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Background and Objective: Cardiovascular diseases is the first cause of mortality in developed and developing countries. This study was done to determine findings of coronary arteries angiography of subjects referring to Kosar angiography center in Golestan province, Iran.

Materials and Methods: In this descriptive study 5444 patients whome referred to the Kosar angiography center in Golestan province, Northern Iran undervent in this study during 2008-09. Gender, age, ethnicity, body mass index (BMI), cigarette smoking, opium, hypertension and coronary arteries angiography findings were completed for each subjects. Coronary arteries angiography was performed on 5400 of subjects. Data was analyzed by using SPSS-13, ANOVA, Chi-Square and Kruskal-Wallis tests.

Results: In this study 52% of subjects were men. 72% of patients were Native Fars. 49.5% of subjects were found to be illiterate. While 92.6% of clients did not reported any history of smoking, 22.5% of subjects were addicted to different opium. The mean BMI was 27.48 and 38.2% of clients reported a history of hypertension. Coronary arteries angiography was performed on 5400 of subjects. Coronary arteries disorders were determined in 3142 of subjects (58.8% males, 41.2% females). Left anterior descending, right coronary artery, circumflex and obtuse marginal were the most involved coronary arterial branches in positive angiograms, respectively.The most severe failure (47.7%) has been found in left anterior descending artery.

Conclusion: Due to high incidence of coronary arteries disease in this region of Iran, it is suggested to design a project to investigate the preventive mearsures of cardiovascular disorders.

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The Iranian elderly population is rapidly growing. Currently more than 5 million Iranians are over 60 years of age which corresponds to nearly 7.26 percent of the population of the country. It is estimated that more than 10 percent of the population of the country will be elderly in the forthcoming twenty years. Structural and physiological changes which occur in the elderly cardiovascular system include: stiffness of the vasculature, decreased relaxation capacity of the heart during diastole, decreased efficiency of cardiac contraction during exercise, weakened heart muscle response to stimulation by adrenaline, and orthostatic hypotension. In the elderly people we are confronting with increased frequency of cardiovascular diseases especially myocardial infarction, stroke, isolated systolic hypertension, calcific aortic stenosis, orthostatic hypotension, and syncopal attacks due to sick sinus syndrome, complete heart block, atrial fibrillation or other rhythm disorders. Alteration in cardiovascular status in the elderly has undesirable effects on their quality of life and longevity. Myocardial infarction is the most common cause of death in the elderly however cardiac arrhythmias and valvular heart disease are other important cardiovascular disease in the old people. Diagnosis of these disorders in the elderly requires special consideration since coexistence of structural/functional changes in the old age with cardiovascular disease would alter the classic features of these disorders and result in delay in their appropriate management. Biological aging as evaluated by reduced telomere length has a strong impact on the incidence of cardiovascular disorders especially coronary heart disease and chronic heart failure. This phenomenon could possibly explain interindividual susceptibility to cardiovascular disorders.

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Anomalous coronary artery origin is a rare clinical entity with varied clinical outcomes ranging from asymptomatic to sudden cardiac death. The incidence of anomalous origin of left coronary artery arising from the right coronary cusp is 0.3-1%. CT angiography is the choice method for coronary anomalies, but often coronary angiography in RAO (right anterior oblique) view shows the coronary course. We present a case that referred to our hospital with post myocardial infarction angina for coronary angiography. A resting 12-lead electrocardiogram showed ST-segment elevation in leads v2, v3, v4. A transthoracic echocardiogram indicated LVEF 25% (Left ventricular ejection fraction), septal akinesia and apical dyskinesia. Coronary Angiography showed an anomalous origin of the left coronary artery from the right coronary cusp and significant stenosis in LAD (left anterior descending) and LCX (left circumflex) arteries with poor run off.

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Background and Objective: Coronary artery diseases are one of the main causes of mortality and morbidity. This study was done to determine the prevalence of risk factors for coronary artery diseases in patients referred to angiography center in Sari, Northern Iran. Materials and Methods: This descriptive study was performed on 2540 patients referred to angiography center in Sari city, northern Iran, during 2005-10. Risk factors including diabetes, hypertension, hyperlipidemia, smoking, Family history, CRP and also ECG changes, type and number of involved artery and the severity of vascular involvement were recorded for each patient. Results: Hypertension, hyperlipidemia, diabetes, smoking were seen in 40.8%, 40.5%, 29.1%, 12.5% of patients, respectively. Positive family history and CRP were found in 10% and 3.4% of the patients, respectively. 23.8% of patients had abnormal ECG. One, two and three vessel diseases were observed in 26.5%, 48.3%, 48.3% of cases, respectively. Left anterior descending artery constriction was seen in 75.8% and 80.4% of males and females, respectively. A significant relationship was found between diabetes and left coronary circumflex (P<0.04) and left anterior descending artery (P<0.03) constriction. Conclusion: Diabetes, hypertension, hyperlipidemia, smoking, family history, abnormal ECG are among the risk factors of coronary artery diseases in this area.

