Ischemic Heart Disease Patients Research Articles

Association between Serum Ferritin and Prognosis in Patients with Ischemic Heart Disease in Intensive Care Units.

Recent years have seen a clear link established between elevated ferritin levels and COVID-19 prognosis. However, the impact of heightened ferritin levels on the prognosis of individuals with severe ischemic heart disease remains uncertain. We utilized the MIMIC IV database to identify a cohort of ischemic heart disease patients who underwent serum ferritin testing. We conducted regression analyses, employed the overlap propensity score weighting model, and utilized the restricted cubic splines model to comprehensively investigate the associations between serum ferritin levels and clinical outcomes. Our cohort included 1173 patients with diagnosed ischemic heart disease, categorized into high and low serum ferritin groups. After meticulous adjustment for confounding factors in a fully adjusted model, the hazard ratios (HRs) for 90-day and 1-year mortality were 1.63 (95% CI: 1.27-2.09) and 1.49 (95% CI: 1.19-1.86), respectively, in the high-ferritin group compared to the low-ferritin group. Subsequent analyses with propensity score weighting confirmed these results. Remarkably, restricted cubic spline analysis revealed an almost linear relationship between log-transformed serum ferritin levels and the risk of both 90-day and 1-year all-cause mortality. Moreover, incorporating ferritin into conventional severity of illness scores significantly improved the area under the curve for both 90-day and 1-year mortality. This study provides compelling evidence regarding the prognostic significance of serum ferritin in predicting 90-day and one-year mortality rates among patients diagnosed with ischemic heart disease.

Research progress of NF-κB signaling pathway and thrombosis.

Venous thromboembolism is a very common and costly health problem. Deep-vein thrombosis (DVT) can cause permanent damage to the venous system and lead to swelling, ulceration, gangrene, and other symptoms in the affected limb. In addition, more than half of the embolus of pulmonary embolism comes from venous thrombosis, which is the most serious cause of death, second only to ischemic heart disease and stroke patients. It can be seen that deep-vein thrombosis has become a serious disease affecting human health. In recent years, with the deepening of research, inflammatory response is considered to be an important pathway to trigger venous thromboembolism, in which the transcription factor NF-κB is the central medium of inflammation, and the NF-κB signaling pathway can regulate the pro-inflammatory and coagulation response. Thus, to explore the mechanism and make use of it may provide new solutions for the prevention and treatment of thrombosis.

Microscope-assisted coronary artery bypass grafting in diffuse coronary artery disease: immediate and mid-term results

