@article { author = {Nikfarjam, Salman and Zadkamali, Mostafa and Salari, Arsalan and Shakiba, Maryam and Janesar Hoseinie, Mahboubeh and Mirbolouk, Fardin}, title = {Comparison Between Intracoronary and Intravenous Eptifibatide and Intracoronary Reteplase in Patients Undergoing Primary Percutaneous Coronary Intervention: A Randomized Clinical Trial}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {6-16}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Despite the benefits of primary percutaneous coronary intervention (PPCI), myocardial perfusion after treatment remains disrupted in some patients. The utility of glycoprotein IIb/IIIa inhibitors and reteplase during the intervention is indeterminate.Methods: We designed a randomized clinical trial to compare intravenous (IV) and intracoronary (IC) eptifibatide and reteplase in 144 patients with ST-elevation myocardial infarction scheduled for PPCI. The primary outcome was coronary blood flow according to the TIMI flow grade (TFG) before and after PPCI. The secondary outcomes were the differences between ST-segment resolution, diastolic left ventricular dysfunction, left ventricular ejection fraction, mitral regurgitation, CK-MB levels, and hemoglobin levels before and after PPCI.Results: TFG III was achieved in all patients (100%) in the control and reteplase groups. TFG III was seen in 32 (88.9%) and 33 (91.7%) patients in the IV and IC eptifibatide groups, respectively. TFG II was reported in 4 (11.1%) and 3 (8.3%) patients in the IV and IC eptifibatide groups in the same order. Postprocedural TFG was not significantly different between the groups. There was a significant increase in the CK-MB level in the reteplase group compared with the other groups (P<0.05). Postprocedural hemoglobin, ST resolution, and ejection fraction were not significantly different between the groups. Reteplase was associated with a significant improvement in diastolic left ventricular dysfunction compared with the control group (odds ratio, 0.31; P=0.02). No difference was shown in the development of mitral regurgitation between the 4 groups.Conclusions: Neither IV nor IC eptifibatide nor reteplase was associated with improvements in the coronary blood flow as determined by TFG, ST resolution, and ejection fraction. (Iranian Heart Journal 2022; 23(1): 6-16)}, keywords = {Primary percutaneous coronary intervention,Eptifibatide,Reteplase,intravenous,Intracoronary}, url = {http://journal.iha.org.ir/article_142593.html}, eprint = {http://journal.iha.org.ir/article_142593_ac1215a7b2182f946aea83bd367edf60.pdf} } @article { author = {Zehtabian, Shahram and Alibakhshi, Reza and Seyedena, Seyed-Yousef and Rai, Ali-Reza}, title = {Development of a New Framework for Health Assessment in Patients With Coronary Artery Disease by Using microRNA-197 in Iranian Adults}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {17-24}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Coronary artery disease (CAD) refers to stenosis or obstruction in a part or all of a coronary artery due to atherosclerosis or clotting. This study aimed to evaluate the possible efficacy of the serum microRNA-197 (miR-197) as an indicator of diagnosis in patients with CAD. Methods: In this study, 100 patients with CAD who had angiography and vascular transplantation were selected and evaluated. The expression level of miR-197 was determined via the real-time RT-PCR technique and the SYBR Green method. For the analysis of the miRNA expression level and the significance of the patient sample, the t test was used. Additionally, the Pearson correlation coefficient test was utilized to determine the relationship between the expression levels of miRNAs and CAD severity. Results: A positive correlation was observed between miR-197 expression and CAD severity. The average expression of 0.78 in the control sample was increased to 2.76 according to the severity of involvement in the patient. In other words, the relative expression of miR-197 in the CAD + group was significantly increased compared with the control group (P<0.004). Conclusions: It appears that miR-197 can be considered an indicator of coronary endothelial cell function, and it is possible to use it as a biomarker for the prognosis, control, or treatment of CAD. (Iranian Heart Journal 2022; 23(1): 17-24)}, keywords = {miR-197,Coronary Artery Disease,Real-Time RT-PCR,U6 snRNA}, url = {http://journal.iha.org.ir/article_142595.html}, eprint = {http://journal.iha.org.ir/article_142595_3af2fce99e7c0bc27575e8015192bc44.pdf} } @article { author = {Rouzbahani, Mohammed and Shirazinezhad, Zahra and Salimi, Yahya and Janjani, Parisa and Salehi, Nahid and Rai, Alireza and Azimivaghar, Javad and Naderipour, Arsalan and Shirazinezhad, Somayeh and Javadi rad, Etrat and Heidari moghadam, Reza}, title = {Comparison of the One-Year Outcome Between Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention in Patients With Multivessel Coronary Artery Disease}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {25-33}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Our study aimed to compare the 1-year therapeutic outcome between coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in patients with multivessel coronary artery disease (CAD). Methods: This retrospective cohort study was conducted on 150 patients with multivessel CAD who underwent CABG or PCI in Imam Ali Cardiovascular Center, Kermanshah, Iran, between March 2017 and March 2019. Data were collected using a checklist developed based on the study objectives. Differences between subgroups were assessed by using the independent t test and the χ2 test (or the Fisher exact test). A multivariate binary logistic regression model was used to determine factors associated with referral to CABG or PCI. Results: The mean age was 63.48 (SD=9.73) years in the PCI group and 60.54 (SD=10.85) years in the CABG group (P=0.741). The CABG group was more likely to have left main disease (16.6% vs 0%; P<0.001). The PCI group was more likely to take an antiplatelet (viz, clopidogrel) and nitrates, whereas the CABG group was more likely to take antihypertensives (angiotensin receptor blockers) and anticoagulants (viz, rivaroxaban and warfarin) (P<0.05). The CABG had significantly higher rates of major bleeding (P=0.003) and arrhythmia (P=0.045) than the PCI group. There was a significant difference in the mortality between the 2 treatment groups (9.3% of the CABG group vs 1.3% of the PCI group; P=0.029). Left main disease was associated with an increased odds of referral to CABG (OR=0.02; P=0.015). Conclusions: PCI was associated with a lower adverse clinical outcome than CABG in patients with multivessel CAD. (Iranian Heart Journal 2022; 23(1): 25-33)}, keywords = {Coronary artery bypass grafting,Coronary Artery Disease,Iran,outcome,ANGIOPLASTY}, url = {http://journal.iha.org.ir/article_142596.html}, eprint = {http://journal.iha.org.ir/article_142596_8927ddb901db11f3d57302de3be48a7c.pdf} } @article { author = {Mayelafshar, Mahnaz and Noohi, Feridoun and Riahi, Leila and Nikravan, Anise}, title = {Discharge Against Medical Advice in the Emergency Department}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {34-41}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Discharge against medical advice (DAMA) is a process during which the patient leaves the hospital voluntarily without completing the course of treatment, which can indicate a significant problem. The present study was conducted in one of the hospitals of Tehran to identify the causes of DAMA and design its dashboard.   