kianoosh hosseini

The Kansas City Cardiomyopathy Questionnaire (KCCQ) has been developed to measure the health status of Congestive heart failure (CHF) patients. This study aimed to translate KCCQ into a Persian version and assess its validity and reliability. We used a forward-backward procedure to translate the questionnaire. In a cross-sectional study, 150 CHF patients and 50 healthy subjects over 30 years old were selected to assess the reliability and construct validity of the instrument. The face and content validity were used for the questionnaire's validity. The validity was examined on a population of patients with CHF using the Persian version of the Minnesota Living Heart Failure Questionnaire (MLHF) health survey. Calculation of the Intraclass correlation coefficient (ICC) and Cronbach's alpha was done to evaluate the questionnaire's reliability. Test-retest reliability was examined by re-administering the KCCQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all domains was higher than 0.93, P≤0.000). Internal consistency was found by Cronbach's alpha to be 0.86 for the clinical summary and 0.87 for the overall summary, respectively. Also, the correlation between the components of KCCQ and MLHQ showed satisfactory construct validity. Good Pearson's Correlation Coefficient was seen between KCCQ and MLHF (r= -0.44, P≤0.000 for the clinical summary; r= -0.45, P≤0.000 for the overall summary). Analysing the data from 50 healthy persons and 150 patients were shown that the Persian version of KCCQ has acceptable discriminate validity for all domains except self-efficacy. The Persian version of the KCCQ had satisfactory reliability and validity for assessing health-related quality of life status for Iranian CHF patients.

The role of polymorphisms on the sequences of the endothelial nitric oxide synthase (eNOS) gene has been proposed to predispose coronary artery disease patients to stent restenosis. We conducted the present study to examine the involvement of the role of the -786T>C variant of the eNOS gene in stent restenosis following coronary stent deployment. This cross-sectional study was conducted on 100 consecutive patients who underwent coronary stenting. The study population was assigned into a case group, who had restenosis and were candidated for revascularization (n, 50), and a matched control group, who underwent coronary stenting but without evidence of restenosis within 6 months of stenting (n, 50). The -786T>C polymorphism was identified, following polymerase chain reaction (PCR), by restriction enzyme digestion. The overall prevalence of restenosis was 34.4%. In total, the frequency of the wild genotype (CC) of the -786T>C variant was 41.9%, the frequency of heterozygous genotype (TC) was 41.9%, and the frequency of the mutant genotype (TT) was 40.9%. We found an association between the presence of stent restenosis and the presence of the -786T>C variant: in the patients with and without restenosis, the frequency of the CC genotype was 24.2% and 51.7%, the frequency of the TC genotype was 12.1% and 20.0%, and the frequency of the TT genotype was 63.6% and 28.3%, respectively (P = 0.023). In the multivariate logistic regression analysis, along with the presence of the -786T>C variant, the other determinants of stent restenosis included male gender, waist circumference, both systolic and diastolic blood pressures, history of dyslipidemia, left anterior descending artery (LAD) involvement, distal position of stenting, and duration of the concomitant use of aspirin and Plavix®. However, in similar analysis, none of the pointed factors could predict the severity and percentage of restenosis. The presence of the -786T>C polymorphism of the eNOS gene is a major and serious risk factor for stent restenosis, independent of the effects of other cardiovascular risk factors. The effect of this polymorphism is particularly highlighted in the LAD. Nevertheless, it seems that the -786T>C polymorphism may not have a central role in the progression and severity of stent restenosis.

Stenosis of the stent is an explanatory outcome of successful results in patients under angioplasty procedures for coronary artery disease. Determination of the risk factors for this phenomenon is an important step for programming to reduce the stenosis rate and improving the outcomes. Hence, this study was performed to determine the association between the metabolic syndrome and stent restenosis. In this cross-sectional descriptive-comparative study, 122 patients with the acute coronary syndrome or chronic stable angina admitted to Shariati hospital, Tehran, Iran, between 2012 and 2014, who had a history of percutaneous coronary intervention (PCI) with coronary stent insertion were enrolled and the prevalence of in-stent stenosis and association with the metabolic syndrome were determined. There was no significant association between the metabolic syndrome and stent stenosis (P=0.129), and 21 (35%) patients and 14 (22.6%) individuals among those with and without the metabolic syndrome had in-stent stenosis. The mean duration of stent placement was 3.63 ± 1.51 and 2.99 ± 1.61 years in those with and without stent stenosis, respectively, showing a significant difference (P=0.046). Among those with dyslipidemia 48.6% and among the patients without dyslipidemia 20% had stenosis in the stent, showing a significant difference (P=0.001). We conclude that the metabolic syndrome is not a contributing factor for stent stenosis.