ABSTRACT
Cardiac resynchronization therapy [CRT] has been introduced as a promising therapeutic choice in heart failure [HF] patients with ventricular dyssynchrony, shown with a wide QRS. In previous study, we showed a positive effect of CRT on ejection fraction. This study aimed to evaluate the effect of CRT on the severity of mitral regurgitation [MR] quantitatively using the volumetric Doppler method in HF patients. In this prospective before-after survey, 22 HF patients with wide QRS [>/=120 ms] and NYHA class III who were included. All patients were evaluated initially for QRS width, NYHA class, MR volume, MR fraction and mitral valve area [MV area]. Biventricular pacing was done through cardiac-resynchronization device along with three pacing leads and same evaluations were done after CRT. The mean [SD] QRS width and NYHA class were significantly decreased after CRT in HF patients [p<0.001]. Also MR volume [46.9 +/- 30.2 mL vs. 27.0 +/- 26.4 mL, p<0.001] and fraction [40.1 +/- 25.5% vs. 26.8 +/- 22.7%, p=0.002] were improved following CRT. The decrease of MV area after CRT was also significant [10.6 +/- 3.0 cm[2] vs. 8.6 +/- 2.6 cm[2], p<0.001]. As MR is associated with morbidity and mortality in HF patients and the standard surgical therapy may not be practical for a majority of them, this novel treatment may improve their disease condition significantly
ABSTRACT
Studies have demonstrated that zinc plays an important role in development of cardiovascular diseases in Western populations. But there is little data for other racial groups. This study was aimed to investigate the association between serum zinc and coronary artery disease [CAD] in Iranian subjects.This study was conducted on 81 subjects, which referred to Heshmat Hospital of Guilan province, Iran, for routine coronary angiography from June to August 2011. Subjects were assigned into 2 groups; 41 CAD patients. case and 40 healthy subjects in control group. Data about smoking habit,physical activity, dietary intake and anthropometric indices were collected by questionnaire. Serum zinc was measured by atomic spectroscopy. The serum zinc concentrations were significantly lower in case group than control [p<0.05]. The mean serum zinc concentration in the case and control group was 73.50 +/- 1.61microg/dl and 78.47 +/- 1.66 micro g/dl, respectively. subjects that lives in rural area had 7.11-fold higher CAD risk in compare to subjects lives in urban after adjustment for confounder factors, they also had lower zinc concentration than urban [p<0.05]. in our study With increasing in serum zinc concentration CAD risk decrease 0.94-fold.Zinc concentration had significant correlation with age [r= -0.23 p<0.05], weight [r=0.26 p<0.05] and Place for living [r=- 0.22 p= 0.04].There were no significant correlation between the dietary intake, Waist circumference ,smoking and serum zinc concentration in our study. Serum zinc concentration was significantly lower in the north of Islamic Republic of Iran patients with abnormal versus those with a normal angiogram. It seems Serum zinc concentration correlate with some risk factors for coronary artery disease
ABSTRACT
Cardiac resynchronization therapy [CRT] has introduced as new treatment strategy in heart failure [HF] patients and some of its effects have been investigated. The aim of this study was to study the effectiveness of CRT in the improvement of left ventricular systolic function indicated by left ventricular ejection fraction [LVEF] in HF patients. In our prospective study 22 HF patients with NYHA class III and above, QRS duration>120 ms and EF [ejection fraction]
ABSTRACT
Exercise training as a part of cardiac rehabilitation aims to restore patient with heart disease to health. However, left ventricular ejection fraction [LVEF] is clinically used as a predictor of long-term prognosis in coronary artery disease [CAD] patients, there is a scarcity of data on the effectiveness of exercise-based cardiac rehabilitation on LVEF. To investigate the effectiveness of exercise-based cardiac rehabilitation on LVEF in early post-event CAD patients. In a single blinded, randomized controlled trial, post-coronary event CAD patients from the age group of 3575 years, surgically [Coronary artery bypass graft or percutaneous coronary angioplasty] or conservatively treated, were recruited from Golsar Hospital, Iran. Exclusion criteria were high-risk group [AACVPR-99] patients and contraindications to exercise testing and training. Forty-two patients were randomized either into Study or Control. The study group underwent a 12-week structured individually tailored exercise program either in the form of Center-based [CExs] or Home-based [HExs] according to the ACSM-2005 guidelines. The control group only received the usual cardiac care without any exercise training. LVEF was measured before and after 12 weeks of exercise training for all three groups. Differences between and within groups were analyzed using the general linear model, two-way repeated measures at alpha=0.05. Mean age of the subjects was 60.5 +/- 8.9 years. There was a significant increase in LVEF in the study [46.9 +/- 5.9 to 61.5 +/- 5.3] group compared with the control [47.9 +/- 7.0 to 47.6 +/- 6.9] group [P=0.001]. There was no significant difference in changes in LVEF between the HExs and CExs groups [P=1 .0]. A 12-week early [within 1 month post-discharge] structured individually tailored exercise training could significantly improve LVEF in post-event CAD patients
ABSTRACT
Permanent pacemakers provide effective relief of symptoms and are life-saving in patients with symptomatic heart block. Implantable cardioverter defibrillators [ICD] are also increasingly recognized as life-saving tools in various groups of patients with malignant ventricular tachyarrhythmias. As part of the "world survey on pacemaker and ICD implantations ", A survey of all device implantations in Iran during the year 2001 was performed. Data was collected and cross-checked through three sources i.e. direct contact with implanting physicians, pacemaker companies and the governmental pacemaker distributing body. During the year studied, 1635 patients received permanent pacemakers. 88% were new implants at an estimated rate of 24 per million population. The mean age of patients was 65 years and 56.2% were male. 40 cardiologists and 19 surgeons implanted the pacemakers at 27 centers throughout the country. Complete heart block was consistently the most common indication at all centers [mean 56.1%], sick sinus syndrome being the next most common one [mean 20.8%]. 69% of the pacemakers were single chamber pacemakers. Transvenous insertion of bipolar steroid-eluting passive fixation leads was the predominant practice at most centers. A total of 60 ICDs were implanted at 7 centers by 9 cardiologists. 45% of ICD implants were dual chamber devices. The survey is the only one available right now and provides useful information about the prevailing pacemaker and defibrillator implantation practice in Iran. Future surveys would be facilitated if a standardized implant registry such as that used in Europe were established in this country