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Temporary pace marker (TPM) usually has been used in emergency conditions. Insertion of TPM is accompanied with vein thrombosis and pulmonary Emboli. TPM was inserted via right femoral vein in 73 years male due to complete heart block. Thereafter, he was suffered from deep vein thrombosis. Echocardiography revealed multiple mobile clots in right atrium, ventricle and impending pulmonary thromboemboli following insertion of permanent pacemaker. Despite of contraindication for the application of thrombolytic agents due to surgical incision for permanent pacemaker and presence of patent foramen oval, the patient survived from massive pulmonary thromboemboli and death due to rapid diagnosis and on time treatment with anticoagulation agents without performing surgery.

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Penetrating atheromatous ulcer is the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into the media. Differentiation of penetrating atheromatous ulcer from other causes of acute aortic syndrome such as intramural haematoma and aortic dissection is difficult. The main symptom is a severe, acute chest pain radiating to the inter-scapular area, similar to classical acute aortic dissection of the thoracic aorta. In present article a case of a 52 years old woman with long- standing retrosternal chest pain and with penetrating atherosclerotic aortic ulcer in descending aorta was reported. Unlike the predominant picture of this disease,associated intramural hematoma was not seen.

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Background and Objective: Cardiovascular diseases are the most frequent cause of death among hemodialysis patients. Left ventricular hypertrophy and systolic dysfunction are potent predictors of cardiovascular morbidity and mortality in hemodialysis patients. Cardiac troponin T and I are the indices of myocardial cell damage. This study was done to determine the relationship between serum cardiac troponin T and I with left ventricular hypertrophy and systolic dysfunction in hemodialysis patients. Method: In this case-control study, 56 hemodialysis patients were divided into two groups according to echocardiographic findings. The first group included 35 patients with left ventricular hypertrophy as case group and 21 patients without left ventricular hypertrophy as controls. Serum level of cardiac troponin T and I were measured using electro chemiluminscence immune assay. Results: Serum level of cardiac troponin T and I was significantly higher in patients with left ventricular hypertrophy (0.99±0.12 ng/ml and 0.17±0.09 ng/ml, respectively) in comparison with controls (0.37±0.05 ng/ml and 0.13±0.09 ng/ml, respectively) (P<0.05). There was no correlation between serum cardiac troponin T and I level with left ventricular systolic dysfunction. Conclusion: Cardiac troponin I and T do not have any value for the diagnosis of left ventricular systolic dysfunction in hemodialysis patients.

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Background and Objective: Kawasaki disease is the common acquired heart disease in children. Kawasaki disease is a vasculitis that predominantly affects the medium-sized arteries, with a striking predilection for the coronary arteries. This study was done to determine the relationship between coronary aneurysm formation and neutrophylia, in childern with Kawasaki disease. Method: This descriptive – analytic study was done on 80 children (45 Males, 35 Females) with typic and atypical Kawasaki disease in Afzalipoor hospital, Kerman, Iran during 2011-13. According to transthoracic echocardiography, patients were divided into childern with and without coronary aneurysm. CBC count, ESR and Peripheral blood smear was performed for each subject. Results: White blood cells, neutrophils, platlets and ESR in childern with coronary aneurysm, was non- significantly more than without aneurysm. Duration of fever in chidern without aneurysm was non-significantly more than childern with coronary aneurysm. Conclusion: Neutrophils counting by itself is not sufficient critria for the prediction of the aneurysm risk in kawazaki disease.

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Background and Objective: ECG is one of the most common diagnostic procedures. Errors related to incorrect placement of electrodes and/or inaccurate connection of them in their standard anatomical location will cause some changes in the ECG waves. These errors may cause therapeutic or diagnostic mismanagements. This study was done to determine the common errors in connection or placement of leads in standard electrocardiograms.
Methods: This descriptive-analytical study was performed on 315 patients admitted to an educational and therapeutic hospital in Gorgan, Iran during 2014. The recorded variables included the distance between the positions of the V1, V2, V5 and V6 leads from the standard location, the displacement of the left and right electrodes in bipolar limb lead I and the incorrect right and left connectivity of V1 and V2, the admission section, the urgency of ECGs and the patient's gender. The gender of ECG operator, the standard ECG voltage, staff shift, the average number of ECGs taken by the personnel, and the precise bonding of wires were observed. In the precordial leads, the distance of more than 2 centimetres from the standard leads location was considered as error threshold.
Results: The misplacement errors were observed in 149 cases (47.3%). In 20 cases (13.42%) of ECGs, the standard voltage was not observed. The highest number of misplacement errors was observed in the V5 (30.2%). Misplacement errors showed a significant differences (P<0.05) for the patient gender (61.77%), the type of department (emergency department 61.67%), the non-urgent application (68.12%), and the average number of ECGs taken by personnel of 5 or less in each shift (11.67%).
Conclusion: Patient's gender and emergency department are the most important factors in misplacement of precordial leads.

