فهرست مطالب

Cardiovascular Biomedicine Journal
Volume:2 Issue: 1, Spring and Winter 2022

  • تاریخ انتشار: 1401/07/17
  • تعداد عناوین: 8
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  • Ahmadali Khalili, Amir Faravan, Razieh Parizad * Pages 1-5

    Redo cardiac surgery is usually more complex than initial surgery and has a higher risk of mortality due to the risks associated with sternotomy.Thoracotomy is a procedure through which easy access to the heart and valves is possible, taking less time. There is no need to release the adhesions of the previous operation. In addition, there is no possibility of heart rupture and unstable hemodynamics in the second CABG operation.Safe peripheral Cardiopulmonary bypass (CPB) access and right thoracotomy are preferred in patients with unstable hemodynamics with a history of CABG and mitral valve replacement (MVR) surgery.A 60 -year old man with a history of prosthetic MVR, CABG, and right-hand paresis due to cerebrovascular accident (CVA) was referred to Madani Hospital in Tabriz, Iran (2020). Transthoracic echocardiography (TTE) revealed signs of severe dysfunction of the prosthetic mitral valve (PMV). Whereas, on anticoagulation, a left ventricular ejection fraction (LVEF) was about 40%, and the patient had mild to moderate aortic regurgitation (AI). The patient underwent an emergency redo MVR operation using the thoracotomy techniques and coronary intervention (hybrid procedure). After two weeks, TTE showed a decreased mobility of one PMV leaflet, and the patient did not respond to full anticoagulation. Therefore, the third surgery was performed.

    Keywords: Thoracotomy, Coronary artery bypass, Prosthetic valve malfunction, Reoperation
  • Abbas Andishmand, Seyedeh Mahdieh Namayandeh *, Seyed Jalil Mirhosseini, Ahmad Masoudi, Mojtaba Andishmand Pages 6-10
    Objectives
    Coronary artery revascularization is the standard treatment for patients with severe left main coronary artery disease (LMCAD). In cases where the patient refuses surgical revascularization or PCI, medical treatment will be the only option. The purpose of this study was to compare the one-year outcomes of patients with (LMCAD) in terms of surgical or medical treatment.
    Methods
    This prospective cohort study was conducted on 139 patients (91 men and 48 women) with severe left main coronary artery disease who were diagnosed by coronary angiography from 1st Mar 2014 to 28th Feb 2014. Patients were followed up for one year as to major adverse cardiac and cerebral events (MACCE) including death, non-fatal myocardial infarction, stroke, and hospitalization.
    Results
    From total of 2661 coronary angiographies, 139 patients (5.2%) with a mean age of 63.2±7.2 years had LMCAD. The mortality rate in the medical treatment group and the surgical group appeared to be 16.7% (6 cases) and 8.7% (9 cases) respectively (p =.156). The rate of stroke in the medical group turned out to be 5.6% (n=2) and in the surgery group 2% (n=2) (p =.27). The rehospitalization rate was 19.4% in the medical treatment group but 4.9% in the surgical group (p =.013). During one year, the survival rate was significantly lower in the medical group than the group undergoing coronary artery bypass graft surgery (58.3% vs. 84.5%) (p =.002).
    Conclusions
    In the short term, the optimal medical treatment of patients with LMCAD was not significantly different from that of CABG patients in terms of fatal cardiac and cerebral events. However, rehospitalization was more common due to recurrent angina pectoris.
    Keywords: unprotected Left main coronary artery disease (LMCAD), Event-free Survival, Major Cardiac, cerebral events (MACCE)
  • MohammadHossein Soltani, Maryam Baghbeheshti, Atousa Ghorbani, Mohammad Dehghan Chenari, Seyed Jalil Mirhosseini, Seyedeh Mahdieh Namayandeh, MohammadMahdi Khosravi Nia * Pages 11-19
    Objectives

    Heart failure is one of the most common chronic cardiovascular diseases, which often triggers disability or death. Health-related Quality of life (HRQoL) is one of the most critical factors in deciding how to treat these patients. In this study, we want to figure out the effect of different factors on the quality of life in patients.

    Methods

    This cross-sectional study was performed on 129 patients with heart failure referring to the center of Afshar Hospital in Yazd City, Iran 2017-2018. The standard (Shot Form survey) SF-36 questionnaire was used to measure different dimensions of quality of life.

    Results

    In the present study, 77 men and 52 women with heart failure were included and the relationship between comorbidities, heart failure classification factors, age, sex, and history of hospitalization with quality of life was measured. The result revealed a significantly higher quality of life in patients under 50 years (P = 0.005) as well as in men (p<0.001). And in the total population, the average quality of life appeared to be 45.46.

