Iranian Heart AssociationIranian Heart Journal16320150901mpact of Low-Dose Heparin on Accurate Anticoagulation during Cardiopulmonary Bypass and Postoperative Blood Loss in Cardiac Surgery111583171ENMitraGolmohammadiDepartment of Cardiac Anesthesiology, Seyed Al-Shohada Hospital,Urmia University of Medical Sciences, Urmia,I.R.Iran.MohammadSaeidiDepartment of Anesthesiology,Seyed Al-Shohada Hospital. Urmia University of Medical Sciences, Urmia, I.R.Iran.Hamid RezaKhalkhaliDepartment of Biostatician Epidemiology and Biostatistics, Urmia University of Medical Sciences, Urmia, I.R.IranJournal Article20190228Background:Activated clotting time (ACT) is most commonly measured for monitoring the anticoagulation effect of heparin during cardiopulmonary bypass (CPB).The aim of this study was to compare the standard heparin dose (300IU/kg) with lower doses to achieve ACTof 480 sec during CPB.Methods:In this prospective, randomized, double-blind clinical trial,120 patients (40/group) who underwent first-time elective coronary artery bypass grafting were randomized into 3groups A, B, and C receiving an initial heparin dose of 200, 250, and 300 IU/kg. Extra incremental heparin (50 IU/kg) was added if requiredto achieve a target ACT of 480 sec before initiating CPB. Postoperative blood loss was measured from the time of heparin reversal until the chest drains were removed 48h after operationin the intensive care unit. Results:The study groups were similar in demographic data. Target ACT was achieved in 32.5%, 50%, and 65% of the patients in groups A, B, and C—respectively—after the initial dose of heparin (P=0.051). The postoperative mean blood loss in the 2 groups of B and C (13.14±1.07 and 12.5±0.79mL/kg, respectively) was lower than that in group A (15.97±1.31mL/kg) (P=0.58). However, this difference between the 3 groups was not statically significant. The mean total dose of heparin in groups A and B was lower than that in group C (P=0.002).Conclusions:Thepatients receiving lower doses of heparin to achieve the target ACTdid not havelower postoperative blood loss. An initial heparin dose of 300 IU/kg was most often sufficientto reach the target ACT withthelowest incremental dose of heparin.(Iranian Heart Journal 2015; 16(3): 11-15)https://journal.iha.org.ir/article_83171_9d9901965e1072a85529f00e0a5e5aa6.pdfIranian Heart AssociationIranian Heart Journal16320150901Adherence to Hemovigilance Protocols on Storage, Preparation, and Administration among Nurses in the Open-Heart Intensive Care Unit162183170ENMohsenZiyaeifardDepartment of Anesthesiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran.ManizhehAhaniDepartment of Anesthesiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran.RasoulAzarfarinDepartment of Anesthesiology, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran.Amad EslamJamalGolzariDepartmentof Anesthesiology and Intensive Care, Tabriz University of Medical Sciences, Tabriz, I.R. IranMasoodMohseniDepartment of Anesthesiology, School of Medicine, Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran, I.R. Iran.Journal Article20190228Background:Adherence to blood storage, preparation, and administration standards has an important role in preventing blood-transfusion errors. In addition, the blood-transfusion rate following open-heart surgery is quite high. The aim of this study was to assess the adherence to hemovigilance standards on blood storage, preparation, and administration among nurses in the intensive care unit (ICU).Methods:One hundred nurses of the Open-Heart ICU of Rajaie Cardiovascular, Medical, and Research Center, Tehran, Iran, participated in this descriptive study. The nurses’ practice was supervised from the time of the entrance of the blood unit to the ICU until the end of the transfusion process. The ICU nurses’ hemovigilance practice was compared with the Iranian Ministry of Health and Medical Education’s standards. The nurses' demographic and occupational characteristics were evaluated regarding the scores of the hemovigilance standards in their practice.Results:Concerning the standards of blood transfusion, 93% of the study nurses adhered to the protocols on blood-unit preservation, 84% on preparation, and 92% on transfusion. There were no statistically significant differences between the nurses’ age, sex, work experience, education, last transfusion workshop participation and practice assessment, number of blood-transfusion procedures performed per month, and achieved standard scores on blood storage, preparation, and administration (all P>0.05). Conclusions:The study nurses achieved 85% of the standard scores on the preservation, preparation, and transfusion of blood units. The demographic and occupational characteristics of the ICU nurses had no effect on their hemovigilance