Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 2 2015 10 13 69 73 EN Payam Safavi-Naeini Department of Cardiology, Texas Heart Institute, Houston, Texas, USA. Mehdi Razavi Department of Cardiology, Texas Heart Institute, Houston, Texas, USA. Mohammad Saeed Department of Cardiology, Texas Heart Institute, Houston, Texas, USA. Abdi Rasekh Department of Cardiology, Texas Heart Institute, Houston, Texas, USA. Ali Massumi Department of Cardiology, Texas Heart Institute, Houston, Texas, USA. 2015 10 13 2015 10 13 The prevalence of atrial fibrillation (AF) is 1-2 % in the general population, and the risk of embolic stroke in AF patients is 4-5 times higher than that in the general population. AF-related strokes are often severe, and the rate of permanent disability is much higher among individuals who have AF-related strokes than in those who have strokes unrelated to AF. In patients with AF, more than 90 % of thrombi originate from the left atrial appendage (LAA). The purpose of this paper is to review the efficacy and safety of performing the LAA closure with the LARIAT Suture Delivery Device to prevent AF-related stroke in patients with contraindications to oral anticoagulant therapy. https://jthc.tums.ac.ir/index.php/jthc/article/view/369 https://jthc.tums.ac.ir/index.php/jthc/article/download/369/362

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 2 2015 10 13 74 79 EN Farzaneh Dastan School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Azita Hajhossein Talasaz School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Mojtahedzadeh School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Abbasali Karimi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Abbas Salehiomran Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Payvand Bina Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Arash Jalali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Aghaie School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 13 2015 10 13 Background: L-carnitine has been demonstrated to confer cardiac protection against ischemia reperfusion injury in animals. This study evaluates the effects of L-carnitine administration on cardiac biomarkers after coronary artery bypass graft (CABG) surgery. Methods: One hundred thirty-four patients undergoing elective CABG surgery, without a history of myocardial ischemia or previous L-carnitine treatment, were enrolled and randomly assigned to an L-carnitine group ([n = 67], 3000 mg/d, started 2 days preoperatively and continued for 2 days after surgery) or a control group (n = 67). CK-MB (creatine kinase, muscle- brain subunits) and troponin T (TnT) levels were assessed in all the patients before surgery as baseline levels and at 8 and 24 hours postoperatively. Results: Our study included 134 patients (99 [73.8%] males) at a mean ± SD age of 59.94 ± 8.61 years who were candidates for CABG and randomized them into control or L-carnitine groups. The baseline demographic characteristics, including age (60.01 ± 9.23 in the L-carnitine group vs. 59.88 ± 7.98 in the control group) and sex (54 [80.6%] in the L-carnitine group vs. 45 [67.2%] in the control group) did not show any significant differences (p value=0.93 and 0.08, respectively). Patients in the L-carnitine group had lower levels of CK-MB (mean ± SD, 25.06 ± 20.29 in the L-carnitine group vs. 24.26 ± 14.61 in the control group), but the difference was not significant (p value = 0.28). TnT levels also showed no significant differences between the two groups (399.50 ± 378.91 in the L-carnitine group vs. 391.48 ± 222.02 in the control group; p value = 0.34). Conclusion: In this population of intermediate- to high-risk patients undergoing CABG surgery, L-carnitine did not reduce CK-MB and TnT levels. https://jthc.tums.ac.ir/index.php/jthc/article/view/370 https://jthc.tums.ac.ir/index.php/jthc/article/download/370/363

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 2 2015 10 13 80 84 EN Saeed Abrootan Department of Cardiology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Saeed Yazdankhah Department of Cardiology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Babak Payami Department of Cardiology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Mohammad Alasti Department of Cardiology, Bahman General Hospital, Tehran, Iran. 2015 10 13 2015 10 13 Background: Patients with chronic stable angina often have a state of sympathetic hyperactivity. It is considered associated with myocardial ischemia and disappears after ischemia elimination. The aim of this study was to investigate the changes in heart rate variability parameters, a noninvasive technique for the evaluation of the autonomic nervous system activity, after successful revascularization in these patients to evaluate this theory. Methods: The patients were enrolled among those who underwent successful percutaneous coronary intervention. Short- term heart rate variability analyses of all the patients were obtained, and time-domain indices (standard deviation of normal- to-normal intervals [SDNN], standard deviation of differences of successive R-R intervals [SDSD], root-mean square differences of successive R-R intervals [rMSSD], percentage of R-R intervals differing > 10 ms from the preceding one [PNN10 percentage of R-R intervals differing > 20 ms from the preceding one [PNN20],percentage of R-R intervals differing > 30 ms from the preceding one [PNN30]percentage of R-R intervals differing > 40 ms from the preceding one [PNN40],percentage of R-R intervals differing > 50 ms from the preceding one [PNN50percentage of R-R intervals differing > 60 msfrom the preceding one [PNN60 percentage of R-R intervals differing > 70 ms from the preceding one [PNN70])were analyzed. All the measurements were made before and after percutaneous coronary intervention. Results: This study included 64 patients, comprising 27 men and 37 women at a mean age of 56.8 ± 9.1 years. There was a significant difference only between pre- and post-revascularization SDNN (27.5 ± 19.72 vs. 41 ± 41.4; p value = 0.013). The other parameters showed no significant differences after successful coronary intervention. Conclusion: Our data indicate that the increase in SDNN in patients with stable angina pectoris undergoing percutaneous coronary intervention seems to be prominent. https://jthc.tums.ac.ir/index.php/jthc/article/view/371 https://jthc.tums.ac.ir/index.php/jthc/article/download/371/364

