@article { author = {Bakhshian, Ramezan and Moshkani Farahani, Maryam and Bahrami Ahmadi, Amir}, title = {ISK FACTOR PROFILE AND ANGIOGRAPHY FINDINGS IN MILITARY AND NON-MILITARY PATIENTS WITH CORONARY ARTERY DISEASE}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {16-21}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background-Military personnel come from the general population and have the same epidemiological style for coronary artery disease (CAD). There are two significant questions: Is there a higher rate of premature CAD in military personnel in comparison with general population and does the risk factor profile in military personnel differ from that of the general population? The present study was designed to answer these questions.Methods- The present case control study was performed on all military and non-military patients referred to angiographic departments due to CAD symptoms between 2003 and 2005. We collected demographic data with major coronary risk factors such as diabetes mellitus, hyperlipidemia, hypertension, and smoking (cigarette or pipe). We divided the recruited patients according the angiographic findings and the number of involved vessels into three groups.Results- Among the patients, 9709 (81%) were affected by CAD. From this total, 3586 (36.93%) were military and 6123 (63.07%) were non-military patients. Premature CAD in the military personnel (868, 24.21%) was significantly higher in the non-military (503, 8.3%) persons (P=0.00). Diabetes and hypertension were significantly lower in the military personnel in comparison with the non-military group. Smoking in the military personnel was significantly higher than in the non-military group. There was a significant association between the number of risk factors and involved vessels in our participants.Conclusion- In light of the fact that the rate of premature CAD was higher in the military personnel in our study, we suggest that screening programs with sensitive tools might be necessary for an earlier detection of the military personnel at a higher risk of CAD.}, keywords = {CORONARY ARTERY DISEASES,risk factor,Military Personnel}, url = {http://journal.iha.org.ir/article_83248.html}, eprint = {http://journal.iha.org.ir/article_83248_f3e10a654a6adf4d2c68a75b11218989.pdf} } @article { author = {Mozaffari, Kambiz}, title = {CARDIAC AMYLOIDOSIS FROM THE PATHOLOGIST'S PERSPECTIVE}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {22-24}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Amyloidosis is a systemic, yet an uncommon and probably underdiagnosed disorder which may have cardiac manifestations drawing the cardiologist’s attention to its existence.1-3 Endomyocardial biopsy material is then referred to the pathology laboratory, mainly as a means to establish or confirm the clinical diagnosis. Although the disease has four major types of clinical presentation, the histopathological findings are the same. Microscopically, amyloid is deposited in different parts of the heart such as the interstices of the myofibers to endocardium, blood vessel walls, valve structures, and epicardial fat. The SA and AV nodes as well as the bundle branches are also shown to be involved by the deposits. Based on the routine staining methods, amyloid is pale pink in color and looks homogeneous, distributing in the subendocardial tissue and interstitial myocardium thus producing myocyte compression and atrophy. Conventionally, the Congo red staining method reveals the characteristic amyloid material under the polarized light, where the apple-green birefringence is noted. Alcian blue stain, Crystal violet, and thioflavin-T fluorescence are also employed to demonstrate amyloidosis in biopsy samples.}, keywords = {CARDIAC AMYLOIDOSIS,Cardiomyopathy,CONGO RED STAIN}, url = {http://journal.iha.org.ir/article_83249.html}, eprint = {http://journal.iha.org.ir/article_83249_7f9f2f4fa91d2790e220be723f5df275.pdf} } @article { author = {Ojaghi Haghighi, S. Zahra and Moshkani Farahani, Maryam and Noohi, Feridoun and Haghighi, Ojaghi and Esmailzadeh, Maryam and Maleki, Majid and Yeganeh Tahoori, Fatemeh}, title = {TISSUE DOPPLER IMAGING AND DOPPLER STUDIES IN PATIENTS WITH TRANSMURAL AND NON-TRANSMURAL MYOCARDIAL INFARCTION}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {25-29}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background - Myocardial longitudinal shortening play an important role in cardiac