Search

Data and computational literacies empower youth to be active participants and future leaders in our increasingly data-driven society. We conducted a design-based research project in which a small group (n = 5) of high school youth from diverse backgrounds learned how to code and create data visualizations and stories with public data about climate change in a 5-day (20 h total) free virtual summer program. Using interaction analysis methods to microanalyze students' engagements with data technologies, we developed the computational data literacy model (CDLM) to describe students' participation in various computational data literacies that emerged from our analysis (remixing, wayfinding, interpreting variables, making hypotheses, and personalizing data) and their use of different data tools (the code, data visualization, variable of interest, and story) to support scientific inquiry and reasoning. Using the CDLM, the presented analysis investigates how students navigated across coding and storytelling cycles of activities. Within those cycles, students collaboratively problem-solved in the code and engaged in collaborative inquiry, drawing on personal experiences to make multivariate hypotheses and stories about human impacts on carbon emissions. Our findings suggest that using a socioscientific issue (SSI) context supported students' back-and-forth movement between coding and storytelling activities, perhaps by affording greater personalization of the data, which, in turn, facilitated data-based reasoning. The findings of this study inform our understanding of the challenges and learning opportunities in this computational, data-rich intervention situated in socioscientific inquiry. We discuss future uses of our model for learning designs to support computational data activities about SSIs. [ABSTRACT FROM AUTHOR]

Introduction: Sodium–glucose cotransporter 2 (SGLT2) inhibitors are emerging antidiabetic agents with various potential cardiovascular benefits. The EMPT‐ANGINA trial examined the effect of empagliflozin on the angina burden in those with concurrent type 2 diabetes mellitus (T2DM) and refractory angina (RA). Method: In this 8‐week, double‐blind, randomized, placebo‐controlled trial, 75 patients with T2DM and RA were randomly assigned to one of two groups: empagliflozin (n = 37) and placebo (n = 38). The primary outcome was an improvement in angina, which was assessed by the Seattle Angina Questionnaire (SAQ). The secondary outcomes of this study included alterations in the SAQ domains and exercise test components. Results: The mean age of individuals in the empagliflozin and placebo groups was 67.46 ± 9.4 and 65.47 ± 7.0 years, respectively (p =.304). Patients who received empagliflozin showed a significant improvement in both the primary endpoint, which was the SAQ Summary Score (192.73 ± 20.70 vs. 224 ± 25.36, p <.001) and the secondary endpoints. Exercise test components, including treadmill exercise duration, time till angina, 1 mm ST‐segment depression onset, and heart rate (HR) recovery, were all significantly improved in the empagliflozin group. This positive impact was reached with no clinically significant changes in resting and exertion HR or blood pressure. There were no significant side effects in the empagliflozin group (p =.125). Conclusion: Empagliflozin can be safely added as a metabolic modulator agent to existing antianginal medications in individuals with concurrent T2DM and RA to reduce angina symptoms and enhance exercise capacity with minimal side effects. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The use of allopurinol has shown promising outcomes in reducing oxidative processes responsible for atherogenic-related cardiovascular events. The current study aims to assess the effects of high-dose allopurinol on the post-revascularization coronary blood flow and inflammatory biomarkers in patients with non-ST segment elevated myocardial infarction (NSTEMI). METHOD: Eighty NSTEMI patients were randomly divided into two groups: the intervention group (n=40), medicated with a high loading dose of 600 mg allopurinol before the coronary angiography, and the control group (n=40), treated with a placebo. The highly sensitive C-reactive protein (hs-CRP) was measured at baseline and within 24 hours after the cardiac interventions and compared between the case and control groups. Post percutaneous coronary intervention (PCI) Thrombolysis in Myocardial Infarction (TIMI) flow grading was also evaluated as a revascularization endpoint. RESULTS: The two groups of the study were similar in terms of demographic, clinical, laboratory, and angiographic characteristics (P-value>0.050). The assessed TIMI flow was similar between the cases and the controls both prior to (P-value=0.141) and after (P-value=0.395) the coronary angioplasty. The hs-CRP (P-value=0.016) was significantly higher in the control group. Post-angiographic assessment of hs-CRP revealed an insignificant difference between the groups (P-value=0.104). CONCLUSION: In conclusion, premedication with a high dose of allopurinol in NSTEMI patients did not affect the inflammatory biomarker or the revascularization endpoint. [ABSTRACT FROM AUTHOR]

