ARYA Atherosclerosis
Year:2018 | Volume:14 | Issue:1|Papers Count:8

BACKGROUND: Atherosclerosis is one of the predominant causes of cardiovascular disease (CVD). Several studies indicated the significant pathophysiological role of salusin-β in atherosclerosis. Cytokines are involved in all stages of atherosclerosis. Therefore, we aimed to assess the effect of salusin-β on interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 18 (IL-18) (as inflammatory cytokines) and interleukin 1Ra (IL-1Ra) (as anti-inflammatory cytokines) levels in human umbilical vein endothelial cells (HUVECs). METHODS: The HUVECs were cultured in HUVEC completed medium and treated with different doses of salusin-β for 6 and 12 hours. For the investigation of nuclear factor ƙ β (NF-ƙ β ) signaling pathway involvement, cells were treated in the presence or absence of Bay 11-7082 (as NF-ƙ β inhibitor). The mRNA expression and protein level of cytokines were measured by a realtime polymerase chain reaction (PCR) system and enzyme-linked immunosorbent assay (ELISA) method, respectively. RESULTS: Salusin-β increased mRNA expression and protein level of IL-6, IL-8 and IL-18. This protein decreased mRNA and protein level of IL-1Ra in HUVECs. NF-ƙ β signaling pathway was involved in the up-regulatory effect of salusin-β on mRNA expression of pro-inflammatory cytokines. The down-regulatory effect of salusin-β on IL-1Ra expression could not be influenced by Bay 11-7082 pre-treatment. CONCLUSION: It seems that salusin-β may participate in a cascade pathway in vascular inflammation. Our findings suggested that salusin-β has potential use as a therapeutic target for atherosclerosis.

BACKGROUND: Vitamin D deficiency is a prevalent condition in Iran and previous studies have shown that a low level of serum vitamin D is related to low ankle-brachial index (ABI). In the present study, the relationship of the serum level of vitamin D with ABI, as an index for atherosclerosis of peripheral arteries, was evaluated. METHODS: In this cross-sectional study, data on 91 patients with metabolic syndrome (Mets) from the Isfahan Cohort Study (ICS) were analyzed in order to evaluate the association between serum 25(OH) vitamin D level and ABI. The participants were divided into two groups; group A with desirable serum vitamin D level and group B with abnormal serum vitamin D level. ABI was measured and compared between these groups. RESULTS: A crude and adjusted model showed no association between vitamin D level and ABI in patients with MetS. CONCLUSION: It can be concluded that serum vitamin D level could not affect ABI in patients with MetS.

BACKGROUND: Differentiating ischemic from non-ischemic functional mitral regurgitation (FMR) in patients with cardiomyopathy is important in terms of the therapeutic decision-making and prognosis, but might be clinically challenging. In this study, the deformation of mitral valve (MV) indices in the prediction of the etiology of FMR was assessed using 2D transthoracic and tissue Doppler echocardiography. METHODS: This case-control study was conducted from April 2015 to January 2016 in Imam Reza Hospital in Mashhad, Iran. The participants consisted of 40 patients with ischemic cardiomyopathy (ICM) and 22 with non-ischemic dilated cardiomyopathy (DCM) who referred to the heart failure clinic. Transthoracic echocardiography was performed using the conventional 2D and tissue Doppler imaging (TDI). MV tenting area (TA), coaptation distance (CD), anterior and posterior mitral leaflet angles (AMLA and PMLA), and regional systolic myocardial velocity (Sm) were measured. RESULTS: There were no significant differences in echocardiographic indices between the two groups, besides Sm and PMLA which were significantly lower and higher, respectively, in ICM subjects in comparison with DCM patients (P = 0. 002). PMLA ≥ 40 degrees and Sm ≤ 4 cm/second have a relatively high value for discriminating the ischemic from non-ischemic origin of functional MR in subjects with systolic heart failure (sensitivity: 80. 0% and 70. 0%, specificity: 73. 0% and 77. 3%; P = 0. 001 and P < 0. 001; respectively). Multivariable logistic regression identified PMLA and anterior Sm as major determinants for ischemic MR {Odds ratio (OR) [95% confidence interval (CI)] = 0. 89 (0. 82-0. 96), P = 0. 003, OR (95% CI) = 0. 29 (0. 14-0. 60), P = 0. 001, respectively}. CONCLUSION: The present study showed that PMLA and Sm had an independent significant association with the mechanism of FMR. These findings are suggestive of the predictive role of mitral deformation echocardiographic indices in the determination of the etiology of FMR in systolic heart failure.

BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPAR-γ ) which controls body weight, glucose homeostasis, and adipocyte differentiation is a valuable candidate gene for insulin resistance (IR). The present study aimed to compare the effects of the Dietary Approaches to Stop Hypertension (DASH) diet and usual dietary advice (UDA) on PPAR-γ gene expression in women at risk for cardiovascular disease (CVD). METHODS: This randomized controlled trial was performed on 44 women aged 20-50 years at risk for CVD (BMI > 25 kg/m2 and low physical activity). Participants were randomly assigned to the UDA (n = 22) or DASH (n = 22) diets for 12 weeks. The DASH diet was rich in fruits, vegetables, whole grains and low-fat dairy products and low in saturated fat, total fat, cholesterol, refined grains and sweets, with a total of 2400 mg/day sodium. The UDA diet was a regular diet with healthy dietary advice. Anthropometric indices and PPAR-γ gene expression were measured and compared between the two groups at the end of the study. RESULTS: After the intervention, body mass index (BMI) and waist circumference (WC) significantly decreased in the DASH group (P < 0. 050) but the results showed no significant differences between the two groups. At the end of the trial, PPAR-γ gene expression was significantly different between the UDA and the DASH diet groups (P = 0. 040) and this difference remained significant after adjustment for BMI, and physical activity (P = 0. 030). CONCLUSION: The result of the study showed that the DASH diet significantly decreased the expression of PPAR-γ . This finding was unexpected and future studies on the current topic are therefore recommended.

BACKGROUND: Clinical imaging studies have demonstrated a strong direct correlation between epicardial fat and abdominal visceral adiposity. There are several studies about positive correlation of epicardial fat and atherosclerotic coronary disease in general population. This study aimed to evaluate the association of epicardial fat thickness with atherosclerotic coronary disease in patients with diabetes mellitus type II. METHODS: This cross-sectional observational study involved 80 patients with diabetes mellitus type II. The patients were chosen using simple sampling method from patients with diabetes mellitus who were referred for angiography because of suspected coronary artery disease. The severity of coronary atherosclerotic lesions was evaluated using modified Gensini scoring system. Epicardial fat thickness was measured by transthoracic echocardiography within 90 days after coronary angiography. Multiple linear regression method was used to evaluate the association between mean epicardial fat thickness and Gensini score. RESULTS: After adjustment for the effects of body mass index (BMI), age, angina, and sex, there was a significant association between Gensini score and epicardial fat thickness (β = 0. 825; P < 0. 001). Patients with higher blood pressure and higher body mass index also had a higher Gensini score (P < 0. 010). CONCLUSION: In patients with diabetes mellitus type II, there is a positive association between epicardial fat thickness and severity of coronary artery disease. So, by echocardiography evaluation of epicardial fat thickness, we could have an estimation of the severity of coronary arteries diseases before using more invasive techniques.

BACKGROUND: Critical aortic stenosis (AS) is an unusual cardiac pathology in pregnancy, but has significant impact on the fetal and maternal outcomes of pregnancy. Pregnant patients with aortic stenosis and heart failure represent a major challenge for the heart team and anesthesiologist who should balance the risks and benefits of different treatment strategies and their effects on the mother and fetus. CASE REPORT: We present a 26-year-old parturient who underwent cesarean section at 30 weeks of gestation under general anesthesia in the presence of cardiac surgical team followed by deferred aortic valve replacement after two weeks. CONCLUSION: This report describes the importance of multidisciplinary preoperative evaluation, and careful surgical and anesthetic planning to avoid the deterioration of perioperative cardiac condition in such patients.

BACKGROUND: Coronary artery spasm (CAS) can result in life-threatening arrhythmia and sudden cardiac death. Although this disorder has been known for a long time, little is known about it, and its mechanisms have been not identified yet. CASE REPORT: We describe a 52-year-old woman with no significant cardiovascular risk factors who experienced several episodes of spontaneous and coincident multivessel coronary artery spasm, which led to myocardial infarction as well as malignant arrhythmias. Coronary angiography revealed severe migratory narrowing in the left anterior descending artery and right coronary artery. CONCLUSION: Simultaneous multivessel coronary artery spasm develop multisite myocardial infarction (MI), and malignant arrhythmias could occur even in the absence of significant stenosis and triggering factors, which would lead to an increased risk of life-threatening cardiac events.

In recent years, cardiac rehabilitation (CR) programs have been well advanced. 1, 2 However, failure to adhere to these programs by patients and failure to follow a healthy lifestyle during and after CR is still a serious disadvantage. 2, 3 In Iran, hospital-based delivery format is still the preferred approach. Although, obstacles such as access have challenged active presence of patients. 4, 5 Thus, providing measures to increase adherence by patients and prevent withdrawal of the treatment program is one of the priorities of the management of CR field...