arsalan khaledifar

Cardiotoxicity is one of the main complications of chemotherapy that increases morbidity and mortality in cancerous patients. The present systematic review aimed to investigate the protective effects of berberine (Ber) on doxorubicin (Dox)-induced cardiotoxicity. The study protocol was developed following the PRISMA statement. An extensive search was performed in multiple databases, including Embase, PubMed, Cochrane library, Web of Science, and Scopus. After defining the inclusion/exclusion criteria of the study, 12 records were included. The desired data of the retrieved articles were extracted from the studies and imported into an Excel form and ultimately, the effects, probable outcomes and mechanisms were surveyed. By activating sirtuin 1 (SIRT1), Ber caused reduced oxidative damage and loss of mitochondria integrity in cardiomyocytes. It also regulated autophagy and apoptosis via down-regulating AMP-activated protein kinase (AMPK), nucleotide-binding oligomerization domain, leucine rich repeat, and pyrin domain containing protein (NLRP) activation. Moreover, Ber increased superoxide dismutase (SOD), catalase (CAT), and plasma glutathione peroxidase (GSH-Px) activities, reduced the levels of malondialdehyde (MDA), up-regulated SIRT3, and subsequently reduced oxidative stress in cardiomyocytes and loss of mitochondria integrity, leading to developed apoptosis and regulating the histopathological and electrocardiogram changes in the myocardium. It also ameliorated the DOX-induced calcium ions (Ca2+) and iron overload. Ber reduced oxidant and inflammatory activity, and regulated apoptosis of cardiomyocytes, thus protecting the cells against DOX-induced cardiotoxicity.

 Atherosclerosis is one of the main reasons why people die from cardiovascular disease. The pathogenesis of atherosclerosis may have been aided by the deregulation of cellular and molecular events in peripheral blood mononuclear cells (PBMCs). This study aimed to investigate the alteration of the expression of matrix metallopeptidase-9 (MMP-9) in PBMCs of subjects who underwent angiography.

 Following a thorough clinical examination and anthropometric assessments, 90 individuals were divided into two groups: 56 coronary artery disease (CAD) participants (subjects with coronary artery stenosis≥50%) and 34 non-CAD participants (subjects with coronary artery stenosis≤30%). Then, this study evaluated fasting serum glucose (FSG), total cholesterol (Chol), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglyceride (TG). Next, the severity of coronary artery stenosis was recorded. Additionally, real-time polymerase chain reaction (PCR) was used to assess the gene expression of MMP-9. MMP-9 protein level was also assessed using western blot techniques. The overexpression of MMP-9 and elevated level of FSG were positively associated with coronary artery stenosis.

 Our results revealed that MMP-9 was upregulated both at the level of transcription and translation. Moreover, the upregulation of MMP-9 had a significant positive correlation with the severity of coronary artery stenosis.

 Significant correlation between the overexpression of MMP-9 and coronary artery stenosis confirms our hypothesis that the upregulation of MMP-9 in PBMCs has an important role in the pathogenesis of atherosclerosis before monocyte recruitment and its subsequent processes.

 Concomitant carotid artery disease (CaAD) in patients referred to coronary surgical revascularization is a strong hazard to perioperative stroke. The current study addressed the epidemiology features of concomitant CaAD in patients referred to a coronary surgical revascularization center.

 This descriptive-analytical cross-sectional study was conducted on all incoming patients to coronary surgical revascularization for two years at a single center who underwent a color duplex-sonography (CDS) interrogation. The demographic, clinical, echocardiographic, coronary angiographic, and color duplex-sonographic data were collected from patients’ medical records. Quantitative and qualitative data were expressed as means and standard deviations, as well as numbers and percentages, respectively. The relationships between quantitative and qualitative variables were investigated using Pearson’s correlation and chi-square test, respectively.

 In total, 430 patients with a mean age of 66.3±9.9 years were included (35% females) in the study. Preoperative CDS was performed on 82% of patients; in addition, 29% of them presented with an increased intima-media ratio, and CtAD was observed in 51%. Based on the results, 77 and 143 patients were detected with unilateral and bilateral involvement, respectively. Severe carotid stenosis accounted for 4% of patients. Age older than 65 years (P=0.02), unstable angina (P=0.045), and the presence of an occluded coronary artery (P=0.002) were associated with the presence of CtAD. Finally, the severity of the left and right carotid stenosis was associated with diabetes mellitus (P<0.05).

