Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170515The effect of reflexotherapy and massage therapy on vital signs and stress before coronary angiography: An open-label clinical trial505510570ENAli KhaledifarMedical Intern, Student Research Committee, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranMarzeih NasiriAssociate Professor, Department of Cardiology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranBorzoo KhaledifarAssociate Professor, Department of Surgery, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranArsalan KhaledifarAssociate Professor, Department of Cardiology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran0000-0003-2323-171XAli MokhtariGeneral Practitioner, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranJournal Article20150702BACKGROUND: Complementary medicine interventions are now successfully used to reduce stress as well as to stabilize hemodynamic indices within different procedures. The present study aimed to examine the effect of massage therapy and reflexotherapy on reducing stress in patients before coronary angiography. METHODS: In this open-label clinical trial, 75 consecutive patients who were candidate for coronary angiography were randomly assigned to receive reflexotherapy (n = 25), or massage therapy (n = 25), or routine care (n = 25) before angiography. The Spielberger State-Trait Anxiety Inventory was used to determine the stress level of patients before and after interventions and vital signs were also measured. RESULTS: Improvement in diastolic blood pressure, heart rate, and respiratory rate was shown in the reflexotherapy group, and similar effects were observed following other interventions including massage therapy and routine resting program. In subjects who received reflexotherapy the level of stress decreased slightly compared with the other two groups. However, following interventions the level of stress in reflexotherapy group was shown to be lower than other study groups. CONCLUSION: Reflexotherapy before coronary angiography can help to stabilize vital sign as well as reduce the level of stress. The effect of massage therapy was limited to reducing stress. Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170515Healthy eating index and cardiovascular risk factors among Iranian elderly individuals566510571ENNafiseh Rashidipour-FardShahid Motahari Hospital, Fooladshahr, Isfahan, IranMajid KarimiShahid Motahari Hospital, Fooladshahr, Isfahan, IranSahar Saraf-BankFood Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IranMohammad Hassan BaghaeiShahid Motahari Hospital, Fooladshahr, Isfahan, IranFahimeh HaghighatdoostFood Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IranLeila AzadbakhtProfessor, Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan AND Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences Tehran, IranJournal Article20151214BACKGROUND: Concurrent with increase in life expectancy, the prevalence of chronic diseases such as cardiovascular diseases (CVD) has also increased. Therefore, the aim of this study was to evaluate the association between healthy eating index (HEI) score and CVD risk factors among Iranian elderly. METHODS: This cross-sectional study was performed on a sample of elderly persons from Isfahan, Iran, in 2013. Totally, 107 retired subjects were entered in statistical analysis. A semi- quantitative food frequency questionnaire was used to assess the dietary intake of participants. Anthropometric measurements and blood pressure of participants were determined. Fasting blood samples were taken for biochemical assessments. RESULTS: The results of linear regression determined a significant inverse association between HEI score and homeostasis model assessment of insulin resistance [HOMA-IR, β = -0.238 (-0.426, -0.048)], fasting blood glucose [β = -0.194 (-0.383, -0.004)], and high-sensitivity C-reactive protein [hs-CRP, β = -0.196, (-0.386, -0.005)]. In addition, a significant positive association was observed between HEI score and high density lipoprotein cholesterol [HDL-C, β = 0.196 (0.006, 0.385)] levels. However, after adjusting for confounding variables, these significant associations were disappeared except for hs-CRP [β = -0.074 (-0.145, -0.003)]. CONCLUSION: Healthy eating index was associated with reduced risk of cardiovascular risk factors in old people. It seems that more adherence with healthy eating index could provide cardio-protective effects in elderly persons. Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170301The role of manual thrombectomy in cardiovascular outcome among patients with total cutoff vessel myocardial infarction undergoing primary percutaneous coronary intervention667210572ENAlireza KhosraviCardiologist, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran0000.0003.0736.2090Davoud RajabiCardiologist, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranMasoud PourmoghaddasCardiologist, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranAfzal RoohiNurse, Chamran Hospital, Isfahan University of Medical Sciences, Isfahan, IranMasoumeh EsmaeiliNurse, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20160423BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014. The culprit lesion was treated with routine PPCI with bailout thrombectomy (111 patients) and routine primary thrombectomy then percutaneous coronary intervention [(PCI), 70 patients] during hospitalization and one month after discharge. Patients in the case group received manual thrombectomy before PPCI and patients in the control group received standard PPCI with bailout thrombectomy. Patients were followed during the study procedure, post-hospitalization and one month later for cardiovascular outcomes including death, recurrent MI, stroke, major bleeding, post PCI arrhythmia, no reflow, thrombolysis in myocardial