into two risk groups according to their major risk factors; low risk (with two or few risk factors) and high risk (with three and more risk factor). The collected data was analyzed with using chi square, independent sample t-test, fisher's exact test and Mann-Whiteny test, Kruskal Wallis test and Pearson's correlation coefficient.
    Results
    The mean concentration of Lp (a) in the case and control groups were 60±11mg/dl and 32 ±3 mg/dl, respectively (P=0.054). 41.8% of the case group and 22.6% of the control group have abnormal level of Lp (a) (≥30mg/dl) (P=0.03). Mean lipoprotein (a) was also higher in three vessels disease compared control group (46±41 vs. 31±23) and maximum level of lipoprotein (a) in control group was 92 mg/dl and in three vessels disease was 520 mg/dl. Between other cardiac risk factors, diabetes was more frequent in case than control groups (29.1% vs 5.7%) and had a significant relationship with severity of coronary disease (P=0.001).
    Conclusion
    The main findings of this study were that mean Lp(a) levels were higher in the three vessels group compared to control and diabetes had significant relationship with the severity of coronary disease.
  • Shabnam Mohammadi, Soheyla Jafarpour Page 41
    Radial artery is used for microsurgery as well as coronary artery grafting. Operators and cardiologists may encounter by anomalies of this artery during surgery. Hence, it is important to identify these anomalies. During a routine dissection in our department, we observed a variation of radial artery on the left upper limb of an adult male cadaver. With regard to important knowledge of unusual patterns of the arteries for surgery and clinical procedures, we present a case of radial artery duplication in the upper limb.