 The prevalence of concomitant CtAD in patients referred to coronary surgical revascularization remains high. The current data warn of the necessity of performing preoperative CDS routinely.

Acute myocardial infarction (MI) is one of the most prevalent heart diseases across the world, including in Iran. The purpose of the present study was to investigate the relationship between acute MI and serum low-density lipoprotein (LDL) levels in patients with acute MI.

In this descriptive-inferential study, 1274 MI patients hospitalized in Shahrekord Hajar Hospital were selected using the census method. The required information was drawn from the patient’s medical records according to inclusion criteria. Statistical analyses were performed using analysis of variance (ANOVA) and chi-square test to examine the relationship between the LDL level and awareness in patients.

In this study, the average age of patients with acute heart attack was 13.79±63.18 years. Of the 1274 studied patients, 78% (999 people) were men and the rest were women. In both male and female genders, most patients had LDL levels between 70 and 129 mg/dL. Regarding statin use, 757, 287, and 162 people had a history of statin use, hypertension (HTN), and cardiovascular disease, respectively. In addition, 150 and 152 people had diabetes and a history of smoking, respectively. In this study, a significant relationship was found between the history of statin use (P<0.0001) and the frequency of MI (P=0.049) in LDL groups.

The results of this research revealed a significant relationship between LDL groups and the number of times acute heart attack occurs as a long-term complication in people who have had one.

This study aimed to compare the effect of the mindfulness-based stress reduction (MBSR) with cognitive approach, with that of the spiritual therapy with Islamic approach on quality of life among hypertensive cardiac patients.

All cardiovascular patients referred to the cohort center in Shahrekord in 2019 were included in this semi-experimental (pretest-posttest design) study. Using convenience sampling method, 75 patients were selected and randomly divided into two experimental groups and one control group in such a way that each group included 25 individuals. The McNew quality of life questionnaire was used to collect the required data. All groups received standard medical drugs under the supervision of a cardiologist. In addition to standard medical treatment, the experimental groups underwent MBSR with a cognitive approach (8 sessions lasting 90 minutes) and spiritual therapy based on Islam (8 sessions lasting 90 minutes); The control group received no non-medical intervention. Data were analyzed by using AVOVA and paired t test.

The overall score of quality of life in the MBSR and spiritual therapy groups increased significantly after the intervention (P<0.001). As for the control group, however, the overall score of quality of life remained unchanged after the intervention (P=0.10). Significant differences were observed in the total scores of quality of life among the three groups so that the mean score of the difference in the total score of quality of life in the spiritual therapy group before and after the intervention was higher than those in other groups (P<0.001).

MBSR therapy and specially Islam-based spiritual therapy had the potential to improve the quality of life in hypertensive cardiac patients.

Considering the high prevalence of cardiovascular diseases, angiography is important for diagnosis of diseases, pain, and fatigue following complete bed rest after percutaneous coronary intervention.

This study aimed to evaluate the effects of hand and foot surface stroke massage on pain intensity and anxiety level in hospitalized patients with acute coronary syndrome.

This clinical trial was conducted on 70 patients with acute coronary syndrome referred to Hajar Hospital, Shahrekord, Iran. The patients were randomly divided into an intervention and a control group (n = 35 for each). Anxiety level was measured using Spielberger’s Anxiety Inventory. Additionally, pain intensity was assessed by a visual analog scale 30 min before and 15 min after the intervention. The data were entered into the SPSS software and were analyzed using descriptive and inferential statistics (t-test, paired t-test, and chi-square test).

Descriptive statistics included frequency and percentage for qualitative variables and mean ± Standard Deviation (SD) for normally distributed quantitative variables. The results revealed a significant decrease in the mean intensity of pain and the mean level of anxiety in the intervention group five minutes after massage. However, no significant difference was observed in this regard in the control group after the intervention. Additionally, no significant difference was observed between the two groups in terms of pain intensity and anxiety level before the intervention (P ≤ 0.05).

Hand and foot massage was useful as a part of a nursing intervention in attenuating the pain intensity and decreasing the anxiety level in the patients with acute coronary syndrome.

Marital Reducing stressors is an effective way to decrease blood pressure and its other associated symptoms. The present study aimed to investigate the effectiveness of mindfulness-based stress reduction (MBSR) on metabolic syndrome among patients with hypertension.