Methods: The present descriptive cross-sectional study examined the causes of DAMA in 2018 in a hospital in Tehran. Data were collected through a checklist prepared by the accreditation office. The collected data were inserted into QlikView software to design the dashboard.   Results: The results demonstrated that the prevalence of DAMA from the hospital under study was 0.7% in the outpatient department and 0.25% in the inpatient department compared with the total number of patients discharged in these departments. The most common reasons for DAMA were, respectively, unwillingness to undergo surgery or procedures and financial problems.   Conclusions: The findings allow hospital managers to take measures aimed at lessening DAMA and, thus, side effects, returns to the hospital, and additional costs. DAMA is a multidimensional phenomenon and is subject to several factors. Therefore, predicting the rate of DAMA and its determining factors can play an effective role in its control. (Iranian Heart Journal 2022; 23(1): 34-41)}, keywords = {Patient Discharge,Emergency Service,Hospital,patients,patient care management}, url = {http://journal.iha.org.ir/article_142597.html}, eprint = {http://journal.iha.org.ir/article_142597_365c83ca46a7066800afd5f331800e88.pdf} } @article { author = {Mehrpouri, Mahdieh and Bashash, Davood and Gheydari, Mohammad Esmail and Mohammadi, Mohammad hossien and Baghestani, Ahmad reza and Hamidpour, Mohsen}, title = {Association Between Increased Expression Levels of SDF-1 and CXCR4 on the Platelets of Patients With Coronary Artery Disease and Low LVEF}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {42-53}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Since coronary artery disease (CAD) is one of the leading causes of death globally, identifying new risk factors can augment risk assessment. This study aimed to investigate the surface expression of stromal cell-derived factor-1 (SDF-1), CXCR4, and CXCR7 on the platelets of CAD patients and to determine whether there is a correlation between their expressions and left ventricular ejection fraction (LVEF).   Methods: Sixty CAD patients and 60 healthy volunteers as normal controls were studied. The mean fluorescence intensity (MFI) of SDF-1 and its receptor expression was evaluated by flow cytometry. Biochemical markers and platelet parameters were investigated with an AutoAnalyzer and a cell counter, respectively.   Results: The platelets of the CAD group expressed SDF-1 and CXCR4 significantly more than those of the control group (MFI=1112±304 vs 943±131; P=0.042 and MFI=23372±6804 vs 20634±3482; P=0.033, respectively). Nevertheless, no significant difference was found in the platelet expression of CXCR7 between the CAD and control groups (MFI=35256±8706 vs 25053±7270; P=0.061). Notably, increased expression levels of SDF-1 and CXCR4 were associated with decreased LVEF (r= −0.388, P=0.003 and r= −0.431, P=0.001).   Conclusions: Our findings demonstrated that the overexpression of SDF-1 and CXCR4 on platelets could be considered a promising candidate indicating that asymptomatic patients with decreased LVEF may be at the risk of CAD. (Iranian Heart Journal 2022; 23(1): 42-53)}, keywords = {SDF-1,CXCR4,CXCR7,Coronary artery disease (CAD),Platelet markers}, url = {http://journal.iha.org.ir/article_142598.html}, eprint = {http://journal.iha.org.ir/article_142598_d4c325e436e4c8637c10c6f25a3da48f.pdf} } @article { author = {Tabib, Avisa and Mahdavi, Mohammad and Moradian, Maryam and Rahimpour, Feisal and Rezaei, Yousef}, title = {N-terminal pro B-type Natriuretic Peptide Levels and Dilated Cardiomyopathy: A Tissue Doppler Echocardiographic Study in Children}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {54-64}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The N-terminal segment of the pro-brain natriuretic peptide (NT-proBNP) has emerged as a marker for heart failure. Dilated cardiomyopathy (DCM) as a major cause of congestive heart failure in children leads to a low cardiac output. However, only a few studies have shown the role of tissue Doppler imaging (TDI) in children with DCM. We sought to explore the associations between TDI parameters and NT-proBNP among DCM patients.   Methods: The present cross-sectional study consecutively enrolled 28 children with DCM. All the patients were on medical therapies in a stable condition upon entrance into the study. All the children were examined by 2D transthoracic echocardiography. TDI imaging was taken from lateral and septal mitral valve areas, and myocardial velocity was calculated by TDI. All the children gave blood samples for the measurement of the NT-proBNP level.   Results: Seventeen patients (60.7%) were female, and the patients’ median age was 10 (IQR25%-75%: 1 to 13) years. The NT-proBNP median was 8614 (IQR25%-75%, 2592 to 20909) pg/mL. There were statistically significant linear relationships between the NT-proBNP level and the lateral myocardial performance index (MPI) (ρ=0.416), the septal MPI (ρ=0.740), the septal E/e´ (ρ=0.533), and the lateral E/e´ (ρ=0.448). The strongest correlation coefficients were observed between the NT-proBNP level and the left ventricular ejection fraction (ρ= −0.754; P=0.001) and the septal MPI (ρ=0.740; P=0.001), even after indexing by body surface area.   Conclusions: NT-proBNP levels correlated strongly with the left ventricular function measured by TDI parameters. Noninvasive echocardiographic evaluations can be implemented to assess children with DCM. (Iranian Heart Journal 2022; 23(1): 54-64)}, keywords = {dilated cardiomyopathy,Brain natriuretic peptides,TISSUE DOPPLER IMAGING,echocardiography}, url = {http://journal.iha.org.ir/article_142599.html}, eprint = {http://journal.iha.org.ir/article_142599_81d87ef5863c4cabc60f30f8f398bdc9.pdf} } @article { author = {Alemzadeh-Ansari, Mohammad Javad and Basiri, Hoseinali and Peighambari, Mohamad Mehdi and Roudbari, Soudeh and Salehi, Pegah and Ameni, Mohammad and Roudbari, Masoud and Pouraliakbar, Hamidreza and Khalili, Yasaman}, title = {Importance of the Neutrophil-to-Lymphocyte Ratio and the Platelet-to-Lymphocyte Ratio in Patients With Venous Thromboembolism}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {65-73}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Acute pulmonary thromboembolism (PTE) is the most common manifestation of venous thromboembolism (VTE). Due to the physiological response of circulating leukocytes to stress, circulation neutrophils increase and lymphocytes decrease. Therefore, the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) can be important measures to assess the severity of systemic inflammation. We sought to study NLR and PLR and their relationships with the severity of VTE and mortality.   Methods: The study enrolled 331 patients with VTE from 2014 through 2018. Based on the complete blood count obtained from the peripheral blood samples of the patients on admission, NLR and PLR were calculated. The incidence of VTE with or without PTE, as well as its severity, was determined based on computed tomography angiography findings and the patients’ clinical status.   