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Background: Pulse pressure has recently been considered as a predictor of coronary heart disease. The difference between systolic and diastolic blood pressure is called pulse pressure. Various factors including increased age, vascular stiffness, stenosis, and hypertension are associated with pulse pressure. The present study, therefore, aimed to investigate the relationship between some cardiovascular function indicators such as vascular stenosis, blood pressure and cardiac output with pulse pressure as a predictor of cardiovascular diseases. Methods: This case-control study was performed on 544 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, from March 2015 to February 2016. In this study, according to the angiographic findings, individuals with artery stenosis were considered as the case group (n=272) and those without artery stenosis were considered as the control group (n=272). Statistical analysis was performed using descriptive statistics, Chi-square and odds ratio estimation by SPSS22 software. Results: According to the findings of this study, ages over 50 (OR: 3.3, 95% CI: 2.1-5.2), high systolic blood pressure (OR: 8, 95% CI: 4.3-15.2), high diastolic blood pressure (OR: 4.9, 95% CI: 2.0-11.7), cardiac output less than 50% (OR: 1.8%, 95% CI: 1.3-2.7) and vascular stenosis (OR: 3.5, 95% CI: 2.4-5.1) were associated with high pulse pressure. The male gender had a preventive role in increasing of pulse pressure (OR: 0.7, 95% CI: 0.5-0.9). A significant relationship was demonstrated between systolic blood pressure and pulse pressure (P

Background: Pulse pressure has recently been considered as a predictor of coronary heart disease. The difference between systolic and diastolic blood pressure is called pulse pressure. Various factors including increased age, vascular stiffness, stenosis, and hypertension are associated with pulse pressure. The present study, therefore, aimed to investigate the relationship between some cardiovascular function indicators such as vascular stenosis, blood pressure and cardiac output with pulse pressure as a predictor of cardiovascular diseases. Methods: This case-control study was performed on 544 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, from March 2015 to February 2016. In this study, according to the angiographic findings, individuals with artery stenosis were considered as the case group (n=272) and those without artery stenosis were considered as the control group (n=272). Statistical analysis was performed using descriptive statistics, Chi-square and odds ratio estimation by SPSS22 software. Results: According to the findings of this study, ages over 50 (OR: 3.3, 95% CI: 2.1- 5.2), high systolic blood pressure (OR: 8, 95% CI: 4.3-15.2), high diastolic blood pressure (OR: 4.9, 95% CI: 2.0-11.7), cardiac output less than 50% (OR: 1.8%, 95% CI: 1.3-2.7) and vascular stenosis (OR: 3.5, 95% CI: 2.4-5.1) were associated with high pulse pressure. The male gender had a preventive role in increasing of pulse pressure (OR: 0.7, 95% CI: 0.5-0.9). A significant relationship was demonstrated between systolic blood pressure and pulse pressure (P<0.0001). Conclusion: Based on the findings of the present study, the chances of having high pulse pressure are high among individuals over 50 years of age, female gender, those with elevated systolic and diastolic blood pressure, and individuals with high coronary artery stenosis. This chance is associated with decreased cardiac output and coronary stenosis. Increased pulse pressure is a predictive indicator of cardiovascular disease and it is recommended that pulse pressure measurements of all referrals, especially those who are being referred to cardiology clinics, are taken into account by medical professionals to prevent adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: Nowadays, coronary artery diseases (CADs) are among the most common diseases in societies. The aim of this study was to study the interplay between cholesterol absorption and synthesis in two groups of Iranian patients with CAD by measuring the markers of cholesterol synthesis and absorption pathways in plasma. Methods: The study population included 128 patients undergoing clinically indicated coronary angiography. Patients were divided into two groups after scoring the severity of their coronary stenosis; the S-stenosis group (patients with CAD, n = 75) had a significant stenosis indicated by coronary angiography, and the second group, N-stenosis (n = 55), had no significant coronary stenosis. Fasting plasma samples were used to measure cholesterol absorption and synthesis markers by gas chromatography-mass spectrometry (GC-MS). Findings: The level of cholesterol absorption markers in patients with coronary artery stenosis was slightly increased compared to patients without coronary artery stenosis, but this change was statistically significant only for cholestanol (P < 0.050). In terms of cholesterol synthesis markers, the results did not show any significant differences between the two groups (P > 0.050 for all). Conclusion: Study of cholesterol synthesis and absorption markers has not been reported in Iranian patients before. This article reports the results of such study for the first time. Considering the high prevalence of CADs and the importance of cholesterol metabolism in pathology of these diseases, the results may be used to understand some underlying mechanisms of development and progression of these diseases, and to manage the patient better.

