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Background: Heat shock protein 27 (HSP27) is an intracellular chaperone constitutively expressed in many cell types including cardio myocytes and endothelial cells. Circulating levels of HSP27 and anti-HSP27 antibody are higher in patients with CVD. Anti-HSP27 antibody concentrations were also reported to be increased in atherogenesis. We aimed to evaluate serum anti-HSP27 antibody titers in individuals with, or without, MetS in the MASHAD study cohort with large sample size in 6,568 subjects.

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality and one of the main challenges for health systems worldwide. In this study, we aimed to evaluate the association of socio-demographic, lifestyle, psychological and anthropometric factors and underlying diseases such as hypertension (HTN), diabetes mellitus (DM) and metabolic syndrome (MS) with CVD risk among a subpopulation of Iranian adults. Methods: In this prospective study, a total of 235 CVD patients along with 8405 healthy and nonsymptomatic individuals who participated in MASHAD cohort study were enrolled. CVD diagnosis was performed by taking electrocardiogram (ECG) and medical history and performing physical examination for each participant. Health and lifestyle questionnaires, the Beck's anxiety inventory (BAI), Beck's depression inventory (BDI) and the James and Schofield human energy requirements equations were completed for all participants. Anthropometric measurements were also recorded for all subjects. All statistical analyses including chi-square and student independent T-test were performed using SPSS 16.0 software (SPSS Inc., Chicago, IL, USA) at a significant level of 0.05. Results: We found that there were significant associations between CVD risk and age, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), diabetes mellitus (DM) and family history (FH) of CVD in both genders; though, there was a significant negative correlation between physical activity level (PAL) and risk of CVD among men and women. Also hypertension (HTN), metabolic syndrome (MS), depression and anxiety were positively and higher education level was negatively associated with CVD events only in females. While, waist-to-hip ratio (WHR) was an independent predictor of CVD among males (P-value< 0.05). Conclusion: There are several modifiable and non-modifiable risk factors that are independently considered as CVD predictors among the MASHAD study population. It is recommended to prioritize the lifestyle modification, development of local risk calculators and gender-related stratified strategies in order to prevent and manage CVD among the Iranian population. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MetS) is comprised of a clustering of various cardiovascular risk factors that can also affect bone health. We aimed the associations between MetS and bone mineral density (BMD) and trabecular bone score (TBS) in subjects with abdominal adiposity. Methods: Individuals with body mass index less than 25 kg/m2 were enrolled from the SUVINA study and allocated into two groups according criteria of IDF for metabolic syndrome. TBS T-score and Z/T score of fore skeletal region were measured using dual-energy X-ray absorptiometry (DXA). SPSS software was used for statistical analysis and p value 0.05<0 was considered significant. Results: DXA measurements were made in 201 participants, of whom 75 had MetS and 126 did not. Scores related to the neck of femur and total femur, radius Z-score and TBST-score were lower in subjects with MetS (all P<0.05). Subjects with FBG=100 had lower TBST-score (p < 0.05). SBP=130 and DBP=85 in subjects, led to the lower TBST-score, and lumbar T-score (both P < 0.05). Subjects with (LDL-C=160 mg/dl) had lower TBST-score, neck of femur Z score, and total femur T/Z scores (all P < 0.05). TBST-score and scores related to neck of femur, and total femur were lower in participants with serum cholesterol=200 mg/dl (P < 0.05). Conclusion: MetS is negatively associated with TBS and BMD scores. Higher levels of LDL-C and cholesterol were the most associated factors related to TBST-score decrease. The neck of femur was the most vulnerable skeletal against the MetS components increment. [ABSTRACT FROM AUTHOR]

Introduction: An association between heat shock protein 27 (Hsp27) antigen with cardiovascular risk factors has been shown previously. Furthermore, higher levels of serum anti-HSP27 antibodies are also related to higher cardiovascular morbidity and mortality. In the current study, we looked at the relationship between serum Hsp27 antibodies and hypertension, as an important cardiovascular risk factor, in individuals without evidence of cardiovascular disease (CVD) . Methods: A sub-population of hypertensive patients (HTN+) without underlying CVD were recruited from the Mashhad stroke and atherosclerosis heart disease (MASHAD) study to assess the association between serum Hsp27 antibodies and hypertension; independent of other cardiovascular risk factors. A total of 1599 people were studied of whom 288 individuals had hypertension and 1311 were used as controls (HTN-) . Results: Mean serum Hsp27 antibody titers were 0.20 (0.27) OD in the whole population sample and was not significantly different in the normotensive (HTN-) compared to HTN+ individuals with different degrees of hypertension . Conclusion: There were no significant