Publications by authors named "Mohammad Javad Zibaeenezhad"

26 Publications

  • Page 1 of 1

Surfing the clinical trials of mesenchymal stem cell therapy in ischemic cardiomyopathy.

Stem Cell Res Ther 2021 06 23;12(1):361. Epub 2021 Jun 23.

Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.

While existing remedies failed to fully address the consequences of heart failure, stem cell therapy has been introduced as a promising approach. The present review is a comprehensive appraisal of the impacts of using mesenchymal stem cells (MSCs) in clinical trials mainly conducted on ischemic cardiomyopathy. The benefits of MSC therapy for dysfunctional myocardium are likely attributed to numerous secreted paracrine factors and immunomodulatory effects. The positive outcomes associated with MSC therapy are scar size reduction, reverse remodeling, and angiogenesis. Also, a decreasing in the level of chronic inflammatory markers of heart failure progression like TNF-α is observed. The intense inflammatory reaction in the injured myocardial micro-environment predicts a poor response of scar tissue to MSC therapy. Subsequently, the interval delay between myocardial injury and MSC therapy is not yet determined. The optimal requested dose of cells ranges between 100 to 150 million cells. Allogenic MSCs have different advantages compared to autogenic cells and intra-myocardial injection is the preferred delivery route. The safety and efficacy of MSCs-based therapy have been confirmed in numerous studies, however several undefined parameters like route of administration, optimal timing, source of stem cells, and necessary dose are limiting the routine use of MSCs therapeutic approach in clinical practice. Lastly, pre-conditioning of MSCs and using of exosomes mediated MSCs or genetically modified MSCs may improve the overall therapeutic effect. Future prospective studies establishing a constant procedure for MSCs transplantation are required in order to apply MSC therapy in our daily clinical practice and subsequently improving the overall prognosis of ischemic heart failure patients.
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http://dx.doi.org/10.1186/s13287-021-02443-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220796PMC
June 2021

A substitution mutation in LRP8 gene is significantly associated with susceptibility to familial myocardial infarction.

ARYA Atheroscler 2020 Nov;16(6):301-305

Assistant Professor, Department of Genetics, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran.

Background: Myocardial infarction (MI) is a multifactorial disease caused by the suspension of blood circulation in a part of the myocardium. Understanding the genetic basis of MI can provide insight regarding the pathogenesis of the disease. The aim of this study was to investigate the association between pathogenic mutations and early-onset MI in five families with familial MI and without common MI risk factor.

Methods: Patients with MI younger than 50 years with family history of MI and without common diagnostic criteria (obesity, diabetes, familial hypercholesterolemia, opium/alcohol use) were evaluated for pathogenic mutations by whole exome sequencing (WES) and mutation was confirmed by polymerase chain reaction (PCR)-Sanger sequencing.

Results: The c.2855G > A missense mutation with homozygous autosomal recessive inheritance was identified in low-density lipoprotein receptor-related protein 8 (LRP8) gene in all patients of a family.

Conclusion: The c.2855G > A (R952Q) mutation in LRP8 gene in homozygous state could be considered as a possible etiology of early-onset familial MI.
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http://dx.doi.org/10.22122/arya.v16i6.1797DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8172235PMC
November 2020

Detection of Coronary Artery Disease by an Erectile Dysfunction Questionnaire.

Cardiol Res Pract 2021 13;2021:6647995. Epub 2021 Mar 13.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Erectile dysfunction (ED) has been become an important health challenge in recent years affecting the quality of life significantly. In addition to imposed social problems, it may warn the existence of cardiovascular diseases especially that of ischemic heart disease (IHD). We aimed to investigate the association between ED and coronary artery disease (CAD) in a population of patients with stable angina based on angiographic findings.

Methods: In this cross-sectional study, among patients who are diagnosed with stable angina referring for coronary angiography (excluding those with acute coronary syndrome), 200 patients were selected. They were divided equally into two groups of case and control. The former were positively CAD patients and the latter were normal peers, with respect to angiographic results. International index of erectile function (IIEF) questionnaire was used in order to evaluate erectile function during recent four weeks. Statistical analyses of the -test and logistic regression were performed. The significance level was considered as a value less than 5%.

Results: The age range of the patients was 40-65 years old. The case group was significantly older (=0.001). There was a remarkable relation between the low score from IIEF (ED) and existence of CAD. Also, the severity of ED was in a close relationship with severity of CAD. In addition, dyslipidemia in terms of high LDL and low HDL was associated with both ED and severity of CAD.

Conclusion: Other than CAD, ED could be considered as one of the manifestations of atherosclerosis. Accordingly, the IIEF questionnaire is a useful tool to early diagnosis of CAD. Also, IIEF-derived scores estimate CAD severity. We suggest subjects with low score of IIEF examine their cardiovascular health with special attention to possible existence of IHD.
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http://dx.doi.org/10.1155/2021/6647995DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987458PMC
March 2021

The Impact of Smoking on Clinical Outcomes after Percutaneous Coronary Intervention in Women Compared to Men.

