The correlation between cardiac magnetic resonance T2* and left ventricular global longitudinal strain in people with ß-thalassemia.

BACKGROUND: Heart failure is the biggest cause of mortality and morbidity in people with thalassemia, and iron deposition in cardiac tissue impairs cardiovascular function. Therefore, early detection of cardiac involvement is important to improve the prognosis in these individuals. METHOD: Two- and three-dimensional echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), left ventricular volumes and diameters, and global longitudinal strain (GLS) in 130 individuals with ß-thalassemia using the speckle tracking method. Magnetic resonance imaging (MRI) was carried out on both the heart and liver. The participants were divided into 2 groups based on cardiac T2* values (normal and abnormal cardiac iron load), and the correlation between cardiac T2* MRI and GLS was evaluated. RESULTS: The statistical analysis showed a significant correlation between cardiac T2* MRI and left ventricular global longitudinal strain. There was a significant difference in global longitudinal strain (P < .0001), liver MRI T2*( P < .0001), and left ventricular ejection fraction (P < .001) between the 2 groups. The optimal cutoff value for GLS was -18.5% with sensitivity and specificity 73.0% and 63.0%, respectively (postitive predictive value = 50%, negative predictive value = 82.3%, AUC = 0.742, std. error = 0.046) which predicts T2* value of <20 ms, according to cardiac MRI. CONCLUSIONS: The participants with cardiac iron overload had a lower GLS than those without one. This suggests that GLS may be a useful method to predict myocardial iron overload particularly in ß-thalassemia patients with subclinical cardiac involvement.

The prevalence and prognostic role of vitamin D deficiency in patients with acute coronary syndrome: a single centre study in South-West of Iran.

BACKGROUND: The objectives of this study were estimating the prevalence of vitamin D deficiency in patients with acute coronary syndrome comparing with normal people and evaluating the relationship between vitamin D deficiency and short-term mortality in these patients. METHODS: We considered 106 patients with non-ST elevation myocardial infarction and high-risk unstable angina and 110 patients with ST elevation myocardial infarction as group A. The control group (group B) consisted of 120 individuals without any known cardiovascular diseases or systemic disease. We measured serum 25-hydroxyvitamin D in all cases and classified them according to their serum 25-hydroxyvitamin D levels. Sufficient vitamin D level was considered ≥30 ng/ml. We followed the patients for 30 days after index admission. RESULTS: The prevalence of hypovitaminosis D in group A was much higher than group B. In group A, 72% of patients had serum 25-hydroxyvitamin D level of 20 ng/ml or less. This percentage was only 27.4% in control group. We did not find any significant relationship between vitamin D deficiency and short-term mortality in patients with acute coronary syndrome. CONCLUSION: Our data suggest that vitamin D deficiency was present in most of patients admitted with acute coronary syndrome in Ahvaz.

Decreased lipoprotein (a) and serum high-sensitivity C-reactive protein levels in male patients with atherosclerosis after supplementation with ginger: A randomized controlled trial.

BACKGROUND: Although the antioxidant properties of ginger have been revealed, there is little available information on the effectiveness of ginger on inflammatory disorders such as atherosclerosis. This study was carried out to examine the effect of ginger on improving the complication of atherosclerosis. METHODS: This study was a double-blind, placebo-controlled, randomized clinical trial conducted on patients with atherosclerosis. Participants in the ginger and control groups received 1600 mg of powdered ginger or placebo (wheat flour) in capsules daily for 8 weeks. Weight, body mass index (BMI), fasting blood sugar (FBS), cholesterol, triglyceride (TG), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL), lipoprotein (a) [Lp(a)], high-sensitivity C-reactive protein (hs-CRP), and total anti-oxidant capacity (TAC) were assessed before and after the intervention. RESULTS: Ginger consumption in the intervention group significantly reduced serum Lp(a) level (27.25 ± 1.30 ng/ml vs. 23.57 ± 0.97 ng/ml) (P = 0.040) and also the level of hs-CRP in the intervention group was 1.90 ± 0.33 µg/ml and 1.24 ± 0.15 µg/ml (P = 0.010) before and after intervention, respectively, but the levels of Lp(a) and hs-CRP were not decreased significantly in the placebo group. The level of TAC in the ginger group was 0.71 ± 0.05 mM and after the trial was 0.57 ± 0.04 mM (P = 0.050); no significant differences were seen in TAC when ginger was administered at 1600 mg/daily for 60 days. Also the level of Lp(a) and hs-CRP but not TAC reduced significantly in ginger group compared to placebo group after intervention. CONCLUSION: This study showed that ginger had anti-atherosclerosis and anti-glycemic properties associated through a significant decreased Lp(a) and FBS in patients with atherosclerosis supplemented with ginger.

QT Dispersion: Does It Change after Percutaneous Coronary Intervention?

BACKGROUND: Myocardial ischemia is one of several causes of prolonged QT dispersion. The aim of this study was to evaluate the effect that percutaneous coronary intervention has on the depolarization and repolarization parameters of surface electrocardiography in patients with chronic stable angina. METHODS: We assessed the effects of full revascularization in patients with chronic stable angina and single-vessel disease who underwent percutaneous coronary intervention. Twelve-lead electrocardiograms were recorded before intervention and 24 hours subsequently. We measured parameters including QRS duration, QT and corrected QT durations, and JT and corrected JT duration in both electrocardiograms and compared the values. RESULTS: There were significant differences between the mean QRS interval (0.086 ± 0.01 sec vs. 0.082 ± 0.01 second; p value = 0.01), mean corrected QT dispersion (0.080 ± 0.04 sec vs. 0.068 ± 0.04 sec; p value = 0.001), and mean corrected JT dispersion (0.074 ± 0.04 sec vs. 0.063 ± 0.04 sec; p value = 0.001) before and after percutaneous coronary intervention. No significant differences were found between the other ECG parameters. CONCLUSION: Our data indicate that the shortening of corrected QT dispersion and corrected JT dispersion in patients undergoing percutaneous coronary intervention is prominent.