@article { author = {Heidari, Ramin and Behjati, Mohaddeseh and Ghadrdoost, Behshid}, title = {Landmark for Percutaneous Transpopliteal Angioplasty on the Lower Extremity}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {6-9}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The recognition of the popliteal artery and vein for transpopliteal angioplasty is difficult in some cases. The puncture site can be identified using arterial pulsation, Doppler guidance, fluoroscopy guidance, and anatomical landmarks. In this study, we aimed to evaluate the success rate of obtaining vascular access using an anatomical landmark.   Methods: Totally, 59 participants were included in this study between September 2016 and October 2017. Eighteen cases were scheduled for venous angioplasty, and the rest were scheduled for arterial angioplasty. The procedures were performed with the patients in the prone position. The patients’ foot was rotated in the prone position so that the most distance between the external and internal tibial condyles could be found. Then, the popliteal vein was located on its medial side since lateral to this landmark passes the popliteal artery. This seems to be the most suitable approach to finding the best landmark. In these locations, 15 mL of Xylocaine was injected, and the needle was kept in place. For the prevention of septic arthritis, the injection was done 1 inch above the landmarks.   Results: The success rate was excellent, with failure reported in only 2 cases. The failure was attributed to the complete occlusion of the popliteal artery due to extensive atheroma in 1 patient and the total occlusion of the popliteal vein by thrombosis in the other case.   Conclusions: The transpopliteal approach using the anatomical landmarks of external and internal tibial condyles for arterial and venous access is a method with a high success rate for lower limb angioplasty. (Iranian Heart Journal 2021; 22(1): 6-9)}, keywords = {Popliteal approach,ANGIOPLASTY,Anatomical landmark,Doppler sonography,Lower extremity}, url = {http://journal.iha.org.ir/article_120925.html}, eprint = {http://journal.iha.org.ir/article_120925_d0de74ab7cbf80fafb85619b6282d2a1.pdf} } @article { author = {Yusuf, Mohamed and Icen, Yahya and Ahmed, Said and Osman, Abdirahman and Hussein, Abdinafic}, title = {Frequency and Pattern of Congenital Heart Diseases Among Children in a Tertiary Hospital in Mogadishu, Somali, 2019: A Hospital-Based Study}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {10-15}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Congenital heart diseases (CHDs) constitute the most common congenital malformations in pediatrics and comprise up to 25% of all congenital anomalies. They contribute significantly to morbidity and mortality in children.   Methods: This retrospective hospital-based study was conducted on children undergoing echocardiography for suspected CHDs between January 2019 and December 2019 in a tertiary teaching hospital.   Results: Out of 460 patients examined, 160 (35%) patients were diagnosed with CHDs, and 33 (7%) children had acquired heart diseases. Male gender was predominant (82/160; 51%), while female patients comprised 49% (78/160) of the study population. The majority of the patients (130/160; 81%) had acyanotic CHDs, whereas 30 (19%) patients had cyanotic CHDs. The most frequent type of acyanotic CHD was ventricular septal defect (59/160; 37%), followed by pulmonary stenosis (22/160; 14%) and patent ductus arteriosus (21/160; 13%). Tetralogy of Fallot was the most common cyanotic CHD in that it was diagnosed in 8 (5%) patients.   Conclusions: Ventricular septal defect was the most common acyanotic CHD in this study, while tetralogy of Fallot was the most frequent cyanotic CHD.  To our knowledge, there are no previous data on CHD in our country. We hope that the results of this study will provide a database for future investigations on the incidence and prevalence of CHDs in tertiary hospitals in Somalia and raise awareness about the significance of their early detection and surgical interventions. (Iranian Heart Journal 2021; 22(1): 10-15)}, keywords = {Congenital heart defect,Acyanotic CHD,Cyanotic CHD,Frequency and pattern of CHD}, url = {http://journal.iha.org.ir/article_120926.html}, eprint = {http://journal.iha.org.ir/article_120926_ce7e22a13f21921340fe1a40d4e2c060.pdf} } @article { author = {Ariafar, Mostafa and Sheikhi, Mohammad Ali and Joreir Ahmadi, Sara and Fassihi, Zahra and Dashti, Fatemeh}, title = {Evaluation of Sodium Nitroprusside Efficacy in Decreasing the Incidence and Duration of Atrial Fibrillation After Coronary Artery Bypass Grafting}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {16-25}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The incidence of atrial fibrillation (AF) after coronary artery bypass grafting (CABG) can leave irreparable sequelae; thus, the prevention of this common arrhythmia has particular importance. The aim of this prospective study was to evaluate the efficacy of sodium nitroprusside (SNP) in lessening the incidence and duration of AF after CABG.   