J Interv Cardiol 2021 16;2021:6619503. Epub 2021 Mar 16.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: For decades, cardiovascular diseases (CVD) have been known as men's disease. However, recent research studies showed that they have become more common in women. Smoking is a strong risk factor for CVD especially that of coronary artery disease (CAD). Several studies reported that women are more susceptible to drastic sequels of smoking than men. There is limited data regarding the impact of smoking on post-revascularization clinical events stratified by gender. This study aimed to investigate if gender significantly changes the incidence of adverse clinical outcomes after percutaneous coronary intervention (PCI) among those with history of smoking.

Methods: Participants were selected from two hospitals from 2003 to 2019. Among patients who had PCI (index PCI), those with stable CAD who underwent elective PCI were included. Exclusion criteria were defined as primary PCI and those with multiple prior revascularizations. Participants were followed up seeking for major adverse cardiac events (MACE) including revascularization (PCI or coronary artery bypass grafting), myocardial infarction, and coronary death in three time intervals according to the time of index PCI (short term: up to 24 hours, mid-term: 24 hours to less than 6 months, and long term: more than 6 months).

Results: Of the 1799 patients, 61% were men and 47.08% had history of smoking (75% of the smokers were men). At the time of index PCI, smokers were significantly younger than nonsmokers. Also, MACE were significantly higher in smokers than nonsmokers, which was particularly pronounced at the long-term interval. In the nonsmokers group, there was no difference in MACE occurrence between men and women. However, of the smokers, women showed significantly higher MACE rate compared with men peers.

Conclusion: Smoking makes women more prone to MACE in comparison to men among patients with stable CAD after PCI with drug-eluting stent.
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http://dx.doi.org/10.1155/2021/6619503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987447PMC
June 2021

Impact of type II diabetes and gender on major clinical events after percutaneous coronary intervention.

Prim Care Diabetes 2021 04 2;15(2):347-351. Epub 2020 Dec 2.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Aims: Incidence of type 2 diabetes is markedly rising worldwide. Some studies suggest that the occurrence of major adverse cardiac events (MACE) after PCI is different in men and women, but data are conflicting.

Methods: We studied patients with stable coronary artery disease (CAD) who underwent PCI between years 2000 and 2017. Patients with primary PCI were excluded. Drug-eluting stent (DES) and dual antiplatelet therapy were administered in all patients. We followed these patients for a mean of 68 months. MACE as a composite of coronary revascularization, myocardial infarction or cardiovascular death was sought in three time windows.

Results: We studied 1799 patients, 29.6% of whom with diabetes. Women were 52%. In multivariate analyses, there were no significant differences in the risk of MACE between diabetic and non-diabetic patients, as well as between men and women, neither in different time windows, nor in the whole duration of follow-up. The components of MACE did not show any significant differences between diabetic and non-diabetic patients, as well as between the genders.

Conclusion: In our patients with stable CAD who received a modern therapeutic management after PCI, neither type 2 diabetes nor gender were associated with an excess risk of MACE.
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http://dx.doi.org/10.1016/j.pcd.2020.11.004DOI Listing
April 2021

Magnitude of the Quality Assurance, Quality Control, and Testing in the Shiraz Cohort Heart Study.

Biomed Res Int 2020 11;2020:8179795. Epub 2020 Aug 11.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran.

To determine the conclusive integrity in the Shiraz Cohort Heart Study (SCHS) project, management began quality assurance (QA) and quality control (QC) of the collected data throughout the study end-points. The QA is a focused process that prevents and detects data collection errors and verification of intended requirements in the SCHS. The QC is a subset of QA intended to capture errors in processing data through testing and preventive processes to identify problems, defects, or intended requirements. SCHS involved 10,000 males and females aged 40-70 over a 10-year follow-up period with cardiovascular diseases (CVDs) in the city of Shiraz, Iran. The study measured events and access to preventive care in Shiraz city. The SCHS identified unique barriers to select national study models in developing standardized measures related to variations in ethnicity, religion, cross-cultural considerations, and others. A suggested response to this problem was to develop a mechanism to standardize elements of the questionnaire, study design, and method of administration. This action was based on the geographically normal distribution of the Family Physician Health and Medical Services in Shiraz. Important QA and QC decisions were developed and adopted in the construction of the SCHS and follow-up to ensure conclusive integrity.
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http://dx.doi.org/10.1155/2020/8179795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441427PMC
April 2021

Angiotensin-converting enzyme 2: a double-edged sword in COVID-19 patients with an increased risk of heart failure.

Heart Fail Rev 2021 03;26(2):371-380

Unit of Translational Critical Care Medicine, Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.