associations between serum anti-Hsp27 concentrations and either the presence or severity of hypertension. Future studies are warranted to explore the association of anti-Hsp27 antibody and antigen levels and other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Introduction: The association between the serum antibody titer of several heat shock proteins (HSPs) and cardiovascular disease (CVD) risk factors so far has been the subject of several previous studies. Aim: To evaluate the association of adiposity indices and HSP-27 antibody titers in healthy individuals. Materials and Methods: Overall 4823 individuals were recruited from Mashhad Stroke and Heart Atherosclerotic Disorders Study (MASHAD study), that included 1496 individuals with normal-weight (body mass index (BMI) <25 kg/m2), 1975 individuals with over-weight (BMI 25-30 kg/m2), and 1352 individuals with obesity (BMI≥ 30 kg/m2). Results: The serum anti-HSP-27 antibody titers were not significantly different among obese individuals [0.21 (0.11 - 0.34) absorbency unit (AU)], over-weight individuals [0.19 (0.10 - 0.33) AU] and normal-weight individuals [0.19 (0.10 - 0.33) AU]. Conclusions: we have found no significant relationship among anti-HSP-27 antibody concentration and degrees of adiposity among Iranian adults. [ABSTRACT FROM AUTHOR]

Background: Heat shock protein 27 (HSP27) is found in several cell types of adults, such as cardiomyocytes, and endothelial cells. It is expressed in response to different cellular stress conditions. HSP27 decreases the levels of reactive oxygen species (ROS) and dyslipidemia is closely associated with increased endothelial production of reactive oxygen species (ROS). Objective: Higher serum HSP27 antigen and anti-HSP27 antibodies have been reported in patients with unstable angina and myocardial infarction Methods: This population-based case-control study was conducted in 2018. We investigated serum anti-HSP27 antibody titers in all participants with dyslipidemia from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study (n=8141) and those who were healthy in terms of dyslipidemia (n=1637) using an in-house enzymelinked immune sorbent assay (ELISA) in individuals with dyslipidemia. Findings: Anti-HSP27 titers were significantly lower in individuals with dyslipidemia compared to people without dyslipidemia (P=0.036). Conclusion: Our results revealed that the anti-HSP27 antibody titer was lower in the participants with dyslipidemia than in the negative group. However, there may be a confounding effect of drug therapy. In a subgroup of dyslipidemic subjects, we observed lower anti-HSP27 antibody titers in patients treated with some drugs (statins or corticosteroids, non-steroidal anti-inflammatory drugs [NSAIDs], or anti-diabetic and antihypertensive) compared to subjects untreated with these drugs. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes (DM) is a type of metabolic disorder that its types are generated by collectingof genetic and environmental risk agents. Here, the association between HSPB1 polymorphism as a genetic risk factor and DM was investigated. Methods: Total 690 participants from MASHAD cohort study population were recruited into the study. Anti-HSP-27level was assessed followed by genotyping using Taqman®-probes-based assay. Anthropometric, demographic and hematological/biochemical characteristics were evaluated. Kaplan-Meier curves were utilized, while logistic regression models were used to assess the association of the genetic variant with clinical characteristics of population. Results: Finds was shown there are meaningful differences among groups of age, height, waist circumference, systolic blood pressure, FBG,TG, HDL-C, and hs-CRP, and was no big -significant difference between theexists in different HSP27 SNP in the two studied groups (with and without DM), also was no remarkable relation between genetic forms of HSPB1and T2DM. This investigation was the first research that analyzed the relationship between the genetic type of the HSPB1 gene (rs2868371) and Type 2 diabetes (DM2). In our population, the CC genotype (%68.1) had a higher prevalence versus GC (%26.6) and GG (%5.3) genotypes and the data shown that no genetic difference of HSPB1 gene polymorphism (rs2868371) was related with DM2. Conclusion: HSPB1 polymorphism, rs2868371, was not associated with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have suggested that diabetes mellitus and obesity are associated with an increased risk of severe complications with COVID. We aimed to investigate whether individuals with obesity and diabetes mellitus are more likely to be infected with COVID19. Methods: The information related to COVID-19 was extracted from the Sina Health system information of Mashhad Health Deputy among participants in Mashhad cohort study (n=9704 people). Information regarding the cardiac risk factors of the individuals was previously recorded during the recruitment phase of the Mashhad cohort study. The relationship between COVID infection and several CVD risk factors was investigated. Results: The results showed that obesity (P= 0.001) and diabetes mellitus (DM), (P= 0.01) were positively related to COVID-19. Furthermore, DM augmented the risk of COVID-19 by 1.79 folds (P-value= 0.004; OR: 1.79; CI:1.21-2.67). Conclusions: The incidence of COVID-19 until 2020.07.19 was 2.36% in Mashhad Study Cohort population. Moreover, DM has increased the risk of COVID-19 by 1.79 folds in the population. [ABSTRACT FROM AUTHOR]

