Abstract BACKGROUND: The purpose of this study is to investigate the relationship between the mean heart dose received in left breast cancer radiation therapy and cardiac injury as measured by Pro-BNP and Troponin laboratory levels and left ventricular systolic function, as measured by LVEF and GLS levels in echocardiography. METHOD: This research was carried out at Omid Hospital, Isfahan City, Iran, using the before and after intervention study and single-arm approach on a population of patients diagnosed with cancer of the left breast who received radiation therapy for the left breast between 2021- 2022. Troponin, Pro-BNP, GLS, and LVEF were investigated before and after intervention. The data was analyzed using the t-test and the Mann-Whitney U test. Ultimately, it was examined using version 22 of the SPSS program. RESULTS: This study showed a statistically significant difference in pro-BNP before and after the intervention (P<0.001). Also, we investigated the relationship between the mean heart dose, mean LAD dose, mean LV dose, radiotherapy protocol, and V25 index with the changes of Troponin, Pro-BNP, GLS, and LVEF, and we observed no statistically significant relationship between them (P>0.05). CONCLUSION: Left breast radiation therapy does not affect cardiac factors like LVEF and troponin in the short term. Also, we observed Pro-BNP meaningful changes and the effect of V25 on GLS after the radiation. Studies with a larger sample size and a longer follow-up period are suggested.

Abstract Purpose: Low-grade chronic inflammation has been linked with several health complications like type II diabetes. Given that exercise potentially has anti-inflammatory effects, this study was designed to compare the impact of 8-week high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on specific inflammatory and metabolic markers among a group of diabetic patients to examine how the intensity of exercise influences inflammation-related biomarkers. Methods: An open-labeled, parallel, randomized, controlled trial was conducted at a cardiovascular center. Twenty-seven participants (15 females, mean age: 51±6.2years, BMI: 29.4±3.9kg/m2) were allocated into three equal groups (n=9): HIIT, MICT, and control (CON). Blood samples were collected at baseline, 24 and 72 hours after the last training session. Plasma levels of calprotectin, myeloperoxidase (MPO), interleukin 6 (IL-6) (primary endpoints), and insulin were measured. Results: Comparing the data over time, none of the biomarkers showed significant differences between the study groups. IL-6 decreased over time in both training groups similarly (p˂0.001). Despite small improvements in anthropometric measures and maximal oxygen consumption (VO2max) among training groups compared to the CON group, the two training protocols had almost similar impacts on the investigated inflammatory and metabolic markers. Conclusions Our findings indicate no statistically significant difference in inflammatory and metabolic measures between the two training groups, so neither of the training protocols is superior. However, both training groups exhibited improvements compared to the control group in glucose, triglyceride, and waist-to-hip ratio. Trial registration: IRCT20181129041797N1 (date: 25 Dec. 2108). The full protocol of our study is also available on www.irct.ir

BackgroundAspergillus spp. are among the fungal pathogens that can cause life-threatening infections in patients with a history of COVID-19.Case presentationWe present the case of a 58-year-old Iranian woman with post-COVID-19 Aspergillus fumigatus endocarditis complicated by numerous thromboembolisms. She underwent mitral valve replacement surgery and multiple lower extremity embolectomies and was treated with voriconazole, which led to her final recovery.ConclusionsAspergillus endocarditis should be considered in any patient with suspected endocarditis who has a history of COVID-19 infection and does not respond to routine antibiotic and antifungal therapy, as COVID-19 interferes with proper immune function, and lack of underlying cardiac conditions and immunodeficiencies does not preclude the diagnosis. Culture and histopathological evaluation of vegetations and emboli, as well as PCR, can confirm the diagnosis. Early initiation of antifungal therapy and surgical removal of infected valves and emboli can improve prognosis in patients with Aspergillus endocarditis.

Exosomes are a subtype of natural extracellular vesicles that transfer a great number of biomolecules, released by almost all types of cells, and can be specifically taken up by recipient cells in order to maintain homeostasis and induce a proper response to stress or harsh environmental conditions. Since the heart is part of complex systems which involve various cell types, exosome-mediated communication plays a crucial role in the cardiovascular field. Given the extended studies on the molecular mechanisms mediated by exosome cargos, leading to cardiovascular diseases, we focus on the most important data that report the roles of proteins and microRNAs (miRNAs) transferred by exosomes and whether they possess cardiotoxicity or cardioprotection and also the potential of these biomolecules as therapeutic tools or diagnostic biomarkers.

Systemic sclerosis (SSc) is a rare connective tissue disease characterized by immune dysfunction, vascular damage, and fibrosis affecting the skin and multiple internal organs, such as the cardiovascular and respiratory systems. In some women with preexisting SSc, pregnancy is associated with negative maternal outcomes. Tachyarrhythmia is a common clinical manifestation of cardiovascular damage in SSc patients. However, few studies have reported the use of catheter ablation and an implantable cardioverter defibrillator (ICD) in patients with SSc complicated by ventricular tachycardia (VT). A 19-year-old woman known case of SSc referred to our center with recurrent VT during pregnancy and after delivery. Two-dimensional Echocardiogram showed severe systolic dysfunction with a left ventricular ejection fraction (LVEF) of 30%. Considering, recurrent VT despite medical treatment and the progressive nature of systemic sclerosis radiofrequency catheter (RF) ablation and ICD implantation were performed. We report a case of systemic sclerosis complicated by VT and left ventricular (LV) dysfunction during pregnancy that was successfully treated with RF ablation.

