The effect of cardiac rehabilitation on ApoA1 and ApoB in men with coronary heart disease [CHD] after coronary artery bypass graft [CABG]

Background: Cardiac rehabilitation is a branch of rehabilitation medicine dealing with optimizing physical function in patients with atherosclerosis after coronary artery bypass graft [CABG]. The aim of this study was to investigate the effects of a period of cardiac rehabilitation on serum levels of apo-A1 and apo-B in middle aged men with myocardial infarction after CABG

Materials and methods: Subjects were selected among middle aged men [50 to 60 years old] with CABG and assigned into two groups of control [n=10] and experimental [n=10]. In experimental group, aerobic exercises [treadmill, cycle and hand ergometer] with the intensity of 11 to 13 on the [basis of burg scale] were performed during eight weeks under control of physician. Before and after the trainings, serum levels of ApoA1 and ApoB were measured by ELISA method

Results: Analysis of data using paired samples T test showed no changes in weight, BMI, levels of apo-A1 and apo-B and apo-B to apo-A1 ratio in control group [P>0.05], but in experimental group weight, BMI, apo-B and apo-B to apo-A1 ratio significantly decreased and apo-A1 increased [P<0.05]. On the basis of independent T-test results, changes of weight, BMI and ApoA1 were significantly differed between two groups [P<0.05]

Conclusion: Eight weeks cardiac rehabilitation, through reduction of apo-A1 and apo-B, can be effective in prevention of recurrent myocardial infarction and morbidity and mortality in middle aged men after CABG

Carotid artery stenosis and coronary artery disease coincidence

Cerebrovascular event is one of the important causes of death in the world. Carotid artery stenosis is one of main risk factors of cerebrovascular events. Risk factors for atherosclerosis are found in carotid artery stenosis. Thus, coincidence of coronary artery disease and carotid artery stenosis were observed. In an individual with high risk of coronary artery plaque formation, peripheral artery stenosis is imaginable. Histological morphology and plaque formation in coronary artery disease and carotid artery stenosis are similar and they occur together most of the time. Although many similar findings were shown in coronary artery disease and carotid artery stenosis, carotid artery stenosis is associated with more severe stenosis compare with coronary artery disease. Carotid artery stenosis does not have exact similar biological activity with coronary artery disease. Some invasive and non-invasive diagnostic methods are established for carotid artery stenosis detection. Same medical and surgical treatment techniques could be used for carotid artery stenosis management that vary due to patient-to-patient specific conditions

Peripheral arterial stenosis and coronary artery disease coincidence

Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease [CAD] is the cause of nearly half [48%] of the deaths and, loss of productivity life. Peripheral arterial disease [PAD] is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index [ABI], duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient's situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease

Two-dimentional speckle tracking strain imaging in the assessment of myocardial diastolic function in patients with stable angina pectoris

Introduction: Ischemic heart disease is caused mainly by obstruction of coronary arteries. The ischemic assessment through echocardiography is dependent on wall motion abnormality detection during systole. In patients with ischemic heart disease the diastolic function is impaired before systolic function and measurement of regional diastolic dysfunction if possible will be most sensitive for assessment of obstructed coronary artery region. This study was designed to determine whether regional left ventricular delayed relaxation diagnosis could be detected with strain imaging derived from two-dimensional speckle-tracking echocardiography in patients with coronary artery disease

Methods: All the articles reviewed were obtained using MEDLINE and ScienceDirect [up to October 2014]. All data extracted by speckle tracking echocardiography. The index which is used is strain imaging diastolic index which is calculated as: [A-B] A×100 . A is the amount of strain at the time Aortic value closure and B is the amount of strain in first one-third point of diastolic duration

Results: Four articles were reviewed. Three articles assessed patients with echocardiography at rest and one with stress echocardiography. All articles showed the coronary artery tracking with significant stenosis is possible by regional deformation analysis through two-dimensional strain

Discussion: The usage of strain images obtained through two-dimensional speckle tracking has been validated for the quantitation assessment of regional dysfunction in ischemic heart disease. Regional LV delayed relaxation diagnosis with strain imaging is a reliable method after treadmill stress test

Conclusion: Strain imaging is reasonable for evaluation of ischemia as a low cost noninvasive test with high accuracy

Coronary artery disease in patients with chronic kidney disease: a brief literature review

