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Cardiovascular and Thoracic Research - Volume:9 Issue: 3, Sep 2017

Journal of Cardiovascular and Thoracic Research
Volume:9 Issue: 3, Sep 2017

  • تاریخ انتشار: 1396/07/26
  • تعداد عناوین: 11
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  • Jahan Porhomayon*, Leili Pourafkari, Ali El-Solh, Nader D. Nader Pages 121-126
    Postoperative respiratory complications are of paramount clinical importance as they prolong the hospitalization, increase the costs of treatment and contribute to the perioperative mortality. Obesity, preexisting pulmonary disease and advanced age are known risk factors for developing postoperative respiratory complications, which affect exceeding number of patients. Hereby, we present a review on the pathogenesis of post-operative respiratory complications particularly in obese and older patients. We further focus on the standard management and emerging therapies for the post-operative respiratory complications.
    Keywords: Respiratory, Perioperative, Surgery, Complication
  • Hassan Amini, Jafar Rezaie, Armin Vosoughi, Reza Rahbarghazi*, Mohammad Nouri * Pages 127-132
    Stem cells (SCs) have special potency to differentiate into different types of cells, especially cardiomyocytes. In order to demonstrate the therapeutic applications of these cells, various investigations are recently being developed. Cardiac progenitor cells are endogenous cardiac SCs that found to express tyrosine kinase receptors, c-Kit and other stemness features in adult heart, contributing to the regeneration of cardiac tissue after injury. This lineage is able to efficiently trans-differentiate into different cell types such as cardiomyocytes, endothelial cells, and smooth muscle cells. Noticeably, several cardiac progenitor cells have been identified until yet. The therapeutic applications of cardiac SCs have been studied previously, which could introduce a novel therapeutic approach in the treatment of cardiac disorders. The current review enlightens the potency of cardiac progenitor cells features and differentiation capacity, with current applications in cardiovascular field.
    Keywords: Cardiac Progenitor Cells, Cardiac Tissue, Regeneration
  • Masoumeh Amani, Akbar Darbin, Masoud Pezeshkian, Abbas Afrasiabi, Naser Safaie, Ahmadreza Jodati, Masoud Darabi, Maghsod Shaaker, Zeinab Latifi, Amir Fattahi, Gholam-Hossein Farjah, Mohammad Nouri*, Mohammad Hassan Khadem-Ansari* Pages 133-139
    Introduction
    Atherosclerosis could be deemed as a chronic, progressive, and inflammatory disease. It has been well-documented that high-density lipoprotein (HDL) can reduce the risk of the atherosclerosis occurrence through exerting some anti-atherogenic mechanisms. In recent years, the strong evidence has suggested that paraoxonase 1 (PON1) may contribute to antioxidant properties of HDL. In the present study, the impact of a diet enriched with cholesterol and also the PON1 inhibition on atheroma formation and lipid profile has been investigated.
    Methods
    In this study, 24 New Zealand rabbits were randomly assigned to three groups receiving standard diet, atherogenic diet, and atherogenic diet plus once daily intramuscular injection of nandrolone decanoate as the PON1 inhibitor. Triglyceride, cholesterol, HDL, and low-density lipoprotein (LDL) were determined and both cholesterol accumulation in aorta and fatty streak formation were evaluated.
    Results
    The comparison of the results in three groups reveals that cholesterol level in the group received cholesterol-enriched diet plus once daily injection of PON1 inhibitor was higher than the groups received standard diet or atherogenic diet without PON1 inhibitor (P
    Conclusion
    It can be concluded that lack of paraoxanase1 or even reduced the activity of this enzyme could accelerate the progression of fatty streak lesions toward advanced atherosclerotic lesions.
    Keywords: Atherosclerosis, Atheroma, Paraoxonase1, Nandrolone Decanoate
  • Hossein Ansari, Mostafa Qorbani*, Fatemeh Rezaei, Shirin Djalalinia, Mojgan Asadi, Sareh Miranzadeh, Mohammad Esmaeil Motlagh, Sahel Bayat, Saeid Safiri, Omid Safari, Morteza Shamsizadeh, Roya Kelishadi Pages 140-146
    Introduction
    This study aims to evaluate the association of birth weight (BW) with weight disorders in a national sample of Iranian pediatric population.