Background: In recent years, a typical candidate for coronary artery bypass grafting (CABG) has become a patient with complex, multivessel coronary artery disease (CAD), often with an unsatisfactory and small distal bed. The prevalence of diffuse CAD is 4.2%-46.0%, and the CABG refusal rate due to this disease accounts for 1.3%-15.0%. Diffuse CAD is an independent predictor of mortality and poor prognosis after CABG. Due to a lack of uniform criteria for diffuse CAD and randomized trials, there is no preferred surgical treatment option for such patients.Objective: To evaluate immediate and mid-term results of microscope-assisted CABG in patients with ischemic heart disease and diffuse CAD.Methods: We calculated a diffuseness score and determined whether the criterion of diffuse lesion by SYNTAX score was met. For our retrospective study we selected 187 ischemic heart disease patients with 3-vessel CAD who underwent microscope-assisted CABG. A coronary lesion with a diffuseness score of >18 was considered diffuse if the SYNTAX score criterion was met for each of the main coronary arteries. The patients were divided into 2 groups: group 1 for patients with diffuse CAD (n = 60) and group 2 for patients with CAD that did not meet the criterion to be considered diffused (n = 127). The propensity score matching was used to reduce differences between the groups. The primary end point was death from any cause; the secondary end points were adverse cardiovascular events (death from cardiac causes, myocardial infarction, repeated revascularization, acute cerebrovascular accident) and angina.Results: No significant differences in the frequency of in-hospital specific and nonspecific complications were found. The frequency of achieved complete revascularization was comparable between the groups. There were no significant differences in the long-term survival, adverse cardiovascular events, and freedom from angina during the median follow-up of 39 months (min 1 month; max 60 months). The univariate analysis after the propensity score matching showed that diffuse CAD was not a significant predictor of death from any cause [hazard ratio (HR), 1.141; 95% CI, 0.348-3.742; P = .83], adverse cardiovascular events [HR, 0.940; 95% CI, 0.425-2.078; P = .88], and angina [HR, 0.817; 95% CI, 0.394-1.696; P = .59]. The multivariate analysis revealed no significant association between diffuse CAD and death from any cause both before [HR, 1.382; 95% CI, 0.396-4.815; P = .61] and after propensity score matching [HR, 2.079; 95% CI, 0.158-27.422; P = .58]. We found that within 60 months after CABG, the risk of death from any cause was increased: by patient’s age [HR, 1.166; 95% CI, 1.043-1.303; P = .007], male sex [HR, 5.583; 95% CI, 1.062-29.344; P = .042], and diabetes mellitus [HR, 3.673; 95% CI, 1.143-11.805; P = .029] before the propensity score matching and by patient’s age [HR, 2.055; 95% CI, 1.028-4.104; P = .041] and cardiopulmonary bypass time [HR, 1.190; 95% CI, 1.014-1.397; P = .033] after the propensity score matching.Conclusion: Microscope-assisted CABG in patients with diffuse CAD can achieve satisfactory immediate and mid-term results. We found no association between diffuse CAD and the risk of adverse events. Received 30 January 2023. Revised 29 June 2023. Accepted 5 July 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: A.N. Semchenko Data collection and analysis: A.M. Shevchenko, I.V. Zaicev, A.V. Semchenko, T.B. VnukovaStatistical analysis: A.N. SemchenkoDrafting the article: A.N. Semchenko, I.V. ZaicevCritical revision of the article: A.M. Shevchenko, A.V. Semchenko, T.B. VnukovaFinal approval of the version to be published: A.N. Semchenko, A.M. Shevchenko, I.V. Zaicev, A.V. Semchenko, T.B. Vnukova

Prediction of therapy for ischemic heart disease from PPG signals using fuzzy GRU network

BackgroundCardiac morbidity like ischemic heart disease (IHD) causes global mortality. Diagnosis of IHD requires coronary angiograms — an invasive, sophisticated, and expensive procedure. However, non-invasive methods could not gain much confidence in swift diagnosis of IHD patients. These potential issues provided the research motivation for diagnosing IHD priorly in this pilot study. ObjectiveA computer-aided technique, as an alternate method to fasten and ease IHD detection and categorization, has been suggested in this cohort study. Here, the classification was conducted by a sandwich model of GRU and fuzzy logic in a deep GRU Fuzzy network. MethodsIn this work, photoplethysmography (PPG) signals were acquired from 355 IHD patients. Gabor–Winger transform was used to derive signal features using statistical identities. Analysis was done with a Fuzzy GRU Network comprising GRU and BiGRU layers with fuzzy layers. An algorithm was designed with a Rete network and three membership functions to deduce fuzzy inference. Then, Choquet Integral was used for defuzzification. ResultsThe proposed network predicted results with 0.85 accuracy, 0.86 recall, 0.84 precision, 0.86 sensitivity, 0.78 Micro-averaged F1-score, and 0.84 specificity. The network architecture was validated using ablation and comparative studies. The PRC and ROC curves gave the highest values of 0.91 AP and 0.90 AUC, respectively for this network. A state-of-the-art study was done to show the superiority of the technique. ConclusionThis computer-aided model using PPG might become a tool in predicting the type of therapy for IHD patients which will provide a non-invasive, inexpensive, and fast mode of diagnosis.