The coronavirus disease (COVID-19) pandemic is a global health priority. Given that cardiovascular diseases (CVD) are the leading cause of morbidity around the world and that several trials have reported severe cardiovascular damage in patients infected with SARS-CoV-2, a substantial number of COVID-19 patients with underlying cardiovascular diseases need to continue their medications in order to improve myocardial contractility and to prevent the onset of major adverse cardiovascular events (MACEs), including heart failure. Some of the current life-saving medications may actually simultaneously expose patients to a higher risk of severe COVID-19. Angiotensin-converting enzyme 2 (ACE2), a key counter regulator of the renin-angiotensin system (RAS), is the main entry gate of SARS-CoV-2 into human host cells and an established drug target to prevent heart failure. In fact, ACE inhibitors, angiotensin II receptor blockers, and mineralocorticoid antagonists may augment ACE2 levels to protect organs from angiotensin II overload. Elevated ACE2 expression on the host cell surface might facilitate viral entrance, at the same time sudden nonadherence to these medications triggers MACEs. Hence, safety issues in the use of RAS inhibitors in COVID-19 patients with cardiac dysfunction remain an unsolved dilemma and need paramount attention. Although ACE2 generally plays an adaptive role in both healthy subjects and patients with systolic and/or diastolic dysfunction, we conducted a literature appraisal on its maladaptive role. Understanding the exact role of ACE2 in COVID-19 patients at risk of heart failure is needed to safely manage RAS inhibitors in frail and non-frail critically ill patients.
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http://dx.doi.org/10.1007/s10741-020-10016-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447089PMC
March 2021

The impact of diabetes mellitus and hypertension on clinical outcomes in a population of Iranian patients who underwent percutaneous coronary intervention: A retrospective cohort study.

J Clin Hypertens (Greenwich) 2019 11 25;21(11):1647-1653. Epub 2019 Sep 25.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

There are heterogeneous data regarding the impact of diabetes mellitus (DM) and hypertension (HTN) on clinical outcomes after percutaneous coronary intervention (PCI). This study explored the effect of history of DM (hDM) and HTN (hHTN), separately and in combination with each other, on major adverse cardiac events (MACE) in short-, mid-, and long-term intervals after PCI. Between 2000 and 2017, 1799 patients who had PCI were registered. They were categorized in four different groups: hDM, hHTN, hDM + hHTN, and no hDMQuery no hHTN. Incidence of myocardial infarction, revascularization, and coronary death totally considered as MACE was sought in short- (<24 hours), mid- (24 hours up to 6 months), and long-term (more than 6 months) intervals after PCI. Among the subjects, 176 had hDM, 648 had hHTN, 370 had hDM + hHTN, and 605 were in no hDM no hHTN group. The median follow-up time was 66.5 months. Time-to-event (time to the first MACE) was not significantly different between four groups. hHTN group was older and hDM group was younger at the time of enrollment PCI. Female gender was dominant only in hDM + hHTN group. Of the total, 130 patients (7.22%) experienced MACE. There was no MACE in short term, 23.07% of the MACEs were in mid-term, and the remaining happened in long term. However, according to the rate ratio, incidence rate of MACE in mid-tem was significantly higher than the long term. Also, MACE occurrence was significantly higher in hDM + hHTN and hHTN groups than the no hDM no hHTN group. Our study showed that the history of HTN significantly increases post-PCI MACE rather than the history of DM. Having history of both DM and HTN synergistically raised MACE incidence. Incidence of MACE per month was higher in mid-term than the long-term interval.
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http://dx.doi.org/10.1111/jch.13705DOI Listing
November 2019

Association of the gene polymorphisms with coronary artery disease susceptibility: A case-control study.

J Cardiovasc Thorac Res 2019 25;11(2):109-115. Epub 2019 Jun 25.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Endothelial nitric oxide synthase (eNOS), the main regulator of cardiac cell functioning, is regulated post-transcriptionally by autophagy-related 9B () gene. The proper function of the heart is partly determined by the intact interaction of these molecules. The present study aimed to investigate the effects of ATG9B rs2373929 and rs7830 gene polymorphisms on the predisposition to coronary artery disease (CAD). In this hospital-based case-control study, 150 patients with CAD compared with 150 healthy subjects for the genotype distributions of rs2373929 and rs7830 polymorphisms using T-ARMS PCR and ARMS PCR, respectively. Considering rs2373929 polymorphism, increased risk of CAD observed in the presence of TT genotype (OR: 3.65; 95% CI: 1.77-7.53; < 0.001) and also in the recessive model for T allele (OR: 3.41; 95% CI: 1.76- 6.60; < 0.001). The frequency of the T allele was higher in cases compared to controls (OR: 1.71; 95% CI: 1.24-2.28; P = 0.001). The genotype and allele frequencies of the rs7830 polymorphism did not differ between the two study groups. The gene rs2373929 polymorphism might involve in the pathogenesis of the CAD and can be considered as a screening molecular marker in the subjects prone to CAD.
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http://dx.doi.org/10.15171/jcvtr.2019.19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669433PMC
June 2019

Association of ABCA1 Haplotypes with Coronary Artery Disease.

Lab Med 2020 Mar;51(2):157-168

Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Adenosine triphosphate (ATP)-binding-cassette-transporter-A1 (ABCA1) transports cholesterol from cells into apolipoprotein A1 to form high-density lipoprotein (HDL) cholesterol.