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Platelet activation and aggregation play a major role in thrombosis formation of coronary arteries in patients with Acute Coronary Syndrome (ACS) and is responsible for most ischemic complications during PCI. There is little information on the benefits and side effects of intracoronary and intravenous injection of Eptifibatide, a potent antiplatelet agent; therefore, this study was performed with the aim to compare coronary blood flow velocity by measurement of TIMI frame count. In intravenous versus intracoronary bolus administration of Eptifibatide during PCI in ACS patients. This non-randomized clinical trial study was performed on 103 patients with acute coronary syndromes who referred to the cardiac emergency ward of Ghaem hospital, Mashhad University of Medical Sciences, and were candidates for urgent coronary angiography and PCI. Forty-eight cases received intracoronary bolus Eptifibatide and 55 intravenous Eptifibatide. TIMI Frame Count and Corrected TIMI Frame Count were used to comparing the effect of these two methods on coronary blood flow velocity. Data were analyzed by SPSS software (version 22). To compare the quantitative variables in the two groups, according to the distribution of variables, the t-test was used if it was normal or the Mann-Whitney test was used if it was not normal. A Chi-square test was also used to compare qualitative variables into two groups. P<0.05 was considered statistically significant. Mean of age, gender, and cardiovascular risk factors were similar in the two groups. There was no significant difference in terms of serum Creatine Kinase MB (CKMB) level, Left Ventricular Ejection Fraction (LVEF), coronary artery lesion length, coronary artery diameter, coronary thrombosis, and coronary artery thrombectomy in two groups. Based on Student's t-test, there was no significant difference between mean TIMI Frame Count in different coronary arteries in the intracoronary and intravenous injection groups (In LAD, P=0.518; For LCX, P=0.576; and in RCA, P=0.964). The complications were observed in 11 patients (22.9%) of the intracoronary injection group and 9 (16.4%) of the intravenous injection group; the difference was not significant (P=0.402). The effects and complications of Eptifibatide were not significantly different in Intracoronary and intravenous administration in ACS patients during PCI and at the time of patients' hospitalization. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Generally, diabetes mellitus is the result of impaired glucose tolerance which together with dyslipidemia are considered as important risk factors of CVD. The aim of this study was to determine the relationship between fasting serum glucose (FSG), lipid profile and CVD endpoints, and to establish an optimal FSG cut-off in the MASHAD cohort study after nearly 6 years of follow-up. Methods: All the participants of MASHAD study were followed up for 6 years to determine their cardiovascular status. FSG, fasting lipids, and physical examinations were all recorded. To identify the optimal cut- off point of FSG, we carried out receiver operating curve (ROC) analysis. Results: We determined MASHAD cutoff point of blood glucose as 90 mg/dl predicting the CVD outcome. The sensitivity and specificity of the FSG criterion were 54.34% and 71.68%, respectively. The AUC was 0.665 (95% CI 0.656-0.675, P< 0.0001). The adjusted hazard ratio show that FSG is associated with 2.34 increase in CVD risk using MASHAD cutoff point (HR 2.34, 95% 1.73-3.17, P< 0.001). Conclusions: These findings suggest that not only FSG and lipid profile are related to CVD outcome in the MASHAD study, but also elevated fasting glucose levels is strongly associated with cardiovascular events in this population. Besides, the fasting glucose at a threshold of 90 mg/dl can be used for screening cardiovascular events among the Iranian population. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD), one of the main mortality causes worldwide is considered to be affected by general oxidative stress and inadequacy antioxidant system. Superoxide dismutase 1 (SOD1), a cytosolic antioxidant enzyme has a key role in neutralizing the excessive prooxidant by scavenging the super oxide anions. SOD1 polymorphic variants exhibit the altered activity properties. In the current study, we are aimed to investigate the association between the SOD1 polymorphism and CVD prevalence. A 6‐years case control follow up study was designed to genotype the 526 participants (311 controls and 215 cases) for studying the 50 bp INS/DEL polymorphism at SOD1 promoter gene and analyze their blood lipid profile and anthropometric characteristics. Among the two possible alleles of the SOD1 gene (Wild [W] and Mutant [M]) the meaningful association was detected between the Mutants' frequency and the prevalence of CVD patients (p‐value <.001). The W and M allele refer to inserted and deleted 50 bp in the polymorphic site of the SOD1 promoter, respectively. The WM and MM genotypes' frequency which indicate the wild heterozygotes and Mutant homozygotes, respectively, were significantly correlated with the prevalence of cardiovascular disease (p‐value <.001). The present study has the potential to introduce the 50 bp INS/DEL polymorphism of SOD1 genotyping as a novel