    Conclusions

    Quality of life in patients with heart failure is related to gender and age, so in women over 50 years, the quality of life proved lower but not related to factors such as, hospitalization, type of failure and stage of the disease. Among diseases related to heart failure, only people with high blood pressure showed lower quality of life scores. The total quality of life index score among our subjects was reported to be moderate to low.

    Keywords: Heart Failure, Quality of Life, Chronic Disease
  • Seyed Mostafa Seyed Hossieni Tezerjani, Nastaran Ahmadi, Seid Kazem Razavi-Ratki, Ali Talebizade *, MohammadTaghi Sareban, Maryam Baghbeheshti Pages 20-28
    Objectives

    Children are the most important asset in any country. Since cardiovascular diseases are built up little by little from childhood, this study attempted to detect the relationship between psychological, spiritual, and social health conditions and cardiovascular risk factors in children. 

    Methods

    This study is a cross-sectional study performed on 1035 children aged 6-18 years by multi-stage random cluster sampling in 2016 in Yazd province of Iran. The lifestyle questionnaire (LSQ) was used to collect data. In addition, demographic information (i.e., age and sex) and cardiac risk factors were measured. Logistic regression and t-test were used to analyze the data. 

    Results

    In this study, by increasing the mean score of psychological and spiritual health, fasting blood sugar (FBS) decreased significantly (OR = 0.14, 95% CI: 0.02-0.80, P trend = 0.003 and OR = 0.05, 95% CI: 0.01, -0.28, P trend = 0.013). Also, with increasing the mean score of spiritual health, body mass index (BMI) reduced significantly too. (OR = 0.35, 95% CI: 0.18-0.66, P trend = 0.014). However, social health failed to be significantly associated with cardiac risk factors. 

    Conclusions

    FBS in children aged 6-18 years is affected by psychological and spiritual health. BMI and the level of spiritual health also turned out to be inversely related. As a result, psychological and spiritual health dimensions should be improved to lower the risk factors for cardiovascular diseases in children aged 6-18 years.

    Keywords: Children, Cardiovascular risk factors, Health, Life style
  • Sepideh Hekmat, Mohammad Chehreghani, Raheleh Hedayati * Pages 29-35
    Objectives
    An accurate non-invasive evaluation of coronary artery disease (CAD) is essential in choosing the right management plan. Dobutamine stress myocardial perfusion imaging (MPI) is a substitute test for patients who cannot exercise. This study aimed to assess the relationship between dobutamine-induced hypotension and risk stratification of annual hard cardiac events evaluated by MPI.
    Methods
    This study is a retrospective study conducted on 1004 patients from October 2015 to august 2019.These patients referred to Rasoul Akram Hospital, because they could not exercise electrocardiography or had contraindications to vasodilator therapy, they were subjected to dobutamine Tc99m-Sestamibi single photon emission tomography (SPECT) protocol. During the protocol, blood pressure was measured with a one-minute interval.  From among the participants, 247 patients had decreased blood pressure by more than 20 mmHg during infusion. Then for patients, a gated MPI scan was performed, and  MPI with a quantitative and visual interpretation determined the risk stratification of the patients. Multivariable logistic regression model assessed the associations between decrease in blood pressure (above 20 mmHg) and risk stratification.
    Results
    A total of 1004 patients with a mean age of 59.07 years were studied. Of these patients, 247 had > 20mmHg drop in systolic BP from baseline. This study revealed a significant correlation between hypotension during the dobutamine stress test and high-risk scan patterns in myocardial perfusion scan. Moreover, there was a significant correlation between age increase, smoking, diabetes mellitus, transient ischemic dilation (TID), high baseline blood pressure, and history of CABG or angioplasty with a high-risk scan pattern in MPI.
    Conclusions
    This study demonstrated that hypotension during the dobutamine stress test is correlated with high-risk scan patterns in MPI.
    Keywords: myocardial perfusion imaging, dobutamine, hypotension
  • MohammadHosein Ahrar Yazdi, Seid Kazem Razavi-Ratki, Abbas Arabi Aliabad, AmirHossein Kheirkhah, Kimia Monshizadeh Ashkezari, Reza Nafisi Moghadam, Ali Pedarzadeh, Nasim Namiranian, Fatemeh Yaghoubi * Pages 36-41
    Objectives

    Cardiovascular diseases are the most critical causes of mortality in the modern world. Additionally, most acute coronary events result from sudden thrombosis leading to atherosclerotic plaque rupture. Computerized tomography (CT) angiography can identify the characteristics and quantity of plaques. This study investigated the relationship between plaque and moderate coronary stenosis.