Cardiovascular is the major cause of death in chronic kidney disease and end-stage renal disease. The cardiovascular mortality rate of patients with renal impairment is evaluated to be higher than general population. Coronary artery disease seems to be an important type of cardiovascular complication among patients with chronic kidney disease and end-stage renal disease before the renal replacement therapy. Due to the strong association between chronic kidney disease and the incidence of coronary artery disease, accurate screening, diagnosis, and management of cardiovascular complications would be essential in patients at different stages of renal dysfunction. Despite the need for the comprehensive knowledge about different aspects of coronary artery disease in patients with renal failure, there is not sufficient evidence regarding the pathophysiology, ideal diagnosis, and treatment strategies for coronary heart disease in population with chronic kidney disease. In this study, we briefly reviewed the existing literatures about the possible screening, diagnosis, and the treatment approaches of risk of coronary heart disease in patients with kidney dysfunction

Effects of 8 weeks of aerobic exercise on matrix metalloproteinase-9 and tissue inhibitor levels in type II diabetic women

Increased vascular stiffness is a marker of atherosclerosis, which is diagnosed in the early stages of diabetes II. Matrix metalloproteinases [MMPs] and their tissue inhibitors [TIMPs] are a family of proteolytic enzymes necessary for structure and function of great vessels. This study examined the effects of 8 weeks of aerobic exercise on MMP9 and TIMP-1 levels in type II diabetic women. This is a quasi-experimental study which included 20 in type II diabetic women with mean age of 53.2 +/- 2.5 years, body mass index [BMI] of 28.73 +/- 2.27 and fat percentage of 30.6 +/- 2.05, who were randomly divided into two groups: aerobic exercise group [8 weeks, 3 sessions per week for 50 minutes] and control group. To examine changes in MMP[9] and TIMP-1, 5 ml of blood was taken from the brachial vein of patients before and 48 hours after completion of exercise period and after 12 hours of fasting at rest. Data analysis was performed using SPSS-16 software with the independent and paired t-tests. A significant decrease was observed in body mass index and body fat percentage in the experimental group [p<0.05]. Compared with the control group, the aerobic exercise group showed a significant decrease in MMP[9] [p=0.01] and a significant increase in TIMP-1 levels [p=0.02] after 8 weeks of aerobic exercise. The results showed that aerobic exercise as a stimulus can change the levels of matrix metalloproteinases and their tissue inhibitors in order to prevent cardiovascular diseases in diabetics

[Evaluation of relationship between serum hs CRP and pulmonary hypertension in chronic obstructive pulmonary disease]

COPD is a common pulmonary disease. One of the inflammatory factors in COPD is CRP which has a pathogenic role in pulmonary hypertension; therefore, our aim was to investigate the relationship between the level of serum CRP and pulmonary hypertension in COPD Patients. This prospective study was done from 2007 to 2008 in patients of pulmonary ward. Initially, COPD was confirmed in patients; and active infections, collagen vascular disease, heart disease, cancers and other diseases were ruled out. Mean pulmonary pressure was measured by echocardiography. Quantitative serum CRP was measured and compared with pulmonary hypertension. From fifty five patients, forty were male and fifteen were female. Mean age was 63.67 year with SD of 9.94 years. According to the Gold Criteria, twenty-eight males and seven females had severe and very severe disease. Thirty-three males and thirteen females had mild pulmonary hypertension. Mean level of FEV[1] percentage was 38.2 with SD of 17.39. Between the level of FEV[1] percentage and hs CRP was seen an inverse linear correlation. Between quantitative serum CRP and mean pulmonary pressure a frank direct linear correlation was seen. CRP induces pulmonary hypertension in COPD and measurement of serum hs CRP for estimating severity of pulmonary hypertension is useful, cost efficient, easy and available

Repair of atrial septal defect through a right anterolateral thoracotomy: a cosmetic and safe approach

The operation for atrial septal defect [ASD] is considered a low risk procedure: the cosmetic result has become an important feature. For this reason the anterolateral thoracotomy is frequently used for closure of ASD. However, difficulty in aortic and caval cannulations to establish cardiopulmonary bypass [CPB] makes it rather awkward for some surgeons. We reviewed the short term results of a consecutive series of 17 patients in whom the atrial defect was closed through a right anterolateral thoracotomy. The average cardiopulmonary bypass time was 36 minutes [range 22 to 53 minutes], with mean cross clamp time of 21 minutes [range 12 to 44 minutes]. There was no preoperative or late mortality. The majority of patients are pleased with their cosmetic results. There were no other late complications. The mean age at operation was 27 years [range 4 to 53 years], and the mean body weight was 51 kg [range 14 to 155 kg]. all the repaired defects were second type ASD. Atrial septal defect can be safety repaired through a right anterior thoracotomy approach, with cosmetic results of avoiding median sternotomy