Methods: This prospective double-blind randomized clinical trial compared the efficacy of SNP in reducing the incidence and duration of post-CABG AF between 2 groups of 30 patients each hospitalized in the Heart Surgery Department of Golestan Hospital, Ahvaz,  Iran, between February 2017 and June 2017.   Results:Post-CABG AF occurred in 8 (26.7%) patients in the control group and 2 (6.7%) in the SNP group (p = 0.038). The average surgery time in the control and SNP groups was 189.93 ± 31.40 minutes and 167.47 ± 13.48 minutes, respectively, which was statistically significant (p = 0.001). The findings concerning preoperative treatment drugs showed that 52% (26/50) of the patients without AF had used clopidogrel, with 10% (1/10) of these patients suffering AF (P = 0.015). The consumption of another agent, either angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), was accompanied by AF in 3 (30%) patients, whereas the use of another agent was not accompanied by AF in 32 (64%) patients (p = 0.046).   Conclusions: This study demonstrated that the prophylactic administration of SNP during the rewarming period in CABG significantly reduced the incidence of postoperative AF and surgery time. Furthermore, preoperative treatment drugs, including clopidogrel and ACE inhibitors or ARBs played a significant role in reducing AF occurrence. (Iranian Heart Journal 2021; 22(1): 16-25)}, keywords = {Coronary artery bypass grafting,Atrial Fibrillation,Sodium nitroprusside}, url = {http://journal.iha.org.ir/article_120929.html}, eprint = {http://journal.iha.org.ir/article_120929_7e2dfc0b9a3473e1d514718a01ab7c1b.pdf} } @article { author = {M elfekky, ehab and othman, khaled and rifaie, osama and yahia, mohamed}, title = {Possible Advantages of Deferred Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction Patients With Moderate-to-High Thrombus Burden}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {26-32}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background:Primary percutaneous coronary intervention is the standard of care for ST-elevation myocardial infarction (STEMI). However, the proper management of the culprit artery with residual moderate-to-high thrombus burden after the initial restoration of flow is still unclear.   Methods:One hundred patients with STEMI underwent primary percutaneous coronary intervention, through which the operators managed to establish thrombolysis in myocardial infarction (TIMI) II–III flow with minimal manipulation but with residual moderate-to-high thrombus burden in the culprit artery. The patients were categorized into 2 equal groups. Group A consisted of patients who underwent immediate stenting, and Group B was comprised of patients for whom the intervention was deferred. After 24 to 48 hours, coronary angiography was repeated in Group B, and stenting was done when needed. The patients had pre-discharge echocardiography and were followed for 4 weeks for major adverse cardiac events (MACE); additionally, echocardiography was repeated 1 month after discharge   Results:There was no difference between the 2 groups regarding the TIMI flow of the culprit artery at the end of the revascularization procedure. There was a significant difference between the groups concerning the need for coronary stenting, which was lower in the deferral group (100% of the patients had stents in Group A vs 58% in Group B; P = 0.000). No significant difference was observed between the immediate and the deferral groups apropos the in-hospital morbidity/mortality or left ventricular function. At follow-up, there was no difference between the 2 groups vis-à-vis MACE and left ventricular function.   