Contribution of diet and major depression to incidence of acute myocardial infarction (AMI)

<p>Abstract</p> <p>Background</p> <p>Despite significant improvements in the treatment of coronary heart disease (CHD), it is still a major cause of mortality and morbidity among the Iranian population. Epidemiological studies have documented that risk factors including smoking and the biochemical profile are responsible for the development of acute myocardial infarction (AMI). Psychological factors have been discussed as potential risk factors for coronary heart disease. Among emotional factors, depression correlates with coronary heart disease, particularly myocardial infarction.</p> <p>Methods</p> <p>This case-control study was conducted on 120 cases (69 males and 51 females) of acute myocardial infarction (AMI) and 120 controls, with a mean age of 62.48 ± 15.39 years. Cases and controls were matched by age, residence and sex.</p> <p>Results</p> <p>The results revealed that severe depression was independently associated with the risk of AMI (P = 0.025, OR = 2.6, 95% CI 1.1-5.8). The analysis of variables indicated that risk factors for developing depression were unmarried, low levels of polyunsaturated fatty acids (PUFAs), total dietary fiber (TDF) and carbohydrates. The levels of these dietary factors were lowest in severely depressed patients compared to those categorised as moderate or mild cases. Furthermore, severely depressed subjects were associated with higher levels of total cholesterol, high systolic blood pressure (SBP) and WHR. Age, income, a family history of coronary heart disease, education level, sex, employment and smoking were not associated with severe depression.</p> <p>Conclusion</p> <p>The present study demonstrated that severe depression symptoms are independent risk factors for AMI. Furthermore, severe depression was associated with an unhealthy diet and AMI risk factors.</p

Evaluation of the Effect of Cardiac Rehabilitation on Left Ventricular Diastolic and Systolic Function and Cardiac Chamber Size in Patients Undergoing Percutaneous Coronary Intervention

Background: Exercise and rehabilitation are important methods for decreasing the risk factors of coronary artery disease (CAD). We aimed to evaluate the effect of the cardiac rehabilitation (CR) exercise program on the cardiac structure and physiology in patients undergoing percutaneous coronary intervention (PCI). Methods: In this randomized controlled study, 146 patients with CAD were divided equally into two groups: case group (undertaking CR after PCI) and control group (without rehabilitation after PCI). All the patients in the case group underwent echocardiography (before and after CR), and echocardiography was performed for the control group simultaneously. The CR exercise program encompassed 24 sessions, twice or three times a week, with each session lasting between 15 and 45 minutes, depending on the individual patient’s tolerance. Left ventricular (LV) ejection fraction, LV diastolic function, LV end-systolic and diastolic diameter, and right ventricular (RV) end-diastolic diameter were measured in the CR group before and after rehabilitation and compared to those in the control group at the same times. Results: In this study, 146 patients (46 female and 100 male) were evaluated: 73 in the rehabilitation group and 73 in the control group. The mean age of the patients in the CR and control groups was 58.05 ± 10.27 and 56.76 ± 10.07 years, respectively. The CR exercise program had useful effects on LV diastolic function after PCI. The distribution of LV diastolic dysfunction after the CR exercise program was changed significantly only in the CR group (p value = 0.043). In the CR group, normal, grade I, grade II, and grade III LV diastolic dysfunction were observed in 20.5%, 69.8%, 6.8%, and 2.7%, respectively. This distribution was changed respectively to 30.1%, 61.6%, 5.4%, and 2.7% following CR, which showed a significant improvement due to CR in LV diastolic function, most prominently in the patients with grade I diastolic dysfunction (p value = 0.390). There was no significant change in LV and RV diameter before and after rehabilitation, while the ejection fraction increased significantly (p value < 0.05) in both groups. Conclusion: The RC exercise program can be effective in the augmentation of LV diastolic dysfunction after PCI, withoutsignificant changes in LV diameters

The efficacy of commitment and acceptance and behavioral cognitive interventions on emotional schemas and quality of life in patients with irritable bowel syndrome with generalized anxiety disorder

Background: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that can be stimulated and intensified by psychological factors such as anxiety and negative imotions and affects the quality of life of these patients. But can help the behavioral cognitive and acceptance and commitment interventions on improve the qulailty of life and emotional schemas in patients with irritable bowel syndrome with generalized anxiety disorder? Aims: The aim of study was the efficacy of behavioral cognitive and acceptance and commitment interventions on qulailty of life and emotional schemas in patients with irritable bowel syndrome with generalized anxiety disorder. Methods: This study was a quasi-experimental study with a pretest and posttest design with a control group and follow up for three months. The statistical population included patients with irritable bowel syndrome and generalized anxiety disorder in Tehran. 60 patients were selected through targeted sampling and were assigned randomly into two experimental groups and one control group (n= 20 each). Experimental groups received twelve 90-minute sessions of behavioral cognitive (Dugas & Robichaud, 2007) and acceptance and commitment (Eifert & Forsyth, 1396) interventions, and the control group received no intervention during this period. Participants were assessed by Patrick & Drossman's IBS Specific Quality of Life Questionnaire (1998) and Jiang & et.al emotional schemas questionnaire (2019) in pre-test and post-test. The results were analysed using multivariate analysis of variance. Results: Both interventions had a significant effect on improve the quality of life and emotional schemas (P<0.01), this effect was stable during follow-up period (P <0.01). Also, there was no significant difference between the two treatments in terms of efficacy and both treatments are equally effective. Conclusion: Each of the behavioral cognitive and acceptance and commitment interventions as an effective intervention can be used in medical centers to improve the quality of life and emotional schemas of patients with irritable bowel syndrome and generalized anxiety disorder

Decreased level of the anti-inflammatory adipokines, secreted frizzled-related protein 5 and adiponectin, in high cholesterol diet-induced atherosclerotic rats

Introduction: The involvement of secreted frizzled-related protein5 (SFRP5) and adiponectin, two important adipokines produced by adipocytes, in cardiovascular diseases demand further assessment. Therefore, in this study the relation of the adipokines and atherosclerosis was evaluated in Rat. Materials and methods: For the study, thirty male Wistar rats were divided into 2 groups (each group contain 15 rats): Control group, received a normal diet and the high cholesterol diet (HCD) group which received an additional 2% cholesterol and 0.5% cholic acid for 15 weeks. At the end of treatment, HCD-induced atheroma plaques were observed by hematoxylin and eosin staining of aortic tissue sections. Furthermore, serum levels of SFRP5 and adiponectin in the two groups of rats were measured by immunoassay and their relationships with the development of atherosclerotic plaques in the experimental group were analyzed. Results: The serum level of SFRP5 and adiponectin was significantly decreased in HCD rats compared with the control group (P<0.05).  There was also an inverse relation between the serum level of the two adipokines and atherosclerotic plaque formation (P<0.05).  Conclusion: Serum levels of SFRP5 and adiponectin are decreased in rats fed with high cholesterol diet, highlighting the involvement of the two adipokines in atherosclerosis