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1.  Heart rate recovery in exercise test in diabetic patients with and without microalbuminuria 
ARYA Atherosclerosis  2013;9(3):167-171.
Diabetes mellitus (DM) has a lot of complications such as macrovessel and microvessel disease. Another complication of DM is cardiac autonomic neuropathy (CAN), which have effect on automatic nervous system of heart. Failure in heart rate slowing after exercise is a presentation of this abnormality.
We selected diabetic patients and divided them to case and control group based on microalbuminuria. Case group comprised of diabetic patients with microalbuminuria and control group included those without microalbuminuria. Patients in both groups exercised on treadmill using Bruce protocol and heart rate was measured in first and second minutes in the recovery period.
We selected 35 patients with microalbuminuria (case group) and 35 without microalbuminuria (control group) among diabetic patients. No statistically significant difference was seen in sex and age between case and control groups. Heart rate recovery in the first minute of recovery in the case and control groups did not show significant difference; but in the second minute of recovery, it was significantly higher in control group (97 ± 19.4 vs. 101.9 ± 12.4 beat per minute, P = 0.04).
In this study we evaluated the heart rate recovery or deceleration in diabetic patients with albuminuria and without microalbuminuria in recovery phase after exercise test. We found out that heart rate recovery at the second minute in the case and control groups has statistically significant difference but at the first minute, it did not.
PMCID: PMC3681282  PMID: 23766772
Diabetes Mellitus; Exercise Test; Heart Rate Recovery
2.  Non-administration of thrombolytic agents in acute myocardial infarction patients in Hajar hospital, Shahrekord, Iran: prevalence rate and causes 
ARYA Atherosclerosis  2013;9(1):115-118.
Cardiovascular diseases are the major causes of mortality worldwide and acute myocardial infarction (AMI) is the leading cause of mortality among cardiovascular diseases. Thrombolytic therapies, especially during the first few hours after the disease onset, can significantly reduce AMI-related mortality.
The current study aimed to determine the prevalence and causes of non-administration of thrombolytic therapy for AMI patients admitted to Hajar Hospital, Shahrekord, Iran, from May until November 2000. Non-probability convenient sampling method was used to select 106 subjects with Q-wave AMI. Data was collected by completing a questionnaire, reviewing medical records, and interviewing with patients. SPSS7.5 was for data analysis.
A total number of 106 AMI patients were studied among whom 62 (59%) individuals received thrombolytic therapy. Delayed referral to the hospital was the major cause of failure to provide thrombolytic therapy. The cause of non-treatment could not be identified in 15 (19.5%) subjects eligible to receive therapy.
Training general practitioners and individuals involved in this regard along with accelerating the process of patient referral to hospitals can reduce AMI-related mortality.
PMCID: PMC3653256  PMID: 23696767
Acute Myocardial Infarction; Thrombolytic; Therapy
3.  The incidence of in-hospital atrial fibrillation after coronary artery bypass grafting using ventricular and atrial pacing 
ARYA Atherosclerosis  2013;9(1):11-15.
Atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery is a common problem. In this study, we sought to evaluate the safety and tolerance of continuous atrial pacing after CABG. We hypothesized that a strategy of temporary atrial pacing after CABG would reduce the incidence of postoperative AF.
During 2012, CABG candidates over 18 years of age at Sina Hospital (Isfahan, Iran) were recruited. Before surgery, the participants were randomly assigned to two groups of ventricular pacing and left atrial ventricular pacing (atrial pacing). The primary end point of the study was the initial occurrence of AF or atrial flutter with a ventricular rate greater than 100 beats per minute for 10 consecutive minutes or completion of the 48-hour monitoring period.
We evaluated 64 consecutive CABG candidates with sinus rhythm. They were allocated to two groups of ventricular pacing and atrial ventricular pacing (n = 32 in each group). Three patients in the ventricular pacing group (10%) and six in the atrial ventricular pacing group (22%) had sustained AF during the first 48 hours after CABG (P = 0.18 according to Fisher’s exact test).
Continuous atrial pacing in the postoperative setting is safe and well-tolerated. In this study, we found that temporary atrial pacing increased the frequency of postoperative AF. Since the difference between the two groups was not significant, larger studies are required to determine the exact relation between pacing method and AF.
PMCID: PMC3653269  PMID: 23696754
Atrial Fibrillation; Coronary Artery Bypass Graft; Atrial Pacing
4.  Association of serum potassium level with ventricular tachycardia after acute myocardial infarction 
ARYA Atherosclerosis  2012;8(2):79-81.
One of the causes of mortality in acute myocardial infarction (AMI) is ventricular tachycardia. Abnormal serum Potassium (K) level is one of the probable causes of ventricular tachycardia in patients with AMI. This study carried out to determine the relationship between serum potassium level and frequency of ventricular tachycardia in early stages of AMI.
Ina cross-sectional study on 162 patients with AMI in the coronary care unit (CCU) of Nour Hospital (Isfahan, Iran), the patients' serum potassium level was classified into three groups: 1) K<3.8 mEq/l, 2) 3.8≤K<4.5 mEq/l and 3) K≥4.5 mEq/l. The incidence of ventricular tachycardia in the first 24 hours after AMI was determined in each group by chi-square statistical method.
The frequency of ventricular tachycardia in the first 24 hours after AMI in K< 3.8 mEq/l, 3.8≤K<4.5 mEq/l and K≥4.5 mEq/l groups were 19.0%, 9.6% and 9.9% respectively. The high frequency of this arrhythmia in the first group as compared with the second and the third group was statistically significant.
Hypokalemia increased the probability of ventricular tachycardia in patients with AMI. Thus, the follow up and treatment of hypokalemia in these patients is of special importance.
PMCID: PMC3463994  PMID: 23056108
Acute Myocardial Infarction; Ventricular Tachycardia; Hypokalemia; SerumPotassium Level

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