Conclusions: Deferred stenting is beneficial in reducing the need for stenting and the associated mortality/morbidity. (Iranian Heart Journal 2021; 22(1): 26-32)}, keywords = {STEMI,Primary PCI,Deferred PCI}, url = {http://journal.iha.org.ir/article_120930.html}, eprint = {http://journal.iha.org.ir/article_120930_ca1b36bf7861f8c525e606471438d17b.pdf} } @article { author = {Torabpour, Masoud and Dianat, Mahin and Badavi, Mohammad and Ahangarpour, Akram and Khodadadi, Ali and Goudarzi, Gholamreza}, title = {Adverse Impact of Ambient Particulate Matter on Cardiac Electrophysiology and the Lipid Profile in Rats}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {33-41}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Particulate matter (PM) is an organic and inorganic mixture of particles of different sizes and chemical compositions. Positive correlations exist between the concentrations of air PM and respiratory and cardiovascular disorders, causing premature mortality and morbidity. This study was designed to evaluate the effects of PM on cardiac electrophysiology and the lipid profile in rats.   Methods: A total of 72 male Wistar rats (250–300 g) were divided into 6 groups: control (intratracheal instillation of 0.1-mL normal saline), PMA (intratracheal instillation of 0.5-mg/kg particles less than 10 μm [PM10]), PMB (intratracheal instillation of 2.5-mg/kg PM10), PMC (intratracheal instillation of 5-mg/kg PM10) twice at 48-hour intervals, calcium chloride (CaCl2) (140 mg/kg, intravenous), and isoproterenol (100 mg/kg, subcutaneous). After 48 hours, lead II electrocardiography was recorded and the inotropic and chronotropic properties of the heart and the incidence of arrhythmias were evaluated. Cardiac lipid parameters, including plasma cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides, and cardiac markers of myocardial infarction, creatine kinase-MB (CK-MB), and lactate dehydrogenase (LDH) were measured.   Results: After the administration of PM10, there was a significant decrease in the voltage of the QRS complex and the R-R interval in comparison with the control group. There was a significant increase in the number of arrhythmias (premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation) after PM10 administration. The administration of PM10 led to an increase in LDL, cholesterol, triglycerides, LDH, and CK-MB and a decrease in HDL in all the concentration groups.   Conclusions: PM10 can be introduced as an arrhythmogenic agent with the potential to affect the cardiac lipid profile by inducing cardiac damage and infarction. (Iranian Heart Journal 2021; 22(1): 33-41)}, keywords = {Particulate Matter,arrhythmia,Inotropic,Chronotropic,Rat}, url = {http://journal.iha.org.ir/article_120931.html}, eprint = {http://journal.iha.org.ir/article_120931_9a371245389d5dde252798737199d78a.pdf} } @article { author = {Jain, Varun and Jadhav, Nitin}, title = {Coronary Angiographic Profile in Acute Coronary Syndrome: A Prospective Observational Study in Southern India}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {42-48}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background:Coronary angiography performed during acute coronary syndrome (ACS) reveals different morphologies of the coronary artery such as occlusion, thrombosis, and stenosis. However, in some cases of ACS, angiography shows normal coronaries. Thus, we aimed to evaluate the pattern of coronary artery disease (CAD) in various cases of ACS using coronary angiography.   Methods:In this prospective study, 100 patients of either gender, aged above 18 years, with the chief complaint of typical chest pain and electrocardiographic abnormalities consistent with ACS, who underwent coronary angiography within 48 hours of admission were studied for angiographic patterns. Statistical analysis was performed using software R, version 3.6.0.   Results:The study population was comprised of 100 patients, of whom the majority were men (60%). The mean age was 56.86 ± 12.79 years. Most of the patients had unstable angina (39%), ST-elevation myocardial infarction (31%), and non–ST-elevation myocardial infarction (30%), followed by single-vessel disease (33%), double-vessel disease (19%), and triple-vessel disease (19%). The left anterior descending (LAD) was the most common artery involved (61%) with 31% of complex and diffuse lesions. Among patients with risk factors, including diabetes and hypertension, 41% had vessel occlusions. Statistically, no significant association was found between risk factors and angiographic findings (P = 0.193). A linear positive correlation was found between total cholesterol and the percentage of the vessel occlusion of an individual epicardial artery (LAD: 0.12r [P = 0.233], left circumflex: 0.104r [P = 0.302], and left main coronary artery: 0.016r [P = 0.869]).   