practice. (Iranian Heart Journal 2015; 16(3): 16-21)https://journal.iha.org.ir/article_83170_54504ac4de692e2ed530130e8da592ae.pdfIranian Heart AssociationIranian Heart Journal16320150901Association between Diastolic Function Parameters and MRI T2 Measurements in a Sample of Iranian Patients with Major Thalassemia121783172ENFatemehRajabipourPediatric Department of Baharlou Hospital, Tehran University of Medical Sciences, Tehran, I.R.Iran.Seyed AbdolhosseinTabatabaeiDepartment of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R.Iran.AtoosaMostafaviDepartment of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R.Iran.Seyedeh SahelRasoulighasemloueiDepartment of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R.Iran.SiamakKhavandiDepartment of Cardiology, Shariati Hospital,Tehran University of Medical Sciences, Tehran, I.R.Iran.Journal Article20190228Background: The aim of the present study was to investigate the relationship between the echocardiographic indices of diastolic dysfunction and MRI T2 measurements, indicating myocardial iron loadings, in patients with thalassemia major and normal left ventricular ejection fractions. Methods: A series of consecutive patients with known thalassemia major under treatment with regular blood transfusions and iron chelation therapy were enrolled in the current study between July 2012 and June 2015 at Baharlou Hospital, Tehran, Iran. All the patients underwent cardiac MRI with the measurement of T2 for the liver and heart, echocardiographic examination with tissue Doppler assessment, and serum ferritin assay. The correlation between diastolic function parameters and T2 measurements was assessed using statistical software. Standard diastolic indices, comprising early (E) and late (A) transmitral peak flow velocities and early deceleration time (DT), were recorded. Results: The mean E/A, mean E/E′, and mean E′ were 2.09±0.54, 0.07±0.011, and 14±1.40 cm/s, respectively. The mean deceleration time (dt) was 190.97±35.89. The average serum ferritin level was 1498±783.08 ng/mL (range =212.7 to >3000 ng/mL). The mean cardiac T2 derived MRI was 26.58±7.54 ms. The frequencies of the different severities of myocardial iron loading based on myocardial T2 were as follows: 44 (80%) normal, 4 (7.3%) mild, 2 (3.6%) moderate, and 5 (9.1%) severe. MRI T2 did not have a significant correlation with E/A (r=0.091; P=0.508), E′ (r=0.130; P=0.345), E/E′ (r=0.005; P=0.971), and dt (r=0.028; P=0.838). Hepatic iron loading based on the MRI T2 values also did not have any correlation with the echocardiographic indices of left ventricular diastolic dysfunction—namely E/A (r=0.151; P=0.270), E′ (r=0.034; P=0.804), E/E′ (r=0.083; P=0.547), and dt (r=0.128; P=0.351). Conclusions: None of the echocardiographic diastolic function parameters examined in this study were found to be suitable for cardiac surveillance in transfusion-dependent patients affected by thalassemia major. Longitudinal studies are needed to evaluate the utility of echocardiographic and MRI parameters to predict cardiac events. At the moment, we cannot recommend the replacement of cardiac MR and T2 measurements, indicating myocardial iron loading, by Doppler echocardiography in patients with a normal systolic function. (Iranian Heart Journal 2016; 17(3):12-17)https://journal.iha.org.ir/article_83172_450f8bff9e8ec3ad6a53125d226fe3d0.pdfIranian Heart AssociationIranian Heart Journal16320150901Depression Status and Related Factors in Patients with Heart Failure222783169ENAtefehGhanbariDepartment of Nursing, Social Determinant of Health Research Center, Guilan University of Medical Sciences, Rasht, I.R. Iran.FatemehMoaddabDepartment of Nursing, Social Determinant of Health Research Center, Guilan University of Medical Sciences, Rasht, I.R. Iran.ArsalanSalariDepartment of Cardiology, Guilan Interventional Cardiovascular Research Center, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, I.R. IranEhsan KazemNezhad LeyliDepartment of Biostatistics, Social Determinant of Health Research Center, Guilan University ofMedical Sciences, Rasht, I.R. IranJournal Article20190228Background:Among patientswith heart failure, patients withdepressive symptoms2-3times higher than inpatients withoutsymptoms of depressionareat increased riskof mortality.The aim ofthis studywas todetermine depression status and related factorsinpatientswith heart failure in 2012-13.Methods:In this descriptive cross-sectional study, 239 patients with heart failure who referred to Dr.Heshmat hospital in Rasht in 2012-13 were assessed. Data were collected using theCardiac Depression Scale, Charlson Comorbidity Index,and NYHA classification system. Data wereanalyzed with SPSSusingdescriptive statistics (frequency, percentage, mean,and standard deviation) and inferential statistics (Kolmogorov–Smirnov test for normal distribution of data,correlation chi-square, t-test,and logistic regression).Results:The results showed that 138 (57.7%) patients haddepressive symptoms.Inthelogistic regressionanalysis,only education and supplementary insurance as a significant predictor of cognitive status were identified,which indicated that thepatients with supplementary insurance and higher education levels were more likely to maintain an optimal cognitive function.Conclusions:Since more than half of the subjects had depressive symptoms, we recommend that depressive symptomsbe assessedand care plans be plannedbased on it.