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 2 2015 10 13 85 92 EN Saba Ghaffary Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Azita Hajhossein-Talasaz Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran AND Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Padideh Ghaeli Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Abbasali Karimi Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Abbas Salehiomran Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Alireza Hajighasemi Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Payvand Bina Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Sayeh Darabi Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Arash Jalali Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. Mehrnoush Dianatkhah Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Maryam Noroozian Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nazila Shahmansouri Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 13 2015 10 13 Background: Postoperative cognitive dysfunction (POCD) has been an important complication of cardiac surgery over the years. Neurocognitive dysfunction can affect quality of life and lead to social, functional, emotional, and financial problems in the patient’s life. To reduce POCD, we sought to identify the association between cognitive dysfunction and perioperative factors in patients undergoing cardiac surgery. Methods: One hundred one patients aged between 45 and 75 years undergoing elective cardiac surgery were enrolled in this study. All the surgeries were performed on-pump by the same medical team. A brief Wechsler Memory Test (WMT) was administered before surgery, 3 to 5 days after the surgery, and 3 months after discharge. All related perioperative parameters were collected in order to study the effect of these parameters on the postoperative WMT scores and WMT score change. Results: The study population consisted of 101 patients, comprising 14 (13.8%) females and 87 (86.2%) males aged between 45 and 75 years. In univariate analysis, the baseline WMT score, serum levels of lactate dehydrogenase and T3, cross-clamp time, and preexistence of chronic obstructive pulmonary disease showed significant effects on the postoperative WMT score (p value < 0.05), whereas only the baseline WMT score and chronic obstructive pulmonary disease showed strong effects on the postoperative WMT score in the multiple regression model. In addition, the multiple regression model demonstrated a significant association between the baseline WMT score, serum creatinine level, and nitrate administration and the WMT score change. Conclusion: Our study showed that preexisting chronic obstructive pulmonary disease and preoperative high serum creatinine levels negatively affected cognitive function after surgery. In addition, there was a strong relationship between the patients’ basic cognition and POCD. Preoperative nitrate administration led to a significant improvement in POCD. It is also concluded that the preoperative administration of specific medicines like nitrates can reduce neurological complications after cardiac surgery. https://jthc.tums.ac.ir/index.php/jthc/article/view/372 https://jthc.tums.ac.ir/index.php/jthc/article/download/372/365

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 2 2015 10 13 93 97 EN Mohammad Sadegh Parsaee Mazandaran University of Medical Sciences, Sari, Iran. Maryam Nabati Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Naser Saffar Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Morteza Taghavi Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 2015 10 13 2015 10 13 Background: The drug-eluting stent (DES) decreases the rate of coronary restenosis and re-obstruction. The aim of this study was to assess prospectively the effectiveness of the new generation DES on the left ventricular (LV) systolic and diastolic functions in patients with isolated severe proximal left anterior descending (LAD) coronary artery stenosis. Methods: A prospective study was conducted on 50 patients with isolated severe proximal LAD stenosis. Successful percutaneous coronary intervention (PCI) with Everolimus-eluting stents was performed for the whole study population. All the patients underwent transthoracic echocardiography within 24 hours before and one month after PCI, and LV systolic and diastolic parameters were compared before and after PCI using the paired samples t-test. Results: The mean age of the study population was 57.68 ± 8.82 years. Within the study population, 26 (52%) patients were male and 24 (48%) were female. There was a significant 10.6% and 5.2% increase in the early diastolic mitral annular motion (e') and the LV ejection fraction following PCI, respectively (p value = 0.005 and p value = 0.044, respectively). Before PCI, wall motion abnormality was seen in 2.21 ± 2.91 segments, which significantly decreased to 1.49 ± 2.58 segments (p value = 0.04) after the procedure. Also, the wall motion score index was 1.18 ± 0.26 before PCI, which significantly decreased to 1.13 ± 0.23 after PCI (p value < 0.001).Also, there was a trend toward a higher ratio of transmitral peak early diastolic velocity to peak late diastolic velocity after PCI (p value = 0.068). Conclusion: Our study showed that the use of the Everolimus-eluting stents improved the LV systolic and diastolic functions in patients with isolated severe LAD stenosis. https://jthc.tums.ac.ir/index.php/jthc/article/view/373 https://jthc.tums.ac.ir/index.php/jthc/article/download/373/366

