جستجوی مقالات مرتبط با کلیدواژه "cardiovascular system" در نشریات گروه "پزشکی"

It has been found that the new coronavirus can affect various parts of the cardiovascular system. Cardiovascular complications caused by coronavirus disease 2019 (COVID-19) are often serious and can increase the mortality rate among infected patients. This study aimed to investigate the prevalence of cardiovascular complications in COVID-19 adult patients. 

A systematic review and meta-analysis of observational studies published in English were conducted between December 2019 and February 2021. A complete search was performed in PubMed (PubMed Central and MEDLINE), Google Scholar, Cochrane Library, Science Direct, Ovid, Embase, Scopus, CINAHL, Web of Science, and WILEY, as well as BioRXiv, MedRXiv, and gray literature. A random effect model was used to examine the prevalence of cardiovascular complications among COVID-19 patients. The I2 test was used to measure heterogeneity across the included studies.

A total of 74 studies involving 34,379 COVID-19 patients were included for meta-analysis. The mean age of the participants was 61.30±14.75 years. The overall pooled prevalence of cardiovascular complications was 23.45%. The most prevalent complications were acute myocardial injury (AMI) (19.38%, 95% CI=13.62-26.81, test for heterogeneity I2=97.5%, P<0.001), arrhythmia (11.16%, 95% CI=8.23-14.96, test for heterogeneity I2=91.5%, P<0.001), heart failure (HF) (7.56%, 95% CI=4.50-12.45, test for heterogeneity I2=96.3%, P<0.001), and cardiomyopathy (2.78%, 95% CI=0.34-9.68). The highest pooled prevalence of cardiac enzymes was lactate dehydrogenase (61.45%), troponin (23.10%), and creatine kinase-myocardial band or creatine kinase (14.52%).

The high prevalence of serious cardiovascular complications in COVID-19 patients (AMI, arrhythmia, and HF) necessitates increased awareness by healthcare administrators.

Photoplethysmography (PPG) contains information about the health condition of the heart and blood vessels. Cardiovascular system modeling using PPG signal measurements can represent, analyze, and predict the cardiovascular system.

This study aims to make a cardiovascular system model using a Windkessel model by dividing the blood vessels into seven segments. This process involves the PPG signal of the fingertips and toes for further analysis to obtain the condition of the elasticity of the blood vessels as the main parameter. The method is to find the Resistance, Inductance, and Capacitance (RLC) value of each segment of the body through the equivalent equation between the electronic unit and the cardiovascular unit. The modeling made is focused on PPG parameters in the form of stiffness index, the time delay (∆t), and augmentation index.

The results of the model simulation using PSpice were then compared with the results of measuring the PPG signal to analyze changes in the behavior of the PPG signal taken from ten healthy people with an average age of 46 years, compared to ten cardiac patients with an average age of 48 years. It is found that decreasing 20% of capacitance value and the arterial stiffness parameter will close to cardiac patients’ data. Compared with the measurement results, the correlation of the PPG signal in the simulation model is more than 0.9.

The proposed model is expected to be used in the early detection of arterial stiffness. It can also be used to study the dynamics of the cardiovascular system, including changes in blood flow velocity and blood pressure.

Chronic kidney disease is a public health problem. The purpose of this study was to compare the effects of sevelamer and calcium- based binders on mortality of hemodialysis patients. PubMed, EMBASE and Web of Science were searched for related articles published before May 14, 2020. We included six studies with 43330 participants, of which 21147 and 22183 received calcium- based phosphate binders and sevelamer, respectively. In the analysis of unadjusted data, sevelamer could lower cardiovascular mortality. When adjusted HRs was pooled, the cardiovascular mortality did not differ significantly in the sevelamer and calcium-based phosphate binders groups. Additionally, the all-cause mortality rate in sevelamer group was different from that in calcium-based phosphate binders group. However, sevelamer could not lower all-cause mortality in terms of the adjusted data. No significant difference was found in calcium and phosphorus between calcium-based phosphate binders and sevalmer. Sensitivity analysis showed that partial results of the study were inconsistent. There was no difference in the effect of sevelamer and calcium- based phosphate binders on the risk of all-cause mortality in patients with hemodialysis, after adjusting confounders. However, given the instability of the results, the results need to be further confirmed by a large sample and high quality RCTs.