Methods: We investigated the frequencies of ABCA1 functional variants in 273 patients with coronary artery disease (CAD) and 261 age-matched, healthy blood donors in southwest Iran. Sequence-specific primer polymerase-chain reaction (SSP-PCR) and polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) were used for genotyping.

Results: Frequencies of the rs2422493-TT genotype and T-allele, rs1800976-GG genotype, and G-allele in the promoter and rs2230806-GG genotype and G allele in the exon of the ABCA1 gene were higher in the patients. Abnormal left ventricular size and left-artery disease correlated with rs2422493-T and rs1800976-G alleles, respectively. Wall-motion abnormalities correlated with the rs1883025-G allele and rs2230806-A allele. Regarding the rs2422493/rs1800976/rs2230806/rs1883025 haplotype, T-G-G-A and T-G-A-A were more frequent in case individuals, whereas C-C-G-G was more frequent in control individuals.

Conclusions: The rs2422493-T allele and the rs1800976-G allele increase the risk of disease, as single polymorphisms and in the haplotype. The effect of the rs1883025-G allele is prominent in the haplotype, rather than individually. Considering that G allele of rs2230806 in the third place is present in both susceptible and protective haplotypes, the susceptibility haplotype can be defined as T-G-X-A.
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http://dx.doi.org/10.1093/labmed/lmz031DOI Listing
March 2020

Analysing cardiovascular risk factors and related outcomes in a middle-aged to older adults population in Iran: a cohort protocol of the Shiraz Heart Study (SHS).

BMJ Open 2019 04 3;9(4):e026317. Epub 2019 Apr 3.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of).

Introduction: The significant increase in the rate of morbidity and mortality due to cardiovascular diseases has become a health challenge globally. Lack of enough knowledge on the underlying causes in Iran and taking the unique characteristics of the Shiraz metropolitan city (the capital city of Fars Province) into consideration prompted us to conduct the Shiraz Heart Study. The aim of this study is to determine the predisposing elements leading to coronary heart disease, cerebrovascular disease and peripheral arterial disease.

Methods And Analysis: In this population-based, prospective study, family physician clinics will become the executive arms. Participants aged 40-70 years old will be recruited to achieve a sample size of 10 000. Socioeconomicta and anthropometric indices supplemented by physical activity, nutritional and psychological questionnaires, as well as routine blood laboratory tests, medical history and electrocardiographic records, will be collected at enrolment in clinics. In addition, blood samples will be obtained to explore the possible role of genetics in outcome occurrence. Follow-up with blood sampling, completion of a lifestyle questionnaire and evaluation of clinical risk factors will be carried out five times in a 2-year interval for all participants. Advanced statistical methods such as mixed model and time-to-event models will be used for data analysis.

Ethics And Dissemination: This study is in accordance with the Helsinki Declaration and has been approved by the Research Ethics Committee of Shiraz University of Medical Sciences (No: 2017-358). Signing a written informed consent is the preliminary step. Participants are free to withdraw on their request at any time. Collected data are kept encrypted in a software with authorities' access only. Findings of the study will be published at a national or international scale through peer-reviewed journals.
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http://dx.doi.org/10.1136/bmjopen-2018-026317DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500324PMC
April 2019

Genetic analysis of early onset familial coronary artery diseases.

Arch Med Sci Atheroscler Dis 2019 25;4:e1-e6. Epub 2018 Feb 25.

Department of Genetics, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran.

Introduction: Coronary artery diseases (CAD) are the most common causes of death. Myocardial infarction (MI) is a complex multifactorial and the most severe type of CAD. Early onset MI in a first-degree relative could be defined as an independent risk factor for CAD. This study was performed to investigate the genetic cause of early onset familial CAD.

Material And Methods: In this study, the genetic cause of familial CAD was investigated in patients with a family history of CAD who underwent angiography before the age of 50 years. The patients did not have any diagnostic criteria for familial hypercholesterolemia, diabetes, or obesity, and also they were not opium or alcohol users. Whole exome sequencing in probands was performed and mutation was confirmed by PCR and Sanger sequencing.

Results: In our studied population, the c.501G>C (p.K167N) mutation in the gene was identified in a family. Mutation was confirmed by PCR and Sanger sequencing in the homozygous state (GG) in patients. Healthy individuals in this family were heterozygous (GC) and homozygous (CC).

Conclusions: This finding suggests that the gene could be a possible cause of early onset familial MI. Considering that parents of all affected individuals had a consanguineous marriage, it is important to perform carrier screening and genetic counseling in this family and their close relatives as a prevention strategy in populations at risk.
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http://dx.doi.org/10.5114/amsad.2019.83149DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412034PMC
February 2018

Almond oil for patients with hyperlipidemia: A randomized open-label controlled clinical trial.

Complement Ther Med 2019 Feb 19;42:33-36. Epub 2018 Oct 19.