    Methods

    This study was a retrospective diagnostic study comprising 91 patients who had been referred to CT angiography at Afshar Hospital in Yazd City, Iran, from 2017 to 2018 and undergone coronary angiography CT while bearing moderate coronary artery stenosis. Using the CT report, location, plaque density, the extent of stenosis, and vein involved were all extracted and recorded. The patients were followed up for one year from the time of the CT scan using the MACE questionnaire. Ultimately, data was analyzed using SPSS software version 22 through Chi-square, Fisher's exact test, and t-test.

    Results

    The results revealed the mean age of the patients to be 62.76±1.08 years; 39 (42.9%) women and 52 (57.1%) men. Based on the obtained results, the most common involved vessel, location of stenosis in CT angiography, and plate density included the left anterior descending artery with 75.8%, the middle part of the left anterior descending artery with 29.7%, mixed density with 54.9% and one segment with 62.6% frequency. Also, according to the significant adverse cardiac event (MACE) questionnaire results, the frequency distribution of cardiovascular events in the studied patients did not exhibit any evidence of cardiovascular events in the patients' one-year follow-up.

    Conclusions

    There was no evidence of cardiovascular events in the patients with moderate coronary artery stenosis during a 1-year follow-up.

    Keywords: Angiography, Plaque, Cardiovascular Diseases, Coronary Artery Disease
  • Majid Gholipour *, Meharn Ghahremani, MohammadReza Asad, Arezoo Tabrizi Pages 42-50
    Objectives

    Heart failure contributes to cellular lesions and left ventricular dysfunction. The present study aimed to determine the effects of intense continuous endurance training on protein synthesis gene expression and prevention of isoproterenol-induced cardiac apoptosis. 

    Methods

    In this experimental study, 16 male Wistar rats were assigned to exercise and control groups. After eight-week treadmill running, with 15° inclination, at 65-75% of VO2max for 30-60 minutes, Isoproterenol (3 mg/kg) was injected into the rats subcutaneously for 7 days. And 24 hours after the last injection, the left ventricular tissue was stored at -80°C for qRT-PCR and TUNEL assay. Between-group differences were determined by parametric and non-parametric tests, using SPSS software version 24. 

    Results

    There was a significant increase in mTORC1 gene expression in the training group (P = 0.026) but AMPK alterations failed to be significant. eEF2K gene expression was suppressed in the training group (P = 0.001) which resulted in a significant increase in eEF2 expression (P = 0.005). Left ventricular weight and heart weight/body weight increased compared to the control group (P = 0.028, P = 0.010, respectively). And the training protocol effectively prevented the formation of isoproterenol-induced apoptotic cells (P <0.001). 

    Conclusions

    The exercise training protocol increased protein synthesis gene expression, and improved cardiac protection by reducing apoptosis. This protocol can be considered a promising modality in preventing and reducing apoptosis induced by heart disease such as myocardial infarction.

    Keywords: Treadmill endurance training, Cardio protection, mRNA translation, Apoptosis, Wistar rat
  • Shokouh Taghipour Zahir, Seyed Hani Mosavi Bioki, Maryam Rahimi Tesiye, Parvin Fonooni Torshiz *, Negin Salehi, Amir Mohammad Babaiemahani Pages 51-56
    Objectives
    Blood urea nitrogen (BUN) and serum creatinine (Cr) levels are the risk factors associated with prognosis in patients with the acute coronary syndrome. This study aimed to investigate whether BUN and Cr have a predictive value in patients diagnosed with acute myocardial infarction (AMI) and their mortality.
    Methods
    This descriptive-analytical study was performed retrospectively by referring to the archives of Shahid Sadoughi Hospital in Yazd, Iran. The participants were 131 patients with acute myocardial infarction whose files were accessible from 2014 until 2018. Parameters such as age, sex, type of stroke, Cr and BUN levels at the time of admission, and outcome were examined. A questionnaire was used to collect data. Data analysis was performed using SPSS software version 21, and graphs were drawn with Sigma Plot software version 12.5.
    Results
    Data analysis showed no significant difference between Cr and BUN levels between men and women (P = 0˃05). The levels of both of these factors elevated with age in the patients (BUN: P ≤ 0.01), (Cr: P ≤ 0.05). In addition, both Cr (P ≤ 0.05) and BUN (P ≤ 0.001) had higher levels in the deceased patients than in the discharged ones. 
    Conclusions
    The results revealed that in addition to elevated Cr and BUN, which are indicators of renal function, age is a significant risk factor in predicting mortality in AMI patients.
    Keywords: Acute myocardial infarction, AMI, Blood urea nitrogen, Creatinine, mortality