International Cardiovascular Research Journal
Volume:9 Issue: 3, Sep 2015

3D non-fluoroscopic mapping systems have been proposed as a useful tool for catheter ablation for many arrhythmias.. The present study aimed to evaluate the effect of a methodical use of 3D mapping systems on the amount of X-ray exposure during catheter ablation..Patients and Our study was conducted on 495 consecutive patients who underwent catheter ablation from January 2007 to December 2011. Since October 2008, all ablation procedures in our EP Lab have been performed using a mapping system. In this study, we compared fluoroscopy time, total X- ray exposure, and duration of each procedure. The data from Atrial Fibrillation (AF) ablations and Supra-Ventricular Tachycardia (SVT) ablations were also analyzed using unpaired non-parametric Mann-Whitney test (MW-test). Besides, Chi-square test (χ2-test) was used to evaluate the impact of mapping system development on X-ray exposure.. The overall median fluoroscopy time decreased significantly by 78% in 5 years, falling from 29.2 min (95% Confidence Interval (CI) [24.3 - 37.8]) in 2007 to 6.3 min (95% CI [5.3 - 9.7]) in 2011 (MW-test, P < 0.001). Additionally, the median total X-ray exposure decreased from 58.18 Gy*cm 2 (95% CI [41.73 - 71.35]) in 2007 to 14.48 Gy*cm 2 (95% CI [9.61 - 18.26]) in 2011 (MW-test, P < 0.001). There was also a slight reduction in the duration of the procedures, 79% of which were acutely successful.. The systematic use of a mapping system markedly reduced fluoroscopy time and total X-ray exposure during catheter ablation. Although improvement in technology and growth in operators’ experience play a central role in radiation exposure reduction, our study showed that only daily use of mapping systems maximized the possibility of reducing exposure..

Coronary Artery Disease (CAD) is an important disease where the arteries and vessels supplying oxygen and nutrients to the heart are narrowed or blocked. Early diagnosis and recognition of CAD leads to its complete treatment. Drug therapy, angiography, coronary angioplasty, and in advanced cases, coronary artery bypass surgery restore the normal flow of blood to the heart muscle.. The present study aimed to identify the association between rs4977574 polymorphism in ANRIL gene and CAD in Iranian patients.. Blood samples were collected from 100 subjects with positive angiography (case group) and 93 ones with negative angiography (control group). Using Taq Man Real Time PCR, the extracted DNAs from the patients and controls were genotyped for rs4977574 polymorphism in ANRIL gene (applied biosystem, USA). Then, the genotypes and clinical parameters were compared by the SPSS statistical software, version 18 (Chicago, USA). The results were compared by one-way ANOVA, simple T-test, and Chi-square test and were presented as mean ± Standard Deviation (SD). P values < 0.05 were considered as statistically significant.. The results showed a significant relationship between CAD and Diastolic Blood Pressure (DBP), Body Mass Index (BMI), uric acid, Low Density Lipoprotein (LDL), cholesterol, and triglyceride. However, no significant association was observed between rs4977574 polymorphism and biochemical characteristics in the two groups. Allele frequency was AA = 22%, AG = 44%, and GG = 34% in the case group and AA = 17%, AG = 44%, and GG = 32% in the control group.. The present study examined the association between rs4977574 polymorphism in ANRIL gene and CAD in a population of Iranian patients. The study findings revealed no direct relationship between rs4977574 polymorphism and the disease in Iranian population..

Previously, endoglin, also known as CD105, was shown to be related to angiogenesis.. The present study aimed to investigate the relationship between endoglin levels and development of Coronary Collateral Circulation (CCC) in patients with acute coronary syndrome..Patients and The study patients who underwent coronary angiography were divided into a poor collateral group (Group 1, N = 45) and a good collateral group (Group 2, N = 42), according to Rentrop classification. After recording the baseline characteristics, including age, Body Mass Index (BMI), systolic and diastolic blood pressures, smoking, history of hypertension, diabetes mellitus, and family history of Coronary Artery Disease (CAD), blood samples were taken for analysis of endoglin and other biochemical variables. The data were statistically analyzed using Mann-Whitney U test, independent sample t-test, chi-square test, ANOVA, Pearson’s or Spearman’s correlation tests, Receiver–Operating Characteristics (ROC) curve analysis, and multivariate logistic regression analysis. P values < 0.05 were considered as statistically significant.. Endoglin levels were significantly higher in Group 1 compared to Group 2 (13.6 ± 3.8 vs. 10.2 ± 2.9 ng/mL, P < 0.001). Serum endoglin levels were negatively correlated to age, C-Reactive Protein (CRP), and Low Density Lipoprotein-Cholesterol (LDL-C) levels. Moreover, ROC analysis (area under curve: 0.758; 95% CI: 0.655-0.844; P < 0.001) provided a cutoff value of ≤ 12.6 ng/mL for endoglin to predict good CCC with 85.7% sensitivity and 60% specificity. In multivariate logistic regression analysis, endoglin levels (OR = 0.97; 95% CI: 0.95 – 0.99; P = 0.002) and presence of total occlusion (OR = 2.51; 95% CI: 1.05 – 5.8; P = 0.036) were predictors of good CCC.. Lower plasma endoglin levels were associated with better CCC development..

