فهرست مطالب kamal khadem-vatani

Cardiovascular diseases are the leading cause of death in developing countries and hemorheological indices are the main factors in developing these diseases.

The main objective of this study was to investigate the impact of eight weeks of moderate intensity aerobic training combined with supplementation of aqueous extract of Cynodon dactylon L. Pers on hemorheological parameters in non-athletic young men.

A total of 40 young non-athletes (with a mean age of 35.63±6.43 years and a body mass index (BMI) of 23.55±2.13 kg/m2 ) were randomly assigned to one of four groups, including control (C), aerobic exercise (E), the C. dactylon extract (CD), and aerobic exercise+C. dactylon extract (E+CD). Changes in fibrinogen, blood and plasma viscosity, and hematocrit were measured at two stages (baseline and 24 hours after the intervention ended).

The blood fibrinogen level in three groups of E, CD, and E+CD showed a significant decline compared to the baseline status (P<0.05). Additionally, there were significant decreases in blood viscosity levels in groups E (P=0.006), CD (P=0.048), and E+CD (P=0.001) after eight weeks of intervention. The plasma viscosity also showed a significant reduction only in group E after eight weeks of intervention (P=0.004). Moreover, hematocrit level significantly decreased in group E+CD (P=0.018).

The findings of this study suggest that eight weeks of moderate intensity aerobic exercises alone and in combination with the consumption of the aqueous extract of C. dactylon L. Pers could improve hemorheological indices and reduce the risk of cardiovascular diseases.

Premature coronary artery disease (CAD) is common in men and women under 45 and 55 years, respectively. It has been demonstrated that R202Q mutation of MEFV gene may increase the risk of cardiovascular disease in individuals with metabolic syndrome. The goal of the present investigation was to evaluate the frequency of MEFV gene mutation R202Q in exon 2 in Iranian patients with premature CAD (West Azerbaijan province of Iran).

A total of 100 patients with premature CAD and 100 healthy individuals participated in this hospital-based study. Cases and controls were selected based on strict criteria, including a minimum of one documented angiography with at least 50% stenosis of the coronary artery. PvuII based PCR-RFLP technique was used for the detection of R202Q mutation in the tested samples.

R202Q mutation was not found in any of the healthy controls; whereas 12 out of 100 patients with premature CAD were heterozygote for R202Q mutation (12%) (12% vs. 0%). Considering the heterozygosity of the R202Q mutation in the patients, the allele frequency was 0.06 (12 out of 200 chromosomes).

Our results indicate that the R202Q mutation in the MEFV gene is frequent in patients with premature CAD. Further studies are necessary to analyze more details regarding variable expressivity or incomplete penetrance of R202Q mutation in the tested population.

Heart disease is a major public health concern with millions of reported deaths annually. Data mining techniques have received attention in recent years as a tool aiding diagnosis and prediction of heart disease cases. This systematic review examines the application of data mining methods to cardiac disease diagnosis in order to identify specific types of heart-related disease that are diagnosed using data mining techniques as well as the most successful data mining methods.

This study involved a systematic review of IEEE, Science Direct, Google Scholar, Web of Science, Scopus and MEDLINE databases from 2008 until April 2023. Inclusion criteria were original papers that used data mining methods for heart disease diagnosis. Non-English papers, those without full text, studies conducted on animals, and other types of papers (conference abstracts and letters) were excluded from the study. All the retrieved references were then assessed by title and abstract according to PRISMA, after which full texts of relevant articles were analyzed. The final sample comprised of 47 articles.

Various classification methods have been utilized to diagnose heart-related disease using different mining tools, with genetic neural network data mining method having the highest accuracy among the studied techniques. Results show that predicting cardiac disease is the most commonly performed task. The demographic, bio-clinical, personal and exercise-related attributes, as well as other features used for classification were identified. The findings suggest that data mining methods hold great potential for detecting and preventing heart disease on both individual and population scales.

The study findings have implications for the prevention and treatment of cardiac disease, especially in high-risk individuals. Data mining methods can be widely applied to detect and prevent heart disease on a population scale, as well as supporting decisions for the most suitable treatment for individual patients to prevent death and reduce treatment costs.