Hypertension is one of the most common comorbidity and the leading cause of cancer-related death in cancer patients. The prevalence of hypertension in cancer patients is much higher than that of the general population. In the older population of cancer patients, specific cancer treatments such as new tyrosine kinase inhibitors and Vascular endothelial growth factor inhibitor drugs give rise to hypertension in cancer patients; The aim of present study is to provide a detailed discussion etiologies of cancer treatment-induced hypertension and explore the most innovative diagnostic and management approaches. This review will address the optimal approach to hypertension treatment, covering treatment initiation thresholds, targets, and the selection of anti-hypertensive agents. The lack of evidence in recent guidelines for managing cardiovascular toxicities in cancer patients can create uncertainty in clinicians' therapeutic and clinical decisions. This review aims to enhance our understanding of hypertension etiology in cancer patients and provide a practical guide to current treatment approaches.

BackgroundThis study examined the perceived barriers of migrants and refugees to vaccinating their children against measles and polio in Iran.MethodsFirst, an instrument was developed and validated through several steps. Next, 1,067 parents who had not vaccinated their children against polio and measles or had delayed receiving any dose of these two vaccines until the age of 15 were selected from 16 provinces and completed the instrument. Finally, the data were analyzed.ResultsThe results of the explanatory factor analysis showed that the perceived barriers affecting vaccination against polio and measles vaccines were categorized into five factors: low knowledge, negative attitude, communication challenges, lack of participation in vaccination programs, and problems related to migration and refugees. Additionally, the results indicated a significant difference in the mean score of perceived barriers based on participants’ level of education, economic status, and nationality.ConclusionThe identified barriers may provide a perspective for developing effective efforts in this area. Interventions should focus on parents with low education and poor economic status.

BackgroundThe aim of the current study is to assess the prevalence of different categories of thyroid dysfunction and their associated risk factors among the modern urban population of Tehran, the capital of Iran.MethodsThe present investigation is a sub-study of the HAMRAH study, a population-based prospective study designed to assess the prevalence of traditional cardiovascular risk factors and their changes through a 10-year follow-up. 2228 (61% female) adults aged between 30 and 75 years old and with no overt cardiovascular diseases were selected through a multistage cluster randomized sampling. Blood levels of thyroid-stimulating hormone (TSH), thyroxin (T4), and triiodothyronine (T3) were measured with the aim of assessing the prevalence of abnormal thyroid function status among the modern urban Iranian population, and in order to report the total prevalence of participants with clinical hypo- or hyperthyroidism, the number of individuals taking thyroid-related drugs were added to the ones with overt thyroid dysfunction. A subgroup analysis was also performed to determine the associated risk factors of thyroid dysfunction.ResultsThe prevalence of thyroid dysfunction among the total population was 7% (95%CI: 5.9 − 8%) and 0.4% (95% CI: 0.1 − 0.6%) for subclinical and overt hypothyroidism, and 1.6% (95% CI: 1 − 2%) and 0.2% (95% CI: 0 − 0.3%) for subclinical and overt hyperthyroidism, respectively. Clinical thyroid dysfunction was detected in 10.3% of the study population (9.4% had clinical hypo- and 0.9% had clinical hyperthyroidism). In the subgroup analysis, thyroid dysfunction was significantly more prevalent among the female participants (P-value = 0.029).ConclusionsIn the current study, the prevalence of different categories of abnormal thyroid status, and also the rate of clinical hypo- and hyperthyroidism was assessed using the data collected from the first phase of the HAMRAH Study. In this study, we detected a higher prevalence of clinical and subclinical hypothyroidism among the Iranian population compared to the previous studies.

The purpose of this study was to assess the connection between FTO rs9939609 (A/T) polymorphism and food preference. The study included 77 participants, 36 of whom were obese and had a low-calorie intake, and 41 non-obese participants with a high-calorie intake. Using a food frequency questionnaire (FFQ), the researchers calculated sweet and fatty food propensity scores. Genomic DNA was extracted from a peripheral blood sample from all participants, and FTO rs9939609 (A/T) polymorphism was assessed using standard methods. The study found no significant differences between the two groups in terms of sweet food preference (15.64 ± 10.53 in obese groups vs. 14.72 ± 7.95 in the non-obese group, p = 0.711) and fatty food preference (16.81 ± 8.84 vs. 17.27 ± 8.75; p = 0.833). Additionally, the study did not find any significant correlation between FTO rs9939609 (A/T) polymorphism and sweet and fatty food preferences in the fully adjusted models (p > 0.05). Therefore, the results of this study do not support the hypothesis of different food preferences.