Pentraxin 3 (PTX3) is a more specific marker of vascular inflammation than C - reactive protein (CRP).. The present study aimed to demonstrate the association between PTX3 and markers of adverse events and poor prognosis in patients with Non-ST-segment Elevation Myocardial Infarction (NSTEMI)..Patients and This case-control study was conducted on 36 patients (10 females, mean age: 58 ± 11 years) with NSTEMI who had admitted to the Cardiology Clinic of Kartal Koşuyolu Heart Research Hospital and 35 age- and gender-matched healthy controls (26 females, mean age: 56 ± 9 years) between January and May 2013. PTX3 levels were measured in the controls and at the 8th and 24th hours of chest symptoms in the patients undergoing coronary angiography during admission.. The patients group had significantly higher PTX-3 levels at both 8th and 24th hours compared to the control group (2.6 ± 3.1 vs. 1.9 ± 2.1 ng/mL, P < 0.001 at the 8th hour; 4.8 ± 7.6 vs. 1.9 ± 2.1 ng/mL, P < 0.010 at the 24th hour). The results showed a significant correlation between PTX3 level and Killip class (r = 0.34, P = 0.040 at the 8th hour; r = 0.43, P = 0.009 at the 24th hour). Besides, serum PTX3 level was positively correlated to the SYNTAX score (r = 0.57, P < 0.001 at the 8th hour) and negatively correlated to hemoglobin level (r = -0.37, P = 0.020).. Among the patients with NSTEMI, PTX3 level was associated with markers of higher risk and worse prognosis (GRACE score, hsCRP, age, NT-proBNP, and hemoglobin). Thus, PTX3 level might be used as a novel cardiac biomarker to determine high-risk patients..

To date, no hospital-based national study with large sample size has been conducted to determine the predictive factors of in-hospital mortality among patients with Myocardial Infarction (MI) in Iran.. This study aimed to determine in-hospital Case Fatality Rate (CFR) and hazard ratio of the factors associated with mortality in the patients with MI diagnosis in Iran..Patients and In this nationwide, hospital-based, prospective study, the researchers made use of the data of 20750 new MI cases registered by Iranian Myocardial Infarction Registry (IMIR) in 31 provinces between April 2012 and March 2013. Demographic, clinical, and laboratory variables were obtained from the medical records of patients with confirmed acute MI. Cox regression was done by Stata software, version 12 using univariate and multiple analyses through Breslow method. P < 0.05 was considered as statistically significant.. In-hospital mortality rate was 12.1% (N = 2511) and female/male ratio of CFR was 1.36 (95% CI: 1.2 - 1.4). Besides, in-hospital CFR was 8.36: 7.81 - 8.94 in females and 6.12: 5.83 - 6.43 in males. Hazard ratio of mortality for ST segment Elevation Myocardial Infarction (STEMI), chest pain resistant to treatment, and Right Bundle Branch Block (RBBB) was 1.32, 4.06, and 2.45, respectively (P < 0.01). Using Percutaneous Coronary Intervention (PCI) decreased the risk of death in the patients (HR: 0.68). Overall, 83.7% of the patients with STEMI died.. In Iran, identifying the risk factors of mortality due to MI could contribute to detecting high-risk individuals and improving healthcare by relevant planning and interventions in clinics and communities..

Congestive Cardiac Failure (CCF) is an important cause of morbidity and mortality among children. It results from various causes, but there are only very few reports from the African sub-region.. This study aimed to define the current trends in the prevalence and causes of CCF among children admitted to the Pediatrics Department of the Lagos State University Teaching Hospital (LASUTH)..Patients and This prospective study was conducted on all the consecutive patients admitted with diagnosis of CCF between January 2011 and December 2012. The data were analyzed using Microsoft Excel. Mean, median, and standard deviation were calculated as necessary. Continuous and discrete data were analyzed using student t-test and chi-square test, respectively. P < 0.05 was considered as statistically significant.. Out of the 5705 children admitted to the Department of Pediatrics of LASUTH, 156 ones (2.73%) had CCF. The subjects’ age ranged from 48 hours to 144 months, with the mean age of 37.1 ± 31.94 months. The common causes of CCF were Acute Lower Respiratory Tract Infections (ALRTI) (32.0%), Congenital Heart Diseases (CHD) (31.4%), and severe anemia (28.8%). Other less common causes were septicaemia (3.84%), acquired heart diseases (3.2%), and renal disorders (0.6%). The rate of mortality was 17.3%, and more than 90% of the deaths occurred within 48 hours of admission.. CCF remains a major cause of morbidity and mortality in Pediatric practice in Nigeria, with ALRTI, CHD, and severe anemia being the common causes..

