Cardiovascular Diseases Research Institute

=12.958, Log-Rank P < 0.001). And Cox regression revealed the hazard ratio for surgical mortality in the mild-ARDS group compared with the no-ARDS group was 2.52 (95%CI 1.41-5.32, P = 0.016).Presurgical mild ARDS increased postoperative respiratory morbidity, and then increased surgical mortality after surgical repair of acute type A aortic dissection by means of DHCA.

Background. Bypass graft surgery of the coronary artery has a significant effect on the creation and development of sexual dysfunction among male patients. The previous studies have demonstrated that date palm pollen (DPP) increases the count and quality of sperm. Additionally, it has been shown that DPP has a protective effect against myocardial infarction and cardiac remodeling. Therefore, this is the first study investigating the impact of DPP (Phoenix dactylifera L.) on managing male sexual dysfunction after coronary artery bypass graft. Methods. This randomized, double-blind, placebo-controlled clinical trial was conducted on 60 patients (DPP group n = 30, control group n = 30) of Iranian men after coronary artery bypass graft. Two parallel groups were randomly generated from the study participants. The intervention group was prescribed 3 grams of the powder of DPP twice a day (9 AM and 9 PM) for two months, while the control group received the same prescription of the placebo powder. Results. The DPP consumption significantly increased the International Index of Erectile Function (IIEF) (from 23.21 to 46.57) and the Hurlbert Index of Sexual Desire (HISD) (from 59.39 to 64.45) scores over time in the intervention group. However, there were no significant changes in the control group. Conclusion. Daily intake of 6 g DPP for two months exhibited beneficial effects on the symptoms of male sexual dysfunction in patients who have undergone coronary artery bypass graft (CABG).

Abstract: Artificial intelligence (AI) technologies have already played a revolutionary role in scientific research, from diagnostics to text-generative AI used in scientific writing. The use of AI in the scientific field needs transparent regulation, especially with a longstanding history of use—the first AI technologies in science were developed in the 1950s. Since then, AI has gone from being able to alter texts to producing them using billions of parameters to generate accurate and natural texts. However, scientific work requires high ethical and professional standards, and the rise of AI use in the field has led to many institutions and journals releasing statements and restrictions on its use. AI, being reliant on its users can exacerbate and increase existing biases in the field without being able to take accountability. AI responses can also often lack specificity and depth. However, it is important not to condemn the use of AI in scientific work as a whole. This article has partial use of an AI large language model (LLM), specifically Chatbot Generative Pre-Trained Transformer (ChatGPT), to demonstrate the theories with clear examples. Several recommendations on both a strategic and regulatory level have been formulated in this paper to enable the complementary use of AI alongside ethically-conducted scientific research or for educational purposes, where it shows great potential as a transformative force in interactive work. Policymakers should create wide-reaching, clear guidelines and legal frameworks for using AI to remove the burden of consideration from educators and senior researchers. Caution in the scientific community is advised, though further understanding and work to improve AI use is encouraged.

Premature ovarian insufficiency (POI) is an uncommon cause of infertility in females characterized by hypoestrogenism. Studies have shown that uterine artery embolization (UAE) is associated with POI. Meanwhile, Asherman syndrome (AS) is a rare condition because of intracervical or intrauterine adhesions, which can happen after dilation and curettage. Both these syndromes are causes of amenorrhea and infertility. This case is of a 40-year-old woman who, after cesarean scar pregnancy and subsequent UAE because of uncontrollable vaginal bleeding, developed premature ovarian failure and AS. She underwent hysteroscopic adhesiolysis. She became pregnant with low anti-Müllerian hormone levels. Initial adhesiolysis and intervention in AS can restore uterine endometrium's ability to host a fetus. Moreover, UAE can cause POI, which might regress to some degree.

Cardiovascular injuries induced by SARS CoV-2 have been reported repeatedly in various studies. Therefore, it is necessary to understand cardiac complications at a low cost, quickly. This study aimed to determine the relationship between cardiological parameters and polymerase chain reaction (PCR) in patients with coronavirus infection. : Patients who were admitted to the emergency department due to the ongoing pandemic, all patients with similar symptoms to coronavirus disease 2019 infection were initially admitted to the respiratory emergency room and underwent subsequent evaluations to confirm or rule out SARS-COV2 infection symptoms were assessed for eligibility. Patient were categorized into 2 groups 1. Positive PCR and negative PCR groups. Binary logistic regression was performed to assess the effect of several factors on the likelihood of developing positive troponin, reduced ejection fraction (EF), and Positive brain natriuretic peptide (BNP). Among 195 patients included, 115 (58.9%) had positive PCR. Patient in the positive PCR and negative PCR were 58.04 ± 18.03 and 59.19 ± 15.38 years of age, respectively. Patients in the "positive PCR" were significantly less likely to have chronic kidney disease (6.69% vs 17.5%, P value: .022), consume calcium channel blockers (6.69% vs 18.75%, P value:0.012). At the univariable level, positive PCR was significantly associated with fewer odds for positive BNP (OR:0.46, P = .019); nevertheless, the association was no longer significant after adjusting for confounders (adjusted OR:0.56, P = .158). Unadjusted positive PCR results were not found to have a significant association with positive troponin or reduced EF. Likewise, multivariable regression revealed no association between positive PCR and positive troponin (aOR:1.28, P = .529) and reduced EF (aOR:0.65, P = .369). PCR positivity did not result in positive troponin and BNP and did not appear to decrease EF. In other words, serial troponin and BNP checks and initial echocardiography in coronavirus disease 2019 respiratory emergencies do not make significant differences in diagnostic and therapeutic management and inpatient outcomes of patients with positive or negative PCR and are not specific findings. Evidence suggests some coronavirus-induced cardiac complications will be manifested in the long term.

