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BACKGROUND: Atrial fibrillation (AF) augments the risk of stroke by 4-5 times. Vitamin D is pivotal in numerous metabolic pathways. A handful of studies have explored the correlation between vitamin D deficiency (VDD) and AF outcomes. Hence, the authors sought to assess the relationship between VDD and AF outcomes. METHODS: From December 2021 to February 2023, 190 patients with AF were incorporated into the authors’ study. Given the seasonal fluctuation of vitamin D levels, these levels were examined from the start of December until the end of March. RESULTS: The final analysis comprised 190 patients (55.8% male) with an average age of 46.22±15.03. Vitamin D deficiency, insufficiency, and sufficiency were noted in 77 (40.5%), 46 (24.2%), and 67 (35.3%) patients, respectively. Fatigue and syncope were significantly more prevalent in the VDD group than in other groups. Three-vessel disease was more frequent in the VDD group (p-value=0.04). Mortality was more prevalent in patients with VDD (6.31%) compared to the VDI (2.10%) and VDS (0.05%) groups (p = 0.03). Successful cardioversion was significantly more prevalent in the VDS group (p = 0.03). CONCLUSION: A sufficient level of vitamin D was linked with a better response to cardioversion. However, low vitamin D levels are correlated with higher mortality in AF patients. [ABSTRACT FROM AUTHOR]

Background: To evaluate the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), and its cardiometabolic risk factors in the southern Iranian adult population. Methods: This is a population-based cross-sectional survey on 3944 middle-aged and elderly adults (35--70 years) from Bandare- Kong. The participants were recruited from 2016 to 2018 and the first phase data of the Bandare-Kong Cohort as a part of the PERSIAN Cohort were used for analysis. Results: Among the 3944 included adults, the age-adjusted prevalence of T2DM and IFG was 17.40% and 20.61%, respectively. Mean FPG was higher among those older than 55 years, females, rural residents, current cigarette smokers, hypertriglyceridemia, hypercholesterolemia, unemployed and low educational level in subjects with diabetes and pre-diabetes. T2DM and IFG were more prevalent in women and men, respectively. Also, those with higher waist circumference (WC), higher body mass index (BMI), lower educational levels, rural residents, former cigarette smokers, hypertension (HTN), hypercholesterolemia, hypertriglyceridemia and age older 45 years, had a higher T2DM and IFG prevalence. Multivariable regression analysis showed that older age, higher WC, HTN and hypertriglyceridemia and living in rural regions were statistically significant predictors of T2DM and pre-diabetes while BMI ≥ 25 kg/m² was the only significant risk factor for IFG. Conclusion: The current study illustrated that T2DM and IFG have a high prevalence among the middle-aged and elderly adult Iranian population, particularly in rural dwellers. Hence, prevention strategies should be implemented to reduce diabetes and pre-diabetes, especially in rural areas. [ABSTRACT FROM AUTHOR]

Phaeochromocytomas/paragangliomas (PPGL) are rare tumours that can cause cardiovascular complications following the secretion of catecholamines. We present a young female presented with heart failure with reduced ejection fraction as a result of norepinephrine secreting para‐aortic paraganglioma and improvement of heart failure sign and symptoms and left ventricular ejection fraction following tumour resection. [ABSTRACT FROM AUTHOR]

Aims: The relationship between insulin resistance (IR) and glucose intolerance with pulmonary hypertension (PH) has been suggested in recent investigations. In the present study, we aimed to show the prevalence of IR and its correlation with haemodynamic variables as well as its prognostic significance in this group of patients. Methods and results: Among 100 new and returning patients with PH, scheduled for right heart catheterization (RHC), 59 non‐diabetic patients were enrolled. The homeostasis model assessment of insulin resistance (HOMA‐IR) was used to assess IR. The study population were followed up for a median (interquartile range) of 48 (23–48) months for all‐cause mortalities. Most of the study population [mean (standard deviation) age of 45.9 (17.3)] were classified as class I of PH classification (47.5%). Overall, 27% of our study population had IR considering the Iranian cut points of HOMA‐IR. The prevalence of IR in non‐diabetic, non‐metabolic syndrome patients with precapillary PH (PAH) was 34.2%, which was higher than the prevalence of IR in non‐diabetic, non‐metabolic syndrome Iranian population (24.1%). There was no difference between IR and insulin sensitive (IS) groups regarding demographic and clinical findings, 6 min walk test, and laboratory and haemodynamic data in univariable and multivariable analyses. The mortality rate in the follow‐up period was 44.1%. The survival of patient with IR was slightly lower than IS patients; however, IR was not an independent predictor of death. Conclusions: The glucose metabolism is dysregulated in patients with PH, and IR may increase the risk of adverse events among these patients. [ABSTRACT FROM AUTHOR]

Background: Thyroid hormones are well-known for their various effects on the cardiovascular system. However, contradictory results have been obtained regarding the association between thyroid hormones within the Reference Range (RR) and Coronary Artery Disease (CAD). Moreover, scarce evidence is available regarding the association between thyroid hormones and Coronary Slow Flow Phenomenon (CSFP). Objective: This study aimed to investigate the relationship between thyroid hormones in the RR, and CSFP and CAD. Methods: A total of 1033 euthyroid patients who underwent coronary angiography were enrolled and divided into four groups based on their coronary angiography and Thrombolysis in Myocardial Infarction (TIMI) flow grade: Normal Coronary Artery (NCA), CSFP, Non-obstructive CAD (N-CAD), and Obstructive CAD (O-CAD). Multivariate multinomial regression analysis was conducted to assess the association between thyroid hormone levels and CSFP as well as CAD. Thereafter, the prediction accuracy of Free Triiodothyronine (FT3) levels for the presence of CSFP and CAD was evaluated by the Receiver Operating Characteristic (ROC) curve analysis. Results: FT3 serum level was significantly lower in the CSFP and both CAD groups compared to the NCA group (P < 0.001). FT3 level was inversely correlated to the presence of CSFP and CAD (both N-CAD and O-CAD) only in young females. Moreover, TSH was found to be an independent predictor of O-CAD in young individuals, regardless of their gender. Furthermore, FT3 levels ≤ 2.56 pg/mL predicted the presence of CSFP (78% sensitivity and 62% specificity) and FT3 levels ≤ 2.38 pg/mL predicted the presence of CAD (64% sensitivity and 75% specificity) in young females. Conclusion: FT3 level was negatively associated with CSFP and CAD in young females. In addition, high levels of TSH were associated with O-CAD only in young patients. Further studies are required to shed more light upon the regarded associations. [ABSTRACT FROM AUTHOR]