contraction. Tissue velocity imaging (TVI) is an ultrasonographic technique that measure myocardial motion and providing a quantitative agreement of left ventricular regional myocardial function in different modalities. The present review discusses the most recent development in the application of TDI in coronary artery disease.Methods - Seventy patients with myocardial infarction (transmural and nontransmural) were included in the study. These subjects were diagnosed with recent myocardial infarction according to electrocardiography, cardiac enzymes and history. The basal segments of septal wall (septal side of mitral annulus) and basal segment of base of RV free wall were examined for tissue Doppler study with complete transthoracic echocardiography study.Results - Mean age in group of inferior MI, anterior MI and non Q wave MI are as follows: 61.87±10.7, 57.04±10.7, 58.45±9.2. Sm was significantly reduced in anterior MI groups than non Q wave MI (PV=0.01).In patients with inferior myocardial infarction 88% of patients had left ventricular ejection fraction (LVEF)>45% and in patients with anterior MI 18.2% patients had EF>45%.In non Q wave MI groups 60% patients had LVEF>45%.Conclusion-Except for Sm, other TDI parameters had no significant difference between two groups (transmural and nontransmural infarction) but it has significant changes in reduced left ventricle function and could be of determinants for prognosis.}, keywords = {}, url = {http://journal.iha.org.ir/article_83250.html}, eprint = {http://journal.iha.org.ir/article_83250_90033b6e8465a023402412255f3d8b07.pdf} } @article { author = {Rastgou, Feridoon and Bitarafan-Rajabi, Ahmad and Farhzadi, Ahmad and Yaghoobi, Nahid and Firoozabady, Hasan and Malek, Hadi and Ali Basiri, Hossein and Moladoust, Hassan}, title = {DIAGNOSTIC ACCURACY ASSESSMENT OF ST-SEGMENT DISPLACEMENTS, CHEST PAIN AND STRESS MYOCARDIAL PERFUSION IMAGING EXERCISE TEST IN CORONARY STENOSIS COMPARED WITH ANGIOGRAPHY FINDINGS}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {30-36}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Introduction- Nowadays, myocardial perfusion imaging (MPI) plays an important role in the early diagnosis of patients with coronary artery disease (CAD). This study sought to assess the performance of MPI alongside chest pain and ST-segment changes during the stress test by comparison with angiography in the diagnosis of coronary artery stenosis. To that end, the accuracy of these modalities in terms of sensitivity and specificity and the degree of greement between their results in the diagnosis of coronary artery stenosis were evaluated.Methods and Materials- The study population, selected from those with known or suspected CAD, was comprised of 85 patients (67 males) at a mean age of 53.7 ± 9.6 years. All the patients were subjected to SPECT imaging of the blood supply to the heart muscle during a two-day state of stress (either pharmacologically with Dipyridamole or through exercise test) and during rest via the injection of 99m Tc - MIBI. ST-segment changes during stress as well as clinical symptoms were recorded. All the patients underwent coronary angiography within two weeks, and coronary artery stenosis>50% was considered positive. Finally, the results of chest pain, ECG changes, and MPI for the evaluation of coronary artery involvement were compared with those of angiography as the gold standard.Results- Of the 85 patients, who underwent angiography, 10 patients had normal coronary angiography, 22 single-vessel disease, 28 two-vessel disease, and 25 three-vessel disease. ST-segment depression and ST-segment elevation were observed in 40 and 6 patients, respectively. The ECG had sensitivity of 57% and specificity of 70% in the diagnosis of coronary artery stenosis. Fifteen patients had chest pain during stress; all of them had coronary involvement according to angiography. Of the 70 patients with no chest pain, coronary angiography was positive in 62 cases; accordingly, chest pain had sensitivity of 20% and specificity of 100% in the diagnosis of coronary artery stenosis. There were 80 patients with abnormal MPI, including 387 fixed and reversible defects. Therefore, MPI had sensitivity of 79%, specificity of 70%, and diagnostic accuracy of 76% in the diagnosis of coronary artery stenosis.Conclusion- MPI enjoyed higher diagnostic accuracy and agreement coefficient than did chest pain and ST-segment changes in the diagnosis of coronary artery stenosis.Given the acceptable results of MPI in the diagnosis of coronary artery stenosis, this modality could be valuable in the management of CAD patients.