    Methods
    This nationwide survey was conducted among 25000 student’s aged 6-18 year-old students, who were selected using multistage cluster random sampling from 30 provinces of Iran in 2011-2012. Anthropometric measures were measured under standard protocols by using calibrated instruments. Abdominal obesity was defined based on waist circumference (WC) ≥90th percentile value for age and sex. The WHO criterion was used to categorize BMI. Students’ BW was asked from parents using validate questionnaire and was categorized as low BW (LBW) (BW 4000 g).
    Results
    This national survey was conducted among 23043 school students (participation rate: 92.6%). The mean age of participants (50.8% boys) was 12.54 ± 3.31 years. Results of multivariate logistic regression show that LBW increased odds of underweight (OR [odds ratio]: 1.61; 95% CI: 1.37, 1.89) and students with HBW had decreased odds of underweight (OR: 0.74; 95% CI: 0.58, 0.93) compared to students with NBW. Students with LBW compared to student with NBW had decreased odds of overweight (OR: 0.83; 95% CI: 0.69, 0.98) and general obesity (OR: 0.73; 95% CI: 0.56, 0.95). On the other hand, HBW increased odd of overweight (OR: 1.28; 95% CI: 1.09, 1.50), generalized obesity (OR: 1.59; 95% CI: 1.29, 1.96) and abdominal obesity (OR: 1.29; 95% CI: 1.11, 1.49) compared to NBW group.
    Conclusion
    BW is a determinant of weight disorders and abdominal obesity in childhood and adolescence. This finding underscores the importance of prenatal care as well as close monitoring of the growth pattern of children born with low or high BW.
    Keywords: Birth Weight, Obesity, Overweight, Underweight, Children, Adolescents
  • Muslum Sahin*, Lutfi Ocal, Ali Kemal Kalkan, Alev Kilicgedik, Mehmet Emin Kalkan, Burak Teymen, Ugur Arslantas, Mehmet Muhsin Turkmen Pages 147-151
    Introduction
    Although percutaneous coronary intervention is an accepted "first-line" therapy in acute ST elevation myocardial infarction (STEMI) in general population, few data are available on the short- and long-term outcomes of very old patients (age >90 years). Our aim is to evaluate and compare the short and long-term outcomes after primary percutaneous coronary intervention (PPCI) or medical therapy in nonagenarian patients with STEMI.
    Methods
    We retrospectively identified patients older than 90 years old in our clinic, with acute STEMI who presented within 12 hours after symptoms onset, either underwent PPCI or medically treated. In hospital events and long-term results analyzed subsequently.
    Results
    From January 2005 to December 2014, 73 patients with STEMI either underwent PPCI (PPCI group n = 42) or had only medical treatment (Non-PPCI group n = 31). Mean age was 92.4 ± 3.1 (90-106). Patients were followed 26.5 ± 20.1 months. Recurrent myocardial infarction during hospitalization was not observed in both groups. In-hospital mortality, cerebrovascular events and acute renal failure rate were similar between two groups (respectively P = 0.797 and P = 1.000, P = 0.288), whereas arrhythmia was significantly higher in the PPCI group ( 0; 21.4%, P = 0.009). Results show re-infarction was similar in both groups (respectively 3.2%; 11.9%, P = 0.382) but mortality in long-term was significantly lower in the PPCI group (respectively 40.9%; 12.9%, P = 0.02).
    Conclusion
    In nonagenarian patients, with STEMI mortality is very high. Although; in-hospital events were similar, the long-term mortality rate was significantly lower in patients treated with PPCI.
    Keywords: Nonagenarian, Elderly, Myocardial Infarction, Primary Percutaneous Intervention
  • Ali Mohammad Haji Zeinali*, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi Pages 152-157
    Introduction
    After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients.
    Methods
    We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves.
    Results
    The procedures were successfully completed in all 5 cases with initial excellent fluoroscopic and echocardiographic verification. There was no valve embolization or paravalvular leakage in any of the cases. Transcatheter valve function was appropriate with echocardiography. Post procedural clinical adverse events like pleural effusion and transient ischemic attack were managed successfully. In midterm follow up all cases remained in appropriate functional class except from the transcatheter pulmonary valve which became moderately stenotic and regurgitant.