In-stent restenosis (ISR) is regarded as the main problem in the utilization of stents in the treatment of coronary artery atherosclerotic stenosis in percutaneous coronary intervention (PCI). This study investigated the possible role of the G22A variant of the Adenosine Deaminase gene (ADA) in the development of ISR. In this study, 91 patients who underwent PCI were divided into two groups of case with ISR (n=40) and control without ISR after six months from stenting (n=51). The case and control groups were matched in terms of age and gender. The genotypes of the G22A variant in the samples were examined by the molecular method of PCR-RFLP and electrophoresis. The results were statistically analyzed using t-test, and the results showed that the frequency of allele A of variant G22A in the (+ISR) group was higher than that in the (-ISR) group. However, there was no significant relationship between the distribution of allele and genotype frequency of this variant with the incidence of ISR (P>0.05). [ABSTRACT FROM AUTHOR]

Background: Kidney stone disease is one of the common disorders of the urinary tract that can be linked to the coronary heart disease due to common risk factors such as hypertension, diabetes, and high uric acid levels. Therefore, in this study, we aimed to investigate the association between kidney stones and coronary heart disease. Methods: In this descriptive cross-sectional study, 600 patients referred to Shahid Chamran Hospital of Isfahan who were candidate for coronary artery angiography were divided into two groups including with coronary stenosis (positive) and without coronary stenosis (negative). The demographic and clinical findings including history of kidney stones of the patients were collected using a designed questionnaire. Results: 28.4% of the patients in the positive angiography group and 5% of the patients in the negative angiography group had kidney stone disease (P=0.001). Furthermore, 20.7% of the patients in the positive angiography group, and 7.5% of the patients in the negative angiography group had history of kidney stone disease (P = 0.04). The frequency of hypertension in the positive angiogram group (49.6%) was significantly higher than the negative angiography group (32.5%) (P=0.04). Conclusion: Kidney stone disease is associated with coronary artery disease. Therefore, interventions to prevent kidney stones, especially with blood pressure control which is considered as a risk factor for both diseases, can reduce the risk of coronary artery disease. However, more extensive studies are needed to confirm the effect of kidney stone disease on the risk of coronary heart disease. [ABSTRACT FROM AUTHOR]

Background and Objectives: In coronary artery stenosis blood flow into heart veins and coronary sinus (CS) vein decreases appreciably. Standard methods of coronary sinus blood flow (CSBF) measurement is by catheterism or radionuclide imaging are invasive. Transthoracic echocardiography (TTE) was used for noninvasive estimation of CSBF, but this method may be not accurate because of some difficulties in blood velocity measurement in CS. The objective of this study was to evaluate the relationship between CS diameters in TTE with significant coronary artery disease (CAD) in patients suspected to have coronary lesion. Subjects and Methods: TTE was performed for 36 patients who were referred for coronary artery angiography (CAG) in a cross sectional study. CS diameter recorded in all of patients a day before CAG. Results: CS diameter showed obvious relationship to significant CAD in present study (P≤0.001). There was a direct relationship relation between number of stenotic coronary arteries and CS diameter. Conclusion: It seems CS diameter measurement by TTE can be used as an easy, noninvasive, accessible method of screening of CAD. [ABSTRACT FROM AUTHOR]