BACKGROUND: Ischemic heart disease (IHD) is the first cause of mortality in the world. Stable coronary artery disease (CAD) is the most common IHD. Medical therapy (MT), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are three strategies for the management of this disease. The main aim of this study was the comparison of MT with PCI or CABG in terms of cardiovascular (CV) mortality, myocardial infarction (MI), unplanned revascularization (UR), stroke, and freedom from angina in managing stable CAD. METHODS: The Cochrane Central Register of Controlled Trials, Embase, PubMed, and Scopus were searched. Two reviewers independently appraised the titles and abstracted data of the identified studies. After the Full-text reviewing phase, eligible studies were analyzed through the random-effect meta-analysis method. Finally, a sensitivity analysis was conducted for the robustness of findings. RESULTS: Nine randomized controlled trials (RCTs) were included. The pooled RR of CV mortality associated with MT compared with PCI and CABG was 1.22 and 1.385, respectively. Overall, The RR of MT associated with MI, UR, stroke, and freedom from angina compared with PCI was 1.001, 1.151, 0.799, and 0.801, respectively. CONCLUSION: Our results revealed no statistically significant difference between MT and PCI in terms of studied primary outcomes. The findings also highlighted that there is no statistically significant difference between MT and CABG in terms of CV mortality. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to predict significant coronary artery disease (CAD) in patients undergoing coronary angiography. METHODS: In this cross-sectional study, data of 384 patients who underwent angiography during 2015-2017 were reviewed. Electrocardiograms (ECGs) were evaluated in terms of having positive T wave in lead V1 (TV1) described as T wave with amplitude of more than 0.15 mV and angiography records were assessed for presence of significant CAD defined as presence of ≥ 70% internal diameter stenosis in at least one major epicardial coronary artery or more than 50% stenosis in left main artery (LMA). RESULTS: Out of 384 patients who participated in this study with mean age of 63.6 ± 10.2 years (40-89 years), 71.6% showed positive TV1 and significant CAD simultaneously and left anterior descending artery (LAD) and left circumflex artery (LCX) lesions were more frequently reported in coronary angiography. Based on chi-square test, the prevalence of significant CAD was obviously more in those with positive TV1 as compared to those without this finding [odds ratio (OR) = 2.74, 95% confidence interval (CI): 1.80-4.19, P < 0.001]. Mann-Whitney test showed significant difference in number of coronary arteries involved in CAD between presence of positive and negative T wave in lead V1 (P < 0.001). Great number of patients with significant CAD had remarkably higher T wave amplitude in lead V1 in comparison to lead V6 (OR = 6.22, 95% CI: 3.14-12.30, P < 0.001). CONCLUSION: Positive TV1 and TV1 > TV6 pattern can be considered as a predictor for significant CAD in patients with otherwise normal ECG. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute coronary syndrome (ACS) is a common condition that needs appropriate treatment like percutaneous coronary intervention (PCI). Glycoprotein IIb/IIIa inhibitors (GPI) like eptifibatide prevent procedural ischemic complications after PCI. Eptifibatide has increased the risk of bleeding complications, although it is effective in reducing mortality and morbidity. Eptifibatide is routinely used in bolus and infusion forms and the aim of this study is to evaluate the efficacy of bolus-only dose and bolus + infusion strategy for administrating eptifibatide in bleeding complications and consequences after PCI. METHODS: This randomized clinical trial was conducted on subjects who experienced PCI after incidence of myocardial infarction (MI). Patients were randomly divided into two groups who received bolus-only dose (n = 51) or bolus + infusion form of eptifibatide (n = 50). Then, PCI blood pressure, mean time duration of hemostasis after arterial sheath removal, laboratory data, need for blood transfusion, and presence of bleeding complications were evaluated. After 6 months, patients were followed for needs for additional coronary interventions. RESULTS: The mean age of participants was 61.68 ± 1.50 years. The prevalence of men was 70.29%. There was no significant difference in mean of systolic blood pressure (SBP) and diastolic blood pressure (DBP) during hospitalization (P > 0.050). The mean time duration of hemostasis was 8.13 ± 0.45 minutes in the bolus-only group and 16.46 ± 0.71 minutes in the bolus + infusion group (P < 0.001). There was no significant difference in the hemoglobin (Hb) level, platelet count, white blood cell (WBC), blood urea nitrogen (BUN), and creatinine level (P > 0.050). CONCLUSION: The results of this study suggested that bolus-only dose of eptifibatide before PCI could be able to decrease significantly bleeding complication and other clinical and cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Management of atrial fibrillation (AF), besides prevention of stroke, mainly stresses symptom control and improvement of quality of life (QOL). In patients with permanent AF, exercising may improve QOL, rhythm, and symptoms. The purpose of this study was to determine the impact of aerobic physical rehabilitation on the QOL of patients suffering from AF and admitted to a coronary care unit (CCU). METHODS: This randomized controlled clinical trial study was conducted on 50 patients who were hospitalized with chronic AF in the CCU of Montazeri Hospital, Najafabad, Iran, and had the inclusion criteria. The participants were selected using convenience sampling method, and were randomly divided into experimental (n = 25) and control (n = 25) groups. The experimental group received a rehabilitation program in the form of an educational package and scheduled physical activity of aerobics for 8 weeks, and the control group received CCU routine care. The researcher measured the patients' QOL before and after the intervention using the 36-Item Short Form Health Survey (SF-36). RESULTS: There was no significant difference in the mean score of total QOL between the control and experimental groups before the intervention (P > 0.050). However, the comparison of the mean score of total QOL after the intervention showed a significant increase in the experimental group (P < 0.050). CONCLUSION: Aerobic rehabilitation activities are effective on the QOL of patients with chronic AF. [ABSTRACT FROM AUTHOR]

Background: Lifestyle modification is an essential factor in the promotion of health in patients with acute coronary syndrome (ACS). One of the interventions to promote lifestyle is interactive follow-up, which, according to the traditional methods, requires spending significant amount of time and cost. Therefore, this study aimed to determine the effectiveness of interactive text message follow-up on health promoting lifestyle of patients with ACS. Materials and Methods: This was a randomized controlled trial among 100 patients suffering from ACS during October-February 2016. The participants were randomly assigned to the experimental and control groups. Collection of data on lifestyle was performed before, 3, and 4 months after the beginning of the intervention using Walker's Health Promoting lifestyle questionnaire. Six messages were sent to the intervention groups each week, and participants asked the questions by sending text message, each week 1 message were sent to the control group for 12 weeks. The statistical analysis of data was performed using independent t-test, Chi-square, Mann-Whitney U test, and repeated measures analysis of variance (ANOVA). Results: Before the intervention, there was no significant difference between the mean score of lifestyle of the two groups, however, 3 months and 4 months after the beginning of the intervention, the mean score of lifestyle in the intervention group was significantly higher than that of the control group (P < 0.001). Conclusion: The interactive text message follow-up is effective in promoting the lifestyle of patients with ACS and can be considered in the planning of follow-up of patients with ACS. [ABSTRACT FROM AUTHOR]

