An echocardiographic study of heart in a group of male adult elite athletes

Background: Severe and prolonged physical training is associated with morphological and physiological cardiac changes, often termed as the "athlete's heart". Echocardiographic features peculiar to elite Iranian athletes have not been previously described. The aim was to examine the echocardiographic characteristics of highly trained Iranian athletes involved in three different sports. Methods: We studied cardiac morphology and function as assessed by rest echocardiography in 50 elite adult male athletes referring to a university hospital in Tehran between February 2001 and March 2006 Resting ejection fraction, interventricular septal wall thickness (IVSWT), left ventricular posterior wall thickness (LVPWT), left ventricular internal end diastolic dimension (LVEdD), left ventricular internal systolic dimension (LVIsD), left ventricular (LV) mass, and relative wall thickness (R W7) were measured The control group consisted of 50 age- and weight-matched normal healthy men. Results. Of the athletes, 38 were engaged in predominantly dynamic (running and soccer) and 12 in predominantly static (weightlifting) sports. The overall mean LVEdD (5I.06±5.49mm) and IVSWT (10.24±1.43mm) were higher in the athletes than those in the normal subjects. The mean of IVSWT in the 38 endurance-trained athletes was significantly more than that of the 12 strength-trained athletes (11.1 mm vs. 10.3 mm, P<0.05). LVEdD was also greater in the endurance-trained athletes, but he difference was not statistically signficant (51.2 mm vs. 50.6 mm). Conclusion: Our results of higher LVEdD and IVSWT in Iranian male athletes are in line with previous reports. To generalize the results, we require more studies with larger sample sizes (with female athletes included)

Next generation sequencing applications for cardiovascular disease

The Human Genome Project (HGP), as the primary sequencing of the human genome, lasted more than one decade to be completed using the traditional Sanger�s method. At present, next-generation sequencing (NGS) technology could provide the genome sequence data in hours. NGS has also decreased the expense of sequencing; therefore, nowadays it is possible to carry out both whole-genome (WGS) and whole-exome sequencing (WES) for the variations detection in patients with rare genetic diseases as well as complex disorders such as common cardiovascular diseases (CVDs). Finding new variants may contribute to establishing a risk profile for the pathology process of diseases. Here, recent applications of NGS in cardiovascular medicine are discussed; both Mendelian disorders of the cardiovascular system and complex genetic CVDs including inherited cardiomyopathy, channelopathies, stroke, coronary artery disease (CAD) and are considered. We also state some future use of NGS in clinical practice for increasing our information about the CVDs genetics and the limitations of this new technology.Key messages Traditional Sanger�s method was the mainstay for Human Genome Project (HGP); Sanger sequencing has high fidelity but is slow and costly as compared to next generation methods. Within cardiovascular medicine, NGS has been shown to be successful in identifying novel causative mutations and in the diagnosis of Mendelian diseases which are caused by a single variant in a single gene. NGS has provided the opportunity to perform parallel analysis of a great number of genes in an unbiased approach (i.e. without knowing the underlying biological mechanism) which probably contribute to advance our knowledge regarding the pathology of complex diseases such as CVD. © 2017 Informa UK Limited, trading as Taylor & Francis Group

Red cell distribution width and severe left ventricular dysfunction in ischemic heart failure

Objective: The red cell distribution width (RDW), a simple and widely available marker, has been linked with an increased risk of adverse outcomes in patients with heart failure (HF) and risk of death, and cardiovascular events in those with previous myocardial infarction, but its relation with the severity of left ventricular (LV) dysfunction is not fully investigated. The aim of this study was to assess the prognostic value of the RDW in post myocardial infarction patients with typical signs and symptoms of HF and with reduced LV ejection fraction (EF). Methods: Patients (n = 350) came from an ongoing registry of consecutive patients who admitted for ischemic heart disease at our center. All patients were followed up 1 year after the initial hospitalization by telephone interviews. The outcomes studied were mortality and hospitalization because of decompensated HF. Results: RDW-coeffcient of variation (express in percentage) was calculated from SD of mean corpuscular volume and mean corpuscular volume itself. Using logistic regression analysis, 3 variables consisting age, RDW level, and hemoglobin were identifed as independent predictors of severe LV dysfunction (LVEF <30). Levels of RDW were associated with the presence of severe LV dysfunction, with an accuracy of 61.4 (95 confdence interval: 56.2-66.4) and 66.9 (95 confdence interval: 61.8-71.6), using cut-off values of higher than 13.5 and 13.8, respectively. Conclusion: Our results suggest that elevated RDW may be used as a prognostic tool among HF patients with the documented myocardial infarction because it is an inexpensive, rapidly calculated test that is already routinely in use in practice. © 2016 Wolters Kluwer Health, Inc. All rights reserved