One of the trends in the development of medical technologies is considered to be telemedicine. This study aimed to evaluate the accuracy of a remote electrocardiogram (ECG) analysis and transmission system in prehospital setting.

In this cross-sectional study, the data of 19,265 ECGs was gathered from emergency medical service (EMS) database of Almaty city, Kazakhstan, from 2015 to 2019. All ECGs were recorded in the prehospital setting by a paramedic, using "Poly-Spectrum" ECG recording device. Subsequently, all ECGs were sent to the cardiologist for interpretation and the findings were compared between software and cardiologist.

19,265 ECGs were registered. The average time from taking ECGs to receiving an expert’s conclusion was 9.2 ± 2.5 minutes. The medical teams were called in 17.9% of cases after paramedic ECG recording; however, in the rest of the cases there was no need to call those teams. Using the device reduced the number of visits of specialist teams. The overall sensitivity, specificity, and accuracy of ECG analysis device in diagnosis of ECG abnormalities were 83.8% (95%CI: 82.6 – 84.9), 95.5% (95%CI: 95.1 – 95.8), and 93.3% (95%CI: 92.9 – 93.7), respectively.

The findings of this study showed the 93.3% accuracy of automatic ECG analysis device in interpretation of ECG abnormalities in prehospital setting compared with the cardiologist interpretations. Using the device causes a decrease in the number of cardiologist visits needed as well as reduction in cost and elapsed time.

Firstly, a new coronavirus emerged in Wuhan, China, sparking a pandemic of acute respiratory syndrome in humans. Corona virus disease-19 (COVID-19) was declared as a pandemic after the infection spread globally and disease caused by the new type of coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was named as COVID-19. The virus originated from bats and has been passed to humans. Initially, SARS-CoV-19 infects respiratory system an acute serious viral infection mainly developed with over a million people worldwide were transmitted rapidly in a few months. SARS-CoV-19, progress a moderate to serious severe respiratory symptoms such as headache, cough, and breathlessness. Also, digestive system symptoms include nausea, vomiting, and stomach pain.  Although the precise of the mechanism of inflammation unclear but this virus firstly use the angiotensin converting enzyme 2 (ACE2) receptor of the alveolar cells of lung tissue causing inflammation and cell death.  Then virus spreads and affects other important organ and tissues with complex pathophysiological alterations, the coronary disease, pulmonary disease, chronic kidney disease and chronic liver disease are the most prevalent comorbidities among patients. In COVID-19 infection therapy lots agents recommended. Unfortunately, there is no clear effective drug for treatment. This review presented potential pathogenic pathway of the SARS-CoV-19 infection and symptoms in the patients and given the information about the negative effects on different systems in the respiratory, cardiac system, nervous system, gastrointestinal system, and urinary tract.

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder caused by impaired steroidogenesis. Glucocorticoid treatment with increased androgens may lead to cardiovascular and metabolic effects in these patients. In this study, we investigated the relationship between cardiovascular risk factors and androgen levels in children and adolescents with CAH due to 21 hydroxylase deficiency.

A cross‑sectional study of 78 patients (37 boys and 41 girls) with CAH aged 3–17 years. Anthropometric, body mass index (BMI), systolic (SBP), and diastolic (DBP) blood pressure were measured. Fasting blood glucose with plasma insulin and lipids were measured, and insulin resistance (HOMA‑IR) calculated using the homeostasis assessment model. Furthermore, testosterone, Dehydroepiandrosterone sulfate (DHEAS), and 17‑Hydroxyprogesterone (17OHP) were investigated.