Valve scarring and collagen deposition are crucial in pathogenesis of Rheumatic Heart Disease (RHD), an autoimmune disorder of the heart. Angiotensin I-Converting Enzyme (ACE) plays a major role in fibrous tissue formation.. The present research work aimed to assess the role of ACE Insertion/Deletion (I/D) polymorphism in progress of RHD..Patients and DNA was pre pared from blood samples from 156 RHD patients (156) and 204 healthy ethnically-matched controls. Then, it was screened using sequence-specific Primers. Polymerase chain reaction and Agarose gel electrophoresis. The data were analyzed using Vassar stats (http://faculty.vassar.edu/lowry/VassarStats.html).. I allele (P = 0.024, OR = 1.42) and II genotype (P = 0.001, OR = 3.07) were significantly higher in Pakistani RHD patients compared to the healthy controls. Also, a significant difference was found between the female, but not male, patients and the controls regarding I allele and II genotype.. The study results provided information about involvement of ACE I/D polymorphism in molecular mechanism of RHD. Thus, it can become one of the useful tools in risk assessment and help with designing strategies to combat the disease..

Chest pain is less likely in old age and evidence of Coronary Artery Disease (CAD) may be detected in the presence of a new or presumably new Left Bundle Branch Block (LBBB).. This study aimed to assess the predictive role of new LBBB in diagnosis of CAD..Patients and This prospective study was conducted on 402 patients with LBBB admitted to our institute between January 2011 and June 2013. Among the patients, only 272 had new or presumably new LBBB. The patients were divided into two groups (age ≤ 65 years and > 65 years) and all the demographic, clinical, and procedural characteristics were prospectively recorded. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS Inc.), version 17.0. Nominal variables were described using frequencies and normal distribution of quantitative variables was tested by means of Kolmogorov-Smirnov test. P < 0.05 was considered as statistically significant.. Patients older than 65 years had less common chest pain, lower procedural use (76.47% vs. 84.56%, P = 0.001), longer duration of hospitalization, and higher rate of in-hospital mortality. Older patients also had either one or three coronary lesions (27.97%) compared to the younger ones 62.50% of whom had no vessel disease.. Presence of new or presumably new LBBB in elders, and even in those without the classic symptoms of chest pain, may be the first manifestation of CAD..

The saphenous vein remains the most commonly used conduit for coronary artery bypass surgery (CABG). However, the long-term success of surgical revascularization is largely limited by development of occlusion in vein grafts.. We sought to reduce graft ischemia by maintaining the blood flow into the harvested vein throughout surgery at lowest costs and without special devices..Patients and This study was conducted on three hundred patients aged 58.5 ± 8 years undergoing elective first-time off-pump CABG with saphenous veins.. In addition to preserving nutritional materials and oxygen, the veins harvested via this novel technique did not go into spasm and were not subjected to high-pressure distension, eventually resulting in minimal damage to the endothelium.. This technique confers favorable myocardial function and protection in the presence of left ventricular dysfunction, especially in elderly patients..

Persistent Left Superior Vena Cava (PLSV) may be found incidentally during pacemaker or implantable cardioverter defibrillator implantation, making the procedure challenging. Herein, we reported the first case of PM implantation via PLSV in a patient with right superior vena cava occlusion, using a coronary sinus delivery system and a long (85 cm) active fixation right ventricular pacing lead..

Coronary-Cameral Fistula (CCF) is an anomalous connection between a coronary artery and cardiac chamber. Most CCFs are discovered incidentally during angiographic evaluation for coronary vascular disorder. Here, we report a 16-year-old boy with exertional breathlessness for 3 years. There was a continuous murmur at the right para sternal border in the 4th and 5th intercostal space. Echocardiography showed Right Ventricular Hypertrophy (RVH) with strain pattern. Besides, transthoracic echocardiography demonstrated a normally functioning left ventricle, but dilated right atrium and ventricle. The right ventricle also showed hypertrophy and trabeculation. Coronary angiography demonstrated a direct connection between the right ventricular cavity and the right epicardial coronary artery. However, the left coronary arterial system was normal. The patient was treated by ligation of the fistulous connection by off-pump surgery..