سال:1397 | دوره: | شماره: |تعداد مقالات:7

Background: CVDs are the first cause of death globally. About 50% of annual deaths are related to this group of diseases in Iran; however, the economic cost of CVD on Iranian society has not been conducted. Objectives: The aim of this study was to estimate the economic burden of CVDs in the southwest of Iran in 2016 from the social perspective. Materials and Methods: This study is a cross-sectional descriptive-analytic study conducted using the cost of illness (COI) framework. The prevalence top-down method was used to quantify the annual cardiovascular costs. Productivity losses were estimated using the human capital approach and the friction cost method, with the discount rate of 3% to convert all future lifetime earnings into the present value. Results: In 2016, the average total cost per patient was $1881. 4 and the total costs resulted in 1159. 62 $million. Direct costs accounted for 60% and indirect costs for 40% of the total costs. The results were robust to a 20% change in the average unit price of all medical and non-medical direct costs and to discount rate of 2% and 10%. Conclusions: The total cardiovascular disease costs in 2016 represented approximately 6. 7% of the Iran gross domestic product. The results of this study would be of special help for policymakers to evaluate the cost-effectiveness and outcomes of health care programs to allocate health care resources efficiently. Primordial Prevention of CVD including lifestyle modifications and dietary interventions resulted in substantial financial savings and is strongly recommended.

Background: Carotid disease is one of the many forms of cardiovascular disease, which may lead to chronic disability and death. It is a multifactorial inflammatory disease, greatly affected by an individual’ s habits like smoking, lack of exercise, and a diet high in fats. MicroRNAs (miRs) are known to be involved in vascular inflammation. Objectives: We aimed to analyse in a case-control study the expression profile of selected miRs from patients with symptomatic carotid disease and to examine their involvement in the disease pathogenesis. Patients and Methods: Samples from 38 symptomatic patients who underwent carotid endarterectomy were collected and adjacent healthy regions from 15 patients were used as control samples. Fold change in the expression of miR21, miR122, miR146a and miR196α was measured using reverse transcription-real time PCR. Western blot was used to quantify the levels of MMP2 protein whose gene is a target of miR21. Results: Compared to control samples, all patients showed upregulation of miR21, miR122, miR146a and miR196a. No statistical significance was found to exist from patients with high or low miRs expression and clinical/laboratory parameters. The levels of MMP2 were found to be decreased in patients when compared to control samples. Conclusions: Our results revealed miRs which showed different expression in endarterectomy specimens from patients with symptomatic carotid disease, suggesting that these miRs correlated with vascular inflammation. Furthermore, mir21 seems an appealing pharmaceutical target since by targeting MMP2 can favour a stable plaque since low levels of the protein of its gene MMP2 target prevent the fibrous cap of the atheroma from getting thinner. Thus, miR21 seems to prevent rupture but further research is required.

Background: Celiac disease (CD) is an autoimmune mediated gluten sensitive enteropathy and cardiac involvement in CD children is frequent. Objectives: This study aimed to investigate cardiac involvements in patients with celiac disease by using Doppler Tissue Echocardiography and conventional echocardiography to identify myocardial dysfunctions in celiac patients compared to healthy individuals. Patients and Methods: This case-control and approved study was performed on 120 children with celiac disease and 60 healthy children aged 1-18 years old in a single center. Patients with valvular disease, rhythm abnormality, CHD, malignancy, systemic inflammatory diseases, diabetes mellitus, renal insufficiency, chronic obstructive pulmonary disease and hypertension were excluded from the study. The participants underwent echocardiography. Data were analyzed through SPSS 17 using Student’ s t-test and Mann-Whitney U. A P value of < 0. 05 was considered as significant. Results: Out of 120 patients with celiac, 55. 83% were females and for the control group it was 43. 33%. The participants in the case and control groups were matched for sex and age. Weight and height showed significant differences between the groups. Right ejection time had significant mean differences of 245. 30 ± 24. 60 and 253 ± 22. 66 for the case and control groups respectively with the t =-2. 03 and P = 0. 044. Similar trends were observed for the left myocardial performance index by DTE with a mean of 0. 79 ± 0. 12 and 0. 72 ± 0. 12 for the case and control groups, respectively (t-3. 32, P = 0. 001). QT and heart rate by ECG and ET, IRT and MPI by DTE had significant differences in the case and control groups. LA in diastole and LVM and Peak A velocity had significant differences in both groups. ET, ICT, and IRT revealed significant differences in the case and control groups. Conclusions: Consistent with many study’ s results, we reached the conclusion that Doppler Tissue Echocardiography and Conventional Echocardiography are good determination methods of systolic and diastolic myocardial functions in patients with celiac disease. Between these two methods, the present study confirmed the importance and strong power for Doppler Tissue Echocardiography.

