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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 8 | Issue 3
Page Nos. 69-87

Online since Friday, November 8, 2019

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ORIGINAL ARTICLES  

Modulation of plasma triglycerides concentration by sterol-based treatment in subjects carrying specific genes p. 69
Ismael San Mauro Martin, Javier Andrés Blumenfeld Olivares, Elena Garicano Vilar, María José Ciudad Cabañas, Luis Collado Yurrita
DOI:10.4103/rcm.rcm_10_19  
Introduction: Genetic load may indirectly influence on cardiovascular risk. This work aimed to analyze the influence of polymorphisms (APOA5 C56G-Ser19Trp, Prothrombin-G20210A, F5 Arg506Gln, MTHFR-C677T, LIPC-C-514T, LPA-I4300M, PPAR_ALPHA-L162V, APOA5-1131T > C, APOE-APOE2/3/4, and APOE-APOE2,3,4) in plasma triglyceride (TG) levels of patients ingesting plant sterols. Materials and Methods: Double-blind, crossover, controlled clinical trial was performed in 45 individuals (25 women). About 2.24 g sterols in milk and placebo milk were ingested daily during 3 weeks each, separated by a 2-week washout period. Blood draws and saliva genomic DNA was extracted. Results: APOA5-C56G-Ser19Trp, MTHFR-C677T, and PPAR_ALPHA-L162V greatly benefit from sterols intake. APOA5-C56G-Ser19Trp GG homozygous carriers lowered their TGs more than CG heterozygote carriers (P = 0.003). TT homozygous carriers of gene LIPC C-514T experienced an increase of TGs. Conclusions: Further studies are needed to establish which genotype combinations is the most protective against hypertriglyceridemia.
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Safety and outcomes of noncardiac surgery in patients with cardiac implantable electronic devices p. 76
Bahman Akhondi, Mohammadmostafa Ansari-Ramandi, Mona Heidarali, Farzad Kamali, Majid Haghjoo
DOI:10.4103/rcm.rcm_16_19  
Background: Electromagnetic interference can cause damage to cardiac implantable electronic devices (CIEDs). The current guidelines recommend the interrogation of all pacemakers and defibrillators before and after surgery. The objective of the study was to evaluate the safety and outcomes of noncardiac surgeries in patients with CIEDs. Methods: Between January 2014 and January 2019, all patients with CIEDs who underwent noncardiac surgery were included. The patient's baseline characteristics and data regarding their procedure and postsurgical complications and mortality were extracted from their medical records. The device analysis 6 months after the procedure was also seen. Results: Of the 54 patients, 16 had permanent pacemaker, 25 implantable cardioverter defibrillator, and 13 cardiac resynchronization therapy device. Most common indication for surgery was inguinal or abdominal hernia (n = 46); three patients underwent surgery for cholecystitis and five for other reasons. Supraventricular tachycardia was reported in one patient during surgery and in another one after surgery. Only one patient experienced intraoperative ventricular tachycardia. There was no device malfunction during and after surgery. During 6-month follow-up, 5.6% mortality rate was reported. Conclusions: With recommended device programming before surgery, noncardiac surgery is well tolerated in the majority of the patients with CIEDs without significant interference in the device function.
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Left ventricular systolic dysfunction in pediatric chronic kidney disease patients p. 79
Igoche D Peter, Ibrahim Aliyu, Mustafa Ohikhena Asani, Patience Ngozi Obiagwu, Olukemi Omowumi Ige, Fidelia Bode-Thomas
DOI:10.4103/rcm.rcm_13_19  
Background: Chronic kidney disease (CKD) affects multiple organs and is an established risk factor for cardiovascular disease and mortality. Impaired systolic function of the left ventricle is common in adult CKD patients. Objective: The main objective of the study is to determine the prevalence of left ventricular systolic dysfunction (LVSD) in children with CKD and its association with age, stage of disease, and history of dialysis. Subjects and Methods: This was a comparative cross-sectional descriptive study. Twenty-one children with CKD aged 3–14 years and an equal number of age- and gender-matched apparently healthy controls were recruited. Outcome Measures: LVSD was considered present when ejection fraction (EF) <50%. Results: The mean EF of 63.9% in the patients was not significantly lower than the 65.3% recorded in the controls, but LVSD was detected in 5 (24%) and none of the controls (Fisher's exact; P = 0.001). Patients with LVSD were older than those with normal left ventricular systolic function, but this difference was not statistically significant (P = 0.067); however, they differed significantly with respect to the stage of CKD (P < 0.001). LVSD was more common in patients who were never dialyzed (P < 0.001). Conclusion: LVSD is more frequent in children with CKD compared with controls. Patients with LVSD were similar to those without it, with respect to age but had more advanced disease (CKD) and less likely to have ever been dialyzed.
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CASE REPORT Top

Anomalous origin of the left coronary artery from the pulmonary artery-adult type with heart failure and ventricular arrhythmia presentation p. 84
Sedigheh Saedi, Alireza Alizadeh Ghavidel, Nasrin Panahifar
DOI:10.4103/rcm.rcm_18_19  
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) syndrome is a rare congenital anomaly occurring in 1 of 300,000 births. As it has high mortality rate during the 1st year of life, adult type is very rare. Arrhythmias, heart failure, myocardial infarction, and sudden cardiac death are common presentations of ALCAPA syndrome in adults. Here, we report a 28-year-old male with malignant ventricular arrhythmia and sudden cardiac death. ALCAPA syndrome was diagnosed by coronary angiography and echocardiography; finally, cardiac surgery was performed with a good result.
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ERRATUM Top

Erratum: Multidisciplinary therapeutic and active follow-up protocols to reduce the rate of amputations and cardiovascular morbidities in patients with critical limb ischemia: IRANCLI study design and rationale – A prospective single-center registry in Iran p. 87

DOI:10.4103/2251-9572.270588  
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