ABSTRACT
Coronary atherosclerosis is a common disorder of the arteries and may block the arteries and cause heart disease. Recently several studies have indicated a role of infectious agents in atherosclerosis and obstructive coronary artery disease. Candida species are normal flora of the human oral cavity and can enter in the blood stream and damage inner walls of coronary arteries by several mechanisms. Thus this study was done to compare the oral candida flora in healthy people and patient with coronary atherosclerosis. In this study, we compared oral candida flora in 90 patients with coronary atherosclerosis and 90 healthy people. All specimens were obtained from oral cavity by swab and cultured on CHOROMagar Candida medium. Identification of isolated colonies was done by RapID yeast plus system. The data were analyzed using the chi-square test. In this study 55.4% [N=61] of patient and 44.6% [N=49] of control group had candida colonization in their oral cavity. Candida albicans was the most common species isolated in both groups. Candida glabrata, Candida krusei, Candida tropicalis and Candida parapsilosis were the most common non albicans species. Although no significant difference was observed between candida colonization in patients and controls, the differences between isolated colony numbers in patient and healthy group were significant [p=0.001]. Hypercolonization of candida species in oral cavity may lead to invasion and enter the organism in the blood stream and damage the coronary arteries
ABSTRACT
Diabetes mellitus [DM] is the most prevalent metabolic disease worldwide and is associated with coronary artery disease [CAD]. Therefore it is very important to find a clue to diagnose the presence of CAD as early as possible in DM patients. The aim of this study was to find any correlation between microalbuminuria [MAU] and the severity of CAD in patients with DM type 2. This was a cross sectional study that included 77 DM type 2 patients with suspected CAD that all of whom were performed coronary angiography in our hospital [from 2010 to 2011]. Patients were divided into two groups, the case group [group 1] that includes patients with MAU and the control group [group 2] that include patients without MAU. Severity of CAD was estimated by using Gensini score and MAU was defined as the ratio of urine albumin to urine creatinine. Of 77 patients forty three [55.8%] were female, mean +/- SD of their ages was 55.8 +/- 10.3 and sixteen [21%] of them had MAU. Gensini score of case group was significantly higher than control group [94.94 +/- 12 versus 33.25 +/- 25.4, P<0.001]. The linear regression analysis revealed urinary albumin to creatinine ratio [UA/CR] as an independent predictor for the severity of CAD [P<0.001]. Based on the ROC curve, 10.25 was the best albumin level cut off point for differentiating Gensini score over and below 70. Area under curve was 0.9; sensitivity and specificity were 72% and 80%, respectively [P<0.001]. According to this study, in patients with DM type2, MAU is an independent predictor of severity of coronary artery stenosis and reveals a positive correlation between MAU and the Gensini score
ABSTRACT
Advanced glycation end-products [AGEs] came up with the recent researches regarding new biomarkers for the diagnosis of heart failure. AGEs are the end products of non-enzymatic glycation and oxidation of proteins, lipids and nucleotides during Maillard biochemical reaction. Although it has been known that AGEs have a role in the pathogenesis of chronic heart failure [CHF], information regarding its role and its pathogenetic mechanism is very limited. The aim of this study was to find any relationship between AGEs with the etiology and severity of chronic heart failure. This study is a prospective cross sectional study that enrolled 85 patients with chronic heart failure. Measurement of left ventricle ejection fraction [LVEF] was done by echocardiography. Blood samples were collected for measuring AGEs just before or after echocardiography assessment [in the same session]. Measurement of AGEs was done by the enzyme-linked immunosorbent assay [ELISA] method. The relationship between AGEs with the severity of CHF and as well as the etiology of CHF were evaluated via SPSS-15. Of 85 patients 48 [56.5%] patients were male and 37 [43.5%] were female; Mean +/- SD of their ages was 55.8 +/- 13.4 years old [ranges from 27 to 84 years]. Correlation coefficient between LVEF and AGEs was 0.269 [P = 0.013]. Mean of AGEs in patients with and without ischemic etiology of their heart failure were 16.8 +/- 9.8 microg/ml and 11.6 +/- 7.3 microg/ml, respectively. Although trend was in favor of ischemic heart failure, the difference between two groups was not statistically significant [P = 0.141]. According to this study the rate of AGES could be helpful in the diagnosis and assessment of severity of CHF. Based on our findings, higher blood levels of AGEs in the ischemic CHF cases, also it could be concluded that in the future this marker may be used for etiologic differentiation of heart failure syndrome
ABSTRACT