Background: Saturated fatty acids and high sugar consumption along with sedentary lifestyle increase. The prevalence of atherosclerotic cardiovascular disease. Objectives: In the present study, dietary high cholesterol and oxidized cholesterol implications after myocardial infarction induced by Isoproterenol compared with myocardial infarction subjects with normal diet were studied. Materials and Methods: 36 animals were allocated randomly in 6 groups; three groups were fed with standard, high-cholesterol or high-oxidized cholesterol diets for 14 weeks. The other three groups received the same diets as well as ISO to induce acute MI. Lipid profile, OxLDL and total antioxidant levels were measured in the serum. The myocardial CoQ10 content was analyzed using a validated RP-HPLC. The infarct size was determined using triphenyl tetrazolium chloride staining. Histological changes and necrosis were evaluated using microscopic analysis. Results: Malondialdehyde concentration and infarct size in all high fat-fed groups were increased compared to the control group, especially in the ISO-induced MI groups. The total antioxidant level was decreased in both ISO-induced MI treated groups. CoQ10 content of the myocardium in control group (4. 45 ± 0. 19 μ g/100 mg) was significantly higher than cholesterol-fed (2. 99 ± 0. 05 μ g/100mg, P < 0. 001) and oxidized Cholesterolfed (1. 42 ± 0. 06 μ g/100mg, P = 0. 00l) groups. This reduction was more intense in the ISO-induced MI groups compared to the ISO group. High cholesterol and oxidized cholesterol diets increased the isoproterenol-induced necrosis in the myocardium (P < 0. 05, P < 0. 01, respectively) compared to the rats taking normal diet. Conclusions: Overall, we concluded that the expansion of the infarct size and reduction of the CoQ10 content in the rat’ s myocardium occurred as a result of elevated level of high serum level of OxLDL rather than non-oxidized LDL.

Background: Statin treatment can cause elevation of the liver aminotransferase levels in 1-3% of the patients with hypercholesterolemia. Previous studies indicate that vitamin E plays a role in declining the increased levels of liver enzymes caused by fatty liver disease. Objectives: We conducted this study to determine the effect of vitamin E on liver aminotransferase levels in patients with elevated aminotransferase levels due to statin consumption. Materials and Methods: This study was a randomized, double-blind, placebo-controlled trials. Eligible patients were those who developed elevated aminotransferase levels after initiation of statin. They were randomized into the intervention group (vitamin E capsules, 400 units/day for one month) and placebo group. Randomization was done with permuted block sampling method with a 2: 1 enrolment ratio. Study capsules were allocated in separate packs blinded and labeled using a four-digit code. Alanine aminotransferase (ALT) and asparate aminotransferase (AST) levels were checked in the beginning and one month after the intervention. Comparison of the levels before and after the intervention was done by paired sample T-test, and between group difference was checked by independent sample T-test. Results: A final number of 23 patients enrolled in this study (15 in the intervention and 8 in the control parallel groups). Baseline ALT and AST levels in both groups showed no difference (74. 3 ± 9. 1 vs. 77. 6 ± 17. 5, P = 0. 9; and 50 ± 8. 2 vs. 43. 3 ± 9. 3, P = 0. 34, respectively). With consumption of vitamin E, ALT level was decreased from 77. 6 ± 17. 5 to 40. 9 ± 13. 4, showing a significant difference with placebo (treatment difference =-25. 7, P = 0. 04). However, the reduction of asparate aminotransferase level from 43. 3 ± 9. 3 to 29. 8 ± 5. 9 was not significant compared to placebo (treatment difference =-1. 5, P = 0. 12). Conclusions: Vitamin E therapy in patients with moderately elevated aminotransferase levels (1. 5-3 times than basal levels) due to statin consumption may be beneficial and can reduce the asymptomatic hepatocellular damages.

Background: Pre-hypertension is known as the precursor of hypertension. We could prevent or delay hypertension by controlling pre-hypertension. Objectives: In this study, we investigated the prevalence of pre-hypertension and its risk factors in an Iranian population, East of Iran, in 2014. Patients and Methods: This cross-sectional study was conducted on 1280 subjects living in Birjand, East of Iran in 2014. After explaining about the project, a questionnaire containing demographic characteristics and clinical backgrounds was filled out by all subjects. Participants were classified as pre-hypertension (PHTN) if systolic blood pressure was 120-139 mmHg or if diastolic blood pressure was 80-89 mmHg. Data were analyzed by chi-square test and multiple logistic regression using SPSS (version 22). P < 0. 05 was considered as statistically significant. Results: Among 1286 participants, 21. 4% had pre-hypertension. Results showed that pre-hypertension, diabetes mellitus (DM) and smoking were more prevalent among men than women (P < 0. 001), while prevalence of dyslipidemia was more observed in women (P < 0. 001). In addition, the risk of pre-hypertension was more in men (OR = 2. 9), overweight (OR = 3. 7), and obese (OR = 5. 6) subjects. Smoking cigarette showed a protective effect (OR = 0. 4). Conclusions: Pre-hypertension was more prevalent among men and obese subjects. Since pre-hypertension progresses to hypertension and increases the risk of cardiovascular disease, it needs more attention by public health policy makers to change people’ s lifestyle.

Isolated congenital Mitral Regurgitation (MR) occurring in infancy is rare (< 0. 4% of live births with congenital heart disease). Presentation in infancy with symptoms of heart failure reflects the severity of the condition and needs mandatory surgical correction to prevent progressive deterioration and death. Isolated Congenital MR in infancy is a surgical challenge and various surgical techniques employed for valve repair have to be judiciously used. We report a case of isolated congenital MR presenting in infancy, who underwent successful surgical correction.