Registry of Ischemic Heart Disease Patients in the Region of Mid Delta, Egypt Data Base and Quality Initiative Project

Background: Cardiovascular diseases are significant contributors to global increased mortality rates. coronary artery disease (CAD) is the most common cause of heart disease globally.
 Aims: Detection of the characteristics [clinical, electrocardiographic, echocardiographic and coronary angiographic] of ischemic heart disease patients in Med Delta region in Egypt and also their management plan.
 Methodology: The registry included 1000 patients of ischemic heart disease (IDH) at Med Delta Region. All patients underwent full medical history, full cardiac examination, detection of ECG changes, cardiac enzymes, other labs, Echocardiography and coronary angiography
 Results: Out of 1000 patients studied 72.1% had chronic coronary syndromes and 27.9% had acute coronary syndrome. Seven hundreds and sixty-seven (76.7%) were known to have hypertension and 725 (72.5%) patients were smokers. left anterior descending artery (LAD) was diseased in 54.9 % of the patients. Single vessel disease was affected in 61.7%, 21.5% had double vessel disease and about 16.8 % had multi vessel disease.
 Conclusion: Chronic coronary syndrome was the most common presentation in the studied patients with hypertension being the most prevalent risk factor and LAD was the mostly affected vessel.

Relationship between Lipid Profile and Thyroid Disturbance and Ischemic Heart Disease in Iraqi Patients

The current study is a case-control study conducted in Baghdad city between 1st of January to the end of, 2023. The study focused on patients admitted to the Coronary Care Unit of Ibn Al Nafees Hospital and Ibn Al Bitar Hospital in Baghdad. And Alyarmok Hospital in Baghdad. The study included 60 Iraqi patients with coronary heart disease, ranging in age from 37 to 66 years. A control group of 30 apparently healthy individuals (15 men and 15 women) was included in the study. The control group was matched with the patients in terms of gender and age to improve the accuracy of the results. Blood samples were collected from both patients and control individuals after 12 hours of fasting. Biochemical colorimetric methods by spectrophotometer were used to determine total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), and Immunofluorescence technique by Afias was used to determine triiodothyronine (T3), thyroxine (T4), and TSH levels and HbA1C levels in the blood. The study analyzed the demographic characteristics of patients with ischemic heart disease (IHD) and the control group, including age groups, sex distribution, and BMI. The majority of IHD patients were non-smokers, with 26.67% being smokers and the majority being non-smokers. The majority of IHD patients had hypertension, while 58.33% had diabetes. The cholesterol levels in IHD patients were significantly higher than the control group, with a p-value of 0.001. The triglyceride levels were also significantly elevated in IHD patients, with a p-value of 0.001. LDL-c levels were significantly elevated in IHD patients, while very low-density lipoprotein cholesterol (VLDLc) levels were significantly elevated in IHD patients. IHD patients had significantly higher T3 levels (1.701 ± 1.21) than the control group (0.87 ± 0.16), suggesting potential differences. T4 levels were also significantly higher in IHD patients with thyroid dysfunction (106.7 ±86.5) compared to the control group (78.5 ±13.65). On the other hand, TSH levels did not show a significant difference between IHD patients with thyroid dysfunction (3.29 ± 2.55) and the control group (3.18 ±2.078). The study found no significant differences in thyroid function parameters among the different age groups of individuals with hypothyroidism. The mean T3 level in the 40-49 age group was 0.49±0.02, the mean T4 level was 43.5±0.7, and the mean TSH level was 4.88±0.38. For the 50-59 age group, the mean T3 level was 0.36±0.17, the mean T4 level was 44.6±0.54, and the mean TSH level was 5.41±1.07. In the >59 age group, the mean T3 level was 0.51±0.03, the mean T4 level was 45.8±6.9, and the mean TSH level was 5.24±0.66. The study showed that hypothyroidism IHD patients tend to be associated with higher levels of cholesterol, triglycerides, LDL-c, and VLDL-c. The highest prevalence of hyperthyroidism among individuals with hypertension was 72.73%, while the highest spread was seen in hypothyroidism among individuals with diabetes. The highest mean value for HbA1c was observed in patients with hypothyroidism (6.99±0.82%), followed by patients with hyperthyroidism (6.46±0.51), and the lowest mean value was seen in patients with normal thyroid function (4.36±0.56%). These differences in mean HbA1c levels among the three groups are statistically significant, as indicated by the p-value: of 0.017.