    Conclusion
    As the first Iranian all-comers case series with midterm follow up for ViV implantation, we had no mortality. Interestingly none of our patients had neurologic sequelae after the procedure. Midterm follow up for our patients was acceptable with good functional class and appropriate echocardiographic findings. Due to high surgical risk of the redo procedure after failing of a bioprosthetic valve especially in elderly patients with comorbidities, ViV implantation would be a good alternative to surgery for this high risk group.
    Keywords: Bioprosthetic Valve, Transcatheter Valve, Edwards SAPEIN Valve, Valve-in-Valve
  • Masoumeh Sadeghi, Azam Soleimani*, Hamidreza Roohafza, Safoura Yazdekhasti, Shahram Oveisgharan, Mohammad Talaei, Nizal Sarrafzadegan Pages 158-163
    Introduction
    As a lack of validated data about cardiovascular (CV) events and its risk factors (RFs) in women of Eastern Mediterranean region, we aimed to evaluate common predictors of CV events among Iranian women.
    Methods
    Isfahan cohort study (ICS) is a prospective cohort that followed 6323 residents (51.3% women, aged 35-75 years) from three counties and their rural districts in central Iran. Common cardiovascular disease (CVD) RFs namely hypertension (HTN), diabetes mellitus, dyslipidemia, abdominal obesity, smoking, low apolipoproteins A ( apo-A) and high apolipoprotein B (apo-B) were evaluated. End points (CV events) were defined as fatal and nonfatal myocardial infarction, sudden cardiac death (SCD), unstable angina and stroke.
    Results
    After 9 years of follow-up, 265 CV events were detected. The mean age of women with CV event was 57.6±10.9; about 8 years older than those without event. All CV RFs were significantly more prevalent in women with CV event except for obesity, overweight and low apo-A. HTN, diabetes, high triglyceride (TG), high LDL-C and low HDL cholesterol were significantly associated with CV events after adjustment for age, smoking and menopausal status (hazard ratios [95% CI]: 2.56 [1.93, 3.95], 2.43 [1.76, 3.35], 2.02 [1.49, 2.74], 1.59 [1.20, 2.11] and 1.49 [1.16-1.92], respectively), while low HDL cholesterol and abdominal obesity were not predictors for CV events (hazard ratios [95% CI]: 1.26 [0.96, 1.65], 1.71 [0.99, 2.96], respectively).
    Conclusion
    In ICS, HTN, diabetes mellitus and high triglyceride are strong predictors for CV events in Iranian women. As almost all strong risk markers of CVD events are preventable, health policy makers have to give urgent consideration to make preventive public health strategies.
    Keywords: Women, Ischemic Heart Disease, Stroke, Risk Factor
  • Leila Abdollahi, Jafar Sadegh Tabrizi, Ahmadreza Jodati, Naser Safaie, Mohammad Moradi-Joo, Amin Daemi* Pages 164-169
    Introduction
    The role of scrub in the prevention of post-surgery infections is well-known. This study aimed to investigate the inputs and process of surgical scrub in operating rooms of the largest heart hospital of northwest Iran.
    Methods
    This study took place with a before-after design as a clinical audit in 2014. A check list developed based on national and international standards of surgical hand scrub was used as the study instrument. Checklists were completed by observation of surgical team scrubbing in real situation. Descriptive statistics and graphs were used to describe the results.
    Results
    A compliance degree with the standards for prerequisites, equipment, general items, process and time of scrub was observed as 58%, 55%, 33%, 68% and 22%, respectively. The compliance degree after the intervention was 72%, 66%, 66%, 85% and 61%, respectively. Improvement was observed in all studied aspects of scrub. The total score of compliance with the standards changed from 47% to 70%. The main issues were incorrect order of scrubbing the areas of the hands, incorrect way of scrubbing the arms, insufficient scrubbing the arms (not above elbow), and lack of awareness about hospital’s policy on scrub time.
