Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Assessment of Pulmonary Regurgitation Severity in Tetralogy of Fallot Total Correction: Comparison Between Doppler Echocardiography and Cardiac MRI
6
11
EN
Majid
Kyavar
Department of Cardiology;Rajaie Cardiovascular,Medial, and Research Center,Iran University ofMedical Sciences, Tehran, I.R. Iran
Reyhaneh
Shabani
Department of Cardiology;Rajaie Cardiovascular,Medial, and Research Center,Iran University ofMedical Sciences, Tehran, I.R. Iran
Hooman
Bakhshandeh Abkenar
Department of Cardiology;Rajaie Cardiovascular,Medial, and Research Center,Iran University ofMedical Sciences, Tehran, I.R. Iran
Peyman
Keyhanvar
Department of Cardiology;Rajaie Cardiovascular,Medial, and Research Center,Iran University ofMedical Sciences, Tehran, I.R. Iran.
Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, I.R. Iran.
Shabnam
Madadi
Department of Cardiology;Rajaie Cardiovascular,Medial, and Research Center,Iran University ofMedical Sciences, Tehran, I.R. Iran
Background: Pulmonary regurgitation is a common finding in patients after tetralogy of Fallot total correction (TFTC). Right ventricular enlargement and dysfunction have been ascribed to pulmonary insufficiency (PI), which is an important issue in the follow-up of patients with TFTC. We sought to compare PI measured by echocardiography with data provided by cardiac magnetic resonance imaging (CMR). Methods: We studied 155 ed patients (91 male; median age = 25.65 y, range = 15–55 y) after TFTC. To quantify the pulmonary regurgitant fraction (PRF) by CMR, we performed flow velocity mapping. On Doppler echocardiography, the length, width, and localization of the regurgitant flow, no-flow time, and pressure half-time were measured. The severity of PI on echocardiography was categorized as nonsignificant and significant and was thereafter compared to the data obtained by CMR. Results: In all 155 patients, the measurement of the flow and volume was possible by CMR, and the measurement of PI was possible by Doppler echocardiography. The mean PRF, as determined by CMR, was 33% ± 16.4%. Pulmonary regurgitation has been reported to be a causative factor in right ventricular volume enlargement. A PRF > 20% was considered significant and was compared with echocardiographic parameters and also right ventricular size and function and other indices resulted CMR. The regression analysis showed a significant correlation between PI severity on CMR and right ventricular enlargement on MRI at end diastole (r = 0.746; P < 0.001) and also at end systole (r = 0.71; P < 0.05). Conclusions: There was no significant correlation between right ventricular ejection fraction and PI severity on CMR (r=0.553; P=0.45). On echocardiography, the semiquantitative estimation of pulmonary regurgitation showed that there were 26 patients with mild-to- moderate PI and 99 patients with severe PI. A right ventricular end-diastolic volume index (RVEDVI) of 121 mL/m² was 87% sensitive and 54% specific for severe PI, and an RVEDVI of 180 mL/m² was 90% specific for severe PI.
Pulmonary regurgitation Cardiac MRI Echocardiography
http://journal.iha.org.ir/article_83137.html
http://journal.iha.org.ir/article_83137_a04e7aa42c7f1070ed8e2d1d372eebf7.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Left and Right Approach Atrioventricular Junctional Ablation in Patients With Permanent Atrial Fibrillation
12
17
EN
Mona
Kia
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran.
Seyed Abdolhussein
Tabatabaei
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran.
Ata Allah
Bagherzadeh
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran.
Farahnaz
Nikdoust
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran.
Background: Despite the clear beneficial effects of atrioventricular nodal ablation (AVNA) in atrial fibrillation (AF), the differences in these effects between the 2 technical methods of AVNA—retrograde and antegrade approaches—remain unclear. The present study aimed to compare the outcome of these 2 AVNA approaches in AF. Methods: This clinical trial was performed on 109 consecutive patients candidated for cardiac resynchronization therapy (CRT) due to the presence of simultaneous heart failure and AF. The eligible patients were randomly scheduled for CRT via left AVNA or CRT via right AVNA or medical treatment approaches. Results: No statistically significant differences were observed between the right (3.12–1.88) and left (3.12–1.78) approaches of AVNA regarding a decrease in New York Heart Association score as well as an increase in left ventricular ejection fraction (18.0%–23.75% in the right approach and 18.46%–25.77% in the left approach). Although the severity of mitral regurgitation significantly decreased following both CRT via the left AVNA approach and CRT via the right AVNA approach, the reduction in the severity of mitral regurgitation was more prominent in those treated by CRT via the right AVNA approach. Conclusions: In reducing the severity of mitral regurgitation as well as femoral complications, right AVNA was superior to left AVNA, while left AVNA was preferable to right AVNA concerning the escape rate, procedure time, and radiofrequency rate.
