ARYA Atherosclerosis
Year:2010 | Volume:6 | Issue:2|Papers Count:8

BACKGROUND: In view of the growing trend of obesity around the world, including in our country, and the effect of reduced physical activity in increasing the incidence of obesity and overweight in children and adolescents and limitations of families in providing transport for their children to attend exercise classes, as well as time limitations of students in taking part in these classes, accessing appropriate methods for presenting physical activity training seems essential.METHODS: This non-pharmacological clinical trial was performed during six months from May to November 2007 on 105 children and adolescents aged 6-18 years with obesity, randomly assigned to 3 groups of thirty-five. Nutrition and treatment behavior were the same in all groups, but physical activity training in the first group was taking part in physical activity training classes twice a week, in the second group by providing a training CD, and in the third group via face-to-face training. Before and after the intervention, anthropometric indicators were measured and recorded.RESULTS: Mean body mass index (BMI) of participants in group attended physical activity training classes, and in the group undergone training with CD, after the interventions was significantly lower than that before the intervention.CONCLUSION: Our findings demonstrated that training using CDs can also be effective in reducing BMI in overweight and obese children and adolescents as much as face-to-face education and participation in physical training classes. Extending such interventions can be effective at the community level.

BACKGROUND: Leptin and adiponectin are two adipose tissue hormones and their association with the incidence of cardiovascular diseases is under evaluation. The aim of this study was to determine the relationship of leptin and adiponectin with coronary artery diseases.METHODS: One hundred and seventy patients with angina pectoris and indications of coronary angiography underwent angiography. Serum levels of blood lipids, leptin, and adiponectin were measured. The gathered data was evaluated using SPSS15 software, by multivariate variance analysis.RESULTS: Analysis of the data demonstrated that 45.1% of the patients had positive angiographic findings. The serum levels of leptin and adiponectin were significantly lower than the minimum levels specified by the kit. However, the two groups, i.e., patients with positive angiographic findings and those with negative findings were not significantly different according to the serum levels of the hormones. Moreover, no significant correlation between the serum levels of the hormones and serum lipids was observed.CONCLUSION: Various studies have demonstrated that high serum level of leptin and the incidence of coronary artery diseases are correlated. On the other hand, they have reported that adiponectin has cardioprotective role. Confirmation of these findings requires more detailed studies.

BACKGROUND: Recent studies have confirmed inflammatory factors and metabolic syndrome (MetS) as important cardiovascular disease (CVD) risk factors. Recently measurement of carotid intima-media thickness (IMT) has been used for evaluation of early atherosclerosis. This study was designed to assess the correlation between IMT with some inflammatory biomarkers, ghrelin and adiponectin in people with and without MetS in a cohort sample in Isfahan province.METHODS: Among participants of Isfahan Cohort Study (ICS) by random sampling, 88 participants were selected and divided into case (with MetS) and control (without MetS) groups. A questionnaire including demographic data and CVD risk factors was completed for all of the participants. Physical examination and blood pressure, height, weight and waist circumference measurements were done for all subjects. Vascular echocardiography was done for evaluation of IMT of each carotid artery of both sides. Interlukin-6 (IL-6), interlukin-10 (IL-10), highly sensitive C-reactive protein (hs-CRP), ghrelin and adiponectin levels were measured using ELIZA method. Data were entered in SPSS15 software and analyzed by t-test, chi square, Pearson correlation and linear regression analyze.RESULTS: The mean waist circumference, BMI, systolic blood pressure, diastolic blood pressure, hs–CRP and IMT of left carotid artery were significantly higher in participants with Mets. There was significant correlation between left carotid IMT and IL-6 level in all patients (P=0.03). After adjustment for age and sex, significant relationship in groups with MetS was only reported between the left IMT and IL-6 (P=0.02). There was no relation between IMT and other inflammatory markers in subjects with and without MetS.CONCLUSION: Significant correlation between IL-6 and IMT was reported in patients with MetS. While no significant correlation between IL-10, adiponectin and ghrelin with IMT was observed in metabolic syndrome group.

BACKGROUND: Glucose-insulin-potassium (GIK) may improve cardiovascular performance after coronary artery bypass graft surgery (CABG). Our study investigated whether an infusion of GIK during elective CABG surgery in type II diabetic patient improved left ventricular performance.METHODS: We measured left ventricular ejection fraction and troponin (Tn), a myofibrillar structural protein. In this research, after ethics committee approval, 50 patients with type 2 diabetes mellitus (DM) were enrolled into a randomized simple sampling, prospective, doubleblind clinical trial study. In the case group, 500 cc dextrose water 5% plus 80 IU regular insulin and 40 mEq KCL were infused at the rate of 30 cc/hr. Patients in control group received 5% dextrose solution at the rate of 30cc/hr. Venous blood samples were taken before induction of anesthesia, after removal of the aortic clamp and before discharging from hospital. The Mann- Whitney-test was used to test for differences in troponin concentration between the groups. Fisher’s exact test was used to determine whether there was a difference in the proportion of patients with a low ejection fraction (<45%) in the case group compared with that in the control group. Changes in potassium and glucose concentrations over time within the groups were examined by ANOVA and paired t-tests. P<0.05 was regarded as significant level for all tests.RESULTS: In this study, 50 patients with type 2 DM were evaluated in case and control groups. The mean age ± SD in the case group was 57.7±9.9 years and in the other group was 61.2±8.4 years. The groups were well-matched for age, sex and number of bypass grafts. Randomization did not give an equal distribution of male and female patients. There wasn’t any significant difference in ejection fraction between the case and control groups before and after CABG (P>0.05). Troponin concentration in the case group was 3.3 ± 5.0 and in the control group was 3.9±5.1. There was no significant difference in Tn between the two groups before and after CABG (P>0.05). There was not any significant difference in hospitalization time between the two groups.CONCLUSION: The results suggested that GIK can’t improve left ventricular performance in routine CABG surgery.