(Iranian Heart Journal 2015; 16(3): 22-27)https://journal.iha.org.ir/article_83169_0d36d554e131368685427acccc334be5.pdfIranian Heart AssociationIranian Heart Journal16320150901Sleep Quality in Patients with Heart Failure:Comparison Between Patients and Non-Patients in Yazd, Iran (2014)283783167ENMahdiehMomayyeziResearch Center for Prevention and Epidemiology of Non-Communicable Diseases, Shahid Sadoughi University of Medical Sciences, Yazd, I.R. Iran.HosseinFallahzadehResearch Center for Prevention and Epidemiology of Non-Communicable Diseases, Shahid Sadoughi University of Medical Sciences, Yazd, I.R. Iran.RazieBarzegarFaculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, I.R. Iran.Journal Article20190228Background:Heart failure is a common and dangerous life-threatening disease, with an impact on various aspects of life such as sleep quality. This study was conducted to determine sleep quality in patients with heart failure (HF) and its correlates.Methods:This case-control study was conducted on 160 individuals referring to Afshar Heart Hospital in Yazd through convenience sampling. After diagnostic tests (i.e.,angiography and echocardiography) and examinations by physicians, 80 patients with HF and 80 healthy individuals (control group) were selected. Data were collected using a questionnaire. The statistical analyses included descriptive statistics, the Mann–Whitney test,and the Kruskal–Wallis test using SPSS (version 16).Results:The patients had an average Pittsburgh Sleep Quality Index(PSQI) score of 5.5 (SD=0.3) with a median of 5. Around 43% of the patients compared with around 34% of the comparison group were identified as poor sleepers; these differences, however, were not statistically significant. The educational level (P=0.033), type of job (P=0.028), history of myocardial infarction (P=0.03), severity of pain (P=0.04), and fatigue (P=0.02) were related to sleep quality. The average daily sleep duration reported by the patients was nearly 6 hours. The mean sleep latency was 20 min amongthepatients. Getting up to urinate was the most common reason for waking up during the night.Conclusions:Increasing the awareness ofpatients withHF about improving sleep and encouraging them to participate in regular courses can improve the quality of their sleep and prevent sleepdisorders.(Iranian Heart Journal 2015; 16(3): 28-37)https://journal.iha.org.ir/article_83167_faff78ae9252e2aa0f2b9f721cb89398.pdfIranian Heart AssociationIranian Heart Journal16320150901Effect of Vitamin D Deficiency on Coronary Artery Stenosis384483166ENAtoosaMostafaviDepartment of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. IranShabahangJafarnejadDepartment of Cardiology, Shahid Rajaie Hospital, Mazandaran University of Medical Sciences, Tonkabon, I.R. Iran.SoheilaKhavandiDepartment of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. IranSeyed AbdolhosseinTabatabaeeDepartment of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, I.R. Iran.Journal Article20190228ackground:Vitamin D is a prohormone that has recently been reported to modulate the inflammatory process and probably atherosclerosis.There isconflicting evidence infavor of the impact of hypovitaminosisof vitamin D on coronary artery stenosis. The aim of this study was to evaluatethe relationship between 25(OH) vitamin D and the extent and severity of coronary artery stenosis in sample of the Iranian population undergoing elective coronary artery angiography.Methods:Patients undergoing elective coronary artery angiography were included in this case-control study.Significant coronary artery stenosis was defined as stenosis>60% of any major coronary arteryand >50% fortheleft main artery as evaluated by quantitative coronary angiography.Results:Hypovitaminosis D was observed in 60.2% of 224 patients. The patientsweredivided according to their vitamin D level (i.e., <10, 11–20,and 21–30) and also based on thepercentageof their coronary artery stenosis(i.e., normal coronary artery, insignificant stenosis,and significant stenosis).A higher vitamin Dlevel was associated with age. Hypovitaminosis D had no association with persistence,extent, and severity of coronary artery stenosis.Conclusions:Hypovitaminosis D was not significantly associated withtheincidence of diabetes mellitus, hypertension,and dyslipidemia.At present, the data regarding the causal link between vitamin D status and coronary artery stenosis are conflicting.These conflicting findingsmay be due tofactors relating to the studydesigns, ethnicity, confounding factors,and other coronaryartery diseaserisk factors. Further research isneeded to determine whether this association doesexist.