Atrial fibrillation ¡ Atrioventricular junctional ablation ¡ Cardiac resynchronization therapy
http://journal.iha.org.ir/article_83138.html
http://journal.iha.org.ir/article_83138_37499a76a2b967b773c75d3f00597adc.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Cardiac Involvement and Echocardiographic Characteristics in Rheumatoid Arthritis
18
24
EN
Farahnaz
Nikdoust
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. Iran.
Reza
Zangeneh
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. Iran.
Seyed Abdolhussein
Tabatabaei
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. Iran.
Background: As the cardiac function in patients with rheumatoid arthritis (RA) has not been well studied via echocardiography yet, we aimed to determine cardiac involvement and echocardiographic features in patients with RA of at least 5 years’ duration who referred to our hospital between 2012 and 2014. Methods: In this cross-sectional study, patients with RA were compared to healthy controls in terms of the cardiac function via Doppler echocardiography. After collecting the clinical and demographic data in both groups, we performed Doppler echocardiography for both groups to evaluate ventricular function and dimensions as well as valvular function. Results: Forty-six patients with RA (mean age = 51.3 y) were compared to 48 healthy controls (mean age = 50.2 y). The body mass index was significantly higher in the patients with RA (P = 0.01). Left ventricular ejection fraction was significantly lower in the case group (P<0.001). The frequency of mitral and tricuspid regurgitation was higher in the patients with RA (P = 0.008 and P = 0.005, respectively). Also, chamber dimensions and tricuspid annular plane systolic excursion (TAPSE) were significantly abnormal in the case group. There was a reverse correlation between TAPSE and disease duration (r = -0.29; P = 0.04). Conclusions: In this study, we observed disturbed echocardiographic characteristic features in the patients with RA as compared with the controls.
Echocardiography ■ Rheumatoid arthritis ■ Left ventricular ejection fraction
http://journal.iha.org.ir/article_83139.html
http://journal.iha.org.ir/article_83139_3f0db6616cb838f15822f17ab2bd835c.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
256-Slice Computed Tomography in the Diagnosis of Coronary Artery Disease in Patients Presenting With Aortic Dissection Between 2011 and 2014 and the Influence of Concomitant Coronary Artery Disease on in-Hospital Mortalit
25
29
EN
Hossein
Azarnik
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Majid
Kyavar
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Shabnam
Madadi
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Nasim
Naderi
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Farzad
Kamali
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Amir
Khosropour
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Javad
Robat Sarpoushi
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Armin
Marashizadeh
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Background: In recent years, noninvasive methods have replaced angiography in the diagnosis of aortic dissection and concomitant coronary artery disease (CAD). Computed tomography (CT) angiography allows the assessment of CAD in this setting. Methods: In this retrospective study, we investigated the incidence of CAD in patients presenting with type A or B aortic dissection between 2011 and 2014 as assessed by CT angiography and the influence of concomitant CAD and coronary artery bypass grafting (CABG) on the in-hospital outcomes of these patients. Results: Ninety-one patients (67% male) were included in this study. Thirty-five (38.5%) patients had concomitant CAD on their CT angiography, and coronary artery ectasia was observed in 17 (18.7%) patients. Sixty-seven (73.6%) patients underwent surgery for their aortic dissection. Concurrent CABG was performed in 22 (62.8%) patients, who had significant coronary stenosis on coronary CT angiography. Mortality was significantly higher in the patients who had concomitant CAD. (Sixty-seven percent of the patients with CAD died; P<0.001.) The total in-hospital mortality rate was 29.7% (n =27). Mortality was higher in the patients with more severe CAD in terms of 2- and 3-vessel diseases, and CABG was significantly associated with higher mortality. Conclusions: Nowadays, invasive coronary angiography is infrequently performed in acute type A aortic dissection due to delay in surgery and increase in the risk of rupture. Multi-slice coronary CT angiography is a good alternative modality for the diagnosis of aortic dissection and CAD simultaneously with acceptable accuracy.
