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Goodarzynejad H, Sheikh Fathollahi M, Shafiee A. Editorial: The role of sex in coronary artery disease. Front Cardiovasc Med 2023; 10:1220439. [PMID: 37332593 PMCID: PMC10275334 DOI: 10.3389/fcvm.2023.1220439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Affiliation(s)
- Hamidreza Goodarzynejad
- Family Medicine Teaching Unit, North York General Hospital, Toronto, Canada
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Sheikh Fathollahi
- Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Sotoudeh Anvari M, Vasei H, Najmabadi H, Badv RS, Golipour A, Mohammadi-Yeganeh S, Salehi S, Mohamadi M, Goodarzynejad H, Mowla SJ. Identification of microRNAs associated with human fragile X syndrome using next-generation sequencing. Sci Rep 2022; 12:5011. [PMID: 35322102 PMCID: PMC8943156 DOI: 10.1038/s41598-022-08916-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Abstract
Fragile X syndrome (FXS) is caused by a mutation in the FMR1 gene which can lead to a loss or shortage of the FMR1 protein. This protein interacts with specific miRNAs and can cause a range of neurological disorders. Therefore, miRNAs could act as a novel class of biomarkers for common CNS diseases. This study aimed to test this theory by exploring the expression profiles of various miRNAs in Iranian using deep sequencing-based technologies and validating the miRNAs affecting the expression of the FMR1 gene. Blood samples were taken from 15 patients with FXS (9 males, 6 females) and 12 controls. 25 miRNAs were differentially expressed in individuals with FXS compared to controls. Levels of 9 miRNAs were found to be significantly changed (3 upregulated and 6 downregulated). In Patients, the levels of hsa-miR-532-5p, hsa-miR-652-3p and hsa-miR-4797-3p were significantly upregulated while levels of hsa-miR-191-5p, hsa-miR-181-5p, hsa-miR-26a-5p, hsa-miR-30e-5p, hsa-miR-186-5p, and hsa-miR-4797-5p exhibited significant downregulation; and these dysregulations were confirmed by RT-qPCR. This study presents among the first evidence of altered miRNA expression in blood samples from patients with FXS, which could be used for diagnostic, prognostic, and treatment purposes. Larger studies are required to confirm these preliminary results.
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Affiliation(s)
- Maryam Sotoudeh Anvari
- Department of Molecular Pathology, School of Medicine, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hamed Vasei
- Department of Mathematical Science, Sharif University of Technology, Tehran, Iran
| | - Hossein Najmabadi
- Department of Genetics, School of Rehabilitation Sciences, Genetic Research Center, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Department of Pediatrics, School of Medicine, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Golipour
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Samira Mohammadi-Yeganeh
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeede Salehi
- Cell-Based Therapies Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Mohamadi
- Department of Pediatrics, School of Medicine, Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Goodarzynejad
- Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Javad Mowla
- Department of Molecular Genetics, Faculty of Biological Science, Tarbiat Modares University, Tehran, Iran.
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Goodarzynejad H, Meaney C, Brauer P, Greiver M, Moineddin R, Monavvari AA. Recent trends in adult body mass index and prevalence of excess weight: Data from the Canadian Primary Care Sentinel Surveillance Network. Can Fam Physician 2022; 68:128-138. [PMID: 35177505 PMCID: PMC9842178 DOI: 10.46747/cfp.6802128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To explore recent body mass index (BMI) trends over time among Canadian adults seen in primary care to identify the best target groups for preventive interventions. DESIGN Retrospective descriptive cohort design. SETTING Data for this study were derived from the Canadian Primary Care Sentinel Surveillance Network database. PARTICIPANTS All patients aged 18 years and older who had BMI measurements available between 2011 and 2016 were identified. A closed cohort (N = 243 078 unique patients) with a start date of January 1, 2011, was defined. Patients were excluded if key variables were missing or if BMI measurements were 15 kg/m2 or less or 50 kg/m2 or greater. MAIN OUTCOME MEASURES The dependent variable for this study was BMI (kg/m2). Measured BMI values recorded in electronic medical records were used. A linear mixed-effect estimate was fit to model changes in BMI over time with control of baseline age and sex. RESULTS Patients in the Canadian Primary Care Sentinel Surveillance Network database experienced a modest increase in mean (95% CI) BMI by 2.1% from 28.5 (28.4 to 28.6) kg/m2 in 2011 to 29.1 (28.9 to 29.2) kg/m2 in 2016 (P < .0001). This increase is not a measured difference in BMI in the same individual but reflects the difference in the average BMI of the population in 2011 versus 2016. Male patients had BMI values that were on average 1.02 kg/m2 higher than those of female patients (P < .0001). Mean BMI values increased most rapidly in young adults (18 to 34 years) compared with older adults. CONCLUSION The findings indicate that current obesity management in primary care is failing to moderate weight trajectories in different groups by age and sex. The results also suggest that younger age groups, in whom accelerated weight gain occurred, should be the target of prevention initiatives.
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Affiliation(s)
- Hamidreza Goodarzynejad
- Clinical researcher in the Department of Clinical and Experimental Research in the Tehran Heart Center at Tehran University of Medical Sciences in Iran
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4
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Mortazavi SH, Oraii A, Goodarzynejad H, Bina P, Jalali A, Ahmadi Tafti SH, Bagheri J, Sadeghian S. Utility of the CHA 2DS 2-VASc Score in Prediction of Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Surgery. J Cardiothorac Vasc Anesth 2021; 36:1304-1309. [PMID: 34384685 DOI: 10.1053/j.jvca.2021.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/28/2021] [Accepted: 07/11/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The authors aimed to investigate the role of CHA2DS2-VASc score and its components in prediction of postoperative atrial fibrillation (POAF) after isolated coronary artery bypass graft (CABG) surgery. DESIGN Retrospective cohort. SETTING Single-center university-affiliated tertiary cardiac center. PARTICIPANTS A total of 2,981 consecutive patients who underwent isolated CABG between 2010 and 2012 were included. INTERVENTIONS All patients underwent isolated CABG and were followed until discharge or in-hospital death. The primary outcome was the development of new-onset POAF during the hospital course. MEASUREMENTS AND MAIN RESULTS During hospitalization, continuous electrocardiogram monitoring was used to detect POAF episodes. New-onset POAF developed in 15.8% of patients following isolated CABG. Patients with POAF had significantly higher CHA2DS2-VASc scores than those without POAF (2.66 ± 1.51 v 2.12 ± 1.36, p < 0.001). After adjustment for potential confounders, CHA2DS2-VASc score was significantly associated with POAF (odds ratio [OR]: 1.295, 95% CI: 1.205-1.391). However, further analyses showed that this effect was restricted to patients with a CHA2DS2-VASc score of ≥2 (OR: 1.813, 95% CI: 1.220-2.694). In multivariate analysis of the CHA2DS2-VASc components, age ≥75 (OR: 3.737, 95% CI: 2.702-5.168), age 65 to 74 (OR: 2.126, 1.701-2.658), hypertension (OR: 1.310, 95% CI: 1.051-1.633), and cerebrovascular accident (OR: 1.807, 95% CI: 1.197-2.726) were independent predictors of POAF. However, the association between POAF and female sex, diabetes mellitus, congestive heart failure, and vascular disease was not statistically significant. CONCLUSIONS CHA2DS2-VASc score is a useful tool for the prediction of POAF after isolated CABG. However, the risk should be interpreted cautiously, since the risk score's promising effect relies on only several of its components.
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Affiliation(s)
| | - Alireza Oraii
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Peyvand Bina
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Jamshid Bagheri
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Sadeghian
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Pourgholi L, Pourgholi F, Ziaee S, Goodarzynejad H, Hosseindokht M, Boroumand M, Mandegary A. The association between CYBA gene C242T variant and risk of metabolic syndrome. Eur J Clin Invest 2020; 50:e13275. [PMID: 32406080 DOI: 10.1111/eci.13275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 04/30/2020] [Accepted: 05/09/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Both inflammation and oxidative stress may contribute to pathogenesis of metabolic syndrome (MetS). The C242T polymorphism (rs4673) in the CYBA gene, as the main components of NAD (P) H oxidase, causes inter-individual variability in the enzyme activity. We aimed to investigate the association between this polymorphism with MetS and its components. METHODS Two hundred nine patients with MetS and 232 controls were included in this study. MetS was defined based on NCEP ATP-III A criteria with some modifications. The C242T polymorphism within CYBA gene was determined by using PCR-based restriction fragment length polymorphism (PCR-RFLP) method. RESULTS After applying a multiple logistic regression model with adjusting for potential confounders of MetS including, age, sex, body mass index, hypertension, used medications, and diabetes mellitus, C242T polymorphism was found to be associated with the presence of MetS in men but not in the total population or in women. T allele as compared to C allele was associated with decreased odds of MetS in men (adjusted OR = 0.42, 95% CI = 0.24-0.74; P = .003), but not in women (adjusted OR = 1.03, 95% CI = 0.07-1.61; P = .890), or in the total population (adjusted OR = 0.72, 95% CI = 0.51-1.02; P = .063). CONCLUSION This study shows that T allele of C242T polymorphism in CYBA gene is protective against MetS in Iranian men but not in women. Further cohort studies with larger sample size in subgroups of men and women are required to confirm such association in other racial or ethnic group.
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Affiliation(s)
- Leyla Pourgholi
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pharmacology & Toxicology, School of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Pourgholi
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayan Ziaee
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Hosseindokht
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadali Boroumand
- Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mandegary
- Department of Pharmacology & Toxicology, School of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran.,Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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Pourgholi L, Goodarzynejad H, Ziaee S, Zare E, Jalali A, Boroumand M. Prothrombin Gene G20210A Variant in Angiographically Documented Patients with Coronary Artery Stenosis. J Tehran Heart Cent 2019; 14:150-155. [PMID: 32461754 PMCID: PMC7231676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Studies on the association between the prothrombin G20210A variant and coronary artery disease (CAD) risk are inconclusive. This study aimed to investigate the possible association between the G20210A variant in the prothrombin gene and documented CAD and its severity. Methods: This study enrolled 1460 patients who were consecutively admitted for elective coronary angiography. Via the standard angiographic techniques, coronary angiographies were done and the presence and severity of CAD were determined through the clinical vessel score and the Gensini score. Prothrombin G20210A genotypes were identified using PCR-RFLP. Results: This cross-sectional study was performed on 953 men and 507 women at a mean age of 58.21±10.33 years. The median and the interquartile range for the Gensini score were not statistically significantly different between the wild (GG) and mutant (AA+GA) genotypes (P=0.440). The association between the G20210A polymorphism and the severity of CAD with respect to the vessel score also showed no significant linear trend of higher numbers of diseased vessels (P= 0.765 for the Mantel-Haenszel test of linear trend) in the AA+GA genotype as compared with the GG genotype. Conclusion: Our data failed to confirm the hypothesis that the G20210A variant mutation may be a significant determinant of CAD risk or its severity.
