International Cardiovascular Research Journal
Volume:6 Issue: 2, Jun 2012

The use of radial access for diagnostic coronary angiogram and percutaneous coronary intervention (PCI) has increased during the last few years, especially due to its benefit regarding reduction in site vascular complication compared with femoral approach. To evaluate the safety and feasibility of diagnostic coronary angiography in patients on chronic anticoagulation therapy without drug interruption and to study the impact of this strategy in terms of bleeding complication as first endpoint and length of hospitalisation as second endpoint. This is a retrospective study of 53 patients on chronic anticoagulation therapy with coumarin derivatives who underwent diagnostic coronary angiography in our centre between January 2003 and July 2011, compared with a control group of 53 patients without anitcoagulation therapy. The international normalised ratio (INR) in the anticoagulated group with uninterrupted anticoagulation therapy was >2. Thrombolysis In Myocardial Infarction (TIMI) classification was used for the evaluation of bleeding complication. Hospitalisation stay was also compared between two groups. Baseline characteristics were similar in both groups except for diagnostic which motivated coronary angiogram and INR level during the procedure. A minimal bleeding occurred in the acenocoumarol group compared with 0 event in control group (1.9% vs. 0%, P=NS). The average of hospitalisation was 6±4.9 days in the acenocoumarol group and 6.3 ±4.1 in the control group (P=NS). This study reveals that diagnostic coronary angiography by radial approach in patients on chronic coumarin derivative therapy without drug interruption is a safe strategy and is not associated with a significant increase in bleeding complication and length of hospitalisation.

The burden of non-communicable diseases is rising globally. The present study was carried out to examine the relationship between different anthropometric indices and blood pressure in the Iranian population. A cross-sectional descriptive study was conducted on 3916 subjects including 1976 males and 1940 females, aged 15- 64 years from a healthy population in Shiraz, IR Iran. Anthropometric variables of each person including weight, height, waist circumference (WC), waist to height ratio (WHR) and body mass index (BMI) were calculated along with measuring systolic and diastolic blood pressures (BP). The relationship between blood pressure and different anthropometric variables was determined in both genders. The mean±SD systolic blood pressures were 123.9±20.0 and 121.2±17.7 mmHg while the mean diastolic blood pressures were 78.3±11.9 and 77.4±12.9 mmHg in men and women respectively (P<0.001). The prevalence of hypertension in men (23.8 %) was significantly more than that of women (21.1 %). Mean systolic and diastolic blood pressures increased with age and BMI in both genders. Anthropometric indices showed a positive association with systolic and diastolic blood pressures. The BMI and WC showed a strong association with systolic and diastolic blood pressure. The suggested lower cut-off values of the anthropometric indicators will cover maximum of the population with higher odds of having hypertension and may help reduce the levels of population’s mean blood pressure.

A retrospective study was conducted to determine whether obesity is a predictor of mortality, morbidity or early readmission to hospital after coronary artery bypass graft (CABG). We analyzed a large cohort of 1057 patients who had undergone isolated CABG. BMI (body mass index) was used as the measure of obesity. The preoperative, intera operative and postoperative risk factors as well as the complication and 30-day mortality rates were compared between the two groups (624 (65.5%) normal-weight and 328 (34.5%) obese patients). Chi square test and logistic regression were used in univariate and multivariate respectively. Of the 1057 patients, 59% had a normal weight and 31% were obese. An increased BMI did not increase the risk of 30-day mortality. In addition, increased BMI was not a predictor of the major complications; arrhythmia, renal complications, neurological complications, pulmonary embolism (PE) except myocardial infarction(MI) (1.8% vs 0.3% with p-value= 0.015). Also investigation on mechanical ventilation time, Reintubation, length of stay in ICU, length of stay in hospital, and readmitting as postoperative variables revealed no significant difference on these two groups(normal-weight and obese patients) Obesity increased myocardial infarction after CABG, but it did not affect the other situations.

The incidence of cardiovascular disease (CVD) is rapidly increasing worldwide. Occupation-related stress such as military parachuting has been considered to be a potentially important cardiovascular risk factor. The present study was performed to determine the prevalence of cardiovascular risk factors and metabolic syndrome among military parachutists which provides a guideline to prevent catastrophic cardiovascular events. This is a cross-sectional study among 96 military parachutists in southern IR Iran; who were evaluated in the military clinic in Shiraz, Southern IR Iran. Information regarding demographic and life style were obtained from each subject. Arterial blood pressure, weight, height, body mass index (BMI), waist circumference (WC) and hip circumference (HC), fasting blood glucose, lipid profile consisting of total cholesterol, LDL, HDL and triglyceride were measured by standard methods. The mean age of participants was 37.4±6.4 years, with mean of successful parachuting experiences being166.8±21.3. There were 5 (5.2%) cases under treatment for cardiovascular diseases, 4 (4.2%) participants were pre-diabetics and 5 (5.2%) suffered from diabetes mellitus. Hypertriglyceridemia and hypercholesterolemia were seen in 23 (24%) and 46 (47%) military parachutists respectively. Although war-related stressors and high intensity physical activities are associated with both acute cardiac events and cardiac risk factors, our data is in favor of lower frequency of cardiovascular risk factors among military parachutists. However, routine monitoring of military parachutists is necessary to find the cardiovascular risk factors.

Increased right atrial pressure due to pulmonary hypertension may impair venous drainage with resultant coronary sinus dilatation. The aim of this study was to search for correlations between coronary sinus diameter and estimated pulmonary artery pressure in children. In a prospective study, 100 children who were referred consecutively for transthoracic echocardiography were included in this study. Ratios of coronary sinus diameter to weight, body surface area and aortic annulus were calculated for in each patient. Correlation between coronary sinus diameter and estimated pulmonary artery pressure was studied by person correlation. A tricuspid regurgitation peak gradient more than 36 mmHg or pulmonary regurgitation peak gradient more than 25 mmHg were considered as pulmonary hypertension. Sixty-eight of our participants had no pulmonary hypertension and 32 did. Mean age was 7.6 years in the patients without pulmonary hypertension and 8.0 years in the patients with pulmonary hypertension (P=0.11). Mean coronary sinus diameter to aortic annulus diameter ratio was 0.49 ± 0.13 in the patient with pulmonary hypertension versus 0.38 ± 0.12 in the patient without pulmonary hypertension (P<0.001). The coronary sinus diameter to body surface area ratio was 1.3 ± 0.59 versus 0.7 ± 0.28 (P<0.001), and coronary sinus diameter to weight ratio was 0.06 ± 0.03 versus 0.02 ± 0.01 (P<0.001). coronary sinus dilation was documented in pediatric patients with pulmonary hypertension. The ratios of coronary sinus diameter to aortic annulus diameter, body surface area and weight correlated significantly with pulmonary hypertension.

Morgagni hernia is a rare diaphragmatic hernia usually due to congenital defects in the diaphragm. It is rarely associated with cardiac anomalies, most commonly atrial (ostium secundum) or ventricular septal defects. We report a rare case of Morgagni hernia occurring in association with partial atrio-ventricular septal defect (ostium primum), and its successful surgical correction.