INTERNATIONAL CARDIOVASCULAR RESEARCH JOURNAL
Year:2015 | Volume:9 | Issue:2|Papers Count:12

Of all birth defects, Congenital Heart Disease (CHD) remains the most prevalent. These malformations are largely multifactorial with both environmental and genetic components, but known chromosomal abnormalities and mutations of single genes account for less than 10% of all cardiac defects (1). They affect approximately 6 to 13 newborns per 1000 live births (2) and are made up of 5 major Atrial Septal Defects (ASDs), including primum and secundum type defects, sinus venosus and coronary sinus defects, and Patent Foramen Ovale (PFO). However, there is debate within the medical community regarding inclusion of PFOs and coronary sinus defects within the realm of CHD. PFOs do not have absent septal tissue, and coronary sinus defects, or unroofed coronary sinus, represent an abnormal communication between the superior portion of the coronary sinus and the neighboring left atrium.

Background: Modulation of Ischemia-Reperfusion (I/R) injury is highly important in medicine, especially in hyperthyroidism condition. The effect of diazepam as a benzodiazepine on cardiac I/R injury is also clinically important. The chronic effect of diazepam in this case has been reported previously.Objectives: This study aimed to investigate the effect of acute diazepam perfusion on isolated heart of hyperthyroid rats during I/R.Materials and Methods: Male rats (n=32, weighing 250 - 300 gr) were randomly divided into 4 groups: control, hyperthyroid, control diazepam perfused, and hyperthyroid diazepam perfused. Isolated hearts were perfused through Langendorff method. Four sets of data were collected at baseline (20 minutes), diazepam perfusion (10 minutes, 100 mmol/L), ischemia (40 minutes), and reperfusion (45 minutes) periods. Cardiac parameters, including Left Ventricular Developed pressure (LVDP; mmHg) and Rate Pressure Product (RPP; mmHg×beats/min) were measured, as well. Lactate dehydrogenase (LDH; mU/mL) was also assessed for evaluation of I/R injury. The data were analyzed using ANOVA and Student t-test and P<0.05 was considered as statistically significant.Results: RPP significantly declined in the hyperthyroid group after diazepam perfusion compared to the baseline (24046±1381 versus 18269±711, P=0.012, 95% CI: 1724-9828). Besides, RPP and LVDP significantly increased in the hyperthyroid diazepam perfused group compared to the hyperthyroid group at the end of the reperfusion period (12469 ± 1422 versus 4007±258, P<0.001, CI: 5066 - 11856 and 47±2.8 versus 23±2.8, P<0.001, CI: 11-35, respectively). These findings were confirmed by LDH levels (19.08±1.06 versus 41.07±8.14, P=0.002, CI: -34.4 - -9.4-35).Conclusions: The results showed that acute diazepam perfusion to isolated hyperthyroid rats' hearts could significantly improve cardiac function following ischemia and protect the heart against I/R injury.

Background: Enoxaparin sodium, in most subcutaneous injections, causes local reactions, such as bruising and pain, at the injection sites. On the other hand, one of the important roles of nurses is safe injection.Objectives: This study aimed at determining the effect of duration of subcutaneous injection of enoxaparin sodium on the extent of bruising and pain intensity at the patients’ injection sites in 2013.Patients and Methods: In this randomized, self-controlled, clinical trial, 100 patients admitted in two educational hospitals affiliated to Bushehr University of Medical Sciences who were treated with enoxaparin were selected using convenience sampling. For each patient, two subcutaneous injection methods were performed: 10-second subcutaneous injection on the right side of the abdomen as the control group and 30-second subcutaneous injection on the left side of the abdomen as the intervention group. The first injection site was determined using simple random assignment. The bruising area was determined by using computer software 48 and 72 hours after each injection. Also, pain intensity was measured by Numeric Rating Scale (NRS) immediately after each injection. The data were then entered into the SPSS statistical software (v.21) and were analyzed using non-parametric tests. Statistical significance was set at P<0.05.Results: The mean and standard error of bruising in 10- and 30-second injections after 48 h were 45.53 ±6.35 and 23.69±3.27 mm2, respectively. After 72 h, these measures were obtained as 26.45±4.70 and 14.76±3.52 mm2, respectively (P<0.001). Besides, the median and interquartile range of pain intensity scores in 10- and 30-second injections were 5 (4-7) and 3 (1.25-5), respectively, (P<0.001).Conclusions: The results indicated that increasing the length of enoxaparin subcutaneous injection reduced the extent of bruising and pain intensity at the injection sites.