Peripheral artery disease (PAD) is the manifestation of atherosclerosis where peripheral arteries are narrowed by the deposition of lipid and cholesterol and formation of fat fiber plaques on their walls. Occlusion and narrowing of the arteries may lead to several cardiovascular diseases and therefore in-time diagnosis and treatment of PAD is essential. There are several invasive and noninvasive methods to diagnosis of PAD, however, still an automated, easy-to-use, and affordable device for in-home monitoring of cardiovascular health is lacking. In this study, an oscillometric system is used to record arterial wall oscillations at different external pressures in lower and upper limbs. Wavelet transform is used to extract features from the amplitude of the recorded arterial wall oscillations and an adaptive neuro-fuzzy inference system (ANFIS) is used to identify PAD based on the extracted features. Because of the ANFIS high computational cost, linear discriminant analysis (LDA) is applied to the features to reduce their dimension before feeding them to ANFIS. The performance of proposed method is compared versus the conventional ankle-brachial test on a dataset of oscillometric recording obtained from 14 patients with PAD and 14 healthy individuals. Based on a five-fold cross validation, our method achieved an accuracy of 82% in detecting PAD. The results show promise toward the development of in-home cardiovascular monitors for cardiovascular health assessment.

Primary malignant tumors of the aorta (PMTAs) are not only extremely rare, but also exhibit enormous histological heterogeneity. We present the first recorded case of a female patient with intimal angiosarcoma of the aortic arch and descending thoracic aorta in China, along with the clinical presentation, histopathologic diagnosis, and surgical excision of the lesion. We propose surgery as a viable curative approach to angiosarcomas of intimal origin. J Curr Surg. 2017;7(4):64-68 doi: https://doi.org/10.14740/jcs332w

Objectives Cold is an important factor contributing to the high incidence of hypertension. In order to explore the mechanisms of cold-induced hypertension. This study observed whether Large conductance calcium-activated potassium channel (BK Ca ) on vascular smooth muscle cells (VSMC) played a role in the development of hypertension during chronic exposure to cold. Methods Forty-eight rats were divided into cold-treated group and control group randomly, then, one subgroup of the cold-treated and one subgroup of control rats were sacrificed at 2, 4, 6 and 8 weeks. Results Systolic blood pressure started to rise after 2 weeks of cold exposure and continued to increase, reaching a maximal level by the 6th week of exposure to cold, and then pressure begin to decrease slowly throughout the remainder of the experiment. The BK Ca current and BK Ca peak current density in aortic VSMC increased significantly as the time of exposure to cold went until the 6th week exposure to cold. Furthermore, the expression of L-type Cav1.2 channelα 1 C subunit mRNA in the cold-treated rats were higher than those in the control rats. Conclusions Cold stress increased expression of L-type Cav1.2 channelα 1 C subunit mRNA, indicate that cytoplasmic Ca 2+ concentration increased with cold-treated extended at 6 weeks in the beginning, resulting in increasing blood pressure. BK Ca channel currents increased in this progress as the negative-feedback regulators of vascular tone. Our results indicated that activation of BK Ca channel could reduce blood pressure (7th and 8th week) in hypertensive subjects.

Cardiac arrhythmias are a leading cause of mortality, morbidity, and sudden cardiac death (SCD). Current treatment strategies for ventricular tachycardia (VT) are effective for many patients; however, in several cases, this does not result in a cure. Despite significant clinical improvements, conventional catheter ablation remains relatively unsuccessful in achieving the best outcomes in some challenging cases. Stereotactic arrhythmia radioablation (STAR), which delivers precise high-dose radiation to well-defined targets with minimal damage to surrounding tissue, is emerging as a new potential treatment option, having the potential to be used for patients at high risk for catheter ablation or who have refractory VT. Ongoing studies and preliminary experiences on f the efficacy of STAR in patients with refractory VT have shown a reduction in VT recurrence and a promising early safety profile. However, STAR is in its infancy, and clinical evidence on its efficacy and safety is limited; thus, conclusions regarding the efficacy of STAR should be drawn with caution. Further investigation of long-term efficacy and tolerability is ongoing to substantiate this promising therapeutic option better. The present review describes the background and general principles, pretreatment procedures, clinical implications, and toxicity of STAR therapy.