}, keywords = {ST-SEGMENT CHANGES,MYOCARDIAL PERFUSION,Chest pain,CORONARY STENOSIS,Angiography}, url = {http://journal.iha.org.ir/article_83251.html}, eprint = {http://journal.iha.org.ir/article_83251_7a6aaa9c9fede00d928a2775ba2563aa.pdf} } @article { author = {Masoumeh, Sadeghi and Pourmoghaddas, Zahra and Alisaeidi, Alireza and Boshtam, Maryam and Yazdekhasti, Safoura and Sarrafzadegan, Nizal}, title = {IS THERE ANY RELATION BETWEEN CIRCULATING ENDOTHELIAL-LEUKOCYTE ADHESION MOLECULE -1 AND EXTENT OF CORONARY ARTERY INVOLVEMENTS IN MEN WITH ANGINA PECTORIS?}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {37-42}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background- Selectins as a group of adhesion molecule arise from the surface of activated cell and involved for atherosclerotic plaque production.Objective- To evaluate the relationship between Circulating Endothelial-Leukocyte adhesion molecule -1 (E-selectin) and the extent of coronary artery involvement in male Patients with coronary heart disease (CHD).Methods- Participants were 103 male patients with symptoms of CHD. Patients underwent coronary angiography and according to angiography results they were divided to 80 patients with severe CHD and 23 with mild coronary involvements according to angiographic score. The Circulating E-selectin level was compared in both groups by ELISA method. Anova and analysis of covariant (ANCOVA) were used for evaluating possible association of E-selectin level and severity of coronary artery involvement by adjusting age, history of diabetes mellitus, hypertension, and dyslipidemia.Results- The mean age of 103 male patients was 58.32±9.42 years. The E-selectin level was not significantly different in both groups with sever and minimal (CHD) (P=0.78). ANCOVA test could not show after significant association between E-selectin level and the extent of coronary artery involvement adjusting age (P=0.94) as well as history of diabetes mellitus, hypertension, and dyslepidemia respectively (P=0.43).Conclusion- The circulating E-selectin level have no association with the severity of CHD in male patients.}, keywords = {ADHESION MOLECULE,E-selectin,CAD,Coronary Angiography,EXTENT}, url = {http://journal.iha.org.ir/article_83252.html}, eprint = {http://journal.iha.org.ir/article_83252_4e0b94bd275f5b8c721ba12560aa4779.pdf} } @article { author = {Assareh, Ahmad Reza and Cheraghi, Maria and Alasti, Mohammad}, title = {TREND OF ACUTE MYOCARDIAL INFARCTION PREVALENCE TOWARD YOUNGER AGES IN AHVAZ}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {43-47}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Objectives - The aim of this study was comparing the prevalence of ST elevation myocardial infarction in 1997 with the prevalence in 2010 considering age groups in the hospitals of Ahvaz Jundishapur University of Medical Sciences.Methods - We considered the patients admitted with acute coronary syndrome at hospitals of Ahvaz Jundishapur University of Medical Sciences and all the patients with ST elevation myocardial infarction were included. We categorized the patients into six groups according their ages.Results - 400 patients in 1997 and 243 patients in 2010 were included in this study. The prevalence of myocardial infarction has increased in patients younger than 35 years. There were no significant changes in the group of 35-45 years and group of 65-75 years. The most important changes in age distribution of myocardial infarction during 2010 were prevalence increasing in age group of 46-55 years and decreasing in age group of 56-65 years. During 1997, 17% of patients were patients older than 75 years while 27% of patients were older than 75 years in 2010.Conclusions - Our data suggest that the prevalence of ST elevation myocardial infarction in age group of 46-55 years old has increased in Ahvaz. This change is especially prominent in male patients.