Background: Myocardial infarction remains a leading cause of morbidity and mortality among cardiac disease. Cardiac wall thickening in patients with myocardial infarction is less than healthy individuals. Accurate measurement of cardiac wall fractional thickening and path-length of myocardium points in healthy data and patients with myocardial infarction can help physicians in diagnosing the affected area. Patients and Methods: Epi/Endocardium of all slices in end-diastole frame were segmented, then more than 150 points in each slice were selected to track by weighted normalized mutual information algorithm overall frames. Weighted normalized mutual information was computed between two three-dimensional masks sized 3 x 3 x 3, pixel that were located in end-diastole and subsequent frames centroid of the selected points. Finally, by computing the distance between endocardium and epicardium in each slice over all frames, cardiac wall thickness and fractional thickening was measured. Moreover, the path-length of each data point during cardiac period was calculated and sketched in bulls-eye format. Evaluation of the method was done by ten healthy and twenty patients with myocardial infarction. Results: Cardiac wall kinesis was evaluated by normalized path length, which was presented in standard 17-segment bull's-eye format. Wall thickness and fractional wall thickening for all slices over all frames were extracted in order to determine the infarct region. Infarct regions had minimal fractional thickening and normalized path length. All evaluations demonstrated hypo-kinesis in the damaged region. Conclusion: Evaluation of obtained results showed significant difference between local parameters of healthy and infarcted myocardium. In all patients, the process was able to precisely determine the affected region that was all well matched with clinical evidence. [ABSTRACT FROM AUTHOR]

Background: Contrast induced nephropathy (CIN) is one of the most common complications after radiographic procedures using intravascular radiocontrast media. The aim of the current study was to assess the effect of atorvastatin on prevention of CIN in patients undergoing coronary angiography. Materials and Methods: In a clinical trial study, 200 patients referred for angiography were randomly divided into two groups of using 80 mg atorvastatin and placebo before the procedure. Furthermore, 100 patients who were under chronic treatment of statins were included as the third group. Serum creatinine (Scr) levels before and after the procedure were evaluated and incidence of CIN (post-procedural Scr of >0.5 mg/dl or >25% from baseline) was assessed. Results: Mean age of the participants was 60.06 ± 0.69 years and 276 (92%) were male. There were no significant differences between group with respect to age and gender. In pre-operation atorvastatin, placebo and long term statin groups, the incidence of CIN was 1%, 2% and 1%, and mean changes of Glomerular filtration rate (GFR) was 3.68 ± 1.32, −0.77 ± 1.21 and 1.37 ± 0.86; and mean changes of creatinine (Cr) was −0.05 ± 0.02, 0.02 ± 0.02 and −0.01 ± 0.01 respectively. (P = 0.776, 0.026 and 0.041 respectively). In pre-operation atorvastatin group, Cr decreased, and GFR increased significantly (P = 0.019 and 0.007 respectively). Conclusion: pre-operation short term high dose atorvastatin use was associated with a significant decrease in serum Cr level and increase in GFR after angiography. [ABSTRACT FROM AUTHOR]

BACKGROUND: Statins are shown effective by some studies in preventing contrast-induced nephropathy (CIN). We evaluated the effectiveness of atorvastatin in the prevention of CIN in computed tomography angiography (CTA) candidates. METHODS: This study was conducted on patients referring for elective CTA with normal renal function. Patients received atorvastatin (80 mg/day) or placebo from 24 h before to 48 h after administration of the contrast material. Serum creatinine was measured before and 48 h after contrast material injection. CIN was defined as an increase in serum creatinine level of ⩾ 0.5 mg/dl or ⩾ 25% of the baseline creatinine. RESULTS: A total of 236 patients completed the study; 115 atorvastatin, 121 placebo, mean age = 58.40 ± 9.80 year, 68.6% male. Serum creatinine increased after contrast material injection in both the atorvastatin (1.00 ± 0.16-1.02 ± 0.15 mg/dl, P = 0.017) and placebo groups (1.03 ± 0.17-1.08 ± 0.18 mg/dl, P < 0.001). Controlling for age, gender, comorbidities, drug history, and baseline serum creatinine level, patients who received atorvastatin experienced less increase in serum creatinine after contrast material injection (beta = 0.127, P = 0.034). However, there was no difference between the atorvastatin and placebo groups in the incidence of CIN (4.3 vs. 5.0%, P = 0.535). CONCLUSION: In patients undergoing CTA, a short-term treatment with high dose atorvastatin is effective in preventing contrast-induced renal dysfunction, in terms of less increase in serum creatinine level after contrast material injection. Further trials including larger sample of patients and longer follow-ups are warranted. [ABSTRACT FROM AUTHOR]