Conclusions:Coronary angiography revealed a high incidence of multiple-vessel disease in our patients with hyperlipidemia, diabetes, and hypertension. However, it showed normal coronaries in a few patients with ACS. Therefore, coronary angiography may not always be useful in the detection of the etiology of myocardial ischemia in every patient. (Iranian Heart Journal 2021; 22(1): 42-48)}, keywords = {Coronary Artery Disease,Diabetes,Hypertension,Hyperlipidemia}, url = {http://journal.iha.org.ir/article_120932.html}, eprint = {http://journal.iha.org.ir/article_120932_7edb26d08a0a0319556ba7461cc398cb.pdf} } @article { author = {Alavi, Seyed Mostafa and Babaei, Touraj and Ziaei Fard, Mohsen and Tirgarfakheri, Kourosh and Bourghani-Farahani, Elnaz and Bakhshandeh, Hooman}, title = {Bispectral Index Monitoring Can Be an Effective Method to Assess Sedation Levels After Open-Heart Surgery}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {49-56}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Proper sedation is the main part of patient management in post-cardiac surgery care units. The bispectral index (BIS) monitor is a noninvasive device that can show the sedation level of patients through electroencephalography processing. We aimed to study the role of BIS monitoring to assess sedation levels in patients after cardiac surgery in the post-cardiac surgery care unit.   Methods: This observational prospective cohort study enrolled 110 patients (37 female, mean age: 60 ± 13 y) candidated for open-heart surgery in Rajaie Cardiovascular Medical and Research Center. In the post-cardiac surgery care unit, sedation levels in 55 patients were monitored via BIS monitoring, while in the control group (n = 55), sedation levels were assessed via the Glasgow Coma Scale, the visual analog scale, and hemodynamic parameters. Both groups had the same sedation protocol. The primary endpoint of the study was the frequency of the prescription of analgesics, and the secondary endpoint was the duration of mechanical ventilation, intensive care unit (ICU) stay, and hospital stay. Data were collected and analyzed using SPSS software, version 22.   Results: The results showed a decrease in the consumption of dexmedetomidine, midazolam, and morphine in the BIS group (p < 0.001), but no significant difference was observed in terms of the use of ketorolac and paracetamol (Apotel) (p > 0.05). Also, in the BIS group, the duration of mechanical ventilation (p < 0.001), ICU stay (P < 0.001), and hospital stay (P < 0.001) decreased significantly compared with that in the BIS group.   Conclusions: BIS monitoring decreased the dose of sedative/analgesic drugs in the participants; it can, therefore, be a reliable method to assess sedation levels. (Iranian Heart Journal 2021; 22(1): 49-56)}, keywords = {Consciousness monitors,Intensive Care Units,Cardiac surgical procedures,Hypnotics and sedatives,analgesics}, url = {http://journal.iha.org.ir/article_120933.html}, eprint = {http://journal.iha.org.ir/article_120933_b2ea1124fcf83c652675aed64ac46761.pdf} } @article { author = {Kaunang, Erling and As’ad, Suryani and Warouw, Sarah and Kabo, Peter}, title = {Correlations Between Lipid Profile, High-Sensitivity C-Reactive Protein, Matrix Metalloproteinase, and Left Ventricular Mass and Function Among Adolescents With Obesity}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {57-65}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The prevalence of obesity among adolescents is steadily increasing. Obese adolescents are thought to have impaired lipid profile, high-sensitivity C-reactive protein (hs-CRP), matrix metalloproteinase 9 (MMP-9), and left ventricular mass and function, which are potential for further research. This study aimed to compare total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, hs-CRP, MMP-9, and left ventricular mass and function between obese and nonobese adolescents.   Methods: A cohort study was conducted in Manado from August 2013 to February 2014. This study enrolled adolescents aged between 13 and 18 years whose body mass index (BMI) was greater than 95th percentile according to CDC 2000 recommendation.   Results: A total of 80 subjects, consisting of 40 subjects in both obese and nonobese arms, were included in this study. The results from the comparative analysis were as follows: total cholesterol: 194.25/160.88 mg/dL, LDL: 136.63/104.65 mg/dL, HDL: 46.13/48.60 mg/dL, triglycerides: 113.10/69.68 mg/dL, hs-CRP: 3.60/0.64 mg/dL, and MMP-9: 620.50/391.64 mg/dL. There were significant differences in total cholesterol, LDL, hs-CRP, and MMP-9 levels (P < 0.001) between the obese and nonobese groups. The univariate analysis showed a significant relationship between BMI and left ventricular mass (P < 0.01), HDL and left ventricular mass (P = 0.036), triglycerides and left ventricular mass (P = 0.01), MMP-9 and left ventricular mass (P < 0.01), and hs-CRP and left ventricular mass (P = 0.001).   