Reduction of LDL sialylation may correlate with coronary artery disease (CAD), but the details of this modification and its effect on CAD are not well studied. This study was aimed to show desialylation of LDL and to reveal more details of this modification. Blood samples were collected from 16 patients with CAD and 25 healthy individuals. Serum sialic acid was determined. LDL was extracted from all samples, and the interaction of the extracted materials with lectins (MAA, SNA, and DSA) was studied using the lectin blotting method. Serum total sialic acid (TSA) concentrations in CAD patients and healthy individuals were 71.9 6 2.66 and 60.76 6 2.34 mg/dL, respectively, and the difference between the two groups was statistically significant (p ,0.001). The intensity of interaction of extracted LDL with SNA and MAA lectins was lower in CAD patients compared to that in normal subjects (p ,0.001). The intensity of interaction of LDL with DSA was higher in CAD (p ,0.001). There was a reverse correlation between TSA and intensity of LDL interaction with SNA and MAA in both groups, but in the case of DSA this correlation was direct and positive. These findings indicated an increase in desialylation of LDL in CAD. It was concluded that LDL was subjected to glycosylation changes in CAD and that there was a positive correlation between TSA and the desialylated form of LDL. This modification may contribute to the pathogenesis of CAD.

Introduction Considering the anticoagulant actions of vitamin D, we hypothesize that vitamin D status might affect the required dose of warfarin for maintaining the therapeutic international normalized ratio (INR). Methods In a retrospective single-center cohort study, serum levels of 25-hydroxyvitamin D were assessed for 89 subjects receiving a stable dose of warfarin for 3 months or longer and had a stable INR between 2 and 3.5 for at least three consecutive visits. A warfarin sensitivity index (WSI), defined as the steady-state INR divided by the mean daily warfarin dose, was used for measuring the warfarin dose response. The relation between the serum level of 25-hydroxyvitamin D and WSI value and the difference in the mean WSI value between the subjects with different vitamin D status categories (sufficient, insufficient, and deficient) were assessed. Results Twenty-one subjects had vitamin D deficiency, 43 had vitamin D insufficiency, and only 25 had normal levels of 25-hydroxyvitamin D. Based on the multiple linear regression analysis, there was a significant but weakly positive correlation between WSI and 25-hydroxyvitamin D serum levels, as the value of WSI increases by almost 0.0027434 for every unit increase in 25-hydroxyvitamin D serum level ( p value = 0.041). Using one-way ANOVA analysis, there was a trend in a significant difference between the groups with different vitamin D status categories regarding the mean WSI value ( F = 2.95, p value = 0.057), as subjects with sufficient vitamin D state compared to those with vitamin D deficiency had a higher WSI value. Conclusions Although the study’s limitations limit our ability to draw definite conclusions, the present data suggest that in addition to other traditional factors, vitamin D status might also affect warfarin sensitivity and maintenance dose requirement. However, to more clearly explain this link, further studies with high involvement subjects are required.

Background and Objective: Pulmonary hypertension is an increase in blood pressure of the pulmonary artery which leads to right ventricular dysfunction. Therefore, the present study aimed to compare echocardiographic parameters in the study of right ventricular failure in patients with pulmonary hypertension. Materials and Methods: In the present descriptive cross-sectional study, data were collected from 100 patients with pulmonary hypertension referred to Farshchian Heart Hospital, Hamadan, Iran between 2017-2019. The cases were detected by two-dimensional echocardiography and tissue Doppler and divided into three groups based on blood pressure of the pulmonary artery. The parameters of PASP, PVR, Tei Index, FAC, IVA, TAPSE, and DTI S Velocity were calculated for each patient.Results: Out of 100 patients with a mean age of 52. 95 ±16. 62 years, 0. 46% had lung problems. The parameters of PASP, PVR, and Tei Index were positively and significantly correlated with each other. Also, a positive and significant relationship was observed between the parameters of FAC, IVA, TAPSE, and DTI S Velocity. However, the parameters of the first and second groups were negatively and significantly related to each other. The results indicated that the mean difference of all indicators was significant between different groups of pulmonary hypertension. The parameter of PVR parameter was one of the factors affecting pulmonary hypertension based on regression analysis. Also, IVA and Tei Index were more consistent with pulmonary hypertension in terms of abnormal values. Conclusion: PVR, IVA, and Tei Index were effective parameters for evaluating the right ventricular function and more attention is recommended to be paid to these parameters.

Background: Coronary artery bypass grafting (CABG) is a surgical procedure used in the treatment of coronary artery disease and to improve heart function. Right ventricular (RV) function is unclear based on myocardial velocities before and after coronary artery bypass graft surgery. RV dysfunction is a known cause of hypotension in early CABG surgery. The diastolic function has been shown to be a significant contributor to mortality and cardiac morbidity in recent years. Our study aimed to assess RV diastolic dysfunction after CABG surgery. Methods: Forty-four patients with the two-vessel disease (2 VD), small vessel disease (SVD) and three-vessel disease (3 VD) facial ischemia candidates for CABG surgery were studied. All patients underwent colour Doppler and RV strain echocardiography before and one month after CABG surgery, and patients’ RV function indices were calculated. Data analysis was performed using SPSS 21 software and a value of P<0.05 was considered statistically significant. Results: Out of forty patients, the male to female ratio was 32:8 and their mean age was 65.17 ± 7.87 years and their mean body mass index was 25.59± 3.20. Four patients were operated on without pumps. One month after CABG, systolic pulmonary artery pressure (SPAP), left ventricular ejection fraction (LVEF) and RV Diameter indexes increased significantly. Fractional area change (FAC), RV global longitudinal strain (GLS), Tissue Doppler imaging systolic wave (SM), RV myocardial perfusion imaging (MPI) and Tricuspid annular plane systolic excursion (TAPSE) decreased, which was less in the 3VD group than in the 1VD/2VD group (P <0.001). There was no significant difference between RV diastolic diameter (RVDD) and left ventricular diastolic diameter (LVDD) before and one month after CABG (P <0.05). Additionally, no significant correlation was detected between changes in RV strain and pump connection time. Conclusion: RV diastolic function is significantly reduced after CABG surgery. Surgery without the pump can certainly not eliminate this dysfunction and be effective in reducing its severity.

Background: Myocardial infarction is considered to be the most common symptom of cardiovascular diseases. Regarding the limitation of access to Morphine sulphate as a special drug and complications followed, this study aims to compare the treatment effects of intravenous acetaminophen and morphine sulphate on the reduction of pain in MI patients and to improve the cardiac performance. Methods: The present study is a triple-blind randomized control trial in which 70 patients were divided into two separated groups and the pain was measured using Visual Analogue Scale. All analysis was done using SPSS Software at the significance level of 5 percent. Results: 42 patients were male (60%) of whom 20 were in case group and 22 in control group. There were no significant difference between intervention group and control group in terms of VAS score (p = 0.520). The index change of VAS over the time was statistically significant (p=0.001) in intervention and control groups (intra group change). The results of variance analysis with repeated measurements showed that mean differences of Ejection Fraction over time in both groups of intervention and control was not statistically significant (p=0.28). Conclusion: The findings of this study demonstrate that although Acetaminophen does not have an improved effect on pain control and cardiac performance than Morphine sulphate, it can be still an appropriate alternative for Morphine sulfate due to the lack of destructive effects and its availability.