Target: 

Bendopnea, defined as dyspnea while bending, can be observed in patients with heart failure (HF). In this study, we investigated the frequency of this symptom in patients with systolic HF and its association with echocardiographic parameters.

In this study, patients with left ventricular ejection fraction (LVEF) ≤45% and decompensated HF referred to our clinics were prospectively recruited. All patients were examined by cardiologists for collecting data on the presence of bendopnea and baseline characteristics. They also underwent electrocardiographic and echocardiographic examinations. All findings compared between patients with or without bendopnea.

A total of 120 patients with a mean age of 65.19 ± 12.62 years were evaluated, and 74.8% were men. Bendopnea was observed in 44.2% of the patients. The etiology of HF was ischemic in most patients (81.9%), and the functional class of most patients (85.9%) was III or IV. The mortality rate at 6 months follow-up was comparable between patients with or without bendopnea (6% vs. 9.5%, p=0.507). The waist circumference (odds ratio [OR] 1.037, 95% confidence interval [CI] 1.005 – 1.070, p = 0.023), paroxysmal nocturnal dyspnea (OR 0.338, 95% CI 0.132 – 0.866, p = 0.024), and right atrium size (OR 1.084, 95% CI 1.002 – 1.172, p = 0.044) were associated with bendopnea.

Bendopnea can be frequently found among patients with systolic HF. This phenomenon is associated with obesity and baseline symptoms of patients and right atrium size upon echocardiographic examinations. It can help clinicians with the risk stratification of HF patients.

The purpose of this study was to identify the angiotensin-converting enzyme (ACE) gene (I/D) variations in CAD patients and healthy controls in an Iranian population (West Azerbaijan province of Iran). This cross-sectional study included 95 CAD patients and 203 healthy controls. ACE I/D polymorphisms were assessed using PCR, and their frequency was determined.  There were 298 people, 95 CAD patients, and 203 controls, with an average age of 50.96±3.45 and 51.14±10.20. We discovered that the frequency of the D allele was significantly higher in CAD patients than in controls (P = 0.0009). In contrast, the frequency of the I allele was significantly higher in controls than in CAD patients (P = 0.0009). The D allele carriers genotypes (DD + ID) were more frequent in the CAD patients than in the control group (P = 0.008). The ACE II genotype-state carriers were more common in the control group than in CAD patients (P = 0.0084). However, in the case of the ACE ID genotype, no significant differences were not found in the tested groups (P = 0.47). These findings suggest that individuals with the ACE DD genotype are predisposed to CAD, whereas individuals with the ACE II genotype state are protected.

The tissue kallikrein-kinin system is an endogenous homeostatic pathway, which its stimulation is associated with cardioprotection. The present study aimed to determine the effect of exercise training on plasma tissue kallikrein (TK) and bradykinin (BK) and their association with cardiac hypertrophy.

22 non-athlete and 22 athlete women were exposed to acute (Bruce test) and chronic (12-week swimming training) exercises. 2D echocardiography was used to evaluate morphological and functional features of the heart. Plasma concentrations of TK and BK were quantified by ELISA.

Athletes had significantly higher values of left ventricle end-diastolic diameter index (LVEDDI) and left ventricle mass index (LVMI) than non-athletes. Exercise intervention affected echocardiographic features in neither of the study groups. Chronic exercise training notably increased plasma levels of TK and BK, which increase was more pronounced in the athletes. Plasma TK negatively correlated with LVEDDI (r=−0.64, P=0.036 and r=−0.58, P=0.027) and LVMI (r=−0.51, P=0.032 and r=−0.63, P=0.028) in the non-athlete and athlete groups. In opposition, there was a positive correlation between plasma TK and left ventricle ejection fraction in non-athletes (r=0.39, P=0.049) and athletes (r=0.53, P=0.019).

The upregulation of the tissue kallikrein-kinin system may be a protective mechanism against excessive cardiac hypertrophy induced by chronic exercise training.