TRANSLATION, CROSS-CULTURAL ADAPTATION, AND DEVELOPING MALAY QUESTIONNAIRES TO MEASURE HEALTH EMPOWERMENT FOR PATIENTS WITH ISCHAEMIC HEART DISEASE (IHD): A VALIDATION STUDY

A multifaceted approach is needed to treat ischaemic heart disease (IHD) patients and improve their overall quality of life. This study aims to translate, cross-culturally adapt and validate questionnaires exploring the multifactorial health empowerment component among IHD patients. This process involved: 1) Adaptation of conceptualising applicable questionnaires; 2) Translation; 3) Cultural adaptation of forward and backward translations; and 4) Pre-tested validation by experts (n=5) and piloted among participants (n=30). Content validity revealed that I-CVI and S- CVI were both 0.98, indicating that the questionnaire items were understandable and relevant. An FKI of 0.87 supported experts’ agreements. Cronbach alpha values ranged from 0.696–0.977 for each construct. Further reinforced by Rasch analysis, an overall Cronbach alpha of 0.87 indicated adequate internal consistency. Data fitted the model, as evidenced by Infit values of mean square (MNSQ) near 1, and Z standard (ZSTD) values near 0. An item reliability of 0.97 indicated that the anticipated items were correctly measured, and an item separation of 5.78 suggests a high degree of separation with precise measurement. A Person separation of 2.38 revealed the capacity to distinguish the participants in the agreement of the questionnaires. Rating scales between -3.54 and 2.77 demonstrated a strong separation of scales. A raw variance explained by measures of 68.3%, unexplained variance in 1st contrast with Eigenvalue 9.98 and noise level of 13.2% demonstrated the instrument is operating as intended. The Perceived Severity to Chronic Disease, Health Consciousness, eHealth Literacy and Patient Adherence questionnaires were valid and reliable tools to be administered and explore the multifactorial component in empowering health among IHD patients.

Anti-SARS-Cov-2 IgG Antibody Response in COVID- 19 Ischemic Heart Disease Patients

Background: Coronavirus disease-2019 (COVID-19), a contagious disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has reached pandemic status, overwhelmed health care systems, strangled the global economy, and led to a devastating loss of life. The presence of cardiovascular comorbidities in COVID-19 patients acts as risk factor for disease severity and is associated with higher rates of cardiac injury, cardiac attack, intensive care unit admission and high mortality. Without pre-existing cardiovascular comorbidities, COVID-19 itself can cause serious heart damage. Serum Anti-SARS-CoV-2 IgG estimation is an important tool for monitoring of COVID-19 patients. Objectives: To assess post COVID-19 Anti-SARS-CoV-2 IgG antibody response in Ischemic heart disease patients. Method: This cross-sectional analytical study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka during the period of January 2021 to December 2021. For this study, a total number of 70 diagnosed COVID-19 patients with or without IHD, were selected according to inclusion and exclusion criteria from Cardiology Department (OPD and Indoor) and Post COVID-19 Follow-up Clinic of Dhaka Medical College Hospital, Dhaka. Among 70 subjects, 35 were post COVID-19 with IHD patients (Cases in group-A) and 35 were post COVID-19 without IHD patients (Comparison group in Group-B). By using safety measures, informed written consent was taken from each patient and venous blood sample was collected for estimation of serum Anti-SARS-CoV-2 IgG level. The results were compared statistically between two groups and the significance was defined as p<0.05. Results: Mean ± SD years of age of the subjects in group-A and Group-B were 57.62 ± 11.32 years and 54.14 ± 11.29 years respectively. Majority of patients were in >60 year’s age group followed by 51-60 years. The serum Anti-SARS-CoV-2 IgG level was significantly higher in group-A than Group-B (Median [IQR]: 10786.5 ......