Results: A positive relationship was observed between PTE and NLR (P=0.01). There was a significant relationship between the NLR and PLR values and PTE based on computed tomography angiography findings (NLR: P=0.001, PLR: P=0.012), but no relationship was detected between the ratios and the patients’ PTE severity based on clinical status. A significant relationship was also observed between NLR and the main pulmonary artery and segmental involvement (P=0.009), while no such association was seen with PLR. Additionally, the results revealed a significant relationship between NLR and mortality (P=0.030).   Conclusions: Our results demonstrated a significant relationship between the NLR and PLR values and PTE severity based on computed tomography angiography results and also mortality in patients with PTE. (Iranian Heart Journal 2022; 23(1): 65-73)}, keywords = {Neutrophil,Lymphocyte,platelet,Venous Thromboembolism}, url = {http://journal.iha.org.ir/article_142600.html}, eprint = {http://journal.iha.org.ir/article_142600_72b49b09341b0a3714a98d96548d8717.pdf} } @article { author = {Vesal, Ahmad and Moradian, Maryam and Ghasemnezhad, Mohsen and Tabib, Avisa and Rashidi Ghader, Fariba and Meraji, Seyyed Mahmoud and Jafari, Farshad and Ghaemi, Hamid Reza and Heidari, Solmaz and Barouti, Shahriar and Mohammadi, Shooka}, title = {Comparison Between 2D Transthoracic Echocardiography, Transesophageal Echocardiography, and Balloon Sizing Methods for Device Size Selection in Pediatric Patients Undergoing Transcatheter Closure of Atrial Septal Defects}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {74-84}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Transcatheter closure of atrial septal defects (ASDs) is considered an alternative technique to surgery, and appropriate device size selection is essential to an effective procedure. We aimed to compare 2D transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), and balloon sizing methods for device size selection in pediatric patients undergoing ASD transcatheter closure and to establish an accurate and simple procedure for device size selection.   Methods: This cross-sectional study was performed on pediatric patients for 8 months in Tehran, Iran. Device size was identified by balloon sizing, 2D TEE, and TTE.   Results: This study enrolled 39 children (64.1% female, average age= 7.1±3.1 y) who underwent successful ASD transcatheter closure. The mean defect size by balloon-stretched diameter measurement was significantly greater than the ASD size measured by 2D TEE and TTE. There was a strong, highly significant positive correlation (P<0.001) between the device waist size and different ASD diameters measured by 2D TEE, TTE, and balloon sizing. A good linear association was found between the ASD size measured by device waist size and 2D TEE (device waist size= 0.99×TEE-derived defect size+1.678; P<0.001) as well as TTE (device waist size= 1.01×TTE-derived defect size+1.17; P<0.001), respectively.   Conclusions: In this study, TEE and TTE-derived defect sizes were significantly associated with the device waist size. Additionally, the equations generated herein may provide a reliable and good prediction for appropriate device size. (Iranian Heart Journal 2022; 23(1): 74-84)}, keywords = {ASD,TTE,TEE,children,Iran}, url = {http://journal.iha.org.ir/article_142601.html}, eprint = {http://journal.iha.org.ir/article_142601_7bc72ae0f97912259668e923eaf34962.pdf} } @article { author = {Alamzadeh-Ansari, Mohammad Javad and Firouzi, Ata and Alimohammadi, Mousa and Khalilipur, Ehsan and Noohi, Feridoun and Maleki, Majid and Peighambari, Mohammad Mehdi and Mohebbi, Bahram and Zadehmehr, Ali and Rashidinejad, Alireza and Shakerian, Farshad and Kiani, Reza and Bakhshandeh, Hooman}, title = {Impact of Drug-Eluting Stent Expansion on Saphenous Vein Graft Percutaneous Intervention}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {85-94}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: We intended to evaluate the effects of stent expansion in percutaneous coronary intervention (PCI) on saphenous vein graft (SVG) lesions and compare over-expansion and under-expansion between SVG stents in the case of major adverse cardiac events (MACE).   Methods: Totally, 196 SVG lesions were treated with drug-eluting stents. The ratio of the stent diameter to the diameter of the normal part of the SVG (which was without lesions and considered the reference part of the SVG) was measured by quantitative coronary angiography. Subsequently, the patients were divided into 3 groups: Group I (<0.90 expansion: undersized stents), Group II (0.90–1.0 expansion: normal-sized stents), and Group III (>1.0: oversized stents). MACE rates during PCI, hospitalization length, and follow-up findings were compared between the groups. Additionally, the effects of the embolic protection device (EPD) on MACE were assessed.   Results: Oversized stenting was associated with increased cardiac enzymes (P=0.035) during hospitalization but was not associated with more MACE or restenosis on follow-up. Statistical analysis demonstrated nonsignificant more revascularization in the oversized group mainly due to unknown vessel revascularization and non-target vessel revascularization (P=0.167 and P=0.108, respectively). There were no differences in other MACE outcomes. The EPD was used in 25% of the patients. By comparison with the group without the EPD, there was no decrease in MACE components except a higher incidence of heart failure in the EPD group (P=0.03).   Conclusions: Aggressive stent expansion in SVG lesions resulted in higher myocardial injury; and unlike native arteries, there was no improvement in target vessel revascularization rates at follow-up. (Iranian Heart Journal 2022; 23(1): 85-94)}, keywords = {Saphenous vein graft,PCI,Stent expansion}, url = {http://journal.iha.org.ir/article_142602.html}, eprint = {http://journal.iha.org.ir/article_142602_b77d80cf07f2578038fd88fe90239602.pdf} } @article { author = {Sadeghi, Hasan Allah and Sheikh Fathollahi, Mahmood and Sadeghi, Sarina and Nikpajouh, Akbar}, title = {Clinical Profile of Patients With Ordinary, Submassive, and Massive Pulmonary Thromboembolism in Rajaie Cardiovascular Medical and Research Center}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {95-105}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Acute pulmonary thromboembolism (PTE) is a common condition with an increasing incidence that causes severe complications and death. We herein describe the clinical profile of patients with PTE who were referred to a large tertiary university heart hospital.   Methods: In this retrospective cohort study, the demographic, clinical, and admission data of patients with PTE admitted to Rajaie Cardiovascular Medical and Research Center in 2 consecutive years were reviewed and analyzed. Based on echocardiography findings, clinical presentation, and pulmonary computed tomography findings, the patients were divided into massive, submassive, and minor PTE groups. The study variables, as well as in-hospital mortality, were compared between the groups.   