Conclusions: Among the obese adolescents in the age group of 13 to 18 years old, there was an alteration in lipid profile, hs-CRP levels, MMP-9 levels, and left ventricular mass and function. (Iranian Heart Journal 2021; 22(1): 57-65)}, keywords = {Obese adolescents,lipid profile,hs-CRP,MMP-9,Left ventricular mass,Left ventricular function}, url = {http://journal.iha.org.ir/article_120934.html}, eprint = {http://journal.iha.org.ir/article_120934_234691eb49669863d94035f0e5d1aaf3.pdf} } @article { author = {Sharoubandi, Seyed Hossein and Rouzitalab, Mostafa and Pishgoo, Bahram and Kiani, Reza}, title = {Evaluation of Clinical and Laboratory Predisposing Factors of Acute Coronary Syndrome in Military Staff}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {66-73}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Cardiovascular diseases are the leading cause of death in the third millennium. Acute coronary syndrome (ACS) is the most fatal cardiovascular disease, and various factors are involved in the development of this disease. These factors include clinical and laboratory factors as well as stress. Occupational stress is a risk factor for heart disease, and it also increases the risk of coronary heart disease. Military work is universally considered to be stressful. The aim of this study was to evaluate the clinical and laboratory predisposing factors of ACS in military staff.   Methods: In this prospective study, 260 patients admitted to Baqiyatallah Hospital were enrolled and divided into 2 groups: 130 patients with ACS and 130 patients with stable coronary artery disease. The study population was studied for various variables, including occupational stress, sedentary lifestyle, and some laboratory markers, including the neutrophil-to-lymphocyte ratio (NLR), the ratio of monocytes to high-density lipoprotein (HDL), and red cell distribution width (RDW).   Results: There were significant differences between the 2 groups in terms of physically demanding tasks (case: 61% vs control: 43%; P = 0.036), an average daily sitting time of more than 3 hours (case: 58.5% vs control: 43.8%; P = 0.048), and an average daily television watching time of more than 2 hours (case: 56.9% vs control: 42.3%; P = 0.048). There was a significant difference concerning NLR between the case and control groups (case: 4.8 ±1.4 vs control: 2.2 ± 0.5; P = 0.011) regarding the ratio of monocytes to HDL (case: 16.6 ± 5.6 vs control: 10.6 ± 3.1; P = 0.034) and RDW (case: 14.5 ± 1.9 vs control: 12.8 ± 1.4; P = 0.041).   Conclusions: According to our findings, an increase in NLR and the ratio of monocytes to HDL are predisposing factors of ACS; in addition, RDW is a predicting factor of ACS in military personnel. A sedentary lifestyle and work stress are also contributing factors to the development of ACS in this population. (Iranian Heart Journal 2021; 22(1): 66-73)}, keywords = {Acute coronary syndrome,Plaque rupture,Inflammatory Markers}, url = {http://journal.iha.org.ir/article_120939.html}, eprint = {http://journal.iha.org.ir/article_120939_ae0dc5f5d11523d71742137c08ba0dd2.pdf} } @article { author = {Bahulekar, Ajinkya and Patil, Virendra and Patil, Shilpa}, title = {Diagnostic Utility of Electrocardiography and Transthoracic Echocardiography in the Diagnosis of Left Ventricular Hypertrophy in Patients With Known Hypertension}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {74-83}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular events. The increase in LV mass is usually screened by electrocardiography (ECG), which is often insensitive. Despite being insensitive, ECG is cost-effective compared with echocardiography. Therefore, this study aimed to assess the diagnostic utility of ECG and echocardiography in the diagnosis of LVH among patients with hypertension.   Methods: This comparative prospective study was carried out on 200 patients with hypertension. ECG and echocardiography were performed on all the patients to evaluate the presence of LVH. The Sokolow–Lyon index, the Romhilt–Estes point, and the Cornell voltage criteria were the ECG criteria used. For 2D echocardiography, interventricular septal thickness (IVST) and left ventricular posterior wall thickness (LVPWT) were considered. The χ2 test was employed to test the significance of the qualitative variables. A P value of less than 0.05 was considered statistically significant.   