فهرست مطالب

International Cardiovascular Research Journal
Volume:11 Issue: 4, Dec 2017

  • تاریخ انتشار: 1396/09/29
  • تعداد عناوین: 6
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  • Faranak Behnaz, Azita Chegini *, Sima Rafieyian, Mahboobe Rasouli Page 125
    Background
    Published studies have shown excellent success rates and also low rates of life-threatening complications with trans-catheter closure of patent ductus arteriosus (PDA). However, most studies to date have been conducted in developed nations and reports from developing countries such as Iran are lacking.
    Objectives
    To report our experience with trans-catheter closure of patent ductus arteriosus (PDA) and compare two devices and complications.
    Patients and
    Methods
    From 2007 to 2011, 72 consecutive PDA cases were prospectively enrolled. For PDAs ≤ 2 mm, the coiling method was employed whereas patients with PDA > 2 mm received Amplatzer duct occlusion (ADO). Success was defined as trivial residual shunt (
    Results
    With the coiling (n = 39) and Amplatzer methods (n = 33), successful closure was observed totally and recovered with no major complications. Frequent complications were benign arrhythmia (44.4%), and hemorrhage in 1 (1.4%) of the patients. Complication rate did not differ between the two techniques (P > 0.05).
    Conclusions
    Excellent and comparable success rates for both closure techniques were observed and no major complications were observed.
    Keywords: Cardiac Catheterization, Adverse Effects, Ductus Arteriosus, Treatment Outcome, Cardiovascular Surgical Procedures
  • Firoozeh Abtahi, Maryam Tahamtan *, Kaynoosh Homayouni, Alireza Moaref, Mahmoud Zamirian Page 130
    Background
    The exact effects of cardiac rehabilitation on the left ventricular (LV) systolic function have still remained controversial.
    Objectives
    The aim of this randomized clinical trial was to assess the effects of cardiac rehabilitation on echocardiographic parameters of LV systolic function in patients treated by Primary Percutaneous Coronary Intervention (PPCI) due to acute ST-segment Elevation Myocardial Infarction (STEMI).
    Patients and
    Methods
    After estimating 50 patients as the total sample size according to previous studies and type of the current study, the patients with acute STEMI who were treated by PPCI in our academic centers and had LV ejection fraction (EF) of 35 - 49% were divided into two groups via permuted block randomization method. The first group (n = 25) underwent an 8-week comprehensive cardiac rehabilitation program. Meanwhile, the controls (n = 25) were just instructed on risk factor management. All patients underwent echocardiographic examination during the first week after acute STEMI and 10 weeks later. The measured parameters included LVEF, stroke volume (SV), LV end-diastolic diameter/volume (LVEDD/LVEDV), LV end-systolic diameter (LVESD/LVESV), fractional shortening (FS), LV mass, and mean global longitudinal LV strain (εLL). The SPSS, version 18.0, was used for data analysis and P values less than 0.05 were considered to be statistically significant.
    Results
    The mean age of the participants was 53.68 ± 6.9, ranging from 38 ± 71 years old; 58% of the patients were men with an approximately similar distribution in both groups. The comparison of changes in variables before and after the rehabilitation period between exercise and control groups illustrated a significant increase in LVEF (mean percentage changes: 13.56 ± 15.98% vs. 2.86 ± 8.46%; P = 0.005) and mean global εLL (16.39 ± 14.97% vs. 2.62 ± 9.98%; P
    Conclusions
    Early exercise-based cardiac rehabilitation program in patients revascularized by PPCI after acute STEMI could have beneficial effects on LV systolic function with no adverse effect on LV remodeling.
    Keywords: Myocardial Infarction, Rehabilitation, Exercise, Left Ventricular Function, Echocardiography
  • Mohammad Abbasi, Somayeh Momenyan*, Fariba Eslamimoqadam, Fatemeh Sarvi, Imaneh Khaki Page 137
    Background
    Heart failure due to changes in the lungs, circulation, and skeletal muscle adversely influences the quality of life.
    Objectives
    The objective of the present study is to assess the reliability and validity of the Persian version of the MacNew in patients with heart failure.
    Patients and
    Methods
    The 200 Iranian patients who referred to Shahid Beheshti hospital in Qom were recruited by convenience sampling. All the patients filled out the MacNew HRQL questionnaire, the hospital anxiety and depression scale (HADS), the Short Form- 36 and socio-demographic and clinical characteristics. The reliability of the MacNew was assessed by internal consistency and test-retest reliability. Construct validity was assessed by factor analysis, convergent validity and discriminant validity. Discriminant validity of MacNew was assessed by the known-groups approach. All analyses were done through SPSS, version 20, and level of significance was considered at P
    Results
    The mean MacNew Global score was 3.6 ± 0.82. Our results demonstrated that internal consistency (α = 0.94) and reproducibility (ICC = 0.84) of the Persian version of the MacNew were confirmed. The Factor analysis confirmed three factors as the original MacNew. Convergent and divergent validity of the MacNew was confirmed by its correlation pattern with physical and mental components of the SF-36. Discriminative validity was confirmed statistically and clinically for the differences in the MacNew scores on the Global scale and each subscale between Iranian patients with and without anxiety and depression.
    Conclusions
    The Persian version of the MacNew HRQL questionnaire can be applied as a reliable and valid tool in the clinical research for Iranian patients with heart failure.
