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VOLUME 14 , ISSUE 3 ( July, 2010 ) > List of Articles


A case control study of cardiovascular health in chemical war disabled Iranian victims

Atoosheh Rohani, Vahid Akbari, Fatemeh Moghadam

Keywords : Cardiovascular abnormalities, chemical warfare, mustard gas

Citation Information : Rohani A, Akbari V, Moghadam F. A case control study of cardiovascular health in chemical war disabled Iranian victims. Indian J Crit Care Med 2010; 14 (3):109-112.

DOI: 10.4103/0972-5229.74168

License: CC BY-ND 3.0

Published Online: 01-06-2017

Copyright Statement:  Copyright © 2010; The Author(s).


Background: Sulfur mustard (SM) is an alkylating chemical warfare agent that was widely used during Iran-Iraq war between 1983 and 1988. SM exposure leads to various late complications. The aim of this study was to determine the late cardiovascular effects of SM in war-disabled Iranian victims. Materials and Methods: This was a retrospective cohort case control study on 50 patients with symptoms of SM exposure and 50 cases who had been in Iran-Iraq war, without chemical injury. We performed exercise stress test and echocardiography for all of patients. Results: The study group comprised 100 males of mean age 45.6 ± 6.2 years. In chemical war injury group, two patients (4%) had positive exercise stress test. On coronary angiography, they were found to have coronary artery disease. One patient had severe mitral regurgitation and normal coronary angiography; he was referred for mitral valve replacement. Left ventricular (LV) diastolic abnormality was detected in 23% of these subjects. In another group, 5% had LV diastolic abnormality (P = 0.02) and all of them had normal stress test. Conclusions: Cardiovascular abnormalities are another late complication in chemical war disabled Iranian victims. Diastolic dysfunction was the most common abnormality in both groups of patients.

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  1. New York Security Council of United Nations, Report of specialists appointed by the Secretary General to investigate allegations by the Islamic Republic of Iran, concerning the use of chemical weapons. Document: 16433, 1986.
  2. Janbazan Organization, Health and Treatment Committee. Statistic Annals Book. Clinical status of chemical warfare victims; 2000 Apr. p 84.
  3. Khateri S, Ghanei M, Keshavarz S, Soroush M, Haines D. Incidence of lung, eye, and skin lesions as late complications in 34,000 Iranians with wartime exposure to mustard agent. J Occup Environ Med 2003;45:1136-43.
  4. Nishimoto Y, Yamakido M, Shigenobu T. Long-term observation of poison gas workers with special reference to respiratory cancers. J UOEH 1983;20:89-94.
  5. Singer AW, Jaax NK, Graham JS, McLeod CG Jr. Cardiomyopathy in Soman and Sarin intoxicated rats. Toxicol Lett 1987;36:243-9.
  6. Gholamrezanezhad A, Saghari M, Vakili A, Mirpour S, Farahani MH. Myocardial perfusion abnormalities in chemical warfare patients intoxicated with mustard gas. Int J Cardiovasc Imaging 2007;23:197-205.
  7. Pishgoo B, Ghanei M, Harandi AA, Farahani MM, Daadjoo Y. Long term cardiac abnormality after single high dose exposure to sulfur mustard? Indian Heart J 2007;59:181-4.
  8. Ghanei M, Ghayumi M, Ahakzani N, Rezvani O, Jafari M, Ani A, et al. Noninvasive diagnosis of bronchiolitis obliterans due to sulfur mustard exposure: Could high-resolution computed tomography give us a clue? Radiol Med 2010;115:413-20.
  9. Ghanei M. Late Pulmonary Complications of Mustard Gas Inhalation. Proceedings of the World Congress on Chemical and Biological Terrorism 2001; April 23-27: Dubrovnic, Croatia.
  10. Emad A, Rezaian GR. Immunoglobulins and cellular constituents of the BAL fluid of patients with sulfur mustard gas induced pulmonary fibrosis. Chest 1999;115:1346-51.
  11. Emad A, Rezaian GR. The diversity of the effects of sulfur mustard gas inhalation on respiratory system 10 years after a single, heavy exposure: Analysis of 197 cases. Chest 1997;112:734-8.
  12. Calvet JH, Gascard JP, Delamanche S. Airway epithelial damage and release of inflammatory mediators in human lung parenchyma after sulfur mustard exposure. Hum Exp Toxicol 1999;18:77-81.
  13. Smith KJ, Hurst CG, Moeller RB, Skelton HG, Sidell FR. Sulfur mustard: Its continuing threat as a chemical warfare agent, the cutaneous lesions induced, progress in understanding its mechanism of action, its long-term health effects, and new developments for protection and therapy. J Am Acad Dermatol 1995;32:765-76.
  14. Javadi MA, Yazdani S, Sajjadi H, Jadidi K, Karimian F, Einollahi B, et al. Chronic and delayed-onset mustard gas keratitis: Report of 48 patients and review of literature. Ophthalmology 2005;112:617-25.
  15. Chaitman BR. Exercise stress Testing. In: Braunwald E, editor. Braunwald′s heart disease. A text book of cardiovascular medicine. 8 th ed. Philadelphia: Saunders; 2008. p. 195-226.
  16. Thomsen AB, Eriksen J, Smidt-Nielsen K. Chronic neuropathic symptoms after exposure to mustard gas: A long-term investigation. J Am Acad Dermatol 1998;39:187-90.
  17. Azizi F, Keshavarz A, Roshanzamir F, Nafarabadi M. Reproductive function in men following exposure to chemical warfare with sulphur mustard. Med War 1995;11:34-44.
  18. Bullman T, Kang H. A fifty year mortality follow-up study of veterans exposed to low level chemical warfare agent, mustard gGas. Ann Epidemiol 2000;10:333-8.
  19. Maisonneuve A, Callebat I, Debordes L, Coppet L. Biological fate of sulphur mustard in rat: Toxicokinetics and disposition. Xenobiotica 1993;23:771-80.
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