BACKGROUND: In most studies, the agreeable risk scores for ST-elevation myocardial infarction (STEMI) consist of thrombolytic in myocardial infarction (TIMI) risk score and modified Gensini risk score. Researchers showed significant relations between TIMI with angiography scores in patients with UA/NSTEMI. We studied this relation in patients with STEMI.METHODS: We studied CCU patients with STEMI hospitalized in several hospitals of Isfahan, Iran from September 2007 to June 2008. Sampling method of 240 patients was random and simple. Exclusion criteria were incomplete history, nonspecific electrocardiogram changes, left bundle branch block and not accomplished angiography or accomplished angiography after 2 months of STEMI. Questionnaire indices collected on the basis of TIMI (0-14 points). Echocardiography and angiography were done and then, we used Gensini (0-400 points) to review films of angiography. Spearman’s rank test and Pearson correlation coefficient were used to study the relation between these scores.RESULTS: One hundred and sixty one patients were male and their average age was 60.02 years. Averages of TIMI and Gensini scores were 6.30±2.5 and 120.77±50.4, respectively. Study showed significant relation between TIMI, age and LVEF (P<0.001, r=-0.46). Also, between Gensini and age, gender and LVEF significant relation was found (P<0.001). But, a meaningful correlation didn’t exist between TIMI and the gender (P=0.08). Our study proved direct relation between TIMI risk scores and modified Gensini scores (P<0.001, r=0.55).CONCLUSION: We may decide quickly and correctly in emergency room to distinguish which patients with STEMI could derive a benefit from invasive strategies using TIMI score. Also, TIMI risk score can be a good predictor to determine the extension of coronary artery disease in patients with STEMI. As a result, we suggest determination of TIMI score for any patient entered emergency room. Also, this score should be recorded at the time patient’s discharge.

BACKGROUND: Atherosclerosis, which is a result of gradual deposition of lipids in the lower part of blood vessel endothelium, is the leading cause of mortality and morbidity around the world. It has been proved that some inflammatory blood markers such as fibrinogen can predict the risk for cardiovascular disease conditions, not only in cardiovascular patients, but also in those who do not have any manifestations of the atherosclerotic development. In this study, the effect of cornus mas L. was evaluated on fibrinogen of hypercholesterolemic rabbits and it was also compared with lovastatin drug.METHODS: In this study, 25 New Zealand adult male rabbits were randomly divided into five groups of five. They were treated for 60 days by 5 different diets, namely basic, high cholesterol, regular plus 1 g/kgBW cornus mas L. powder, high cholesterol plus 1 g/kgBW cornus mas L. powder, and high cholesterol plus 10 mg/kgBW lovastatin. At the beginning and at the end of this period, blood samples were collected from the rabbits and their serum fibrinogen levels were measured.RESULTS: Cornus mas L. powder and lovastatin significantly decreased fibrinogen levels in comparison with high cholesterol group (P<0.05). Furthermore cornus mas L. powder could reduce the fibrinogen level more than lovastatin (P<0.05).CONCLUSION: The results indicated that consumption of cornus mas L. might be beneficial in atherosclerotic patients due to its reducing effects on fibrinogen.

Cardiovascular diseases have become an increasing clinical issue worldwide. Acute ischaemic injury and chronic cardiomyopathies lead to permanent loss of cardiac tissue and ultimately heart failure. Current therapies widely aim to attenuate the pathological changes that occur after injury and to reduce risk factors of cardiovascular diseases. However, they do not improve the patient’s quality of life or the prognosis more than moderate. A new challenge in the treatment of the cardiovascular disease is cellular transplantation or cellular cardiomyoplasty. Different types of stem cells have been used for stem cell therapy. Clinical trials using primary bone-marrowderived cells and skeletal myoblasts have also shown some encouraging results. An additional clinical and pre-clinical study to further enhance the beneficial effects of cell therapy is necessary. Recent studies have shown that there are various pools of putative resident stem cells in an adult heart, raising the hope that these cells can contribute to the treatment of cardiovascular diseases.

Lower extremity complications are the most common problems encountered during transfemoral diagnostic coronary artery angiography. Dissection, thrombosis and perforation of arteries of lower extremities although not uncommon, very rarely occur simultaneously. We did not find any report in the literature in this issue. In this report we describe a case of simultaneous occurrence of all three complications during coronary angiography in one patient. It also represents some of our uncertainties regarding the best management of the patient. In this patient, arterial perforation and dissection was managed conservatively, but we applied an invasive treatment (surgical thrombectomy) for arterial thrombosis with excellent short and longterm results.