Aortic dissection ■ Coronary artery disease ■ 256-slice coronary CT angiography
http://journal.iha.org.ir/article_83140.html
http://journal.iha.org.ir/article_83140_ffb79e786dae205d239434a9fac43e54.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Ten Years of Experience in a Tertiary Center in Pulmonary Valvuloplasty in Pediatric and Adult Populations
30
37
EN
Ata
Firouzi
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Sakineh
Ahmadzadeh
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Mohammadreza
Bayanati
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Parham
Sadeghipour
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Reza
Kiani
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Hamid Reza
Sanati
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Negar
Salehi
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Farshad
Shakerian
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Ali
Zahedmehr
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Leila
Shokrian
Department of Interventional Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Background: The preferred treatment for isolated pulmonary valve stenosis is percutaneous balloon pulmonary valvuloplasty. The aim of our study was to evaluate the efficacy and short-term results of this procedure in pediatric and adult patients with pulmonary valve stenosis. Methods: In this retrospective case series, we reviewed the hospital records of pediatric and adult patients with a diagnosis of pulmonary valve stenosis subjected to balloon pulmonary valvuloplasty over a period of 10 years. Data regarding the immediate postprocedural findings as well as echocardiographic transvalvular pressure gradients after 6 months were recorded and analyzed. Results: Between 2003 and 2013, a total of 248 patients underwent balloon pulmonary valvuloplasty in our institution. Seventy-nine (31.8%) patients were < 18 years of age. The immediate success rate was 61%. However, the drop in right ventricular pulmonary artery pressure gradient was significantly more prevalent in the patients < 18 years old (73.1% in those < 18 y vs. 55.4% in those ≥ 18 y; P = 0.008). Regarding the success rate over 6 months after discharge, 75% of the patients < 18 years old and 79% of those ≥18 years old had transvalvular pressure gradients < 50% of the baseline transvalvular pressure gradients on echocardiography performed within 6 months after the initial procedure. Conclusions: In our case series, we demonstrated that balloon pulmonary valvuloplasty was an effective and safe method for the treatment of pulmonary valve stenosis in both pediatric and adult populations. However, there was a tendency toward a higher postprocedural pressure gradient in the older patients, which made the obstruction more difficult to regress.
Congenital heart diseases ■ Pulmonary valve stenosis ■ Balloon valvuloplasty
http://journal.iha.org.ir/article_83141.html
http://journal.iha.org.ir/article_83141_c903d244fd5f7b7b1aee6c74a7dd7e3a.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Is There Concordance Between CMR and Echocardiography in Assessing Aortic Stenosis Severity?
38
43
EN
Sepideh
Jafari Naeini
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Mozhgan
Parsaee
Department of EchocardiographyLaboratory, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran
Shabnam
Madadi
Department of ElectrophysiologyLaboratory, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Zahra
Hosseini
Department of Cardiology, Rajaie Cardiovascular,Medical,and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Background: Although echocardiography has constituted the primary method of evaluating cardiac disease for many years now, using another method to complete the examination—especially in dubious situations such as calcified valvular diseases or poor echocardiography window—seems necessary. In studies in different countries, cardiac magnetic resonance imaging (CMR) has been introduced as an acceptable noninvasive complementary method for the evaluation of the severity of aortic stenosis (AS) with good reproducibility and reliable results in comparison with echocardiography. Methods: In a cross-sectional survey in Rajaie Cardiovascular, Medical, and Research Center’s CMR Department between 2009 and 2014, all patients with a diagnosis of AS were evaluated for the severity of AS in terms of peak velocity and peak gradients via both echocardiography and CMR (velocity-encoded method), and the results were analyzed by SPSS using the t-test and ANOVA. Results: After the exclusi
http://journal.iha.org.ir/article_83142.html
http://journal.iha.org.ir/article_83142_56f2747d63311632e168528e5b4691f0.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Double Left Anterior Descending Artery Arising the Left and Right Coronary Arteries in a Patient Undergoing Preoperative Evaluation Before Elective Noncardiac Surgery
44
47
EN
Seyed Kianoosh
Hosseini
Department of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R. Iran.
Masoud
Fakhraei
Department of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R. Iran.
Siamak
Khavandi
School of Medicine, Tehran University of Medical Sciences, Tehran,I.R. Iran.
Soheila
Khavandi
Department of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R. Iran.
A double left anterior descending coronary artery originating the left and right coronary arteries is a rare congenital coronary artery anomaly. In the present report, we describe a patient with a double left anterior descending coronary artery arising the left and right coronary arteries. To our knowledge, only a limited number of such cases have been reported in the literature so far.
Coronary artery anomaly Double left anterior descending arteryCoronary artery angiography
http://journal.iha.org.ir/article_83143.html
http://journal.iha.org.ir/article_83143_5855488acbd987d82f6a44562bc0248f.pdf
Iranian Heart Association
Iranian Heart Journal
17
2
2016
06
01
Patent Foramen Ovale: A Source of Emboli or an Innocent Bystander?
48
52
EN
Ahmad
Mirdamadi
Department of Cardiology, Najafabad branch,Islamic Azad University, Najafabad,Isfahan,I.R.Iran
Mojgan
Gharipour
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan I.R. Iran
Seied Mahfar
Arasteh
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan I.R. Iran
Although a patent foramen ovale (PFO) has been suggested as a risk factor for recurrent strokes, many stroke patients with PFOs have another source of emboli that remains unidentified if the PFO is considered the only embolic source. We report a case of stroke due to emboli an aortic aneurysm with a concomitant PFO.
Patent foramen ovale Stroke
http://journal.iha.org.ir/article_83144.html
http://journal.iha.org.ir/article_83144_6b11f7d3cdbccb0ff7e8fbc7da8024a5.pdf