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Najafian J.,Isfahan University of Medical Sciences | Mohamadifard N.,Isfahan Cardiovascular Research Institute | Siadat Z.D.,Isfahan University of Medical Sciences | Sadri G.,Isfahan University of Medical Sciences | Rahmati M.R.,Arak University of Medical Sciences
Nigerian Journal of Clinical Practice | Year: 2013

Background: Recent studies revealed an association between sleep disturbance and metabolic disorders, such as obesity and metabolic syndrome. An aim of this study was to assess the relation between sleep duration and diabetes mellitus in a representative sample of the Iranian population. Materials and Methods: Participants were 12514 individuals, (6123 men and 6391 women) studied in the baseline survey of a community based program entitled Isfahan healthy heart program (IHHP). Sleep time was obtained by validated questionnaire. Diabetes mellitus was defined as fasting glucose over 126 mg/dl or 2 hour post prandial glucose at glucose tolerance test over 200 mg/dl, or if the patient was on diabetic medication. The relation between the sleep time and diabetes was examined using categorical logistic regression with adjustment for sex, body mass index and waist circumference. Results: Compared with those, sleeping 7.8 hours per night, the individuals with sleeping time of 5 hours or less and aged <60 years had an increased odd ratio for diabetes and an impaired glucose tolerance. (OR = 1.37 and 95% CI = 1.13,1.67). Conclusion: Sleep duration of 5 hours or less in individuals under age 60 years is associated with an increased prevalence of diabetes mellitus and an impaired glucose tolerance test. This finding should be confirmed in longitudinal studies.


Khosravi-Boroujeni H.,Cardiac Rehabilitation Research Center | Sarrafzadegan N.,Isfahan Cardiovascular Research Institute | Mohammadifard N.,Isfahan Cardiovascular Research Institute | Alikhasi H.,Isfahan Cardiovascular Research Institute | And 3 more authors.
Obesity Facts | Year: 2012

Background: Few data are available linking intake of sugar-sweetened beverages (SSBs) with the metabolic syndrome. Furthermore, findings from these studies are inconsistent and most are from Western societies; no information is available in this regard from Middle Eastern populations. Objective: This study was conducted to assess the relationship between SSB consumption and metabolic syndrome in an Iranian adult population. Methods: In this cross-sectional study, data from 1,752 people (782 men and 970 women) that were selected with the multistage cluster random sampling method from three counties of Isfahan, Najafabad and Arak were used. A validated food frequency questionnaire was used to assess participants' usual dietary intakes. Consumption of SSBs was calculated by summing up the consumption of 'soft drinks' and 'artificially sweetened fruit juices'. To categorize participants, we used three levels of SSB consumption: <1 time/week, 1-3 times/week, and >3 times/week. Biochemical assessments were done after an overnight fasting. Metabolic syndrome was defined according to the guidelines of Adult Treatment Panel III. Results: Subjects with high consumption of SSBs (>3 times/week) were younger than those with low consumption (<1 time/week). Mean BMI was not significantly different across SSB categories. High consumption of SSBs was associated with greater intakes of energy and almost all food groups. We found a significant difference in serum triglyceride levels between men consuming SSBs 1-3 times/week and those consuming <1 time/week. However, after controlling for potential confounders, this association disappeared. In crude models, no significant associations were found between SSB intake and prevalence of the metabolic syndrome in either gender. After adjustment for potential confounders including BMI, we found that men in the top category of SSB intake were 17% more likely to have the metabolic syndrome (odds ratio (OR) 1.17; 95% confidence interval (95% CI) 0.56-2.46), while women in the highest category were 20% less likely to have the syndrome (OR 0.80; 95% CI 0.46-1.42) as compared with those in the bottom category. However, these associations were not significant in either men or women. Conclusion: Our results do not support the previous findings on the association between SSB consumption and metabolic syndrome. Prospective studies are needed to further explore for this association. Copyright © 2012 S. Karger GmbH, Freiburg.