The mean SBP and DBP were 112.01 ± 19.13 and 69.77 ± 7.56, respectively. The mean of HOMA‑IR in patients was 2.25 ± 1.46. The frequency of patients with overweight and High HOMA index were, respectively, 33.3% and 29.3%. The correlation analysis between clinical characteristics and androgen serum levels showed that DBP and BMI had a significant positive correlation with 17OHP. The median regression analysis showed, only DBP in the adjusted model had a significant positive effect with 17OHP level (P < 0.05), and no significant relationship was observed for other characteristics.

A significant association was found between BMI and DBP with serum concentrations of 17‑OHP, suggesting that elevated 17‑OHP can lead to an increased risk of cardiovascular disorders in children and adolescents with CAH.

Raising knowledge over cardiac complications and managing them can play a key role in theirrecovery. In this study, we aim to investigate the evidence regarding the prevalence of cardiac complicationsand the resulting mortality rate in COVID-19 patients.

Search was conducted in electronic databasesof Medline (using PubMed), Embase, Scopus, and Web of Science, in addition to the manual search in preprintdatabases, and Google and Google scholar search engines, for articles published from 2019 until April 30th,2020. Inclusion criterion was reviewing and reporting cardiac complications in patients with confirmed COVID-19.

The initial search resulted in 853 records, out of which 40 articles were included. Overall analysisshowed that the prevalence of acute cardiac injury, heart failure and cardiac arrest were 19.46% (95% CI: 18.23-20.72), 19.07% (95% CI: 15.38-23.04) and 3.44% (95% CI: 3.08-3.82), respectively. Moreover, abnormal serumtroponin level was observed in 22.86% (95% CI: 21.19-24.56) of the COVID-19 patients. Further analysis revealedthat the overall odds of mortality is 14.24 (95% CI: 8.67-23.38) times higher when patients develop acute car-diac injury. The pooled odds ratio of mortality when the analysis was limited to abnormal serum troponin levelwas 19.03 (95% CI: 11.85-30.56).

Acute cardiac injury and abnormal serum troponin level were themost prevalent cardiac complications/abnormalities in COVID-19 patients. The importance of cardiac compli-cations is emphasized due to the higher mortality rate among patients with these complications. Thus, troponinscreenings and cardiac evaluations are recommended to be performed in routine patient assessments.

Periaqueductal gray (PAG) is a mesencephalic area divided into four columns including ventrolateral periaqueductal gray (vlPAG). vlPAG plays a role in cardiovascular regulation during normal and hemorrhagic (Hem) conditions. Due to presence of glutamate in this area, we evaluated the effect of glutamatergic receptors of this area on cardiovascular activity in normotensive and hypovolemic Hem rats.

Animals were divided into twelve groups: saline (vehicle), Glutamate, GYK52466 (non-NMDA receptor antagonist), and MK801 (NMDA receptor antagonist) with and without Glu microinjected into vlPAG in normal and Hem conditions. Following the femoral artery cannulating and microinjecting, changes (Δ) of heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure (MAP) were recorded via a PowerLab unit.

In normotensive conditions, microinjection of Glu increased ΔMAP, ΔSBP, and ΔHR (p <0.001). MK-801 and GYKI-52466 nonsignificant reduced cardiovascular responses than vehicle while their changes were significant compared with glutamate (p <0.001). Co-injection of GYKI- 52466 with Glu did not significantly reduce ΔSBP and ΔMAP induced by Glu (P>0.05) but co-injection of MK-801 with Glu significantly attenuate these effects(p <0.01). In Hem, Glu increased ΔSBP, ΔMAP, and ΔHR (p <0.05). GYKI-52466 alone did not change cardiovascular responses but MK-801 decreased ΔSBP than Hem (p <0.01). Co-injection of GYKI-52466 with Glu had significant(p <0.05) but MK-801 with Glu had no significant effect compared with Hem (P>0.05).