Background: Apolipoprotein E (Apo E) is a key factor in the atherosclerosis process, but the influence of its genetic polimorphisms in southern Europe populations is not well known.Objectives: The present transversal, population-based study aimed to determine if Apo E genetic polymorphism is associated with early atherosclerosis, as assessed by carotid Intima-Media Thickness (cIMT), or with presence of carotid atherosclerotic plaques.Patients and Methods: The study sample included 171 individuals older than 40 years who were randomly selected from the population assigned to a district medical center of Burgos, Spain. The proportion of males and females in the sample and their ages matched the adult Spanish general population. cIMT and number of carotid atherosclerotic plaques were determined to assess if higher values were associated with a particular ApoE genetic polymorphism.Results: Neither cIMT nor the number of atherosclerotic plaques differed among the subjects with Apo E2, E3, and E4 genotypes. However, both total cholesterol and Low Density Lipoprotein (LDL) -cholesterol were higher in the E4 than in the E2 group.Conclusions: In this sample of adult Spanish population, no association was found between Apo E genotypes and cIMT.

Background: Nutritional supplements have been widely used in order to enhance athletic performance and improve health.Objectives: This study aimed to investigate the effect of Beta-Hydroxy Beta-Methylbutyrate (HMB) supplementation on cardiovascular risk factors after 4 weeks of resistance training in athletes.Patients and Methods: In this double-blind study, 20 male athletes were selected through simple random sampling, were assigned to supplement and control groups, and participated in resistance training 3 sessions a week for 4 weeks. The supplement group consumed 3 g HMB supplement per day and the control group consumed the placebo (rice flour) in this period. Before and after the test period, blood pressure was measured and fasting blood samples were obtained to determine blood lipids and hematological parameters. After all, paired and unpaired t-test were used to examine within and between group differences, respectively. P≤0.05 was considered as statistically significant.Results: After the training period, no significant differences were found between HMB and placebo groups regarding blood lipids, blood pressure, and hematological parameters.Conclusions: The results of the present study indicated that HMB supplementation was safe and did not result in any adverse effects. Thus, HMB can be used safely by human as an ergogenic aid for exercise training.

Background: Metabolic Syndrome (MetS) is prevalent in Asian countries, but there is limited information about its distribution in rural communities.Objectives: This study aimed to determine the prevalence of MetS and its components in a rural population in southern Iran.Patients and Methods: This cross-sectional study was conducted on 13304 adults living in Kavar, southern Iran. The participants aged³20 years (67.4% female and 32.6% male) and were selected from a larger survey including 20000 subjects. MetS was diagnosed by the National Cholesterol Education program-Adult Treatment Panel III (ATP III) and its prevalence was compared to the rates estimated by modified ATPIII and International Diabetes Federation (IDF) definitions. The data were collected through a structured questionnaire. Anthropometric, clinical, and biochemical parameters including blood pressure, Body Mass Index (BMI), waist circumference, Fasting Plasma Glucose (FPG), and lipid profile were recorded. Then, the data were entered into the SPSS statistical software (v.15) and analyzed using student's t-test, Chi-square test, and logistic regression analysis. P<0.05 was considered as statistically significant.Results: The prevalence of ATP III-defined-MetS was 25.1% compared to 27.7% and 28.3% using the modified ATP III and IDF definitions, respectively. Yet, the prevalence rate was higher among the females compared to the males by all the definitions (e.g.28.4% in females and 18.9% in males by ATP III criteria, P<0.001). Also, the prevalence of Mets increased with age (P<0.001). The most and least common components were low serum High Density Lipoprotein Cholesterol (HDL-C) and impaired FPG, respectively.Conclusions: MetS was prevalent in this rural area and dyslipidemia was its major component. These findings make it critical to plan further healthcare interventions in order to prevent the adverse consequences of the disease.

Background: Dilated cardiomyopathy is revealed with left ventricular dilatation and systolic dysfunction.Objectives: This study aimed to compare the children with dilated cardiomyopathy and control group regarding the level of Calcitonin Gene Related Peptide (CGRP) and its relationship with echocardiography findings Patients and Methods: This case-control study was conducted on 37 children with dilated cardiomyopathy and free of any clinical symptoms and 37 healthy age- and sex-matched children referring to Ali-e-Asghar and Ali Ebne Abitaleb hospitals in Zahedan, Iran. After taking history, echocardiography was performed for both groups. The data were analyzed using the SPSS statistical software and appropriate statistical tests.Results: The two groups were significantly different regarding most of the echocardiographic parameters (P<0.05). Also, a significant difference was found between the two groups concerning the mean CGRP levels (P=0.001). Among echocardiographic parameters, CGRP was directly related to Interventricular Septal dimension in Systole (IVSS) (P=0.022, R=0.375). However, no significant relationship was observed between CGRP level and Ross classification.Conclusions: The findings of this study showed an increase in CGRP serum levels in the case group. Besides, a direct correlation was observed between CGRP level and IVSS.