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Affiliation(s)
- Leyla Pourgholi
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shayan Ziaee
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Elmira Zare
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arash Jalali
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammadali Boroumand
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Mohammadali Boroumand, Professor of Pathology, Pathology Department, Tehran Heart Center, North Kargar Street,Tehran, Iran. 1411713138. Tel: +98 21 88029256. Fax: +98 21 88029256.E-mail: .
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Abstract
The Human Genome Project (HGP), as the primary sequencing of the human genome, lasted more than one decade to be completed using the traditional Sanger's method. At present, next-generation sequencing (NGS) technology could provide the genome sequence data in hours. NGS has also decreased the expense of sequencing; therefore, nowadays it is possible to carry out both whole-genome (WGS) and whole-exome sequencing (WES) for the variations detection in patients with rare genetic diseases as well as complex disorders such as common cardiovascular diseases (CVDs). Finding new variants may contribute to establishing a risk profile for the pathology process of diseases. Here, recent applications of NGS in cardiovascular medicine are discussed; both Mendelian disorders of the cardiovascular system and complex genetic CVDs including inherited cardiomyopathy, channelopathies, stroke, coronary artery disease (CAD) and are considered. We also state some future use of NGS in clinical practice for increasing our information about the CVDs genetics and the limitations of this new technology. Key messages Traditional Sanger's method was the mainstay for Human Genome Project (HGP); Sanger sequencing has high fidelity but is slow and costly as compared to next generation methods. Within cardiovascular medicine, NGS has been shown to be successful in identifying novel causative mutations and in the diagnosis of Mendelian diseases which are caused by a single variant in a single gene. NGS has provided the opportunity to perform parallel analysis of a great number of genes in an unbiased approach (i.e. without knowing the underlying biological mechanism) which probably contribute to advance our knowledge regarding the pathology of complex diseases such as CVD.
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Affiliation(s)
- Samira Kalayinia
- a Cardiogenetic Research Laboratory , Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences , Tehran , Iran
| | | | - Majid Maleki
- a Cardiogenetic Research Laboratory , Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences , Tehran , Iran
| | - Nejat Mahdieh
- a Cardiogenetic Research Laboratory , Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences , Tehran , Iran
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Boroumand M, Pourgholi L, Goodarzynejad H, Ziaee S, Hajhosseini-Talasaz A, Sotoudeh-Anvari M, Mandegary A. NQO1 C609T Polymorphism is Associated with Coronary Artery Disease in a Gender-Dependent Manner. Cardiovasc Toxicol 2017; 17:35-41. [PMID: 26690082 DOI: 10.1007/s12012-015-9353-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Findings on the association of NQO1 C609T polymorphism in the NQO1 gene and cardiovascular disease susceptibility are controversial. The objective of the current study was to examine the relationship between this polymorphism and the presence and severity of angiographically determined coronary artery disease (CAD). One-hundred and forty-five patients with newly diagnosed angiographically documented CAD (≥50 % luminal stenosis of any coronary vessel) as case group were compared to 139 controls (subjects with no luminal stenosis at coronary arteries). The presence of C609T polymorphism was analyzed using polymerase chain reaction-based restriction fragment length polymorphism. Among total population, those with combined CT/TT (T allele carrier) genotype showed a trend toward lower odds of CAD compared to those with CC (wild type) genotype, but it did not reach a statistically significant level (p = 0.061). When data were analyzed separately for men or women, CT + TT group as compared to CC genotype was associated with decreased odds of CAD in women (adjusted OR 0.4, 95 % CI 0.2-0.9; p = 0.043), but not in men (adjusted OR 0.8, 95 % CI 0.3-1.9; p = 0.612). The C609T polymorphism within NQO1 is independently associated with CAD in women, but no association was observed in whole study population or in men.
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Affiliation(s)
- Mohammadali Boroumand
- Department of Clinical Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, P.O. Box 1411713138, Iran
| | - Leyla Pourgholi
- Department of Clinical Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, P.O. Box 1411713138, Iran.,Department of Pharmacology and Toxicology, School of Pharmacy, Kerman University of Medical Sciences, Kerman, P.O. Box 7616911319, Iran
| | - Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, P.O. Box 1411713138, Iran
| | - Shayan Ziaee
- Department of Clinical Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, P.O. Box 1411713138, Iran
| | - Azita Hajhosseini-Talasaz
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, P.O. Box 141556451, Iran
| | - Maryam Sotoudeh-Anvari
- Department of Clinical Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, P.O. Box 1411713138, Iran
| | - Ali Mandegary
- Department of Pharmacology and Toxicology, School of Pharmacy, Kerman University of Medical Sciences, Kerman, P.O. Box 7616911319, Iran. .,Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, P.O. Box 7616911319, Iran.
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Goodarzynejad H, Boroumand M, Behmanesh M, Ziaee S, Jalali A, Pourgholi L. Association between the Hepatic Lipase Promoter Region Polymorphism (-514 C/T) and the Presence and Severity of Premature Coronary Artery Disease. J Tehran Heart Cent 2017; 12:119-127. [PMID: 29062379 PMCID: PMC5643869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Hepatic lipase (HL) plays a crucial role in lipid metabolism, but there is debate about whether HL acts in a more pro- or more anti-atherogenic fashion. We aimed to examine the relationship between the -514 C/T polymorphism within the HL gene (LIPC) and the risk of angiographically determined premature coronary artery disease (CAD). Methods: Four hundred seventy-one patients with newly diagnosed angiographically documented (≥ 50% luminal stenosis of any coronary vessel) premature CAD were compared to 503 controls (subjects with no luminal stenosis in coronary arteries). A real-time polymerase chain reaction and high-resolution melting analysis was used to distinguish between the genotypes. Results: There was no significant difference in the distribution of -514 C/T genotypes between the 2 groups in the whole population or in the men, but the examined polymorphism was found to be associated with the presence of CAD in the women (p value = 0.029). After the application of a multiple logistic regression model, the minor T allele of the LIPC gene was not found to be independently associated with the presence of CAD either in the total population (adjusted OR = 0.97, 95% CI = 0.75-1.25; p value = 0.807) or in the women (adjusted OR = 0.91, 95% CI = 0.59-1.40; p value = 0.650) and in the men (adjusted OR = 1.15, 95% CI = 0.81-1.64; p value = 0.437) separately. Conclusion: Our findings suggest that there is no relationship between the LIPC -514 C/T and the risk of premature CAD or its severity in patients undergoing coronary angiography.
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Affiliation(s)
| | - Mohammadali Boroumand
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Mohammadali Boroumand, Professor of Clinical Pathology, Molecular Pathology Department, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029231. Fax: +98 21 88029262.E-mail: .
| | - Mehrdad Behmanesh
- School of Biological Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Shayan Ziaee
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Leyla Pourgholi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Anvari MS, Sabagh M, Goodarzynejad H, Ziaei S, Boroumand MA, Pourgholi L, Jenab Y, Abbasi K. Association between herpes simplex virus Types 1 and 2 with cardiac myxoma. Cardiovasc Pathol 2017; 27:31-34. [PMID: 28081512 DOI: 10.1016/j.carpath.2016.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/23/2016] [Accepted: 12/29/2016] [Indexed: 11/15/2022] Open
Abstract
Most cases of atrial myxoma are sporadic, and the exact etiology is unknown. We examined if herpes simplex virus (HSV)-1 and HSV-2 antigens and/or DNA could be detected in a cohort of Iranian patients with cardiac myxomas. From July 2004 to June 2014, among a total of 36,703 patients undergoing open heart surgeries, consecutive patients with cardiac myxoma who were treated by surgical excision at our center included in this study. Of 73 patients studied, 56% were female with a mean age of 54 years (ranging from 23 to 77 years). Seventy-four myxomas were surgically removed from 73 patients, since one patient had two myxomas which were located on both the right atrium and right ventricle. The materials for this analysis were retrospectively gathered from extracted tumors that stored in a pathology bank of tissue paraffin blocks. The formalin fixed paraffin embedded tissue samples were investigated for HSV genomic DNA by both immunohistochemistry (IHC) and polymerase chain reaction (PCR) analysis. In all 74 cases there was no presence of HSV 1 and HSV 2 infection. This suggests that HSV may not play a role in sporadic cardiac myxomas; however, evidence for such association is currently lacking, and further studies are required to determine such a role.
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Affiliation(s)
- Maryam Sotoudeh Anvari
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran..
| | - Moud Sabagh
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Goodarzynejad
- Department of Clinical and Experimental Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Ziaei
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Boroumand
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leyla Pourgholi
- Department of pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Jenab
- Department of cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kyomars Abbasi
- Department of cardiac surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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11
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Pourgholi F, Hajivalili M, Razavi R, Esmaeili S, Baradaran B, Movasaghpour AA, Sadreddini S, Goodarzynejad H, Mirshafiey A, Yousefi M. The Role of M2000 as an Anti-inflammatory Agent in Toll-Like Receptor 2/microRNA-155 Pathway. Avicenna J Med Biotechnol 2017; 9:8-12. [PMID: 28090274 PMCID: PMC5219823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND M2000 is a newly designed and safe Non-Steroidal Anti-Inflammatory Drug (NSAID). The aim of this study was to assess the effects of M2000 on expression levels of Suppressor of Cytokine Signaling-1 (SOCS-1) and Src Homology-2 domain-containing inositol-5'-phosphatase 1 (SHIP1) proteins via Toll-Like Receptor (TLR) 2/microRNA-155 pathway. METHODS HEK293 TLR2 cell line and Peripheral Blood Mononuclear Cells (PBMCs) were treated by different concentrations of M2000 in MTT assay. RNA was extracted by miRNeasy Mini kit. Then, cDNA was synthesized and the expression levels of SOCS1, SHIP1 and miRNA155 were evaluated by Quantitative Real time PCR. RESULTS Our results showed that M2000 significantly increased the expression levels of SOCS1 and SHIP-1 in Lipopolysachride (LPS)-treated and non-treated cells. Moreover, M2000 decreased expression level of miR-155 in LPS treated PBMCs. CONCLUSION M2000 can be used as NSAID in LPS induced inflammation and decrease inflammatory cytokines production by targeting SOCS1, SHIP1 and miR-155 in auto-immune and inflammatory diseases.