Results: The specificity of the Cornell voltage criteria was high compared with that of the other criteria of ECG, although the sensitivity was low for all the other ECG criteria. The occurrence of LVH according to the IVST criteria of 2D echocardiography was significantly associated with the severity and duration of hypertension (P = 0.042). The majority of the patients with diastolic dysfunction were in Stage I hypertension.   Conclusions: The diagnostic utility of ECG compared with echocardiography was found to be insensitive. Hence, echocardiography is the preferred method in the detection of LVH in patients with hypertension. However, improved ECG criteria can be adopted in the future for LVH detection due to its cost-effective nature. (Iranian Heart Journal 2021; 22(1): 74-83)}, keywords = {Electrocardiography,Hypertension,Left ventricular hypertrophy,Ventricular septum}, url = {http://journal.iha.org.ir/article_120940.html}, eprint = {http://journal.iha.org.ir/article_120940_97d6ac3ee070f4f4b939d6764b9d7693.pdf} } @article { author = {Mohammadzadeh, Ali and Zahedmehr, Ali and Pourtaghi, Sanaz and Nahardani, Ali and Borhani, Ali and Shojaie, Layla and Mohammadzadeh, Maryam}, title = {Resting-State Cardiac Magnetic Resonance Perfusion Imaging Accuracy in Diagnosing Patients With Coronary Artery Disease: A Comparison with Percutaneous Coronary Intervention}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {84-90}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Myocardial ischemia may occur as a result of a variety of vascular and congenital conditions. There are different methods to assess ischemic myocardial tissue This study aimed to assess the diagnostic accuracy of cardiac magnetic resonance imaging (CMR) in advanced coronary artery disease (CAD).   Methods: Thirty patients with a predefined history of severe CAD underwent CMR with a 1.5 T CMR machine. The imaging protocol consisted of 4 steps: left ventricular functional imaging, T1-weighted contrast-enhanced magnetic resonance perfusion imaging, early gadolinium enhancement, and delayed gadolinium enhancement. The left ventricular functional indices and time-intensity curves (TICs) of the magnetic resonance perfusion imaging were calculated using a CMR analysis software tool. The TICs were drawn on 90 normal, early, and delayed gadolinium-enhanced territories under the guidance of percutaneous coronary angiography reports.   Results: Overall, 90 territories were derived from the 30 patients. Fifty-two territories were diagnosed with significant CAD and 38 with a normal coronary status. Our analysis revealed 35 regions with flattened TICs (increased time to peak, deceased maximum intensity, and more time-lasting plateaus) and 17 with normal patterns in diseased territories. From the total 38 angiographically normal regions, 36 regions presented normal TICs and 2 showed diseased patterns. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CMR were 78.8%, 67.3%, 94.7%, 94.59%, and 67.92%, respectively, in comparison with percutaneous coronary angiography.   Conclusions: Resting-state CMR can be used to detect the presence of any severe/significant coronary artery lesion with an acceptable accuracy. (Iranian Heart Journal 2021; 22(1): 84-90)}, keywords = {Magnetic resonance imaging,Coronary Artery Disease,myocardial ischemia,Perfusion magnetic resonance imaging,Percutaneous Coronary Intervention}, url = {http://journal.iha.org.ir/article_120942.html}, eprint = {http://journal.iha.org.ir/article_120942_2885b594c26912b358eb5f26c51ff731.pdf} } @article { author = {Nayak, Krishnananda and Varghese, Sara and Razak, Abdul and A, Megha and Devasia, Tom and Edward Lewis, Leslie and Prabhu, Sridevi}, title = {Echocardiographic Screening for Myocardial Dysfunction Among Asphyxiated Newborns}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {91-99}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Perinatal asphyxia/ischemia is an interruption in the availability of oxygen supply to the myocardium. We sought to assess myocardial function among asphyxiated and non-asphyxiated neonates using echocardiography.   Methods: The present case-control study was undertaken at the neonatal intensive care unit (NICU) of a tertiary care hospital. Neonates with asphyxia who were admitted to the NICU were included in the study. The diagnosis of asphyxia was established on the basis of the APGAR score at 1 and 5 minutes. Myocardial function was assessed in terms of serum cardiac troponin I (CTnI) and different echocardiographic parameters such as M-Mode, Doppler flow parameters, and tissue Doppler imaging.   