Objectives:Exposure to second-hand smoke (SHS) is widespread in restaurants in Ulaanbaatar, the capital city of Mongolia. While a smoke-free policy is the most effective way of protecting restaurant workers and customers from SHS, this has not been well accepted in Mongolia. Furthermore, little is known about restaurants’ attitude toward the smoke-free policy.Methods:A cross-sectional survey directed to restaurant owners or managers was conducted in 475 representative restaurants in Ulaanbaatar. Face-to-face interviews using a questionnaire and on-site observation were performed.Results:Only 29.3% of the restaurants claimed to prohibit smoking; none of the remaining had any protection toward SHS, and half of the restaurants estimated that more than 20% of customers would smoke inside. None of them had visible “no smoking” signs and the majority never received complaints about SHS. Despite the generally high level of knowledge of the health effects of SHS, of the 336 restaurants that were not smoke free, only 25.9% expressed that they planned to take action in the near future. By contrast, 87.8% of restaurants would support the government if it asked all restaurants to ban smoking. Multivariate analysis identified that restaurants having menus in foreign languages, selling cigarettes and predicting business decline were less likely to support the government smoke-free policy.Conclusions:This survey demonstrates that restaurants owners and managers were reluctant to take action on their own, but would support government policy. The government can assume a stronger role first by revising the law on tobacco control following the Framework Convention on Tobacco Control guideline.

Growing numbers of studies have shown that hyperhomocysteinemia is an independent, modifiable risk factor for cardiovascular diseases. Hyperhomocysteinemia has been found to be negatively associated with the vitamin B group, especially folate and cobalamin. Because of the relative scarcity of fruits and vegetables in Mongolian foods, and the high cardiovascular diseases rate in Mongolia, we examined homocysteine level and its relation with atherosclerotic change in middle-aged Mongolian women. This cross-sectional study included 79 female asymptomatic residents of Ulaanbaatar, Mongolia. Besides analysis of homocysteine and chemistry tests, participants were interviewed and underwent physical and Doppler ultrasound examination of extracranial vessels. The mean homocysteine level was 9.87 +/- 3.6 micromol/l, and the 2.5th and 97.5th percentiles were 2.2 micromol/l and 19.9 micromol/l. Participants with abnormal Doppler ultrasound finding had significantly higher homocysteine levels (12.8 +/- 4.5 micromol/l vs 8.7 +/- 2.3 micomol/l, P < 0.001) and homocysteine was significantly associated with having atherosclerotic change (odds ratio 2.2, 95% confidence interval = 1.42-3.49, P < 0.001) after adjustment for age, low-density lipoprotein, diastolic blood pressure, and body mass index. Hyperhomocysteinemia was found to be significantly associated with atherosclerotic change in female Mongolian adults. Further studies are necessary to determine factors associated with homocysteine elevation among the Mongolian population.

Background: The prevalence of heart failure in the Mongolian population is unknown. Thus, in this study, we aimed to define the prevalence of heart failure in the Mongolian population and to identify significant risk factors for heart failure among Mongolian adults. Methods: This population-based study included individuals 20 years and older from seven provinces as well as six districts of the capital city of Mongolia. The prevalence of heart failure was based on the European Society of Cardiology diagnostic criteria. Results: In total, 3480 participants were enrolled, of which 1345 (38.6%) participants were males, and the median age was 41.0 years (IQR 30–54 years). The overall prevalence of heart failure was 4.94%. Patients with heart failure had significantly higher body mass index, heart rate, oxygen saturation, respiratory rate, and systolic/diastolic blood pressure than patients without heart failure. In the logistic regression analysis, hypertension (OR 4.855, 95% CI 3.127–7.538), previous myocardial infarction (OR 5.117, 95% CI 3.040–9.350), and valvular heart disease (OR 3.872, 95% CI 2.112–7.099) were significantly correlated with heart failure. Conclusions: This is the first report on the prevalence of heart failure in the Mongolian population. Among the cardiovascular diseases, hypertension, old myocardial infarction, and valvular heart disease were identified as the three foremost risk factors in the development of heart failure.

Objective    The purpose of this study was to investigate the association between global longitudinal strain (GLS) and plasma NT-proBNP for predicting left ventricular (LV) performance in asymptomatic patients after acute myocardial infarction (AMI).Material and methods    We prospectively included patients with diagnosis of AMI without clinical signs and symptoms of heart failure (HF) and followed these patients for 6 mos. Baseline echocardiography was performed at admission, and follow-up echocardiography was performed after 6 mos. A normal GLS was defined as having an absolute value of ≥16 %. According to the baseline GLS, participants were divided into two groups and compared. In all participants, blood samples of plasma NT-proBNP were obtained at admission, before discharge, and 6 mo after discharge.Results    The study population was consisted of 98 participants, of which 80 (81.6 %) were males, and the mean age was 56.0±9.3 years. Baseline echocardiography showed that most of the participants (60, 61.2 %) had abnormal GLS<16 %, whereas 38 (38.8 %) participants had normal or borderline GLS ≥16 %. Compared with the normal GLS group, participants with abnormal GLS had higher GRACE score, higher troponin I concentration, lower systolic blood pressure, lower mean LV ejection fraction, and decreased LV diastolic function. At 6‑mo follow-up, only LV systolic function remained significantly different between the two groups. Compared to baseline, there was a significant improvement of GLS in the abnormal GLS group at 6‑mo follow-up (p=0.04). Prevalence of complications after AMI was significantly higher in this group. There were significant differences between baseline and discharge NT-proBNP concentrations between the two groups (p<0.05). In the abnormal GLS group, there were significant correlations between baseline and discharge NT-proBNP concentrations with baseline LV systolic function. Discharge NT-proBNP concentration also correlated significantly with 6‑mo follow-up GLS. For determining the effect of baseline GLS abnormality, the areas under the ROC curve for baseline and discharge NT-proBNP concentrations were 0.73 (95 % CI 0.60–0.85, p=0.001) and 0.77 (95 % CI 0.66–0.87, p<0.001), respectively. Regarding early prediction of follow-up GLS abnormality, the area under the ROC curve for discharge NT-proBNP concentration was significantly higher 0.70 (95 % CI 0.55–0.84, p=0.016). The optimum cut-off value of discharge NT-pro-BNP was 688.5 pg / ml, with 72.4 % sensitivity and 65.4 % specificity to predict 6‑mon GLS abnormality following acute myocardial infarction.Conclusion    The main finding of this study is that impaired LV GLS is associated with elevated plasma concentrations of NT-proBNP in post-AMI patients. Pre-discharge NT-proBNP concentration combined with impaired initial GLS could predict worsening LV systolic function over time in asymptomatic post-AMI patients.