Does multi-parity affect the size of the ascending thoracic aorta in women: a prospective cohort study.

OBJECTIVE: Aortic dissection is an uncommon and potentially fatal complication of pregnancy; however, the association of the number of pregnancies with the indexed and absolute size of the ascending aorta in patients without aortic aneurysm or connective tissue disorders is not well elucidated. RESEARCH DESIGN AND METHODS: In this prospective observational study, women aged 18-80 years old undergoing transesophageal echocardiography in a university-affiliated echocardiography laboratory between 1 January 2015 and 1 September 2015 were enrolled. Indexed and absolute sizes of ascending aorta at the levels of annulus, root, sinotubular junction (STJ), proximal and arch were measured. Patients were grouped according to their gravida number into three classes (class I: ≤3, class II: 4-7, class III: ≥7). RESULTS: Of 653 screened patients, 437 women were included (38.9% gravida class I, 44.3% gravida class II and 16.7% gravida class III). In univariate analysis, the number of pregnancies correlated with indexed diameters of the root (p < .001), STJ (p < .001) and the proximal ascending aorta (p < .001). Meanwhile, the number of pregnancies neither correlated with the annular diameter nor with the arch (p = .070 and p = .154, respectively). In multivariate analyses, the gravida class was among the independent predictors of the root size along with age, aortic insufficiency and the presence of congestive heart failure. CONCLUSION: Gravida class was an independent predictor of aortic size at levels of the root, STJ and the proximal ascending aorta. The largest increase was observed at the level of the aortic root.

Air pollution and admissions due to ST elevation myocardial infarction-a time-series study from northwest of Iran.

We investigated the association between the levels of air pollutants and the number of daily admissions due to ST segment elevation myocardial infarction (STEMI) in a metropolitan in the northwest of Iran. Daily concentrations of common air pollutants were obtained for the greater city of Tabriz for a period of 2 years. These reports included sulfur dioxide (SO2), nitrogen dioxide (NO2), nitric oxide (NO), nitrogen byproducts (NOx), carbon monoxide (CO), ozone (O3), and particulate matters < 10 µm (PM10). The census of admissions for STEMI was retrieved for the same period from hospital registries. The association of daily variations in air pollutant levels and the daily number of STEMI admissions were investigated in a time-series analysis. In the multi-pollutant model adjusting for long-term trend, seasonality, and temperature, a significant association was found for 1-h [NO2] and 24-h [CO]. A marginally significant association was observed for 24-h [NO2] and 8-h [CO]. The 24-h [CO] had the strongest association with the number of admissions with STEMI. Maximum 1-h concentrations of NO2 on the same day and on the prior day as well as 24-h concentrations of CO on the prior day were independently associated with increased number of STEMI admissions. However, daily concentrations of SO2, NO, O3, and PM10 were not associated with the frequency of hospital admissions for STEMI.

Association of serum uric acid level with mortality and morbidity of patients with acute ST-elevation myocardial infarction.

INTRODUCTION: Investigating the clinical impact of serum uric acid (UA) and its lowering agents on the complications and mortality of acute ST-elevation myocardial infarction (STEMI) can open a new era in STEMI treatment. The aim of this study was to evaluate the effect of on admission serum UA level on the mortality and morbidity of patients admitted with STEMI. METHODS: A number of 608 patients with STEMI were enrolled in this study from December 21, 2012 until February 19, 2014. Patients were followed for 20 months. Male to female ratio was 2.53, and the mean age of patients was 62.6±13.4. The relationship between the level of UA and patients' mortality and morbidity, left ventricular ejection fraction (LVEF), atrial and ventricular arrhythmia was analyzed. RESULTS: Patients with high serum UA level had higher Killip class after STEMI (P=0.001). Mean LVEF was measured to be 39.5±9.6 in normal UA group and 34.6±11.6 in high UA group (P=0.001). In comparison with normal UA group, high UA group had significantly higher cTnI (2.68±0.09 vs 4.09±0.42, respectively, P=0.001), increased blood pressure (P=0.009), and higher atrial fibrillation (AF) occurrence (P=0.03), but no association was seen between ventricular tachycardia and serum UA level. Short term and midterm mortality were not different in two groups (P=0.44 and 0.31, respectively). CONCLUSION: In the current study, high serum UA level in patients with acute myocardial infarction (MI) was not associated with higher in-hospital or midterm mortality, but it was associated with lower LVEF, higher Killip class, elevated cTnI, creatinine, triglyceride, and higher AF.