Promising Anti-atherosclerotic Effect of Berberine: Evidence from In Vitro, In Vivo, and Clinical Studies.

Elevated levels of plasma cholesterol, impaired vascular wall, and presence of inflammatory macrophages are important atherogenic risk factors contributing to atherosclerotic plaque formation and progression. The interventions modulating these risk factors have been found to protect against atherosclerosis development and to decrease atherosclerosis-related cardiovascular disorders. Nutritional approaches involving supplements followed by improving dietary habits and lifestyle have become growingly attractive and acceptable methods used to control atherosclerosis risk factors, mainly high levels of plasma cholesterol. There are a large number of studies that show berberine, a plant bioactive compound, could ameliorate atherosclerosis-related risk factors. In the present literature review, we put together this studies and provide integrated evidence that exhibits berberine has the potential atheroprotective effect through reducing increased levels of plasma cholesterol, particularly low-density lipoprotein (LDL) cholesterol (LDL-C) via LDL receptor (LDLR)-dependent and LDL receptor-independent mechanisms, inhibiting migration and inflammatory activity of macrophages, improving the functionality of endothelial cells via anti-oxidant activities, and suppressing proliferation of vascular smooth muscle cells. In conclusion, berberine can exert inhibitory effects on the atherosclerotic plaque development mainly through LDL-lowering activity and suppressing atherogenic functions of mentioned cells. As the second achievement of this review, among the signaling pathways through which berberine regulates intracellular processes, AMP-activated protein kinase (AMPK) has a central and critical role, showing that enhancing activity of AMPK pathway can be considered as a promising therapeutic approach for atherosclerosis treatment.

A case report of a rare cardiac complication in novel coronavirus disease.

BACKGROUND: Since late 2019, the outbreak of COVID-19 has rapidly spread worldwide. As it is a newly emerged disease, many of its manifestations and complications are unknown to us. Cardiac involvement and arrhythmias are another aspect of the disease about which very little is known. CASE SUMMARY: A 71-year-old male patient presented at the Emergency Department complaining of fever, a dry cough, and dyspneoa. He was admitted due to these symptoms suggestive of COVID-19, and a chest CT and PCR test confirmed the diagnosis. During admission, cardiac involvement was detected, i.e. second-degree atrioventricular block with intermittent left bundle branch block (LBBB) which progressed to fixed LBBB and eventually developed into atrial fibrillation/flutter with bradycardia. Both cardiac troponin and echocardiographic findings for detecting myocarditis were negative. We waited 14 days for resolution of atrioventricular block before permanent pacemaker implantation, but the condition still did not improve after the waiting period. DISCUSSION: COVID-19 is mainly a respiratory infection but cardiac involvement is not uncommon in the course of the disease. Arrhythmia, during this infection, seems to be caused by an inflammatory response in the myocardium, electrolyte disturbances, and hypoxia; the course of the disease in our case study shows that the virus can preferentially and irreversibly involve the cardiac conduction system.

The effects of pharmacological interventions, exercise, and dietary supplements on extra-cardiac radioactivity in myocardial perfusion single-photon emission computed tomography imaging.

Myocardial perfusion imaging (MPI) as an imaging modality plays a key role in the monitoring of patients with cardiovascular disease. MPI enables the assessment of cardiovascular disease, the effectiveness of therapy, and viable myocardial tissue. However, MPI suffers from some downfalls and limitations, which can influence its clinical applications. These limitations can arise from the patient's condition, equipment, or the actions of the technologist. In this review, we mainly focused on the different effective parameters on radioactivity uptake of organs including liver, intestines, stomach, and gall bladder and how they affect the quality of the acquired images in nuclear medicine. More importantly, we cover how different suggested medicines, foods and exercise alleviative this problem.

Evaluation of Percutaneous Coronary Intervention and stenting of Left Main Coronary Artery Stenosis in Tehran's Rajaie and Lavasani Hospitals from 2010 to 2011.

BACKGROUND: Data of the results from treatment of unprotected and protected LMCA diseases with PCI and stent implantations in our country were limited. Surgical therapy is considered as an standard care for patients with unprotected LMCA stenosis. This notion is based on some randomized and observational studies performed three decades ago which convincingly showed superiority of CABGs over medical therapy. Moreover, preliminary studies have shown that the use of DES for the treatment of unprotected LMCA diseases is associated with very favorable mid-term outcome, which is highly competitive with that of surgery, especially for ostial lesions. OBJECTIVES: This study sought to evaluate one year safety and effectiveness of PCI and stenting in LMCA disease. PATIENTS AND METHODS: We performed a one year clinical follow-up of any patients with LMCA disease "Protected and Unprotected" who underwent PCI and stenting (n = 40) with BMS (n = 17) or DES (n = 23) in Tehran's Rajaje and Lavasani hospitals from September 2010 to September 2011. The primary end points were all-cause mortality, and MACCE which consisted of the composite of death, MI, stroke, and target vessel revascularization, and the duration of hospitalization change the severity of angina pain and the function class of physical activity. RESULTS: In the one year follow-up, the adjusted risk of death was 5% and the composite of death, MI, stroke and target vessel revascularization (MACCE) was 22%. In 94.7% the number of patients, the severity of angina pain were decreased, and in 92.5% of patients, the function class of physical activity has been improved. The duration of hospitalization was 4.38 ± 1.63 days which was less than that of CABGs. CONCLUSIONS: For the treatment of protected and unprotected LMCA diseases, PCI with stent implantation is effective, and leads to decreasing the mortality and the death rate, MI, stroke, the severity of angina pain, and improving the function class of physical activity and tolerance.