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  Background & Objectives: Acute myocardial infarction (AMI) is one of the most common causes of admissions in industrialized countries and each year a lot of deaths occur due to this disease. AMI is commonly associated with leukocytosis and an elevated neutrophil count. It is not clear whether neutrophilia is a cause or effect of acute myocardial injury and heart failure. Nevertheless, proving such a correlation will have a lot of clinical utilities.

  Methods: From among 146 patients hospitalized by AMI diagnosis in the CCU ward of Shahid Madani hospital, 68 patients (having our inclusion criteria) took part in this cross-sectional and analytical study. The criteria for AMI were clinical symptoms, ECG criteria and paraclinical findings. CBCH₁ was performed for the patients. All the patients were evaluated for presence or absence of congestive heart failure (CHF) in first 4 days of hospitalization. The data were analyzed with SPSS software using t-test and Chi-square.

  Results: Mean neutrophil count was 11291 in patients with evidence of congestive heart failure (CHF) and 8440 in those without it (P =0.01). This difference was statistically significant. Among 23 patients with CHF, 16 had neutrophil counts >8500, but among 45 patients without CHF only 19 cases showed this value (Odds ratio=3.12, P=0.03). Also among 35 patients with neutrophil counts >8500, 24 patients had ejection fraction (EF) of less than 45% and 11 cases had EF>45%(P=0.015).

Conclusion: In this study we found a direct correlation between neutrophilia on admission and the presence of CHF and echocardiographic left ventricular dysfunction in first 4 days of hospitalization. So the patients with high neutrophilia need more invasive treatments to reduce the possibility of CHF.

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  Background & Objectives: Heart failure (HF) is a pathophysiologic state in which cardiac dysfunction leads to insufficient pumpage of blood for metabolic needs of body. One of the important problems in primary approach to patients with HF, is estimation of HF severity. The present research is an attempt to investigate the accuracy of CXR in diagnosis of HF severity especially in emergency wards.

  Methods: This sensitivity analysis study was conducted on 59 patients admitted to emergency ward of Buali Hospital during March–September 2003, with primary diagnosis of HF. One randiologist used to observe and report radiologic findings without knowing the results of each cardiography.Then cardiologists used to check on the reports and selected patients whose EF was under 50% and eventually sensitivity and specificity of radiologic findings in diagnosing severity of HF (EF ≤ 35%) were calculated.

  Results: 59 patients (53% female and the rest male) were investigated whose age mean was 65.6±10.9 EF mean was 33.4±9.09. In the diagnosis of pulmonary arterial hypertension, CXR had 72% sensivity and 18% specifity, considering the reliance on the CXR in diagnosis of severe HF (EF ≤ 35%) findings were: cardiomeglay (94%), pulmonary artery congestion (75%), interstitial edema (78%) and alveolar edema (76%) with high specifity the reliance on the combination of pulmonary cephalization, interstitial edema and pleural effusion was to have 92% sensivity and 10% specifity.

  Conclusion: According to high sensitivity of cardiomegaly, pulmonary arterial congestion, interstitial edema and pleural effusion, lack of there findings in CXR reduce probability of severe HF. Alveolar edema because of its high specificity increases probability of severe HF. CXR also has high sensivity in diagnosis and R/O of PAH.

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  Background & Objectives: Usually, among the candidate patients for cardiac valve's surgery, the coronary artery angiography is performed according to their age and gender. By this research, the prevalence of coronary artery disease is studied in addition we have tried to consider the risk - factors of coronary artery disease to predict the probability of coronary artery disease among them.

  Methods: we studied prospectively a population of 320 patients (144 male and 176 female) who were candidate to cardiac valve's surgery and underwent preoperative angiography in the cath - Lab of Imam Khomeini hospital in Tehran, from April - 1999 to October - 2003.

