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Background and Aims: Computed tomography angiography (CTA) is the gold standard for the diagnosis of massive (MPE) and submassive pulmonary embolism (SMPE). Ultrasound has not been accepted as a diagnostic tool. We aim to evaluate the pattern of pulmonary Doppler echocardiography in patients with pulmonary embolism (PE). Methods: From 2020 to 2022, 30 patients with acute MPE or SMPE confirmed by CTA and normal pulmonary pressures were selected. A control group was created with 30 individuals without PE. All patients had an echocardiography Doppler study of the pulmonary flow with a focus on early systolic notching (ESN), McConnell's (MC) sign, Right ventricular outflow tract velocity time integral (RVOT VTI), segmental thickness variability (STV), right ventricular end-diastolic diameter (RVEDD), tricuspid regurgitation (TR) gradient, pulmonary artery pressure (PAP), and acceleration (AT) or ejection time (ET). Results: ESN was identified in 96.6% of PE patients and 0% of the control group (p < 0.001). In comparison with the control group, STV (p < 0.001), RVOT VTI (p < 0.001), ET (p = 0.04), and AT (p < 0.001) values were lower in patients with PE while RVEDD, TR gradient, PAP, ESN, MC sign, and d-shape were higher (p < 0.001). Identification of the ESN pattern and AT/ET < 0.4 showed excellent predictive ability for MPE and SMPE with a sensitivity of 97.0% and 100%, specificity of 99.0% and 97%, and an area under the ROC curve of 0.967 (95% CI 0.914-1.00) and 0.933 (95% CI 0.844-1.00), respectively. Conclusion: Doppler echocardiography with particular attention to ESN, may be a suitable noninvasive method for the diagnosis of MPE and SMPE. Further studies with more sample sizes are needed to confirm its diagnostic benefit.
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OBJECTIVE: Obesity has been linked to cardiovascular risk factors characterized by endothelial dysfunction and arterial wall thickening. Regular exercise training is recognized as a powerful tool to improve endothelial function and cardiovascular risk profile, but it is unknown which of high-intensity interval training or moderate-intensity continuous training is the best exercise. MATERIALS AND METHODS: A total of 33 inactive and overweight women aged 40-50 years old and body mass index >27 kg/m2 were randomized to high-intensity interval training, moderate-intensity continuous training, or control. The exercise intervention consisted of 12 weeks of training and three supervised sessions per week. The moderate-intensity group was trained continuously for 47 min at 60-70% of maximal heart rate. High-intensity interval training consisted of four interval bouts of 4 min at 85%-95% of maximal heart rate with 3 min breaks at 50%-60% of maximal heart rate between the intervals. For all analyses, statistical significance was assigned at P < 0.05. RESULTS: According to our findings, while carotid intima-media thickness decreased in both training groups, this reduction was not statistically significant. In the high-intensity training group, the right ankle-brachial index increased significantly (P = 0.007). CONCLUSION: Twelve weeks of exercise training, especially in high-intensity interval training, have led to improving lipid profiles and endothelial function, it can be said that regular and prolonged exercise can probably be a preventive factor in cardiovascular disease in overweight women.
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Inflammation plays a key role in the initiation, progression, and clinical manifestation of atherosclerosis. Cigarette smoking is a risk factor for atherosclerosis and cardiovascular disease. The aim of the current study was to investigate the serum concentrations of 12 cytokines and growth factors (EGF, INF-γ, IL-1α/-1ß/-2/-4/-6/-8/-10, MCP-1, TNF-α, and VEGF) in an Iranian population, including 192 smokers, comparing these values with concentrations in nonsmokers. One hundred and ninety-two cases were enrolled from the Mashhad University of Medical Sciences. Of these cases, 82 were cigarette smokers and 110 were nonsmokers. Sex and age were matched for the two groups. The serum concentration of 12 cytokines and growth factors were determined using EV-3513-cytokine-biochip arrays, by competitive chemiluminescence immunoassays. The level of serum MCP-1 was significantly ( p < .001) lower in the female group of cigarette smokers (mean = 88.1 dL/ng), compared with nonsmokers (mean = 155.6 dL/ng). There were no significant differences for the other cytokines and growth factors between the groups. Our finding demonstrate the association of MCP-1 with cigarette smoking, supporting further studies in larger population on evaluating the role of cigarette smoking on pro-/anti-inflammatory cytokines.