The Article Abstract is not available.

BACKGROUND: Door-to-needle (DTN) is the duration between patient's arrival at the hospital and receiving intravenous thrombolysis in ischemic stroke settings, for which studies have reported delays in women. The "D's of stroke care" describes 8 steps (D1 to D8) in patients' time tracker. We implemented simple modifications to the "D's of stroke care" by splitting D4 and D6 steps into these substeps: patients' arrival to the emergency room (D4-A), early assessment by a neurologist (D4-B), neurologist decision on patient's eligibility to receive recombinant tissue plasminogen activator (D6-A), and patient's transfer to the stroke unit (D6-B). We evaluated the effect of these changes on reducing DTN time disparity between men and women. METHODS: This study was conducted from September 2019 to August 2021, at a comprehensive stroke center. Patients were analyzed in 2 groups: group 1, before, and group 2, after using the modifications. Sex as the main variable of interest along with other covariates was regressed toward the DTN time. RESULTS: In groups 1 and 2, 47 and 56 patients received intravenous thrombolysis, respectively. Although there was a significant difference in DTN≤1 hour between women and men in group 1 (36% vs. 52%, P =0.019), it was not significantly different in group 2 ( P =0.97). Regression analysis showed being female was a significant predictor of DTN>1 hour in group 1 (adjusted odds ratio=6.65, P =0.02), whereas after using the modifications, sex was not a significant predictor for delayed DTN. CONCLUSIONS: Implementing these substeps reduced sex disparity in DTN time in our center.

Background : Abiraterone has applications in the treatment of prostate cancer.It can potentially be associated with various cardiac arrhythmias, such as torsade de pointes.We report a case where the patient experienced syncope episodes following the administration of this medication, and torsade de pointes was detected during monitoring.Case summary: A 73-year-old man with a history of hypertension and prostate cancer presented to the emergency department with complaints of syncope.He was taking medications for his conditions, including abiraterone acetate and bicalutamide.An ECG revealed a prolonged QT interval and continuous cardiac monitoring showed multiple premature ventricular contractions (PVCs) followed by torsade de pointes.The

Abstract Background High-density lipoprotein cholesterol (HDL-C) is shown to be an independent protective factor against coronary artery diseases (CAD). Yet there are limited studies focusing on the association between HDL-C and coronary artery bypass graft (CABG) surgery outcomes. Hypothesis Low levels of HDL-C are associated with higher incidence of adverse outcomes in patients undergoing CABG. Methods This registry-based study included 17,772 patients who underwent elective isolated CABG between 2007 and 2017. Participants were assigned into low and optimal HDL-C groups based on serum HDL-C levels at admission and were followed for one year after surgery. Cox proportional hazard models were performed to evaluate the association between HDL-C levels and incidence of mortality as well as major adverse cardiovascular and cerebrovascular events (MACCE), while adjusting for potential confounders. Moreover, participants were stratified based on gender and the association was also investigated in each subgroup separately. Results No significant difference was found between the groups regarding incidence of both mortality and MACCE, after adjusting with IPW [HR (95%CI): 1.109 (0.815–1.509) and HR (95% CI): 1.192 (0.995–1.428), respectively]. According to the gender-based subgroup analysis, low HDL-C group exhibited higher MACCE incidence solely in the male subgroup, after adjusting with IPW. Conclusion The association between perioperative HDL-C level and incidence of MACCE during 1-year post-CABG surgery in the male subgroup suggests HDL-C level as a possible prognostic factor in this population. Further studies are warranted to clarify the role of HDL-C level in predicting the prognosis of patients undergoing CABG.

We aimed to evaluate the effect of some simple modifications on reducing sex disparities, with a focus on Door-to-needle (DTN) time.

Research of cardiac calcium ion release channel( RyR2) had obtained great advance in recent 20 years.Function,regulation of RyR2and its relationship with some cardiovascular diseases such as arrhythmia( catecholaminergic polymorphic ventricular tachycardia,arrhythmogenic right ventricular cardiomyopathy and atrial fibrillation),heart failure,myocardial infarction and drug-induced hypertension and drugs which block RyR2channel such as JTV519 and S107 are reviewed in brief in this paper.We question this view that myocardial infarction should be classificated as category of cardiac calcium ion channelopathy.

