Journal of Cardiovascular and Thoracic Research
Year:2018 | Volume:10 | Issue:2|Papers Count:10

Introduction: The objectives of this study were to provide an estimate of the prevalence of metabolic syndrome (MetS) and its components among women with PCOS; and calculate the odds ratio (OR) for MetS (using different definitions of MetS) in women with PCOS, compared to healthy controls. Methods: All of the relevant databases were used to search for appropriate articles that were published during the period 2003-2016. We included observational studies (cross-sectional, comparative cross-sectional) among women who met the inclusion criteria. The random-effect models were used to pool the prevalence of MetS and its components among PCOS women. This model was also applied to the pooled OR assessing the association between MetS and PCOS. Results: The pooled prevalence of MetS among PCOS women was found to be 26. 30% (95% CI: 23. 68– 28. 93), but varied from 7. 10% (95% CI: 1. 64-12. 56) to 37. 50% (95% CI: 28. 84-46. 16), depending upon the diagnostic criteria used. Low high-density lipoprotein cholesterol (HDL)-61. 87% (95% CI: 53. 31– 70. 43) and high waist circumference (WC)-52. 23% (95% CI: 43. 84– 60. 61) were the most common components of MetS in PCOS women. Compared to healthy controls, the overall pooled (OR) of MetS in PCOS patients was 2. 09 (95% CI: 1. 67-2. 60), but this ranged from 0. 31 (95% CI: 0. 13-0. 74) to 4. 69 (95% CI: 2. 09-10. 52), depending upon the diagnostic criteria used. Conclusion: Women with PCOS had a much higher prevalence of MetS than was found among the healthy controls. Furthermore, as low HDL and high WC were the most common components of MetS in PCOS women, these two components specifically need to be addressed in prevention strategies.

Introduction: Prospective studies have shown the relation between acute coronary syndrome (ACS) and neurocognitive dysfunction with prevalence ranging between 10. 51% and 66. 8%. The present study aims to determine the prevalence level of neurocognitive dysfunction; the relations between sociodemographic, clinical and emotional variables and neurocognitive functioning in a sample of ACS patients. Methods: The sample comprised of 53 patients engaged in cardiac rehabilitation within 3 months after an ACS. Patients with any medical history of neuropsychiatric problems prior to the ACS and illiterate subjects were not included in the study. Results: The majority of the sample (85%) exhibits some degree of cognitive impairment, with 84. 8% showing verbal fluency impairment, 60. 3% memory impairment and only 26, 4% had language compromised. Neurocognitive general functioning was correlated with age. Memory domain was negatively correlated with the number of daily smoked cigarettes before the ACS. Verbal fluency was influenced by schooling. Language domain was correlated with mean diastolic pressure and with the type of profession, visuospatial domain was correlated with schooling, number of cardiovascular risk factors, distress, anxiety levels and type of ACS. Conclusion: Prevalence rate of neurocognitive dysfunction is considerably high. Besides global neurocognitive functioning, verbal fluency and memory are the most affected domains. Several variables were related to neurocognitive performance: sociodemographic; cardiovascular risk factors; clinical; psychological. The underlying mechanisms of neurocognitive dysfunction should be further explored.

Introduction: This study presents the prevalence of cardiometabolic risk factors in a nationally representative sample of Iranian children and adolescents. Methods: This multi-centric study was conducted in 2015 among 4200 students aged 7– 18 years. They were selected by multistage cluster sampling from 30 provinces of Iran. Anthropometric indices, biochemical and clinical parameters were measured. Results: The mean of weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) was higher in boys than in girls (P < 0. 05). The mean of triglyceride (TG), total cholesterol (TC) and low-density lipoprotein (LDL) levels were higher in girls than in boys (P < 0. 05). The mean of weight, height, WC, SBP, DBP, alanine transaminase (ALT) and body mass index (BMI) was higher in urban than in rural residents (P < 0. 05). Overall, 16. 1%, 9. 4% and 11. 4% were underweight, overweight and obese. Abdominal obesity was documented in 21. 6% of boys and 20. 5% of girls. Low HDL-C was the most prevalent abnormality of lipid profile (29. 5%) followed by high serum TGs (27. 7%). Low HDL-C was more prevalent in boys than in girls (32. 7% vs. 26%, respectively, P < 0. 05). Prevalence of obesity and overweight were higher in girls than in boys (P < 0. 05). The prevalence of obesity and overweight, abdominal obesity, and low HDL-C were higher in urban than in rural residents (P < 0. 05). Conclusion: We found considerably high prevalence of some cardiometabolic risk factors including overweight and obesity, low HDL-C and hypertriglyceridemia in Iranian children and adolescents. The current findings underscore the necessity of intensifying health interventions for primordial and primary prevention of noncommunicable diseases from early life.