Introduction: Chronic obstructive pulmonary disease (COPD) is the most common cause of death and disability due to pulmonary disease, in Which microbial agents has a significant role. Regarding the role of Chlamydia pneumonia infection in the initiation and development of COPD, this study aimed to evaluate the serum antibody level against C.pneumonia infection in patients with COPD in Tabriz hospitals in 2017. Methods: In this descriptive cross-sectional study, 200 patients with COPD participated. Anti C.pneumoniae titers were determined by ELISA method. Statistical analysis was performed using SPSS software and T-tcst. Results: The mean IgG antibody was 73.94% and the mean IgM antibody was 0.955%. There was no association between sex with antibody level, smoker status, coronary artery stenosis, and anti-infectious antibodies to C.pneumoniae. Conclusion: According to the results, although there was no significant correlation between C.pneumonia infection and COPD. However, due to the importance of C.pneumoniae as a causative pathogen, it is recommended to use more specific methods, such as determining the presence of the bacterial genome in the case and control groups. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery aneurysms (CAAs) and ectasia (CAE) are diseases that have been increasingly noticed as the increase in utilization of coronary angiograms. Objective: The aim of this study is to determine the prevalence of coronary artery aneurysms and ectasia and describe the patients admitted to a private clinic in 2012 to 2014. Materials and Methods: This is a retrospective cross-sectional study involved all patient with invasive coronary angiogram that was performed at Dr.Heshmat and Golsar hospital in Rasht from may 2012 to may 2014. All data included cardiovascular disease major rick factors, demographic and angiographic characteristics were recorded in check list. Statistical analyses were performed by using SPSS version 19. Results: A total of 1705 coronary angiography were performed during the period of the study. CAE was found in 216 patients (12.7 % of all coronary angiograms). The majority (54.6%) were male. The mean age was 61.34±9.44 years (range, 30 to 83 years). CAE was associated with significant coronary artery stenosis in 123 patients (56.9%).The frequency of arterial involvement was: the right coronary artery (RCA) 56.9 %; left circumflex artery (LCx), 56.9%; the left anterior descending artery (LAD), 51.9 %.Coronary ectasia involved a single vessel in 50.9 %, two vessels in26.9 %, and three vessels in 20.4 %. Hyperlipidemia (81.5%) and hypertension (73.6%) were also most comorbidty in these patients. Coronary artery aneurysm was found in 7 patients (0.4% of all coronary angiograms). Conclusion: The prevalence of coronary artery ectasia in this study among patient who went for coronary angiography is higher than what has been published in others studies [ABSTRACT FROM AUTHOR]

Background and Objectives: Coronary Artery Diseases (CAD) are the major cause of morbidity and mortality in most societies. Despite the invasive nature of angiography, it was used as a diagnostic procedure evaluates coronary artery diseases. This study was aimed at evaluating the Pattern of coronary arteries and anatomic risk factors of significant stenosis by 64-slice multi-detector computed tomography (MDCT). Material and Methods: In this prospective-analytic study, CT angiography data of 200 patients with suspected CAD reviewed in order to identify the coronary arteries anatomy and determine the site of stenosis. Also, Length of LM and the first Diagonal from the origin of LAD were measured. Results: There were three types of dominancy of coronary artery: 91% with Right Coronary Artery (RCA), 8% with Left Coronary Artery (LCA), two patients with co-dominant system. Also stenosis was observed in 6 (3%), 5 (2.5%) and 4 (2%) of arteries in LCx, RI and LM, respectively. In 21 (67.7%) of LAD stenosis were near the first diagonal (D1) origin and in RCA were near the SAN origin. Conclusion: There was no significant relationship between the length of LM and the first Diagonal and number of LAD branching and stenosis frequency in LAD. [ABSTRACT FROM AUTHOR]

