Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Echocardiographic Evaluation of Patients with Behçet's Disease
6
11
EN
Farahnaz
Nikdoust
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran
Gelayol
Ansari
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran
Farhad
Shahram
Department of Rheumatology, Shariati Hospital, Tehran University of Medical Sciences, Tehran,I.R.Iran
Seyed Abdolhussein
Tabatabaie
Department of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran
Background:Considering the nature of Behçet's disease(BD),which involves multisystem inflammation, we soughtto compare the echocardiographic characteristics of BD >5years’duration with those of healthy subjects. Methods:We compared 73 patientswith BDwith 74 age-and sex-matched healthy controls. The subjects underwent transthoracic echocardiography and tissue Doppler imaging for the measurement ofcardiac function and evaluation ofthe heart valves. The echocardiographic parameters were then compared between the study groups. Results:Among the echocardiographicparameters, only left ventricular end-diastolic diameter was significantly lower inthepatientswith BD(47.0±5.2)than that in thecontrol group (50.8±4.7; P<0.001). There was also no relationshipbetween the echocardiographic parameters andtheactive stage of the disease. Conclusions:Diastolic dysfunction was significantly more common in thepatients withBD>5 years’duration than in thecontrol group. The other echocardiographic indices were similar in both groups. (Iranian Heart Journal 2015; 16(4): 6-11)
Behçet's Disease,echocardiography,Left ventricular end-diastolic diameter,Systolic function,Diastolic function
http://journal.iha.org.ir/article_83177.html
http://journal.iha.org.ir/article_83177_6a89e6e01f4f6e00c0982b0ed811ff8b.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Relationship between Late Gadolinium Enhancement Extent in Cardiac Magnetic Resonance Imaging and Severity of Coronary Artery Disease in old Myocardial Infarction
12
18
EN
Mohsen
Maadani
Department of Cardiology; Rajaie Cardiovascular,Medical and Research Center,IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Shabnam
Madadi
Department of Cardiology; Rajaie Cardiovascular,Medical and Research Center,IranUniversity of Medical Sciences, Tehran, I.R.Iran
Mahmoud
Fagheeh
Department of Cardiology; Rajaie Cardiovascular,Medical and Research Center,IranUniversity of Medical Sciences, Tehran, I.R.Iran
Sara
Adimi
Occupational therapist in hand center ofIran, USWR University of Medical Sciences, Tehran, I.R.Iran
Yaghoob
Bagheri
Department of Cardiology; Rajaie Cardiovascular,Medical and Research Center,IranUniversity of Medical Sciences, Tehran, I.R.Iran
Background:Contrast-enhanced cardiac magnetic resonance imaging (CMR) is an accurate imaging modality for the noninvasive evaluation of myocardial infarction (MI).We sought to assess the relationship between the severity of coronary involvement and the extent and pattern of myocardial scars in CMR of patients with a history of remote MI.Methods:The CMR of 60patients with a history of remote ST-elevation or non-ST elevation MI who were candidatedfor selective coronary angiography and referred for CMR for an evaluation ofmyocardial viability wasreviewed and compared with selective coronary angiographic findings.Results:Among the 60 patients withahistory of old MI, 78.3%were male andthe mean(SD) of age was 61.2±11.5years. There was no association between the severityof coronary stenosis in each territory andthepresence of myocardial scar detected bythelate gadolinium enhancement of CMR.(P values for all the territories of the 3 vessels were >0.05.)There wasasignificant association between coronary artery run-off and the presence of late gadolinium enhancementin CMR.(P values for the left anterior descending,left circumflex artery,and right coronary arterywere0.002, <0.001,and <0.001,respectively.)We found a significant relationship between the pattern of the scarsin terms of beingtransmural or non-transmural andtheseverity of coronary artery stenosis (P<0.001),and the pattern of the scarswas not associated with coronary artery run-off (P=0.2).Conclusions:The resultsof this study support the hypothesis that the time window for revascularization will be increased in the presence of an antegrade coronary flow in the jeopardizedmyocardium andthat itcouldlimit infarct progression and resultina subsequent lesser extent of myocardial scar.(Iranian Heart Journal 2015; 16(4): 12-18)
Magnetic resonance imaging,Late gadolinium enhancement,Myocardial Infarction
http://journal.iha.org.ir/article_83178.html
http://journal.iha.org.ir/article_83178_911c27d84334438a20f85343f7ca139c.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Can C-Reactive Protein and Fibrinogen Predict Major Adverse Cardiac Events in Cardiovascular and Cerebrovascular Patients?