Introduction: Lipid phosphatase and tensin homolog deleted from chromosome 10 (PTEN) antagonizes phosphoinositide 3-kinase (PI3K)/AKT cell survival pathway. The effect of PTEN inhibitors has been rarely examined on cell survival following reperfusion injury. In this study, we investigated the neuroprotective effect of SF1670, as a new PTEN inhibitor, on an in vitro stroke-like model. Methods: PC12 cells were exposed to oxygen-glucose deprivation/reperfusion (OGD/R). The cells were treated in five conditions as follows: normoxic normoglycemic (NO/NG); 60 minutes OGD; 60 minutes OGD and 6 h reperfusion (OGD/R); OGD/R treated with 10 μ M SF1670 (OGD/RSF), and NO/NG treated with 10 μ M SF1670 (NO/NG-SF). Then, phosphorylation levels of AKT, P38 in PC12 cells were measured by immunoblotting. The cell viability was also determined by colorimetric assay. Results: The results of immunoblotting revealed that following OGD/R the levels of phospho-AKT (p-AKT) significantly decreased, compared to NO/NG cells (P < 0. 05). However, the ratio of p-AKT/total AKT significantly increased in the presence of SF1670 in the OGD/R-SF group, compared to the OGD/R condition. On the other hand, SF1670 significantly reduced the p-P38 MAPK and p-JNK levels, compared to OGD/R cells. Moreover, cell viability significantly decreased in the OGD and OGD/R condition compared to NO/NG cells. Surprisingly, SF-treated cells (OGD/R-SF and NO/NG-SF group) showed low cell viability compared to NO/NG condition. Conclusion: Overall, our results demonstrated that complete inhibition of phosphatase activity of PTEN not only did not exhibit neuroprotective effect but also promoted PC12-deprived cells to death.

Introduction: Cardiac dysfunction is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Previous studies have shown that kidney transplantation can reverse some of the gross changes in the myocardial structure such as left ventricular ejection fraction (LVEF) and volumes. Whether kidney transplantation can reverse the subtle and early myocardial changes in ESRD patients who do not suffer from gross alternations in myocardial function is not yet studied. The aim of this study was to answer this question. Methods: We followed 25 patients with ESRD at baseline that all of them had a kidney transplant and were reassessed 1 month after the transplantation. Conventional and speckle tracking echocardiography (STE)was done at baseline and 1 month after kidney transplantation in patients. Results: LV hypertrophy was the most prevalent finding at baseline (58%), followed by diastolic dysfunction (53%). Kidney transplantation significantly improved the ejection fraction (EF) (treatment effect = 4. 23 ± 2. 06%; P = 0. 046) and apical 4-chamber strain (treatment effect =-0. 89 ± 0. 37%; P = 0. 021) in the patients. It also reduced the LV mass index (treatment effect =-73. 82 ± 11. 6; P < 0. 001) and relative wall thickness (treatment effect =-0. 056± 0. 023; P = 0. 021). Other variables including global longitudinal strain and diastolic dysfunction were not improved significantly. Conclusion: STE may show early improvements in myocardial function 1 month after renal transplantation.

Introduction: Limited information exists regarding the effects of high protein (HP) diets on cardiovascular disease (CVD) risk factors among overweight and obese children. Our aim was to determine the effects of an HP diet on anthropometric indexes and CVD risk factors among overweight and obese children. Methods: In a parallel randomized controlled trial, we recruited 50 overweight and obese children, aged 6-11 years, for a 10 week HP or control diet (protein, carbohydrate, fat: 25%, 45%, 30% in the HP diet vs. 15%, 55%, 30% in the control diet, respectively). Fasting blood glucose (FBG) serum insulin levels, lipid profiles, systolic and diastolic blood pressure (SBP and DBP), and anthropometric measurements were assessed using standard guidelines. Results: 86% of children completed the trial. Percent changes (PC) for anthropometric and biochemical variables were not significantly different between the two groups. The PC of serum triglyceride (TG) level was significantly decreased in the HP group compared to in the control group (PC:-10. 16± 4. 30% vs. 12. 11± 7. 80%; P = 0. 01) in the crude model, but not in the adjusted model. For other variables, we did not find any significant differences between the HP group and the controls. Conclusion: In the present study, we did not find any significant effect of adherence to an HP diet in improving anthropometric measurements or other CVD risk factors among obese and overweight children.