Cardiovascular Research Center, TAHA clinical trial group, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Background: Cardiovascular diseases currently account for nearly half of non-communicable diseases. It was shown that enjoying a handful of nuts every day can significantly reduce the risk of developing heart diseases as they contain a variety of nutrients and other bioactive substances contributing to lowering the risk of heart diseases and controlling the cholesterol. The aim of this study was to determine the effect of almond oil on the lipid profile of patients with hyperlipidemia.

Methods: Ninety-seven patients were divided into the intervention (n = 49) and control (n = 48) groups. The intervention group received 10 ml of almond oil two times daily for 30 days. There was no intervention for the control group. The serum lipoproteins were measured before and after the study.

Results: The total cholesterol and LDL levels decreased significantly in the intervention group (treatment difference = -16.12 ± 26.16, P = 0.009; treatment difference = -20.88 ± 18.4, p < 0.001 respectively). But regular almond oil consumption did not significantly affect the triglyceride and HDL in this sample of hyperlipidemic patients.

Conclusion: Consumption of almond could reduce the total cholesterol and LDL in dyslipidemic patients.
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http://dx.doi.org/10.1016/j.ctim.2018.10.013DOI Listing
February 2019

A Proteomic Analysis of the Virulence Factors of Three Common Bacterial Species Involved in Periodontitis and Consequent Possible Atherosclerosis: A Narrative Review.

Curr Protein Pept Sci 2018 ;19(11):1124-1130

Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain.

The incidence of cardiovascular disorders, especially coronary artery disease and atherosclerosis, is increasing alarmingly. Clarifying the underlying causes is of the utmost importance and should be elucidated in order to reduce this growing trend. Periodontitis is known as a chronic destructive disease with sophisticated pathophysiological mechanisms that slowly impose negative effects not only on the oral tissues but also on distant organs. Additionally, it has been shown in many studies that atherosclerosis and periodontitis utilized common inflammatory signaling pathways and mediators. Several lines of evidence have demonstrated the signatures of periodontitis-related bacteria in atherosclerotic plaque specimens. It is proposed that virulent proteins of these bacteria probably accelerate the initiation or development of plaque formation on the inner walls of the coronary arteries. Proteomics techniques are very sensitive and have a global point of view. They can help to discover host factors and pathogenrelated biomarkers. This review summarizes the studies focused on the three most important bacterial species involved in both diseases and presents recent findings about the proteomic evaluation of virulence factors of these bacteria. The known mechanisms of action of the virulence factors are also described.
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http://dx.doi.org/10.2174/1389203719666180625111449DOI Listing
July 2019

Rhus coriaria L. increases serum apolipoprotein-A1 and high-density lipoprotein cholesterol levels: a double-blind placebo-controlled randomized clinical trial.

J Integr Med 2018 01 14;16(1):45-50. Epub 2017 Dec 14.

Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz 98713, Iran. Electronic address:

Background: Lipid-lowering effect of Rhus coriaria L. (Rhus) has been investigated in multiple animal studies with promising results. Nonetheless, its clinical efficacy has not been adequately examined.

Objective: The aim of this study was to evaluate the lipid-lowering effects of Rhus among patients with hyperlipidemia.

Design, Setting, Participants And Interventions: The study was designed as a two-arm, double-blind placebo-controlled randomized clinical trial, using a parallel design. Eighty patients with primary hyperlipidemia were randomly assigned to receive Rhus capsules or placebo for 6 weeks.

Main Outcome Measures: The serum lipid levels, apolipoprotein-A1 (Apo-A1) and apolipoprotein-B (Apo-B) were measured.

Results: Mean serum high-density lipoprotein cholesterol (HDL-C) and Apo-A1 levels were significantly increased in the Rhus group, compared with the placebo group, after 6 weeks of intervention (P = 0.001). The analysis of covariance test including age, gender, body mass index (BMI), and smoking as co-variables revealed that the increase in HDL-C and Apo-A1 levels remained significant, and increases in HDL-C were dependent on the increase in Apo-A1 levels. No significant difference was observed between Rhus and placebo groups in terms of mean reductions in total cholesterol, low-density lipoprotein cholesterol and triglyceride levels; however, more significant improvement was observed among obese patients (BMI ≥ 30 kg/m).

Conclusion: The study showed significant increases in HDL-C and Apo-A1 levels in response to Rhus supplementation in patients with hyperlipidemia.

Trial Registration: ClinicalTrials.gov ID: NCT02295293.
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http://dx.doi.org/10.1016/j.joim.2017.12.007DOI Listing
January 2018

Comparison of the effect of omega-3 supplements and fresh fish on lipid profile: a randomized, open-labeled trial.

Nutr Diabetes 2017 Dec 19;7(12). Epub 2017 Dec 19.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Dietary fish is a rich source of Omega-3 poly-unsaturated fatty acids (PUFAs). These compounds may have protective effect against cardiovascular events possibly by modifying lipid profiles. Consequently, fish oil supplements are produced commercially to complement low fish intake. It is not clear if both interventions have similar effects. The aim of this trial was to compare the anti-hyperlipidemic effect of omega3 fatty acid supplements with fresh fish.