19
27
EN
Jafar
Golshahi
sfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R.Iran
Somayeh
Khalesi
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R.Iran.
Masoumeh
Sadeghi
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R.Iran.
Nizal
Sarrafzadegan
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R.Iran.
Mojgan
Gharipour
Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R.Iran
Minoo
Dianatkhah
Heart failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, I.R.Iran.
Asma
Salehi
Department of Statistics and Computer Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, I.R.Iran.
Background:We aimed to examine the value ofC-reactive protein (CRP)and fibrinogen levels to predictcardiovascular events and compare theirpredicting power between patients witha history of the acute coronary syndrome, patients with a history of stroke (ischemic type),and healthy individuals.Methods:Thiscase-control study assessed79 patients with ahistory ofthe acute coronary syndromeand 88 patients with a history of stroke (cerebral ischemia) occurring at least3 months previously. The patients were selected and followed up from September 2013 to September 2014 for 3 and 6 months after initial assessment to determine 6-month major adverse cardiac events(MACE). The serum levels of CRP and fibrinogen were measured using ELISA kits. Results:The serum CRP level was significantly higher in the group with the acute coronary syndrome than in the group with a history of stroke andinthe healthy group (P=0.045). The Cox regression model showedincreasedlevelsof CRP (HR=1.29 [1.01-1.66];P=0.038) and fibrinogen (HR=1.01 [1.01-1.02]; P<0.001)in the group with ahistory ofthe acute coronary syndrome. It also demonstrated increased levelsof CRP(HR=1.61 [0.97-2.67]; P=0.065) and fibrinogen (HR=1.02 [1.01-1.04];P=0.010)in the stroke groupand increased levels of CRP(HR= 2.06 [0.71-5.99]; P=0.183) and fibrinogen (HR=1.01 [0.99-1.04]; P=0.294)in the normal group. Consequently,the groupswith ahistoryof theacute coronary syndrome anda history ofstroke effectively predicted6-month MACE in the crude and age-and sex-adjusted models. Conclusions:Our study achieved 2 important findings. First, our resultsshowedthathigher values of these biomarkers were able to predict MACE, even aftertheinclusionof baseline covariates. Increased levelsof CRP and fibrinogen,measured after evaluating the acute phase and their related outcome, were able to predict recurrent cardiovascular eventsin the patients with a history of cerebrovascular ischemia andtheacute coronary syndrome.In addition,there were higherlevels of both CRP and fibrinogen markers in thepatients with ahistory oftheacute coronary syndrome and stroke than in the healthy individuals. (Iranian Heart Journal 2015; 16(4): 19-27)
CRP,fibrinogen,Cerebrovascular,Cardiovascular,MACE
http://journal.iha.org.ir/article_83179.html
http://journal.iha.org.ir/article_83179_91ec07f0944a1cfa318fe13c69a5af15.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Evaluation of Pentoxifylline in the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention
28
34
EN
Ata
Firouzi
Department of Cardiology, Rajaie Cardiovascular,Medical and Research Center, IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Hossein
Shahsavari
Department of Cardiology, Rajaie Cardiovascular,Medical and Research Center, IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Reza
Kiani
Department of Cardiology, Rajaie Cardiovascular,Medical and Research Center, IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Kamran
Aeinfar
Department of Cardiology, Rajaie Cardiovascular,Medical and Research Center, IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Yousef
Shamloo
Department of Cardiology, Rajaie Cardiovascular,Medical and Research Center, IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Hojjat
Mortezaian
Department of Cardiology, Rajaie Cardiovascular,Medical and Research Center, IranUniversity of Medical Sciences, Tehran, I.R.Iran.
