Dark or Bright Half of the Moon: A Qualitative Study Exploring the Experience of Iranian Heart Failure Patients Regarding their Quality of Life

BACKGROUND: Heart failure (HF) is a major public health problem in different societies and has numerous impacts on quality of life (QOL). AIM: The present study was carried out with the aim to explore the experience of HF patients regarding the negative effects of the disease on their QOL. METHODS: In this qualitative exploratory study data collection was performed through face-to-face, semi-structured, in-depth interviews with 19 patients with HF, who were selected through purposive sampling method from April to September 2017. Data analysis was carried out based on the framework analysis method. RESULTS: The negative consequences of HF on QOL emerged in the form of 6 main themes including symptoms, disease complications, cognitive impairment, psychological distress, functional limitations and economic problems. Most of the participants (14 out of 19) assessed their QOL as well or very well. CONCLUSION: The majority of the patients in this study, despite the many negative impacts of HF, had a high QOL that could indicate their satisfaction and effective coping with HF by creating a positive outlook and the perceived positive effects of the disease

Changes of Serum Intercellular Adhesion Molecule – 1, Vascular Adhesion Molecule-1 and C – Reactive Protein in Middle-Aged Men with Heart Failure after Eight Weeks of Aerobic Exercise

Introduction: The evidence has shown that expansion of cardiovascular disease has inflammation base, and general inflammation (systemic) plays a pivotal role in the development of atherosclerosis. The purpose of this research was evaluation of changes in intercellular adhesion molecule &ndash; 1, vascular adhesion molecule-1 and C &ndash; reactive protein in middle-aged men with heart failure after eight weeks of aerobic exercise. Methods: Twenty four middle-aged men with heart failure were selected as volunteers, and were divided into two groups; the aerobic training and the control groups. Aerobic training program was eight weeks, three times per week with the intensity of 40%-70% maximum heart rate. Fasting blood samples were taken from all subjects before and after eight weeks of aerobic exercise. . Data were analyzed by paired sample t-test and independent sample t-test at a significance levels of P<0.05. Results: In the aerobic training group, comparison within groups showed, serum levels of ICAM-1, VCAM-1 and CRP (respectively P=0.001, P=0.001 and P=0.001) were significantly reduced. There was a significant reduction in comparison between groups only for VCAM-1 (P=0.001) and CRP (P=0.002). Conclusion: Aerobic exercise with reducing levels of inflammatory markers ICAM-1 and CRP may play an important role in the prevention and control of cardiovascular diseases in middle-aged men with heart failure

Genetic Insights from Consanguineous Cardiomyopathy Families

Inherited cardiomyopathies are a prevalent cause of heart failure and sudden cardiac death. Both hypertrophic (HCM) and dilated cardiomyopathy (DCM) are genetically heterogeneous and typically present with an autosomal dominant mode of transmission. Whole exome sequencing and autozygosity mapping was carried out in eight un-related probands from consanguineous Middle Eastern families presenting with HCM/DCM followed by bioinformatic and co-segregation analysis to predict the potential pathogenicity of candidate variants. We identified homozygous missense variants in TNNI3K, DSP, and RBCK1 linked with a dilated phenotype, in NRAP linked with a mixed phenotype of dilated/hypertrophic, and in KLHL24 linked with a mixed phenotype of dilated/hypertrophic and non-compaction features. Co-segregation analysis in family members confirmed autosomal recessive inheritance presenting in early childhood/early adulthood. Our findings add to the mutational spectrum of recessive cardiomyopathies, supporting inclusion of KLHL24, NRAP and RBCK1 as disease-causing genes. We also provide evidence for novel (recessive) modes of inheritance of a well-established gene TNNI3K and expand our knowledge of the clinical heterogeneity of cardiomyopathies. A greater understanding of the genetic causes of recessive cardiomyopathies has major implications for diagnosis and screening, particularly in underrepresented populations, such as those of the Middle East