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Loghman Henareh

Publications and source records attributed to Loghman Henareh.

6 recordsLinked to original sources

Disturbed glucose metabolism is associated with left ventricular dysfunction using tissue Doppler imaging in patients with myocardial infarction.

AIMS: To investigate the association between glucose abnormalities and left ventricular (LV) function assessed by tissue Doppler imaging (TDI) in patients with previous history of myocardial infarction and without known diabetes mellitus. PATIENTS AND METHODS: In a cross-sectional study, 123 patients, aged 31-80 years, with a history of previous myocardial infarction and without known diabetes mellitus were examined with TDI echocardiography. A standard oral glucose test (OGTT) with 75 g of glucose was performed. RESULTS: Two-hour plasma glucose were significantly and negatively associated with TDI parameters such as LV ejection time; early diastolic filling velocity (E'-v); ratio of the early to late diastolic filling velocity (E'/A') and positively associated with regional myocardial performance index (MPI) (P<0.05). Left ventricular ejection time and MPI were significantly higher; E'/A' and E'-v were significantly lower in patients with disturbed glucose metabolism compared with patients with normal glucose tolerance (P<0.01). These differences remain significant also when the patients with DM were excluded. CONCLUSIONS: The present study demonstrates that disturbed glucose metabolism is associated with more pronounced LV dysfunction using TDI in patients with myocardial infarction. These abnormalities in LV function were more common not only in subjects with diabetes, but also in patients with prediabetic condition, impaired glucose intolerance.

Adult↗

Endothelial function in conduit and resistance arteries in men with coronary disease.

The aims of this study were to determine whether non-invasive measurement of endothelial function in conduit arteries reflects that of subcutaneous resistance arteries measured in vitro and to examine whether there is an endothelial dysfunction also in resistance arteries in patients with a previous myocardial infarction. The brachial artery diameter responses to a hyperemic flow stimulus and an in vitro method, pressure myography, to directly evaluate flow-mediated responses in arteries obtained from biopsies of subcutaneous fat were measured in 25 patients with a previous myocardial infarction and in 8 aged matched healthy subjects. Flow-mediated dilatation of the brachial artery was more pronounced in the healthy group compared with the group with coronary disease, 5.1 +/- 2.5% and 2.6 +/- 2.1%, respectively (p < 0.05). The flow-mediated dilatation in subcutaneous arteries from CHD patients was significantly reduced compared to control subjects (e.g. percent change from initial preconstriction at maximum flow rate of 204 microl/min: 42 +/- 7% CHD (n = 25) versus 84 +/- 24% control (n = 8), ANOVA, p = 0.03). There was a significant correlation between flow-mediated dilatation of the brachial artery and maximum flow-mediated dilatation at microvascular level, (p < 0.01). In conclusion this study demonstrates endothelial dysfunction in both conduit and resistance circulation in patients after myocardial infarction compared to an aged-matched healthy control group. Furthermore, a significant and independent relationship between endothelial function by means of flow-mediated dilatation in large conduit arteries and resistance arteries was observed.

Adult↗

Intima-media complex of both the brachial artery and the common carotid artery are associated with left ventricular hypertrophy in patients with previous myocardial infarction.

OBJECTIVES: Prospective trials have established intima-media thickness (IMT) of the carotid artery, flow-mediated dilation (FMD) of the brachial artery and cardiac left ventricular hypertrophy (LVH) as predictors of cardiovascular events. The aim of this study was to examine the relationship between intima-media complex of the brachial artery to FMD, intima-media complex of the common carotid artery and cardiac hypertrophy in patients with coronary heart disease. METHODS AND PROCEDURES: Cross-sectional design. Procedures were undertaken within the Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden. A total of 123 patients with a previous acute myocardial infarction (MI) were investigated. Calculated intima-media area (cIMa) of the brachial and common carotid arteries and FMD of the brachial artery and left ventricular dimensions were examined. RESULTS: The brachial cIMa was significantly associated with age, p-triglycerides, common carotid cIMa, ejection fraction, septum thickness, posterior wall thickness and left ventricular mass index (P < 0.05). Brachial cIMa also tended to be associated with systolic blood pressure (P = 0.056). Common carotid cIMa was significantly associated with age, systolic blood pressure, brachial cIMa, FMD and septum thickness (P < 0.05). FMD was significantly associated with age and carotid cIMa (P < 0.05). CONCLUSION: Both cIMa of the common carotid artery and the cIMa of the brachial artery were independently and significantly associated with ventricular septum thickness of the heart in patients with previous myocardial infarction.