The prevalence of diabetes has made necessary changes in lifestyle to prevent its complications. In this study, the effect of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) with staxanthin supplementation on inflammatory biomarkers in the cardiac tissue of diabetic rats was investigated.

In this study, 42 male rats (age six weeks), after induction of type 2 diabetes,were randomly divided into seven groups (six in each group): 1)diabetic control; 2) diabetic Sham; 3) diabetes+supplement; 4) diabetes+HIIT; 5) diabetes+HIIT+supplement; 6) diabetes+MICT; and 7) diabetes+MICT+supplement. The HIIT groups ran with an intensity of 80% VO2max, and MICT groups ran with an intensity of about 65% to 75% VO2max on the treadmill (five sessions per week for eight weeks). The supplement was taken daily at a dose of 3 mg per kg. The cardiac tissue was removed 24h after the last training session (night fasting). Inflammatory biomarkers (IL-1b, IL-6, TNF-α, and CRP) of the cardiac tissue were measured by Western blotting.

After eight weeks of training, inflammatory biomarkers showed a significant decrease compared to the control group (p<0.05), and no significant changes were observed in the supplement group.

Due to the effect of MICT and HIIT in reducing inflammatory biomarkers, it can be used as a therapeutic strategy. It seems that the MICT with supplements may have more effective in these patients, while supplements alone have no effect on inflammatory markers.

There is no self-management to control the pain of heart patients, and these patients perform self-management using their own resources after coronary artery bypass graft surgery. The aim of this study was to determine the effect of acceptance-based self-management training on pain intensity in patients undergoing coronary artery bypass graft surgery.

This study is a clinical trial that was performed on 60 patients who were candidates for coronary artery bypass graft surgery. The samples were randomly divided into control and intervention groups. All patients received pain management self-management training immediately after hospitalization and were re-evaluated on the day of discharge. Data collection tools included demographic characteristics and Data analysis was performed using paired and independent t-test using SPSS software at a significant level of p <0.05.

Independent group t-test showed that the difference in postoperative pain scores of patients undergoing coronary artery bypass graft surgery before the intervention between the control and intervention groups was not significant (t = -0.678 and p = 0.50). However, the scores of postoperative pain in patients undergoing coronary artery bypass graft surgery after the intervention were significantly different between the control and intervention groups (t = 2.28 and p = 0.02).

Psychological aspects of pain acceptance interventions as a complement to self-management training can accelerate the patientchr('39')s adaptation to new painful conditions and subsequent behavioral changes desired by medical staff.

It is still unclear whether platelet count can predict the outcomes of acute myocardial infarction. In this study, we assessed the relationship between the initial platelet count on the degree of ST-segment depression and coronary flow rate among patients with MI who underwent percutaneous coronary intervention (PCI).

In this study, a total of 218 patients suffering from MI, who underwent primary PCI during 2016-2017 (Seyed-Shohada hospital, Urmia, Iran) were selected by consensus method. Demographic information and past medical history such as diabetes mellitus (DM), cigarette smoking, using Integrilin, and door-to-balloon (DTB) time were recorded. All patients were investigated in terms of cell blood count. Serial electrocardiogram (ECG) was also performed and the degree of ST-segment elevation was measured.

The mean (SD) age of participants was 58.67 (11.44) years. The initial platelet count was similar between patients with and without improvement in the ST-segment (P=0.275). There was no significant difference regarding thrombolysis in myocardial infarction (TIMI) between patients with and without improved ST-segment (P=0.380).

According to our results, the initial platelet count in patients who underwent angioplasty was not associated with coronary flow and echocardiographic responses to treatment

Klotho allele status is associated with increased risk of cardiovascular diseases, diabetes and hypertension.

To determine if serum klotho level was lower among diabetic and hypertensive patients compared to control group. Patients and

This was a cross-sectional study of 90 participants. Thirty pure diabetic patients and 30 participants with pure hypertension were compared with the healthy control group. Multiple logistic regressions were used to examine the association between serum klotho and diabetes and hypertension. We also tested the cut off point of serum klotho to predict hypertension and diabetes by using ROC (receiver operating characteristic) curve.