infarction (TIMI)-flow and TIMI myocardial blush grade (TMBG), which were assessed and recorded. RESULTS: Myocardial perfusion and angiographic outcomes had no significant differences in the two groups (P = 0.730). There was also no significant difference in no reflow prevalence between the two groups (P > 0.990). There were no significant differences for primary outcomes such as death, stroke, major bleeding and arrhythmia between the two groups (P < 0.050). In particular, outcomes were the same for both groups during hospitalization period and one month after discharge. Mortality rate during hospitalization was 5.7% for the control group and 4.5% for the case group (P = 0.730). However, one-month mortality rate was quite similar in both groups. CONCLUSION: This study showed there is no significant difference in cardiovascular outcomes such as death, stroke, bleeding, arrhythmia, target vessel revascularization, and distal embolization during hospitalization and one month after discharge in patients with acute MI and total cutoff of the involved vessel, who underwent PPCI with and without primary Export® aspiration catheter direct thrombosuction. Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170515Evaluation of pentraxin-3 level and its related factors in patients undergoing primary percutaneous coronary intervention737810573ENSaeed Alipour-ParsaAssociate Professor, Cardiovascular Research Center AND Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranHabib HaybarAssistant Professor Cardiovascular Research Center AND Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranMohammad Hasan NamaziProfessor, Cardiovascular Research Center AND Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranMorteza SafiProfessor, Cardiovascular Research Center AND Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranIsa KhaheshiAssistant Professor, Cardiovascular Research Center AND Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranMehdi MemaryanCardiologist, Cardiovascular Research Center AND Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranAmir Mohammad Eghbalnejad-MofradStudent of Medicine, Student Research Committee, Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranJournal Article20160622BACKGROUND: Inflammation has an important role in the development and progression of atherosclerosis, and acute phase proteins such as pentraxin-3 (PTX3) can be deployed in determining the prognosis of coronary artery disease (CAD). So the purpose of this paper was to evaluate the PTX3 level and its related factors in patients undergoing primary percutaneous coronary intervention (PCI). METHODS: In this cross-sectional study, the PTX3 levels were determined for 100 patients with ST-elevation myocardial infarction referred to the Modarres Hospital, Tehran, Iran. Checklist included demographic data [age, gender, history of myocardial infarction (MI)] and characteristics of heart disease (type of MI, culprit, and pre-dilation). PTX3 was measured for all patients before PCI. RESULTS: In this study, the mean age of the participants was 58.7 (11.4). Global registry of acute coronary events (GRACE) score was higher in the group with abnormal PTX3 levels (P = 0.008). The number of the involved vessels (P = 0.005), MI type (P = 0.05), and the need for PCI all had a significant relation with abnormal PTX3 levels. The increased levels of PTX3 received higher Killip class, lower ejection fraction, and higher GRACE score. The group with abnormal PTX3 had a significant difference in platelet counts (P = 0.018) in comparison with the group with normal level of PTX3. CONCLUSION: Currently, the biomarkers are highly important in the field of cardiovascular diseases. The diagnostic and prognostic importance of PTX3 as a new marker has been underscored in recent studies. Differentiating between high-risk patients with acute cardiac infarction and low-risk ones through their clinical signs is difficult. Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170516Acute myocardial infarction in very young adults: A clinical presentation, risk factors, hospital outcome index, and their angiographic characteristics in North India - AMIYA Study798710574ENSantosh KumarSinhaAssistant Professor, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India0000-0002-1776-1485Vinay KrishnaAssistant Professor, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India0000-0003-0086-2260Ramesh ThakurProfessor, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India0000-0002-9298-5980Ashutosh KumarSenior Researcher, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaVikas MishraDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaMukesh JitendraJhaDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, India0000-1234-7890-5678Karandeep SinghDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaMohit SachanDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaRupesh SinhaDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaMohammad AsifDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaNasar AfdaaliDepartment of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaChandra MohanVarmaProfessor, Department of Cardiology, Laxmipat Singhania (LPS) Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, Kanpur, IndiaJournal Article20160719BACKGROUND: India is currently in the fourth stage of epidemiological transitions where cardiovascular disease is the leading cause of mortality and morbidity. Purpose of the present study was to assess the risk factors, clinical presentation, angiographic profile including severity, and in-hospital outcome of very young adults (aged ≤ 30 years) with first acute myocardial infarction (AMI). METHODS: Total of 1,116 consecutive patients with ST-segment elevation acute myocardial infarction (STEMI) were studied between March 2013 and February 2015 at LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India. RESULTS: Mean age of the patients was 26.3 years. Risk factors were smoking (78.5%), family history of premature coronary artery disease (CAD) (46.8%), obesity (39.1%), physical inactivity (38.7%) and stressful life events (29.6%). The most common symptom and presentation was chest pain and anterior wall MI (AWMI) in 94.8% and 58.8%, respectively. About 80.6% of patients had obstructive CAD with single vessel disease (57.6%), double-vessel disease (12.9%) and left main involvement (3.2%). Left anterior descending (LAD) was commonest culprit artery (58.1%) followed by right coronary artery in 28.2%. In-hospital mortality was 2.8%. Percutaneous coronary intervention was performed in 71.6% of patients. Median number and length of stent were 1.18 and 28 ± 16 mm, respectively. CONCLUSION: AMI in very young adult occurred most commonly in male. Smoking was the most common risk factor. AWMI owing to LAD artery involvement was the most common presentation. Mean time of presentation after symptom onset was 16.9 hours. In contrast to western population, it is characterised by earlier onset, delayed presentation, more severity, diffuse disease, and more morbidity but with favourable in-hospital mortality Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170515Two cases of parachute tricuspid valve confirmed by three-dimensional echocardiography889010575ENHedieh AlimiAssistant Professor, Cardiovascular Research Center AND Department of Cardiology, School of Medicine, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-8826-2675Afsoon FazlinezhadProfessor, Cardiovascular Research Center AND Department of Cardiology, School of Medicine, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-9479-2309Journal Article20160312BACKGROUND: Parachute tricuspid valve is a rare congenital malformations explained in the literature. In most cases, this malformation coexists with other congenital defects. The importance of this condition depends on its functional consequences. CASE REPORT: First case was a 52-year-old female patient presented with palpitation. She had a history of paroxysmal supraventricular tachycardia. Transthoracic echocardiography revealed large secundum type atrial septal defect and all the tricuspid valve leaflets appeared to be connected to a single calcified papillary muscle in right ventricle suggestive of parachute tricuspid valve. Echocardiography showed severe right ventricle and right atrial enlargement, and moderate to severe tricuspid regurgitation without significant tricuspid stenosis. Another case was a 30-year-old female patient referred for echocardiography prior to her breast cancer chemotherapy. Transthoracic echocardiography revealed a right ventricle with an unusual fusion of papillary muscles resulting in a single calcified head for the attachment of all tricuspid leaflets. These findings were suggestive of a parachute-like tricuspid valve. Other data were mild to moderate tricuspid regurgitation without any stenosis, and normal right ventricle size and function. In both cases, parachute tricuspid valve was confirmed by three dimensional echocardiograph. CONCLUSION: In our first case, parachute tricuspid valve was associated with atrial septal defect, although in the second case, no associated anomaly was detected, a condition not previously reported in the literature. In both cases, parachute tricuspid valve was not associated with tricuspid stenosis. Based on other published cases, parachute involvement of the tricuspid valve is less often reported than cases involving the mitral valve. Additionally, the associated consequences in tricuspid valve position such as tricuspid stenosis seem to be less significant than cases involving mitral valve. It is recommended that in patients with tricuspid valve involvement, parachute anomaly should be considered as a possible rare cause. Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170301Right ventricular thrombosis as a manifestation of Behçet’s syndrome919410576ENPayam EbrahimifarCardiologist, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranJavad ShahabiAssistant Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20151117BACKGROUND: Behçet's disease (BD) is a rare condition with a classic triad of oral and genital ulceration and eye disease. Cardiovascular complication is a rare finding in BD. CASE REPORT: In this report, we present a seventeen years old patient with a history of fever for 20 days, who developed a clot in right ventricle (RV). Cardiac magnetic resonance imaging (MRI) and echocardiography demonstrated a thrombosis in RV and a thoracic multi detector computed tomographic image showed pulmonary thromboembolism (PTE) in patient. The patient was administered with methylprednisolone, cyclophosphamide and anticoagulant. A regular follow-up was carried out. Two months later, the RV clot had disappeared on transthoracic echocardiography (TTE). CONCLUSION: In BD, early cardiac MRI and echocardiography should be performed for the detection of cardiac involvement, and medical treatment is the first choice of treatment. Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170515Some facts about the Metabolic Syndrome in Iran959610577ENAbdollah Mohammadian-HafshejaniPhD Candidate, Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan AND Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranNizal SarrafzadeganProfessor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranMasoumeh SadeghiProfessor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-7179-5558Journal Article20150807-Cardiovascular research institute, Isfahan University of Medical SciencesARYA Atherosclerosis Journal1735-395513220170301Journal Index10569ENIndex Journal0000-0002-1825-0097Journal Article20170830Click to download the index of this issue.