Background: Lead is a pollutant with numerous adverse effects on health. Since it can affect blood pressure, peripheral blood vessels, and the heart, the present study aimed to evaluate the relation between occupational exposure to lead and blood pressure. Materials and Methods: This cross-sectional study included male individuals working in battery firms in Isfahan. A questionnaire covering demographic characteristics and the history of different diseases and occupational exposure to lead was completed. Each participant's blood pressure was also measured and recorded. After obtaining blood samples and determining lead levels, mean and frequency analyses were performed. In addition, Pearson's correlation test and linear regression were used to assess the relation between blood lead levels (BLLs) and systolic and diastolic blood pressure. All analyses were performed in SPSS.19 Results: The mean age of the 182 studied workers was 42.85 ± 13.65 years. They had worked in battery firms for a mean period of 23.67 ± 14.72 years. Moreover, the mean value of BLLs among the participants was 7.92 ± 3.44 µg/dL. Correlation between BLL and systolic and diastolic blood pressure was not significant. The effects of lead on systolic and diastolic blood pressure after stepwise regression were B = -0.327 [confidence interval (CI) 95%: -0.877 to 0.223] and B = -0.094 (CI 95%: -0.495 to 0.307), respectively. Conclusion: This study revealed that BLLs in battery firm workers to be normal. Additionally, BLLs were not significantly related with either systolic or diastolic blood pressure which might have been the result of normal BLLs. [ABSTRACT FROM AUTHOR]

BACKGROUND: The present study assessed the significance of troponin and myeloperoxidase levels in the prediction of major adverse cardiac events (MACE) during the 1st month after percutaneous coronary intervention (PCI). METHODS: This prospective, longitudinal study included 100 patients with acute coronary syndrome who underwent PCI. The participants' characteristics were recorded in a questionnaire. Blood samples were obtained before and 24 h after PCI, and troponin, and myeloperoxidase levels were measured. During the 1st month after PCI, death, myocardial reinfarction, and revascularization during admission were investigated through weekly phone calls. The value of troponin and myeloperoxidase levels before and after PCI in predicting MACE was evaluated using Cox regression. RESULTS: Considering the obtained methods and the short duration of the study, 99% of the patients completed the study. Moreover, one death and four cases of myocardial infarction and revascularization were reported. Cox regression did not show significant relations between the incidence of MACE and myeloperoxidase levels before (hazard ratio: 1.12; 95% confidence interval 0.9, 1.39) and after PCI (hazard ratio: 0.86; 95% confidence interval: 0.43, 1.71), or troponin levels before (hazard ratio: 0.97; 95% confidence interval: 0.81, 1.17) and after PCI (hazard ratio: 1.03; 95% confidence interval: 0.96, 1.11). CONCLUSION: It seems that the few cases of MACE, due to the small sample size and short duration of follow-up, had been insufficient for determining the predictive value of troponin and myeloperoxidase levels before and after PCI. Therefore, further studies with larger sample size and longer follow-up duration are recommended. [ABSTRACT FROM AUTHOR]

Introduction. Oats are high in soluble fibers and effective in reducing the risk of cardiovascular diseases (CVD). We assessed the effects of beta-glucan fromoat bran on serumnitric oxide (NO) endothelial function in patientswith hypercholesterolemia.Method. Sixty hypercholesterolemic patients were randomly divided to receive an experimental bread rich in beta-glucan from oat bran (intervention) or bread rich in wheat fiber (control) for four weeks. All subjects had the same diet for two-week baseline period and hypocaloric diet for four weeks of intervention. SerumNO concentration and flow-mediated dilation (FMD) were determined before and after the experiment. Results. Mean age of the participants was 51.1 ± 9.3 years and 65% (n = 39) were female. After intervention, serum NO concentration increased by 50.2 ± 19.8 μmol/lit in the intervention group (P = 0.017), but no change was observed in the control group (17.5 ± 27.5 μmol/lit; P = 0.530). No change of FMD was observed in the intervention (0.48 ± 0.78%; P = 0.546) or in the control group (0.59 ± 0.92%; P = 0.533). Conclusion. Consumption of oat bread for four weeks increases serum NO concentration but has no effect on FMD. Further studies are warranted in this regard. [ABSTRACT FROM AUTHOR]

BACKGROUND: Iron is essential for many physiological processes; whereas, iron overload has been known as a risk factor in progression of atherosclerosis. The aim of this study was to investigate the importance of serum ferritin levels, which are known as an indicator of body iron stored in the incidence of coronary artery disease (CAD). METHODS: In a case-control study, we evaluated 432 eligible men who underwent coronary angiography at Chamran Cardiology Hospital, Isfahan, Iran. They were separated into two groups of case (with CAD) and control (without CAD). All subjects had given written informed consents. Then, the blood samples were taken after 12-14 hours of fast by a biologist for measuring cardiovascular risk factors and body iron stores, including serum ferritin, serum iron, and total iron binding capacity (TIBC). For statistical analyses, chi-square test, Student's t-test, one-way ANOVA, and the logistic regression were used. RESULTS: In the present study, 212 participants with CAD in the case group and 220 participants free of CAD in the control group were included in the analysis. At baseline, there were significant differences in serum ferritin (P < 0.001) and other cardiovascular risk factors between the two groups. Moreover, when other risk factors of CVD were included in the model, serum ferritin [Odd Ratio (OR) = 1.006, 95% confidence interval (CI) 1.00-1.01, P = 0.045] and serum ferritin ≥ 200 (OR = 4.49, 95% CI 1.72-11.70, P < 0.001) were associated with CAD. CONCLUSION: High iron store, as assessed by serum ferritin, was associated with the increased risk of CAD. Furthermore, it was a strong and independent risk factor in the incident of atherosclerosis in the Iranian male population. [ABSTRACT FROM AUTHOR]