The level of serum klotho was significantly lower in diabetic and hypertensive patients. Participants with higher klotho were less likely to have diabetes and hypertension [OR: 0.48, 95% CI (0.22-0.81)] even after adjustment for covariates. ROC curve for diabetes and hypertension indicated 0.8 area under the curve which was statistically significant.

This study found that serum klotho was associated with lower odds of diabetes and hypertension. Further longitudinal studies are necessary to confirm this finding.

Epicardial fat thickness (EFT) can reflect risk of cardiovascular disease particularly coronary artery disease (CAD). The aim of this study was to investigate the association of EFT assessed by echocardiography and presence as well as severity of CAD.

Two hundred and twenty consecutive patients who candidate for coronary angiography because of possible CAD were studied. EFT was evaluated in standard parasternal long axis (PlAX) and parasternal short axis (PSAX) view from 3 cardiac cycles at the end of systole and diastole. The severity of CAD was defined in two ways: (1) SYNTAX score, (2) number of vessels with significant lesion.

PLAX (EFTS ) (EFT in systole) and PLAX (EFTd ) (EFT in diastole) were significantly higher in patients with CAD in comparison with patients without CAD (P = 0.046, P = 0.041 respectively). There was a significant correlation between PLAX (EFTS ) (P = 0.05), PLAX (EFTd ) (P = 0.04) and SYNTAX score. There was no statistically significant relationship between EFT and number of diseased vessel (P > 0.05). Multivariate analysis was done for adjusting the effects of confounding factors and it showed that EFT (OR: 10.53, P = 0.004) was significantly correlated severe CAD as assessed by the SYNTAX score.

EFT assessed by transthoracic echocardiography was higher significantly in patients with CAD than in normal patients. EFT as an easily available and cost-effective echocardiographic feature might be useful to predict complexity of CAD.

Serum Klotho is suggested to have protective effect against cardiovascular diseases. Nitric oxide production and preventing of oxidative stress have been suggested as its possible mechanisms of action. In this study we aimed to evaluate the association between serum Klotho level and cardiovascular diseases.

According to coronary angiography results, 40 patients with normal coronary artery and 40 patients with coronary artery disease included in this study. Serum Klotho level and laboratory data were analyzed for each patient and the association between serum Klotho level and coronary artery disease was evaluated.

Our results showed that Serum Klotho level in patients with 1 vessle, 2 vessle and 3 vessel disease was 2.16± 0.2, 2.2±0.13, 1.98±0.2 mIU/L respectively. (P value=0.02) The plasma Klotho concentration was significantly lower in patients with coronary artery disease.

Serum Klotho level can be a useful marker for evaluation of patients with coronary artery disease.

Multiple studies have shown that vitamin D deficiency can increase the risk of cardiovascular disorders. However, the role of vitamin D in increasing the risk of coronary atherosclerotic disorders and cardiac dysfunction is yet unknown. Accordingly, the present study aimed to assess the relationship between the serum level of vitamin D and the echocardiographic indices of the left ventricular (LV) function or valvular defects.

This cross-sectional study was performed on 80 consecutive patients who were the candidate for diagnostic coronary angiography and demonstrated a sign of slow coronary flow (SCF) or minimal coronary artery disease (CAD) while without any evidence of CAD. The serum level of 25-hydroxy vitamin D was measured by ELISA (enzyme-linked immunosorbent assay) method. Finally, patients were evaluated by transthoracic 2D, Doppler echocardiography, and tissue Doppler imaging in order to investigate the systolic and diastolic function of the left ventricle.

Based on angiography reports, 36.2% of patients had normal coronaries while 50.0%, 7.6%, and 6.2% of them were diagnosed with isolated minimal CAD, isolated SCF, and a combination of minimal CAD and SCF, respectively. In addition, the mean serum level of 25-hydroxy vitamin D in our patients was 30.33 ± 19.27. Further, the mean level of this parameter was 29.37 ± 22.16, 30.39 ± 16.22, 18.24 ± 4.32, and 44.65 ± 25.52 in the normal coronary group, as well as patients with isolated minimal CAD, concurrent minimal CAD and SCF, and those with isolated SCF, respectively, indicating no significant difference among the groups regarding 25-hydroxy vitamin D concentration (P=0.147). Furthermore, the level of 25-hydroxy vitamin D had no relationship with the echocardiography indices of the LV function or valvular defects.