    Keywords: Quality of Life, Heart Failure, Validation Study
  • Leila Malekmakan, Mehrab Sayadi *, Maryam Pakfetrat, Badrosadat Moosavi, Houri Mousavinezhad Page 143
    Background
    Ramadan is the fasting month among Muslims and the change in eating and sleep pattern can cause changes in human health.
    Objectives
    This study was carried out to determine the effect of fasting in Ramadan on the anthropometric parameters and blood pressure level.
    Patients and
    Methods
    This is a semi-experimental study conducted as before and after design on 93 staff of Shiraz University of Medical Sciences in 2014. The participants were selected through convenience sampling method. All the subjects were assessed for anthropometry parameters and blood pressure levels in two sections, before and after Ramadan. Data were presented as mean (SD) or number (%) for continuous or discrete variables, respectively. The data were analyzed via paired and independent t-test or Chi-square test. All the analyses were performed using the statistical Package for Social Sciences, version 17.0 (SPSS Inc., Chicago, IL, USA). P value less than 5% was considered significant.
    Results
    All the subjects completed the study. In this study, 93 subjects with an agerange of 25 - 57 years and mean of age 37.2 ± 7.9 years participated. Among them, 49 cases (52.7%) were men. All the anthropometric parameters and blood pressure showed a significant difference; BMI: (26.1 ± 3.3 vs. 25.7 ± 3.2, P
    Conclusions
    The data revealed that Ramadan can reduce anthropometric parameters and blood pressure levels. It was found that reduction in BMI and HC in men was significantly greater than women.
    Keywords: Body Mass Index, Anthropometry, Blood Pressure, Fasting
  • Samaneh Abdolahpour, Azam Bakhshandeh, Touraj Farazmandfar, Mehdi Rayatnavaz, Majid Shahbazi * Page 149
    Background
    Cardiovascular disease (CVD) is the most common cause of mortality and morbidity worldwide. Coronary artery disease (CAD) is the leading cause of CVD. In CAD, atherosclerotic plaques lead to coronary artery stenosis, hereby impairing myocardial blood and oxygen supply. The oxidative changes in LDL at the vascular wall play a critical role in the development of atherosclerotic lesions. The paraoxonase 1 (PON1) enzyme present in the HDL surface is capable of destroying oxidized LDL and, therefore has an antiatherogenic activity.
    Objectives
    This study was conducted to investigate the association of two functional polymorphisms in PON1 gene with CAD in northern Iran.
    Materials And Methods
    This study was a case-control study with the case-base sampling method for the control group. Genomic DNA was extracted from the peripheral blood collected from 305 patients with CAD and 302 healthy controls. Two polymorphisms of PON1(L55M)T > A and PON1(Q192R)A > G, for all samples were genotyped by Single- Specific Primer-PCR. GraphPad6 software was used for statistical analysis.
    Results
    Logistic regression analysis showed that age, gender, smoking status, and diabetes mellitus were significantly associated with CAD disease (P A polymorphism and CAD disease (P = 0.011). The results indicated that allele A in this SNP was also significantly associated with the CAD disease (P = 0.005). Analysis of dominant genetic model in PON1 (L55M)T > A showed that one copy of A is sufficient for increased risk (P = 0.016).
    Conclusions
    Our findings, at least in the population of Golestan province, indicated that the PON1(L55M) polymorphism might be associated with atherosclerotic disease.
    Keywords: Coronary Artery Disease, Paroxonase1, Polymorphism
  • Jayme Ferro, Giovanni Tortorella, Massimo Pantaleoni, Vincenzo Guiducci Page 153
    Spontaneous coronary artery dissection (SCAD) is the spontaneous separation of the coronary artery wall, not iatrogenic or related to trauma. SCAD is an uncommon disease in which the left main coronary involvement is rare. SCAD is commonly nonatherosclerotic, according to predisposing factors (fibromuscular dysplasia, female gender, pregnancy, ecc) and precipating factors (intense exercise/emotional stress, vigorous Valsalva type activities, abuse of recreational drugs, ecc). Diagnosis of SCAD is first based on clinical grounds and then confirmed with imaging. Access to different imaging techniques, in particular coronary angiography (CA) and intravascular ultrasound (IVUS), is crucial to recognize and manage SCAD in acute care settings. We report an unusual case of high risk acute coronary syndrome due to the left main coronary dissection in a 33 year-old pregnant woman at 19th week of gestation. According to coronary angiography and clinical unstable conditions, LM was successfully treated with a provisional stenting technique. Intra-procedural IVUS was helpful to obtain good stent apposition and confirm the underlying intramural hematoma. Before invasive strategy, the cooperation of the heart team was crucial because we not only considered some protocols to reduce radiation and contrast agent exposure, but also planned a follow up in order to organize the delivery and minimize potential stress conditions and bleeding risk to the fetus.
    SCAD should not be underestimated when associated to ACS and pregnancy: urgent coronary angiography and bail-out adjunctive imaging are crucial. Improvements in materials and techniques together with a protocol for radiation/contrast media exposure and for antithrombotics drugs administration could make percutaneous interventions feasible and safe in these scenarios.
    Keywords: Coronary Artery Dissection, Spontaneous, Pregnancy, Angioplasty, Acute Coronary Syndrome