Nekouei Z.K.,Islamic Azad University | Neshatdoost H.,University of Isfahan | Yousefy A.,Isfahan University of Medical Sciences | Sadeghei M.,Isfahan Cardiovascular Research Institute | Manshaee G.,Islamic Azad University
ARYA Atherosclerosis | Year: 2013

BACKGROUND: Although psychological factors play an important role in coronary heart diseases (CHD), it seems there is a need for more researches in this respect. The present study aimed to review psychological factors, including depression, anxiety and stress related to etiology and prognosis of CHD. METHODS: This was a review on medical and psychological literatures, particularly in the years 1995-2012. RESULTS: As protective factor or risk factor, psychological factors play an important role in CHD. CONCLUSION: Given the findings of this study, it seems necessary that we pay attention to psychological factors, as independent risk factors or protective factors for CHD.


Shemirani H.,Isfahan University of Medical Sciences | Khosravi A.,Isfahan Cardiovascular Research Institute | Hemmati R.,Elam University of Medical science | Gharipou M.,Isfahan Cardiovascular Research Institute
International Journal of Preventive Medicine | Year: 2012

Background: Numerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained - 'Which is more important for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients?' Methods: The current study was a cross-section study conducted on a total of 126 non-diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio (UACR) was determined as an indicator of microalbuminuria. Complete two-dimensional, doppler, and tissue-doppler echocardiography was performed and the recording of the diastolic function parameters was carried out. Results: High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter. Conclusion: According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients.


Asgary S.,Isfahan University of Medical Sciences | Rafieian-Kopaei M.,Shahrekord University of Medical Sciences | Shamsi F.,Shahrekord University of Medical Sciences | Najafi S.,Isfahan Cardiovascular Research Institute | Sahebkar A.,Mashhad University of Medical Sciences
Journal of Complementary and Integrative Medicine | Year: 2014

Background: Anthocyanins are phytochemicals with a multitude of pharmacological actions including anti-diabetic and anti-hyperlipidemic effects. This study was undertaken to evaluate the anti-hyperglycemic and antihyperlipidemic effects of cornelian cherry (Cornus mas L., CM) fruits - that are rich in anthocyanins and known to have medicinal properties- in alloxan-induced diabetic rats. Methods: Twenty-eight adult male rats were randomly assigned to four groups of seven animals each: non-diabetic control, diabetic control, glibenclamide-treated (0.6 mg/kg/day; 4 weeks) and CM fruit-treated (2 g/day; 4 weeks) group. Diabetes was induced by a single injection of alloxan (120 mg/kg). Fasting serum levels of glucose, total cholesterol (TC), low- (LDL-C) and high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), aspartate (AST) and alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were measured at the end of study period. Results: Diabetic rats had significantly elevated levels of serum glucose, LDL-C, TG, AST, ALP and ALT and decreased levels of HDL-C compared to the non-diabetic group (p < 0.05). Treatment with either glibenclamide or CM counterbalanced the above-mentioned abnormalities. The effects of CM were comparable to those of glibenclamide at the doses tested in this study. Serum glucose, TG, ALP and HDL concentrations in the normal group were significantly changed compared to the diabetic control group (p < 0.05). There were no significant changes in evaluated biochemical parameters between the glibenclamide and CM groups with normal group. Histopathological examinations revealed a less severe hepatic portal inflammation in the CM-treated vs. other study groups. Conclusions: Dietary supplementation with CM fruits effectively prevents the development of diabetes mellitus, dyslipidemia and hepatic inflammation in alloxan-induced diabetes.


Golabchi A.,Isfahan Cardiovascular Research Institute | Golabchi A.,Tehran University of Medical Sciences | Basati F.,University of Isfahan | Kargarfard M.,University of Isfahan | Sadeghi M.,Isfahan University of Medical Sciences
ARYA Atherosclerosis | Year: 2012