In general, the serum level of 25-hydroxy vitamin D may not be a predictive factor for the LV function or valvular defects.

Cardiac tamponade nearly always requires urgent intervention, but the optimal management of pericardial effusion is still controversial. The aim of our study was to introduce the profile and treatment results of patients with tamponade in our referral heart center.

From November 2010 to November 2014, our retrospective study was performed on 220 patients with tamponade. All the clinical and echocardiographic findings of the patients, as well as their operative and follow-up data, were recorded and analyzed.

The overall prevalence of tamponade relative to the entire study population undergoing heart surgery was 8.5%. There were 106 men and 114 women at a mean age of 55.5 years (range = 5–99). The most common causes of tamponade were cardiac diseases (21%), malignancy (20.4%), unknown (20.4%), chronic renal failure (15%), and post-cardiac surgery complications (10.5%). The approaches for pericardial effusion drainage were the subxiphoid approach (97.7%), mini-thoracotomy (1.4%), and percutaneous pericardiocentesis (0.9%). The intraprocedural mortality rate was zero, the mortality rate during hospital stay was 4.5%, and the recurrence rate was 9.1%. Patients with primary sanguineous pericardial effusion, malignant etiologies of tamponade, and malignant pericardial effusion had significantly poor survival. The survival rates at 1 month, 1 year, 2 years, and 3 years were 87.1%, 67.7%, 64.5%, and57.2%, respectively.

We found an association between left pleural effusion and small amounts of pericardial effusion, hence the necessity of more attention in the echocardiographic evaluation of these patients. The subxiphoid approach for pericardial effusion drainage is a safe and simple procedure associated with relatively lower postoperative complications, mortality, and recurrence rate. Sanguineous pericardial effusion is concomitant with poor prognoses.

Adherence to antihypertension medications is an important factor in the control of hypertension. In this regard, the present study aimed to estimate the extent of medication adherence in hypertensive patients and its determinants in the special clinic of Seyed-al Shohada Cardiovascular Tertiary Hospital in Urmia, Iran.

In this cross-sectional study, a total of 650 hypertensive patients were investigated during October to December 2016. In this study, two questionnaires were used to collect the data. The first questionnaire included the demographic and clinical characteristics, smoking status, family history of hypertension, and blood pressure measurements. The eight-item Morisky medication adherence scale was used to measure the extent of medication adherence of the participants. Moreover, the Chi-square test and logistic regression model were employed to identify the determinants of medication adherence.

Mean value of the participant age was reported as 59.5±10.4 years, and 63.5% of the subjects were female. Overall, 48%, 30.8%, and 21.2% of the subjects were reported with complete, moderate, and poor adherence, respectively. Among the investigated determinants, age (OR=1.02, 95% CI: 1.01-1.05), occupational status (OR=1.83, 95% CI: 1.19-2.83), absence of adverse effects of the drugs (OR=1.83, 95% CI: 1.02-2.71), use of two drugs (OR=1.75, 95% CI: 1.12-2.74), use of three drugs and more (OR=2.25, 95% CI: 1.30-3.88), and history of angioplasty (OR=1.80, 95% CI: 1.19-2.71) were associated with good adherence (i.e., complete and moderate) in this study. Only 39.4% of all participants had controlled level of hypertension.

According to the obtained results, the patients with hypertension had good medication adherence. The determinants effective in medication adherence outlined in this study can help identify patients with low extent of adherence.