  Result: There was aortic valvulopathy in 131 patients, mitral in 90 and combined Mitro-aortic in 99. Angina was present in 35% and coronary artery disease risk factors in 27.8% of patients. The prevalence of coronary artery disease was 13.1 %. The prevalence of coronary artery disease in patients with angina was significantly higher (22.3% versus 8.2% in patients without angina). In addition the prevalence of coronary artery disease was significantly higher in patients with coronary artery disease risk factors (22.5% versus 9.5% in patients without risk factors). Three predictive factors of CAD in these patients were age, presence of angina pectoris and presence of CAD risk Factors. The prevalence of CAD in patients who have neither angina nor risk factors was 4.6%. In this group of patients no male under 60 years old and only 3.5% of female patients under 65 years old had coronary artery disease.

  Conclusion: The study showed that due to the low prevalence of coronary artery disease in patients with none of the coronary risk factors or without angina, we can avoid preoperative coronary angiography in males under 60 years old and females under 65 years old who have neither angina nor risk factors of CAD.

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Background & Objective: Some studies have shown the protective effects of Etomoxir and Ranolazine in the hypoxic and ischemic condition of the heart. However, at present, there has not been any comparative study between the effects of Etomoxir and Ranolazine on
ischemia/reperfusion injuries (esp. infarct size), So their effects on infarct size in the ischemic isolated rat heart were studied and  compared.
Methods: Isolated rat hearts were divided into 3 groups randomly (n=6 in each group) and mounted on a Langendorff apparatus then perfused by a modified Krebs-Henseleit solution. In control group, the hearts were perfused by the solution at stabilization, 30min regional ischemia and 120min reperfusion while in the test groups they were perfused by enriched Krebs solution with 1μM of Etomoxir or 20μM of Ranolazine during ischemia/reperfusion. At the end of reperfusion, Evans Blue solution was infused to stain the non-ischemic area. Then the heart was incubated in 1% thriphenyl tetrazolium chloride solution and fixed by formalin. The infarct size was determined by a computerized planimetry package.
Results: The results showed that Etomoxir results in the significant decrease in the size of infracted area. In the control group, infarct size was 6.3±2.9%, while Etomoxir reduced infarct size to 20.9±5% (p< 0.01). Perfusion of the hearts by Ranolazine enriched Krebs solution produced greater reduction in infarct size (16.4±3.6%, p< 0.001). The effect was not statistically significant between the test groups.
Conclusion: It seems that Etomoxir (an inhibitor of fatty acid uptake by mitochondria) and Ranolazine (an inhibitor of fatty acid oxidation by mitochondria) probably, by indirect increasing of glucose oxidation, duning ischemia and reperfusion, may improve reperfusion recovery of ischemic heart and reduce infarct size. The results showed protective effects of Etomoxir and Ranolazine on infarct size without any significant difference between them.

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  Background & Objectives :�Heart rate deflection point (HRDP) plays an important role in predicting anaerobic threshold and monitoring athletes training schedule. Despite some research, the physiological mechanisms involved in occurrence of the HRDP remains to be fully elucidated. The objective of this study was to survey of the agreement between Heart Rate Deflection Point (HRDP) and the Potassium Turn Point (KTP) in young athlete men.

  Methods :�Thirty young men athlete volunteer (Mean ± SD age= 20 ± 1.21 years height = 176 ± 7.34 Cm and weight = 6.58 ± 5.66 Kg) were selected as subjects. Hofmann protocol was used to cause the HRDP. One week later and after determining the HRDP by using the S.Dmax method, subjects performed Hofmann protocol again and blood samples were taken from left forearm vein in five phases, simultaneously. The amount of potassium was measured directly by the Flamephotometer.

  Results :�According to the results of study, the HRDP and KTP were occurred in average in 78% HRmax and 79% HRmax, in all of the subjects, also there was a highly agreement between HRDP and KTP (158 3.84 vs. 159 3.88 b/min). HRDP & KTP were occurred in third phase, simultaneously.

  Conclusion: Based on these results, exercise induced increase in serum potassium during Hofmann incremental cycle ergo-meter testing protocol can be one of the mechanisms of the occurrence of HRDP.