The glutamatergic system of vlPAG increases cardiovascular values that are mostly mediated through the NMDA receptor. Since vlPAG is well known as an inhibitory region, it seems that glutamate does not have a noteworthy cardiovascular role in vlPAG during Hem and normal conditions.

Asafoetida is an oleo-gum-resin obtained from the rhizome of Ferula assa-foetida plant that its effects on hypertension have been reported. This study examines the effect of aqueous extract of asafoetida on the cardiovascular parameters in acute hypertension induced by angiotensin II (AngII).

Thirty-six male rats were divided into six groups including Group 1: control; Group 2: AngII (50 ng/kg, intravenous); Group 3: losartan (Los; 10 mg/kg, i. p) + AngII; and Groups 4, 5, and 6 that received three doses of asafoetida (10, 30, and 60 mg/kg, i. p), separately. Los and extract were injected 30 min before hypertension induced by AngII. The femoral artery was cannulated and was connected to a pressure transducer, and cardiovascular parameters (systolic blood pressure [SBP], mean arterial pressure [MAP], and heart rate [HR]) were continuously recorded by a Power Lab system. The changes (△) of parameters were calculated and used for statistical analysis.

AngII significantly increased the value of △ SBP and △ MAP compared to the control and significantly decreased △ HR value. Injection of Los attenuated increased cardiovascular responses by AngII. Three doses of asafoetida ameliorated cardiovascular responses by AngII. Three doses of asafoetida decreased the △ HR non significantly compared to AngII.

Our results indicated that aqueous extract of asafoetida ameliorated cardiovascular responses in acute hypertension induced by AngII. This effect in a lower dose was more effective and comparable with Los. Therefore, a part of antihypertensive effect of asafoetida is mediated through inhibition of the AngII receptor type 1 receptor of AngII.

Air pollution is one of the most critical environmental problems around the world.

This study aimed to estimate cardiovascular mortality related to NO2, PM10, SO2, and O3 concentrations in Arak in 2014.

This ecological study was performed on 599634 participants. Data about air pollutant concentrations, including NO2, PM10, SO2, and O3, in the urban population of Arak in 2014 were obtained from Arak Environment Department. Cardiovascular mortality related to air pollutant exposure was estimated using Baseline Incidences (BI) and Relative Risks (RR) based on the World Health Organization (WHO) databases and time-series and case-crossover studies about the association between air pollutants and health outcomes and using the AirQ2.2.3 software.

The results showed that the annual average concentrations of PM10, NO2, O3, and SO2 were 69, 38, 57, and 53 μg/m3, respectively during the study period. In addition, the number of excess cases for cardiovascular mortality in the central RR was 138, 100, 55, and 16 for PM10, SO2, O3, and NO2, respectively. The cumulative number of cardiovascular mortality due to exposure to NO2 (RR = 1.00, 1.002, and 1.004) was 16, while this measure was 55 for cardiovascular mortality due to O3 (RR = 1.00, 1.004, and 1.006).

This study showed that PM10 and SO2 had the highest adverse health effects in relation to cardiovascular mortality in Arak. This necessitates important and vital measures and planning by national and international officials.

IL-33 is a type of cytokine and a new member of the IL-1 family labeled as an alarmin, which is released under stressful settings. IL-33 is a biomechanically induced protein and is mainly produced by cardiac fibroblasts and is expressed by various cell types after pro-inflammatory stimulation. Although the physiological role of IL-33 as a nuclear factor is not fully understood, it seems to be involved in transcriptional suppression via binding to nucleosomes and regulating the density of chromatins. It can play different roles, from progression to protection against a disease, depending on the type of the disease. Its signaling happens by means of the sST2 receptor. sST2 is a mechanically induced protein of the cardiac muscle. The IL-33/ST2 axis plays an important role in various illnesses such as cardiovascular diseases and can be a potential target for disease treatment. This review provides an overview of different aspects of IL-33 and its related receptor, sST2 along with the role of IL-33/sST2 axis in different cardiovascular diseases.