Background: To evaluate the association of apolipoprotein B (apoB), apolipoprotein A (apoA), and apoB/apoA ratio with the body fat indicators in patients with stable angina pectoris (SA). Materials and Methods: One hundred and twenty two participants aged 40-60 years old, with a mean age of 52.1 ± 7.2 years and SA, were recruited for the present study. Body weight, height, and waist circumference (WC) were measured, and waist to height ratio (WHtR) was calculated. After 12 hours of fasting, a blood sample was obtained and serum levels of apoB and apoA were measured and the apoB/apoA ratio was calculated. These patients underwent an abdominal computerized tomography scan (CTS) to assess visceral and subcutaneous adipose tissue (VAT, SAT). Linear regressions were computed to assess the relation of apoB, apoA, and their ratio with various measurements of adiposity (VAT, SAT, WC, and WHtR), with adjustment for age, sex, and BMI ≥ 25, WC ≥ 80 in women and WC ≥ 90 in men and WHtR ≥ 0.59. Results: From totally 123 patients with SA with a mean age of 52.1 ± 7.2 years, 44.7% male and 55.3% women were entered. Significant positive associations were found between visceral fat area and the apoB/apoA ratio (P = 0.02, β = 0.2), and significant negative correlations were observed between visceral fat area and apoA concentrations (P = 0.04, β = -0.2). Conclusion: As abdominal fat accumulation is associated with other risk factors such as apolipoproteins in ischemic patients, then we most focus on control of these factors. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of the present study is to evaluate the accuracy of 64-multidetector-row computed tomography angiography (CTA) in comparison to conventional invasive angiography (CIA) in the diagnosis of significant stenosis (≥ 50%) of coronary artery tree. METHODS: Assessment of CTA in the detection of coronary artery disease (CAD) was performed in patients referred because of symptoms or stress studies suggestive of ischemia. For this purpose, among more than 1000 cases of coronary CTA in a 20 months period a study population of 54 patients suspected to have significant stenosis of the coronary artery tree was investigated. The CIA procedure was performed in these patients one month after CTA. The accuracy of CTA in detecting significant stenosis was compared to CIA. RESULTS: For vessel based analysis of 179 coronary vessels, CTA had a sensitivity of 96%, specificity of 87.5%, positive predictive value of 90.5%, and negative predictive value of 94.6%. For patient-base analysis, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CTA were 97.9%, 28.6%, 66.6%, and 90.2%, respectively. CONCLUSION: The findings of this study reveal that CT angiography with 64-slice scanner could be considered as a suitable technique for rapid triage of patients presenting to hospitals with chest pain. High values of sensitivity and PPV reveal the good performance of CTA in detecting CAD. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to examine the association between left ventricular ejection fraction (LVEF) and incidence of depression following the myocardial infarction (MI). METHODS: In a prospective study, 176 patients aged 32-84 years with the mean age of 56 years (SD = 10.05) with a definitive diagnosis of myocardial infarction and admitted to one of the coronary care units (CCU) of Isfahan during April to August 2006 were selected through consecutive sampling method. The demographic and medical characteristics were collected by their medical record and also the results of the LVEF assessment of the patients were obtained through echocardiography or angiography following the myocardial infarction. Thereafter, the patients were given Beck Depression Inventory for the primary care (BDI-PC) in three months after myocardial infarction. The collected data were analyzed during the hospitalization and follow-up periods using logistic regression method. RESULTS: The findings indicated that left ventricular dysfunction identified by the Left ventricular ejection fraction index was significantly correlated with depression three months after the myocardial infarction (P < 0.01). In addition, the exploratory model (which only includes LVEF variable) had the predictive validity of 64.8% with 55.7% sensitivity and 72.1% specificity. CONCLUSION: Left ventricular dysfunction is associated with increased risk of depression following the myocardial infarction. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lead contamination can affect many body organs including the heart. This study assessed a number of echocardiographic indices to clarify the effects of lead on cardiac function among battery factory workers who are in constant exposure to lead. METHODS: In a cross sectional study, 142 male battery factory workers who had been exposed to lead for at least 1 year were evaluated. The subjects aged 25 55 years old and were excluded if they had hypertension, diabetes, or cardiovascular diseases. Demographic characteristics, professional profile, lead exposure, history of respiratory diseases, drugs intake, and lifestyle information of the participants were collected. Height, weight and blood pressure measurements were then performed. Blood tests were also ordered to determine blood lead levels. The subjects finally underwent M-mode and Doppler echocardiography. Linear regression analysis was used to establish the effects of lead on the target indices. All statistical analyses were conducted in SPSS18. RESULTS: The mean age and mean duration of lead exposure of the subjects were 41.78 ± 13.58 and 23.54 ± 14.44 years, respectively. The mean blood lead level was 7.59 ± 2.75 0g/dl. Left ventricular hypertrophy was detected in 12% of the participants. Blood lead levels were not significantly related with echocardiographic indices in the crude model or after adjustments for age alone or for age and other risk factors. CONCLUSION: Blood lead levels of our participants were below standard values. In addition, no significant relation was found between left ventricular function indices and blood lead levels. The absence of such relations could have been caused by the exclusion of individuals with hypertension or cardiovascular diseases. Structural modifications in battery factories following legislations in Iran might have been responsible for low blood lead levels among the subjects. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lack of heart rate increase proportionate to exercise causes poor prognosis. Moreover, inflammatory factors such as C-reactive protein (CRP) are associated with atherosclerosis. The current study compared these two indices in individuals with and without metabolic syndrome in Isfahan, Iran. METHODS: This study was performed on 203 people without and 123 patients with metabolic syndrome who were randomly selected from the participants of the Isfahan Cohort Study. The demographic data, waist circumference, blood pressure, height, and weight of the participants were recorded. Moreover, serum tr'viglyceride (TG), fasting blood sugar (FBS), total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and high-sensitivity CRP (hs-CRP) levels were measured. Exercise test was carried out according to the Bruce standard protocol and heart rate reserve (HRR) was determined and recorded. The age-adjusted data was analyzed using generalized linear regression and student's t-test in SPSS15. RESULTS: The mean ages of participants without and with metabolic syndrome were 54.16 ± 8.61 and 54.29 ± 7.6 years, respectively. The corresponding values for mean LDL levels were 116.17 ± 24.04 and 120.12 ± 29.55 mg/dl. TG levels were 140.38 ± 61.65 and 259.99 ± 184.49 mg/dl for subjects without and with the metabolic syndrome, respectively. The mean FBS levels were 81.81 ± 9.90 mg/dl in the participants without the syndrome and 107.13 ± 48.46 mg/dl in those with metabolic syndrome. The mean systolic blood pressure was 116.06 ± 13.69 mmHg in persons without metabolic syndrome and 130.73 ± 15.15 mmHg in patients with the syndrome. The values for mean diastolic levels in the two groups were 76.52 ± 6.69 and 82.84 ± 8.7 mmHg, respectively. While the two groups were not significantly different in terms of HRR (P = 0.27), hs-CRP levels in the metabolic syndrome group was significantly higher than the other group (P = 0.02). CONCLUSION: We failed to establish a relationship between HRR and the metabolic syndrome. However, the observed relationship between metabolic syndrome and hs-CRP level, which is an inflammatory factor, indicates elevated levels of hs-CRP in patients with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Objective: There are many studies indicating the role of psychological factors in the pathogenesis of cardiovascular disorders. Type D as a new personality construct has been proposed by Denollet, characterized by the joint global traits including negative affectivity and social inhibition. The purpose of this study was to examine the link between type D personality and hyperlipidemia in patients with myocardial infarction (MI). Materials and Methods: One hundred and seventy-six consecutive patients admitted to the cardiac care unit (CCU) wards of nine hospitals in Isfahan, Iran, following MI, were selected based on the inclusive and exclusive criteria. The patients completed demographic questionnaire and Type D Personality Scale (DS14). Their medical data were obtained from medical records. Chi-squared test, Student's t-test, and multivariate logistic regression were used to analyze the data. Results: Of the 176 subjects, 63 patients (35.8%) were type D. In univariate analysis, hyperlipidemia was the only significant variable (56% vs. 40%, P = 0.041) found to be associated with type D. Also, by multivariable logistic regression analysis, hyperlipidemia [Odds Ratio (OR) 0.374; 95% confidence interval (CI) 0.175-0.796] was the only independently significant variable found to be linked with type D personality. No other statistically significant differences were found between the two groups on demographic and medical factors characteristics. Conclusion: The type D personality was associated with hyperlipidemia. Thus, personality factors may make people vulnerable to metabolic syndromes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Today, ischemic heart diseases (IHDs) are the most common diseases worldwide. Angiography is the best way to diagnose IHDs. Angiographic complications however can include death, myocardial infarction, nausea, spasm of the coronary arteries, chest pain, bradyarrhythmia, hypotension, or hypertension. This study aimed to determine the effects of a simultaneous injection of trinitroglycerin (TNG) with contrast agent on the early complications of angiography. METHODS: This clinical trial was conducted in Chamran Hospital, Isfahan, Iran in 2005. Before the angiography, the study population were randomly assigned into two groups of intervention (n = 111) and placebo (n = 112). TNG was mixed with contrast material in the intervention group and distilled water was mixed with contrast agent in the placebo group to be used for angiography. Nausea, spasm of the coronary arteries, chest pain, bradyarrhythmia and the mean systolic and diastolic blood pressures were compared during and after the angiography in patients of both groups. The obtained data was analyzed by chi-square and t tests. RESULTS: The mean age in the intervention and placebo groups were 59.93 ± 9.14 and 59.37 ± 10.12 years, respectively (P > 0.05). The two groups were not significantly different in terms of gender distribution. The frequency of nausea was 4.5% and 6.2% in the intervention and placebo groups, respectively. The corresponding values were 0.9% and 5.4% for coronary artery spasm and 1.8% and 6.3% for chest pain. Bradyarrhythmia occurred in 7.1% of patients in both groups. There were no significant differences in the abovementioned complications. Mean values of the highest and lowest systolic and diastolic blood pressures of the intervention group were significantly different from the placebo group (P = 0.001). Simultaneous injection of TNG and the contrast agent in this study resulted in positive findings (except for changes in blood pressure). CONCLUSION: More studies are recommended with different doses of TNG, different times of injection and considering at-risk individuals. [ABSTRACT FROM AUTHOR]