Results: Thirty asphyxiated (the case group) and 30 non-asphyxiated (the control group) term neonates were enrolled in the study. The asphyxia group had significantly lower (P < 0.001) 1- and 5-minute APGAR scores than the controls. The asphyxia group had a higher serum CTnI value. The differences between the 2 groups concerning M-Mode parameters in the first 12 hours of life were statistically significant (P < 0.001). The case and control groups were also statistically significantly different regarding left atrial pressure at 48 hours following birth, calculated as a ratio of E/e’ (P < 0.001). The differences between the 2 study groups at 24 hours after birth as regards tissue Doppler parameters, including left ventricular ejection time and left ventricular Tei index, were also statistically significant (P < 0.001). The case and control groups also showed statistically meaningful differences concerning right ventricular ejection period/ ejection time at 24 hours after birth (P < 0.002).   Conclusions: It can be concluded that the myocardial function assessment using CTnI and different echocardiographic techniques is the most sensitive and specific method in the detection of ischemic cardiac injury in asphyxiated newborns. (Iranian Heart Journal 2021; 22(1): 91-99)}, keywords = {Asphyxia,APGAR score,Newborn,Troponin}, url = {http://journal.iha.org.ir/article_120943.html}, eprint = {http://journal.iha.org.ir/article_120943_228e08e97d6654790cb2a34a4b8ea52d.pdf} } @article { author = {Shafipoor, Seyed Shafi and Baradaran, Abdolvahab and Nikdoust, Farahnaz and Tabatabaei, Seyed Abdolhossein}, title = {Efficacy of Remote Ischemic Preconditioning in the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography /Angioplasty}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {100-105}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Contrast-induced nephropathy (CIN) is a significant common complication in patients undergoing coronary angiography. This study was carried out to determine the efficacy of remote ischemic preconditioning in the prevention of CIN in patients undergoing coronary angiography/angioplasty.   Methods: This randomized controlled trial assessed 171 eligible patients undergoing coronary angiography/angioplasty in Shariati Hospital between May 2018 and June 2019. The patients were randomly assigned to either the remote ischemic preconditioning group or the control group. The glomerular filtration rate (GFR), CIN, and creatinine levels were compared between the groups.   Results: The incidence rate of CIN was 1.2% in the intervention group and 9.4% in the control group (P = 0.018), with a risk ratio of 0.125. There were significant improvements in creatinine and GFR in the intervention group (P = 0.007 and P = 0.001, respectively), while there were no meaningful improvements in creatinine and GFR in the control group. The intervention group featured 11 patients in Stage IV chronic kidney disease, none of whom was CIN-positive, whereas the control group had 2 patients in Stage IV, both of whom were CIN-positive (P < 0.001).   Conclusions:The results showed the efficacy of remote ischemic preconditioning in the prevention of CIN, the reduction of creatinine reduction, and the elevation of GFR in patients undergoing coronary angiography/angioplasty. (Iranian Heart Journal 2021; 22(1): 100-105)}, keywords = {Remote ischemic preconditioning,Contrast-induced nephropathy,Coronary Angiography}, url = {http://journal.iha.org.ir/article_120944.html}, eprint = {http://journal.iha.org.ir/article_120944_3d714c0f73e416c66513f5891fc4aaa1.pdf} } @article { author = {Jafari Fesharaki, Mehrdad and Mahjoob, Mohammad Parsa and Kachoueian, Naser and Ebrahimi, Abdolali}, title = {Left Atrial Mass in a Patient With Rheumatic Mitral Stenosis: A Case Report}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {106-108}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Rheumatic mitral stenosis is common in developing countries. The left atrium, due to its large size, is prone to thrombus formation, and the presence of a large mass is more suggestive of a clot. Myxomas are some of the most common benign heart tumors; however, they have been reported rarely in rheumatic mitral stenosis. Here, we describe a patient with mitral stenosis who presented with a large left atrial mass, which was ultimately diagnosed as a tumor. (Iranian Heart Journal 2021; 22(1): 106-108)}, keywords = {CARDIAC TUMOR,Left atrial mass,Left atrial myxoma,Mitral stenosis}, url = {http://journal.iha.org.ir/article_120945.html}, eprint = {http://journal.iha.org.ir/article_120945_d3733e7c191ce1db6dce7cc6c355b927.pdf} } @article { author = {Hussein, Abdinafic and Kürşat Korkmaz, Ufuk and Yapıcı, kubilay and Ali, Abdijalil and Kizilay, Mehmet}, title = {Successfully Managed Case of Cardiac Tamponade due to Tuberculous Pericardial Effusion: A Case Study}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {109-111}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Pericardial tuberculosis (TB) is considered a rare form of extra-pulmonary TB that affects up to 2% of patients with TB. Because of its rarity, the clinical presentation of pericardial TB is nonspecific and requires a high degree of clinical suspicion, which may delay the timely diagnosis and intervention and result in late complications and increased mortality.  We herein describe a 24-year-old female medical student who was referred to our department of cardiovascular surgery complaining of fever, dyspnea on exertion, orthopnea, edema, nonproductive cough, and fatigue. Imaging studies on the chest showed pericardial effusion and thickened pericardium. The pericardial fluid analysis was positive with TB. Timely management was achieved through cardiac surgery (pericardial window) and medical treatment. Therefore, we conclude that in patients who present with pericardial effusion, TB should be a major suspect, especially in developing countries and successful management could be achieved through pericardial windowing in combination with anti-TB drugs and corticosteroids. (Iranian Heart Journal 2021; 22(1): 109-111)}, keywords = {Pericardial effusion,Tuberculosis,Cardiac tamponade}, url = {http://journal.iha.org.ir/article_120946.html}, eprint = {http://journal.iha.org.ir/article_120946_5537a7a98e87d3dc5f9bcfe52e669fff.pdf} } @article { author = {Asadian, Sanaz and Rabiei, Parham and Rezaiean, Nahid and Kamali, Farzad and Madadi, Shabnam}, title = {Electroanatomical Mapping in the Differentiation Between Arrhythmogenic Right Ventricular Cardiomyopathy and Cardiac Sarcoidosis in a Patient With Ventricular Tachycardia Storm}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {112-116}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {A 36-year-old man with frequent episodes of ventricular tachycardia (VT) was referred to our hospital for ablation due to the suspicion of sarcoidosis and arrhythmogenic right ventricular cardiomyopathy in cardiac magnetic resonance imaging. After implantable cardioverter-defibrillator implantation, the patient presented with VT storm, without any endocardial scar and with an extensive epicardial scar in voltage mapping. Consequently, he underwent epicardial VT ablation. (Iranian Heart Journal 2021; 22(1): 112-116)}, keywords = {ARVC,Epicardial ablation,VT storm,ICD,sarcoidosis}, url = {http://journal.iha.org.ir/article_120947.html}, eprint = {http://journal.iha.org.ir/article_120947_7cfdabf82eb5ca4cf597cd753dc2417c.pdf} } @article { author = {Mulia, Eka and Dewi, Ivana and Julario, Rerdin and Budiarto, Mohammad}, title = {Percutaneous Aspiration Thrombectomy in Acute Upper Limb Ischemia: A Case Report}, journal = {Iranian Heart Journal}, volume = {22}, number = {1}, pages = {117-124}, year = {2021}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Introduction:Acute upper limb ischemia (AULI) is an unusual presentation of limb-threatening emergency. Only a few cases of percutaneous thrombectomy in AULI have been published.   Case Presentation:A 55-year-old woman presented with sudden burning pains in the right hand of 11 hours’ duration. Duplex ultrasound identified a thrombus along the proximal brachial artery to the distal radial artery. Arteriography revealed total occlusion in the proximal brachial artery. Transfemoral percutaneous aspiration thrombectomy (PAT) with the result of a red thrombus was subsequently performed. Successful recanalization with a flow from the brachial artery to the distal radial artery was obtained after PAT. Unfortunately, the patient died from septic shock and respiratory failure 4 days later.   Discussion: Successful PAT on the right brachial artery was performed in our case with the prior procedural identification of the occluded artery using duplex ultrasound and angiography.   Conclusions:AULI is a limb- and life-threatening condition. PAT can be an option for vasculature recanalization in upper limb extremities. (Iranian Heart Journal 2021; 22(1): 117-124)}, keywords = {Acute upper limb ischemia,Ali,Percutaneous aspiration thrombectomy,Thrombus,Technique}, url = {http://journal.iha.org.ir/article_120948.html}, eprint = {http://journal.iha.org.ir/article_120948_7445b23df68d6f85f7034b5607e236d2.pdf} }