Although invasive coronary angiography (CAG) is the gold standard for the diagnosis of coronary artery disease (CAD), myocardial perfusion imaging (MPI) is also used in suspected cases. In this study, we sought to determine the diagnostic value of MPI in the anatomical localization of CAD. In a retrospective study, all patients with an intermediate to high probability of CAD who had positive single-photon emission computed tomography MPI and subsequently underwent CAG between January 2016 and January 2017 were evaluated. A total of 210 patients at a mean age of 60.2±10.6 years underwent MPI and CAG. Abnormal anterior segments in MPI had a positive predictive value (PPV) of 68.1% to detect a diseased left anterior descending artery (LAD), and the negative predictive value (NPV) of similar segments for a concomitant LAD and right coronary artery (RCA) involvement was the highest (90.4%). Abnormal inferior segments in MPI had PPVs of 65.1% and 47% for the LAD and the RCA, respectively. The NPV was 81.8% for a concomitant LAD and RCA involvement and it was greater than either of each alone. Among the patients with abnormal posterior segments, the RCA and the left circumflex artery (LCX) had a PPV of 66.7%, which was greater than that of a concomitant RCA and LCX involvement. The NPV for either RAC or LCX alone or both arteries together was similar. MPI provides a relatively good diagnostic accuracy to detect abnormal segments matched to the involved coronary arteries in CAG. However, diagnostic accuracy was more pronounced in matching single-vessel CAD compared with double-vessel CAD.

Previous studies have been demonstrated the effect of fasting insulin concentration in coronary artery disease of patients with diabetes mellitus. Because of discrepancy in recent studies about this association in non-diabetic patients, we evaluated this effect. In this cross-sectional study, coronary artery angiography was done for 110 non-diabetic patients, and they were divided into two groups of normal coronary artery as control group and those with coronary artery stenosis as case group. Serum levels of glucose, cholesterol, triglycerides, low-density lipoprotein (LDL), and insulin were evaluated after 12 hours fasting period. One-way ANOVA and t tests were used for statistical analysis. Fasting blood sugar (FBS) in non-diabetic patients with and without coronary artery disease was 94.4 ± 14.9 and 90.52 ± 13.82 mg/dl, respectively (P = 0.150). The mean insulin concentration was 12.77 ± 3.29 mIU/l in case and 7.01 ± 3.25 mIU/l in control group (P = 0.001). We did not find any difference between men and women according to their fasting insulin concentration (P = 0.210). Higher serum level of fasting insulin seems to have correlation with coronary artery disease in non-diabetic patients; but further studies with larger population study are needed for better evaluation.

Recent studies have shown that some of the MEFV gene mutations are common in patients with coronary artery disease. The present study was designed to investigate the presence or absence of E148Q mutation in exon 2 of MEFV gene in patients with premature coronary artery disease. In this study, 90 patients with coronary artery disease were voluntarily selected for molecular analysis of the E148Q mutation in the exon 2 of the MEFV gene. 2-3 ml of peripheral blood was collected in tubes containing EDTA. Genomic DNA was extracted using "salting out" method. RFLP-PCR was used to determine the E148Q mutation. Of 90 patients studied, 7 (7.8%) patients were heterozygous for the E148Q mutation. In other words, of 180 chromosomes examined, 7 chromosomes (3.9%) had a mutated allele regarding E148Q mutation. In this study, the E148Q mutation was not found to be homozygote in tested samples. It can be concluded that E148Q mutation is not a risk factor for coronary artery disease in the tested group.

Cardiac hydatid cysts are uncommon and pericardial involvement is extremely uncommon. We report a rare case of a cardiac hydatid cyst that was surprisingly found during an emergent tamponade surgery in a woman. She was pale, febrile, ill and toxic and 300cc turbid and purulent fluid was drained. In taking history, it was found that the patient had six sheep dogs in her house. Laboratory analysis revealed elevated C-reactive protein, elevated white blood cell count (neutrophil 80% and eosinophils less than 5%), anemia and negative immunoglobulin ELISA. Complete reevaluation revealed two relatively large hydatid cysts; the biggest one (5cm diameter) was in the lateral side of the left atrium and the other one (2.5cm diameter) was in the inferior of ascending aorta. Surgical removal of the cyst was performed via median sternotomy and cardiopulmonary bypass. The patient had pericarditis, fibrinous adhesions and heart inflammation. Postoperative period was uneventful and the patient received Albendazole for six months. There was no recurrence during the one- year follow-up period.

