Evaluation of anthropometric indices of patients with left ventricle dysfunction fallowing first acute anterior myocardial infarction

In the current study, we evaluated the effect of anthropometric indices on ejection fraction following first acute anterior myocardial infarction. In an analytic-cross sectional study, 50 patients with acute anterior myocardial infarction and abnormal anthropometric indices [Body Mass Index [BMI] >/= 30, Waist Hip Ratio [WHR] >/= 1 and >/= 0.85 in males and females respectively and Waist Circumference [WC] >/= 102 cm and >/= 88 cm in males and females respectively] were recruited as case group and 50 patients with acute anterior myocardial infarction and normal anthropometric indices as control group. Subsequently, the relation between anthropometric indices and left ventricle dysfunction was evaluated and compared between two groups. 77 people of the studied patients were male and 23 female with the mean age of 59 +/- 1.2 years and an age range of 32-90 years. To evaluate the left ventricle function, the mean ejection fraction of the patients was measured as 34.3 +/- 7.2% and 44.8 +/- 6.3% in patients with abnormal anthropometric indices and patients with normal anthropometric indices respectively [P= 0.0001]. Calculation of the correlation coefficient between ejection fraction and BMI, WHR and WC in males and females revealed a moderate reverse [r=-0.521 to r=-0.691] and statistically significant [P= 0.0001] relations which was of more strength in females. Anthropometric indices including BMI and waist circumference influence cardiac function following myocardial infarction.

Comparison of the length of hospital stay between the patients with atrial fibrillation treated with amiodarone and patients with normal sinus rhythm after coronary artery bypass graft

Postoperative atrial fibrillation occurs in 20% to 40% of patients undergoing coronary artery bypass grafting [CABG] and contributes to increasing length of stay and hospital cost. The purpose of our study was to compare the length of hospital stay between patients of postoperative atrial fibrillation treated with amiodarone [experimental] and those with normal sinus rhythm [NSR] [Control] after CABG. From October of 2008 to October 2010, our experimental group including 26 patients was treated with amiodarone in Tabriz Madani Heart Center. The background variables, length of atrial fibrillation, and length of hospital stay were recorded. The experimental group was compared with a control group of 50 patients. The two groups were the same in terms of age, gender, ejection fraction, vascular diseases and risk factors. The hospital stay duration was 8.0 +/- 1.6 and 7.4 +/- 1.4 days [p = 0.08] for experimental, and control groups respectively. Atrial fibrillation occurred mainly [60%] on the second postoperative day. 25 patients out of 26 patients [96%] returned to NSR after starting the amiodarone protocol and the length of hospital stay in the experimental group was not significantly different from that of the control group. Thus, treating with Amiodarone in postoperative atrial fibrillation can reduce hospital stay duration compared to that of normal sinus patients.

Association between diabetic retinopathy and left ventricular dysfunction in diabetic patients with unstable angina

Diabetes mellitus [DM] is associated with serious complications including macro- and microvascular problems such as diabetic retinopathy. Coronary involvement in diabetic patients is believed to be a consequence of microvascular complications. However, the available data are inconclusive and scarce. This study aimed to evaluate the probable association between diabetic retinopathy and left ventricular dysfunction in diabetic patients with unstable angina [UA]. In this cross-sectional study, 200 diabetic patients with UA [100 cases with diabetic retinopathy and 100 cases without diabetic retinopathy] were enrolled in a teaching hospital. Left ventricular ejection fraction [LVEF] as well as the frequency of cases with left ventricular dysfunction [LVEF<50%] were compared between the two groups and different degrees of diabetic retinopathy [proliferative and non-proliferative]. Patients' demographic variables were comparable between the two groups. Mean diagnosis time of DM was significantly higher in the patients with diabetic retinopathy [8.40 +/- 6.60 vs. 3.81 +/- 3.58 years; P=0.001]. Mean LVEF was significantly lower in the retinopathy group [50.50 +/- 6.91% vs. 53.07 +/- 4.87%; P=0.003]. Frequency of cases with left ventricular dysfunction was significantly higher in the group with diabetic retinopathy [31% vs. 12%; P=0.001, OR=3.33, 95%CI: 1.58-7.14]. The frequency of cases with left ventricular dysfunction was significantly yet independently higher in patients with proliferative vs. non-proliferative diabetic retinopathy. Left ventricular dysfunction is more common in diabetic patients with unstable angina and diabetic retinopathy compared with their counterparts without diabetic retinopathy

Comparison of serum homocysteine concentrations between smoker and nonsmoker patients with acute coronary syndrome in Tabriz shahid madani hospital during 2008-2009