Physiological experiments show that mean blood pressure is controlled by the nervous system in long-term. The nucleus tractus solitarius (NTS), located in the dorsomedial medulla oblongata is extensively recognized as an essential brain area complicated in the integration of numerous viscerosensory processes, such as respiratory, cardiovascular, hepatic gustatory, and renal regulation mechanisms. NTS is a region of the brain stem in which primary baroreceptor afferents terminate and synapse with the rostral ventrolateral medulla (RVLM) via a nitric oxidergic pathway and hence is vital in the normal control of arterial pressure (AP). The NTS as a comparator evaluates the error signals between afferents of cardiovascular receptor and central neural structures and sends signals to nuclei that normalize the circulatory variables. Furthermore, during exercise, signals from the muscle receptors reach the NTS that activate sympathetic premotor neurons and thus cause pressor and tachycardiac responses. The GABAergic interneurons of NTS may contribute to baroreceptor reflex resetting by the inhibition of the barosensitive NTS neurons, thereby enhancing the sympathetic nerve activity. The basic functions of the NTS with respect to regulating the cardiovascular system are introduced in this review. Then, the potential mechanisms underlying cardiovascular regulation are discussed with a focus on NTS functions.

Cardiovascular nurses play a key role in improving the treatment outcomes in patients. Compassion satisfaction and fatigue influence the quality of nursing care. Thus, it is important to examine the levels of compassion satisfaction and fatigue in cardiovascular nurses.This study was performed to determine compassion satisfaction and fatigue in cardiovascular nurses.

This cross‑sectional, descriptive study was conducted with a single‑stagedesign on 200 cardiovascular nurses who were randomly selected from among nurses working in four educational hospitals in Isfahan, Iran, in July–October 2018. Data collection was conducted using the Professional Quality Of Life Scale (version 5) (ProQOL‑ version 5) with 30 items in the three subscales of compassion satisfaction, burnout, and Secondary Traumatic Stress (STS). The results were analyzed using descriptive and inferential statistics in SPSS software.

The results indicatedthe high mean (SD) score of 41.39 (5.54) for compassion satisfaction and the moderate mean (SD) scores of 26.93 (4.62) and 26.69 (5.90) for burnout and STS, respectively, in more than two‑thirdsof the nurses. Pearson correlation coefficient showed no significant relationship between the nurses’age, level of education, work experience, and monthly working hours and scores of compassionsatisfaction, burnout, and STS, and total compassion fatigue score (p > 0.05). Work experience was directly related to STS score (r = 0.18, p = 0.01). However, it had no significant relationship with compassion satisfaction and burnout (p > 0.05).

The results showed that the score of compassion satisfaction was high and fatigue was moderate in the cardiovascular nurses. Furtherresearch seems necessary to enhance compassion satisfaction and reduce fatigue in nurses.

A single episode of breath holding (BH) is known to elevate the blood pressure and regular breathing exercise lowers the blood pressure. This prompted us to investigate how a series of BH epochs would affect the cardiovascular system.

To observe arterial blood pressure (ABP) and heart rate (HR) changes associated with a series of “BH epochs” following maximum inspiration and maximum expiration and find the underlying mechanisms for the change by auntonomic activity.

Thirty-five healthy young adults were instructed to hold their breath repetitively, for 5 minutes, in two patterns, one following maximum inspiration and other following maximum expiration. ABP and ECG (for Heart Rate Variability) were continuously recorded at rest and during both the maneuvers. Capillary blood gases (BG) were analysed at baseline and at the break point of the last epoch of BH.