    Conclusion
    The results showed defects in the surgical scrub of the studied hospital and that the compliance with the standards can be improved by simple interventions. Periodical audit and observation of the scrub and then feedback is recommended.
    Keywords: Surgical Scrubbing, Clinical Audit, Hand Hygiene, Infection Control
  • Nahid Shahmoradi, Mahboobeh Nasiri*, Hajar Kamfiroozi, Mohammad Ali Kheiry Pages 170-174
    Introduction
    Variants in long non-coding RNAs (lncRNAs) have been implicated as potential biomarkers in prediction of complex disorders such as coronary artery disease (CAD). Studies considering the impact of the SENCR antisense lncRNAs on CAD have not established yet in Iranian population. This study aimed to investigate the association between SENCR rs555172 polymorphism and CAD in south Iranian population.
    Methods
    Amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) was performed to determine the allele and the genotype distribution of SENCR lncRNA polymorphism in 150 patients with CAD compared with 149 healthy controls through this hospital-based case-control study.
    Results
    The frequency of AA, AG, and GG genotypes in cases were 32.7%, 44.7%, and 22.6%, and in controls were 26.8%, 49%, and 24.2%, respectively. Association was not found with any of the genotypes in comparison of cases and controls. The allelic frequencies did not differ between cases and controls. Cross-tabulating the population based on the gender, the frequency of the GG genotype was significantly higher among women of the case group compared to men. The difference was not seen in the control group between two sexes.
    Conclusion
    The results suggested that the SENCR gene polymorphism did not confer susceptibility to CAD.
    Keywords: Coronary Artery Disease, Polymorphism, SENCR, lncRNA
  • Ali Movahedi, Seyed Reza Mirhafez, Hamidreza Behnam-Voshani, Hamidreza Reihani, Gordon A. Ferns, Javad Malekzadeh* Pages 175-178
    Introduction
    Diabetes mellitus is a risk factor for cardiovascular disease. Some recent studies have shown an association between diabetes and out-of-hospital cardiac arrest incidence and survival. We aimed to investigate whether there is an association between the presence of diabetes mellitus and survival after cardiopulmonary resuscitation (CPR) in patients with an in-hospital cardiac arrest.
    Methods
    A cross-sectional study was conducted during the period of January to February 2014, among 80 cases of cardiopulmonary arrest in patients at Qaem hospital of Mashhad, Iran. A code 99 was announced after a cardiac arrest was identified, and CPR was performed by the cardiac arrest team. Twenty four hour survival was compared in diabetic and non-diabetic patients who had a return to spontaneous circulation after CPR. We used SPSS statistics for Windows version 16 for data analysis.
    Results
    The return to spontaneous circulation in the diabetic group was not significantly lower than for the non-diabetic group (42.9% versus 61.0% [P = 0.15]). However, the 24-hour survival in the diabetic group was significantly lower than for the non-diabetic group (19.0% versus 44.1% [P = 0.04]).
    Conclusion
    The presence of diabetes mellitus is associated with a significantly lower rate of survival after CPR.
    Keywords: Diabetes Mellitus, Cardiopulmonary Resuscitation, 24-Hour Survival
  • Hamid Bigdelian, Mohsen Sedighi* Pages 179-182
    Introduction
    Most of the ventricular septal defects (VSD) are complicated with pulmonary arterial hypertension (PAH) which is the major cause of pulmonary hypertensive crisis and right ventricular failure.
    Methods
    We reviewed clinical outcomes of 63 infants who underwent cardiac surgery and were divided into three groups. Control group (n=20) did not received sildenafil while group A (n = 22) received drug (0.3 mg/kg) before and after surgery. Group B (n=21) received drug at the initiation of surgery. Demographic data, preoperative and postoperative variables were compared among the patients.
    Results
    Patients in the group A had lower preoperative pulmonary arterial pressure (PAP) compared to other groups (P
    Conclusion
    Preoperative sildenafil therapy seems to be effective and safe to prevent postoperative PAH and pulmonary hypertensive crisis in children with ventricular septal defects and has a positive impact on postoperative care.
    Keywords: Pulmonary Hypertension, Sildenafil Citrate, Cardiac Surgical Procedures, Infant