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Background and Objective: Dyspnea is the main cause of hospitalization of patients with heart failure and it is often associated with anxiety. This study was conducted to determine the effect of Chamomile tea on the severity of dyspnea and anxiety in patients with chronic heart failure.
Methods: This randomized clinical trial study was conducted on 60 patients with chronic heart failure in an outpatient clinic of Jahrom University of Medical Sciences, Iran during 2014. Patients were randomly divided into intervention and control groups. Subjects in intervention group consumed Chamomile tea for 4 weeks. Oxygen cost diagram (OCD) and Beck anxiety inventory were recorded for each subject.
Results: The mean of severity of dyspnea in the intervention and control groups was 16.66±5.76 and 29.43±13.1, respectively (P<0.05). The mean anxiety severity in the intervention and control groups was 12.07±1.1 and 6.7±6.2, 20, respectively (P<0.05).
Conclusion: Chamomile tea can reduces the severity of dyspnea and anxiety in patients with chronic heart failure.

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Atherosclerosis which is the result of cholesterol deposit in coronary arteries is the main cause of morbidity and mortality, worldwide. Reverse cholesterol transport (RCT) is a process that causes efflux of excess cholesterol in vessels layers and reduces the risk of atherosclerosis. Adenosine triphosphate (ATP) binding cassette transporters G5 and G8 (ABCG5 and ABCG8) are two membrane cholesterol transporters in hepatocytes and enterocytes that transport cholesterol into the bile and feces. Considering importance of ABCG5 and ABCG8 in RCT and prevention and treatment of coronary atherosclerosis, the aim of this review article was to study the ABCG5 and ABCG8 functions, the role of them in heart stroke prevention and the effects of exercise trainings on genes expression of these two substances. Atherosclerosis, exercise, physical activity, RCT, ABCG5 and ABCG8 were used keywords for searching of related articles between years 1990 to 2018 in google scholar, PubMed, Elsevier, Scopus, SID, science direct and ProQuest databases. 294 articles were found and after precise reading of them, 84 articles were selected for this review article. Overall, considering role of transcription factors LXR/RXR are responsible for regulation of genes involved in cholesterol efflux (ABCA1, ABCG1), cholesterol transport (lipoprotein lipase, CETP), cholesterol transformation to bile acids (CYP7A) and metabolism and excretion of cholesterol into bile or gut lumen, stimulation of them induces elevation of ABCG5 and ABCG8 genes expression. The effect of exercise on these factors is a novel subject that may increase our knowledge to prevention and treatment of atherosclerosis.

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Background and Objective: Todays, coronary artery disease is one of the most important health issues. Antioxidants are the agents that can play important role in reducing cardiovascular diseases. The present study was done to determine the effect of resveratrol supplementation during rehabilitation exercises training on systemic inflammation factors in patients after coronary artery bypass surgery.
Methods: This clinical trial study was done on 40 patients after coronary artery bypass surgery in the heart rehabilitation center of Farshchian cardiovascular specialist hospital in Hamadan, Iran during 2016. Patients randomly assigned into four groups including control (Con; n=10), resveratrol supplementation (RS; n=10), rehabilitation exercise training (RXT; n=10), and resveratrol supplements-cardiac rehabilitation exercise training (REX; n=10). Rehabilitation exercise training was done in nonconsecutive three sessions for eight weeks in the form of endurance training at 50-70% HRmax for 15-20 min, and resistance training at 20-50 one-repetition maximum (1RM). The number of repetitions was 8-15 reps, where done based on the capacity and ability of the subject, while the subjects in supplement groups consumed daily 400 mg of resveratrol. Blood sample was done before and 48 hours after exercise training and supplementation, and concentrations of Tumor necrosis factor alpha (TNFα), Interleukin- 6 (IL-6), Interleukin 1 beta (IL-1β) and C-reactive protein (CRP) were measured in the plasma.
Results: CRP, TNF-alpha and IL-1beta and IL-6 were significantly reduced in resveratrol supplements-cardiac rehabilitation exercise training group in compared to control, resveratrol supplementation and rehabilitation exercise training groups (P˂0.05).
Conclusion: This study showed that combination of consuming resveratrol with rehabilitation exercise training in reducing some inflammatory factors was evaluated selectively, more effective than rehabilitation exercise training and resveratrol supplementation alone.