Method: A total of 106 patients with hyperlipidemia were randomized. One group received 2 g/day of omega-3 capsules for a period of 8 weeks and the other group received a mean of 250 g trout fish twice weekly (for dinner and lunch) for the same time period. The effects of these diets on the lipid profile after the intervention were compared between the two groups.

Results: Data from 48 patients in fish oil group and 47 patients from fish group was used for final analysis. In both groups, total cholesterol, non-HDL cholesterol, triglyceride (TG) levels, and Castelli I index (total cholesterol/HDL ratio) were reduced significantly following the treatment; however, dietary-fish intake had a more pronounced effect (-85.08 ± 74.82 vs. -30.75 ± 89.00, P < 0.001; 75.06 ± 35.43 vs. -16.93 ± 40.21, P < 0.001; -66.55 ± 30.79 vs. -12.7 ± 35.48, P = 0.003; and -0.77 ± 1.39 vs. -3.02 ± 1.85, P < 0.001; respectively). HDL level was increased in both groups with a higher effect in dietary fish group (4.47 ± 7.83 vs. 8.51 ± 8.79, P = 0.022). Atherogenic (Log [TG/HDL ratio]) and Castelli II (LDL/HDL ratio) indices did not change in fish oil group while were reduced significantly by fresh fish consumption (-0.04 ± 0.27 vs. -0.26 ± 0.17, P < 0.001; and 0.15 ± 0.7 vs. -1.32 ± 1.15, P < 0.001, respectively). LDL level was increased in the supplementation group, while it was significantly reduced in the dietary-fish group (+18.7 ± 24.97 vs. -22.75 ± 27.28, P < 0.001).

Conclusion: Consumption of fresh fish seems to be superior in positively modifying the lipid profiles which may have important translations in the occurrence of cardiovascular events.
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http://dx.doi.org/10.1038/s41387-017-0007-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865539PMC
December 2017

Effect of kernel oil consumption on lipid profile of the patients with dyslipidemia: a randomized, open-label controlled clinical trial.

Oncotarget 2017 Oct 4;8(45):79636-79641. Epub 2017 Jul 4.

Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.

Background: Amygdalus scoparia kernel (ASK) oil is traditionally used for Hyperlipidemia. Compared to olive oil, it has higher proportion of unsaturated to saturated fatty acid besides exhibiting higher index of oxidative stability. The lipid-lowering effects of ASK oil however, has not been investigated yet. This study is the first one to evaluate such effects in patients with dyslipidemia.

Results: Serum triglyceride levels significantly decreased in the intervention compared to control group (24.80 ± 51.70 vs 3.13 ± 44.80, -value = 0.03). Serum total cholesterol, LDL and HDL cholesterol levels did not change significantly ( = 0.28 and = 0.68 and = 0.10 respectively).

Materials And Methods: In a double arm, open-label, randomized controlled trial,101 hyperlipidemic patients were recruited. The designation of hyperlipidemia was upon meeting either of the three criteria: having serum low-density lipoprotein (LDL) cholesterol level 130-190 (mg/dl), serum triglyceride level 150-400 (mg/dl), and serum high-density lipoprotein (HDL) cholesterol level less than 50 (mg/dl) for women and 40 (mg/dl) for men. Patients who have ever been prescribed with an antihyperlipidemic medication were excluded. They were randomly assigned to intervention group, receiving the ASK oil, for 60 days and control group. Serum lipid measurements were repeated at the end of the intervention period.

Conclusions: ASK oil supplementation may have a positive effect in reducing serum triglyceride level in patients with dyslipidemia without significant effect on serum cholesterol levels.
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http://dx.doi.org/10.18632/oncotarget.18956DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668076PMC
October 2017

Kefir drink causes a significant yet similar improvement in serum lipid profile, compared with low-fat milk, in a dairy-rich diet in overweight or obese premenopausal women: A randomized controlled trial.

J Clin Lipidol 2017 Jan - Feb;11(1):136-146. Epub 2016 Nov 9.

Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Background: Controversy exists as to whether the lipid-lowering properties of kefir drink (a fermented probiotic dairy product) in animal models could be replicated in humans.

Objective: To assess and compare the potential lipid-lowering effects of kefir drink with low-fat milk in a dairy-rich diet in overweight or obese premenopausal women.

Methods: In this 8-week, single-center, multiarm, parallel-group, outpatient, randomized controlled trial, 75 eligible Iranian women aged 25 to 45 years were randomly allocated to kefir, milk, or control groups. Women in the control group received a weight-maintenance diet containing 2 servings/d of low-fat dairy products, whereas subjects in the milk and kefir groups received a similar diet containing 2 additional servings/d (a total of 4 servings/d) of dairy products from low-fat milk or kefir drink, respectively. At baseline and study end point, serum levels/ratios of total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDLC and HDLC), triglyceride, Non-HDLC, TC/HDLC, LDLC/HDLC, and triglyceride/LDLC were measured as outcome measures.