}, keywords = {Myocardial Infarction,Prevalence,age,Ahvaz}, url = {http://journal.iha.org.ir/article_83253.html}, eprint = {http://journal.iha.org.ir/article_83253_1a8edcdff48b3b00d566a26ec3de886a.pdf} } @article { author = {Abbasi Tashnizi, Mohammad and Zirak, Nahid and Heidari Bakavoli, Alireza and Tayyebi, Mohammad and Moienpour, Aliasghar and Mirkazemi, Masoud}, title = {ATRIAL FIBRILLATION AFTER OFF-PUMP VERSUS ON-PUMP CORONARY ARTERY BYPASS GRAFT SURGERY}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {48-53}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background - Atrial fibrillation (AF) is the most common postoperative arrhythmic complication after coronary artery bypass graft surgery (CABG). The aim of the present study was to compare AF prevalence after off-pump versus on-pump CABG.Methods- In this prospective study, performed between September 2008 and September 2009, 128 consecutive patients in our local cardiovascular surgery ward were allocated into two groups of off-pump (95 patients) and on-pump CABG (33 cases).We compared preoperative risk factors such as left ventricular ejection fraction (LVEF)<%40, hypertension (HTN), and Cr>2mg/dl, site of grafting such as the left coronary descending artery (LAD), right coronary artery (RCA), and left circumflex artery (LCX) in the two groups of surgery techniques (on-pump versus off-pump CABG) with/without postoperative AF after 24 hours of surgery in the Intensive Care Unit. Statistical power of the study was 80%, and a P-value less than 0.05 was considered significant.Results - The prevalence of AF was 15 (15.8%) in the off-pump group versus 7 (21.2%) in the on-pump group (p=0.67) 24 hours after CABG. In the on-pump group, there was no difference between age categories (p=0.11). In the on-pump group, as opposed to the off-pump CABG group, there was no relationship between the surgery techniques with or without AF, LVEF<%40, and HTN. There was a significant relation with Cr more than 2 mg/dl in the on-pump CABG group (p=0.001) versus the off-pump CABG group (p=0.057).There was no statistical relation between the type of vascular graft (LAD, RCA, and LCX) between the on-pump and off-pump CABG patients attributed to with or without AF.Conclusion - There was no reduction in the AF rate in the on-pump CABG versus off-pump CABG. It seems that there was another predictive factor for AF in the off and on-pump CABG groups, so further prospective trials with larger sample sizes are recommended.}, keywords = {Atrial Fibrillation,OFF VERSUS ON PUMP,Coronary artery bypass graft surgery}, url = {http://journal.iha.org.ir/article_83254.html}, eprint = {http://journal.iha.org.ir/article_83254_adadc29256095ba6423c546e86f5d9c6.pdf} } @article { author = {Parsaee, Mojgan and Amin, Ahmad and Nematollahi, Mahmood Reza and Babolian, Azerakhsh}, title = {COMPARISON OF TRANSTHORACIC ECHOCARDIOGRAPHY AND RIGHT HEART CATHETERIZATION FOR ASSESSING PULMONARY ARTERIAL PRESSURE IN PATIENTS WITH CONGENITAL OR VALVULAR HEART DEFECTS}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {54-61}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background- Although right heart catheterization (RHC) has acceptable accuracy for the measurement of pulmonary arterial pressure (PAP), significant risks and cost issues are worrisome. Thus, a non-invasive technique such as echocardiography for assessing PAP would clearly be of great clinical value. We aimed to compare estimated systolic PAP (SPAP) by echocardiogram with the actual RHC measurements in the two groups of congenital and valvular heart diseases (CHD and VHD, respectively), in whom pulmonary hypertension (PHT) was clinically suspected.Methods- A total of 103 consecutive patients with confirmed CHD or VHD referred to our center between January and December 2009 were studied. Participants underwent transthoracic echocardiography and RHC within 4 hours of each other.Results- The mean SPAP in the CHD group was no different measured by RHC or echo (46.49 ± 29.04 vs.46.45 ± 23 mmHg, p=0.541). The mean SPAP in the VHD group measured by RHC was significantly higher than that measured by echo (48.70 ± 14.50 vs.44.90 ± 11.0 mmHg, p=0.041). Fifty-one (49.5%) patients were found to have PHT at RHC. Echocardiography correctly identified 48 of these patients (sensitivity=94.1%). Nineteen of the 52 patients without PHT on RHC were correctly identified by echocardiography (specificity=36.5%). The positive and negative predictive values for echocardiography in assessing the presence or absence of PHT were 59.3% and 86.4%, respectively.Conclusion- Integration of hemodynamic data with the echo examination can appropriately provide comprehensive assessment of PHT with high sensitivity in individual patients with congenital or valvular heart defects.