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Affiliation(s)
- Fatemeh Pourgholi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Hajivalili
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rasoul Razavi
- Department of Hematology and Blood Banking, Tarbiat Modares University, Tehran, Iran
| | - Shadi Esmaeili
- Department of Hematology and Blood Banking, Tarbiat Modares University, Tehran, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akbar Movasaghpour
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanam Sadreddini
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Abbas Mirshafiey
- Department of Immunology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yousefi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: Mehdi Yousefi, Ph.D., Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Tel: +98 41 33364665, Fax: +98 41 33364665 E-mail:
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12
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Bozorgi A, Mehrabi Nasab E, Khoshnevis M, Dogmehchi E, Hamze G, Goodarzynejad H. Red Cell Distribution Width and Severe Left Ventricular Dysfunction in Ischemic Heart Failure. Crit Pathw Cardiol 2016; 15:174-178. [PMID: 27846011 DOI: 10.1097/hpc.0000000000000094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The red cell distribution width (RDW), a simple and widely available marker, has been linked with an increased risk of adverse outcomes in patients with heart failure (HF) and risk of death, and cardiovascular events in those with previous myocardial infarction, but its relation with the severity of left ventricular (LV) dysfunction is not fully investigated. The aim of this study was to assess the prognostic value of the RDW in post myocardial infarction patients with typical signs and symptoms of HF and with reduced LV ejection fraction (EF). METHODS Patients (n = 350) came from an ongoing registry of consecutive patients who admitted for ischemic heart disease at our center. All patients were followed up 1 year after the initial hospitalization by telephone interviews. The outcomes studied were mortality and hospitalization because of decompensated HF. RESULTS RDW-coefficient of variation (express in percentage) was calculated from SD of mean corpuscular volume and mean corpuscular volume itself. Using logistic regression analysis, 3 variables consisting age, RDW level, and hemoglobin were identified as independent predictors of severe LV dysfunction (LVEF <30%). Levels of RDW were associated with the presence of severe LV dysfunction, with an accuracy of 61.4% (95% confidence interval: 56.2%-66.4%) and 66.9% (95% confidence interval: 61.8%-71.6%), using cut-off values of higher than 13.5 and 13.8, respectively. CONCLUSION Our results suggest that elevated RDW may be used as a prognostic tool among HF patients with the documented myocardial infarction because it is an inexpensive, rapidly calculated test that is already routinely in use in practice.
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Affiliation(s)
- Ali Bozorgi
- From the *Department of Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; †Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; ‡Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran; §Department of Emergency Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran; and ¶Department of Clinical and Basic Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Sotoudeh Anvari M, Masoudkabir F, Abbasi K, Boroumand MA, Zarghampour M, Goodarzynejad H. Takayasu's Arteritis Presenting with Headache and Peripheral Facial Palsy: A Case Report. J Tehran Heart Cent 2016; 11:195-197. [PMID: 28496512 PMCID: PMC5424842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Takayasu's arteritis (TA) is a rare case of granulomatous arteritis which mainly involves the aorta and its large branches. Although arterial hypertension is the most common feature of the disease in both adults and children, patients with TA may present with numerous clinical manifestations. Our patient was a 45-year-old woman, known to have hypertension from 3 years earlier following assessments made for severe headache. One year after the diagnosis of hypertension, she developed a left-sided lower motor neuron facial palsy, which was treated with oral corticosteroids (Prednisolone). Notably, the patient's headache was relieved after she took corticosteroid therapy. Transthoracic echocardiography revealed severe aortic insufficiency and aneurysmal changes in the ascending aorta, and she was referred to our center for further evaluation. In multi-slice computed-tomography angiography, significant long stenosis of the left subclavian artery was seen and the diameter of the ascending aorta was 50 mm. The patient underwent the Bentall operation. The pathologic examination of the aortic wall specimen was compatible with giant cell aortitis and more in favor of TA with the ascending aortic aneurysm. At 6months' follow-up, the patient was in good condition and had almost recovered from facial palsy.
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Affiliation(s)
| | | | | | | | | | - Hamidreza Goodarzynejad
- Corresponding Author: Hamidreza Goodarzynejad, Research Department, Tehran Heart Center, Tehran University of Medical Sciences, North Karegar and Jalal-Al-Ahmad Crossroads, Tehran, Iran. Tel: +98 21 88029245. Fax: +98 21 88029731..
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14
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Goodarzynejad H, Boroumand M, Behmanesh M, Ziaee S, Jalali A. Cholesteryl ester transfer protein gene polymorphism (I405V) and premature coronary artery disease in an Iranian population. Bosn J Basic Med Sci 2016; 16. [PMID: 26773179 PMCID: PMC4852992 DOI: 10.17305/bjbms.2015.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The effect of human cholesteryl ester transfer protein (CETP) expression on atherogenesis is still under debate. The rs5882 (I405V) polymorphism affect CETP function. We aimed to examine the relationship between the rs5882 polymorphism and the risk of angiographically determined coronary artery disease (CAD). To define premature CAD (PCAD), an age cutoff of 55 years for women and 45 years for men was used. An age- and sex-matched case-control study was conducted in 560 patients with newly diagnosed angiographically documented PCAD (≥50% luminal stenosis of any coronary vessel) and an equal number of control patients with normal coronary arteries (no luminal stenosis at coronary arteries). The severity of CAD was determined by vessel score and Gensini score. A real-time polymerase chain reaction (PCR) and high resolution melting analysis were used to distinguish between genotypes. The I405V genotype distributions were not statistically different in CAD and non-CAD groups in univariate and multivariable-adjusted logistic regression analyzes. The median and inter-quartile range for Gensini score was not significantly different among the AA (43, 24 to 73), AG (40, 20 to 66), and GG (45, 25 to 72) genotypes (p = 0.097). Furthermore, the distribution of vessel score did not statistically differ between these genotypes (p = 0.691). Our results suggest that there is no significant association between CETP I405V polymorphism and the risk of PCAD presence and severity. Larger prospective studies are needed to investigate such associations in different populations.
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Affiliation(s)
- Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadali Boroumand
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran,Corresponding authors: Mohammadali Boroumand, Tehran Heart Center, North Karegar Ave. and Jalal-Al-Ahmad Cross, Tehran, Iran. E-mail:
| | - Mehrdad Behmanesh
- Department of Genetics, School of Biological Sciences, Tarbiat Modares University, Tehran, Iran,
Mehrdad Behmanesh, Tarbiat Modares University, No.7, Jalal-Al-Ahmad Highway, Tehran, Iran. P.O. Box: 14115-154. E-mail:
| | - Shayan Ziaee
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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15
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Kashani H, Zeraati H, Mohammad K, Goodarzynejad H, Mahmoudi M, Sadeghian S, Boroumand M. Analyzing Gensini Score as a Semi-Continuous Outcome. J Tehran Heart Cent 2016; 11:55-61. [PMID: 27928255 PMCID: PMC5027161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Investigators frequently encounter continuous outcomes with plenty of values clumped at zero called semi-continuous outcomes. The Gensini score, one of the most widely used scoring systems for expressing coronary angiographic results, is of this type. The aim of this study was to apply two statistical approaches based on the categorization and original scale of the Gensini score to simultaneously assess the association between covariates and the presence and severity of coronary artery disease (CAD). Methods: We considered the data on 1594 individuals admitted to Tehran Heart Center with CAD symptoms from July 2004 to February 2008. The participants' baseline demographic and clinical characteristics were collected, and their coronary angiographic results were expressed through the Gensini score. The generalized ordinal threshold and two-part models were applied for the statistical analyses. Results: Totally, 320 (20.1%) individuals had a Gensini score of zero. The results of neither the two-part model nor the generalized ordinal threshold model showed a significant association between Factor V Leiden and the occurrence of CAD. However, based on the two-part model, Factor V Leiden was associated with the severity of CAD, such that the Gensini score increased by moving from a wild genotype to a heterozygote (β = 0.44; 95% CI: 0.20-0.69 in logarithm scale) or a homozygote mutant (β = 0.70; 95% CI: 0.28- 1.12 in logarithm scale). The proportional odds assumption was not met in our data ([Formula: see text]= 54.26; p value < 0.001); however, a trend toward severe CAD was also observed at each category of the Gensini score using the generalized ordinal threshold model. Conclusion: We conclude that besides loss of information by sorting a semi-continuous outcome, violation from the proportional odds assumption complicates the final decision, especially for clinicians. Therefore, more straightforward models such as the two-part model should receive more attention while analyzing such outcomes.
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Affiliation(s)
- Homa Kashani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Hojjat Zeraati, Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, Iran. 1417613151. Tel: +98 21 88989123. Fax: +98 21 88989127. .