The association between CYBA gene C242T variant and risk of metabolic syndrome

Background: Both inflammation and oxidative stress may contribute to pathogenesis of metabolic syndrome (MetS). The C242T polymorphism (rs4673) in the CYBA gene, as the main components of NAD (P) H oxidase, causes inter-individual variability in the enzyme activity. We aimed to investigate the association between this polymorphism with MetS and its components. Methods: Two hundred nine patients with MetS and 232 controls were included in this study. MetS was defined based on NCEP ATP-III A criteria with some modifications. The C242T polymorphism within CYBA gene was determined by using PCR-based restriction fragment length polymorphism (PCR-RFLP) method. Results: After applying a multiple logistic regression model with adjusting for potential confounders of MetS including, age, sex, body mass index, hypertension, used medications, and diabetes mellitus, C242T polymorphism was found to be associated with the presence of MetS in men but not in the total population or in women. T allele as compared to C allele was associated with decreased odds of MetS in men (adjusted OR = 0.42, 95 CI = 0.24-0.74; P =.003), but not in women (adjusted OR = 1.03, 95 CI = 0.07-1.61; P =.890), or in the total population (adjusted OR = 0.72, 95 CI = 0.51-1.02; P =.063). Conclusion: This study shows that T allele of C242T polymorphism in CYBA gene is protective against MetS in Iranian men but not in women. Further cohort studies with larger sample size in subgroups of men and women are required to confirm such association in other racial or ethnic group. © 2020 Stichting European Society for Clinical Investigation Journal Foundatio

NQO1 C609T Polymorphism is Associated with Coronary Artery Disease in a Gender-Dependent Manner

Findings on the association of NQO1 C609T polymorphism in the NQO1 gene and cardiovascular disease susceptibility are controversial. The objective of the current study was to examine the relationship between this polymorphism and the presence and severity of angiographically determined coronary artery disease (CAD). One-hundred and forty-five patients with newly diagnosed angiographically documented CAD (≥50 % luminal stenosis of any coronary vessel) as case group were compared to 139 controls (subjects with no luminal stenosis at coronary arteries). The presence of C609T polymorphism was analyzed using polymerase chain reaction-based restriction fragment length polymorphism. Among total population, those with combined CT/TT (T allele carrier) genotype showed a trend toward lower odds of CAD compared to those with CC (wild type) genotype, but it did not reach a statistically significant level (p = 0.061). When data were analyzed separately for men or women, CT + TT group as compared to CC genotype was associated with decreased odds of CAD in women (adjusted OR 0.4, 95 % CI 0.2-0.9; p = 0.043), but not in men (adjusted OR 0.8, 95 % CI 0.3-1.9; p = 0.612). The C609T polymorphism within NQO1 is independently associated with CAD in women, but no association was observed in whole study population or in men

Learning from OCTET - Exploring the Acceptability of Clinical Trials Management Methods

Background Conducting research can be time consuming, difficult and challenging. Guidance and pragmatic advice focusing on randomised controlled trial conduct are available but do not necessarily constitute comprehensive guidance. A successful trial is one that recruits to time and target and collects high quality data within the originally agreed budget. Standardised trial management tools have outlined key project management elements for a successful trial as a method of ensuring good practice in research trials: initiation, planning, execution, monitoring, and closure. Lessons are also frequently learnt during the development and conduct of trialsbut rarely shared for the benefit of others. For the wider research team, the key focus will always be on the execution and delivery of a study. The aim of this study was to evaluate the acceptability of clinical trials management methods, focusing on study execution and monitoring, as implemented in the National Institute for Health Research Health Technology Assessment Programme funded Obsessive Compulsive Treatment Efficacy Trial (OCTET). Methods Workshops, questionnaires and semi-structured interviews were used to explore acceptability of trial management methods with members of the OCTET Trial research team. Nine members participated in the focus group, 10 completed a questionnaire and 20 were interviewed as part of qualitative work for the main OCTET study. Data was collected and analysed using thematic analysis. Results Six key themes were identified: support; communication; processes; resources; training and ethos. Clear and open communication,enthusiasm and accessibility of the trial managers and Chief Investigator were consistently noted as an important facet of the successful running of the trial. Clear resources and training materials were also found to be crucial in helping staff to work within the trial setting. Constructive suggestions were also made for improvement of these resources, for example including both checklists and flowcharts within trial processes. Conclusion Organisation, openness, and positivity are crucial for executing a trial successfully, whilst clear and focused processes and resources are essential in monitoring and controlling the trial progress. Although derived from a single study, these findings are likely to be applicable to the successful conduct of all trials. Trial managers should consider developing these elements when setting up a study. Trial Registration: Clinical Trial Registry: ISRCTN73535163, Date of Registration: 05.04.2011, Prospective registration. Key Words: Randomised controlled trial, project management, trial management, qualitativ