Results: The study population consisted of 328 patients with PTE: 210 patients (64.0%) with ordinary PTE, 88 (26.8%) with submassive PTE, and 30 (9.1%) with massive PTE. The patients with massive PTE were significantly younger (P=0.007) and had a higher rate of tachypnea (P=0.002), tachycardia (P=0.013), and hypotension (P<0.001) at presentation. The patients with submassive PTE were more likely to be male and had higher uric acid levels (P=0.002). Chest pain and hypertension were more frequent in the patients with ordinary PTE (P=0.019 and P=0.016, respectively). In pulmonary computed tomography angiography, the involvement of the left and right pulmonary arteries was more frequently observed in the patients with submassive PTE (P=0.013 and P=0.007, respectively). More patients in the massive PTE group received thrombolytic therapy (P<0.001) with a significantly higher mortality rate (P<0.001), a shorter ICU stay (P=0.001), and a shorter hospitalization period (P<0.001).   Conclusions: Patients with massive PTE have a higher risk of mortality and should be considered for more aggressive therapy. (Iranian Heart Journal 2022; 23(1): 95-105)}, keywords = {pulmonary thromboembolism,Epidemiology,Massive pulmonary emboli,Treatment outcome}, url = {http://journal.iha.org.ir/article_142603.html}, eprint = {http://journal.iha.org.ir/article_142603_7666f09aea67dd2b9bbdd1c224efe697.pdf} } @article { author = {Emamgholipour, Sara and Moeini, Sajad}, title = {Comparison of the Economic Burden Between Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention at a One-Year Follow-up}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {106-111}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Cardiovascular disease is one of the leading causes of death and disability in the world. There is limited information about the economic burden of this disease in Iran. This study aimed to compare the economic burden between coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI) from 2018 through 2019. Methods: The cost of cardiovascular disease was calculated from a sociological perspective based on a top-down approach. The study samples were 379 cardiac patients with venous congestion above 70% who were sampled at Tehran Heart Center by simple random sampling. The cost information was collected in 3 different periods using the hospital information system and interviewing patients. Results: The direct medical cost of CABG was higher than that of PCI (183 907 460 rials vs 122 508 920 rials). The direct nonmedical cost and the indirect cost of CABG were 15 848 570 rials and 79 420 960 rials, respectively, while these costs were 7 951 900 rials and 26 315 170 rials, respectively, for PCI. Conclusions: At 1 year’s postoperative follow-up, CABG had a higher cost than PCI for the patients and, thus, the country’s healthcare system. (Iranian Heart Journal 2022; 23(1): 106-111)}, keywords = {Economic burden,Cost,Open-heart surgery,ANGIOPLASTY,CABG}, url = {http://journal.iha.org.ir/article_142604.html}, eprint = {http://journal.iha.org.ir/article_142604_eac280f99c680e76370210c3826fb2f1.pdf} } @article { author = {Abbaszadeh, Reza and Azari, Behrouz and meraji, mahmoud and Azari, Gholamreza and Khalili, Yasaman and Nikpajouh, Akbar}, title = {Can Pulmonary Arterial Pressure Exceeding 15 mm Hg Predict Prognosis in Patients With a Single-Ventricle Defect Undergoing the Glenn Procedure?}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {112-117}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The primary goal of the Fontan reconstructive surgery is not only to achieve optimal systemic blood flow and simultaneous controlled pulmonary balance but also to prevent the blood from returning to the ventricles. Such measures as the use of systemic-pulmonary shunts can help achieve the desired outcome in this type of surgery. It appears that reducing the resistance of pulmonary arteries and maintaining pulmonary arterial pressure (PAP) could serve as prognostic factors in patients undergoing this surgery. We sought to test the hypothesis that preserved PAP in patients with a single-ventricle defect undergoing the Fontan procedure via the Glenn shunt implantation could confer a better prognosis. Methods: This retrospective cohort study was conducted on 54 consecutive patients with a single-ventricle defect who underwent the Glenn procedure in Rajaie Cardiovascular Medical and Research Center in Tehran in 2019. Based on PAP assessed by angiography, the patients were classified into 2 groups: PAP equal to or less than 15 mm Hg (n=27) and PAP above 15 mm Hg (n=27). Information on the surgical outcome was compared between the 2 groups. Results: No difference was observed between the groups in the rate of cardiac arrhythmia (P=0.192), but the prevalence rates of ascites (7.4% vs 48.1%; P=0.001) and pleural effusion (33.3% vs 85.2%; P=0.001) were higher in the high-PAP group. The mean length of hospital stay (6.00±2.37 d vs 9.48±6.86 d; P=0.16) and the mean length of ICU stay (3.93±1.07 d vs 5.30±2.30 d; P=0.008) were longer in the high-PAP group. Conclusions: High PAP is regarded as a prognostic factor in patients undergoing the Glenn procedure since it places patients at risk for postoperative ascites and pleural effusion and, thus, the need for long-term hospitalization. (Iranian Heart Journal 2022; 23(1): 112-117)}, keywords = {Coronavirus disease 2019 (COVID-19),Deep vein thrombosis (DVT),Incidence rate,SARS-CoV-2}, url = {http://journal.iha.org.ir/article_142605.html}, eprint = {http://journal.iha.org.ir/article_142605_2a3cf5c0c2070ebb6ff1e55dd074718a.pdf} } @article { author = {Amoozgar, Hamid and Azadi, sahar and Zahmatkeshan, Mozhgan and Safarpour, Ali Reza}, title = {Electrocardiographic and Echocardiographic Findings in Pre-Liver Transplant Pediatric and Young Adult Patients With Wilson’s Disease: A Case-Control Study}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {118-128}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Wilson’s cardiac involvement causes cardiomyopathy, arrhythmia, autonomic nervous system dysfunction, and sudden cardiac death. This study aimed to evaluate cardiac dysfunction in pre-liver transplant patients suffering from Wilson’s disease and to classify their risk of arrhythmia and sudden cardiac death. Methods: This case-control study was performed in the Transplant Coordination Center at Namazi Hospital, Shiraz University of Medical Sciences, between 2012 and 2014. The cardiac function was evaluated with 12-lead electrocardiography and echocardiography (M-mode, color Doppler, and tissue Doppler imaging). P-wave dispersion, QT dispersion, and T peak to T end-dispersion were measured in the patient group, and these values were compared with those in the control group. Results: Totally, 23 patients with Wilson’s disease and 47 healthy individuals were included in this study. P-wave dispersion and QT dispersion were significantly increased in the patients with Wilson’s disease (P<0.05). Pulsed Doppler echocardiographic findings showed significantly increased E and A peak velocities of the mitral and tricuspid annuli in the patient group (P<0.05). Tissue Doppler imaging was in favor of a significant increase in systolic and early and late diastolic velocities of the mitral and tricuspid annuli. Conclusions: The prolongation of P-wave dispersion and QT dispersion renders patients with Wilson’s disease susceptible to atrial and ventricular arrhythmias and sudden cardiac death. The evaluation of the cardiac function of such patients should include color Doppler