abdollah amirfarhangi

The prevalence of coronavirus and its health-related psychological consequences such as fear and anxiety has been one of the most important health concerns in the 21st century.

This study aimed to investigate the predictive role of fear of COVID-19 and lockdown fatigue in coronavirus anxiety among patients with Congenital Heart Disease (CHD).

This descriptive-correlational study was conducted through path analysis. The statistical population included the patients with CHD referred to Shahid Rajaei Hospital and Tehran Heart Center, 105 of whom were selected using convenience sampling. The data were collected using the Coronavirus Anxiety Scale (CAS), Fear of COVID-19 Scale (FCV19S), and Lockdown Fatigue Scale (LFS). The reliability and validity of these scales were approved in the previous studies. After all, the data were entered into the SPSS 21 software and were analyzed using Pearson’s correlation test and step-wise regression analysis.

The study was conducted on 105 participants (6% males and 94% females) aged 20 to above 41 years. Considering marital status, 5% of the participants were single, 94% were married, and 1% were divorced. In addition, the participants’ education levels ranged from diploma and lower degrees to postgraduate and higher degrees. According to the findings, coronavirus anxiety was positively correlated to the fear of COVID-19 (r = 0.509, P = 0.000) and lockdown fatigue (r = 0.466, P = 0.000) in patients with CHD. The results of step-wise regression analysis showed that based on the calculated coefficient of determination, 31% of the variability of coronavirus anxiety could be explained by the fear of COVID-19 and lockdown fatigue.

The study findings indicated that the fear of COVID-19 and lockdown fatigue could predict coronavirus anxiety. Therefore, interventions are recommended to be designed based on the introduction of programs concerning coronavirus anxiety, which may help reduce the anxiety and fear experienced by these patients. They can also be used as prevention programs to help prevent the onset of coronavirus anxiety in patients with CHD.

Restenosis after coronary angioplasty can have serious complications such as coronary artery bypass graft, myocardial infarction, and death.

The present study aimed at investigating the factors affecting the recurrence of coronary artery stenosis in patients undergoing angioplasty using the recurrent event data analysis.

A cohort study was performed on patients undergoing coronary angioplasty from March 23, 2009, to January 21, 2011. All patients were followed up from angioplasty to January 21, 2015. First, each of the independent variables was entered into the univariate Cox model with a frailty component. Then, variables with p-values of less than 0.2 were entered into the multivariate analysis. The statistical analysis was done using R software, version 3.6, at the significance level of 0.05.

The present study was conducted on 1,000 patients who underwent coronary angioplasty. We found that 441 patients experienced restenosis at least once in the study period. The mean survival time to the first event of restenosis was 44.08 ± 1.06 months. Patients with a history of diabetes, unstable angina, and myocardial infarction had a significantly higher hazard of restenosis compared to other patients (P < 0.05).

The results of the recurrent event survival analysis confirmed the significant role of risk factors such as a history of diabetes, unstable angina, and myocardial infarction. Therefore, training to enhance the patients’ awareness and attitude seems necessary to prevent them from exposing whit known risk factors. The periodic follow-up of patients with risk factors and more ongoing care are also necessary.

Atherosclerosis is developed due to the formation of atheroma plaques in the coronary arteries. In this process, M1 macrophages and vascular smooth muscle cells (VSMCs) are the main functional cells. Inflammatory mediators such as histamine may inflame M1 macrophages. The aim of this study was to determine the effect of M1 macrophage secretion contents on the gene and protein expression levels of focal adhesion kinase (FAK), vasodilator-stimulated phosphoprotein (VASP), and thrombospondin1 (THBS1). Whole blood samples from the six healthy subjects (stenosis<5%), and six patients (stenosis>70%) were prepared and peripheral blood mononuclear cells (PBMCs) were isolated. Then monocytes were differentiated into M1 macrophages using 100 ng/mL granulocyte-macrophage colony stimulating factor (GM-CSF). The differentiated M1 macrophages were treated with histamine (10-6 M), and their secretion contents were harvested and added to the culture medium of VSMCs. The FAK, VASP, and THBS1 gene expression and protein levels were measured using RT-qPCR and western blot techniques in VSMCs, respectively. The FAK and THBS1 gene expression levels significantly increased in VSMCs after adding secretion contents obtained from histamine-treated M1 macrophages (p=0.023 and 0.05, respectively), while significant results were not observed for VASP gene (p=0.45). In converse with the phosphorylated VASP (pVASP) (p<0.34), the phosphorylated FAK (pFAK) and THBS1 protein levels increased in VSMCs (p<0.001). We concluded that in inflammatory conditions, the immune events could affect the macrophages by histamine. The activated macrophages could locally activate signaling pathways via FAK and THBS1 genes that are effective in the proliferation and migration of VSMCs.