ABP rose significantly at the breakpoint during both the maneuvers. No change in HR was observed.   There was significant fall in PO2 from 94.7(4.1) mmHg at baseline to 79.1(9.0) mmHg during inspiratory and 76.90(12.1) mmHg during expiratory BH. Similarly, SPO2 decreased from 96.3(1.9)% at baseline to 95.4(1.5)% and 94.5(2.7)% during inspiratory and expiratory BH respectively. Rise in PCO2 from 39.5(3.1)mmHg at baseline to 42.9(2.7)mmHg and 42.1(2.8)mmHg during inspiratory and expiratory BH respectively was observed. There was no significant correlation between blood gases and arterial blood pressure. Among HRV parameters, a significant decrease in SDNN, RMSSD, HFnu, total power and SD1/SD2 and significant increase in LFnu, LF/HF and SD2 was observed during both BH patterns.

Rhythmic BH patterns affect the cardiovascular system in similar way as a single episode of BH. Sympathetic over activity could be the postulated mechanism for the same.

Previous studies demonstrated a health improving effect in patients underwent an automatic vibratory massage taking 10 minutes. One of reasons that may explain a healing effect of the automatic massage is a stimulated increase in both blood circulation through vascular system and effective size of blood vessels.

This paper aims to quantify a contribution of the automatic mechanical massage of lower extremities into the observed reduction in arterial blood pressure and explain this effect.

In our experimental study, the lower extremities of male and female patients were exposed to low frequency (12 Hz) mechanical vibrations for 10 minutes and the change in systolic and diastolic arterial blood pressures before and after this procedure was measured.

The experiments showed there is a reduction in systolic and diastolic arterial blood pressures after vibrational massage. There were corresponding 3.5±1.8 mmHg and 3.1±1.6 mm Hg arterial blood pressure reductions among men and 5.5±3.2 mm Hg and 2.2±1.2 mm Hg reductions among women.

We explained this effect by increasing effective radius of blood vessels. Based on the Hagen-Poiseuille equation, we made estimates for the relative change in the effective radius of blood vessels. They gave the 0.7% and 1.3% increases in the effective radius of blood vessels in lower extremities in men during systole and diastole, respectively, and the corresponding 1.1% and 0.6% increases in the effective radius of blood vessels of lower extremities in women during the same periods.

This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM10) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS).

This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM10 were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM10. The latent effects of PM10 were estimated in single and cumulative lags, up to 14 days.

In the adjusted model, for each IQR increase in the average daily PM10 concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM10 in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions.

Increase in daily PM10 concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.

Exercise training has been inversely associated with cardiovascular risk factors. However, the clinical trials examining the effect of exercise training on reducing cardiovascular risk factors have produced conflicting results. We aimed to assess the effect of concurrent exercise training on cardiorespiratory capacity and cardio-vascular risk factors among sedentary overweight or obese post-menopausal women. Settings and Design: This randomized controlled trial was done in 2016. This study was conducted on 22 healthy post-menopausal overweight and obese females, which randomly divided into concurrent endurance and resistance (ER) exercise (n = 12) and control (n = 10) groups. The participants did not have any history of any serious medical condition or using drugs. Demographic questionnaire was completed, vital signs and biochemical tests were measured, and Rockport one-mile submaximal exercise test for assessing maximal oxygen consumption (VO2max) was performed before and after the study. Statistical Analysis Used: Mean, standard deviation, and paired and independent t-test were used for statistical analysis. The data from the ER groups showed that the body mass index (BMI), heart rate (HR), systolic and diastolic blood pressure, triglyceride, high-sensitivity C-reactive protein (CRP) decreased, high-density lipoprotein, and VO2max increased significantly, during the 8 weeks (P < 0.05). Moreover, no changes were found in the cardiovascular risk factors of women who did not exercise (P > 0.05). Concurrent ER training can be a suitable exercise program for improving plasma lipid profile as well as reducing body composition, high-sensitivity CRP, and increasing VO2max in postmenopausal women.