and tissue Doppler imaging to assess diastolic dysfunction as one of the initial cardiac involvements. (Iranian Heart Journal 2022; 23(1): 118-128)}, keywords = {Cardiac evaluation,Wilson’s disease,diastolic dysfunction,echocardiography,Electrocardiography}, url = {http://journal.iha.org.ir/article_142606.html}, eprint = {http://journal.iha.org.ir/article_142606_8f285c45d77648235101dcdb1103b5fe.pdf} } @article { author = {Sadeghi Ghahrodi, Mohsen and Mousavi, Seyed Vahid and Dadjou, Yahya and Khedmat, Leila and Abdollah Zadeh Arpanahi, Mansour and Jafari, Ramezan and Maghsoudi, Houshyar and Gholami Fesharaki, Mohammad and Asadollah, Atieh and Ghazale, Amirhosein}, title = {COVID-19 Prognosis in Patients With/Without a History of ACEI/ARB Consumption}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {129-139}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Hypertension is a critical risk factor in increasing the mortality rate of COVID-19 inpatients. This association can be confounded by a history of consuming some angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs).Objective: This study aimed to assess the COVID-19 prognosis in patients with/without a history of taking ACEIs and ARBs. Methods: This single-center, prospective, observational study was performed on 345 patients with COVID-19 hospitalized in Baqiyatallah Hospital. The patients were categorized into 2 groups: with a history of ACEI/ARB consumption (the case group, n=115) and without such a history (the control group, n=230). Results: After the exclusion of some patients, the COVID-19 prognosis of 294 patients (ncontrol =184, ncase=110, 53% female) at a mean age of 64±9.7 years was evaluated. Unequal variables were adjusted between the case and control groups, and the results showed no significant differences in oxygen saturation, the computed tomography scan score, the erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase, D-dimer, the white blood cell count, lymphocytes, hemoglobin, platelets, and mortality between the 2 groups. However, a significant difference in the average length of hospital stay was found between the control (6.55±0.56 d) and case (8.53±0.55 d) groups (P=0.013). Conclusions: The dosage adjustments and changes of ACEIs and ARBs are not recommended due to increased referrals to health centers involved with the COVID-19 risk. The prognosis, safety, and efficacy of ACEI/ARB consumption should be assessed further in larger studies on middle-aged to old patients with COVID-19. (Iranian Heart Journal 2022; 23(1): 129-139)}, keywords = {ACE inhibitors,Angiotensin II receptor blockers,Antihypertensive drugs,COVID-19,Hypertension}, url = {http://journal.iha.org.ir/article_142607.html}, eprint = {http://journal.iha.org.ir/article_142607_c5563b98ca2d2c96e0d5988652af8507.pdf} } @article { author = {Mohammadi, Nooredin and Shahsavari, Elham and Azarfarin, Rasoul and Bakhshandeh Abkenar, Hooman}, title = {Relationship Between Demographic Characteristics, Clinical Parameters, and Extubation Time in Post-Cardiac Surgery Patients}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {140-148}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Understanding factors influencing extubation in cardiac surgery patients is essential. This study aimed to determine the relationship between demographic characteristics, medical and clinical variables, and the extubation time in patients undergoing cardiac surgery in a cardiovascular center.   Methods: This causal-comparative study was conducted on 210 adult patients who underwent cardiac surgery in 2018 in Tehran. The study samples were selected via the convenience sampling method. The data collection tool was a researcher-made observation checklist that featured 4 sections on the patients’ demographic characteristics, clinical variables during surgery, clinical conditions in the ICU, and high-risk factors related to the disease. The subjects were categorized into 2 study groups of more than 6 hours of mechanical ventilation and equal to or less than 6 hours of mechanical ventilation based on their mechanical ventilation time. Via the multivariate analysis test, the factors affecting endotracheal tube extubation were determined. IBM SPSS Statistics software, version 21, was used for statistical analysis.   Results: The study population consisted of 210 post-cardiac surgery patients, 142 men and 68 women, at a median age of 55 years. The findings indicated that age, sedation, and the duration of pulmonary circulation had a significant influence on the extubation time in post-cardiac surgery patients.   Conclusions: In our sample of post-cardiac surgery patients, age, sedation, and the duration of pulmonary circulation impacted the process of extubation. The implementation of a precise discontinuation program from mechanical ventilation by considering these factors is recommended to prevent long-term mechanical ventilation and shorten the ICU length of stay. (Iranian Heart Journal 2022; 23(1): 140-148)}, keywords = {Extubation of the endotracheal tube,Cardiac Surgery,intensive care,Mechanical Ventilation}, url = {http://journal.iha.org.ir/article_142608.html}, eprint = {http://journal.iha.org.ir/article_142608_30a7c380b64e6ea26af79d8256326539.pdf} } @article { author = {Futuhi, Farzaneh and Malakootian, Mahshid and Maleki, Majid and Peighambari, Mohammad Mehdi and Hosseini Moghadam, Maryam and Hosseini, Mohammad Javad and Boudagh, Shabnam and Arabian, Maedeh}, title = {Intravenous Vitamin C to Prevent Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {149-159}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: This retrospective cohort study aimed to evaluate the effects of the intravenous administration of vitamin C before and after exposure to the contrast medium for the prophylaxis of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. Methods: Data on 210 patients with chronic kidney disease (CKD) (defined as an estimated glomerular filtration rate ≤60 mL/min/1.73m2) were obtained through medical chart reviews and electronic data in 3 different groups: 1) no vitamin C administered, 2) vitamin C administered 30 minutes before angiography, and 3) vitamin C administered 30 minutes after angiography. Each group consisted of 70 patients, and vitamin C was administered intravenously. CIN incidence in all the groups was defined as an increase of 0.5 mg/dL or 25% in serum creatinine levels. Results: Overall, CIN incidence was significantly lower in patients who received intravenous vitamin C before (P≤0.05) and after (P≤0.05) angiography than in patients with no prophylaxis. The post-angiography administration of vitamin C was very effective in diminishing creatinine rise and preventing CIN. CIN occurred in 7.1% of the patients in the pre-administered and post-administered groups. Conclusions: The intravenous administration of vitamin C before and after angiography could effectively decrease CIN incidence in patients undergoing percutaneous coronary intervention. The post-angiography administration of vitamin C is more effective to decrease serum creatinine levels. (Iranian Heart Journal 2022; 23(1): 149-159)}, keywords = {Contrast-induced nephropathy,Chronic kidney disease,Coronary Angiography,Vitamin C,Antioxidant}, url = {http://journal.iha.org.ir/article_142609.html}, eprint = {http://journal.iha.org.ir/article_142609_4d91b558b54083471948ea7f0da157cf.pdf} } @article { author = {Aryafar, Maryam and Kord Varkaneh, Hamed and kathirgamathamby, vaani and Fotovati, zahra and Mahdavi, Mohammad and khaleghparast, shiva}, title = {Comparison of Vitamin D Status Between Infants With Dilated Cardiomyopathy and Infants With Other Congenital Heart Diseases}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {160-171}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Vitamin D plays an essential role in calcium homeostasis and cardiac muscle function, hence the significance of the screening, diagnosing, preventing, and treating of vitamin D deficiency (VDD). In children susceptible to VDD, cardiomyopathy is a likely occurrence. We sought to compare vitamin D status between children with dilated cardiomyopathy (DCM) and children with other congenital heart diseases.   