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  Background & Objectives: Following to estrogen depletion in postmenopausal womens, its cardioprotective effect decreases. Stroke usually occurs in women during the menopause years. Estrogen hormone therapy is still controversial. Epidemiological data suggest that phytoestrogens have a preventive effect on various estrogen-related diseases/symptoms such as menopausal symptoms, cardiovascular diseases. Some studies suggest that genistein as an important component of soy have cardioprotection effects but its role on inflammation and cardiomyocte injury remained to be elucidated. So, this study was goaled to investigate the cardioprotective effect of methanolic soy extract on heart tissue injures.

  Method: In this study 40 female rats were randomly allocated into 4 groups: 1) Control (intact animals), 2) sham surgery (without ovarictomy), 3) ovariectomized (ovx), and 4) treatment (ovx and soy gavage) group that received 60mg/kg per day soy extract in drinking water for 28days (4 weeks). At the end of experiments, the rat heart tissue was processed histologically and the sections were stained with hematoxylin and eosin to examine under light microscope. Statistical analysis was performed using the wilcoxon test.

  Results: The results showed that ovariectomy significantly increased inflammation and cardiomyocte injury and soy extract significantly promoted heart tissue recovery (p<0.05).

  Conclosions: This study indicated that oral administration of soy extract has a positive effect on attenuation of inflammation and myocyte injury in ovariectomized rat.

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  Background & Objectives: Low dose aspirin has been widely used in the prevention and treatment of cardiovascular disease. The bimodel action of aspirin on serum uric acid showed that aspirin at a high dosage promoted uricusuria while intermediate doses were (1-2gr/day) caused uric acid retention. The main goal of this study was to survey the effect of low dose aspirin on serum level of uric acid in patients with ischemic heart disease.

  Methods: The study design was cross-sectional and analytical type. In this study we selected 60 patients who used low dose aspirin among the patients of Imam Khomeini hospital's heart clinic (2008-9) and their information was registered in special questionnaires including serum level of uric acid and creatinine before and after prescription of aspirin. Data was then statistically analyzed using Paired t test and Willcoxon.

  Results: Of 60 patients 11 ( 18.3 % ) were under 50 years and 49 ( 81.7%) were above 50 years. The male to female ratio was 1.72 (38: 63.3% versus 22: 36.7%). 53.3 % of patients showed an increase in serum uric acid, but 46.7% did not. No significant differences in uric acid levels was found in patients under 50 years before and after administration of aspirin. Serum uric acid levels were increased after administration of 0.1unit of aspirin.

  Conclusion: Low -dose aspirin (80 mg/ day) caused a slight but significant increase in serum uric acid and creatinine levels in patients over 50 years of age.

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  Background & Objectives : Nowadays, coronary artery disease is the most common cause of death in developed countries and in the whole world. According to the WHO reports, it will be the main cause of death in 2020. Myocardial infarction is the most common diagnosis among hospitalized patients in industrialized countries. This disease causes more mortality and morbidity than others. Coronary artery bypass grafting surgery (CABGS) is one of the common treatments for ischemic heart disease but it may have some complications. In this study we wanted to evaluate the incidence of CABGS complications in Imam Khomeini Hospital of Ardabil in the first month after CABG.

  Methods: This study was a cross sectional analytic descriptive type and performed on all of the patients underwent CABGS in Imam Khomeini Hospital during 2011-2012. All of the data from patients (like demographic, past medical history, physical exam findings, paraclinical findings and CABGS complications) were inserted in special forms after gathering, and analyzed by SPSS v.16.

  Results: In this study, 211 patients were studied. About 145 (68.72%) of them were male and 66 (31.28%) were female. Seventy patient (33.17%) were more than 70 years old. About 33.22% of patients had a history of cigarette smoking and 9.95% were opioid abused. The 34.12% of patients had hypertension (HTN) history, 40.28% diabetes mellitus (DM), 17.06% history of hyperlipidemia and 63.98% had a history of the previous MI. Chest pain was the most common complication among the patients (93.36%). According to our study the prevalence rate of post CABGS complications were: bleeding after surgery 13.27%, postoperative myocardial infection 8.05%, neurological disorders 12.32%, renal complications 2.36%, respiratory symptoms 11.37% and 34.59% for cardiovascular complications. Also the total mortality was 5 (2.36%) persons. The data analysis showed that there was a significant relationship between sex with survival status, local infection and neurological disorders, and also there was a significant relationship between age with post CABGS survival, bleeding after surgery and renal complications. There was also a significant relationship between DM and post CABGS survival, local infections and respiratory complications and between HTN and local infections.