Premature coronary heart disease (PCHD) affects public health and leads to death. PCHD has several genetic and environmental risk factors. The aim of this study was to analysis of the mutations in exon 10 of MEFV gene in patients with PCHD in West Azerbaijan province of Iran.
Totally 41 PCHD patients who were admitted to the cardiology unit of Sayedoshohada hospital (Urmia, Iran) enrolled in the study. Selection of the patients was done based on the strict criteria, that is, who had a minimum of one angiographically documented coronary artery with the stenosis of 50%. Mutations in exon 10 of MEFV gene were found by direct sequencing.
V726A, M680I, K695R, and A744S mutations with 2.44%, 1.22%, 1.22%, and 1.22%, allelic frequency were found, respectively. Five patients (12.2%) with PCHD carried at least one mutated MEFV allele. Heterozygote V726A was the most frequent mutation among tested cases (4.88%), followed by heterozygote M680I, heterozygote K695R, and heterozygote A744S.
The results of the present study imply that the frequency of the MEFV gene exon 10 is significantly high in PCHD patients. This is the first report in its own kind in clinically diagnosed PCHD pa­tients of Iranian Azeri Turkish population.

Due to the prevalence of Opioid dependency, the aim of this study was to investigate features and in-hospital prognosis of myocardial infarction in patients with and without opioid dependency.
In this study 95 patients were included and divided into two groups (opium dependent and non-dependent). The peak CK-MB level, length of stay, STEMI prevalence, EF, infarction site and post AMI complications (VT, VF), and mortality were checked out in both groups.
In this study, the average age and length of stay in opioid dependent patients were 59.65±16.68 and 8±2.085, respectively. In opioid dependent patients, infarction site was anterior in 46.3%, inferior in 38.40% and non-STEMI in 15.3%, 6 patients had VT/VF and 5 patients died whereas 15 patients had no post MI complications.
There was no significant correlation between groups in length of stay, age, STEMI prevalence, infarction site (anterior/inferior), EF and peak CPK-MB level. But there was significant correlation between opioid dependent patients and post MI complications (VT, VF and mortality).

The aim of this study was to determine the clinical importance of PR segment depression after MI in prognosis of patients with acute myocardial infarction.
This descriptive analysis study was conducted on 413 patients (283 patients were men and 130 women). The first ECG of all myocardial infarction patients was checked to determine PR segment depression. All patients were divided into two groups according to PR segment depression and then both groups were examined for cardiac complications.
Accordingly, 12 men and 1 woman had PR segment depression. 325 patients had STEMI and 88 patients had non-STEMI. The average length of stay in patients with STEMI and non-STEMI was 7.26 and 6.75 days, respectively. There was no correlation between the kind of MI and length of stay (P>0.05). Cardiac complications were seen in 7 patients with PR segment depression and not observed in 48 patients. There was significant correlation between cardiac complications and PR segment depression (P There were no significant correlation between PR segment depression and sex, age, EF, length of stay and CK-MB level. But there was a significant correlation with cardiac complications.

Primary cardiac tumors are rare entities with an autopsy frequency ranging between 0.017% and 0.19%. The present study aimed to summerize 5 years of our clinical experience with surgical resection of intracardiac tumors.
In this study, 3245 consecutive cases of cardiac operations performed at Seyed-al-Shohada Cardiovascular Center between November 2009 and December 2014 were retrospectively reviewd. The data of 13 patients with open heart surgery due to cardiac tumors were selected and analyzed. All patients underwent median sternotomy and cardiopulmonary bypass.
The prevalence of cardiac operations for primary cardiac tumors was 0.4% among the corresponding period cardiac operations. Of 13 operated patients, 6 were female (46.2%) and 7 male (53.8%). The average age of the patients was 15 to 82 (mean 55.1 ± 16.2). The typical presentations were cardioembolic stroke in 30.8% and congestive symptoms in 46.2%. It was an incidental finding in 23% of cases (3 patients). Myxoma (84.6%) was the most common diagnosis, typically affecting the left atrium (81.8%). Malignant tumors represented 7.7% of cases. Mean tumor dimension was 5.2 cm in largest diameter. Three patients (23%) had concommitant surgery together with tumor resection. Papillary myxoma was found in 54.5% of patients (6 of 11 myxoma) and strongly was associated with preoperative cardioembolic stroke (CVA). There were no early hospital deaths in the perioperative period, and follow-up ranged from 6 to 44 months (mean23 months). Only one patient died during follow-up after 2 years of surgery for malignant tumor. None of the myxoma patients had tumour recurrence. At the last follow-up examination, all of patients were in functional NYHA classes I or II.
Surgical resection provides excellent outcome in patients with benign cardiac tumors and surgery for cardiac myxoma is associated with low long-term mortality and morbidity. Malignant tumors are a challenge despite good local tumor control because local recurrence and metastatic disease lead to limited survival.