Methods: This observational case-control study, conducted from 2018 through 2019 in Rajaie Cardiovascular Medical and Research Center, compared vitamin D status between a case group, consisting of 33 infants with DCM, and a control group, composed of 35 infants with other congenital heart diseases. The serum levels of iron, magnesium, calcium, albumin, parathyroid hormone, and 25(OH)D3 were measured in all the children.   Results: The study population consisted of 68 infants (31 males and 37 females) at a mean age of 64.96±51 days. The DCM group presented with a significantly higher incidence of VDD (27.3%) than the control group (8.6%). Multivariable-adjusted analysis for DCM based on the tertiles of vitamin D levels revealed an odds ratio of 0.25 (95% CI, 0.06 to 1.01) for tertile 3 (>24 nmol/L) compared with an odds ratio of 0.89 (95% CI, 0.24 to 3.30) for tertile 2 (16–24 nmol/L) and tertile 1 (<16 nmol/L) designated as the reference (P=0.05), indicating near statistical significance.   Conclusions: In assessing a child with newly diagnosed DCM or other congenital heart diseases, VDD and electrolyte imbalances should be promptly screened to avert the precipitating decompensation of the cardiovascular function. (Iranian Heart Journal 2022; 23(1): 160-171)}, keywords = {dilated cardiomyopathy,Infant,Vitamin D,Vitamin D deficiency}, url = {http://journal.iha.org.ir/article_142610.html}, eprint = {http://journal.iha.org.ir/article_142610_ab833c2bfac8f64334c04da154efcffd.pdf} } @article { author = {Noori, Noor Mohammad and Pezzhan, Ali and Teimouri, Alireza}, title = {The Effects of Intravenous Immunoglobulin on Coronary Artery Abnormalities in Children With Kawasaki Disease}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {172-183}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Kawasaki disease (KD) is an acute systemic vasculitis in childhood, with a strong effect on the heart. The present study aimed to evaluate the effects of intravenous immunoglobulin (IVIG) on coronary artery abnormalities in children with KD. Methods: This study was performed on 101 children with KD between 2004 and 2019. Echocardiography was used to assess coronary artery abnormalities. A coronary artery was considered abnormal if the internal lumen diameter exceeded 2 mm in infants, 3 mm in children aged between 2 and 5 years, and 4 mm in children older than 5 years. Data analysis was done using the SPSS software, version 22. A P value less than 0.05 was considered statistically. Results: Before IVIG administration, abnormal left coronary arteries were reported in 21 children. However, 2, 6, and 12 months following IVIG administration, the number of children with left coronary artery abnormalities dropped to 5, 2, and 1, respectively.  Before IVIG administration, abnormal right coronary arteries were reported in 13 patients. Nonetheless, 2, 6, and 12 months after IVIG administration, the number of patients with right coronary artery abnormalities fell to 5, 1, and 1, respectively. Conclusions: IVIG administration in our children with KD significantly affected left and right coronary artery abnormalities after 6 months, with the effect being stronger in the left coronary artery. (Iranian Heart Journal 2022; 23(1): 172-183)}, keywords = {Kawasaki disease,intravenous immunoglobulin,Coronary Artery,children}, url = {http://journal.iha.org.ir/article_142611.html}, eprint = {http://journal.iha.org.ir/article_142611_7f9bd4a23ada1519599311672b4b85ce.pdf} } @article { author = {Rastgou, Feridoon and Soltanabadi, Masume and Firoozabadi, Hassan and Bitarafan-Rajabi, Ahmad and Malek, Hadi and Yaghoobi, Nahid and Bakhshandeh, Hooman and Hedayati, Raheleh}, title = {Correlation Between Ventricular Perfusion Ischemia and Left Ventricular Dyssynchrony in Phase Analysis by Gated SPECT MPI}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {184-191}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: The gated single-photon emission computed tomography (Gated SPECT), myocardial perfusion imaging (MPI) is one of the most accurate methods to evaluate the extent of myocardial ischemia. The present study aimed to assess the correlation between the severity of ischemia and left ventricular dyssynchrony in phase analysis with GATED SPECT MPI by comparing the indices of perfusion, function, and phase analysis in stress and rest phases.   Methods: This cross-sectional study was performed on patients referred for Gated SPECT MPI. Fifty-six patients with ischemic heart disease based on Gated SPECT MPI and invasive coronary angiography were included. Parameters regarding myocardial perfusion and function in stress and rest conditions and coronary vessel parameters were assessed. Phase analysis indices, including phase standard deviation (PSD), phase histogram bandwidth (PHB), and entropy, based on Gated SPECT MPI (with the QGS software) were also evaluated   Results: Phase parameters, including PSD, PHB, and entropy, showed a good correlation with the severity of ischemia in stress conditions (P<0.05).   Conclusions: Scintigraphic indices of ischemia severity were highly correlated with phase analysis indices by Gated SPECT MPI. Therefore, an evaluation of these indices may accurately estimate systolic ventricular dyssynchrony, predict relative poor outcomes of cardiac ischemic events, and determine priorities for interventional cardiologists. (Iranian Heart Journal 2022; 23(1): 184-191)}, keywords = {DYSSYNCHRONY,Phase analysis,Ischemia,Gated SPECT,MPI}, url = {http://journal.iha.org.ir/article_142612.html}, eprint = {http://journal.iha.org.ir/article_142612_20737b18203759671608a7bb3f7b8978.pdf} } @article { author = {Dalili, Mohammad and Abbaszadeh, Reza and Mohammadi, Abutaleb and Sadeghpour-Tabaei, Ali and Sheikh Fathollahi, Mahmood}, title = {Intraoperative Measurement of the Pulmonary Artery Pressure: Is It Reliable?}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {192-197}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Measurement of pulmonary artery pressure (PAP) is important for therapeutic planning in most types of structural heart diseases. The standard route for measuring PAP is cardiac catheterization. Nevertheless, in some cases, abnormal cardiac structures do not allow for advancing the catheter into the pulmonary artery. Measurement of pulmonary venous wedge pressure is another way, but it is not possible in some cases. During cardiac surgery, it is possible to measure PAP by directly entering a small needle into the pulmonary artery. This study aimed to evaluate the accuracy of PAP measurement during cardiac surgery in patients in a surgical environment.   