Background: Stiffening of the large vessels, especially aorta, plays a significant role in increasing the left ventricular work and aggravating the cardiovascular diseases by attenuating the vascular wall distensibility and its buffering effect.Objectives: This study aimed to compare the stiffness of proximal aorta in the patients with established diagnosis of Non-Ischemic Dilated Cardiomyopathy (NIDC) and the normal population.Patients and Methods: This case-control study aimed to compare 50 patients with established diagnosis of NIDC and 50 individuals with no history of significant cardiovascular diseases in the outpatient echocardiography clinics affiliated to Shiraz University of Medical Sciences, Shiraz, Iran during a three-month period in 2011. The patients with aortic valve disorders, coronary artery disease, congenital heart disease, diabetes mellitus, hypertension, and renal failure were excluded from the study. Stiffness indices were determined using the data gathered via echocardiography (left ventricular ejection fraction, end-systolic and end-diastolic volumes, and internal aortic diameter) and blood pressure measurement. Ordinal and quantitative data were analyzed by Chi-square and independent T-test, respectively using the SPSS statistical software, version 16.0. Besides, P<0.05 was considered as statistically significant.Results: The results of this study revealed significantly lower aortic strain (0.05±0.02 in the NIDC patients versus 0.20 ± 0.46 in the controls, P<0.001) and brachial pulse pressure (40.50±9.00 in the NIDC patients versus 45.90±8.08 in the controls, P<0.001) in the NIDC patients.Conclusions: Aortic stiffness is capable of deteriorating the cardiovascular function by augmenting the afterload. Thus, it should be seriously considered as an issue while approaching NIDC patients since they demonstrate lower aortic distensibility.

Background: Patients with Chronic Heart Failure (CHF) have been shown to have enhanced risk of Erectile Dysfunction (ED) due to low cardiac output, endothelial dysfunction, medications, co-morbid conditions, and psychogenic factors.Objectives: The present study aimed to evaluate the effects of sildenafil on erectile function of patients with stable CHF using the abridged 5-item version of the International Index of Erectile Function (IIEF-5).Patients and Methods: Using convenience sampling, 222 sexually-active adult males with NYHA class I-III stable CHF were included in this cross-sectional study. All the patients filled out the IIEF-5 questionnaire, in which they were required to score the five domains of male sexual function, including erectile function, orgasm function, sexual desire, intercourse satisfaction, and overall satisfaction. All the analyses were performed using the SPSS statistical software (v.19) and P<0.05 was considered as statistically significant.Results: In our sample, the patients’ mean age was 47.14±11.86 years, their mean left ventricular ejection fraction was 20% (15%-25%), and the prevalence of ED was 70.3%. In addition, severe, moderate, mild to moderate, and mild ED were seen in 57%, 17%, 7%, and 19% of the patients with ED, respectively. ED was significantly more prevalent in the patients with ischemic heart failure compared to those with idiopathic dilated cardiomyopathy (84.68% vs.55.85%, P<0.001). Moreover, the prevalence of ED was significantly lower in the patients taking sildenafil compared to the other group (42.85% vs.82.89%, P<0.001).Conclusions: Sildenafil appears to provide satisfactory results toward improving sexual function in patients with CHF.

Background: Endothelium is an essential organ for maintaining an adequate vascular tone and preventing the pathological process of atherosclerosis. Heart-lung machine is a mechanical support for maintenance of blood circulation during open heart surgery. It has been shown that flow of blood through this circuit can induce complement activation, endotoxines production, and release of many inflammatory mediators.Objectives: Cardiopulmonary Bypass (CPB) has some detrimental effects on endothelial function. Flow Mediated Dilation (FMD) is also a noninvasive method for evaluation of endothelial function.Patients and Methods: This study was conducted on 22 patients who were admitted in cardiac surgery ward for open heart operation and met the inclusion criteria of the study. Brachial artery FMD was measured the day before and 2 days after CPB.Results: The mean duration of CPB was 62.95 minutes. The mean percent of FMD changes was measured and compared before and after CPB (4.29 and 0.03 vs.1.38 and 1.99, <0.001). The results showed a significant relationship between CPB and bronchial endothelial function.Conclusions: This study revealed the influence of CPB on endothelial function. Yet, more studies are necessary to confirm this important issue, and decline in use of CPB is appreciated.

In this report, we presented a 71-year-old woman who suffered a syncopal episode in the context of advanced atrioventricular block associated with takotsubo cardiomyopathy. The heart block did not resolve and a permanent pacemaker was implanted while there was a gradual improvement of the left ventricular systolic function. We also provided a detailed review of the literature regarding the association between atrioventricular block and takotsubo cardiomyopathy. Moreover, we critically discussed other cases reporting development of takotsubo cardiomyopathy after pacemaker implantation, possibly related to the perioperative stress.

Cardiac hydatid cyst is rare and usually occurs in the setting of disseminated disease. Herein, we reported a case of isolated right atrial hydatid cyst misdiagnosed clinically as a tumor. A 65-year-old woman diagnosed as having large right atrial mass suspected of malignancy underwent resection of the cardiac mass. Histopathological examination showed laminated membrane and protoscolices of Echinococcus Granulosus. However, all other work-ups failed to document systemic diseases. Therefore, isolated cardiac hydatid cyst was diagnosed. Hydatid cysts should be considered in differential diagnosis of any cardiac mass, especially in endemic areas.