Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 121 124 Mahmood Mirhoseini Medical college of Wisconsin, U. S. A Mary Cayton Medical college of Wisconsin, U. S. A Suhas Shelgikar Medical college of Wisconsin, U. S. A 2015 10 03 NO ABSTRACT https://jthc.tums.ac.ir/index.php/jthc/article/view/22 https://jthc.tums.ac.ir/index.php/jthc/article/download/22/20

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 125 136 Gerald Blackwell Heart Center, Kingsport, Tennessee, USA. Samuel Wann Wisconsin Heart Hospital, Milwaukee, Wisconsine, USA. Sitaram Kadekar Heart Center, Kingsport, Tennessee, USA. 2015 10 03 The application of magnetic resonance to diagnostic medical imaging stands as one of the great scientific achievements in the past 50 years. Magnetic resonance techniques are easily applied to organs which remain stationary during the imaging procedure, such as the brain and musculoskeletal system. Imaging of moving heart structures and circulating blood is considerably more difficult.  Clinical application of magnetic resonance to the cardiovascular system remains challenging but continuing technological innovations have enabled cardiovascular specialists to more effectively utilize magnetic resonance in clinical practice as well as for innovative research.  Cardiovascular magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) are now being used with increasing frequency for the assessment of patients with cardiovascular disease. This paper will introduce clinicians to the current applications of these flexible and robust tools. A brief introduction will be given to the physics of MRI, the instrumentation and the imaging strategies. The main focus of the article, however, is to review how these techniques are being applied by clinicians in routine daily care. https://jthc.tums.ac.ir/index.php/jthc/article/view/23 https://jthc.tums.ac.ir/index.php/jthc/article/download/23/21

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 125 136 Shahram Dabiri Emam Hospital, Nuclear Medicine Department, Tabriz University of Medical Sciences, Tabriz, Iran. Naser Aslanabadi Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 03 Background: Diagnosis of coronary artery disease (CAD) in patients with left bundle branch block (LBBB) is considered as a challenge in cardiology due to the low accuracy of noninvasive methods such as basal and stress electrocardiography (ECG). This diagnostic challenge can be reduced but not eliminated using dipyridamole as a stress method instead of exercise. The aim of this study was to assess the diagnostic value of dipyridamole stress Tc-99m Sestamibi single photon emission computed tomography (SPECT) myocardial perfusion imaging in patients with complete LBBB. Methods: We studied 40 patients with permanent and complete LBBB using Tc-99m Sestamibi SPECT and dipyridamole stress to evaluate CAD. Perfusion defect was considered fixed when there was no difference between rest and stress score, while reversible defect was defined as a segment with higher score on stress images. All patients underwent coronary angiography. Results: Eleven patients (27.5%) had normal myocardial perfusion SPECT and 29 patients (72.5%) had reversible perfusion defects. Angiography was positive in 30 patients, while 10 cases showed normal angiography. The sensitivity, specificity, positive predict value and negative predict value of our study for detecting >50% coronary stenosis was 86.6%, 70%, 89% and 64% respectively. Conclusion: We found 33 (82.5%) patients with concordant angiography and myocardial perfusion SPECT results (p=0.002). Angiography was positive in 90% of patients with reversible perfusion defects on myocardial perfusion SPECT. In summary, Tc-99m Sestamibi SPECT in patients with LBBB showed high accuracy (82.5%) in detecting >50% coronary stenosis. https://jthc.tums.ac.ir/index.php/jthc/article/view/24 https://jthc.tums.ac.ir/index.php/jthc/article/download/24/22

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 141 145 Majid Maleki Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Gilda Estahbanaty Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Niloufar Samiei Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Fereidoon Noohi Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Ahmad Mohebi Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Zahra ojaghi Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Maryam Esmaeilzadeh Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Anita Sadeghpour Shahid Radjaie Cardiovascular Center, Iran University of Medical Sciences, Tehran, Iran. Ozlem Soran Cardiovascular Institute, University of Pittsburgh, USA. 2015 10 03 Background: The aim of this study was to echocardiographically assess the effects of EECP (Enhanced External Counterpulsation Therapy) therapy on systolic and diastolic cardiac function. Methods: LVEF (left ventricular ejection fraction), ESV (end-systolic volume), EDV (end-diastolic volume), Sm (myocardial systolic wave), Ea (myocardial early diastolic wave), Vp (propagation velocity), E/Ea (peak early diastolic transmitral flow velocity/Ea), E/Vp and diastolic function grade were studied in twenty-five patients before and after 35 hours of EECP. Results: EECP reduced ESV and EDV and increased EF significantly (p=0.018, 0.013, 0.002, respectively) in patients with baseline LVEF≤50%, but not in patients with baseline LVEF>50%. Patients with E/Ea≥14 had a significant reduction in EDV and ESV (p=0.038 and 0.32, respectively) and an increase in LVEF (p=0.007) after EECP, whereas patients with baseline E/Ea<14 had no significant change in these parameters. Similarly, EECP significantly improved ESV, EDV and LVEF (p=0.014, 0.032, 0.027 respectively) in patients with grades II and III of diastolic dysfunction (decreased compliance) at baseline, but not in patients with normal diastolic function or grade I diastolic dysfunction (impaired relaxation). Patients with Ea<7 cm/sec prior to EECP showed significant improvement in EDV, ESV and LVEF after therapy (p=0.024, 0.015, 0.001), while patients with Ea ≥7cm/sec showed no significant change. Similarly, patients with Sm<7cm/sec prior to EECP showed significant improvement in EDV, ESV and LVEF after EECP (p=0.016, 0.017, 0.006), while patients with Sm ≥7cm/sec did not. Conclusion: These results provide new insight into the hemodynamic effectiveness and potential clinical applications of EECP. https://jthc.tums.ac.ir/index.php/jthc/article/view/25 https://jthc.tums.ac.ir/index.php/jthc/article/download/25/23