Methods: The study enrolled 105 consecutive patients with congenital heart defects in whom cardiac catheterization was done before cardiac surgery. Systolic and diastolic pressures of the aorta and the pulmonary artery were measured and recorded both during catheterization and during cardiac surgery, and their correlations were assessed.   Results: Most of the pressures measured during cardiac surgery were lower than those measured during catheterization; nevertheless, no linear or other clear associations were found between them. There was no meaningful correlation concerning the amount of change between systemic and pulmonary pressures.   Conclusions: PAP significantly changes during general anesthesia and with an opened chest cage. PAP measured during surgery could not be relied upon for critical decisions such as univentricular approaches. (Iranian Heart Journal 2022; 23(1): 192-197)}, keywords = {Congenital heart,children,Pulmonary artery pressure,Cardiac Surgery}, url = {http://journal.iha.org.ir/article_142613.html}, eprint = {http://journal.iha.org.ir/article_142613_0e1d72bcffca0bb0793925be9df2e65b.pdf} } @article { author = {Peighambari, Mohammad Mehdi and Alemzadeh-Ansari, Mohammad Javad and Yaghoubzadeh, Golnoush and Masteri Farahani, Sepideh}, title = {Cardiac Troponin Variation Trends in Patients With Acute Pulmonary Embolism}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {198-204}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Pulmonary embolism (PE) is among the deadliest diseases in that it can cause sudden death. The present study aimed to determine cardiac troponin I (CTnI) variation trends in patients with acute PE referred to Rajaie Cardiovascular Medical and Research Center.   Methods: This cross-sectional descriptive-analytical study consecutively enrolled 54 patients with acute PE. Variation trends of CTnI were measured in the study population at 5 different time points: upon admission and subsequently 8, 24, 48, and 72 hours post-admission. The relationships between CTnI variation trends and computed tomography angiography, echocardiography, and electrocardiography findings were investigated. CTnI variation trends were compared between a group undergoing catheter-directed thrombolysis (CDT) and a group receiving the conventional anticoagulant treatment. The data were analyzed using the SPSS software, version 20.   Results: A reduction was observed in the CTnI variation trends of all the samples. Both groups exhibited a decline in CTnI levels, but the slope of this reduction was steeper in the CDT group (P=0.04). Additionally, a significant relationship was also detected between CTnI reduction and right ventricular function improvement (P=0.04). No significant association was observed between systolic pulmonary artery pressure changes and CTnI variation trends.   Conclusions: The results indicated a significant relationship between reduced CTnI levels and improved right ventricular function. Additionally, the CDT group showed a significant fall in the CTnI level compared with the anticoagulant-only group. (Iranian Heart Journal 2022; 23(1): 198-204)}, keywords = {pulmonary thromboembolism,Anticoagulant,Cardiac troponin I}, url = {http://journal.iha.org.ir/article_142614.html}, eprint = {http://journal.iha.org.ir/article_142614_b0b1709f0d6db2bd11b31abf8d53f396.pdf} } @article { author = {Aghdaii, Nahid and Azarfarin, Rasoul and Ziyaeifard, Mohsen and Navabi, Zahra sadat and Faritous, Zahra}, title = {Effectiveness of the Self-report Pain Intensity Scale in Pain Control After Coronary Artery Bypass Surgery}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {205-213}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Background: Pain following cardiac surgery is common, and pain assessment is a precondition for adequate pain management. We designed this study to evaluate the effectiveness of pain control using the self-report pain intensity scale during the postoperative period after coronary artery bypass surgery in the cardiac ICU.   Methods: Of 160 patients scheduled for elective coronary revascularization, 154 patients were included in this prospective, double-blind clinical trial. The pain management program was performed on conscious patients for 48 hours. The study population was randomly divided into 2 groups. One group received analgesics as needed, based on conventional nurse-controlled analgesia (the NCA group; n=77), and the other group received analgesics based on the pain intensity score determined using the linear numerical rating scale (NRS group; n=77). In both groups, opioid and non-opioid analgesic consumption and satisfaction levels with pain relief were recorded.   Results: The use of the self-report pain intensity scale led to an increase in the number of recipients of analgesic drugs and a decrease in their opioid/analgesic consumption during a 48-hour period in the NRS group. Satisfaction levels with pain relief were higher in the NRS group than in the NCA group (maximum satisfaction =43 [55.8%] vs 9 [11.8%], respectively; P=0.0001).   Conclusions: The findings of this study showed the efficacy of the self-report pain intensity scale in controlling patients’ pain, using adequate and appropriate analgesics, prescribing accurate amounts of medication based on patients’ pain, and increasing patients’ satisfaction with pain relief. (Iranian Heart Journal 2022; 23(1): 205-213)}, keywords = {Pain measurement tool,Pain management,Cardiac Surgery,Intensive Care Unit}, url = {http://journal.iha.org.ir/article_142615.html}, eprint = {http://journal.iha.org.ir/article_142615_e356e0353d7f18ebd78fced3e3818c5c.pdf} } @article { author = {Eskandarian, Rahimeh and Alizadeh Sani, Zahra and Behjati, Mohaddeseh and Alizadehsani, Roohallah and Khosravi, Abbas and Nahavandi, Saeid and Shariful Islam, Sheikh Mohammed}, title = {A Case of Myocardial Infarction With Nonobstructive Coronary Arteries due to the Compressive Effects of a Type B Thymoma With Internal Hemorrhage}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {214-219}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Our case was a 45-year-old woman who presented with a chief complaint of intermittent typical chest pain. In electrocardiography, ST-elevation in the lateral leads was observed. Echocardiography showed mild left ventricular systolic dysfunction with hypokinesia in the anteroapical segment. Coronary angiography was normal, and chest computed tomography showed a large mediastinal mass without any compression on the coronary arteries. Cardiac magnetic resonance imaging demonstrated a nonhomogeneous encapsulated mass close to the right ventricle and adjacent to the ascending aorta, the pulmonary artery trunk, and the superior vena cava, with compression effects on the coronary artery. There was transmural gadolinium enhancement in the mid-to-apical anterior and inferior walls with akinesia in these segments, in favor of myocardial infarction with nonobstructive coronary arteries. The patient underwent surgical mass resection, and the pathological investigation confirmed the diagnosis of a type B1 thymoma. (Iranian Heart Journal 2022; 23(1): 214-219)}, keywords = {Myocardial