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Introduction: Many studies have reported on the association between human coronary artery disease (CAD) and certain persistent bacterial and viral infections. Currently, it is unclear whether hepatitis B virus infection is associated with the risk of the atherosclerosis. The aim of this study was to investigate the possible association between hepatitis B virus infection and angiography-proven CAD. Materials and Methods: Sera from 5004 patients who underwent coronary angiography were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbant assay at Madani Heart Hospital, Tabriz University of Medical Sciences, Iran. Results: Our study population comprised 66% male and 34% female, with an age range of 36 to 86 years. The prevalence of HBsAg positivity tended to be higher in CAD patients than in those without CAD (3.28% versus 2.17%), but the difference was not statistically significant. Conclusion: Our results suggest that hepatitis B virus infection is not associated with coronary atherosclerosis in this population. Key words: Atherosclerosis, Coronary artery disease, Hepatitis B virus

Background: Percutaneous balloon mitral valvotomy (BMV) is the gold standard treatment for rheumatic mitral stenosis (MS) in that it causes significant changes in mitral valve area (MVA) and improves leaflet mobility. Development of or increase in mitral regurgitation (MR) is common after BMV. This study evaluated MR severity and its changes after BMV in Iranian patients. Methods: We prospectively evaluated consecutive patients with severe rheumatic MS undergoing BMV using the Inoue balloon technique between February 2010 and January 2013 in Madani Heart Center, Tabriz, Iran. New York Heart Association (NYHA) functional class and echocardiographic and catheterization data, including MVA, mitral valve mean and peak gradient (MVPG and MVMG), left atrial (LA) pressure, pulmonary artery systolic pressure (PAPs), and MR severity before and after BMV, were evaluated. Results: Totally, 105 patients (80% female) at a mean age of 45.81 ± 13.37 years were enrolled. NYHA class was significantly improved after BMV: 55.2% of the patients were in NYHA functional class III before BMV compared to 36.2% after the procedure (p value < 0.001). MVA significantly increased (mean area = 0.64 ± 0.29 cm2 before BMV vs. 1.90 ± 0.22 cm2 after BMV; p value < 0.001) and PAPs, LA pressure, MVPG, and MVMG significantly decreased. MR severity did not change in 82 (78.1%) patients, but it increased in 18 (17.1%) and decreased in 5 (4.8%) patients. Patients with increased MR had a significantly higher calcification score (2.03 ± 0.53 vs.1.50 ± 0.51; p value < 0.001) and lower MVA before BMV (0.81 ± 0.23 vs.0.94 ± 0.18; p value = 0.010). There were no major complications. Conclusion: In our study, BMV had excellent immediate hemodynamic and clinical results inasmuch as MR severity increased only in some patients and, interestingly, decreased in a few. Our results, underscore BMV efficacy in severe MS. The echocardiographic calcification score was useful for identifying patients likely to have MR development or MR increase after BMV.

Introduction: Considering the importance of serum paraoxonase (PON1) in preventing fromproduction of oxidized low-density lipoprotein (LDL), and consequently, its role in prohibiting fromdevelopment of atherosclerosis, we investigated paraoxonase and arylesterase activities of PON1 inpatients with coronary artery disease (CAD) and with different coronary stenosis.Materials and Methods: In the present study, 120 patients with CAD were examined and theirstenosis documented by coronary angiography. Then, the patients were divided into two groups: 60patients with less than 50% of stenosis and 60 patients with more than 70% of stenosis. Paraoxonaseand arylesterase activity was measured with substrates of paraoxon and phenylacetate, respectively.The effects of eight drugs, which are prescribed in cardiovascular diseases, were assayed onparaoxonase activity.Results: There were no significant differences in LDL-C, total cholesterol and triglyceride levelsbetween two groups, but HDL levels in patients with >70% of stenosis were significantly decreased ascompared with those of patients who had 70% of stenosis were significantly lower (P70% of stenosis were lower than patients with

Introduction: Considering the high incidence of patients with coronary artery disease (CAD) in the Iranian population and a preventive role of serum paraoxonase (PON1) in development of CAD, the present study was designed to determine the distribution of PON1 phenotypes in patients with CAD. Materials and Methods: A total of 61 patients with coronary stenosis of 70% were included in this study. Paraoxonase and arylesterase activities were measured using paraoxon and phenylacetate as substrate, respectively. Phenotyping of the PON1 Q192R polymorphism was determined by calculating the ratio of salt-stimulated paraoxonase activity to arylesterase activity (double-substrate method). Results: Patients with stenosis of 70% at ratios of 2.42 and 5.91. In patients with stenosis of 70% were 48%, 41% and 11%, respectively. Conclusions: Based on his study and other studies conducted in Iran, it can be concluded that in the Iranian population there is no statistically difference in phenotype distribution of PON1 between patients with CAD (with severe stenosis or mild stenosis) and healthy individuals.

Context: Coronary artery diseases are mostly detected using angiographic methods demonstrating arteries status. Nevertheless, Myocardial Infarction (MI) may occur in the presence of angiographically normal coronary arteries. Therefore, this study aimed to investigate the prevalence of MI with normal angiography and its possible etiologies in a systematic review. Evidence Acquisition: In this meta-analysis, the required data were collected from PubMed, Science Direct, Google Scholar, Scopus, Magiran, Scientific Information Database, and Medlib databases using the following keywords: “coronary angiograph”, “normal coronary arteries”, “near-normal coronary arteries”, “heart diseases”, “coronary artery disease”, “coronary disease”, “cardiac troponin I”, “Myocardial infarction”, “risk factor”, “prevalence”, “outcome”, and their Persian equivalents. Then, Comprehensive Meta-Analysis software, version 2 using randomized model was employed to determine the prevalence of each complication and perform the meta-analysis. P values less than 0.05 were considered to be statistically significant. Results: Totally, 20 studies including 139957 patients were entered into the analysis. The patients’ mean age was 47.62 ± 6.63 years and 64.4% of the patients were male. The prevalence of MI with normal or near-normal coronary arteries was 3.5% (CI = 95%, min = 2.2%, and max = 5.7%). Additionally, smoking and family history of cardiovascular diseases were the most important risk factors. The results showed no significant difference between MIs with normal angiography and 1- or 2-vessel involvement regarding the frequency of major adverse cardiac events (5.4% vs. 7.3%, P = 0.32). However, a significant difference was found between the patients with normal angiography and those with 3-vessel involvement in this regard (5.4% vs. 20.2%, P < 0.001). Conclusions: Although angiographic studies are required to assess the underlying etiology of MI, physicians facing patients presenting with the clinical features of MI in presence of normal or near-normal coronary arteries should consider the prevalence and risk factors of MI with normal or near-normal coronary arteries.