BACKGROUND: Current guidelines recommend cardiac rehabilitation programs (CRP) as a means to improve functional status of patients after coronary revascularization. However, research supporting this recommendation has been limited and positive effects of CRP on diastolic function are controversial. The aim of this study was to examine the effects of an 8-week CRP on left ventricular diastolic function. METHODS: This randomized, clinical trial included 29 men with ST elevation myocardial infarction (MI) who had received reperfusion therapy, i.e. coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). They were randomized to a training group (n = 15; mean age: 54.2 ± 9.04 years old) and a control group (n = 14; mean age: 51.71 ± 6.98 years old). Patients in the training group performed an 8-week CRP with an intensity of 60-85% of maximum heart rate. Exercise sessions lasted 60-90 minutes and were held three times a week. At the start and end of the study, all patients performed symptom-limited exercise test based on Naughton treadmill protocol. Pulsed-wave Doppler echocardiography was also used to determine peak velocity of early (E) and late (A) waves, E/A ratios, and the deceleration time of E (DT). RESULTS: Left ventricular diastolic indices (E, A, E/A ratio, DT) did not change significantly after the CRP. Compared to baseline, patients in the training group had significant improvements in functional capacity (8.30 ± 1.30 vs. 9.7 ± 1.7) and maximum heart rate (118.50 ± 24.48 vs. 126.85 ± 22.75). Moreover, resting heart rate of the training group was significantly better than the control group at the end of the study (75.36 ± 7.94 vs. 79.80 ± 7.67; P < 0.001). CONCLUSION: An 8-week CRP in post-MI patients revascularized with PCI or CABG led to improved exercise capacity. However, the CRP failed to enhance diastolic function.


Gharipour M.,Isfahan Cardiovascular Research Institute | Ramezani M.A.,Tehran University of Medical Sciences | Sadeghi M.,Isfahan Cardiovascular Research Institute | Khosravi A.,Isfahan Cardiovascular Research Institute | And 4 more authors.
Journal of Research in Medical Sciences | Year: 2013

Background: C-reactive protein (CRP) and white blood cell (WBC) are proinflammatory markers. They are major pathophysiological for the development of metabolic syndrome (MetS). This study aimed to address the independent associations between MetS and WBC counts and serum CRP levels and evaluation of their magnitude in relation to the MetS, based on the sex in the Iranian adults. Materials and Methods: In this cross-sectional study, subjects who met the MetS criteria, based on the Adult Treatment Panel III were selected from the Isfahan Healthy Heart Program database. A questionnaire containing the demographic data, weight, height, waist, and hip circumference of the respondents was completed for each person. Blood pressure was measured and the anthropometric measurements were done, and fasting blood samples were taken for 2 h postload plasma glucose (2 hpp). Serum [total, high-density lipoprotein (HDL), and low-density lipoprotein] levels of cholesterol, triglyceride, and CRP as well as WBC counts were determined. The univariate analyses were carried out to assess the relation between the CRP levels, WBC counts with the MetS in both sexes the. Results: In men with the abdominal obesity, the higher levels of WBC count, high serum triglyceride and blood glucose levels, a low serum HDL level, and raised systolic and diastolic blood pressure were observed. However, the higher serum CRP levels were only observed in those with the low serum HDL-cholesterol levels. The mean values of the WBC counts were statistically different between the men with and without MetS, but the mean values of the CRP levels were similar between the two groups. In women, the mean values of WBC count and CRP levels were statistically different in the subjects with and without a MetS components (except for the low serum HDL levels and high diastolic blood pressure for the WBC measures and abdominal obesity for the CRP measures) and for those with and without MetS. The age and smoking adjusted changes in the CRP levels and WBC counts correlated with the number of Mets components in the women. Conclusion: The findings of this study suggest substantial implications for the prevention and management of the MetS and atherosclerotic diseases, as these involve the suppression of inflammatory conditions rather than the incitement of anti-inflammatory conditions.


Sadeghi M.,Isfahan University of Medical Sciences | Ghashghaei F.E.,Isfahan University of Medical Sciences | Rabiei K.,Isfahan Cardiovascular Research Institute | Roohafza H.,Isfahan University of Medical Sciences | Afshar H.,Isfahan University of Medical Sciences
Journal of Research in Medical Sciences | Year: 2012