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Background and Objective: Coronary artery disease (CAD) is one of the major cardiovascular diseases that affect the global population. This study was performed to evaluate the electrocardiogram (ECG) changes of patients before and after coronary artery bypass graft (CABG) surgery.
Methods: This descriptive-analytical study was performed on 100 patients (71 males and 29 females) in the age range of 37 to 78 years (mean age of 57.87±8.14 years) by census method undergoing CABG surgery in Amir Al-Momenin Kordkoy Hospital, north of Iran during the second half of 2020. Data including age, sex, and results of ECG changes, including changes in heart rate and pulse rate (PR) the day before surgery, the day of hospitalization, 4 hours after surgery, 18 hours after surgery, one day, and two days after surgery was recorded in a questionnaire.
Results: The highest mean heart rate and PR were observed at 4 hours after surgery and then heart rate and PR were reduced and on the second day, heart rate and PR were lower than  the day of hospitalization (P<0.05).
Conclusion: Considering the significant changes in ECG after surgery, careful examination and monitoring of patients, especially high-risk individuals led to early detection of significant changes in patients and reduced subsequently complications in patients with appropriate and timely treatment.

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Myocardial infarction is characterized by the interruption of blood supply to part of the myocardium, leading to tissue damage. Acute myocardial infarction rarely affects young adults. However, considering the possibility of its occurrence, particularly in the presence of risk factors such as obesity and smoking, can help provide appropriate and timely diagnostic and therapeutic measures. Herein, were present a case of acute myocardial infarction in a young adult male.
 

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Background and Objective: Echocardiographic measurement of ventricular elastance is essential for evaluating cardiac function. With the technological advancements in echocardiography devices, assessing fetal heart function has become more accurate. Ventricular elastance reflects ventricular function, while arterial elastance measures ventricular afterload. Ventricular-arterial coupling demonstrates the interaction between the ventricle and artery. This study aimed to estimate ventricular end-systolic elastance, arterial elastance, and ventricular-arterial coupling using a non-invasive echocardiographic method.
Methods: This descriptive-analytical study was conducted on 67 fetuses with a gestational age of 19-24 weeks (38 female fetuses and 29 male fetuses) and 43 infants aged 10-60 days (25 female and 18 male) referred to the cardiac echocardiography clinic of the Children's Medical Center over a period of 14 months. Mothers and infants were healthy, and there was no structural heart disease in the fetuses and infants. Those with abnormal rhythm, a vague view, and an unfavorable quality of Doppler signal were excluded. Ventricular end-systolic elastance (Ea), arterial elastance (Ees), and ventricular-arterial coupling (Ea/Ees) were compared in fetuses with the calculated values in newborns. An estimation of the normal value for ventricular and arterial elastances and ventricular-arterial coupling in healthy fetuses and newborns were obtained.
Results: The mean arterial elastance of fetuses and newborns was determined as 84.4±20.04 mmHg/ml and 12.6±2.88 mmHg/ml, respectively (P<0.05). The mean ventricular elastance of fetuses and newborns was 88.5±20.49 mmHg/ml and 15.07±2.89 mmHg/ml, respectively (P<0.05). Fetal and newborn ventricular-arterial coupling were calculated as 0.96±0.14 mmHg/ml and 0.84±0.13 mmHg/ml, respectively (P<0.05).
Conclusion: The amounts of arterial and ventricular elastance and ventricular-arterial coupling in fetuses were significantly higher than infants and decreased with increasing age.
 

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Unusual chest pain is often observed in older women with diabetes, high blood pressure, and heart disease. Some unusual manifestations of myocardial infarction have so far been reported, including earache, flank pain, fatigue, neck pain, nausea and vomiting, shortness of breath, and shoulder pain. In this article, we report a case of rare symptoms of cardiovascular disease with referral symptoms, including abdominal colic pain. The patient was a 55-year-old man with a history of diabetes under treatment with insulin who had abdominal colic pain, periodic epigastric tenderness, and frequent nausea and vomiting for 2 days. At first, he was suspected of pancreatitis, but considering that his amylase and lipase enzymes were normal and no evidence of the existence of free abdominal and pelvic fluid was observed according to ultrasound results, the hypothesis of pancreatitis was rejected. Despite the normality of the initial ECG until the night before the visit by the cardiologist, the patient experienced more severe pain and, as a result, was referred to the cardiac internal ward until the end of the same night, after angiography, it was found that the obtuse marginal (OM1) branch of coronary arteries had severe narrowing (90-99%). Abdominal tenderness and colic pain are among the unusual manifestations of myocardial infarction. In patients with cardiac risk factors, such as diabetes and chronic kidney disease, despite the existence of a normal ECG, uncommon manifestations should be checked.