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Mahmood Mahmoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Saeed Sadeghian
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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16
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Goodarzynejad H, Boroumand M, Behmanesh M, Ziaee S, Jalali A. Cholesteryl ester transfer protein gene polymorphism (I405V) and premature coronary artery disease in an Iranian population. Bosn J Basic Med Sci 2016; 16:114-20. [PMID: 26773179 DOI: 10.17305/bjbms.2016.942] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 12/18/2015] [Accepted: 12/19/2015] [Indexed: 12/14/2022] Open
Abstract
The effect of human cholesteryl ester transfer protein (CETP) expression on atherogenesis is still under debate. The rs5882 (I405V) polymorphism affect CETP function. We aimed to examine the relationship between the rs5882 polymorphism and the risk of angiographically determined coronary artery disease (CAD). To define premature CAD (PCAD), an age cutoff of 55 years for women and 45 years for men was used. An age- and sex-matched case-control study was conducted in 560 patients with newly diagnosed angiographically documented PCAD (≥50% luminal stenosis of any coronary vessel) and an equal number of control patients with normal coronary arteries (no luminal stenosis at coronary arteries). The severity of CAD was determined by vessel score and Gensini score. A real-time polymerase chain reaction (PCR) and high resolution melting analysis were used to distinguish between genotypes. The I405V genotype distributions were not statistically different in CAD and non-CAD groups in univariate and multivariable-adjusted logistic regression analyzes. The median and inter-quartile range for Gensini score was not significantly different among the AA (43, 24 to 73), AG (40, 20 to 66), and GG (45, 25 to 72) genotypes (p = 0.097). Furthermore, the distribution of vessel score did not statistically differ between these genotypes (p = 0.691). Our results suggest that there is no significant association between CETP I405V polymorphism and the risk of PCAD presence and severity. Larger prospective studies are needed to investigate such associations in different populations.
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Affiliation(s)
- Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Goodarzynejad H, Boroumand M, Behmanesh M, Ziaee S, Jalali A. The rs5888 single nucleotide polymorphism in scavenger receptor class B type 1 (SCARB1) gene and the risk of premature coronary artery disease: a case-control study. Lipids Health Dis 2016; 15:7. [PMID: 26754576 PMCID: PMC4709878 DOI: 10.1186/s12944-016-0176-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/04/2016] [Indexed: 12/19/2022] Open
Abstract
Background Several single nucleotide polymorphisms (SNPs) in lipid transport genes have been shown to be associated with premature coronary artery disease (PCAD). The scavenger receptor BI (SCARB1) is a key component of the reverse cholesterol transport and lipid metabolism. We aimed to examine the relationship between the rs5888 SNP within SCARB1and the risk of angiographically determined PCAD. Methods We used an age cut-off of 55 years for women and 45 years for men to define PCAD. Five-hundred and five patients with newly diagnosed angiographically documented PCAD (≥50 % luminal stenosis of any coronary vessel) as case group compared with 546 controls (subjects with no luminal stenosis at coronary arteries). The severity of CAD was determined by vessel score as well as Gensini score. A real-time polymerase chain reaction (PCR) and High Resolution Melting (HRM) analysis was used to distinguish between genotypes. Results T allele as compared to C allele was associated with increased odds of PCAD in total population (adjusted OR = 1.3, 95 % CI = 1.0 to 1.5; p = 0.020), and in women (adjusted OR = 1.3, 95 % CI = 1.0 to 1.8; p = 0.037), but not in men (adjusted OR = 1.2, 95 % CI = 0.9 to 1.5; p = 0.311). There was also no significant association between the examined polymorphism and the severity of CAD in whole or in men or women subgroups. Conclusions Our findings suggest that the SNP (rs5888) within SCARB1 is independently associated with PCAD in a sex-dependent manner.
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Affiliation(s)
- Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadali Boroumand
- Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Ave.and Jalal-Al-Ahmad cross, Tehran, Iran.
| | - Mehrdad Behmanesh
- Department of Genetics, School of Biological Sciences, Tarbiat Modares University, P.O. Box: 14115-154, Tehran, Iran.
| | - Shayan Ziaee
- Department of Laboratory Medicine and Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Sotoudeh Anvari M, Mortazavian Babaki M, Boroumand MA, Eslami B, Jalali A, Goodarzynejad H. Relationship between calculated total antioxidant status and atherosclerotic coronary artery disease. Anatol J Cardiol 2015; 16:689-95. [PMID: 27488746 PMCID: PMC5331354 DOI: 10.5152/anatoljcardiol.2015.6482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective: Antioxidants play a major role in the cellular protection cascade against oxidative damage. Oxidative stress has been linked to the pathogenesis of coronary atherosclerosis. Our aim was to evaluate the association between calculated serum total antioxidant status (cTAS) and the presence and severity of coronary artery disease (CAD). Methods: One hundred and seventy-four patients with angiographically documented significant (≥50%) luminal stenosis (n=123) or with minimal (<50%) luminal stenosis (n=51) in at least one coronary artery or major branch segment in the epicardial coronary tree were categorized as CAD+ group; 88 patients with no luminal stenosis were considered as the control group. The level of cTAS (mmol/L) was evaluated using the following equation: (0.63´albumin concentration)+(1.02´uric acid concentration)+(1.53´bilirubin concentration). Results: In univariate analyses, mean levels of cTAS, uric acid, and creatinine were significantly higher in CAD+ group than in controls. However, adjusted cTAS level was not found to be a CAD predictor in the total population [odds ratio (OR)=1.20; 95% confidence interval (CI): 0.81–1.76; p=0.364] or in men (OR=1.25; 95% CI: 0.73–2.12; p=0.420) and women (OR=1.20; 95% CI: 0.66–2.19; p=0.553). A weak but statistically significant correlation was found between cTAS and Gensini score (Spearman’s r=0.16, p=0.015). Conclusion: In patients with suspicious CAD, the level of cTAS was not found to be an independent predictor for the presence of CAD. Further studies with larger sample size are required to confirm the results.
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Affiliation(s)
- Maryam Sotoudeh Anvari
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran-Iran
| | - Maryam Mortazavian Babaki
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran-Iran
| | - Mohammad Ali Boroumand
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran-Iran
| | - Bahareh Eslami
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran-Iran
| | - Arash Jalali
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran-Iran
| | - Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran-Iran. ,
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Anvari MS, Boroumand M, Sadeghipour S, Bina P, Soleymanzadeh M, Jalali A, Goodarzynejad H. Immunohistochemical analysis of estrogen and progesterone receptor expression in cardiac myxomas. Int J Cardiol 2015; 195:243-4. [DOI: 10.1016/j.ijcard.2015.05.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 05/20/2015] [Accepted: 05/26/2015] [Indexed: 10/23/2022]
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Goodarzynejad H, Babamahmoodi A. Project Management of Randomized Clinical Trials: A Narrative Review. Iran Red Crescent Med J 2015; 17:e11602. [PMID: 26430517 PMCID: PMC4586955 DOI: 10.5812/ircmj.11602] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/02/2015] [Accepted: 06/10/2015] [Indexed: 11/16/2022]
Abstract
Context: A well-structured protocol for a clinical trial may be able to answer clinical questions, but it cannot be deemed enough to ensure success in the face of incompetent management of time as well as human and economic resources. To address this problem, in this article, we present our literature review on evidence as to how a good knowledge of proper management among researchers can enhance the likelihood of the success of clinical trial projects. Evidence Acquisition: Using multiple search strategies, we conducted a literature review on published studies in the English language from 2002 to 2012 by searching the Cochrane Database of Systematic Reviews, MEDLINE, Google Scholar, and EMBASE. Results: Our review suggests that a successful trial requires a work plan or work scope as well as a timeline. The trial manager should subsequently manage the study in accordance with the plan and the timeline. Many research units have called for a clinical project manager with scientific background and regulatory skills to effect coordination among various aspects of a clinical trial. Conclusions: Project management may benefit both the managerial and scientific aspects of medical projects and reduce fund waste. However, little has been written to date on project management in the context of clinical research. The suggestions represent the views of the individual authors. To provide a high level of evidence in this regard, we recommend that a randomized controlled trial be performed to compare trial projects progressed with and without the use of project management.
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Affiliation(s)
- Hamidreza Goodarzynejad
- Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Hamidreza Goodarzynejad, Department of Cardiac Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188029245, Fax: +98-2188029256, E-mail:
| | - Abdolreza Babamahmoodi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Pournajafian AR, Ghodraty MR, Faiz SHR, Rahimzadeh P, Goodarzynejad H, Dogmehchi E. Comparing GlideScope Video Laryngoscope and Macintosh Laryngoscope Regarding Hemodynamic Responses During Orotracheal Intubation: A Randomized Controlled Trial. Iran Red Crescent Med J 2014; 16:e12334. [PMID: 24910788 PMCID: PMC4028761 DOI: 10.5812/ircmj.12334] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 07/04/2013] [Accepted: 07/24/2013] [Indexed: 01/20/2023]
Abstract
BACKGROUND To determine if the GlideScope® videolaryngoscope (GVL) could attenuate the hemodynamic responses to orotracheal intubation compared with conventional Macintosh laryngoscope. OBJECTIVES The aim of this relatively large randomized trial was to compare the hemodynamic stress responses during laryngoscopy and tracheal intubation using GVL versus MCL amongst healthy adult individuals receiving general anesthesia for elective surgeries. PATIENTS AND METHODS Ninety five healthy adult patients with American Society of Anesthesiologists physical status class I or II that were scheduled for elective surgery under general anesthesia were randomly allocated to either Macintosh or GlideScope arms. All patients received a standardized protocol of general anesthesia. Hemodynamic changes associated with intubation were recorded before and at 1, 3 and 5 minutes after the intubation. The time taken to perform endotracheal intubation was also noted in both groups. RESULTS Immediately before laryngoscopy (pre-laryngoscopy), the values of all hemodynamic variables did not differ significantly between the two groups (All P values > 0.05). Blood pressures and HR values changed significantly over time within the groups. Time to intubation was significantly longer in the GlideScope (15.9 ± 6.7 seconds) than in the Macintosh group (7.8 ± 3.7 sec) (P< 0.001). However, there were no significant differences between the two groups in hemodynamic responses at all time points. CONCLUSIONS The longer intubation time using GVL suggests that the benefit of GVL could become apparent if the time taken for orotracheal intubation could be decreased in GlideScope group.