BACKGROUND: Type D personality is based on two global and stable personality traits, including negative affectivity (NA) and social inhibition (SI). The aim of this study was to examine the relationship between type D personality and perceived social support in post myocardial infarction (MI) patients. METHODS: One hundred seventy six consecutive patients following MI admitted to the cardiac care unit (CCU) of nine hospitals in Isfahan, Iran from April to September 2006 were selected based on the inclusive and exclusive criteria. The patients completed the Persian version of type D personality scale and the Persian version of multidimensional scale of perceived social support (MSPSS). Also, demographic and medical questionnaire was completed for each patient. Chi-squared test, t-test and MANOVA were used to analyze the data. RESULTS: The findings indicated that 35.8% patients (35.8 %) were classified as type D. The results of MANOVA showed that type D patients were significantly different from non-type D patients (F = 8.72, p = 0.0001) on MSPSS scores and on all dimensions including family subscale (F = 11.52, p = 0.001), friends subscale (F= 16.16, p = 0.0001) and significant others subscale (F = 5.04, p = 0.026). CONCLUSIONS: Type D personality substantially affects the way MI patients perceive availability of social support from different sources including family, friends, and significant others. One implication of this finding may be to develop tailor-made interventions for MI patients with type D. [ABSTRACT FROM AUTHOR]