Background: According to previous studies elevated blood total homosyteine has been suggested to be an independent risk factor for cardiovascular disease. The aim of this study was evaluation of homosyteine serum in smoker and nonsmoker patients with acute coronary syndrome [ACS]. Methods: Eighty five patients were enrolled in this study. Forty eight patients [21smoker and 27non-smoker] diagnosed with acute myocardial infarction [AMI], 37 patients [14smoker and 23non-smoker] with unstable angina [UA] that admitted in Shahid Madani Heart center in Tabriz in 2008-2009. The mean age of patients with AMI and UA were 61.83 +/- 13.78 and 59.90 +/- 11.95 years, respectively. Homocysteine serum Levels were measured by Hitachi Auto analyzer. Results: The mean age of patients with AMI was 61.83 +/- 13.78 years and in patients with UA was 59.90 +/- 11.95 years [p=0.53]. Mean serum levels of homocysteine were not significant difference between AMI and UA patients [17.61 +/- 11.25 µmol/L vs. 22.25 +/- 12.44, p=0.78]. There was also a significant correlation between high levels of homocysteine with AMI and UA diseases in comparison with normal reference values. There were not statistically significant differences in serum homocysteine levels between smoker and nonsmoker patients in both AMI and UA groups. Conclusion: The Mean levels of Homocysteine in AMI and UA groups were not significantly different. Our study showed age of smoker patients in AMI and UA groups were significantly lower than nonsmoker patients

Non invasive assessment of myocardial perfusion after first myocardial infarction with transthoracic echocardiography

Standard methods for the measurement of myocardial perfusion are invasive and require cardiac catheterization or the use of radioisotope dyes. The coronary sinus blood flow [CSBF] is an appropriate criterion for the efficacy of myocardial perfusion. This study sought to measure CSBF via transthoracic echocardiography [TTE] in patients with acute myocardial infarction [AMI] and to assess its relation with left ventricular ejection fraction [LVEF], wall motion scoring index [WMSI], and in-hospital mortality. This case-control study evaluated 20 patients [pts] with anterior AMI and 20 healthy individuals as controls over a 6-month period [in 2005] in Madani Heart Center in Tabriz [Iran]. All the patients received the same drugs for AMI treatment [e.g. fibrinolytic]. CSBF and WMSI, having been obtained via TTE, were compared between the two groups. Baseline variables were similar between the two groups [P>0.05]. CSBF in the AMI group was 287.8 +/- 128 ml/ min and in the control group was 415_127 ml/min [P=0.001]. There was a significant correlation between CSBF and LVEF [r=0.52, P=0.01], between CSBF and WMSI [r=-0.77, P=0.0001], and between CSBF and in-hospital mortality [r=0.58, P=0.03]. Our study demonstrated a good correlation between CSBF measured with 2D-doppler TTE and LVEF, WMSI, and in-hospital mortality

Cardiovascular disease risk factors in patients with confirmed cardiovascular disease

To assess the magnitude of the problem of cardiovascular risk factors in hospitalized patients, and to establish cardiovascular disease [CVD] risk factor profiles. The study included 476 confirmed CVD patients selected by a multi stage stratified cluster random sampling technique in Tabriz Heart Center [Shaheed Madani Hospital], Tabriz, Iran from February 2004 to May 2005. After obtaining demographic information and performing physical examination, biochemical parameters were measured. Data was analyzed using the Statistical Package for Social Science version 10.05, where p value of <0.05 was considered significant. Obesity was the most common abnormality [93.5%] followed by diabetes mellitus [58.4%], low high-density lipoprotein cholesterol [HDL-c] [45.4%], low physical activity [41.6%], high total cholesterol [40.1%], high triglyceride [37.2%], high low-density lipoprotein cholesterol [30.7%], diastolic hypertension [28.4%], high systolic blood pressure [24.8%] and smoking [20%]. Of the total number of patients, 93% had one risk factors for CVD, 43% had 2, 16% had 3, and 5% had 4 risk factors. The prevalence of lipid disorders in females was more than males except for low HDL-c [p<0.05]. Between lipid profiles, only TG showed a correlation between age [p<0.05]. It was noticed that obesity accompanied by lipid profile abnormalities as low serum levels of HDL-c and high level of TG, TC, and LDL-c were more seen in obese patients [p<0.05]. This study revealed a high prevalence of risk factors in CVD patients; thus, urgent lifestyle modification is recommended

Study of the association between activity level at onset of symptoms and patient outcome of first acute myocardial infarction

This study sought to compare the clinical features and outcome of a first acute myocardial infarction [AMI] with onset of symptoms during or within 30 minutes of exercise, at rest and in bed.Information collected using a standard questionnaire was used to relate activity at the onset of symptoms and in-hospital outcome in 500 consecutive patients admitted to our heart center with a first AMI between 2000-2002.Patients with exercise-related onset were more likely to be younger and male. Those with onset in bed were more likely to be older and have a history of stable or unstable angina. By way of comparison between patients whose symptoms began at rest and exercise, those with exercise-related onset had lower in-hospital mortality after adjusting for age and gender [odd's ratio [OR] 0.53, 95% confidence interval [CI] 0.39-0.93 [p= 0.03]]. Compared with patients whose symptoms began at rest, patients with onset in bed had a higher mortality rate [OR 1.42, 95% CI 1.03 - 1.98 [p= 0.028]].The incidence of moderate or severe left ventricular dysfunction was also lower for exercise-related onset [OR 0.79, 95% CI 0.6-1.01 [p=0.32-but not statistically significant]] and higher when onset was in bed [OR 1.5, 95% CI 1.2-1.77 [p= 0.039]].There is an association between activity at onset and outcome of AMI. Differences in pathophysiology or in the population at risk could explain this observation