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Affiliation(s)
- Ali Reza Pournajafian
- Department of Anaesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Reza Ghodraty
- Department of Anaesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran
| | - Seyed Hamid Reza Faiz
- Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Poupak Rahimzadeh
- Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran
| | - Hamidreza Goodarzynejad
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Enseyeh Dogmehchi
- Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Enseyeh Dogmehchi, Department of Anesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188947672, Fax: +98-2188942622, E-mail:
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Bagherzadeh A, Keshavarzi T, Farahani MM, Goodarzynejad H. Determinants of immediate success for catheter ablation of atrioventricular nodal reentry tachycardia in patients without junctional rhythm. J Interv Card Electrophysiol 2013; 39:19-23. [DOI: 10.1007/s10840-013-9839-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 09/02/2013] [Indexed: 11/24/2022]
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Poorgholi L, Saffar H, Fathollahi MS, Davoodi G, Anvari MS, Goodarzynejad H, Ziaee S, Boroumand MA. Angiotensin- converting enzyme insertion/deletion polymorphism and its association with coronary artery disease in an Iranian population. J Tehran Heart Cent 2013; 8:89-94. [PMID: 23967030 PMCID: PMC3740114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 09/17/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The study of the association between genotype and phenotype is of great importance for the prediction of many diseases and pathophysiological conditions. The relationship between angiotensin-converting enzyme (ACE) gene insertion/ deletion (I/D) polymorphism and pathological processes such as coronary artery disease (CAD) has been investigated previously with discordant results. This study was designed to determine the association between ACE gene I/D polymorphism and CAD in an Iranian population. METHODS A total of 1050 individuals who were referred to Tehran Heart Center for coronary angiography were recruited. Six hundred seventy-six CAD-positive patients (documented by coronary angiography and Gensini scores higher than 6) and 374 CAD-negative patients were evaluated for ACE gene I/D polymorphism via the Polymerase Chain Reaction Amplification method. The patients' age, sex, smoking status and its duration as well as familial history of CAD, hypertension, and diabetes mellitus were recorded. RESULTS Five hundred four (74.6%) of the CAD-positive patients were male, and the mean age of this group was 60 (60 ± 10). In the CAD-negative individuals, the mean age was 56 (56 ± 10) and 196 of them were male (52.4%). After the analysis of all the groups and gender subgroups, neither genotype nor allele frequency was significantly different between the CAD-positive and CAD-negative groups (p values for genotypes and allele frequencies were 0.494 and 0.397, respectively). CONCLUSION ACE gene I/D polymorphism was not associated with an increased risk of CAD in an Iranian population.
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Affiliation(s)
| | | | | | | | | | | | | | - Mohammad Ali Boroumand
- Corresponding Author: Mohammad Ali Boroumand, Associate Professor of Clinical Pathology, Molecular Pathology Department, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel.: +98 21 88029231. Fax: +98 21 88029262. E-mail:
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Jandaghi SHSS, Abdolhoseinpour H, Ghofraniha A, Tofighirad N, Dogmehchi E, Goodarzynejad H. A Limb-Saving Procedure for Treatment of Arterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report. J Tehran Heart Cent 2013; 8:61-4. [PMID: 23646051 PMCID: PMC3587677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 06/27/2012] [Indexed: 11/21/2022] Open
Abstract
As the major hazard of percutaneous vertebroplasty (PV), cement extravasation into the venous system, systemic embolism, and spinal canal has been previously reported. However, to our knowledge, only one case of the arterial migration of cement has been previously reported that is directly associated with this technique without any symptom in the immediate post-intervention and in the follow-up period. An arterial embolus of cement occurred in a 46-year-old woman undergoing lumbar PV for breast cancer metastasis. Less than one hour later, the patient complained of severe pain and numbness in her left leg. A diagnosis of acute left leg ischemia due to the acute occlusion of the infrapopliteal arteries by the cement was made. Transluminal angioplasty (PTA) for the infrapopliteal arteries was recommended because there were diffuse and long vessel involvements, leaving no distal targets for bypass vascular surgery. The patient's postoperative course was uncomplicated; the extremity tenderness and mottled skin were improved. A follow-up ultrasound 2 months later revealed an acceptable distal flow in the arteries of the affected limb, and the patient remained asymptomatic (except for a mild leg pain on exertion) at the one-year follow-up examination. In conclusion, PTA may save the limb from amputation in case of peripheral arterial embolism caused by cement during PV.
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Affiliation(s)
- Seyed Hashem Sezavar Seyedi Jandaghi
- Hazrat Rasool Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Seyed Hashem Sesavar Seyedi Jandaghi, Laleh Hospital, Simaye Iran Street, Phase 5, Shahrake Gharb, Tehran, Iran. 14676 Tel: +98 21 88369862. Fax: +98 21 88571081. E-mail:
| | | | | | - Navid Tofighirad
- Amir-Al-Momenin Hospital, Tehran Medical Branch of Islamic Azad University, Tehran, Iran
| | - Enseyeh Dogmehchi
- Hazrat Rasool Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Faramarzi N, Salarifar M, Kassaian SE, Zeinali AMH, Alidoosti M, Pourhoseini H, Nematipour E, Mousavi MR, Goodarzynejad H. Mid-Term Follow-Up of Drug-Eluting Stenting for In-Stent Restenosis: Bare-Metal Stents versus Drug-Eluting Stents. J Tehran Heart Cent 2013; 8:14-20. [PMID: 23646043 PMCID: PMC3587669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 08/06/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Despite major advances in percutaneous coronary intervention (PCI), in-stent restenosis (ISR) remains a therapeutic challenge. We sought to compare the mid-term clinical outcomes after treatment with repeat drug-eluting stent (DES) implantation ("DES sandwich" technique) with DES placement in the bare-metal stent (DES-in-BMS) in a "real world" setting. METHODS We retrospectively identified and analyzed clinical and angiographic data on 194 patients previously treated with the DES who underwent repeat PCI for ISR with a DES or a BMS. ISR was defined, by visual assessment, as a luminal stenosis greater than 50% within the stent or within 5 mm of its edges. We recorded the occurrence of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, and the need for target vessel revascularization (TVR). RESULTS Of the 194 study participants, 130 were men (67.0%) and the mean ± SD of age was 57.0 ± 10.4 years, ranging from 37 to 80 years. In-hospital events (death and Q-wave myocardial infarction) occurred at a similar frequency in both groups. Outcomes at twelve months were also similar between the groups with cumulative clinical MACE at one-year follow-up of 9.6% and 11.3% in the DES-in-BMS and the DES-in-DES groups, respectively (p value = 0.702). Although not significant, there was a trend toward a higher TVR rate in the intra-DES ISR group as compared to the intra-BMS ISR group (0.9% BMS vs. 5.2% DES; p value = 0.16). CONCLUSION Our study suggests that the outcome of the patients presenting with ISR did not seem to be different between the two groups of DES-in-DES and DES-in-BMS at one-year follow-up, except for a trend toward more frequent TVR in the DES-in-DES group. Repeat DES implantation for DES restenosis could be feasible and safe with a relatively low incidence of MACE at mid-term follow-up.
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Affiliation(s)
| | - Mojtaba Salarifar
- Corresponding Author: Mojtaba Salarifar, Assistant Professor of Interventional Cardiology, Cardiology Department, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029257. Fax: +98 21 88029256. E-mail:
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Najafi M, Goodarzynejad H. Determinants of length of stay in surgical ward after coronary bypass surgery: glycosylated hemoglobin as a predictor in all patients, diabetic or non-diabetic. J Tehran Heart Cent 2012; 7:170-6. [PMID: 23323078 PMCID: PMC3537203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 07/23/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Reports on the determinants of morbidity in coronary artery bypass graft surgery (CABG) have focused on outcome measures such as length of postoperative stay in the Intensive Care Unit (ICU). We proposed that major comorbidities in the ICU hampered the prognostic effect of other weaker but important preventable risk factors with effect on patients' length of hospitalization. So we aimed at evaluating postoperative length of stay in the ICU and surgical ward separately. METHODS We studied isolated CABG candidates who were not dialysis dependent. Preoperative, operative, and postoperative variables as well as all classic risk factors of coronary artery disease were recorded. Using multivariate analysis, we determined the independent predictors of length of stay in the ICU and in the surgical ward. RESULTS Independent predictors of extended length of stay in the surgical ward ( > 3 days) were a history of peripheral vascular disease, total administered insulin during a 24-hour period after surgery, glycosylated hemoglobin (HbA1c), last fasting blood sugar of the patients before surgery, and inotropic usage after cardiopulmonary bypass. The area under the Receiver Operating Characteristic Curve (AUC) was found to be 0.71 and Hosmer-Lemeshow (HL) goodness of fit statistic p value was 0.88. Independent predictors of extended length of stay in the ICU ( > 48 hours) were surgeon category, New York Heart Association functional class, intra-aortic balloon pump, postoperative arrhythmias, total administered insulin during a 24-hour period after surgery, and mean base excess of the first 6 postoperative hours (AUC = 0.70, HL p value = 0.94). CONCLUSION This study revealed that the indices of glycemic control were the most important predictors of length of stay in the ward after cardiac surgery in all patients, diabetic or non-diabetic. However, because HbA1c level did not change under the influence of perioperative events, it could be deemed a valuable measure in predicting outcome in CABG candidates.
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Affiliation(s)
- Mahdi Najafi
- Corresponding Author: Mahdi Najafi, Assistant Professor of Anesthesiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran Heart Center, North Karegar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029600. Fax: +98 21 88029731. E-mail:
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Kassaian SE, Goodarzynejad H, Boroumand MA, Salarifar M, Masoudkabir F, Mohajeri-Tehrani MR, Pourhoseini H, Sadeghian S, Ramezanpour N, Alidoosti M, Hakki E, Saadat S, Nematipour E. Glycosylated hemoglobin (HbA1c) levels and clinical outcomes in diabetic patients following coronary artery stenting. Cardiovasc Diabetol 2012; 11:82. [PMID: 22805289 PMCID: PMC3444922 DOI: 10.1186/1475-2840-11-82] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 07/01/2012] [Indexed: 01/21/2023] Open
Abstract
Background Diabetes has been shown to be independent predictor of restenosis after percutaneous coronary intervention (PCI). The aim of the present study was to investigate whether a pre- and post-procedural glycaemic control in diabetic patients was related to major advance cardiovascular events (MACE) during follow up. Methods We evaluated 2884 consecutive patients including 2181 non-diabetic patients and 703 diabetics who underwent coronary stenting. Diabetes mellitus was defined as the fasting blood sugar concentration ≥ 126 mg/dL, or the use of an oral hypoglycemic agent or insulin at the time of admission. Diabetic patients were categorized into two groups based on their mean HbA1c levels for three measurements (at 0, 1, and 6 months following procedure): 291 (41.4%) diabetics with good glycaemic control (HbA1c ≤ 7%) and 412 (58.6%) diabetics with poor glycaemic control (HbA1c > 7%). Results The adjusted risk of MACE in diabetic patients with poor glycaemic control (HbA1c > 7%) was 2.1 times of the risk in non-diabetics (adjusted HR = 2.1, 95% CI: 1.10 to 3.95, p = 0.02). However, the risk of MACE in diabetics with good glycaemic control (HbA1c ≤ 7%) was not significantly different from that of non-diabetics (adjusted HR = 1.33, 95% CI: 0.38 to 4.68, p = 0.66). Conclusions Our data suggest that there is an association between good glycaemic control to obtain HbA1c levels ≤7% (both pre-procedural glycaemic control and post-procedural) with a better clinical outcome after PCI.
