INTERNATIONAL CARDIOVASCULAR RESEARCH JOURNAL
Year:2010 | Volume:4 | Issue:1|Papers Count:11

Background: The alpha chemokine, stromal-derived factor (SDF)-1 is produced by bone marrow stromal cells and other cells, especially damaged tissues. SDF-1 receptor, a chemokine receptor 4 (CXCR4), is expressed on inflammatory cells and that SDF-1/CXCR4 axis plays a critical role in migration of inflammatory cells. In cardiovascular diseases, SDF-1 is produced by endothelial cells and plaques and that SDF-1 chemoattracts monocytes to the endothelial cells resulting in a local inflammation. Simvastatin, a cholesterol-lowering agent, is a general drug for treatment of cardiovascular diseases. However, its molecular mechanism has not yet been completely elucidated.Method: Herein, we investigated the role of simvastatin on the SDF- 1/CXCR4 axis by employing flow cytometry, RT-PCR, chemotaxis and adhesion assays. Results: Simvastatin (i) downregulates CXCR4 expression on monocytic cell line (THP-1) and primary monocyte in a dose-dependent manner, (ii) inhibits adhesion of monocytes to endothelial cells and (iii) decreases SDF-1 production by endothelial cells. Moreover, preincubation with simvastatin significantly decreased the migration of THP-1 towards the SDF-1 gradient.Conclusion: All together our data indicate that simvastatin inhibits the binding of monocytes to endothelial cells through disrupting of the SDF-1/CXCR4 axis.

Background: Risk assessment for fast growing burden of cardiovascular diseases is very important and difficult. As a response to this challenge, in particular, genetic risk factors which potentially modify risk, we conducted a survey of primary data registry of Shiraz Heart Study on integration and application of family history data in prevention of cardiovascular disorders. Method: This study is a longitudinal cohort project to be extended from subpopulations of different job groups to the community.Results: Parental family history of MI, diabetes mellitus (DM), hyperlipidemia (HPL), hypertension (HTN) was reported more frequently among females than males. Histories of MI, DM, HPL, and HTN in both parents were respectively positive in 2.6%, 2%, 4.6%, and 7.9 % of the participants. Odd ratios (OR) for risk of MI from family history of MI were 2.7; risk of DM from family history of DM 4.5; risk of HPL from family history of HPL 2.04; and risk of HTN from family history HTN 4.7. Also, family history of MI modifies risk of HPL (OR=1.7, P<0.0001); and family history of DM modifies risk of HPL (OR=2.04, P<0.0001). Conclusion: Our primary result shows potent application of family history data in risk assessment of cardiovascular outcome. In particular, HTN appears as a silent and leading risk modifier. In regard to the course of continuing Shiraz Heart Study integration of family history of risk factors crucial in public health we suggest to adopt a network of electronic health records from the “Health House” to the “Heart House”.

Background: Patent foramen ovale (PFO) causes a right-to-left shunt in about a quarter of normal population. Hypercoagulation may be a risk factor for embolic cerebrovascular accidents (CVA) in these patients by paradoxical emboli. In this study, we checked hypercoagulation states in the embolic CVA patients with PFO. Methods: In a cross- sectional study, 40 patients with CVA or transient ischemic attack (TIA) and PFO participated in the study. Serum level of Homocystein, lupus anticoagulant screening test, Factor V leiden, Anti Cardiolipin Antibody (ACLA) (IgG, IgM ), Anti- thrombin III, protein C, protein S,Anti B2 glycoprotein1 and platelet count were checked in all patients. The data were analyzed using the statistical package for social science series (SPSS 15.0) and descriptive statistical method.Results: The mean age was 42.4±12.1. Seventeen (42.5%) patients were females. Twenty- two (55%) cases were diagnosed as having CVA and the others as TIA. Three (7.5%) of the patients were diabetic and 8 (20%) had a history of different stages of hypertension. Hyperlipidemia was detected in 6 (15%) patients and according to the laboratory data none had any signs of hypercoagulation. Conclusion: According to the present study, hypercoagulation as a cofactor in CVA patients with PFO did not seem to be a direct risk factor for embolic CVA at least any higher than for normal population. 

Background: Randomized controlled studies over the last 4 decades demonstrated that controlling blood pressure could reduce the risks of cardiovascular disease. The relationship between diet ingredient (particularly the salt) and blood pressure has been well established and since bread is the main element in population diet, especially in our country, the determination of sodium content of bread is of high priority and warrants further investigation. Method: A total of 204 bakeries were selected for this study and the amount of salt in different bread was measured once during spring and summer, using the method of Iran’s Organization for Standards and Industrial Investigation. The study was performed on 6 different kinds of bread baked in different districts of Shiraz city. Results: This study demonstrated that 17.9% of bread’s salt level in Shiraz exceeds the standard level and the remaining 82.1% is within the standard range. Mean percentage of bread’s salt was reported as 1.31 gram%. Conclusion: Compared to the previous reports, the results of present study fortunately showed a reduction of salt in bread during the last two decades. However, 17.9% of bread’s salt is yet more than the standard level.

