International Journal of Cardiovascular Practice

Review Article

Imaging for Diagnosis and Monitoring of Cardiac Sarcoidosis

Ghazaleh Mehdipoor, Sabahat Bokhari, Martin R. Prince

International Journal of Cardiovascular Practice, Vol. 3 No. 2 (2018), 18 April 2018, Page 21-24

Sarcoidosis is a granulomatous condition, primarily affecting the lungs and thoracic lymph nodes. Clinical cardiac involvement might occur in 2 to 5% of patients with sarcoidosis, and can be associated with serious complications including heart block, cardiomyopathy, ventricular arrhythmias, and potentially death. Timely diagnosis helps initiate treatment before cardiac damage becomes irreversible. In this brief review, we discuss imaging updates for diagnosis and monitoring of cardiac sarcoidosis.

Original Articles

Determination of Arterial Compliance Using Thoracic Bioimpedance to Predict the Presence of Heart Diseases

Souhir Chabchoub, Sofienne Mansouri, Ridha Ben Salah

International Journal of Cardiovascular Practice, Vol. 3 No. 2 (2018), 18 April 2018, Page 25-29

Introduction: Thoracic bioimpedance is a simple, cost-effective, and non-invasive tool used generally to determine several hemodynamic parameters. Based on this technique, the cardiac output and the stroke volume are the most common parameters used for diagnosing heart diseases. This study aims to investigate the ability of the arterial compliance parameter to predict or detect the presence of heart diseases.

Methods: two groups of young subjects participated in this study: a control group consisted of 10 subjects including 2 athletes and a group of 10 patients with various heart diseases. The thoracic bioimpedance recordings are used to determine the arterial compliance for the 2 groups of subjects. Statistical analyses are performed using the Student’s t-test and the ROC curve analysis.

Results: Experimental results show that the arterial compliance is significantly lower in patients with heart diseases compared to control subjects (P < 0.001).

Conclusions: The arterial compliance is a potentially useful hemodynamic parameter which could be successfully used to predict or detect the presence of heart diseases.

Association of Serum Vitamin D Level and Serum Lipids Profile

Roxana Sadeghi, Mohammad Reza Eidi, Nasim Zamani

International Journal of Cardiovascular Practice, Vol. 3 No. 2 (2018), 18 April 2018, Page 30-33

Introduction: High level of vitamin D is associated with a better health status. The role of vitamin D deficiency in the incidence of cardiovascular events is demonstrated in previous studies. The current study aimed at evaluating the effect of vitamin D supplement therapy on serum lipids profile, as a risk factor for cardiovascular diseases.

Methods: The current prospective cohort study included 221 patients admitted to a university hospital from March 2014 to March 2015. The baseline levels of the patients' serum vitamin D and lipid profile of the study subjects were recorded. After three months treatment with vitamin D, the patients' serum vitamin D level and lipid profile were re-evaluated. The results before and after the supplement therapy were compared using statistical methods.

Results: The mean age of the patients was 48.2 ± 14.0 years. The mean vitamin D level was 21.0 ± 16.6 ng/mL at baseline, which increased to 35.8 ± 32.7 ng/mL (P = 0.001) after a three-month vitamin D supplement therapy. Mean low-density lipoprotein (LDL) decreased from 112.1 ± 30.0 to 98.7 ± 31.7 mg/dL (P = 0.003) after the supplement therapy. Mean high-density lipoprotein (HDL) increased from 42.8 ± 11.2 to 44.5 ± 9.0 mg/dL, but the difference was insignificant before and after the treatment (P = 0.2). Mean cholesterol reduced from 183.8 ± 42.3 to 169.5 ± 41.9 mg/dL (P = 0.02) and the mean TG dropped from 147.5 ± 98.7 to 134.7 ± 71.1 mg/dL, (P = 0.1) after vitamin D intake.