Adult↗

Reduced quality of life after myocardial infarction in women compared with men.

BACKGROUND: Psychosocial factors have been suggested as risk factors for atherosclerotic disease. HYPOTHESIS: The purpose of the present study was to examine whether there is a gender difference in quality of life after a myocardial infarction with modem treatment of acute ischemic heart disease. METHODS: In all, 123 men and women aged between 31 and 80 years, and with a hospital-diagnosed myocardial infarction occurring 1-12 months prior to inclusion, were studied. Minor symptoms evaluation profile (MSEP) was used to estimate quality of life at entry. RESULTS: Age, hemodynamic data, smoking habits, as well as laboratory data, concomitant cardiovascular disease, and revascularization rate did not differ between men and women. Women had significantly more negative feelings regarding all the estimated dimensions of quality of life (Contentment, Vitality, and Sleep) than did men. CONCLUSION: Self-assessed quality of life after a myocardial infarction was significantly lower among women than among men despite similar age, treatment, and hemodynamic and laboratory data. The causal relationship is however, not known. Further studies are needed to evaluate the underlying mechanism of this observation. This may lead to the development of novel treatment strategies in female patients after a myocardial infarction.

Adult↗

Should oral glucose tolerance test be a routine examination after a myocardial infarction?

BACKGROUND: Diabetes mellitus (DM) and impaired glucose tolerance (IGT) are important cardiovascular risk factors. The objective of this study was to assess the prevalence of DM and IGT in patients discharged from the CCU without known DM after a myocardial infarction. METHODS: One hundred and ten patients, men and women aged 31-80 years with a myocardial infarction 1-12 months before inclusion were examined with oral glucose tolerance test. Patients with known DM were excluded. A standard oral glucose test (OGTT) with 75 g of glucose was performed. RESULTS: IGT was observed in 29 (26%) patients and DM in 13 (12%) patients in the OGTT. If only fasting plasma glucose (FPG) was used alone five (38.5%) patients with diabetes subjects and three (10.3%) with IGT were identified. Thus, a FPG test alone identified only 19.0% of the patients with pathological OGTT. The prevalence of DM and IGT in patients discharged from the CCU after a myocardial infarction without known DM diagnosis was high (38%). A fasting glucose alone failed to identify more than 80% of the patients with pathological glucose tolerance in this study. CONCLUSION: Since pathological glucose tolerance is an important cardiovascular risk factor, oral glucose tolerance test should be considered as a routine test after a myocardial infarction in subjects without known DM.

Administration, Oral↗

Non-invasive assessment of endothelial function - relation between vasodilatory responses in skin microcirculation and brachial artery.

OBJECTIVE: To compare different non-invasive methods for determination of human endothelial function in peripheral circulation. DESIGN: Observational, cross-sectional study in 39 healthy subjects (21 females, age 17-56 years). SETTING: Vascular research laboratory at university hospital. METHODS: Laser Doppler (LD) flowmetry was used to compare skin microvascular perfusion changes during postocclusive reactive hyperaemia with those induced by iontophoretic administration of acetylcholine (ACh), an endothelial-dependent vasodilator. LD measurements were compared with ultrasonographic measurements of postocclusive flow-mediated dilatation (FMD) in the brachial artery (n = 21). RESULTS: Local ACh induced a larger and more sustained skin perfusion increase than reactive hyperaemia after 4 min of regional arterial occlusion (P<0.001). A significant correlation was found between the magnitude of ACh-induced vasodilatation and peak reactive hyperaemia, both in absolute (r = 0.62, P<0.001) and relative terms (r = 0.58, P<0.001). A correlation was also found between brachial artery FMD and the magnitude of ACh-induced skin perfusion increase (r = 0.43, P<0.05) but not between FMD and reactive hyperaemia. CONCLUSION: Endothelial function, an early marker of cardiovascular risk, can be non-invasively assessed and graded by LD and FMD-measurements and despite inherent differences, both methods do correlate.

Adolescent↗