It has been shown that coronary artery calcium scoring [CACS] can be used as a diagnostic method in coronary artery disease [CAD]. The relationship between CACS and calcium metabolism in the body has been shown. The arterial calcification is an organized process similar to bone formation which is controled by parathormone [PTH]. The relationship between PTH as an osteoregulatory factor and CACS has been also indicated. In this study, we tried to assess the value of serum PTH and CACS in patients planned to undergo coronary angiography [CAG] in order to find a simple, cost-benefit, noninvasive way, for ruling in/out obstructive CAD. In a cross sectional study in Imam Khomeini hospital in 1390, CACS by using non-enhanced multi detector computed tomography [MDCT] and measurement of serum level of PTH, Calcium and Phosphate were done in 178 patients suspected to CAD which were scheduled to undergo coronary angiography serum PTH was measured by immuno-radiometric assay [IRMA] and serum Ca and Phosphate were measured by spectrophotometry methods. Of 178 Patients, 50 patients were females and 126 patients were male. Mean age of them was 56.2 +/- 11.6. The correlation coefficient between CACS and Gensini score [0.507, P<0.001], PTH [0.037, P=0.693], Ca [0.062, P=0.499] and Phosphate [0.061, P=0.506] were obtained. The level of serum PTH in the patients with and without coronary artery disease were 21.8 +/- 11.6 pg/dl, 23.2 +/- 11.5 pg/dl [P=0.427] respectively. Our study showed association between CACS and CAD that was statistically significant while no relationship was found between PTH, CACS and CAD.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Calcium/blood , Coronary Vessels , Coronary Artery Disease , Coronary Angiography , Cross-Sectional StudiesABSTRACT
Measurements of mitral valve area [MVA] are essential to determine the severity of mitral stenosis [MS] and adopt the best management strategies. The aim of the present study was to compare MVA determined by two-dimensional [2D] planimetry to MVA measured by continuity equation [CE] in patients with moderate to severe MS. We evaluated 73 consecutive patients with the diagnosis of MS scheduled for balloon mitral valvuloplasty or with moderate to severe rheumatic MS admitted at the echocardiography clinic of Imam Khomeini Hospital in 2010. Using 2D images of mitral valve obtained from paraesternal short axis view, 2D planimetry of the mitral orifice area was performed by an experienced cardiologist. MVA by CE was calculated from aortic forward stroke volume divided by transmitral time-velocity integral. The mean value of MVA by 2-D planimetry was 1.0 +/- 0.3 cm[2]. The average values of MVA measured by PHT and CE were 1.0 +/- 0.3 cm[2] and 0.9 +/- 0.4 cm[2], respectively. The MVA determined by planimetry correlated well with CE [r=0.832, standard error of estimation [SEE]= 0.166, P<0.001]. The mean values of MVA calculated by CE highly correlated with those calculated by 2-D planimetry in patients presenting with both non-significant [r=0.701] and significant [r=0.761] AIs. When planimetry is not feasible, such as in severe calcification of mitral valve or after percutaneous balloon valvuloplasty, CE could be an alternative method for MVA measurement in comparison with PHT.
ABSTRACT
Right bundle branch block [RBBB] is considered as an important predictor of poor outcome in patients with acute myocardial infarction, but the prognostic implication of RBBB in patients with suspected coronary artery disease [CAD] is unclear. Furthermore, the association between RBBB and incidence of CAD also its influence on the severity of stenosis in coronary arteries has not been established. This study was designed to assess the relationship between RBBB and the presence and the severity of CAD in patients with suspected CAD. The study population consisted of 172 patients with RBBB and 174 patients with normal resting electrocardiography [ECG]. Severity of CAD was defined as estimated Gensini score according to the degree, quantity and distribution of lesions in angiographic study. According to our study based on angiographic investigations, in patients with RBBB the prevalence of CAD was 77.3 percent versus 70.1 percent in patients with normal resting ECG [P=0.13]. Also, there was no significant association between the presence of RBBB and magnitude of Gensini score [OR=0.87, P=0.62]. However, male gender and history of diabetes mellitus were associated with higher Gensini score [OR=3.41; 95% CI: 1.96-5.93, P<0.0001 and OR=3.22; 95% CI: 1.77-5.87, P<0.0001 respectively]. This study suggests that although RBBB was associated with more severity of stenosis in left coronary system [LAD and LCX], but as a whole there was no association between RBBB and the presence and severity of CAD
Subject(s)
Humans , Female , Male , Adult , Middle Aged , Aged , Coronary Artery Disease/diagnosis , Coronary Artery Disease/epidemiology , Electrocardiography , Coronary AngiographyABSTRACT
Experimental and clinical studies have shown that intracoronary transplantation of autologous bone marrow mesenchymal stem cells [BMSCs] has resulted in regenerated infarcted myocardium and improved left ventricular [LV] function. The aim of this pilot study was to assess the benefical effects of intracoronary transplantation of BMSC in patients with old myocardial infarction [OMI]. Autologous BMSCs were transplanted by the intracoronary method via percutaneous transluminal coronary balloon angioplasty [PTCA] in five patients with old myocardial infarction. Time from myocardial infarction [MI] to cell therapy was 5.2 +/- 3.11 months [mean +/- SD]. All patients were <70 years old [32-61 years] and had significant LV dysfunction [LV ejection fraction, mean +/- SD, 34% +/- 10.83%], and severe wall motion abnormality [akinesia and / dyskinesia] at the location of infarcted area. Follow up angiography was performed 6-9 months [mean +/- SD,7 +/- 1.4 months] after BMSC transplantation, which revealed an increased trend in the LV ejection fraction [LVEF] of patients after treatment [LVEF: Mean +/- SD from 34% +/- 10.83% to 46.25% +/- 9.46%, P= 0.051 and median from 35% to 42.5%]. Clinical follow up [for 12-18 months] also revealed appreciable improvement in their symptoms or functional class [dyspnea from New York Heart Association[NYHA]-Class Sha-IV to I-II and Chest discomfort from Canadian Cardiovascular Society [CCS] Class II-IV to I-II]. Intracoronary transplantation of autologous BMSC in patients with old myocardial infarction appears to be feasible, safe and effective .The therapeutic effect could be attributed to BMSCs ability to regenerate myocardium