<title>Abstract</title> <bold>Background: </bold>Anal fistula is an abnormal tract between the anal canal and the perianal skin. Anal fistula plug (AFP) as a sphincter-preventing method has drawn more interest because of its simple procedure and low risk of incontinence. Small intestine submucosa (SIS) as a biomaterial plug has been applied in managing anal fistulae. Platelet-rich fibrin (PRF) is a platelet-derived product containing several growth factors. PRF has been widely used for soft tissue regeneration because it promotes angiogenesis and mitogenesis and inhibits inflammation in the wound site. Because of the rigid consistency of SIS and the low mechanical resistance of PRF and their tissue-regenerative properties, we created a novel SIS-PRF plug for managing anal fistula. <bold>Methods: </bold>Anal fistulae were created in the rabbit model. 18 rabbits were used. Animals were divided into three groups, including SIS-PRF, SIS and control. Five weeks’ post-treatment, animals were sacrificed, and fistula specimens were obtained. <bold>Results: </bold>According to histological analysis, inflammation was significantly lower in the SIS-PRF group compared to other groups. Treatment with both biomaterials increased the number of closed fistula tracts, but it was markedly higher in the SIS-PRF group compared to the SIS group. No foreign body reaction was seen in the SIS-PRF group. <bold>Conclusions: </bold>In this study, SIS-PRF reduced inflammation and increased connective tissue in fistulae. Taken together, SIS-PRF can be used in further studies about anal fistula management in humans.

Background: The present study aimed to investigate the association between acute cardiac injury (ACI) and outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19) in Iran. Methods: The current cohort study enrolled all consecutive hospitalized patients with COVID-19 (≥ 18 y) who had serum high-sensitivity cardiac troponin-I (hs-cTnT) measurements on admission between March 2020 and March 2021. ACI was determined as hs-cTnT levels exceeding the 99th percentile of normal values. Data on demographics, comorbidities, clinical and laboratory characteristics, and outcomes were collected from Web-based electronic health records. Results: The study population consisted of 1413 hospitalized patients with COVID-19, of whom 319 patients (22.58%) presented with ACI. The patients with ACI had a significantly higher mortality rate than those without ACI (48.28% vs 15.63%; P<0.001) within a mean follow-up of 218.86 days from symptom onset. ACI on admission was independently associated with mortality (HR, 1.44; P=0.018). In multivariable logistic regression, age (OR, 1.034; P<0.001), preexisting cardiac disease (OR, 1.49; P=0.035), preexisting malignancy (OR, 2.01; P=0.030), oxygen saturation reduced to less than 90% (OR, 2.15; P<0.001), leukocytosis (OR, 1.45; P=0.043), lymphopenia (OR, 1.49; P=0.020), reduced estimated glomerular filtration rates (eGFRs) (OR, 0.99; P=0.008), and treatment with intravenous immunoglobulin during hospitalization (OR, 4.03; P=0.006) were independently associated with ACI development. Conclusion: ACI occurrence on admission was associated with long-term mortality in our hospitalized patients with COVID-19. The finding further underscores the significance of evaluating ACI occurrence on admission, particularly in individuals more prone to ACI, including older individuals and those with preexisting comorbidities, reduced oxygen saturation, and increased inflammatory responses.

Atrial fibrillation( AF) is the most common arrhythmia. As one of the most important non-pharmaceutical therapy for AF,catheter ablation has been developed rapidly and widely accepted. Although the electrical isolation of pulmonary veins has been commonly accepted as the procedural endpoint for paroxysmal atrial fibrillation,the ablation strategy and endpoints for persistent atrial fibrillation are still controversial. So this paper is to briefly discuss the current ablation methods and strategies for persistent atrial fibrillation.

Aim. To identify associations of mtDNA polymorphisms with sudden cardiac death. Materials and Methods. DNA was isolated from the cardiac tissue excised during the autopsy from individuals who died from sudden cardiac death (n = 260). The frequencies of the most common European mtDNA haplogroups (H, U, T and J) were determined using restriction fragment length polymorphism analysis. In addition, we performed a comparative analysis using previously published data on mtDNA polymorphisms in the West Siberian population. Results. The distribution of mtDNA haplogroups in the patients who died from sudden cardiac death was similar as in the general population: 40% for haplogroup H, 23% for haplogroup U, 12% for haplogroup T and 6.5% for haplogroup J. We found no significant differences regarding the frequency of mtDNA haplogroups in individuals who died from sudden cardiac death and the population level. Conclusion. We discovered no associations of H, U, T, and J mtDNA haplogroups with sudden cardiac death. These results indicate the necessity of a detailed analysis of mitochondrial genome to determine mtDNA variants associated with sudden cardiac death.

QT interval and related indices prolongation are common in rheumatological diseases,which is associated with immunity and inflammation,suggesting complex ventricular arrhythmia and cardiac sudden death. Therefore,12-lead electrocardiogram,24-h Holter recording,and echocardiogram should be used to assess the cardiac profiles in rheumatological diseases.