Results: After 8 weeks, subjects in the kefir group had significantly lower serum levels/ratios of lipoproteins than those in the control group (mean between-group differences were -10.4 mg/dL, -9.7 mg/dL, -11.5 mg/dL, -0.4, and -0.3 for TC, LDLC, non-HDLC, TC/HDLC, and LDLC/HDLC, respectively; all P < .05). Similar results were observed in the milk group. However, no such significant differences were found between the kefir and milk groups.

Conclusion: Kefir drink causes a significant yet similar improvement in serum lipid profile, compared with low-fat milk, in a dairy-rich diet in overweight or obese premenopausal women.
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http://dx.doi.org/10.1016/j.jacl.2016.10.016DOI Listing
October 2017

Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women: a randomized controlled trial.

Eur J Nutr 2016 Feb 5;55(1):295-304. Epub 2015 Feb 5.

Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: Controversy exists regarding whether increasing dairy intake without energy restriction would lead to weight loss. We aimed to compare the potential weight-reducing effects of kefir drink (a probiotic dairy product) and milk in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women.

Methods: One hundred and forty-four subjects were assessed for eligibility in this single-center, multi-arm, parallel-group, randomized controlled trial. Of these, seventy-five eligible women aged 25-45 years were randomly assigned to three groups, labeled as control, milk, and kefir, to receive an outpatient dietary regimen for 8 weeks. Subjects in the control group received a diet providing a maintenance level of energy intake, containing 2 servings/day of low-fat dairy products, while those in the milk and kefir groups received a weight maintenance diet, containing 2 additional servings/day (a total of 4 servings/day) of dairy products from low-fat milk or commercial kefir drink, respectively. Anthropometric outcomes including weight, body mass index (BMI), and waist circumference (WC) were measured every 2 weeks.

Results: Fifty-eight subjects completed the study. Using analysis of covariance models in the intention-to-treat population (n = 75), we found that at 8 weeks, subjects in the kefir and milk groups had significantly greater reductions in weight, BMI, and WC compared to those in the control group (all p < 0.01). However, no such significant differences were found between the kefir and milk groups.

Conclusions: Kefir drink leads to a similar weight loss, compared with milk, in a dairy-rich non-energy-restricted diet in overweight or obese premenopausal women. However, further studies are warranted.
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http://dx.doi.org/10.1007/s00394-015-0846-9DOI Listing
February 2016

The effect of educational programs on hypertension management.

Int Cardiovasc Res J 2014 Sep 1;8(3):94-8. Epub 2014 Sep 1.

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.

Background: Hypertension is the main risk factor for cardiovascular diseases and stroke. Blood pressure control is a challenge for healthcare providers and the rate of blood pressure control is not more than 50% worldwide.

Objectives: The present study aimed to determine the effectiveness of a short-term educational program on the level of knowledge, lifestyle changes, and blood pressure control among hypertensive patients.

Patients And Methods: This quasi-experimental study was conducted on the hypertensive patients attending Shiraz Healthy Heart House. In this study, 112 patients were selected via systematic random sampling. The study data were collected using a data gathering form which consisted of baseline characteristics and measurements of blood pressure. Multivariate analyses were used to assess the relationship between education and hypertension.

Results: At baseline, the scores of aware, treated, and controlled hypertensive patients were 21%, 20%, and 12%, respectively. However, these measures were increased to 92%, 95%, and 51%, respectively at the end of the study. The mean knowledge scores improved from 2.77 ± 2.7 to 7.99 ± 1.78 after 3 months (P < 0.001). Also, the mean lifestyle scores changed from 3.15 ± 1.52 to 4.53 ± 1.23 (P < 0.001).

Conclusions: The results of the current study indicated that the educational programs were effective in increasing knowledge, improving self-management, and controlling detrimental lifestyle habits of the patients with hypertension.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4109043PMC
September 2014

International Cardiovascular Research Journal and Its Contribution to Iran's Scientific Growth.

Int Cardiovasc Res J 2014 Sep 1;8(3):81-2. Epub 2014 Sep 1.

Cardiovascular Engineering Laboratory, Biomedical Engineering Department, Amirkabir University of Technology, Tehran, IR Iran.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4109040PMC
http://dx.doi.org/10.17795/icrj-20449DOI Listing
September 2014

The impact of education on weight loss in overweight and obese adults.

Int Cardiovasc Res J 2013 Sep 1;7(3):79-82. Epub 2013 Sep 1.

Department of Physiology, Islamic Azad University, Arsanjan Branch, Arsanjan, IR Iran.

Background: Prevalence of obesity is rapidly rising. To reverse the obesity epidemic, efforts should be made to incorporate intensive weight loss programs into medical practice. The primary aim of this study was to change the behavior for achieving a mean weight loss of 5-10% of initial body weight over 6 months in overweight and obese adults.

