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1.  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
2.  Body Mass Index or Microalbuminuria, Which One is More Important for the Prediction and Prevention of Diastolic Dysfunction in Non-diabetic Hypertensive Patients? 
Numerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained – ‘Which is more important for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients?’
The current study was a cross-section study conducted on a total of 126 non-diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio (UACR) was determined as an indicator of microalbuminuria. Complete two-dimensional, doppler, and tissue-doppler echocardiography was performed and the recording of the diastolic function parameters was carried out.
High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter.
According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients.
PMCID: PMC3309635  PMID: 22448314
Hypertension; microalbuminuria; heart failure; obesity
3.  Echocardiographic assessment of inappropriate left ventricular mass and left ventricular hypertrophy in patients with diastolic dysfunction 
Early diagnosis of left ventricular mass (LVM) inappropriateness and left ventricular hypertrophy (LVH) can result in preventing diastolic left ventricular dysfunction and its related morbidity and mortality. This study was performed to determine if diastolic dysfunction is associated with LVH and inappropriate LVM.
Materials and Methods:
One hundred and twenty five uncomplicated hypertension from Isfahan Healthy Heart Program underwent two-dimensional echocardiography. Inappropriate LVM was defined as an LVM index greater than 88 g/m2 of body-surface area in women and greater than 102 g/m2 in men. LVH-defined septal and posterior wall thickness greater than 0/9 cm in women and greater than 1 cm in men, respectively. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), and E/early mitral annulus velocity (E′) were measured.
The mean systolic and diastolic blood pressure at the patients’ admission day were 142.87 ± 18.12 and 88.45 ± 9.18 mmHg, respectively. Totally, 21.7% of subjects had inappropriate LV mass that moderate and severe abnormal LV mass was revealed in 5.6% and 5.6%, respectively. The mean of age and BMI was significantly higher in patients with moderate left ventricular hypertrophy (P < 0.05). Adjusted by age, gender, BMI, and systolic and diastolic blood pressures, both E/A ratio and deceleration time were higher in those with the severer ventricular hypertrophy. Subjects with severe showed significantly higher BMI 33. 7 ± 3.7 (P < 0.001). There was a slight difference between the grade of diastolic dysfunction and the severity of inappropriate LV mass (P = 0.065). But no significant difference was found between E/A, E/E′, and deceleration time and the level of inappropriate LV mass (P > 0.05). Spearman's Rank test was used to test the correlation between diastolic dysfunction and LV mass (P = 0.025).
LVH is correlated with the severity of diastolic dysfunction manifested by the E/A value and deceleration time, but inappropriate LVM can slightly predict diastolic dysfunction severity in uncomplicated hypertension.
PMCID: PMC3525029  PMID: 23264785
Echocardiographic; left ventricular mass; left ventricular hypertrophy; Diastolic dysfunction
4.  The association between epicardial fat thickness in echocardiography and coronary restenosis in drug eluting stents 
ARYA Atherosclerosis  2011;7(1):11-17.
The association between epicardial fat and coronary in-stent restenosis has not been evaluated. The objective of the present study was to evaluate the relationship of echocardiographic epicardial fat thickness (EFT) with restenosis in drug eluting stents (DES).
In this study, 117 patients who underwent coronary angiography due to recurrent clinical symptoms or findings of non-invasive cardiac tests one year after stent implantation were selected. According to angiographic results, they were divided into two groups, 65 patients with in-stent restenosis (case group) and 52 patients without such finding (control group). EFT was measured perpendicularly on the free wall of the right ventricle at the end of systole in two echocardiographic views (parasternal short and long axis) at least in three cardiac cycles. The average of obtained values was determined and recorded as EFT. Furthermore, the history of hypertension, smoking and diabetes, age and sex were investigated and body mass index (BMI) of each patient was also calculated.
There were no significant differences in the baseline characteristics (P=0.812). Patients with in-stent restenosis did not have statistically significant difference (4.6±1.8 mm) in EFT compared to subjects with patent stents (4.5±1.8 mm; P=0.88). The above results were also confirmed using multiple linear regressions. No significant correlation was found between EFT and other clinical variables (P >0.05).
In this selected population, the risk of restenosis was not correlated with epicardial fat thickness. Future studies for determining the role of epicardial fat in development of in-stent restenosis are warranted.
PMCID: PMC3347840  PMID: 22577439
Epicardial Fat Thickness; Echocardiography; In-Stent Restenosis (ISR)
5.  Relationship between depression and apolipoproteins A and B: a case–control study 
Clinics  2011;66(1):113-117.
To investigate the relation between major depressive disorder and metabolic risk factors of coronary heart disease.
Little evidence is available indicating a relationship between major depressive disorder and metabolic risk factors of coronary heart disease such as lipoprotein and apolipoprotein.
This case–control study included 153 patients with major depressive disorder who fulfilled the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV), and 147 healthy individuals. All participants completed a demographic questionnaire and Hamilton rating scale for depression. Anthropometric characteristics were recorded. Blood samples were taken and total cholesterol, high‐ and low‐density lipoproteins and apolipoproteins A and B were measured. To analyze the data, t‐test, χ2 test, Pearson correlation test and linear regression were applied.
Depression was a negative predictor of apolipoprotein A (β = −0.328, p<0.01) and positive predictor of apolipoprotein B (β = 0.290, p<0.05). Apolipoprotein A was inversely predicted by total cholesterol (β = −0.269, p<0.05) and positively predicted by high‐density lipoprotein (β = 0.401, p<0.01). Also, low‐density lipoprotein was a predictor of apolipoprotein B (β = 0.340, p<0.01). The severity of depression was correlated with the increment in serum apolipoprotein B levels and the decrement in serum apolipoprotein A level.
In view of the relationship between apolipoproteins A and B and depression, it would seem that screening of these metabolic risk factors besides psychological interventions is necessary in depressed patients.
PMCID: PMC3044579  PMID: 21437446
Coronary risk factors; Coronary heart disease; Major depression
6.  Assessment of Clopidogrel on the Left Ventricular Ejection Fraction in Acute Myocardial Infarction 
Left ventricular (LV) dysfunction heart failure is one of the causes of morbidity and mortality following ST elevation myocardial infarction (STEMI). This study was done to determine the clopidogrel effect in preventing reduced LV function in patients with STEMI.
In this study, 144 patients with STEMI admitted to the Isfahan University of Medical Sciences hospitals were followed in two groups for one month. The case group received Clopidogrel, 300 mg, on admission and then, 75 mg daily, while the control group received routine therapy for STEMI without Clopidogrel. Left ventricular ejection fraction (LVEF) on the 4th day and one month after STEMI was measured by echocardiography. The results of LVEF were compared within and between groups.
The mean LVEF in the case group on the 4th day and one month after STEMI were 45.92 and 52.15%, respectively (P<0.001). The mean LVEF in the control group on 4th day and one month after STEMI were 44.72 and 42.71%, respectively.
We suggest that Clopidogrel is effective in prevention of LVEF reduction in patients with STEMI.
PMCID: PMC3075522  PMID: 21566782
Heart failure; Myocardial infarction; Prevention

Results 1-6 (6)