Background:As percutaneous coronary intervention (PCI) technologies conferincreasing patient advantage, the use of iodinated contrast media for diagnostic and interventional procedures is increased. Although contrast media obstacles are transient and mild, contrast-induced nephropathy(CIN)negativelyaffects long-term patient mortality. PCI createsa high-risk condition for the incidence of CIN even in patients with a normal renal function. Pentoxifylline (PTX) with a variety of mechanisms may prevent CIN.We soughtto assess the positive effect of PTX administration at the beginningprior to contrast media use to 24 hours after PCI to prevent CIN inpatients withSTEMI.Methods:In this double-blind, single-center,clinical trial, we randomly assigned 296 consecutive patients to the control group (n=148) without PTX and the case group (n=148) with PTX 400mg/tid at the time of hospitalization to 24 hours after the procedure. Serum creatinine was measured before and 48 hours after the procedure. The occurrence of CIN within48 hours was our end point. CIN was defined as a 0.5 mg/dLincrease or more in serum creatinine or a 25% increase or more above baseline serum creatinine.Results:A total of 296 patients were enrolled in this trial and were randomly assigned to receive either primary PCI plus PTX or only primary PCI. Out of 148 patients who receivedPTX,only 12.2% were seen to have CIN incidence (>0.5mg/dLor a 25% increase intheCr level);however,the difference between the 2groups regarding CIN was not significant (P=0.4). Out of the 296 patients,only 20 were found to havechronic kidney disease (CKD)(CKD wasdefined as baseline Cr>1.5);and of those patients,3(15%) showed CIN incidence. Nevertheless,the difference between the 2groupsregarding CIN incidence was not significant (P=0.7). The regression test showed that between all confounding factors in the 2groups of PTXpositive and negative, sex and ejection fractionhad positive effectsonthe rise in theCr level and,consequently,theincidence of CIN (95% CI: 1.60 to 30.85; P=0.01 and95%CI:0.92 to 1; P=0.05). Conclusions:Administration of oral PTX to patients with increased risk for CIN scheduled for primary PCI may not reduce the Cr level and thus the occurrence of CIN. Given thehigher prevalence of hypotension inthepatients without PTX, higher prevalence of CKD in the patients without PTX,and absence of significant difference between the 2groups regarding the incidence of CIN, PTX had nopreventive effect onCIN occurrence in STEMI. Among all factors influencingCIN occurrence,sex and ejection fraction hadpositive effects on the rise in the Cr level.(Iranian Heart Journal 2015; 16(4): 28-34)
Contrast Media,Primary PCI,Contrast-induced nephropathy,pentoxifylline
http://journal.iha.org.ir/article_83180.html
http://journal.iha.org.ir/article_83180_348e8f8c2058e0b7bc137bb388b81d13.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
QT Interval Parameters: A Screen Test for Left Ventricular Hypertrophy Detection
35
40
EN
Arsalan
Salari
Department of Cardiology, Guilan Interventional Cardiovascular Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, I.R.Iran.
Fardin
Mirblook
Department of Cardiology, Guilan Interventional Cardiovascular Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, I.R.Iran.
Zohre
Heidarnezhad
Department of Cardiology, Guilan Interventional Cardiovascular Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, I.R.Iran.
Zahre
Atrkar-Roshan
Departmentof Biostatistics, Guilan University of Medical Sciences, Rasht, I.R.Iran.
Fereshteh
Saadati
Department of Cardiology, Guilan Interventional Cardiovascular Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, I.R.Iran
Fatemeh
Moaddab
Department of Nursing Instructor, Guilan Interventional Cardiovascular Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, I.R.Iran.