Methods: In this quasi-experimental study, 266 out of 533 subjects screened for coronary heart disease risk factors in Shiraz Healthy Heart House were overweight or obese. 140 individuals with BMI≥25 completed this study's 6 month program. The subjects were visited on day 1 and at 2 week intervals and taught intensive lifestyle modification. The subjects who did not lose 5% of their initial body weight after 3 months were assigned to receive 120 mg orlistat three times daily for 3 months in addition to counseling sessions. The main outcome measures were body weight and BMI.

Results: The mean weight and BMI of participants were 78.6±10.7 kg and 30±0.2 kg/m2, respectively. Women included 58% of the sample. 110 subjects (78.5%) lost ≥5% of their initial body weight during 3 months. The Mean weight and BMI loss in these subjects were 7.6±0.8 kg and 2.4±0.3 kg/m2, respectively.

Conclusions: Teaching of how to modify lifestyle and to gain more self-control with eating have the major role in reducing weight and BMI. So, training accompanied by continual follow up for performing the instructions could lead to favourable results.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987437PMC
September 2013

Interventional Revascularization of Coronary Artery Lesions in Diabetic Patients; In-hospital and One Year Follow up.

Int Cardiovasc Res J 2012 Dec 15;6(4):113-7. Epub 2012 Dec 15.

Cardiovascular Research Center, Shiraz University of Medical Science, Shiraz, IR Iran.

Background: Diabetes mellitus is a life threatening disease accompanied by several micro- and macro vascular complications. Several modalities are available for interventional revascularization of coronary artery lesions, but their efficacy in diabetic patients is studied only in few patients.

Materials And Method: This study evaluated major in- hospital complications and clinical outcome after one year in 200 consecutive patients who underwent percutaneous Coronary Intervention from 2007 to 2009.

Results: Our findings showed comparable single and 2 vessel stenting, regarding major adverse cardiovascular event in diabetic and nondiabetic patients. In connection with long term and in hospital outcome, no statistically significant difference was found between one and two vessel stenting when drug eluting stent was used in diabetic patients.

Conclusion: The use of drug eluting stent in single or two vessel disease of diabetic patients is technically satisfactory and clinically safe and can substitute for coronary artery bypass grafting.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987412PMC
December 2012

The effects of unripe grape juice on lipid profile improvement.

Cholesterol 2012 29;2012:890262. Epub 2012 Aug 29.

Department of Cardiology, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction. Consumption of unripe grape juice (verjuice) has been portrayed by the traditional belief, as a means of combating dyslipidemia. We aimed to evaluate the effects of unripe grape juice consumption on lipid profile in healthy human volunteers. Methods. We asked 42 enrolled volunteers to drink 10 cc of verjuice within 30 minutes to 2 hours after lunch and 10 cc of it after dinner. After taking 120 doses of verjuice, another fasting lipid profile was obtained from each participant. The statistical analysis was performed by SPSS 13 software. Results. After analysis of the data, the mean ± standard deviation for all the variables was obtained. Among those improvement of HDL-C was significant after the trial (P value < 0.001). TG, TC, and LDL improvement were not significant. Conclusion. Our study declared that verjuice has a dramatic effect on improving HDL-C level of serum but no any other lipid improvement effect was obtained.
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http://dx.doi.org/10.1155/2012/890262DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437268PMC
September 2012

Heparin infusion after successful percutaneous coronary intervention: a prospective, randomized trial.

Acta Cardiol 2009 Feb;64(1):65-70

Cardiovascular Research Centre (CRC), Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.

Objective: The aim of this randomized trial was to evaluate whether omission of heparin infusion after successful coronary interventions increased the incidence of ischaemic complications. Continuous heparin infusion after percutaneous coronary interventions could increase the occurrence of bleeding; however, the probable advantages of prolonged heparin infusion are unknown.

Methods And Results: A total of 200 consecutive patients who underwent successful PTCA were randomly assigned to receive either prolonged heparin (heparin group) or no post-procedural heparin (control group). The two treatment groups were comparable with respect to clinical and angiographic characteristics. The primary end point of the study was in-hospital bleeding and vascular events and secondary end points included in-hospital ischaemic events. Ischaemic complications occurred in 17 (8.5%) patients; ten patients (10%) in the control group and seven patients (7%) in the heparin group. Chest pain with new ECG changes was seen in 11 (5.5%) patients (4% in the heparin group vs. 7% in the control group). Two patients (2%) in the control group had a Q-wave myocardial infarction and one patient in the control group died as a result of ischaemic complications. In the heparin group 2 (2%) patients developed non-Q-wave myocardial infarction and one patient (1%) underwent emergency CABG during the same hospitalization. The difference between groups regarding secondary end points was not statistically significant (P = 0.44).

Conclusion: Heparin infusion after successful coronary interventions could increase the occurrence of bleeding and vascular injury; however, omission of heparin after a successful procedure did not significantly increase the incidence of ischaemic complications. Thus routine post-procedure heparin is not recommended.
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http://dx.doi.org/10.2143/AC.64.1.2034364DOI Listing
February 2009
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