Effect of an Education Programme on Cardiovascular Health Index among Patients with Myocardial Infarction: A Preliminary Study

Psychosocial interventions and mental health in patients with cardiovascular diseases living in low- and middle-income countries: A systematic review and meta-analysis

OBJECTIVE

Mental health issues are closely associated with symptoms and outcomes of cardiovascular diseases (CVDs). The magnitude of this problem is alarmingly high in low and middle-income countries (LMICs). This systematic review and meta-analysis aimed to examine the effectiveness of psychosocial interventions on mental health outcomes among patients with CVDs living in LMICs.

METHODS

This review includes Randomized controlled trials (RCTs) and quasi-experimental studies conducted on adult patients who had a CVD and/or hypertension and located in LMICs. Studies published in English between 2010 and March, 2021 and which primarily reported mental health outcomes of resilience, self-efficacy, Quality of life (QoL), depression and anxiety were included. Studies were screened, extracted and critically appraised by two independent reviewers. Meta-analysis was conducted for RCTs and narrative summaries were conducted for all other studies. PRISMA guidelines were followed for reporting review methods and findings.

RESULTS

109 studies included in this review reported educational, nursing, behavioral and psychological, spiritual, relaxation, and mindfulness interventions provided by multidisciplinary teams. 14 studies reported self-efficacy, 70 reported QoL, 62 reported one or both of anxiety and depression, and no study was found that reported resilience as an outcome in this population. Pooled analysis showed improvements in self-efficacy and QoL outcomes. The majority of studies showed improvement in outcomes, though the quality of the included studies varied.

CONCLUSION

Patients with CVDs in LMICs may experience improved mental health through the use of diverse psychosocial interventions. Evaluations are needed to investigate whether the impact of interventions on mental health are sustained over time.

Polydatin protects H9c2 cells from hypoxia-induced injury via up-regulating long non-coding RNA DGCR5

Polydatin (PD), a monocrystalline polyphenolic drug mainly found in the roots of Polygonum cuspidatum, has various pharmacological activities. Long non-coding RNAs (lncRNA) DiGeorge syndrome critical region gene 5 (DGCR5) was found to participate in the suppression of multiple cancers. Here, we proposed to study the effect of PD on myocardial infarction (MI) by inducing DGCR5. CCK-8 assay was performed to detect the viability of H9c2 cells. Flow cytometry was utilized to test apoptosis of H9c2 cells. These results determined the optimal concentration and effect time of hypoxia as well as PD. Si-DGCR5 was transfected into cells and the expression level was determined by qRT-PCR. Western blot was utilized to evaluate the expression of apoptosis-related proteins, Bcl-2, Bax, and cleaved-caspase-3, as well as autophagy-associated proteins including Beclin-1, p62, and LC3-II/LC3-I. As a result, PD efficiently attenuated hypoxia-induced apoptosis and autophagy in H9c2 cells. The expression of DGCR5 was down-regulated by hypoxia and up-regulated by PD. Besides, knocking-down the expression of DGCR5 inhibited the protection of PD in H9c2 cells. In addition, PD up-regulated the accumulation of DGCR5, DGCR5 decreased the expression of Bcl-2 and p62, raised the expression of Bax and cleaved-caspase-3, and the proportion of LC3-II/LC3-I. PD stimulated the PI3K/AKT/mTOR and MEK/ERK signaling pathways via up-regulating the expression of DGCR5. Our data demonstrated that PD reduced cell apoptosis and autophagy induced by hypoxia in cardiomyocytes. Moreover, PD activated PI3K/AKT/mTOR and MEK/ERK signaling pathways by up-regulating the expression of DGCR5.

Heavy Smoking is Associated with Low Depression and Stress: a Smokers' Paradox in Cardiovascular Disease?

INTRODUCTION

Smoking, anxiety and depression constitute predisposing factors of coronary artery disease.

AIM

The aim of this study was to investigate the degree of nicotine dependence in coronary patients and its relationship to anxiety and depression.

METHODS

The study population consisted of 208 coronary patients, 131 men and 77 women, who were hospitalized in a hospital in Attica and were all smokers. The degree of nicotine dependence was measured by the Fagerstrom scale, while depression and anxiety intensity were assessed with the Zung SDS and SAS scales respectively.

RESULTS

158 participants (75.9%) were moderately to highly dependent on nicotine, 108 participants (51.9%) reported moderate to severe depression intensity levels while 91 participants (43.8%) reported moderate to severe anxiety intensity levels. The degree of dependence on nicotine was negatively related to the intensity of anxiety and depression experienced by coronary patients. Additionally, the degree of nicotine dependence, anxiety and depression was associated with various sociodemographic and clinical factors such as educational level, social support, and information on their condition and treatment.

CONCLUSION

Overall, the findings of this study point to an inverse relationship of nicotine dependence, depression and anxiety. However, this paradoxical association could be a product of shared risk factors or confounding. Nonetheless, the development of individualized educational and supportive interventions to quit smoking in coronary patients should primarily focus on the assessment of depression and stress.