Background: Epicardial fat tissue is known as a risk factor in cardiovascular diseases. This study was designed to compare the epicardial fat thickness in patients with cardiovascular diseases and normal patients. It also tried to find a correlation between epicardial fat thickness and severity of coronary stenosis. Methods: This study was conducted from September 2010 to April 2011 at two university hospitals (Noor and Chamran Referral centers) associated to Isfahan University of Medical Sciences, Isfahan, Iran. A total number of 196 subjects were allocate to three groups of control (n = 68), acute coronary syndrome (n = 64) and chronic stable angina (n = 64). After registering demographic data, all individuals underwent echocardiography in diastolic subcostal view to determine the epicardial fat thickness. Angiography was also conducted to assess the severity of coronary stenosis. The thickness of epicardial fat was compared between groups and its correlations with age, sex, hypertension, hypercholesterolemia, diabetes, waist circumference, body mass index and severity of coronary stenosis were evaluated. Findings: The mean age of participants was 59.54 ± 11.01 years. There were statistical differences between age, sex, smoking and severity of coronary stenosis (P < 0.001, P = 0.03, P = 0.04, and P < 0.001, respectively). The mean of epicardial fat thickness in acute coronary syndrome, chronic stable angina and control groups were 5.7 ± 2.1, 6.2 ± 2.0 and 4.6 ± 1.9 mm (P < 0.001). There were no independent correlation between predicting factors and epicardial fat thickness (P > 0.05). Conclusion: This study indicated the thickness of epicardial fat to be more in cardiovascular diseases compared with normal persons. Future studies for evaluating the sensitivity and specificity of this diagnostic method are warranted. [ABSTRACT FROM AUTHOR]

Background: Many factors may have an important role in coronary artery disease (CAD). These factors may lead to coronary artery stenosis. Some patients do not have any plaque or stenosis in angiography but have chest pain and angina. This problem is called X syndrome. Although the causes of X syndrome are unknown, some believe that coronary tortuosity might be responsible for angina. The aim of this study was to understand the relation between coronary tortuosity and chest pain. Methods: This was a case-control study performed in Isfahan hospitals, Iran during 2010-2011. The patients candidate for coronary angiography were selected and divided into two groups based on coronary tortuosity. Demographic information, risk factors, angiographic findings and Gensini scores were collected and compared. All analyses were conducted in SPSS18. Findings: Overall, 15% of all patients had coronary tortuosity. Among clinical signs, CCS class and functional class significantly differed between the two groups. The prevalence of the mentioned symptoms was also different between the groups. The mean Gensini index was lower in the case group. Stenosis in left anterior descending artery (LAD), left circumflex artery (LCX), right ventricular apex (RVA), obtuse marginal (OM), and left main coronary artery (LM) were different between the two groups. Conclusion: There were many differences between tortuous and non-tortuous groups in demographic characteristics, risk factors and angiographic findings. Thus, tortuosity may lead to signs and symptoms due to epicardial coronary stenosis. [ABSTRACT FROM AUTHOR]

Background: Left main coronary artery (LMCA) stenosis is a leading cause of mortality and morbidity in many countries. Metabolic syndrome (MS) is a risk factor for coronary artery disease (CAD). The effects of MS on left main coronary artery stenosis are not well-defined. The aim of this study was to examine the effects of MS on left main coronary artery stenosis. Methods: A total number of 495 patients who underwent elective coronary angiography in the Catheter Laboratory of Cardiovascular in Shariati Hospital 2008- 2010 were included in the study. MS definition was based on the National Cholesterol Education Program (NCEP)- Adult Treatment Panel III (ATP III) criteria. The stenosis in left main coronary arteries was determined by examining the coronary angiograms of the patients. Results: The study population consisted of 249 (50.3%) men, and 246 (49.7%) women. The mean age of the participants was 58.01±10 years. MS was present in 86 (17.4%) of the patients based on NCEP- ATP III criteria. LMCA stenosis was seen in 25 (5%) patients. A positive correlation was found between MS and LMCA stenosis (r=0.305, P=0.012). Moreover, a positive correlation was found between age (r=0.192, P=0.05), sex (r=0.334, P=0.007), smoking (r=0.336, P=0.01) and diabetes (r=0.253, P=0.03) and LMCA stenosis. Conclusion: The metabolic syndrome correlates with LMCA stenosis. LMCA stenosis and its correlation with MS is precipitated by high FBG, age, male sex, and smoking which may synergistically increase the risk for the disease. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate subepicardial and subendocardial left ventricular (LV) functions in patients with single coronary artery lesion at early stage after percutaneous coronary intervention (PCI). Methods: Patients with left anterior descending (LAD) lesion (n = 40) were evaluated. Patients underwent PCI and at least one coronary stent was placed. After PCI, the pulsed-wave tissue doppler imaging (pw-TDI) parameters taken from subepicardial and subepicardial layers were compared among the them. Finding: The systolic and diastolic pw-TDI parameters were apparently different between the patient after PCI, while the systolic pw-TDI parameters did not change. The diastolic pw-TDI parameters taken from both subepicardial (circumferential contraction) and subendocardial layers (longitudinal contraction) improved after PCI. After PCI, it was shown that while Ea velocity (P = 0.012) taken from the subendocardial layer increased, IVRa velocity (P < 0.001) taken from the subepicardial layer decreased. Conclusion: In our study, left ventricular, left atrium, and aortic valve diameter increase in patients with coronary artery disease. The systolic and diastolic functions were impaired at subendocardial and subepicardial layers. These dysfunctions can be easily presented with pw-TDI. Although systolic dysfunction persists, diastolic dysfunction improves at early stage after PCI. [ABSTRACT FROM AUTHOR]