  Conclusion: According to the results of this study, the most common post CABGS complications were cardiovascular complications, especially arrhythmias.

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  Background & objectives: Heart failure is considered as a major cause of hospitalization. Many studies have shown association between sleep-related breathing disorders and heart failure. It has been shown that the relationship between nocturnal hypoxia and left ventricular dysfunction can cause significant morbidity and mortality in patients with congestive heart failure (CHF ). Accordingly, treatment of sleep related breathing disorders (SRBD) can give rise to improvement in CHF treatment too. This study surveys the prevalence of sleep disorder in stable heart failure patients regardless of ejection fraction.

  Methods : This study was a descriptive-analytical study. One hundred and eight patients with heart failure disease were studied. A questionnaire consisting of two parts (part I consistent of demographic information and part II consistent of sleep disorders) and clinical examination (pulse oximetery and echocardiography) were used for collection of data. The data were analyzed with SPSS statistical software using descriptive and analytical tests including the chi-square, Pearson correlation and ANOVA.

  Results: Fifty six persons (51.9%) of patients were female and 52 persons (48.1%) were male with mean age of 65.42 ± 11 years. In total sleep duration, 95 patients (88%) had nocturnal hypoxemia . There was correlation between arterial oxygen desaturation at night and ejection fraction .

  Conclusion : This study confirmed strong associations between nocturnal hypoxia and left ventricular dysfunction and SRBD should be considered in clinical treatment of systolic heart failure.

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 Background & objectives: Diazinon (DZN) as an organophosphate pesticide widely used in agriculture is associated with reducing the antioxidant capacity of the cell. Use of thiol compounds such as N-acetyl cysteine (NAC) as an antioxidant decreases oxidative stress in the cells. The aim of this study was to investigate the effect of NAC as an antioxidant against DZN- induced oxidative stress in rat brain and heart. 

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Background & objectives: cardiovascular diseases are the main cause of mortality around the whole world. However, there is limited information on its economic costs in Iran. The aim of this study was to evaluate the economic costs of coronary heart disease in Iran in 2014.
Methods: The diseases costs were calculated based on the incidence approach using a bottom-up method and a community-oriented perspective.   The drug cost information was obtained from angiographed patients (607 cases) in Shahid Modarres Hospital using simple random sampling method. Other information like disease incidence, distribution of patients, treatment patterns, length of stay and mortality rate was gathered from the literature, interview with patients, consultation with specialists, questionnaire, ministry of health and statistical center of Iran.
Results: Coronary heart diseases impose a significant economic burden in the range of 4,715 and 4,908 billion dollars (210,037,860,000,000-201,778,425,000,000 rials) upon Iran economic system. The medical costs and the costs of lost productivity due to premature death were calculated at USD 3.572 billion (152,863,740,000,000 rials) and USD 933 million (39,927,735,000,000 rials) respectively. The major part of medical costs was related to angioplasty costs (47%) and the minor part was related to drug costs (1.15%).
Conclusion: Coronary heart diseases impose a lot of financial costs to Iran healthcare system which cover more than 16% of whole healthcare financial costs. It is possible to streamline all consequential costs due to coronary heart disease by means of economic and effective use of resources and widespread self-care plan.
 