infarction with nonobstructive coronary arteries,Coronary artery compression,thymoma}, url = {http://journal.iha.org.ir/article_142625.html}, eprint = {http://journal.iha.org.ir/article_142625_9941d34fe503ecb896a5e53c0cdf7b2b.pdf} } @article { author = {Salehi-ardebili, Shahyad and Radvar, Mohammad and Askari, Behnam}, title = {Candida albicans Endocarditis in a Child With Acute Lymphoblastic Leukemia: A Rare Case Report}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {220-222}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Fungal endocarditis is rare and has a mortality rate of over 80%. It must be suspected in all immunocompromised patients with culture-negative sepsis and failure of antibiotic treatment. In such cases, echocardiography can be diagnostic.We herein describe a child with Candida albicans endocarditis presenting with heart failure, severe jaundice, and anasarca. A large obstructive mass of the tricuspid valve was detected by echocardiography, and blood culture confirmed the diagnosis. The patient was successfully treated with the surgical excision of the vegetation and intravenous liposomal amphotericin B for 3 weeks. (Iranian Heart Journal 2022; 23(1): 220-222)}, keywords = {Fungal infection,Childhood cancer,Candida endocarditis}, url = {http://journal.iha.org.ir/article_142627.html}, eprint = {http://journal.iha.org.ir/article_142627_85ec32e414ea02c2de68b34492398d6b.pdf} } @article { author = {Monfared, Mahmood and Farzin, Alireza and Hekmat, Manouchehr and Ansariaval, Zahra and Heidarpour, Azadeh}, title = {Vascular Thromboembolism is a Grave Complication of COVID-19}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {223-227}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {There is ample evidence that the coronavirus can cause fatal blood clots. Angiotensin-converting enzyme 2 (ACE2) receptors act as a gateway for the coronavirus to enter the body and facilitate infection. ACE2 receptors are scientifically linked to disease severity in smokers because nicotine is thought to affect ACE2 expression in different ways. Patients admitted with severe COVID-19 infection with high levels of factor V Leiden are prone to serious damage from blood clots such as deep vein thrombosis or pulmonary embolism. Damage to the vascular endothelium is a complication that can be caused by the coronavirus. It can cause vascular clots, in the formation of which factors such as age, sex, blood type, and underlying diseases are effective. Thrombotic events, especially venous thrombosis, following COVID-19 infection have already been described; nonetheless, data are scarce on arterial thrombosis. Herein we report 4 cases of COVID-19 infection complicated by arterial thrombosis. (Iranian Heart Journal 2022; 23(1): 223-227)}, keywords = {COVID-19,Arterial thrombosis,echocardiography}, url = {http://journal.iha.org.ir/article_142628.html}, eprint = {http://journal.iha.org.ir/article_142628_5203bd9395dd969e67c8a8624465ad81.pdf} } @article { author = {Seilani, Parisa and Alizadehasl, Azin and kamranzadeh fumani, hossein and Moradian, Maryam and Ghorbanpoor, Mina and Parhizgar, Seyed Ehsan}, title = {Radiation-Induced Valvulopathy}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {228-232}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Cardiovascular disease and cancer are the 2 leading causes of morbidity and mortality in the world. Radiation to the mediastinum is a key component of treatment for numerous neoplasms, including Hodgkin’s lymphoma and breast cancer. Improvements in oncological treatments have increased the number of survivors, some of whom may suffer from adverse cardiovascular effects due to radiation therapy. 1, 2 The delayed detrimental cardiovascular effects of such radiotherapy protocols have been recognized more recently, largely due to the latency of presentation. 3 Because of the increased life expectancy of these patients, healthcare providers are witnessing an increasing number of long-term side effects of these treatments. Mediastinal radiotherapy is known to cause valvular disease, pericarditis, coronary artery disease, and cardiomyopathy. 4 We herein describe a patient who developed radiation-induced valvulopathy with the typical presentation of radiation-induced heart disease 8 years after a left-sided mastectomy and receiving chemotherapy and radiotherapy for breast cancer. (Iranian Heart Journal 2022; 23(1): 228-232)}, keywords = {Radiation-induced heart disease (RIHD),breast cancer,Cancer treatment}, url = {http://journal.iha.org.ir/article_142629.html}, eprint = {http://journal.iha.org.ir/article_142629_62433f625e235348dc3c22142f536985.pdf} } @article { author = {Alizadehasl, Azin and Alemzadeh-Ansari, Mohammad Javad and Mostafavi, Atousa and Saedi, Sedigheh and Kamranzade Fumani, Hossein and Saedi, Tahereh}, title = {Left Atrial Myxoma With Atypical Echocardiographic Features}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {233-236}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Accurate diagnoses of cardiac masses constitute a challenge to the cardiologist. Echocardiography plays an essential role, but differentiating between benign and malignant masses that may mimic the features of each other may not be easy by echocardiography. Myxomas are primary benign tumors of the heart with typical echocardiographic features that are generally found in certain locations in the heart. Nonetheless, they are occasionally found in atypical locations in the heart chambers and echocardiographic features mimicking malignant tumors. Myxomas may present with obstructive, embolic, and constitutional symptoms, or they might be found incidentally based on the tumor size and location. Herein, we describe a 78-year-old man with a cardiac mass with echocardiographic features inconsistent with a benign tumor, although further evaluation confirmed it as a myxoma. Benign or malignant cardiac masses could mimic the typical imaging features of each other, and the diagnosis should be based on pathologic findings. (Iranian Heart Journal 2022; 23(1): 233-236)}, keywords = {Cardiac mass,Myxoma,echocardiography,Imaging}, url = {http://journal.iha.org.ir/article_142630.html}, eprint = {http://journal.iha.org.ir/article_142630_4dbf3915cc742100aa4fdb242f5a9d06.pdf} } @article { author = {Mohammadi, Khadije and Parsaei, Mozhgan and Pouraliakbar, Hamidreza and Fattahi neisiani, Hamed}, title = {Chronic Pericardial Hematoma With A Cystic-Like Appearance}, journal = {Iranian Heart Journal}, volume = {23}, number = {1}, pages = {237-239}, year = {2022}, publisher = {Iranian Heart Association}, issn = {}, eissn = {}, doi = {}, abstract = {Intrapericardial hematomas are mostly found in association with traumas, cardiac surgical operations, and coronary interventions. In the case of open-heart surgeries, intrapericardial hematomas usually resolve without complications. However, in rare cases, they could be chronic or mimic the features of other lesions. We herein introduce a case of pericardial hematoma late after coronary artery bypass surgery with a cystic-like appearance. (Iranian Heart Journal 2022; 23(1): 237-239)}, keywords = {PERICARDIAL CYST,hematoma,Coronary artery bypass surgery}, url = {http://journal.iha.org.ir/article_142631.html}, eprint = {http://journal.iha.org.ir/article_142631_de5967fc8d7912cf3bdadb73386eb13c.pdf} }