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Affiliation(s)
- Seyed Ebrahim Kassaian
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Davoodi S, Sheikhvatan M, Karimi A, Ahmadi SH, Goodarzynejad H, Fathollahi MS. Outcomes and long-term quality of life of patients with severe left ventricular dysfunction who underwent coronary artery bypass surgery. Gen Thorac Cardiovasc Surg 2012; 60:202-12. [DOI: 10.1007/s11748-010-0918-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 10/15/2010] [Indexed: 10/28/2022]
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Anvari MS, Boroumand MA, Mojarad EA, Karimi A, Abbasi K, Shirzad M, Omran AS, Movahedi N, Shirani S, Goodarzynejad H. Do Adventitial Mast Cells Contribute to the Pathogenesis of Ascending Thoracic Aorta Aneurysm? Int J Surg Pathol 2012; 20:474-9. [DOI: 10.1177/1066896912440820] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The precise pathogenesis of the ascending aortic aneurysm (AscAA) remains to be determined. Mast cells in the adventitia of human AscAA lesions may play a role in this pathogenesis. Adventitial mast cell density per 10 high-power fields (0.25 mm2) was assessed in multiple biopsy samples, from aneurysmal aortic sections (n = 41) and control (nondilated) aortic specimens (n = 50), stained by orcein-Giemsa method, an inexpensive (<$1) method. In a multivariable adjusted logistic regression model, using AscAA as the dependent variable, mast cell density was found to be an independent predictor of AscAA occurrence (odds ratio = 2.21; 95% confidence interval = 1.58-3.08; P < .001). Receiver operating characteristic curve analysis showed that the proposed cutoff value of ≥3 mast cells per 10 high-power fields was very sensitive to detect AscAA occurrence, yielding a sensitivity of 90% with a specificity of 80%. In conclusion, a significant increase in the number of mast cells in the adventitia of human ascending aortic lesions proposes a role for these cells in the pathogenesis of AscAA.
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Rokni N, Salarifar M, Hakki Kazazi E, Goodarzynejad H. Frequency and predictors of renal artery stenosis in patients undergoing simultaneous coronary and renal catheterization. J Tehran Heart Cent 2012; 7:58-64. [PMID: 23074639 PMCID: PMC3466904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 02/27/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Atherosclerotic renal artery stenosis (ARAS) remains underdiagnosed due to its nonspecific demonstrations. We aimed to both estimate the frequency of ARAS in high-risk non-selected patients undergoing simultaneous coronary and renal catheterization and possibly identify a predictive model for ARAS using baseline clinical, laboratory, and coronary angiographic variables. METHODS The records of 866 patients aged ≥ 21 years undergoing simultaneous coronary and renal angiography were retrieved for analysis from our computerized database. The degree of ARAS was estimated visually by experienced attending interventional cardiologists. Lesions with an estimated stenosis of ≥ 50% were considered significant. Multivariable stepwise logistic regression models were used to identify the risk factors predicting the presence and extent of ARAS. RESULTS Of a total of 866 consecutive patients undergoing renal angiography in conjunction with coronary angiography (mean age ± SD: 63.06 ± 10.32, ranging from 24 to 89 years), 454 (57%) were men. A total of 345 (39.8%) cases had significant ARAS, 77 (22.3%) of which were bilateral. Using significant ARAS as the dependent variable, six variables were identified as the independent predictors significantly associated with the presence of ARAS, namely age, female sex (male sex was found to be a protector), hypertension, history of renal failure, left anterior descending artery (LAD) stenosis > 50%, and left circumflex artery (LCX) stenosis > 50%. The Gensini score was not found to be a predictor of the presence of ARAS, but it was more likely associated with a trend towards a more extensive ARAS (adjusted OR = 1.00, 95% CI = 1.00-1.01; p value = 0.039). Other independent determinants of the ARAS extent were the same as the predictors of the ARAS presence. CONCLUSION Although risk versus benefit was not tested in this study, it seems that clinicians could consider renal catheterization in combination with coronary angiography particularly in female patients with advanced age and with significant coronary artery stenoses in the LAD and LCX.
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Affiliation(s)
| | - Mojtaba Salarifar
- Corresponding Author: Mojtaba Salarifar, Mojtaba Salarifar, Associate Professor of Interventional Cardiology, Cardiology Department, Tehran Heart Center, North Kargar Street, Tehran Heart Center, Tehran, Iran. 1411713138. Tel: +98 21 88029257. Fax: +98 21 88029256. E-mail:
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Manouchehri J, Goodarzynejad H, Khoshgoftar Z, Sheikh Fathollahi M, Aghamohammadi Abyaneh M. Discharge against Medical Advice among Inpatients with Heart Disease in Iran. J Tehran Heart Cent 2012; 7:72-7. [PMID: 23074641 PMCID: PMC3466903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 02/27/2012] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Discharge against medical advice (DAMA) is a relatively common problem worldwide. We sought to determine the prevalence of and reasons for DAMA among inpatients of our cardiac center. METHODS From a total of 20289 discharges from our cardiac teaching hospital, 992 (4.9%) patients at a minimum age of 18 years were cases of DAMA. After excluding 49 cases due to missing data, we retrospectively analyzed our prospectively collected data from 943 patients, who were DAMA cases. Patients' characteristics, including demographic details, reason for discharge, insurance status, and length of stay before discharge, were examined. RESULTS The mean age of the study patients was 60.7 ± 13.0 (range, 18-94 years) with a male-to-female ratio of 2.1/1. Lack of consent to surgery or other invasive procedures was the reason cited for DAMA in 31% of the patients, followed by personal or family issues (17%). No reason for DAMA was reported in 26 (2.8%) of the patients. Women compared to men were more likely to cite "lack of consent to surgery or invasive procedures" as the reason for DAMA (p value = 0.005), whereas men more prevalently stated "personal or family issues" as the reason for DAMA (18.7% vs. 12.7%, p value = 0.022). CONCLUSION The most frequent self-reported reason for DAMA in our cardiac patients was lack of consent to surgery or invasive procedures. This may be because of fear of undergoing invasive procedures such as revascularization. Explaining the stages of a given invasive procedure to patients and comparing its risks versus benefits may lessen impulsive decision-making and DAMA.
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Affiliation(s)
| | - Hamidreza Goodarzynejad
- Corresponding Author: Hamidreza Goodarzynejad, Research Department, University of Medical Sciences, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029245. Fax: +98 21 88029731. E-mail:
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Boroumand M, Ghasemi Y, Shirani S, Pourgholi L, Anvari MS, Sepehriseresht S, Mohammadtaghvaei N, Ghaedi M, Sheikhfathollahi M, Goodarzynejad H. Association Between Estrogen Receptor-α PvuII and XbaI Gene Polymorphisms With Extracranial Carotid Stenosis. Lab Med 2011. [DOI: 10.1309/lm4yrrfcms2k6dpj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Hosseini SK, Masoudkabir F, Vasheghani-Farahani A, Alipour-Parsa S, Sheikh Fathollahi M, Rahimi-Foroushani A, Hakki E, Goodarzynejad H, Eftekhar H. Opium consumption and coronary atherosclerosis in diabetic patients: a propensity score-matched study. Planta Med 2011; 77:1870-1875. [PMID: 21800277 DOI: 10.1055/s-0031-1280017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There is a traditional belief among Eastern people that opium may have ameliorating effects on cardiovascular risk factors, especially diabetes; thus, it is widely used among diabetic patients. We attempted to investigate the association of opium consumption with coronary artery disease (CAD) in diabetic patients. A cross-sectional study was conducted on diabetic patients undergoing coronary angiography in our center. Out of 1925 diabetic patients included in the study, 228 were opium users, and the remaining 1697 non-opium users were used as a pool of potential comparators. Propensity scores were used to match the 228 opium consumers with 228 matched comparators for age, sex, and smoking status. The Gensini score and extent score were respectively used to assess the angiographic severity and extent of CAD. The mean Gensini score (86.9 ± 62.7 vs. 59.6 ± 43.4, p < 0.0001) and extent score (7.1 ± 2.9 vs. 5.9 ± 2.9, p < 0.0001) were significantly higher in opium user diabetic patients than in non-opium users. After adjustment for potential confounders, a dose-response relationship was observed between dose of opium and the Gensini score ( β = 0.27, p = 0.04). There were no significant differences between the routes of opium administration (inhalation vs. oral) regarding the severity and extent of CAD. In conclusion, exposure to opium in diabetic patients may be positively associated with the risk of CAD, and with the angiographically determined severity and extent of the disease. Furthermore, dosage of opium consumption may correlate with severity of CAD.
