Correlation between blood levels of adhesion molecules ICAM-1 and VCAM-1 and thrombomodulin with coronary artery disease

The results of studies on coronary artery disease risk factors have demonstrated that some adhesion molecules could be risk factors for coronary artery disease. ICAM-1 and VACM-1 are the most important adhesion molecules. On the other hand, thrombomodulin is an anti-inflammatory factor and can reduce the risk for coronary artery disease. In this study, as well as evaluating these factors, we also studies the effect of the interaction between these factors on coronary artery disease. One hundred twenty-three patients between the ages of 45 and 70 years old who were admitted for coronary angiography in the cardiovascular center and met the inclusion criteria for the research, were selected in the first half of 2008. After recording their personal information and medical history in the questionnaires, blood samples were collected and after routine examination, the blood levels of these factors were measured. WE then entered the acquired results of the blood examination and the angiography in the patients' charts and analyzed the results using statistical methods. The angiography results in patient showed that 18 [14.7%] had normal coronary arteries, 5 [4%] had minimal coronary artery disease, 40 [32.5%] had single-vessel disease, 25 [20.3%] had two-vessel disease, and 35 [28.5%] had three-vessel disease. In laboratory tests, the mean soluble ICAM-1 level in patients with normal coronary arteries was 236 ngr/mL; however, in patients with coronary artery disease, the mean level was 274 ngr/mL. The average amount of VCAM-1 in patients with normal coronary arteries was 697 ngr/mL, whereas patients with coronary artery disase had an average of 108 ngr/mL. Thrombomodulin in the normal coronary artery group was 42 ngr/mL, but in patients with coronary artery disease the average level was 30 ngr/mL. The results in this research showed that increased levels of soluble ICAM-1 and also decreased levels of soluble thrombomodulin increased the risk and intensity of coronary artery disease, with statistical significance. The increase in soluble VCMA-1 also increased the risk of coronary artery disease; this was, however, not statistically significant. The important point is that increased levels of soluble ICAM-1 is a risk factor when the level of thrombomodulin is normal or below normal. When the levels of thrombomodulin and ICAM-1 have both increased, the increased risk and intensity of coronary disease is not statistically important

Prognostic value of serum B-Type natriuretic peptide in early mortality and morbidity of children with congenital heart disease after open heart surgery

Brain type natriuretic peptide [BNP] is a cardiac hormone that is secreted mainly by the ventricles in response to volume expansion and pressure load. It can predict post-operative complications after heart surgery in adults. We sought to investigate the prognostic value of BNP in children after heart surgery. We measured the BNP serum levels in 96 children with congenital heart diseases before, immediately after, and 12 hours after open heart surgery. We studied the ability of the post-operative BNP serum level variations to predict mortality and morbidity in children. In total, 96 patients, comprising 40 [41.7%] females and 56 [58.3%] males with a mean age of 4.1 years [range: 1 month to 17 years], with various congenital heart diseases were studied. The rise in the serum BNP level 12 hours post surgery was directly related to mortality before discharge from hospital [P value=0.004], congestive heart failure after surgery [P value<0.001], patients' cyanosis [P value=0.045], duration of ICU stay [r=0.342, P value=0.004], and post-operative need for inotropic drugs [P value<0.001]. The rise in the BNP serum level 12 hours after heart surgery is a good marker for predicting mortality, morbidity, and early diagnosis of heart failure in children

Correlation between blood levels of CRP, TNT-alpha [as inflammatory factors], and IL-10 [as anti-inflammatory factor] and coronary artery disease

