New Insight of Methylenetetrahydrofolate Reductase (MTHFR) C677T Gene Polymorphisms, and Serum Electrolytes in Cardiac Syndrome X Patients

Background: Cardiac Syndrome X (CSX) is a condition affecting the cardiovascular system with a significant degree of morbidity. Diagnosis and treatment are challenging when the cause is unclear. Subsequently, a molecular marker for screening of people with CSX is highly recommended. The present study evaluated the association between MTHFR C677T gene polymorphism among Sudanese patients with CSX. Materials and Methods: A total of 100 subjects were enrolled. Venous blood sample was collected from each participant in Ethylene Diamine Tetracetic Acid (EDTA) containers. DNA was extracted from blood samples using guanidine chloride method and MTHFR mutation was detected by PCR-restriction fragment polymorphism (PCR-RFLP). Statistical package for social sciences (SPSS) was used to analyze data. Results: Most patients 30(60%) were females, their age ranged between 30-60 with mean age 44.98±7.34 SD. MTHFR 677CT genotype frequency was statistically significant (P≤0.014), where 10(20%) had 677CT and 1(2%) had 677TT among patients group respectively compared to control individuals who had only 2(4%) 677CT. T alleles were significantly more frequent among our participant than C alleles. There is insignificant slightly decreased (2.4 ±2.8, and 2.5±3.2) in serum magnesium levels among patients compared to control respectively, as well as random blood glucose. Elevated mean levels of total cholesterol, and HDL among patients (182 ±18.1, and 49.7±7.1) vs (180 ±20.3, and 46.6 ±11.3) among control group, all findings were statistically non-significant. Slightly decrease in magnesium level (2.2 ±2.1, vs 2.9 ±0.8) among heterozygous CT genotypes compared to homozygous genotypes. Conclusion: MTHFR C677T is linked to CSX in the Sudanese population, and serum magnesium level was slightly decreased among heterozygous MTHFR C677T. Furthermore, the mutation could be used as a disease molecular screening technique.

The Effect of Mobile Health Intervention on Adherence to a Healthy Lifestyle in Patients with Cardiac Syndrome X (CSX)

Background: Cardiac syndrome X (CSX) is regarded as a form of ischemic heart disease with functional coronary microvascular abnormalities. This abnormal functioning of coronary microvasculature, often associated with endothelial dysfunction, results in a reduced coronary blood flow reserve. The incidence of CSX in patients undergoing invasive diagnostics for coronary heart disease was approximately 20–30%. Moreover, about 60–70% of CSX patients are female. The CSX symptoms are often debilitating and sufferers have a poor quality of life, with costly demand for healthcare services. METHODS The quasi-experimental survey was conducted in a teaching hospital. In this study, 100 Iranian outpatients who were referred to the heart clinic were recruited by randomized sampling. CSX patients were asked to fill out the demographic characteristics form and questionnaires in pre-test then after the period of intervention has been performed the post-test. Results: The independent t-test for continuous variable and chi - square test for categorical variables were used. There was no significant difference between two groups for all demographic of intervention and control groups, and RM-Manova was done for main research variables. The result revealed that score of knowledge on CSX risk factors was significantly higher in the experimental group (mean = 20.96) & (SD = 1.77), compared with the control group (mean = 16.32) & (SD = 3.12). Conclusion The mobile health messaging intervention significantly is useful for CSX Patients. The educational programs and Lifestyle modification represent a highly effective and low-cost intervention in order to improve the adherence to a healthy lifestyle among cardiac patients.

A Cross-Sectional Study of Microcirculatory Transit Time as a Risk Stratification Method in Cardiac Syndrome X Conducted in a Tertiary Hospital at Hyderabad, Telangana

BACKGROUND Cardiac syndrome X (CSX) is not benign, and it needs long-term follow up and risk factor modification. In this study, we wanted to calculate microcirculatory transit time on coronary angiography in patients with cardiac syndrome X (CSX), compare microcirculatory transit time in patients with and without CSX and to see whether microcirculatory transit time can be proposed as a risk stratification method in CSX. METHODS Cross sectional study of 52 patients. The angiogram was taken at 15 frames per second. The left coronary artery was injected with 7 ml of contrast approximately. Microcirculatory transit time (MCTT) was obtained offline. The microcirculatory transit time in seconds is calculated as last frame count minus first frame count/15. Microcirculatory transit time was compared and analysed in both groups. RESULTS A total of 52 subjects were analysed. There were 26 cases in the angina group with a mean age of 49.96 years and 26 cases in the control group with a mean age of 50.32 years. Dyslipidemia, smoking and statin use were more common in the angina group, which was statistically significant (P < 0.05). The mean MCTT of the group with angina and positive treadmill test (TMT) was 6.76 seconds, whereas the negative TMT group was 6.39 seconds. The mean frame count was 58.1, and the mean MCTT was 3.8 seconds in the control group, whereas the mean frame count and mean MCTT were 98.1 and 6.5 seconds in the angina group, which was statistically significant (P < 0.001). CONCLUSIONS CSX patients had longer MCTT than patients without chest pain and normal coronary arteries. MCTT can be used to assess the risks of CSX. Long-term followup studies with a large sample size should be conducted. KEYWORDS Cardiac Syndrome X, Angina, Coronary Artery Disease, Microcirculation