Background: The relationship between Coronary Artery Disease (CAD) and the prevalence of Renal Artery Stenosis (RAS) has been demonstrated. Despite high incidence of heart diseases and high frequency of CAD risk factors among Iranian population, this relation has not been clearly determined. This study estimated the prevalence of RAS and its determinants in Iranian angiographic candidates. We also tried to find which risk factors of atherosclerosis are associated more frequently with renal artery stenosis. Methods: In a cross-sectional study that was performed at the Tehran Heart Center, in Tehran, Iran, 146 patients who were candidate for angiography with suspected CAD were consecutively included. Selective renal angiography was performed following coronary angiography in all patients with established coronary artery stenosis and the presence and severity of RAS was evaluated. Results: Prevalence of RAS in study patients was 25.3% (men, 13.7% and women 47.1%, (p<0.001). We found that only 6.2% of the patients had bilateral R.A.S. Also, RAS≥50% was found in 17.1% of patients. Regarding number of defected coronary vessels, twoand three-vessel diseases were found in 30.0% and 39.0% of participants, respectively. No significant relationship was found between the number of involved coronaries and the severity as well as side of RAS (p=0.716) Significant multivariate predictors of RAS were female gender (p=0.001), advanced age, (p=0.046) duration of hypertension (p=0.032) and baseline serum creatinine concentration (p=0.018). Conclusions: Routine angiographic assessment of renal arteries following coronary angiography is recommended especially in women as well as those with long-term duration of hypertension or renal dysfunction. [ABSTRACT FROM AUTHOR]

Background: Coronary Artery Disease (CAD) is one of the leading causes of mortality and morbidity all over the world. One of the most important predictors of the outcome of the coronary stenosis is the site of the lesions i.e. Proximal versus nonproximal lesions. This study designed to evaluate the relationship between CAD risk factors and site of stenosis. Methods: In this case- control study in the patients undergone coronary angiography (CAG) in Imam Khomeini Hospital, Tehran, Iran a total of 125 CAD patients with proximal lesion in CAG enrolled the study as case group and equal sex and age matched number of patients with non proximal lesion selected as control group. Two groups were compared based on presence or absence of DM, hypertension, hyper cholestrolemia, hypertriglyceridemia and cigarette smoking. Results: Relative frequency of DM was 33.6% and 10.4% in case and control group respectively (p< 0.0001). Relative frequency in two groups were 33.6 vs 28.8% For HTN (p= 0.41), 30.4% vs 29.6% for hyper cholestrolemia (p= 0.89), 19.2% vs 16.8% for hypertriglyceridemia (p= 0.062) and 28.8 vs 39.2 for C/S (p= 0.08). Multivessle disease was significantly more prevalent in diabetics compared with non diabetic patients 89.1% vs 61% (p< 0.0001), no relationship was seen with HTN (p= 0.41), Hyper cholestrolemia (p= 0.052) hypertriglyceridemia (p= 0.38) and cigarette smoking (p= 0.375). Conclusion: Proximal involvement of coronary arteries and multivessle disease in CAD patients is related to history of DM but not to history of hypertension, hypercholestrolemia, hypertriglyceridemia and cigarette smoking. [ABSTRACT FROM AUTHOR]