}, keywords = {Pulmonary Hypertension,echocardiography,Pulmonary artery pressure,RIGHT HEART CATHETERIZATION}, url = {http://journal.iha.org.ir/article_83256.html}, eprint = {http://journal.iha.org.ir/article_83256_1660bab92d368b3c9c1a520f6a17d5f7.pdf} } @article { author = {Amin, Ahmad and Vakilian, Farveh and Maleki, Majid}, title = {LIVER FUNCTION TESTS AND URIC ACID SERUM LEVELS IN RELATION TO HEMODYNAMIC PROFILE: A COMPARISON BETWEEN HEART FAILURE AND PULMONARY ARTERIAL HYPERTENSION PATIENTS}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {6-15}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background- Systemic venous congestion has been considered the main cause of liver dysfunction in heart failure patients. In this study, we assessed the relation of liver function tests to hemodynamic profile in patients with systolic heart failure (SHF) and primary pulmonary arterial hypertension (PAH).Methods- Fifty patients with left ventricular ejection fraction<35% and 27 patients with mean PAH>25 mmHg were enrolled. Hemodynamic indices, including PAP, right atrial and ventricular pressures (RAP & RVP), pulmonary capillary wedge pressure (PCWP), and cardiac index (CI), were obtained and liver function tests and serum uric acid levels were measured simultaneously. Fifty age- and sex-matched normal controls were also studied.Results- CO was significantly lower in the HF group (P=0.006). Multivariate analysis showed a significant correlation between total bilirubin level and mean PAP (R=0.04, P=0.004), RAP (R=0.33, P<0.03), RVP (R=0.43, P<0.004), PCWP (R=0.36, P<0.01), and direct bilirubin with mean PAP (R=0.01, P=0.02), RVP (R=0.33, P<0.03), PCWP (R=0.32, P<0.03), and CI (R=0.33, P<0.01). In the PAH group, such correlations were mostly absent.Conclusion- Systemic venous congestion, more prominent in PAH, might not play the main role in deteriorating liver function. Further studies are needed to determine whether hepatic blood flow, which is significantly decreased in SHF, is a more important factor.}, keywords = {Heart failure,PULMONARY ARTERIAL HYPERTENSION,CATHETERIZATION,Liver function tests}, url = {http://journal.iha.org.ir/article_83262.html}, eprint = {http://journal.iha.org.ir/article_83262_e272580b809ed9c5716da68c0b33bc95.pdf} } @article { author = {Moinipoor, Aliasghar and Hoseinikhah Manshadi, Hamid and Abbasi, Mohammad and Soltany, Ghasem and Hoseinzade Maleki, Mahmood}, title = {CASE REPORT: PALLIATIVE BYPASS FOR A LARGE ADVANCED ANGIOSARCOMA OF RIGHT ATRIUM AND RIGHT VENTRICLE WITH PERICARDIAL EFFUSION: CASE PRESENTATION}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {62-65}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {We present the case of an advanced and large cardiac angiosarcoma in the right atrium and right ventricle, which occupied the most part of the right heart and created a significant stenosis in the pulmonary circulation. Our patient was in very bad general condition with severe respiratory distress and had very unstable hemodynamic. Also, he experienced two episodes of CPR (cardiopulmonary resuscitation) before he was transferred to the operating room. Given the patient’s poor condition and limited life expectancy, we performed a palliative bypass procedure, consisting of cavopulmonary anastomosis.}, keywords = {CARDIAC TUMOR,ANGIOSARCOMA,Pericardial effusion}, url = {http://journal.iha.org.ir/article_83266.html}, eprint = {http://journal.iha.org.ir/article_83266_9ba8c000c77314e9dc6855c457df9aef.pdf} } @article { author = {Mirmansouri, Ali and Dadkhah Tirani, Heidar and Imantalab, Vali and SadeghiMeiabadi, Ali Mohammad and Sedighinejad,, Abbas and Abad, Mohsen}, title = {CASE REPORT: RIGHT INTERNAL MAMMARY CATHETER INSERTION: A RARE COMPLICATION OF RT SUBCLAVIAN VEIN CATHETERIZATION}, journal = {Iranian Heart Journal}, volume = {12}, number = {4}, pages = {66-70}, year = {2012}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {This is the report of the insertion of a central venous catheter into the Rt internal mammary artery in lieu ofthe Rt subclavian vein by mistake in a 19-year-old patient scheduled for the correction of Tetralogy of Fallot.}, keywords = {Central venous catheterization,INTERNAL MAMMARY ARTERY,COMPLICATION OF CV LINE INSERTION}, url = {http://journal.iha.org.ir/article_83269.html}, eprint = {http://journal.iha.org.ir/article_83269_464afd31c4458d0d326a675ad5b53b80.pdf} }