Background and Coronary artery stenosis is a progressive process associated with artery calcification. Although the role of matrix Gla protein (MGP) is not completely clear but its expression in vascular smooth muscle cells (VSMCs) and sub-endothelial macrophages suggests a role in vascular calcification. The rs1800799 is one of the polymorphisms oriented within transcription factor elements in the promoter region of the MGP gene that may modify MGP expression patterns resulting in artery calcification. In this study, we examined the serum level and rs1800799 polymorphism of MGP gene promoter in patients with stenosis of coronary artery in Tehran.
One hundred sixty three individuals undergoing coronary angiography were divided into two groups: patients (n=100) and controls (n=63). The lipid profile, serum MGP concentration and rs1800799 genotypes were measured by routine laboratory, ELIZA, and RFLP-PCR assays, respectively.
In this study, we observed positive relationships between the two groups in LDL, total cholesterol, and TG levels (P 0.05). Also, genotype and allele distributions did not differ significantly between the cases and controls (P> 0.05). Furthermore, the serum levels of MGP were not significantly different between genotypes (P> 0.1).
In this study, the rs1800799 genotype distribution and serum MGP value were not significantly associated with coronary heart disease. Moreover, the serum MGP level showed no major role in the progression of coronary artery stenosis.

Ischemic heart disease and acute myocardial infarction is one of the most dramatic manifestations in one of the most investigated fields in the past few decades. In this study, the prognostic value of white blood cells count in patients with myocardial infarction (MI) was investigated in a six months follow-up. In this cohort study, 106 patients with MI were investigated. White blood cell counts were assessed 48 hours after MI and the location of MI was determined using ECG. Mortality rate was determined and their correlation with leukocytosis was analyzed up to 6 months of follow-up. Binary logistic regression analysis was applied between factors such as mortality rate, location of the myocardial infarction, sex, hemoglobin and WBC count. Mean age of the patients was 62.5±13.3 years. 76.4% were men. 26% of patients had leukocytosis. Leukocytosis was significantly correlated with mortality in a six-month follow-up period (P<0.001). Fifteen (14.2%) patients died during the first three months of follow-up, of which 13 (86.7%) had leukocytosis. It was also shown that mean age of the patients and anemia in deceased group were significantly more than the survived group. High WBC count in the first 48-h after MI can be regarded as a poor prognostic factor and it has an independent role in determining prognosis of patients with MI for the next six months.

The aim of this study was to evaluate and compare the clinical and ‎electrocardiographic (ECG) manifestations of benzodiazepines (BZs).‎ In this retrospective study, all BZ-poisoned patients hospitalized at Loghman ‎Hakim Hospital between September 2010 and March 2011 were evaluated. Patients’ ‎information including age, sex, time elapsed between the ingestion and presentation, ‎and type of the BZ used were extracted from the patients'' charts and recorded. ECGs ‎on presentation to the emergency department (ED) were evaluated and parameters ‎such as PR interval, QRS duration, corrected QT, amplitude of S wave in lead I, height ‎of R wave and R/S ratio in the lead aVR were also measured and recorded.‎ Oxazepam, chlordiazepoxide, lorazepam, alprazolam, diazepam, and ‎clonazepam were ingested by 9 (3%), 13 (4.4%), 29 (9.9%), 105 (35.8%), 65 (22.2%), ‎and 72 (24.6%) patients, respectively. Mean PR interval was reported to be 0.16 ± 0.03 ‎sec and PR interval of greater than 200 msec was detected in 12 (4.5%) patients. Mean ‎QRS duration was 0.07 ± 0.01sec and QRS≥120 msec was observed in 7 (2.6%) ‎cases. Diazepam is the only BZ that does not cause QRS widening and ‎oxazepam is the only one not causing PR prolongation. It can be concluded that if a ‎patient refers with a decreased level of consciousness and accompanying signs of BZ ‎toxicity, QRS widening in ECG rules out diazepam, whereas PR prolongation rules out ‎oxazepam toxicity.‎