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 147 149 Seyed Hossein Ahmadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Abbasali Karimi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Mehrab Marzban Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Namvar Movahedi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Mohamad Reza Khatami Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Saeed Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Banafsheh Alinejad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Seyed Hesameddin Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran 2015 10 03 Background: Dialysis patients frequently have coronary artery disease but are regarded as high risk patients for coronary artery bypass grafting (CABG). Methods: Between February 2002 and September 2006, seventeen dialysis-dependent patients underwent isolated CABG at our center. CABG was performed under cardiopulmonary bypass (CPB) for all the patients. All cases had been maintained on hemodialysis and the duration of preoperative hemodialysis ranged from 6 to 24 months (mean 13.4±6.4). The patients’ characteristics, clinical and operative data as well as perioperative and mid-term outcome were reviewed. Results: All patients were men with a mean age of 53±8.4 years. Mean preoperative ejection fraction was 45.5%±10.4% (range 25 to 60 %). One internal mammary graft was used in 16 (94.1%) patients.  Cardiopulmonary bypass and aortic cross-clamp times were 71.3±18.7   and 40.5±8.3 minutes respectively. The more frequent complication was prolonged mechanical ventilation in 2 (11.7%), there was no perioperative mortality. In mid-term follow-up (mean time: 11.8±9.5 months) the mid-term mortality rate was 20% (3 patients). Conclusion: CABG in chronic renal dialysis patients can be accomplished with acceptable short and mid-term morbidity and mortality.   https://jthc.tums.ac.ir/index.php/jthc/article/view/26 https://jthc.tums.ac.ir/index.php/jthc/article/download/26/24

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 151 154 Eftekhar Mahmudi Ghaem Hospital Medical Center, Mashad University of Medical Sciences (MUMS), Mashad, Iran. Farah Ashrafzadeh Ghaem Hospital Medical Center, Mashad University of Medical Sciences (MUMS), Mashad, Iran. Saeed Talebi Ghaem Hospital Medical Center, Mashad University of Medical Sciences (MUMS), Mashad, Iran. Fatemeh Ghaneh Ghaem Hospital Medical Center, Mashad University of Medical Sciences (MUMS), Mashad, Iran. Vahid Jafari Ghaem Hospital Medical Center, Mashad University of Medical Sciences (MUMS), Mashad, Iran. 2015 10 03 Background: To evaluate the frequency, clinical presentation and cardiac involvement of children with RF in the North-East of Iran. Methods: A case series analysis was conducted on 80 patients with acute rheumatic fever (ARF), who were hospitalized  at Ghaem hospital in Mashad between 1994 and 2000, were studied. Laboratory tests and results from echocardiographic examinations, and clinical findings were analyzed. All patients received standard care for children with ARF. The X2 test was used for comparison of binary data. Results: When compared to similar studies from developed countries, our study demonstrates a decreased frequency of RF in North-East Iran over the past few years. However, it is still a major health problem and the most common cause of acquired heart disease in childhood. The distribution of the major modified Jones criteria in our study is slightly different from that described in the literature, with a higher incidence of carditis. Conclusion: It appears that carditis is endemic in this region. Considering the high morbidity and complications involved in this disease, there is an immediate need for effective preventive programs for the initiating cause streptococcal infections, especially since it is treatable. https://jthc.tums.ac.ir/index.php/jthc/article/view/27 https://jthc.tums.ac.ir/index.php/jthc/article/download/27/25