Fibroblast Gross Factor-23 and Carotid Artery Stiffness in Hemodialysis Patient

Abstract Background FGF23 is a free circulating hormone secreted by osteocytes affecting mainly phosphate metabolism as it inhibits its renal tubular reabsorption by suppressing the expression of luminal sodium-phosphate co –transporters (Na Pi). Aim of the Work Aim of study is to verify the usefulness of FGF23 as a marker for diagnosis of arterial stiffness in CKD patients on regular hemodialysis (3 sessions per week, 4 hours each). Patients and Methods The present study enrolled 30 living end stage renal disease patients on regular hemodialysis randomly selected from hemodialysis unit at Ain Shams University hospitals after exclusion of patients of known cardiovascular disease or ischemic heart disease, also patients of age below 18 years and above 50 years were excluded as well as patients having arterio venous fistulas on both arms. All patients were subjected to complete medical history taking, including (Age, Sex, Etiology of chronic kidney disease, drugs and duration of dialysis), and detailed clinical examination was done. Results In this study patients have elevated serum levels of FGF-23 ranging from 100 up to 700 pg/ml. when the normal reference range is 18-108 pg/ml. Also our study result revealed a statistical significance of negative correlation between FGF-23 and diabetes mellitus duration, serum phosphorous, corrected calcium and estimated glomerular filtration rate as well. The current study shows statistical correlation of positive significance between FGF-23 and hypertension duration where, common carotid artery intima media thickness as well as present plaques in common carotid artery. Moreover there is no statistical significant correlation between FGF-23 and pulse pressure. Conclusion FGF23 serum levels are markedly elevated in chronic kidney disease CKD and among patients on regular hemodialysis causing arterial stiffness.

Probing Evidence of Cerebral White Matter Microstructural Disruptions in Ischemic Heart Disease Before and Following Cardiac Rehabilitation: A Diffusion Tensor MR Imaging Study.

Ischemic heart disease (IHD) is linked to brain white matter (WM) breakdown but how age or disease effects WM integrity, and whether it is reversible using cardiac rehabilitation (CR), remains unclear. To assess the effects of brain aging, cardiovascular disease, and CR on WM microstructure in brains of IHD patients following a cardiac event. Retrospective. Thirty-five IHD patients (9 females; mean age = 59 ± 8 years), 21 age-matched healthy controls (10 females; mean age = 59 ± 8 years), and 25 younger controls (14 females; mean age = 26 ± 4 years). 3 T diffusion-weighted imaging with single-shot echo planar imaging acquired at 3 months and 9 months post-cardiac event. Tract-based spatial statistics (TBSS) and tractometry were used to compare fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in cerebral WM between: 1) older and younger controls to distinguish age-related from disease-related WM changes; 2) IHD patients at baseline (pre-CR) and age-matched controls to investigate if cardiovascular disease exacerbates age-related WM changes; and 3) IHD patients pre-CR and post-CR to investigate the neuroplastic effect of CR on WM microstructure. Two-sample unpaired t-test (age: older vs. younger controls; IHD: IHD pre-CR vs. age-matched controls). One-sample paired t-test (CR: IHD pre- vs. post-CR). Statistical threshold: P < 0.05 (FWE-corrected). TBSS and tractometry revealed widespread WM changes in older controls compared to younger controls while WM clusters of decreased FA in the fornix and increased MD in body of corpus callosum were observed in IHD patients pre-CR compared to age-matched controls. Robust WM improvements (increased FA, increased AD) were observed in IHD patients post-CR. In IHD, both brain aging and cardiovascular disease may contribute to WM disruptions. IHD-related WM disruptions may be favorably modified by CR. 3 TECHNICAL EFFICACY: Stage 2.

Predictive performance of CHA2DS2-VASc-HS score and Framingham risk scores for coronary disease severity in ischemic heart disease patients with invasive coronary angiography.