BACKGROUND: Type D personality is based on two global and stable personality traits, including negative affectivity (NA) and social inhibition (SI). The aim of this study was to examine the relationship between type D personality and perceived social support in post myocardial infarction (MI) patients. METHODS: One hundred seventy six consecutive patients following MI admitted to the cardiac care unit (CCU) of nine hospitals in Isfahan, Iran from April to September 2006 were selected based on the inclusive and exclusive criteria. The patients completed the Persian version of type D personality scale and the Persian version of multidimensional scale of perceived social support (MSPSS). Also, demographic and medical questionnaire was completed for each patient. Chisquared test, t-test and MANOVA were used to analyze the data. RESULTS: The findings indicated that 35.8% patients (35.8 %) were classified as type D. The results of MANOVA showed that type D patients were significantly different from non-type D patients (F = 8.72, p = 0.0001) on MSPSS scores and on all dimensions including family subscale (F = 11.52, p = 0.001), friends subscale (F= 16.16, p = 0.0001) and significant others subscale (F = 5.04, p = 0.026). CONCLUSIONS: Type D personality substantially affects the way MI patients perceive availability of social support from different sources including family, friends, and significant others. One implication of this finding may be to develop tailor-made interventions for MI patients with type D. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the relation between fat distribution in subcutaneous and visceral area with other variables in patients suffered for stable angina. Methods: This cross sectional study was done on 40-60 years patients with stable angina. CT scan was determined subcutaneous (deep and superficial) and visceral fat. Body mass index, waist circumference, and blood pressure measurement were calculated by standard protocols. Sugar, triglyceride, total cholesterol, LDL-c, HDL-c, Leptin and apolipoproteins A and B were recorded. Data was entered in SPSS15 and analyzed by Student-t and correlation test. Finding: Sixty-six men and 88 women were studied. The mean of BMI, apo A, Leptin, lipids variables were significantly different in two sexes. Total variable fat accumulation in women was greater than men (P < 0.05). The correlation was significant between weight, BMI, WC and Leptin level in both sexes. Conclusion: Relation of fat distributions and other risk factors was different in both sexes, but BMI and WC had significant correlation with CT scan variables. [ABSTRACT FROM AUTHOR]

BACKGROUND: Considering that determining the effect of both contrast dye injection and balloon inflation on electrophysiological parameters would help us to predict the ischemic event during PTCA, the aim of this study was to determine the effects of these factors on QTc and QTc dispersion during PTCA in Isfahan. METHODS: In this cross-sectional study, consecutive patients undergoing elective PTCA in Chamran hospital in Isfahan enrolled. All patients were in sinus rhythm. A 12-lead electrocardiogram was continuously recorded before (baseline) and during PTCA after dye injection and balloon inflation. QTc and QT dispersion was calculated in all 12 leads of electrocardiogram during the mentioned times and compared with each other. RESULTS: 33 patients with mean age of 49.1 ± 16.2 years were studied. Anatomic distribution of the coronary artery stenosis was as follows: left anterior descending artery (LAD) in 76.7% patients, left circumflex (Cx) in 16.6% and right coronary (RCA) in 6.66%. Mean of QTc at baseline, after contrast dye injection and after balloon inflation was 423.9 ± 28.5, 437 ± 29 and 437 ± 22 msec, respectively (P < 0.05). Mean of QTc dispersion at baseline, after contrast dye injection and after balloon inflation was 92.3 ± 7.2, 95.4 ± 8.3 and 93.75 ± 7.5, respectively (P > 0.05). CONCLUSION: The findings of this research supports the fact that during PTCA a transient myocardial ischemia occurs but further studies is recommended to accurately determine the stages at which ischemia occurred and the extent of its effect of it on cardiac depolarization and repolarization periods. [ABSTRACT FROM AUTHOR]

BACKGROUND: Doppler echocardiography has been proposed as an appropriate non-invasive assay to estimate left ventricular end diastolic pressure (LVEDP). The aim of present research was to estimate the LVEDP in patients with ischemic heart disease by echocardiography and compare it with the results of cardiac catheterisation and to determine the effect of different echocardiographic variables on its measurement. METHODS: In this descriptive-analytic study, patients with diagnosed ischemic heart disease were selected by nonrandomized sampling method. Selected population underwent M-mode and pulse doppler echocardiographic evaluation and parameters such as Q-Mitral valve E (Q-MVE), Q-Aortic valve closure (Q-AVC), Aortic valve closure-E (AVC-E), Q-Mitral valve closure/Aortic valve closure-E (Q-MVC/AVC-E), left ventricle-deceleration time (LV-DT), peak velocity-deceleration time (PV-DT) and A/E velocity time integral (A/E VTI) were evaluated. Immediately after echocardiography all patients underwent left heart catheterization for LVEDP measurement. The relation between different echocardiographic measurements and LVEDP, obtained by cardiac catheterization, was evaluated. RESULTS: In this study, 47 patients with ischemic heart disease with mean age (±SD) of 53 ± 13 were studied. There was a significant correlation between LVDEP and A/E VTI (r=0.44, P = 0.001, and also between LVEDP and PV-DT in patients with A/E VTI ≥1.1(r = -0.58, P = 0.02). There was a significant correlation between LVEDP and Q-MVC/AVC-E in patients with LVEDP >18mmHg (r = 0.76, P= 0.03) and those with LVEDP ≤18 mmHg and A/E VTI < 1.1 (r = 0.37, P= 0.03). The correlation between LVEDP and A/E VTI was more significant in men, in patients aged > 50 years with EF > 55%, without LVH, without MR and those with coronary artery disease (P < 0.05). CONCLUSION: Some echocardiographic indices such as A/E VTI, Q-MVC/AVC-E and PV-DT are able to measure LVEDP especially in male patients aged > 50 years, without LVH, without MR and those with coronary artery disease but it is necessary to determine specific conditions and factors affecting these indices, by further studies. [ABSTRACT FROM AUTHOR]