Introduction: Coronary artery disease (CAD) is the leading cause of death and disability all over the world. A sedentary lifestyle and dyslipidemia are known to be the major risk factors, which play an important role in the progression of coronary artery disease. Regarding gender differences, the risk of developing coronary heart disease is recognized as being different between non-obese males and non-obese females. Hence, the aim of this study is to assess the benefits of a comprehensive cardiac rehabilitation program (CRP) on the functional capacity and lipid profiles, such as, total cholesterol, triglycerides, low density lipoprotein cholesterol, and high density lipoprotein cholesterol in non-obese males and non-obese females with coronary artery disease, and comparing these groups. Materials and Methods: We evaluated 585 non-obese males and females with coronary artery disease. All the participants completed the cardiac rehabilitation program for two months, which included 24 exercise training sessions, medical evaluation, and consultation. For investigation of the effects of the cardiac rehabilitation program on the functional capacity and lipid profiles, exercise tests were carried out by each patient, and also, their blood samples were taken on entrance and at the end of this period. Results: The findings, following 24 sessions in the cardiac rehabilitation program, showed that the functional capacity (P = 0.00) and all lipid profiles had significantly improved in both the groups, except that the high density lipoprotein cholesterol did not show a significant difference in non-obese females. In addition, comparing the two groups did not show any significant differences in lipid profiles, but the changes in functional capacity were significant (P = 0.00) between the two groups, following the cardiac rehabilitation program. Conclusion: The CRP, which was performed by the patients under supervision of a physician and an exercise physiologist, plays a key role in improving the functional capacity (FC) and all lipid profiles in non-obese males and females with coronary artery disease, without any attention to gender differences.


PubMed | Isfahan Cardiovascular Research Institute and Isfahan University of Medical Sciences
Type: | Journal: Advanced biomedical research | Year: 2015

Early screening and diagnosis of right ventricular (RV) dysfunction and pulmonary artery hypertension is vital in patients with end-stage renal disease (ESRD) because of its relation to patients survival. The present study is aimed to address and compare RV function parameters and pulmonary artery pressure (PAP) before and shortly after hemodialysis in patients with ESRD.This quasi-experimental study performed at Alzahra Hospital in Isfahan in 2014, 40 consecutive patients with ESRD that referred to hemodialysis ward were assessed by M-mode echocardiography and tissue Doppler imaging before and 30 min after completing hemodialysis to assess RV function parameters and PAP.Following hemodialysis, mean body weight, both systolic, and diastolic blood pressures (BPs) and also mean systolic PAP significantly decreased, while tricuspid annulus plane systolic excursion (TAPSE), RV fractional area change (RVFAC) significantly increased 30 min after hemodialysis compared with before this procedure. However, systolic myocardial remained unchanged. Changes in body weight after dialysis was adversely associated with patients age and duration of dialysis. Moreover, change in PAP was positively associated with the level of serum creatinine.Early reduction in body weight and BP, as well as improvement in RV function, and PAP is predictable shortly after starting hemodialysis in patients with ESRD. We found that RVFAC and TAPSE values were dependent on preload, but RV S velocity was load independent. Change in body weight is predicted more in older patients and those who undergoing prolonged hemodialysis. Change in PAP is strongly affected by the severity of renal failure, but RV function may not be influenced by age or duration of dialysis.


PubMed | Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences and University of Isfahan
Type: Journal Article | Journal: Iranian journal of nursing and midwifery research | Year: 2016

Heart failure is one of the most important and prevalent diseases that may have negative effects on the quality of life (QOL). Today, the promotion of QOL in patients with heart failure is important in nursing care programs. This research aimed to determine the efficacy of hope-promoting interventions based on religious beliefs on the QOL of patients with congestive heart failure (CHF).In this randomized clinical trial (IRCT2014100619413N1) conducted in Isfahan, Iran, 46 adult patients with CHF were selected and randomly assigned to study and control groups. Ferrans and Powers Quality of Life Index (QLI) was completed by both groups before, immediately after, and 1 month after the intervention. For the study group participants and their families, 60-min sessions of hope-promoting interventions based on religious beliefs were held twice a week for 3 weeks. Independent t, repeated measures analysis of variance (ANOVA), Chi-square, Mann-Whitney, and Fishers exact tests were adopted for data analysis.The mean (standard deviation) overall QOL score in the area of satisfaction significantly increased in the study group, compared to the controls, immediately [70.7 (8.5) vs. 59.2 (12.5)] and 1 month after the intervention [75.2 (7.4) vs. 59.4 (12.9)] (P < 0.05). There was also a similar difference between the two groups in the area of importance immediately [73.6 (5.8) vs. 65.7 (7.5)] and 1 month after the intervention [76.3 (8.1) vs. 66.8 (8.5)] (P < 0.05).Hope-promoting intervention based on religious beliefs is a useful method for improving QOL in patients with CHF.

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