Over the last decade, cardiovascular disease (CVD) has become the single largest cause of death worldwide including all developing regions. The coronary artery disease (CAD) is the most lethal form of CVD. Ceruloplasmin is a ferroxidase enzyme with two paradoxically oxidative and antioxidative performances. Some studies show that ceruloplasmin give rise to atherosclerosis by oxidative effect on low density lipoprotein (LDL). This study was done in Urmia Seyed-ol Shohada Hospital. The serum levels of ceruloplasmin were measured in 43 consecutive CAD patients (more than 75% stenosis at least in one coronary arteries by selective coronary angiography) and 43 consecutive control subjects (normal epicardial coronary arteries by selective coronary angiography). Exclusion criteria were lymphoma, pregnancy, oral contraceptive drugs, rheumatoid arthritis, Alzheimer's disease, heart failure (LVEF<40%), diabetes mellitus, heavy smokers, obsessive disorders, schizophrenia, dyslipidemia, and hypertension. CAD patients and normal group were matched for hypertension and dyslipidemia. There wasn’t significant statistical difference in serum ceruloplasmin level between CAD patients (298±115mg/L) and control subjects (281±81mg/L).There wasn’t significant gender difference in serum ceruloplasmin level. The result of the present study doesn’t support the hypothesis that a high serum ceruloplasmin level is a risk factor for coronary artery disease. If we exclude major CAD risk factors and effective factors on serum ceruloplasmin level, it can be stated that a high serum ceruloplasmin level is not an independent risk factor for atherosclerotic CAD.

Glycated hemoglobin (HbA1c) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, and retinopathy. Monitoring HbA1c in type 1 diabetic patients may improve outcomes. This study aimed to evaluate the relationship between serum HbA1C level and severity of coronary artery disease (CAD) in diabetic patients at Urmia Taleghani Hospital by selective coronary angiography. This descriptive and solidarity research was performed on 188 diabetic patients candidate for selective coronary angiography (SCA) in Urmia Taleghani Hospital according to purposive and including criteria. These patients were divided into 3 groups on the base of serum HbA1C level (HbA1C<7%,HbA1C between 7-9% andHbA1C>9%). Also the patients were divided into 4 groups on the base of SCA no CAD, one vessel disease (1VD), 2 vessel disease (2VD), and 3 vessel disease (3VD). Samples were analyzed by SPSS-16. There were 86(45.7%) male and 102(54.3%) female. The mean age of patients was 58.63+/-9.66 years. Coronary angiography revealed 1VD in 59 patients (31.4%), 2VD in 43 patients (22.9%), 3VD in 51 patients (27.1%) and normal coronary arteries in 35 patients (18.6%). Results of study showed HbA1C>9% in 73 patients (38.8%), HbA1C=7-9% in 96 patients (51%) and HbA1C<7% in 19 patients (10.2%). There was significant statistical relationship between serum HbA1C level and severity of CAD (P=0.002). Also there was significant relationship between CAD and positive family history (P=0.03). Analyses were performed independently in males and females and there was no relationship between smoking and severity of CAD on the base of gender consideration (P-value in male=0.160 and P-value in female=0.281). The findings of our study revealed significant relationship between serum HbA1C level and severity of CAD in diabetic patients. HbA1C can estimate severity of CAD. Accordingly with tight controlled diabetic mellitus, we can reduce number of severe CAD.