This experimental research was conducted based on a pretest-posttest control group design. A total number of 50 cardiovascular patients referring to Shahrekord Cohort Study, Shahrekord, Iran, in 2019 were selected using the convenience sampling method and randomly divided into experimental and control groups (n=25 each). Metabolic syndrome indices, including blood pressure, blood sugar, glucose triglyceride, high-density lipoprotein, and low-density lipoprotein, were used to collect the required data. All groups received the same standard medications under the supervision of an interventional cardiologist. In addition to the standard medical treatment, the experimental group received the intervention of MBSR (eight 90-minute sessions). The control group did not receive any non-pharmacological intervention. Data were analyzed using multivariate analysis of covariance.

The results showed that MBSR was effective in improving metabolic syndrome symptoms in cardiovascular patients with hypertension (P<0.05).

The employment of MBSR along with medical and pharmacological treatments could help cardiovascular disease patients to improve the symptoms of metabolic syndrome.

Following the development of technology and the increase of intensive  care beds has led to the highest level of need for professional care team in these departments. In addition, intensive care personnel are exposed to serious occupational stressors such as time pressure reduced social support, overwork, and spiritual and moral distress. The aim of this study was to explain the strategies for promoting quality care in pediatric angiography

This is a qualitative study that was conducted purposefully with the participation of 20 members of the care team. Sampling was done until data saturation. Data analysis was performed using qualitative content analysis.

By analyzing the data, three categories were identified that included categories of structural correction,   human management modification and human interaction modification .

Findings of this study show that strategies to improve the management of the angiography department are affected by various factors such as structural management correction, human management, and human interaction correction. Therefore, in order to improve the management of this department, it is necessary to align managers in the field of standardization of the department and increase the level of communication skills of the care team

Anxiety is one of the most common psychological problems after myocardial infarction and can lead to many problems in acute coronary syndrome (ACS). Two possible ways to reduce anxiety are to listen to music and to recite the Holy Quran, the effects of which have never been compared to date.

The aim of this study was to compare the effect of listening to instrumental music and listening to Quran recitation on the anxiety level of patients with acute coronary syndrome.

This semi-experimental study was conducted among 96 patients with ACS referred to Hajar Hospital, Shahrekord, Iran, from 3/10/2019 to 4/30/2019. The patients were entered into the study using the convenience sampling method and then randomly assigned to the three groups of Quran recitation, instrumental music, and control. In this study, the patients’ anxiety level was measured using Spielberger’s state-trait anxiety inventory (STAI) before and after listening to Quran recitation and instrumental music. Data were analyzed by SPSS version 16 using descriptive and analytical tests, including paired samples t-test, Chi-square, and one-way ANOVA.

Anxiety level decreased from 43.1 ± 6.15 to 38.5 ± 3.82 in Quran recitation group (P < 0.001) and from 44.2 ± 1.21 to 39.1 ± 4.17 in the instrumental music group (P = 0.035), and from 46.3 ± 3.84 to 44.7 ± 6.21 in the control group (P < 0.001). There was no significant difference between the three groups before the program. However, the mean score of anxiety level showed a significant difference, indicating that listening to Quran recitation had a greater effect than listening to instrumental music in reducing the patients’ anxiety (P = 0.02).

Both interventions can be useful in decreasing the anxiety level of patients with ACS; however, the Holy Quran recitation had a greater effect in this regard.

Patients with acute myocardial infarction (MI) need care due to the complications of the disease. This study aimed to evaluate the effect of the family-centered intervention on the quality of life of patients with acute MI.

A randomized clinical trial study was conducted on 80 patients with acute myocardial infarction, who were hospitalized in Hajar and Kashani hospitals in Shahrekord, Iran and one of their family members. The subjects were randomly divided into two groups of control (N=40) and test (N=40) using statistical software. In the test group, four short messages were sent weekly for three months about necessary care after MI. On the other hand, subjects in the control group received routine intervention. After that, the quality of life of subjects was assessed before and immediately after the termination of intervention in both groups. In addition, data were collected using demographic characteristics questionnaire and McNeigh's quality of life inventory. Furthermore, data analysis was performed in SPSS version 23 using descriptive statistics (mean and standard deviation), as well independent and paired t-tests.

The findings were indicative of no significant difference between the test and control groups regarding the mean score of quality of life. However, a significant difference was found between the groups after the intervention in this regard. Moreover, the mean scores of changes in the quality of life of subjects in the test and control group were significantly different before and after the intervention. The results of the independent t-test demonstrated a significant difference between mean changes in the quality of life of the study groups.