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 3 2006 07 19 155 161 Seyed Ebrahim Kassaian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Sahebjam Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Salarifar Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Alidoosti Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Alimohammad Haji Zeinali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Davood Kazemi Saleh Baghiatallah Hospital, Baghiatallah University of Medical Sciences, Tehran, Iran. Hamidreza Poorhoseini Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Navid Paydari Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Davoodi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mehran Mahmoodian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Hesameddin Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 03 Background: This study sought to access differences in long-term (9 months) outcomes between Acute Coronary Syndrome (ACS) patients who undergo early intervention compared to Percutaneous Coronary Intervention (PCI) in stable and refractory conditions. Methods: Data originated from Tehran Heart Center Registry- interventional cardiology (THCR-IC) and consisted of 1267 patients divided into two categories; 227 patients had features corresponding to acute coronary syndromes (17.9%) and 1040 patients suffered from stable angina (82.1%). They were admitted between April 3, 2003 and April 25, 2004. Results: The clinical success rate of PCI was higher in ACS (97% vs. 94%; P=0.037), while In-hospital complications were similar in both groups. Dur; 0.7 vs. 0.92±0.3 mg/dl), BUN (17.76±7.8 vs. 19.35±9.6 mg/dl), GFR (83.01±26.7 vs. 81.36±24.9 ml/min) Na+ (139.08±3.6 vs. 138.54±2.7 mEq/l) and K+ (4.30±0.4 vs. 4.19±0.3 mEq/l). In the control group, there was a significant fall in GFR after angiography (86.10±34.8 vs. 80.7±30.4 ml/min, P=0.03). Following angiography, there were no significant difference in serum creatinine, BUN, GFR, Na+ and K+ level between the two groups. None of the patients in either group faced contrast induced nephropathy. Conclusion:  Theophylline does not appear to add a protective role in preventing against contrast induced nephropathy in patients undergoing angiographic procedures.   https://jthc.tums.ac.ir/index.php/jthc/article/view/18 https://jthc.tums.ac.ir/index.php/jthc/article/download/18/16

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 2 2006 04 16 105 108 Saeed Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Feryal Taleghani Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Abdorreza Dorafshan Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Maria Raissi Dehkordi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 03 Background: Coronary artery disease is recognized as one of the three major causes of mortality around the world. The role of inflammation in producing coronary artery disease has been established in previous studies. Since periodontitis, which is highly prevalent, is considered as a cause of inflammation, its influence on producing coronary artery disease was investigated in the present study considering its four main indices. Methods: In this case-control study, 60 patients with angiographically proven coronary artery disease were selected as case group  After matching for some baseline characteristics including educational level, age, sex, and some established risk factors for coronary artery disease, 60 healthy individuals were selected as control group from a population in whom coronary artery disease had been angiographically ruled out. Then, the existence of periodontitis was compared with statistical methods in these two groups, considering four different dental indices. Results: The mean plaque index (PI) was 57.82±2.92% in cases vs. 35.73±2.53% in controls (p<0.05). Mean bleeding on probing (BOP) was 36.3±3.38% in cases versus 18.6±2.6% in controls, while mean Attachment Loss>4mm was 35.14±3.89% and 15.48±2.79% in cases and controls, respectively (P<0.05). The mean loss of teeth (LOT) was not significantly different in cases and controls (5.08±0.52 versus 5.38±0.53, P>0.05). Therefore, except for the number of lost teeth, there was a statistically significant difference between these two groups. For an evaluation of independent variables, multiple logistic regression analysis was used. Odds ratio was 1.02 for attachment loss and 2.2 for BOP.  Conclusion: Periodontitis may be counted as a risk factor for coronary artery disease and it is essential to study the effects of control and management of these diseases as primary and secondary prevention for coronary artery disease in future studies. https://jthc.tums.ac.ir/index.php/jthc/article/view/19 https://jthc.tums.ac.ir/index.php/jthc/article/download/19/17

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 2 2006 04 16 109 112 Maryam Esmaeilzadeh Shahid Rajaei Cardiovascular Medical Center, Iran University of Medical Sciences, Tehran, Iran. Rozita Jalalian Shahid Rajaei Cardiovascular Medical Center, Iran University of Medical Sciences, Tehran, Iran. ParidokhtNakhostin Davari Shahid Rajaei Cardiovascular Medical Center, Iran University of Medical Sciences, Tehran, Iran. 2015 10 03 Noncompaction of the ventricular myocardium is an embryonic cardiomyopathy that is increasingly being recognized. Noncompaction of LV myocardium, right ventricular myocardium, or both can occur in isolation, in congenital heart diseases, in valvular heart diseases, in neuromuscular disorders, skeletal abnormalities and in endocrinologic abnormalities. Clinical manifestations of ventricular non-compaction include congestive heart failure, arrhythmia, sudden cardiac death and embolic events. This report is illustrative of non-compaction left ventricle associated with WPW syndrome in a 12-year-old girl presented with aborted sudden cardiac death and heart failure. https://jthc.tums.ac.ir/index.php/jthc/article/view/20 https://jthc.tums.ac.ir/index.php/jthc/article/download/20/18

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 1 2 2006 04 16 113 115 Saeed Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Yamini Sharif Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Davoodi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Kazemi saeid Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 03 The overall rate of atrial pacing lead dislodgement is estimated to be about 3%. These leads are generally repositioned via a second operation through opening the pacemaker pocket. Some operators have introduced percutaneous techniques using snare system or deflectable catheters for this purpose. In this article we present our experience with five cases of percutaneous lead re