Cascade screening can be life‑saving: a family with multiple cases of brugada syndrome and sudden cardiac death

Brugada syndrome (BrS) may cause a spectrum of symptoms from asymptomatic patients to those who experience cardiac arrest and sudden cardiac death. The diagnosis is confirmed after observation of type I Brugada pattern on the electrocardiogram. Following the diagnosis, risk stratification can help select therapeutic options. Cascade screening should be started to find other family members with BrS. We present a 41-year-old woman diagnosed with BrS, and cascade screening of her relatives unveiled a pedigree of BrS among their family.

Plasma vitamin D status and its correlation with risk factors of thrombosis, P-selectin and hs-CRP level in patients with venous thromboembolism; the first study of iranian population

Low plasma level of vitamin D is linked to the increased risk of cardiovascular diseases such as hypertension, diabetes, dyslipidemia and peripheral vascular diseases. Vitamin D deficiency is a worldwide problem that involves Iranian population. To the best of our knowledge, this was the first investigation on venous thromboembolism [VTE] subjects that assessed the correlation of vitamin D level with plasma P-selectin, hs-CRP, and risk factors of thrombosis. In this prospective study, patients with diagnosis of acute deep vein thrombosis and or pulmonary eboembolism were enrolled. All patients' clinical data, demographics and risk factors of thrombosis were evaluated. Plasma level of P-selectin and hs-CRP were measured by ELISA method. Radio immune assay method was used to determine plasma level of 25-hydroxy vitamin D. In this study, 60 subjects were included. The mean +/- SD plasma 25-hydroxy vitamin D level [25[OH] D] of participants was 21.4 +/- 14.6 ng/mL. The vitamin D deficiency was reported in 60% of patients. No significant relation was found between the plasma 25[OH]D level and P-selectin and hs-CRP. In multiple regression analysis, there was a significant relationship between the level of 25[OH]D and the patients' age [beta = 0.452; p = 0.001], diabetes [beta = 0.280; p = 0.036] and positive family history of cardiovascular diseases [beta = 0.373; p = 0.003]. Vitamin D deficiency is a frequent problem in Iranian VTE patients. Moreover, Plasma level of vitamin D is not associated with increase level of P-selectin and hs-CRP in VTE patients

Effect of enhanced external counterpulsation [EECP] on exercise time duration and functional capacity in patients with refractory angina pectoris

Enhanced external counterpulsation [EECP] is a noninvasive technique used for patients with refractory angina pectoris. There are controversial data on the effectiveness of EECP in improving patients with refractory stable angina. The aim of the present study was to evaluate the effectiveness and safety of EECP for the treatment of patients with refractory angina pectoris. Twenty consecutive patients with refractory angina pectoris were treated with EECP, and their symptoms, echocardiographic measures, treadmill exercise test parameters, and Canadian Cardiovascular Society Class were evaluated before and immediately after EECP. The patients were followed up for 6months post treatment. There were significant differences regarding total exercise time before and after treatment [p value < 0.001]. The patients showed a significant reduction in angina classes III and IV immediately after EECP [p value < 0.001]; for most of the patients, these beneficial effects were sustained for 6 months [p value = 0.010]. There was no significant improvement in the echocardiographic parameters. EECP decreased symptoms and increased total exercise time in our study population. These beneficial effects were sustained for 6 months

Comparison of benefits from cardiac resynchronization therapy between patients with ischemic Cardiomyopathy and patients with idiopathic dilated cardiomyopathy

Cardiac resynchronization therapy [CRT] is an effective treatment for patients with moderate to severe heart failure. However, 20-30% of patients remain non-responders to CRT. We sought to identify which patients benefit the most from CRT in regard to the etiology of heart failure. Eighty-three consecutive patients [62 men] who had a biventricular pacemaker inserted at Tehran Heart Center between May 2004 and March 2007 were evaluated retrospectively. The inclusion criteria were comprised of New York Heart Association [NYHA] class III or IV, left ventricular ejection fraction<35%, and QRS>120ms. After 6 months, response was defined as being alive, no hospitalization for cardiac decompensation, and an improvement in NYHA class>1 grade. After 6 months, 60 patients out of the 83 patients were responders. Amongst the 83 patients, 48 had ischemic cardiomyopathy and 35 had non-ischemic cardiomyopathy. A cross-tabulation of response versus etiology showed no significant difference between ischemic versus non-ischemic cardiomyopathy with regard to response to CRT [P=0.322]. According to our study, there was no difference in response to CRT between ischemic versus non-ischemic cardiomyopathy at six months' follow-up