According to the results of the study, SMS intervention as a distance learning method improved the quality of life in patients. Therefore, it is recommended that the intervention be applied to improve the quality of life in patients after acute MI.

Today, cardiovascular diseases are one of the main causes of mortality around the world including in Iran. One of the important factors in these diseases is healthy nutrition behaviors. Therefore, the current study aims to investigate preventive nutrition behaviors for cardiovascular diseases in women in city of Behbahan based on health belief model.

This descriptive study was carried out in year 1394 (March 2015 to March 2016) on 63 housewives visiting healthcare centers in city of Behbahan. Data gathering tool was a valid and reliable questionnaire based on health belief components filled by participants in the study. Gathered data was analyzed using ANOVA and Pearson correlation test at the significance level of P

The average knowledge score of women was 68.57±14.25 while the average scores for sensitivity and perceived intensity were 55.65±10.02 and 58.63±12.67 respectively. The average scores for perceived benefits, perceived barriers and self-sufficiency were 63.68±13.19, 59.46±15.83 and 43.84±7.27 respectively. The difference of average scores between people with and without previous diet experiences was not significant in any of the dimensions. There was also no significant difference between average scores of people with and without family history of cardiovascular diseases (P>0.05).

Based on awareness and knowledge level of women, it seems that implementation of programs based on educational models can help reduce the number of cardiovascular diseases.

This study aimed to find the influence of education level on the trends of changes of these risk factors among a great sample of Iranian population.

This cross‑sectional study is a secondary analysis of Isfahan Healthy Heart Program (IHHP). Blood samples were taken to determine the lipid levels including total cholesterol (TC), low‑density lipoprotein cholesterol (LDL‑C), low levels of high‑density lipoprotein cholesterol (HDL‑C), and triglycerides. Education categorized based on training system in Iran as 1‑5, 6‑12, and more than 12 years training.

The prevalence of diabetes was higher among illiterate participants in both areas. Hypertension was more prevalent in illiterate subjects (2001; 44.0% and 2007; 46.3%) in intervention area (P < 0.001). Dyslipidemia was more prevalent among illiterate people (P < 0.001). In the intervention, illiterates have higher BMI in both 2001 and 2007 (P < 0.001). The prevalence of current smoking was the highest in education level range 6 to 12 years and was steadily decreased in higher education levels (P < 0.001). Subjects with 6‑12 years of education have more unhealthy nutritional habits in both areas. In 2001, subjects with 12 years of education or more had more physical activity than other groups (P < 0.001), whereas, in 2007, subjects with 6‑12 years of education were more active (P < 0.001).

Although the prevalence of diabetes, hypertension obesity, and dyslipidemia are more in illiterate subjects and prevalence of diabetes and hyperlipidemia was sharply decreased with education level, it seems that well educated participants have higher daily physically activity compared with those who have lower education without considering the place or residency.

This study aims to evaluate the impact of the Isfahan Healthy Heart Program (IHHP) interventions concerning healthy behavior, on the prevalence of the metabolic syndrome (MetS) and its components in the Iranian population.

The IHHP targeted the population at large in three districts in central Iran from 2000 to 2007. Numerous interventional activities were performed to improve lifestyle. The main intervention strategies were public education through mass media, intersectional cooperation, health professional education, marketing and organizational development, legislation and policy development, as well as research and evaluation. MetS was defined based on the Adult Treatment Panel (ATP) III definition. The logistic regression method was applied to explore the relationship between lifestyle factors with components of metabolic risk factors.

The mean age of the participants was 44.68 ± 14.43 years in 2001. The mean values of the MetS components differed from 2001 to 2007. The mean of systolic blood pressure (SBP) decreased from 126.7 ± 22.31 to 124.21 ± 20.0 and from 129.47 ± 23.08 to 126.26 ± 21.88 among females in both the intervention and reference areas. Similar changes were observed among males. The mean diastolic blood pressure (DBP) and triglycerides decreased significantly in the intervention area and increased significantly in the reference area in both sexes. High density protein cholesterol (HDL-C) was decreased in both sexes, from 2001 to 2007, in both areas. A strong relationship between tobacco control with high SBP and hypertriglyceridemia was found (P < 0.01).

Lifestyle improvement programs could be useful to improve the MetS status among men and women.