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Affiliation(s)
- Seyed Kianoosh Hosseini
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Shirani S, Sadeghian H, Hossein Mandegar M, Goodarzynejad H. A case of heterotopic heart transplantation with evaluation of cardiac CT angiography. J Cardiovasc Surg (Torino) 2011; 52:756-758. [PMID: 21894145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Boroumand MA, Anvari MS, Pourgholi L, Shoar S, Naderan M, Amelimojarad E, Goodarzynejad H. Local factors affecting cost/benefit of methicillin-resistant Staphylococcus aureus screening, a study from a low-income country. Am J Infect Control 2011; 39:703-705. [PMID: 21784560 DOI: 10.1016/j.ajic.2011.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 01/11/2011] [Indexed: 11/18/2022]
Affiliation(s)
- Mohammad Ali Boroumand
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Maryam Sotoudeh Anvari
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Pourgholi
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Shoar
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Naderan
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Amelimojarad
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Goodarzynejad
- Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Masoudkabir F, Karbalai S, Vasheghani-Farahani A, Aliabadi LL, Boroumand MA, Aiatollahzade-Esfahani F, Pashing M, Hakki E, Goodarzynejad H, Saadat S. The association of liver transaminase activity with presence and severity of premature coronary artery disease. Angiology 2011; 62:614-9. [PMID: 21561994 DOI: 10.1177/0003319711405312] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There is growing clinical interest in liver transaminases as novel biomarkers of cardiovascular risk. We investigated the possible association of serum liver transaminase activity with the presence and angiographic severity of premature coronary artery disease (CAD). A cross-sectional study was conducted on 187 younger patients (females < 55 years and males < 45 years) who underwent coronary angiography and had serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitivity C-reactive protein (hsCRP) measured. Evaluation of coronary stenosis was by Gensini score. Both ALT and AST were significantly correlated with the presence of CAD in univariate and multivariate analyses. Both ALT and AST were also significantly correlated with Gensini score even after adjustment for potential confounders. Serum ALT and AST levels are independently positively associated with the risk and severity of premature CAD, suggesting that these enzymes could serve as surrogate markers for cardiovascular risk in this specific group of patients.
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Affiliation(s)
- Farzad Masoudkabir
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
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Boroumand MA, Anvari MS, Amelimojarad E, Shoar S, Naderan M, Yazdanifard P, Karimi A, Goodarzynejad H. Association between angiographically assessed coronary artery disease and serum levels of prostate specific antigen. Clin Lab 2011; 57:975-981. [PMID: 22239030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The increased incidence of coronary artery disease (CAD) in patients with conventional cardiovascular risk factors cannot be fully explained by the known risk factors. The aim of the study was to test whether there is an association between the levels of serum total PSA with the presence of CAD and its severity. METHODS The study population consisted of 151 male patients aged < 55 years admitted at our center for elective coronary angiography. Patients having angiographic evidence of atherosclerosis (Gensini score > 6) in their epicardial coronary tree were categorized as having coronary artery disease (CAD(+) case group). Patients with Gensini score < or = 6 classified as having normal coronary arteries (CAD(-) control group). The presence and severity of CAD was determined by vessel score and Gensini score. The PSA levels were measured by the electrochemoluminescence (ECLIA) method. RESULTS The mean level of serum PSA was found to be significantly higher in CAD patients than in those without CAD. In a multivariable logistic regression model, after adjusting for covariates, PSA level remained as an independent predictor for CAD occurrence (OR = 2.79; 95% CI: 1.04 - 7.49; p = 0.042). No significant correlation was found between the serum PSA level and the severity of CAD (r = 0.127, p = 0.122) or between PSA level and hsCRP level (r = 0.088, p = 0.282). CONCLUSIONS It appears that PSA level is significantly associated with the presence of CAD. Further studies with larger sample size are required to confirm this result.
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Affiliation(s)
- Mohammad Ali Boroumand
- Department of Surgical and Clinical Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Iran
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Kassaian SE, Goodarzynejad H. Carotid artery stenting, endarterectomy, or medical treatment alone: the debate is not over. J Tehran Heart Cent 2011; 6:1-13. [PMID: 23074598 PMCID: PMC3466861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 11/13/2010] [Indexed: 10/25/2022] Open
Abstract
The management of carotid artery stenosis reduces the risk of stroke and its related deaths. Management options include risk factor modification and medical therapy, carotid endarterectomy (CEA), and carotid artery stenting (CAS). Although several randomized controlled trials (RCTs), mostly conducted in late-1980s and mid-1990s, have proved CEA to be effective in the prevention of ipsilateral ischemic events in selected patients with carotid artery stenosis, aggressive risk factor modification and medical therapy with recently introduced antiplatelet agents, statins, and more effective antihypertensive medications may have reduced compelling indications for immediate surgery in asymptomatic populations. Also recently, due to improvements in percutaneous techniques and carotid stents, CAS has received wide attention as a potential alternative to CEA. Herein, we review the recent data on the management options of carotid artery stenosis and seek to identify the most appropriate treatment strategy in selected patients with carotid artery stenosis.
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Affiliation(s)
- Seyed Ebrahim Kassaian
- Corresponding Author: Seyed Ebrahim Kassaian, Associate Professor of Cardiology, Tehran University of Medical Sciences, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029256. Fax: +98 21 88029256.
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Nosrati M, Boroumand M, Tahmasebi S, Sotoudeh M, Sheikhfathollahi M, Goodarzynejad H. Excess costs associated with common healthcare-associated infections in an Iranian cardiac surgical unit. J Hosp Infect 2010; 76:304-7. [DOI: 10.1016/j.jhin.2010.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2010] [Accepted: 07/08/2010] [Indexed: 11/24/2022]
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Nosrati M, Amelimojarad E, Anvari M, Goodarzynejad H, Sheikhfathollahi M, Boroumand M. Prevalence of nosocomial infections in a tertiary heart centre in Iran, 2006 and 2007. J Hosp Infect 2010; 76:367-8. [DOI: 10.1016/j.jhin.2010.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 05/28/2010] [Indexed: 10/19/2022]
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Sadeghian H, Ahmadi F, Lotfi-Tokaldany M, Kazemisaeid A, Fathollahi MS, Goodarzynejad H. Ventricular asynchrony of time-to-peak systolic velocity in structurally normal heart by tissue Doppler imaging. Echocardiography 2010; 27:823-30. [PMID: 20545999 DOI: 10.1111/j.1540-8175.2010.01156.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Echocardiographic measurements of time-to-peak systolic velocities (Ts) are helpful for assessing the degree of cardiac asynchrony. We assessed the degree of ventricular asynchrony in structurally normal heart according to Ts by tissue Doppler imaging. METHODS We performed conventional echocardiography and tissue velocity imaging for 65 healthy adult volunteers to measure the Ts of 12 left ventricular segments in the mid and basal levels delay of Ts and standard deviation (SD) of Ts in all and basal segments. Six frequently used markers of dyssynchrony were measured and were also compared between men and women. Data are presented as median (25th and 75th percentile). RESULTS Septal-lateral and anteroseptal-posterior delays were 50 (20, 90) and 20 (0, 55) ms. The delay between the longest and the shortest Ts in basal and all segments were 100 (80, 120) and 110 (83, 128) ms, respectively. SD of Ts was 39 (24, 52) ms for basal and 41 (28, 51) ms for all segments. Overall, 76.9% of cases had at least one marker of dyssynchrony. Frequencies of dyssynchrony markers were almost significantly higher in women compared to men. The most frequently observed dyssynchrony marker was SD of Ts of all segments (70.8%) and the lowest was anteroseptal-posterior delay (21.5%). CONCLUSIONS Normal population almost had dyssynchrony by previously described markers and many of these markers were more frequent in women. Conducting more studies on normal population by other tissue Doppler modalities may give better description of cardiac synchronicity.
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Affiliation(s)
- Hakimeh Sadeghian
- Echocardiography Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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Rezaei O, Khodaie-Ardakani MR, Mandegar MH, Dogmehchi E, Goodarzynejad H. Prevalence of metabolic syndrome among an Iranian cohort of inpatients with schizophrenia. Int J Psychiatry Med 2010; 39:451-62. [PMID: 20391865 DOI: 10.2190/pm.39.4.i] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiovascular disease is an important cause among natural causes of death in schizophrenic patients. The metabolic syndrome (MetS) has been associated with an increased risk of morbidity and mortality due to cardiovascular disease. There are limited if any data on prevalence of MetS in Iranian patients with schizophrenia. METHODS Between December 2007 and May 2008, all consecutive patients with schizophrenia hospitalized at our university psychiatry hospital were entered in the study. The prevalence of MetS was evaluated based on the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III), the adapted ATP-III guidelines (ATP-III A), and the recently suggested criteria by International Diabetes Federation (IDF). RESULTS Of the study participants, 223 were men (59.9%) and 149 women (40.1%). Overall prevalence of the MetS according to the different definitions were 27.4% (ATP-III), 37.6% (ATP-III A), and 38.7% (IDF), which was over 30% more than the prevalence of MetS in the Iranian general population. The MetS was much more prevalent in women which mainly related to the fact that women had central obesity more frequently. CONCLUSIONS Our results confirm the high prevalence of MetS in schizophrenic patients. These results clearly suggest the necessity for a careful monitoring and management of metabolic risk factors in this high-risk population.
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Affiliation(s)
- Omid Rezaei
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Jebeli M, Ghazinoor M, Mandegar MH, Rasouli MR, Eghtesadi-Araghi P, Goodarzynejad H, Mohammadzadeh R, Darehzereshki A, Dianat S. Effect of milrinone on short-term outcome of patients with myocardial dysfunction undergoing coronary artery bypass graft: A randomized controlled trial. Cardiol J 2010; 17:73-78. [PMID: 20104460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Myocardial dysfunction needing inotropic support is a typical complication after on-pump cardiac surgery. In this study, we evaluate the effect of milrinone on patients with ventricular dysfunction undergoing coronary artery bypass graft (CABG). METHODS Seventy patients with impaired left ventricular function [left ventricular ejection fraction (LVEF) < 35%] undergoing on-pump CABG were enrolled. Patients were randomized to receive either an intraoperative bolus of milrinone (50 microg/kg) or saline as placebo followed by a 24-hour infusion of each agent (0.5 microg/kg/min). Hemodynamic parameters and transthoracic echocardiographic measurement of systolic and diastolic functions were the variables evaluated. RESULTS Serum levels of creatine phosphokinase (CPK), the MB isoenzyme of creatine kinase (CK-MB), occurrence of myocardial ischemia or infarction, and mean duration of using inotropic agents were significantly lower in the milrinone group (p < 0.05). There were no significant differences between the two groups regarding the development of ventricular arrhythmia, duration of cardiopulmonary bypass, intra-aortic balloon pump and inotropic support requirement, duration of mechanical ventilation, duration of intensive care unit stay and mortality rate. Although mean pre-operative LVEF was significantly lower in the milrinone group, there was no significant difference between post-operative LVEFs. CONCLUSIONS We suggest that perioperative administration of milrinone in patients undergoing on-pump CABG, especially those with low LVEF, is beneficial.