The results of a great amount of research done the world over in recent years have indicated that atherosclerosis is an inflammatory disease. Most of these investigations were conducted on the correlation between inflammatory factors such as CRP, Il- and Il-1 and atherosclerosis. In this study, we evaluated inflammatory factors such as CRP and TNF-alpha as well as anti-inflammatory factor IL-10 and analyzed the correlation between the balance of these factors with atherosclerosis. In total, 135 patients between the ages of 45 and 70 years who were admitted for coronary angiography were selected. All of the selected patients met the inclusion criteria for the research. After recording personal information, medical history, and any previous treatment in the questionnaire, blood samples were collected and levels of CRP [high-sensitive quantitative test], TNF-alpha, and IL-10 were measured in all the samples. We entered the acquired results, the routine blood examination, and the angiography results in the patients' charts and analyzed the results using statistical methods. The angiography results in the 135 patients were as follows: 19 [14.1%] cases had normal coronary arteries, 6 [4.4%] had minimal CAD, 43 [31.8%] had single-vessel disease, 29 [21.5%] two-vessel, and 38 [28.1] had three-vessel disease. In the laboratory tests, the mean CRP level in patients with normal coronary arteries was 6 +/- 4 mg/l, however in patients with CAD it was 17 +/- 9 mg/l. Also, the mean IL=10 level in cases with normal coronary arteries was 4.4 pgr/mL, while in patients with CAD it was 2.6 pgr/mL, and serum level of TNF-alpha in patients with CAD was 6.2 +/- 3.8 pgr/mL, whereas in cases with normal coronary arteries, the average serum level of TNF-alpha was 4.5 +/- 2.2 pgr/mL. The obtained results in this research showed a direct correlation between the blood levels of CRP and TNF-alpha with the existence and intensity of coronary artery disease. In addition, we found a reverse significant correlation between blood levels of IL-10 and existence of coronary artery disease. Although we found a correlation between reduced levels of IL-10 and intensity of coronary artery disease, it was not statistically significant. Furthermore, in patients with elevated blood levels of inflammatory and antiinflammatory factors, the intensity of the coronary artery disease was far less than that in patients with high levels of inflammatory factors and reduced levels of antiinflammatory factors. Therefore, we concluded that high levels of CRP and TNF-alpha and low levels of IL-10 had a significant correlation with the intensity of coronary artery disease and also the balance between these factors had a significant correlation with the intensity of the coronary artery disease

Correlation of post-operative hypoalbuminemia with outcome of pediatric cardiac surgery

Hypoalbuminemia may be caused by liver disease, nephrotic syndrome, burns, protein-losing entropathy, malnutrition, and metabolic stress. Alterations in albumin in metabolic stress such as cardiac surgery have been previously investigated. We studied serum albumin concentration in children with congenital heart disease and also the association of hypoalbuminemia with mortality and morbidity after pediatric cardiac surgery. We measured serum albumin concentration prospectively in 300 children with congenital heart disease who underwent surgery between July and September 2008 in Shaheed Rajaee hospital. Serum albumin concentration was measured before and 48 hours after cardiac surgery and was subsequently compared between 2 groups: cyanotic and acyanotic and also with normal values. Serum albumin concentration decreased on the second post-operative day in 70 [23.3%] patients. There was a positive correlation between the post-surgical hypoalbuminemia and cyanotic heart disease. The cyanotic children had lower serum albumin concentration Thant the acyanotic ones [P value < 0.001]. There was a significant association between post-operative serum albumin concentration and acute renal failure [P value < 0.001] and death [P value < 0.001]. Drop in serum albumin concentration was more prominent in the males than in the females [P value= 0.038] and in the cyanotic patients than in the acyanotic ones [P value < 0.001] as well as in those with acute renal failure [P value < 0.001], pericardial effusion [P value= 0.050], seizure [P value < 0.001], and death [P value < 0.001]. Hypoalbuminemia was not associated with longer hospital [P value = 0.142] or intensive care unit stay [P value = 0.199]. Post-operative serum albumin concentration was lower in the cyanotic children and male patients in our study. In addition, the post-operative decrease in albumin was associated with an increased risk of pericardial effusion, renal failure, seizure, and death.

Investigation of polymorphisms in non-coding region of human mitochondrial DNA in 31 Iranian hypertrophic cardiomyopathy [HCM] patients

The D-loop region is a hot spot for mitochondrial DNA [mtDNA] alterations, containing two hypervariable segments, HVS-I and HVS-II. In order to identify polymorphic sites and potential genetic background accounting for Hypertrophic CardioMyopathy [HCM] disease, the complete non-coding region of mtDNA from 31 unrelated HCM patients and 45 normal controls were sequenced. The sequences were aligned upon the revised Cambridge Reference Sequence [rCRS] and any incompatibilities were recorded as numerical changes in homoPolymeric C Tract [PCT], single base substitutions, insertions and deletions [Indels]. Nucleotide substitutions were found to make up the majority of the mutations, rather than indels. We drew significantly high transition rate [81.8%] versus lower frequency of transversions [18.2%]. 12 polymorphisms were identified in this study which had not been published in the MitoMap database. PCT changes at position 303-309 were detected in 83% of our samples. Our results suggest that an increased level of HVS-I and HVS-II substitutions may be an indicator of mitochondrial DNA instability. Furthermore, mtDNA mutations may play an important role in pathogenesis of cardiac arrest which has remained unexplained for long