Conclusions: The mean levels of LDL and cholesterol significantly decreased during the three-month intervention; in addition, although some changes were observed in the level of HDL and TG, the differences were statistically insignificant. Further studies on larger sample sizes and longer follow-ups are recommended.

Comparison of Serum Levels of Vitamin D in Patients With and Without Acute Coronary Syndrome

Reza Hassanzadeh Makoui, Mahsa Soltannejad Dizaji, Hamid Khederlou

International Journal of Cardiovascular Practice, Vol. 3 No. 2 (2018), 18 April 2018, Page 34-37

Introduction: Coronary artery disease is one of the most common causes of mortality around the world. The association between vitamin D deficiency and the incidence  of diseases, such as hypertension, diabetes, and metabolic syndrome, has been demonstrated previously. There have been studies concerning the relationship between vitamin D deficiency and cardiovascular diseases, which have shown different results. Therefore, this study aimed at determining the association between serum levels of vitamin D and acute coronary syndrome.

Methods: In this case-control study, serum levels of vitamin D were compared between 50 patients with acute coronary syndrome and 50 individuals without this syndrome. A checklist, including demographic data of patients, comorbidities, vitamin D levels, lipid profiles, Electrocardiogram (ECG) changes and echocardiography results, was completed during hospitalization.

Results: Mean age in the case and control group was 63.26 ± 10.76 and 61.22 ± 10.71 years, respectively. The prevalence of diabetes and high blood pressure in the case group was 32% and 54% versus 10% and 8% in the control group, respectively. Overall, 70% and 18% of subjects were smokers in the control and case groups, respectively. Mean concentration of vitamin D in serum was 20.63 ± 13.90 ng/mL, which was significantly lower than the control group with a mean concentration of 29.54 ± 16.8 ng/mL (P-Value = 0.002). Finally, it was shown that for every one unit increase in vitamin D levels, the risk of acute coronary syndrome was reduced by 7% (P-Value = 0.005).

Conclusions: The results of this study showed that the serum levels of vitamin D were significantly lower in patients with acute coronary syndrome compared to those without this disease.

Predictive Implications of Serum Lipid Metabolism over Time in Intensive Care Unit Admitted Patients

Mehdi Motafaker Azad, Mohammad Amin Abbasi, Niloofar Basharzad, Abbas Fadaei

International Journal of Cardiovascular Practice, Vol. 3 No. 2 (2018), 18 April 2018, Page 38-42

Introduction: Serum lipoprotein levels change during hospitalization and effect patient’s outcome in case of sepsis. The aim of this study was to investigate the prognostic values of the serum levels of lipids in Intensive Care Unit (ICU) admitted patients.
Methods: Intensive Care Unit admitted patients with various etiologies were enrolled in this study. Serum lipid level was collected on the first and seventh day of admission. Clinical outcome and baseline characteristics, including age, gender, cause of admission, length of ICU stay, and discharge or death were monitored prospectively in a short cohort.
Results: A total of 108 patients were enrolled in this study. The overall mortality rate was 45%. The average duration of hospitalization at the ICU was significantly lengthier in the un-survived group. Lipid profile had a similar pattern in both genders. Triglyceride level seemed to increase from Day one to Day seven. These changes were observed in both unsurvived and survived group and were not significantly different. A considerable decline of 24% in High Density Lipoprotein (HDL) was detected among unsurvived patients. The mean value of TG on day seven among unsurvived patients was significantly higher than that of the survived group. Receiver Operating Characteristic (ROC) curve illustrated the higher diagnostic ability of HDL level in comparison with other parameters. On day seven, serum HDL cutoff value of 32 (sensitivity 75%; specificity 60%) was observed for predicting the mortality.
Conclusions: Cholesterol is essential for integrity as well as the function of the cell membrane, therefore, dyslipidemia occurring during hospitalization may negatively influence the outcome. Consequently, changes in lipid profile could be a prognostic biomarker for predicting mortality in ICU-admitted patients.