OBJECTIVE: The objective of this study was to determine the predictive performance and compatibility of CHA2DS2-VASc-HS scores and Framingham risk scores (FRS) in patients with coronary angiography. PATIENTS AND METHODS: This cross-sectional analysis study enrolled 98 patients with ischemic heart disease who were indicated for invasive coronary angiography. Sensitivity and specificity were determined using the cut-off values of the ROC curve. The Gensini score was used to evaluate the correlation. RESULTS: The cut-off value of the Congestive heart failure, hypertension, age 75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category - hyperlipidemia, smoking (CHA2DS2-VASc-HS) score was 2.5, and for FRS, it was 14.5. The area under the curve (95% CI) for the CHA2DS2-VASc-HS score and FRS were 0.76 (0.66, 0.85) and 0.80 (0.71, 0.85), respectively. For every 1-point increase in the CHA2DS2-VASc-HS score, the Gensini score increased by 0.44 (r = 0.56; R2 = 0.19, Beta = 0.44, p < 0.01), and the number of stenosis coronary branches increased by 0.55 (r = 0.56; R2 = 0.30, Beta = 0.55, p < 0.01). For every 10-point increase in FRS, the Gensini score increased by 3.8 (r = 0.57; R2 = 0.14, Beta = 0.38, p < 0.01), and the number of stenosis coronary branches increased by 5 (r = 0.53; R2 = 0.25, Beta = 0.5, p < 0.01). CONCLUSIONS: Our study demonstrated a high predictive performance of coronary artery injury using the CHA2DS2-VASc-HS score and Framingham risk scores. These scores could be applied in predicting ischemic heart disease in non-symptomatic cases where invasive coronary angiography is not indicated.

Effects of cardiac rehabilitation on inflammatory biomarkers in unstable ischemic heart disease patients following percutaneous coronary intervention: A randomized controlled study

Effects of cardiac rehabilitation on inflammatory biomarkers in unstable ischemic heart disease patients following percutaneous coronary intervention: A randomized controlled study

A higher probability of subsequent stroke and ischemic heart disease in migraine patients: a longitudinal follow-up study in Korea

BackgroundWhether migraine is related to the risk of cardiovascular diseases (CVDs) remains unclear. Therefore, we conducted a longitudinal follow-up study to address the association between migraine and the development of CVDs in Korea.MethodsUsing data from the national health screening cohort, we included 45,246 patients diagnosed with migraine between 2002 and 2019 and age-, sex-, income-, and residential region-matched nonmigraine participants at a ratio of 1:4. Participants with previous CVDs were excluded. Cox proportional hazards regression models were used to estimate the hazard ratios of three CVDs, stroke, ischemic heart disease, and heart failure, in patients with migraine after adjusting for potential cardiovascular risk factors.ResultsThe incidence rate differences of stroke, ischemic heart disease, and heart failure among patients with migraine were 2.61, 1.69, and 0.11, respectively. The probability of developing stroke and ischemic heart disease in patients with migraine was significantly higher than that in controls after controlling for multiple confounders (adjusted hazard ratio [HR] = 1.35, 95% confidence interval [CI] = 1.31–1.39 and adjusted HR = 1.31, 95% CI = 1.26–1.35, respectively). However, when compared with the patients without migraine, patients with migraine did not have an increased HR of developing heart failure (adjusted HR = 1.01, 95% CI = 0.95–1.08). The overall migraine group, as well as groups stratified by migraine subtypes with and without aura, each showed a significantly higher probability of subsequent stroke and ischemic heart disease than the control group.ConclusionsOur longitudinal follow-up study demonstrated a significant association between the presence of migraine and the development of stroke and ischemic heart disease in Korea, even after adjusting for cardiovascular risk factors.