(Iranian Heart Journal 2015; 16(3): 38-44https://journal.iha.org.ir/article_83166_5f2938f1950b0a2fc4c97ed71df05f63.pdfIranian Heart AssociationIranian Heart Journal16320150901Application of Nanotechnology in Device Promotion in Cardiology: A Promising Horizon for Nanocardiology toward Personalized Medicine455383165ENPeymanKeyhanvarRajaie Cardiovascular,Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran
Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, I.R. IranNedaBohlouliRajaie Cardiovascular,Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran.SajadBahramiFaculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, I.R. Iran.
Student Research Committee, Iran University of Medical Sciences, Tehran,I.R. Iran.AliYousefzadehRoyan Institute for Stem Cell Biology and Technology, Academic Center for Education, Culture and Research, Tehran, I.R. IranShabnamMadadiRajaie Cardiovascular,Medical and Research Center, Iran University of Medical Sciences, Tehran, I.R. Iran.Journal Article20190228Cardiovascular diseasessuch as coronary artery disease, stroke,and atherosclerosis constitute some ofthe most challenging problems in the medical fieldbecause of their high mortality rates. Nanotechnology in medicine/nanomedicine has several applications indifferent medical fields,especially in cardiology. Recent advances in nanotechnology and nanomedicinehave created many opportunities for cardiovascular diseases, from diagnosis, treatment, and monitoring to drug delivery and nanoscale surgery. We reviewed recent applicationsof nano-enabled devicesin cardiology suchas targeted drug delivery, nanocoateddrug-eluting stents, injectable peptide nanofibers, anticoagulation applications,and post-surgical monitoring.(Iranian Heart Journal 2015; 16(3): 45-53)https://journal.iha.org.ir/article_83165_04d524031f29c89d78cae864bd6f0de7.pdfIranian Heart AssociationIranian Heart Journal16320150901Large Left Atrial Myxoma Concomitant with Three-Vessel Coronary Artery Disease: A Rare Presentation of Heart Disease545683163ENHamidHoseinikhahDepartment of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad,I.R.Iran.MehdiFathiDepartment of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad,I.R.Iran.AlirezaSepehri ShamloDepartment of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad,I.R.Iran.AliasgharMoinipourDepartment of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad,I.R.Iran.Journal Article20190228We describe a 67-year-old man with a primary diagnosis of left atrial myxoma. Preoperative coronary angiography revealed a significant three-vessel disease. The patient underwent surgery, comprising the complete resection of the left atrial mass concomitant with coronary artery bypass grafting. He had good recovery without any complications in the early and late follow-up. There was no residual tumor or recurrence. The histopathological examination of the mass confirmed the diagnosis of the left atrial myxoma.(Iranian Heart Journal 2015;16(3):54-56)https://journal.iha.org.ir/article_83163_2f01222e0a208c0dd5818c558c5f88d4.pdfIranian Heart AssociationIranian Heart Journal16320150901Left Ventricular Clot due to Wild-Type Homozygous Factor V Leiden Mutation: A Case Report575983164ENFarahnazNikdoustDepartment of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran,I.R.Iran.MahdiehEmamiDepartment of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran,I.R.Iran.Seyed AbdolhusseinTabatabaeiDepartment of Cardiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran,I.R.Iran.Journal Article20190228Factor V Leiden (FVL) mutation has been identified as a frequent risk factor for life-threatening venous thromboembolic events. We describe a 39-year-old man admitted with sudden-onset blurred vision and mild lower-limb paresthesia with a positive activated protein C resistance test. The polymerase chain reaction confirmed wild-type homozygous FVL mutation. Transthoracic echocardiography revealed a highly elongated mobile mass attached to the akinetic cardiac apex, which extended to the left ventricular outflow tract. The thrombosis was removed by thrombectomy through aortotomy. The patient was in good clinical condition atthe last follow-up. (Iranian Heart Journal 2015;16(3):57-59)https://journal.iha.org.ir/article_83164_a456e3aa3c4eabc5db513f2eba293f7c.pdf