Introduction: The causal attributions and perceived risk factors can affect patients’ health behaviors. Therefore, the present study aimed to assess (i) the effect of an outpatient cardiac rehabilitation (CR) program on perceived heart risk factors (PHRFs) and on psychological stress, and (ii) the role of changes of PHRFs at pre-post CR in predicting changes in psychological stress. Methods: In this longitudinal study, 110 CR patients were assessed from June to November 2016 in a hospital in Iran. Perceived heart risk factors and perceived stress were investigated using the PHRFs scale and the Depression, Anxiety, Stress Scale-21, respectively. PHRFs and DASS-21 Stress scale scores were compared before and after 26 sessions of exercise-based CR through paired sample t-tests. In addition, we investigated the effect of PHRF’ s change scores on DASS-21 Stress scale scores using linear regression analysis. Results: Results showed that CR has a little impact in improving the patients’ perception of heart risk factors, However, CR is significantly effective in reducing stress (P < 0. 05). Regression analysis evidenced that improvements in patients’ perception of risk factors can significantly predict a reduction in psychological stress (P = 0. 030). The model explained 11. 2% of the variance in the results. Conclusion: PHRFs appear to be significant predictive components of CR’ s stress reduction. Practitioners should focus on patients’ perception of risk factors to facilitate stress management in CR program.

Introduction: Cancer antigen 125 (CA-125) is a tumor marker of ovarian cancer, which has shown to be increased in different cardiovascular diseases. Although the prognostic role of CA-125 in heart failure and coronary heart disease is well-established, there is little known about its role in acute myocardial infarction (AMI). In this study we aimed to evaluate the serum levels of CA-125 in patients with AMI and its prognostic role in evaluating the in-hospital outcome of AMI. Methods: We evaluated 120 male patients with AMI and 120 male normal subjects. CA-125 levels were measured upon the patient’ s admission to hospital. The in-hospital major adverse cardiac events (MACE) and its predictors were also recorded for AMI patients. Results: CA-125 levels were significantly higher in AMI patients compared to normal subjects (7. 99± 6. 83 vs. 5. 70± 4. 62, P = 0. 003). We found significant positive correlations between CA-125 levels with creatine kinase-MB (CKMB) (r=0. 621, P < 0. 001) and CTnI (r=0. 491, P < 0. 001). The in-hospital MACE was observed in 19 cases (15. 8%). Patients with MACE had significantly higher value of CA-125, CKMB and CTnI and lower LVEF compared to patients without MACE. CKMB (OR=0. 967, 95% CI [0. 943-0. 991], P = 0. 007) and CA-125 levels (OR=0. 821, 95% CI [0. 688-0. 979], P = 0. 02) were independent predictors of MACE. Conclusion: Serum CA-125 levels are significantly higher in male patients with AMI compared to normal subjects and have a significant role in predicting in-hospital MACE after AMI. In patients with higher CA-125 more aggressive treatment and close observation should be performed in order to reduce the possible adverse outcomes.

An ascending aortic thrombus is a rare source for embolic transient ischemic attack (TIA) or stroke without an associated aortic pathology. Here we describe a case of a patient who presented with generalized symptoms of headache and fatigue who, on subsequent work-up, was found to have an ascending aortic thrombus with no obvious associated aortic pathology, and was successfully treated with apixaban, a newer direct oral anticoagulant.

We describe a case of a 43-year old woman with Marfan’ s syndrome, tricuspid valve regurgitation and severe pectus excavatum who required an aortic root replacement and valvuloplasty for an ascending aortic aneurism with aortic valve regurgitation and tricuspid valve regurgitation. There was a severe angulation of the sternum which was close to 1. 5 cm to the column vertebrae. Such cases are quite rare and always a challenge for surgeons to achieve adequate exposure of the heart and prevent excessive cardiac compression. We present our access, a safe and efficient exposure of the heart in order to achieve the best outcome.