Frank's sign associated with the severity of ischemic heart disease in patients under 65 years old

Background and objectiveFrank's sign is the diagonal ear fold which has been associated with ischemic heart disease. The objective of this work was to evaluate the relationship of Frank's sign with severity of ischemic heart disease in adults ≤ 65 years old in the northeast of Mexico. Patients and methodsA cross-sectional study was conducted in patients ≤ 65 years old who underwent coronary angiography consecutively over a period of 5 months in 2022. Severe coronary artery disease (CAD) was associated with Frank's sign and other common cardiovascular risks. To determine the association, bivariate and multivariate analysis was performed using logistic regression that included variables with a value of p<0.05. Statistical analysis was performed with SPSS version 22. ResultsWe included 311 patients ≤ 65 years, of whom 80% were men. The median age was 57 years (range 28–65). Frank's sign was positive in 62% of the population. The main clinical characteristics in patients with Frank's sign were type 2 diabetes mellitus (55%), p=0.003, dyslipidemia (53%), p=0.026 and smoking (68%), p=0.002.In the multivariate analysis, the independent variables associated with severe CAD were Frank's Sign OR 3.26; 95% CI (1.98–5.38), p≤0.001, male gender OR 2.28; 95% CI (1.20–4.35), p=0.012, and dyslipidemia OR 1.81; 95% CI (1.11–2.97), p=0.017. ConclusionsThere is an independent association between Frank's sign with the presence of severe CAD in patients ≤ 65 years old, which may be useful for screening and prevention.

Assessment of clinical and social aspects of the course of coronary heart disease after coronary bypass graphing according to the International Classification of Functioning, Disabilities and Health

BACKGROUND: It has been established that the prognosis of ischemic heart disease patients after myocardial revascularization depends on the presence of comorbid pathology, which includes, in addition to cardiovascular and non-cardiac, low physical activity as well as the patients social status and environmental barriers. The use of the international classification of functioning in this category of patients makes it possible to assess the severity of the impairment of the structures and functions of the organs and systems involved in the process as well as the role of social, personal and contextual environmental factors necessary for the implementation of a comprehensive rehabilitation program.&#x0D; AIM: To study structural and functional changes in the cardiovascular system and other organs and systems of the body based on clinical and expert parameters and the International Classification of Functioning, Disabilities and Health, the need for social protection measures, the main directions of complex rehabilitation of patients with coronary heart disease after coronary artery bypass grafting.&#x0D; MATERIALS AND METHODS: The study included 221 patients with severe coronary artery disease requiring myocardial revascularization. All the patients have been examined after coronary bypass surgery in the Bureau of Medical and Social Expertise in Saint Petersburg and recognized as disabled by the third group. The amount of surgical intervention in the patients was different; in most cases (55%) 3 coronary bypass grafts have been inserted. Comorbidity has been assessed according to the Charltson and Kaplan Feinstein indices.&#x0D; RESULTS: High frequency of comorbid pathology has been revealed; the most common are cardiovascular diseases, less common lung diseases, the diseases of the musculoskeletal system, diabetes mellitus. The value of the Kaplan Feinstein index was 10.08 0.25; Charlson index 6.50 0.16. In addition to structural disorders of the cardiovascular system, moderate dysfunctions of the respiratory and digestive systems, and metabolism have been determined. Violations of the functions and structures of the body led to restrictions on the categories of life activity: the ability to self-service in 85.07%, independent movement in 81.90%, labor activity in 100%. Among the domains of the international classification of functioning that characterize activity and participation, problems with paid labor activity (100%), movement, housework, and recreation have been identified.&#x0D; CONCLUSIONS: The study expands the understanding of the frequency of comorbid pathology of disabled people due to coronary artery disease, its impact on prognosis and the development and implementation of an individual rehabilitation program. The international classification of functioning allows to assess the severity of functional and structural changes, disability as well as to determine the need for social protection measures in patients with coronary artery disease.

Cell sheet transplantation for ischemic heart disease: a systematic review.