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Background & Objectives: Based on the probably positive role of exercise on total oxidative status (TOS) and total antioxidant system (TAS) and their effect on the process of angiogenesis, the aim of the current study was to evaluate the effect of one course of moderate-intensity endurance training on the gene expression level of vascular endothelial growth factor-B (VEGF-B) and angiopoietin-1(ANGPT-1) and TAS and TOS status in cardiac tissue of male rats.
Methods: In this study, 20 male Wistar rats were divided into two equal groups as follows:   1-training group and 2- control group: no sports activities were performed on them. Rats in the training group performed moderate endurance training for 6 weeks and 5 sessions per week from the twelfth week of life. Twenty-four hours after the last training session, heart tissue samples were extracted to measure gene expression levels of VEGF-B and ANGPT-1 and the TAS and TOS status in heart tissues. T-test with the statistical level of (p˂0.05) was used for between groups comparison.
Results:­ Findings showed that after six weeks of endurance training, the expression level of ANGPT-1 and VEGF-B and the amount of TAS in the exercise group significantly increased (p=0.001) and the amount of TOS significantly decreased compared to the control group (p=0.008).
Conclusion: According to the results of the present study, it seems that moderate-intensity endurance training can be effective in preventing cardiovascular disease by increasing factors involving in angiogenesis, improving TAS and reducing TOS in heart tissue of rats.

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Background & objectives: Endurance activity affects muscles through changes in hormone- secretion and related receptors. The aim of this study was to evaluate the effect of endurance training on Thrap1 gene expression in cardiac tissue and fast and slow twitch skeletal muscles in male Wistar rats.
Methods: The subjects of this experimental study were 14 male rats with a mean and standard deviation of 234±34g, all of which were kept in natural conditions (free access to water and food, cycle of darkness and light, suitable temperature and humidity). They were randomly divided into two groups of control (n=7) and experimental (n=7). The experimental group had endurance activities 6 sessions per week at the speed of 30 meters per minute for 14 weeks. 48 hours after the last training session, they were anesthetized and dissected under sterile conditions, and Real- time RT-PCR method was employed to determine the gene expression. Finally,a t-test was used to evaluate the data.
Results: The results of this study showed that the expression of the Thrap1 gene in the soleus muscle (p=0.001) and heart (p=0.001) of experimental rats increased significantly, while there was not a significant change in the expression of the Thrap1 gene in fast twitch muscles (p=0.508) due to endurance activity.
Conclusions: It seems the expression of the Thrap1 gene in slow twitch muscles is more affected than fast twitch muscles by endurance activity.
 

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Background & objectives: The increase of Bnip3 and Parkin plays an important role in maintaining mitochondrial function and inhibiting ROS. A correlation was observed between the mitochondrial respiratory capacity and the subjects' mRNA levels of Bnip3 and Parkin proteins as a result of exercise, which shows the significant role of mitochondrial dynamics on the improvement of respiratory capacity. This study aimed to investigate the effect of eight weeks of high-intensity interval training and curcumin supplementation on Bnip3 and parkin mitochondrial gene expression levels in cardiomyocytes of male heart attack model rats.
Methods: In this experimental study, 32 male Wistar rats were subjected to myocardial infarction using  intraperitoneal injection of isoproterenol (100 mg/kg for two consecutive days) and, after confirmation of infarction (troponin measurement), randomly divided into four groups; Control, high-intensity interval training, curcumin (pure curcumin 15mg and dimethyl sulfoxide with a concentration of 10% per kg of body weight five days a week by gavage) and combination group (supplement+exercise).The exercise and combination groups were subjected to high-intensity interval training (10 bouts of four-minute activity with an intensity of 85-90% VO2max) for eight weeks. Bnip3 and Parkin gene expression levels were obtained using the Real-time PCR method. The data were analyzed using the Kolmogorov-Smirnov test and one-way analysis of variance.
Results: The results showed that there is a significant difference between the mean of the groups in Bnip3 and parkin gene expression levels. The results of Tukey's test showed that the expression level of Bnip3 and Parkin genes was higher in the intense interval training and exercise-supplement groups than in the control and supplement groups. There was no significant difference between the supplement and control groups; in fact the use of curcumin without training did not affect Bnip3 and PARKIN gene expression levels compared to the control group.
Conclusion: This study shows that intermittent exercise and curcumin consumption have a protective effect on mitochondrial quality during infarction.