Background:Electrocardiographic parameters for the detection of left ventricular hypertrophy (LVH) asan independent cardiovascular risk factor and signifier end-organ damage in patients with hypertensionare known. The aim of this study was to evaluate the relation between QT interval parameters and LVH in patients with hypertension.Methods:This cross-sectional study recruited100 patients with primary hypertension who underwent cardiac echocardiography for the evaluationof left ventricular mass (LVM). Standard 12-lead electrocardiography was performed for all the patients,and QT interval parameters (QTmax, QTcmax, QTd[dispersion], and QTdF[difference between maximum and minimum QT intervals])were calculated. The data were analyzed using SPSS (version 18). The t-test wasapplied to assesstherelationship between QT parameters and left ventricular mass index (LVMI),and the receiver operating characteristic(ROC)curve was drawn to determine thecutoffpoint forthe mentioned electrocardiographictest.Results:The mean age ofthepatients was 60.52±9.74 years. The meanof QTd, QTmax,and QTcdin the patients with LVH was significantly greater thanthat of thepatients without LVH (P<0.05). ROC curve analyses of QT interval parameters showed thatthecutoffpointsfor QTmax, QTd, QTcmax,and QTcdvalues were420(specificity=0.79 and sensitivity=0.40), 50 (specificity=0.58 and sensitivity=0.76), 478 (specificity=0.29 and sensitivity=0.58), and 59 (specificity=0.65 and sensitivity=0.76), respectively. Conclusions:According to our findings, QTcdandQTcwould be better testsforthedetection of LVH. We recommend further research with larger sample sizes to obtain more generalizable findings. (Iranian Heart Journal 2015; 16(4): 35-40)
Electrocardiography,Hypertension,Left ventricular hypertrophy,QT interval
http://journal.iha.org.ir/article_83181.html
http://journal.iha.org.ir/article_83181_f02c56f85748c4245921a74941dca433.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Correlation between Post Percutaneous Coronary Intervention CKMB Elevation and One-Year Major Adverse Cardiac and Cerebrovascular Events
41
46
EN
Farzad
Emami
Department of Cardiology,Ekbatan Hospital, Hamedan University of Medical Sciences,Hamedan, I.R.Iran.
Shafee
Membari
Department of Cardiology,Ekbatan Hospital, Hamedan University of Medical Sciences,Hamedan, I.R.Iran.
Behshad
Naghshtabrizi
Department of Cardiology,Ekbatan Hospital, Hamedan University of Medical Sciences,Hamedan, I.R.Iran
Zahra
Sohrabi
Department of Cardiology,Ekbatan Hospital, Hamedan University of Medical Sciences,Hamedan, I.R.Iran.
Background:CKMB elevation after percutaneous coronaryintervention (PCI) correlates with major adverse cardiac and cerebrovascularevents(MACCE). There is, however, some controversy over this issue, with some studies having reported different conclusions. We assessed the correlation betweentheCKMB level afterPCI and one-year MACCE incidence in these patients. Methods:We measured the CKMB level before and after PCI in 221 patients with normal baseline CKMB who underwent PCI at Ekbatan University Hospital, Hamedan, Iran,between April 2013and October 2013,and divided them into 4groups based on the post-PCICKMB level. Then, we evaluated one-year MACCE incidence.Results:CKMB elevation was detectedin 81 (37.6%) patients and MACCEoccurred in 11 (5%) patients. CKMB elevation after PCI was correlated toMACCE. The predictors of CKMB elevation were hyperlipidemia, number of deployed stents, stent diameter≥4mm,and complicated PCI.Conclusions:CKMB elevation after PCI was detected in 37.6% of the study populationand wascommon in the setting of hyperlipidemia, more than 1stent deployment,stent diameter ≥4mm,and complicated PCI. MACCE at 1year occurred in 5% of the patients and was correlated with the post-PCI CKMB level ≥3 times ofnormal, history of diabetes mellitus, history of hypertension,and inappropriateuse ofclopidogrel.(Iranian Heart Journal 2015; 16(4): 41-46)
Percutaneous Coronary Intervention,CKMB,Major adverse cardiac and cerebrovascular events
http://journal.iha.org.ir/article_83174.html
http://journal.iha.org.ir/article_83174_0b917807893fa3da43149cd74d7c1339.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Correlation between Angiographic Findings and Pain and Its Palliative Factors in Patients with Chest Pain Referring to Rajaie Cardiovascular, Medical and Research Center
47
56
EN
Nafiseh
Taraghi Delgarm
Department of Cardiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Farshad
Shakerian
Department of Cardiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Hosein
Azarnik
Department of Cardiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Vida
Khanlarzade
Department of Cardiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Mahdie
Mahdinegad
Department of Cardiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R.Iran.