Background: Excessive body fat is associated with increasing risk of ischemic heart disease (IHD). Some fat cell mediators such as adiponectin and leptin have been recognized as possible new IHD risk factors. We assessed the association of fat cell's size and number, serum leptin and adiponectin with IHD. Methods: The study was designed as a "case control" study in 40 to 60 years old patients with ischemic heart disease symptoms underwent coronary angiography. The cases had significant stenosis in coronary angiography. The control subjects had normal angiography. Serum lipid levels, adiponectin, leptin, and insulin were examined in all cases and controls by Enzymayic method. The biopsies from abdominal and gluteal fat tissue regions were fixed and stained using the Hematoxilin-eosin method. Slides were photographed with a microscopic digital camera. Fat cell's size and number were assessed using Image tool V3 software. Data were analyzed with SPSS software. Findings: There were no significant difference between cases and controls in fat cell's size and number, serum leptin and adiponectin. However, serum leptin was correlated not only to waist circumference (r = 0.31, P = 0.036), but also to body mass index (r = 0.32, P = 0.033). Conclusion: Although Leptin and adiponectin are correlated with obesity and are introduced as IHD risk factors; they showed no association with ischemic heart disease in our study. More investigation is required to confirm this relationship in the Iranian population. [ABSTRACT FROM AUTHOR]

Background: Ischemic heart disease is the leading cause of mortality and morbidity in the world. Vascular inflammation is the noticeable risk factors of ischemic heart disease. In this study the relation between intracellular adhesion molecule (ICAM) and vascular adhesion molecule (VCAM) as inflammation indicator with extent of coronary involvement were evaluated. Methods: In this cross sectional study, 82 patients with stable angina who candidates for angiography were studied. Those with acute coronary syndrome, and recent surgery, inflammatory disease, some drug consumption, kidney and liver disease, Phlebitis and PTE are excluding from study. Then blood sampling for biochemical VCAM and ICAM analysis were drawn. After it, coronary angiography was done via standard method. Findings: Mean ages of the patients were 58.4 ± 10.1 year old with 72% male. The mean of ICAM and VCAM were 183.9 ± 78 and 150.3 ± 136 ng/dl, respectively. There isn't any correlation between VCAM and ICAM and the severity of coronary artery disease. In linear regression analysis even with considering of hypertension, hyperlipidemia and diabetes as cofounders, there was not any relation between these factors and CAD. Conclusion: According to our findings, inflammatory markers (VCAM and ICAM) didn't add any further information about extent of CAD. [ABSTRACT FROM AUTHOR]

Background: Myocardial Infarction is a common and lethal disease, especially in first hours. Rapid and correct decision is essential for priority of advance therapies and this study follows the accuracy of a scoring system for this triage. The aim was to assess the correlation of Thrombolysis in Myocardial Infarction Risk score and Angio score in patients with ST Elevation Myocardial Infarction. Methods: In this cross sectional study, 240 patients with ST elevation myocardial infarction from CCU of universal hospitals participated in the study. Thrombolysis in myocardial infarction risk score was calculated and during 2 month they underwent angiography and follow up. Findings: Mean age was 60.02 and 79 patients were female. Correlation between thrombolysis in myocardial infarction risk and angio score was significant (P < 0.001). Correlation between ejection fraction and thrombolysis in myocardial infarction risk score (P < 0.001) and angio score with age (P < 0.001) was significant too. There was no significant correlation between Angio score and recurrent angina (P = 0.143), rehospitalization (P = 0.524) and death (P = 0.179). Pearson's correlation showed significant relation between thrombolysis in myocardial infarction risk score and angio score (P < 0.001, r = 0.556). Conclusion: This correlation shows that thrombolysis in myocardial infarction risk score probably can be used for evaluating angiographic extent of coronary artery disease. Simple clinical use of this score at bedside if confirms with a prospective cohort study, makes this score a method to stratify patients in high and low risk groups and accordingly diagnostic- therapeutic strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Systemic lupus involves different body organs including lungs. However, there is limited information on the systemic lupus without respiratory symptoms. The aim of this study was to investigate the diffusing capacity of the lung for carbon monoxide in women with disseminated lupus erythematosus and to compare it with a control group. METHODS: This prospective study was conducted during 2005 in the Rheumatology Clinic of Alzahra Hospital, Isfahan, Iran. The diffusing capacity of the lung for carbon monoxide and pulmonary parameters were measured using the unrelated samples in 76 female patients with systemic lupus. RESULTS: Mean diffusing capacity of the lung for carbon monoxide in patients with lupus was lower than the control group (P ≤ 0.001). The amount of corrected volumetric capacity of carbon monoxide in lungs of patients was significantly different from the control group (P ≤ 0.001). Residual volume and total capacity of lungs in the female patients with lupus were higher than the control group (P ≤ 0.001). CONCLUSION: Decreased diffusing capacity for carbon monoxide in lungs of females with systemic lupus without respiratory symptoms is prevalent. It indicates alveolar capillary membrane involvement in these patients. Increased residual volume and total capacity of lungs in these patients can be caused by bronchiolitis. [ABSTRACT FROM AUTHOR]