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Affiliation(s)
- Mohammad Jebeli
- Cardiac Surgery Department, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
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Najafi M, Goodarzynejad H, Sheikhfathollahi M, Adibi H. Role of surgeon in length of stay in ICU after cardiac bypass surgery. J Tehran Heart Cent 2010; 5:9-13. [PMID: 23074561 PMCID: PMC3466845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Accepted: 10/08/2009] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND We presumed that the surgeon himself has an impact on the results after coronary artery bypass grafting (CABG) as there is no unique protocol for the discharge of post-operative cardiac patients at our institution. Therefore, we examined whether the surgeon himself has an impact on the intensive care unit (ICU) stay of isolated CABG patients. METHODS We prospectively studied a total of 570 consecutive patients undergoing elective CABG. Length of stay in the ICU was defined as the number of days in the ICU unit post-operatively. Seven operating surgeons were classified in 3 categories on the basis of the mean hospital stay of their patients (1, 2 and 3 if the mean total patients' stay in hospital was <8 days, between 8 to 10 days, and longer than 10 days; respectively). Using a multivariable regression model, we determined the independent predictors of length of stay in the ICU (> 48 hours) and examined the role of surgeon in this regard. RESULTS Incidence of post-operative arrhythmia and length of ICU stay were higher in the patients of surgeon category 3 than those of surgeon categories 1 and 2. Surgeon category 3 also operated on patients with higher EuroSCOREs than did surgeon categories 1 and 2. With the aid of a multivariable stepwise analysis, three variables were identified as independent predictors significantly associated with ICU length of stay: age, history of cerebrovascular accident, and surgeon category. CONCLUSION Surgeon category may independently predict a prolonged length of stay in the ICU. We suggest that a unique discharge protocol for post-CABG patients be considered to restrict the role of surgeon in the ICU stay of these patients.
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Affiliation(s)
- Mahdi Najafi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Mahdi Najafi, Assistant Professor of Anesthesiology, Tehran University of Medical Sciences, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029674. Fax: +98 21 88029724. E-mail:
| | | | | | - Hossein Adibi
- Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Goodarzynejad H, Anvari MS, Boroumand MA, Karimi A, Abbasi SH, Davoodi G. Hyperuricemia and the Presence and Severity of Coronary Artery Disease. Lab Med 2010. [DOI: 10.1309/lmkdb9pbkzgus20t] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Boroumand M, Goodarzynejad H. Monitoring of anticoagulant therapy in heart disease: considerations for the current assays. J Tehran Heart Cent 2010; 5:57-68. [PMID: 23074569 PMCID: PMC3466827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Clinicians should be aware of new developments to familiarize themselves with pharmacokinetic and pharmacodynamic characteristics of new anticoagulant agents to appropriately and safely use them. For the moment, cardiologists and other clinicians also require to master currently available drugs, realizing the mechanism of action, side effects, and laboratory monitoring to measure their anticoagulant effects. Warfarin and heparin have narrow therapeutic window with high inter- and intra-patient variability, thereby the use of either drug needs careful laboratory monitoring and dose adjustment to ensure proper antithrombotic protection while minimizing the bleeding risk. The prothrombin time (PT) and the activated partial thromboplastin time (aPTT) are laboratory tests commonly used to monitor warfarin and heparin, respectively. These two tests depend highly on the combination of reagent and instrument utilized. Results for a single specimen tested in different laboratories are variable; this is mostly attributable to the specific reagents and to a much lesser degree to the instrument used. The PT stands alone as the single coagulation test that has undergone the most extensive attempt at assay standardization. The international normalized ratio (INR) was introduced to "normalize" all PT reagents to a World Health Organization (WHO) reference thromboplastin preparation standard, such that a PT measured anywhere in the world would result in an INR value similar to that which would have been achieved had the WHO reference thromboplastin been utilized. However, INRs are reproducible between laboratories for only those patients who are stably anticoagulated with vitamin K antagonists (VKAs) (i.e., at least 6 weeks of VKA therapy), and are not reliable or reproducible between laboratories for patients for whom VKA therapy has recently been started or any other clinical conditions associated with a prolonged PT such as liver disease, disseminated intravascular coagulation, and congenital factor deficiencies. In contrast to marked progress in the standardization of PT reagents for INR reporting, no standardization system has been globally adopted for standardization of PTT reagents. Recently College of American Pathologists recommend that individual laboratories establish their own therapeutic range by using aPTT values calibrated against accepted therapeutic unfractionated heparin (UFH) levels calibrated against accepted therapeutic UFH levels performing anti-Xa test (which is the most accurate assay for monitoring UFH therapy).Herein, we review recent data on the monitoring of conventional anticoagulant agents. Marked interlaboratory variability still exists for PT, INR, and PTT tests. Further research should be focused on improving the standardization and calibration of these assays.
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Affiliation(s)
- Mohammadali Boroumand
- Corresponding Author: Mohammad Ali Boroumand, Associate Professor of Pathology, Tehran Heart Center, North Kargar Street, Tehran, Iran. 1411713138. Tel: +98 21 88029231. Fax: +98 21 88029231. E-mail:
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Anvari MS, Boroumand MA, Pourgholi L, Sheikhfathollahi M, Rouhzendeh M, Rabbani S, Goodarzynejad H. Potential Link of Microalbuminuria with Metabolic Syndrome in Patients Undergoing Coronary Angiography. Arch Med Res 2009; 40:399-405. [DOI: 10.1016/j.arcmed.2009.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 06/15/2009] [Indexed: 11/26/2022]
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Boroumand M, Ghaedi M, Mohammadtaghvaei N, Pourgholi L, Anvari MS, Davoodi G, Amirzadegan A, Saadat S, Sheikhfathollahi M, Goodarzynejad H. Lipid profile and inflammatory markers associated with estrogen receptor alpha PvuII and XbaI gene polymorphisms. Transl Res 2009; 153:288-95. [PMID: 19446283 DOI: 10.1016/j.trsl.2009.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 02/17/2009] [Accepted: 02/18/2009] [Indexed: 10/21/2022]
Abstract
Estrogen is established to influence lipoprotein metabolism and inflammatory markers. Alternations in estrogen receptor alpha (ESR1) expression and function may affect the role of estrogen in this regard. The aim of this study was to determine whether ESR1 PvuII and XbaI gene polymorphisms have effects on lipoprotein (a) as well as inflammatory variables in an Iranian population. Three hundred and ninety seven consecutive participants (228 men, 57.4%) who were admitted at our center for elective coronary angiography because of symptoms related to coronary artery disease (CAD) were enrolled in our study. Total cholesterol, high-density lipoprotein (HDL)-cholesterol, and triglyceride levels were determined by standard methods using commercial kits. Low-density lipoprotein (LDL)-cholesterol was calculated according to the Friedewald formula. The lipoprotein (a) levels were measured by ELISA method using Biopool kit, and the CRP concentrations were determined by Latex Immunoturbidometry. The presence of PvuII and XbaI polymorphisms within the ESR gene were analyzed using polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP). The frequency of homozygous and heterozygous were 25.9% and 50.1%, for PvuII genotypes, and the frequency was 23.7% and 48.6%, for XbaI genotypes, respectively. After adjusting for CAD and age, no impacts of ESR1 PvuII and XbaI polymorphisms were found on lipid profile, lipoprotein (a) level, and quantitative CRP either in total population or in subgroups stratified by gender. In conclusion, our data demonstrate that ESR1 PvuII and XbaI gene polymorphisms did not seem to have an effect on lipoprotein metabolism or on inflammatory variables such as CRP.
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Karimi A, Marzban M, Movahedi N, Salehiomran A, Sadeghian S, Goodarzynejad H. Traditional cardiac risk factors profile in Iranian patients undergoing coronary artery bypass surgery. Acta Cardiol 2009; 64:371-7. [PMID: 19593949 DOI: 10.2143/ac.64.3.2038024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE It is well known that the traditional cardiac risk factors (TCRFs) affect short-term and long-term outcome following coronary artery bypass graft surgery (CABG). The objective of this study was to detect the prevalence of these risk factors i.e., hypertension, diabetes mellitus, hyperlipidaemia, smoking and family history of premature CAD in an Iranian population undergoing coronary artery bypass surgery. METHODS AND RESULTS From March 2001 to September 2005, we retrospectively analysed prospectively collected data from our registry. Data were achieved regarding TCRFs in 10,622 consecutive patients undergoing elective CABG. Mean age of the patients was 58.75 +/- 9.72 years and 74.4% were men. The majority of the patients were overweight with a body mass index (BMI) > or = 25.0 kg/m2. Hyperlipidaemia was present in 63.9% of the patients. Over half of all the patients had hypertension and over one third diabetes. History of smoking was present in 37.7% of the patients and one third had a family history of CAD. Of all the patients, 91.6% had at least one of the TCRFs. As compared to men, women were more overweight or obese, and had a greater prevalence of hyperlipidaemia, hypertension, diabetes mellitus, and family history of CAD but smoking was much more common in men than in women. CONCLUSION The current study revealed a high prevalence of most of TCRFs in an Iranian population that underwent CABG.
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Affiliation(s)
- Abbasali Karimi
- Department of Cardiac Surgery, Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran
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Najafi M, Goodarzynejad H, Karimi A, Ghiasi A, Soltaninia H, Marzban M, Salehiomran A, Alinejad B, Soleymanzadeh M. Is preoperative serum creatinine a reliable indicator of outcome in patients undergoing coronary artery bypass surgery? J Thorac Cardiovasc Surg 2009; 137:304-8. [DOI: 10.1016/j.jtcvs.2008.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 06/30/2008] [Accepted: 08/04/2008] [Indexed: 11/30/2022]
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