Background:In patientsreferred for an evaluation of chest pain, the incidenceof cardiac disease may be as lowas 11–27%. Furthermore, the incidence of normal coronaryanatomy in patients investigated invasively varieswidely, between 11% and 37%, at different cardiac centers. In this study,we evaluatedthe correlation between angiographicfindings and pain and its palliative factors in patients with chest pain referring to RajaieCardiovascular, Medical and Research Center.Methods:All patients with chest pain who were admittedto the Emergency Department ofRajaie Cardiovascular, Medical and Research Center between September 2013 andMarch 2014 and needed coronary angiography were enrolled. Demographic data andtheresults of physical examinationsand characteristics of pain and its palliative factors and the chest pain scorebased on a check list were collected. Thereafter,angiography was performed and correlationsbetween angiographicfindings and pain(characteristicsand score) and its palliative factors were assessed.Results:Totally,194 patients with the average age of 58±10years wereinvestigated. Ofthe194 patients, coronary arteries were normal in 57 (29%)patients. Of these patients,37 patients were women and 20 patients weremen. Single-vessel disease was observed in 53(40%), 2-vessel disease in 39(30%),and 3-vessel disease in 40(30%). Left main stenosis was observed in 1(0.5%)patient,and3-vessel diseaseaccompanied withtheleft main was documented in 4 (2.1%). Also, slow flow was observed in5 (2.6%)patients. Regarding the localization of the involved vessel,left maininvolvement was observed in 5 (3.1%)patients, left anterior descendingin 82 (24.3%), left circumflex in 62 (32%),and right coronary artery in 54 (27.8%).Apain scoreof 0waspresent in 24 (12%)patients, pain scoreof1 in 47 (24%),painscoreof2 in 73 (37%),and pain scoreof3 in 50 (25%).The sensitivity value of the pain score in our research was calculated to be 80% by takingadvantage of a chest pain scoreof0 as the negative predictor of the coronary vessel disease and a chest pain scoreof 1 to 3 as the positive predictor of coronary vessel disease. Conclusions:In the present study,there wasnorelationship between pain characteristics andthe results fromtheinvolved vessel andthe final angiographicresults.The pain score isgreatly useful in patients with ahigher risk of coronary artery disease, whereasin patients withanintermediate pain score,it is important to perform other examinations such as scan or treadmill tests for correct decision-making.(Iranian Heart Journal 2015; 16(4): 47-56
Chest pain characteristics,pain score,Angiography,risk stratification
http://journal.iha.org.ir/article_83175.html
http://journal.iha.org.ir/article_83175_a60e9eaee4085f45792e1035affd7b52.pdf
Iranian Heart Association
Iranian Heart Journal
16
4
2015
12
01
Friedreich's Ataxia and Hypertrophic Cardiomyopathy: A Case Report and Review
57
59
EN
Hanane
Benhalla
Hassan II Hospital of Laayoune,University Hospital of Casablanca, Morocco.
Camelia
Sorea
Hassan II Hospital of Laayoune,University Hospital of Casablanca, Morocco.
Friedreich's ataxia is an autosomal recessive, spinocerebellar, degenerative disease characterized clinically by the ataxia of the limbs and trunk, dysarthria, loss of deep tendon reflexes, sensory abnormalities, skeletal deformities, diabetes mellitus, and cardiac involvement. Friedreich's ataxia is generally associated with concentric hypertrophic cardiomyopathy. Cardiac death occurs primarily in those developing dilated cardiomyopathy. These patients tend to do poorly with rapid progression to end-stage congestive heart failure. (Iranian Heart Journal 2015; 16(4): 57-59)
Friedreich's ataxia,Hypertrophic cardiomyopathy,Familial neurodegenerative disease
http://journal.iha.org.ir/article_83176.html
http://journal.iha.org.ir/article_83176_ef6945603f2e581dcdc035e075070364.pdf