Cell sheet transplantation is emerging as an appealing alternative for ischemic heart disease patients as it potentially can increase stem cell viability and retention. But the outcomes and safety of this treatment are still limited in literature and the result varies widely. We conduct a systematic review to look at the efficacy and safety of this promising transplantation method. A systematic review was performed according to PRISMA guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, and Embase databases. Articles were thoroughly evaluated and analyzed. Seven publications about cell sheet transplantation for ischemic heart disease patients were included. The primary outcomes measured were left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) class. Safety measurement was depicted by cardiac-related readmission and deaths. The follow-up time ranged from 3 to 36months for clinical outcomes and 8.5years for safety outcomes. Cell sheet transplantation showed improvement in LVEF and NYHA class in most studies. Cardiac-related readmission and adverse events of cell sheet transplantation range from 0 to 30.4%, all were nonfatal as no cardiac-related death was reported. Patient preoperative status seems can affect the patient's response to cell sheet therapy. Cell sheet transplantation can safely improve LVEF and NYHA class in ischemic heart disease patients, even in very low ejection fraction patients with unsuccessful standard therapy before. Further studies with better patient inclusion, larger population, and long-term follow-up required to confirm these results.

Exploring the Role of Human Endothelial Nitric Oxide Synthase (eNOS) in Ischemic Heart Disease (IHD)

Background: Ischemic heart disease, also called coronary artery disease, is the term given to heart problems caused by narrowed heart (coronary) arteries that supply blood to the heart muscle. Aim of the Study: The aim of the study is to determine the levels of Nitric oxide synthase (eNOS) in patients with coronary artery disease. Patients and Methods: The current study is case-control study conducted in Tikrit city during the period between 10th of January to 10th of April 2023 on patients admitted to Coronary Care Unit of Salah Al-Din Teaching Hospital The study included 60 Iraqi patients with coronary heart disease with age range (37-66 years). The study also included 30 healthy individuals with same age range and from both sexes who apparently haven’t any acute or chronic diseases. Blood was collected from each patients for determination Nitric oxide synthase by enzyme-linked immunosorbent assay (ELISA) and lactate dehydrogenase (LDH) by chemiluminence technique. Results: The study showed that lowest mean of Human Endothelial Nitric Oxide Synthase (eNOS) was detected among IHD patients (2.41±0.74 ng/ml) and the maximum mean was within the control group (5.15±1.24 ng/ml). The differences were highly significant (P-value: 0.0001). The study confirmed that the peak mean of lactate dehydrogenase was detected among IHD patients (257.8±94.9 IU/L) and the deepest mean was in the control group (168.9±16.8 IU/L). The differences were highly significant (P-value: 0.0001). The study showed that the mean eNOS was 2.17 ng/ml in patients with hypertension, which was significantly lower than that in non-hypertensive IHD patients (2.76 ng/ml), at a P value of 0.024. The study showed that the mean LDH was 284.6 IU/L in patients with hypertension, which was significantly more than that in non-hypertensive IHD patients (217.5 IU/L), at a P value of 0.001. Conclusions: In conclusion, the findings of the study suggest that patients with ischemic heart disease (IHD) have reduced levels of serum eNOS compared to healthy individuals. More researches are needed to fully understand the relationship among eNOS, cardiovascular disease and to determine the clinical utility of their measuring in the diagnosis and management of these conditions.

Serum Leptin in Ischemic Heart Disease Patients with and without Significant Diastolic Dysfunction in Lean and Obese Patients; Cross-Sectional Study

Serum Leptin in Ischemic Heart Disease Patients with and without Significant Diastolic Dysfunction in Lean and Obese Patients; Cross-Sectional Study

Implications of a Novel Modified Strategy for Combined Coronary Artery Bypass Grafting and Mitral Valve Replacement for Ischaemic Heart Disease Patients

Implications of a Novel Modified Strategy for Combined Coronary Artery Bypass Grafting and Mitral Valve Replacement for Ischaemic Heart Disease Patients

Comparison Study between Three Analgesic Techniques in Ischemic Heart Disease Patients Undergoing Hip Replacement Surgeries

Comparison Study between Three Analgesic Techniques in Ischemic Heart Disease Patients Undergoing Hip Replacement Surgeries