unique diagnostic approach for screening the high risk CVD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although the role of enteroviruses has been proved in heart diseases, extensive information is not available on the association between enteroviruses and unstable angina. In the present study, the authors compared the prevalence of enteroviruses in patients with and without unstable angina. METHODS: Blood samples were taken from 51 patients with unstable angina and 55 patients without unstable angina or myocardial infarction that were admitted to Imam Reza and Ghaem hospitals (Mashhad, northeast of Iran). Reverse transcription polymerase chain reaction (RTPCR) was performed using specific primers for the detection of the enteroviruses in blood samples of study subjects. RESULTS: Patients with and without unstable angina were similar in age with mean ± standard deviation of 62.6 ± 12.8 and 59.7 ± 12.7 years, respectively (P = 0.243) and there were no differences in gender in these two groups (P = 0.174). Prevalence of the enteroviruses in patients with unstable angina was higher only in 66-80 years age group compared to the control group (patients without unstable angina, P = 0.032). There was a higher prevalence of enterovirus RNA positivity in the blood samples of women with unstable angina (75.9%) than those without unstable angina (41.7%, P = 0.011), however, no significant difference was observed in men (P = 0.983). CONCLUSION: Our data showed that enteroviral RNA positivity was higher in patients with unstable angina compared to those without unstable angina. However, the differences between the two groups were not statistically significant. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to evaluate the effects of hospitalization on the nutritional status and prooxidant-antioxidant balance (PAB) of the patients with myocardial infarction (MI). Methods: This study was conducted on 57 patients diagnosed with MI with the mean age of 58.44±12.80 years. The patients were admitted to the cardiac care unit (CCU) of Ghaem Hospital in Mashhad, Iran. Nutritional status of the patients was assessed using the nutritional risk screening (NRS-2002) questionnaire. In addition, anthropometric and biochemical parameters and their changes were evaluated. PAB was also assessed as an oxidative stress marker. In total, 15 patients stayed in the hospital for more than one week. The measurements were performed upon admission and discharge. Results: Upon admission, 49.1% of the patients were well-nourished, and 50.9% were at nutritional risk. As expected, the patients were overweight (36.8%) or obese (19.2%), and all the measures of adiposity were high. Well-nourished patients had lower serum PAB comparatively, while the difference was not statistically significant. The prevalence of the suboptimal nutrition index increased from 46.7% upon admission to 53.3% upon discharge. However, the increase was not considered significant due to the small sample size. Serum PAB increased within one week after admission, while the change was not significant (P=0.249). Conclusion: According to the results, the prevalence of suboptimal nutrition was high in the MI patients in Iran and increases during hospitalization. [ABSTRACT FROM AUTHOR]

Introduction: Sudden sensorineural hearing-loss (SSNHL) patients constitute approximately 2-3% of referrals to ear, nose and throat (ENT) clinics. Several predisposing factors have been proposed for this condition; one of which is vascular disorders and perfusion compromise. In this research the atherosclerotic changes and their known risk factors are studied in SSNHL patients. Materials and Methods: Thirty SSNHL patients and 30 controls were evaluated with regard to cardiovascular risks including history, heart examination, blood pressure, body mass index, waist circumference, electrocardiogram, blood sugar, triglycerides, cholesterol, high-sensitivity C-reactive protein (HSCRP); also, carotid artery color Doppler study was undertaken to measure intima media thickness(IMT). Results: IMT and HSCRP showed an increased risk in the case group compared with the controls (P= 0.005 & P=0.001). However, waist circumference, history of smoking, fasting blood sugar, lipid profile, and electrocardiogram revealed no significant difference between the two groups. Interestingly, blood pressure and body mass index were higher in the controls in this study. Conclusion: Sudden sensorineural hearing loss may be associated with subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]

Coronary artery diseases affect both systolic and diastolic functions and can be assessed both globally and regionally. Tissue doppler imaging is a novel technique with additional advantages to the currently used two-dimensional echocardiography. This paper is a review of the published articles on documented Coronary artery diseases patients confirmed by angiography, without any previous myocardial infarction and with normal left ventricular ejection fraction. Accordingly, a significant relationship was achieved between systolic rather than diastolic parameters with Coronary artery diseases. Furthermore, major heterogeneity was noticed among the available studies in this respect. The incremental values of tissue doppler imaging in patients with stable angina in addition to other non invasive tests has led to its recommendation by ACC/AHA. [ABSTRACT FROM AUTHOR]