Background: The incidence of cardiovascular disease (CVD) is rapidly increasing at an alarming rate worldwide and is currently considered as the leading cause of death in both developing and developed countries. The aim of the present study is to determine the prevalence and clear analysis of cardiovascular risk factors among army population and provide a guideline for improving the health status of army personnel.Methods: This is a cross-sectional study on the prevalence of cardiovascular risk factors among 341 male subjects from a military population in southern Iran. Each eligible participant was evaluated in the military clinic in Shiraz, Southern Iran. Information regarding demographic and life style were obtained from each subject. Arterial blood pressure, weight, height, body mass index (BMI), waist circumference (WC) and hip circumference (HC), fasting blood glucose, lipid profile consisting of total cholesterol, LDL, HDL and triglyceride were measured by standard methods.Results: Mean age of the population under study was 35.1±7.5 years. Twenty-nine (8.8%) individuals were hypertensive whereas 108 (32.9%) had blood pressure in the range of pre-hypertension. According to laboratory investigations, 29 (8.5%) participants had glucose intolerance while 6 (1.8%) of them had diabetes mellitus. On the other hand, prevalence of hypertriglyceridemia and hypercholesterolemia were 104 (30.5%) and 114 (33.4%) respectively. Twenty-eight (8.2%) subjects had criteria for metabolic syndrome.Conclusions: Clinical and Para-clinical data indicated that army population in southern Iran had a low level of CVD risk factors that may be related to their life styles.

Background: Open heart surgery is associated with acute perioperative changes in plasma levels of neurohormonal stress factors, cortisol, interleukin-6 and C-reactive protein. Human studies involving cardiopulmonary bypass have shown that very low doses of ketamine can attenuate the markers of inflammation without adverse effects. The aim of this study was to investigate whether, low dose infusion of ketamine when administered during 48 hours after induction, have anti-inflammatory effect and attenuate stress factors, in on-pump coronary artery bypass graft surgery.Methods: In this prospective randomized-controlled trial, 50 patients undergoing on-pump coronary artery bypass graft were randomly assigned to receive either 1.25mcg/kg/min of ketamine (Ketamine group, n=25) or normal saline (Control group, n=25) infusion during and for 48 hours after surgery. Inflammatory and stress response markers including C-reactive protein, cortisol, White blood cell count and differential , glucose and lactate level were measured ,before induction (T1), 4 hours after surgery (T2), and on the first and the second days after surgery (T3 and T4). Results: The level of lactate was higher in ketamine compared with control group four hours after operation (P< 0.05) without any significant differences detected in other measurements.Conclusion: Low dose ketamine did not cause any change in C-reactive protein, cortisol, White blood cell count and glucose level, however lactate level was higher compared to control group.

Tako-tsubo cardiomyopathy is a rare but reversible entity that mimics acute myocardial infarction or congestive heart failure. Its timely recognition is important not only for appropriate treatment of this condition but also to Prevent the disease recurrence and the use of potentially life threatening procedures for comparable conditions.

Background: A strong independent relationship has been observed in epidemiological studies between serum cholesterol and coronary heart disease. Method: Study group consisted of 100 healthy newborns and hundred healthy volunteers (age group 18-25 years) served as controls. Samples were analyzed for lipid profile (total cholesterol, triglycerides, HDL cholesterol, VLDL cholesterol, and LDL cholesterol), apolipoproteins: ApoA-I, ApoB. Atherogenic index (A.I.) was calculated as ratio of Apo-B to ApoA-I. Results: Lipid profile parameters were significantly lower in cord blood as compared to adults (P<0.001), cord blood of female newborns had higher total cholesterol (T-C), HDL-C, LDL-C Apo A-I, Apo B and A.I. as compared to male newborns, whereas triglycerides and VLDL–C were higher in male newborns. Conclusion: Gender-related factors might influence lipid levels and the pathological processes for CVD and its risk factors have been rooted in childhood which can change favorably in youth with lifestyle modifications and obesity reduction.

Background: Syncope in patients with Wolff-Parkinson-White (WPW) syndrome is related to rapid reciprocating tachycardia or rapid ventricular response over the accessory pathway during atrial fibrillation (AF). The aim of this retrospective study is to evaluate the frequency of syncope in patients with WPW syndrome. Methods: We reviewed the records of 150 consecutive patients with WPW syndrome.Results: There were 20 patients (13.3%) who reported at least one episode of syncope and 130 patients (86.7%) without such a history.Conclusion: Syncope is relatively frequent in patients with WPW. Patient with WPW syndrome who has experienced this symptom should be thoroughly evaluated.

A 55 year-old woman was admitted to the CCU ward of our university hospital due to typical chest pain. The patient received supportive care and was transferred to the operating room for an emergency repair of the ventricular septal defect (VSD) and myocardial revascularization. The surgical team was notified regarding the tolerance to cooling detected by the temperature monitoring and also, the congestion of eye and blanching of forehead. After a few maneuvers, the cannula was repositioned. In a few seconds, the forehead was cooled, while the airlocking episodes were lifted completely and the blanching and chemosis in the face and eyes all resolved. The septal defect was approached through the left ventricle; a 15 in 20 mm foramen, due to the ischemic rupture of the superior portion of the anteroseptal wall, was repaired with a patch of hemoshield. The incision over the LV was then repaired with 2 parallel bands of felt. The patient was operated on and transferred to the intensive care unit.

A 46-year-old man was admitted with chief complaint of chest pain and fatigue on exertion for the last 2 years. Physical examination was normal. Thransthoracic echocardiography showed mild right ventricular dilatation and ejection fraction of 50%. Coronary angiogram (CAG) was done that revealed significant lesion at mid part of left anterior descending artery (LAD) and a fistula arising from the mid part of LAD artery communicating with main pulmonary artery. Transcatheter coil embolism was successfully performed. The patient was free of symptoms during 12 months follow up.