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 2 2015 10 13 98 100 EN Adem Guler Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey. Mehmet Ali-Sahin Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey. Fahri Gurkan-Yesil Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey. Uzeyir Yildizoglu Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey. Sait Demirkol Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey. Mehmet Arslan ="en_US">1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia. 2Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia. Mila Kovacevic 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia. 2Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia. Aleksandar Redzek 1University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia. 2Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia. Miklos Fabri Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia. 2019 08 23 2020 07 30 The most common cause of coronary artery aneurysms is atherosclerosis, which is associated with over 50% of all aneurysms diagnosed in adults. Although patients can be asymptomatic throughout their lives, giant coronary artery aneurysms can manifest themselves as myocardial infarction, aneurysmal rupture, and sudden cardiac death as well. Herein, we describe an asymptomatic patient with numerous risk factors and a positive cardiopulmonary exercise test who was admitted to the cardiology clinic for coronary angiography. A giant coronary artery aneurysm (3.0×2.0 cm in diameter) in the left anterior descending coronary artery and significant stenosis in both left and right coronary arteries were found. After discussing possible treatment options, the hospital’s heart team recommended the surgical resection of the aneurysm and double coronary artery bypass graft. Four years after the cardiac surgery, at the time of writing the current manuscript, the patient is still in good condition and with no symptoms. https://jthc.tums.ac.ir/index.php/jthc/article/view/1130 https://jthc.tums.ac.ir/index.php/jthc/article/download/1130/928

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 15 4 2020 10 31 183 188 Roya Sattarzadeh Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Saeed Ghodsi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Masoud Eslami Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Reza Mollazadeh Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Reza Safaei Nodehi Cancer Research Center, Iran Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. Zahra Hosseini Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2019 08 16 2021 01 28 Cutaneous T-cell lymphomas constitute a rare category of non-Hodgkin lymphomas, which may involve the heart in the timeline of their natural course as an infrequent picture with a poor prognosis. Syncope, either due to outflow obstruction or conduction block, is also an uncommon presentation of cardiac metastasis. We herein describe a 35-year-old man, who presented with weight loss, dyspnea of 6 months’ duration, an indolent skin ulcer in the left flank, lower limb deep vein thrombosis (DVT), and recurrent syncope. He underwent implantation of a permanent pacemaker due to a complete heart block and received anticoagulants for the DVT. Skin biopsy demonstrated a T-cell lymphoma. The syncopal episodes ceased thereafter. Echocardiography and computed tomography scan revealed cardiac metastasis, which responded to systemic chemotherapy. In the first follow-up visit after 3 months, he was still pacemaker-dependent. However, the DVT was partially resolved, and the symptoms had disappeared. https://jthc.tums.ac.ir/index.php/jthc/article/view/1127 https://jthc.tums.ac.ir/index.php/jthc/article/download/1127/929

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 15 4 2020 10 31 189 194 Mehdi Peighambari Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Marziyeh Pakbaz Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Azin Alizadehasl Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Saeid Hosseini Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Hamidreza Pouraliakbar Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. 2018 10 09 2020 09 13 Coronary artery fistulas constitute a rare anomaly defined as an abnormal communication between a coronary artery and a great vessel or any cardiac chamber. The majority of these fistulas arise from the right coronary artery and the left anterior descending coronary artery; the circumflex coronary artery is rarely involved.  We present an unusual case of a coronary artery fistula in a middle-aged woman who presented with symptoms of heart failure and abnormal auscultation. Echocardiography and conventional and computed tomography angiography showed that the coronary fistula originated from the left circumflex coronary artery and drained majorly into the right ventricle. Given the complex anatomy of the fistula, we managed it surgically rather than percutaneously. There were no complications early after surgery and at 1 year’s follow-up. https://jthc.tums.ac.ir/index.php/jthc/article/view/970 https://jthc.tums.ac.ir/index.php/jthc/article/download/970/943

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 15 4 2020 10 31 195 196 Marjan Hadadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Hosseinsabet Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Bozorgi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2020 01 02 2020 05 14 - https://jthc.tums.ac.ir/index.php/jthc/article/view/1201 https://jthc.tums.ac.ir/index.php/jthc/article/download/1201/944

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 15 4 2020 10 31 197 198 Saeed Changizi-Ashtiyani Near Amiral-Momenin Hospital, Arak University of Medical Sciences, Arak, Iran. Mohammad Hossein Asadi Near Amiral-Momenin Hospital, Arak University of Medical Sciences,Arak, Iran. 2019 12 12 2020 03 30 - https://jthc.tums.ac.ir/index.php/jthc/article/view/1193 https://jthc.tums.ac.ir/index.php/jthc/article/download/1193/939

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 15 4 2020 10 31 199 201 Behshad Naghshtabrizi Associate Professor of Cardiology, Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran. Saeed Bashirian Associate Professor of Health Education, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Naghme Shirafkan Department of Immunology, Hamadan University of Medical Sciences, Hamadan, Iran. Nima Naghshtabrizi Assistant Professor of Cardiology, Cardiology Department Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Fereshteh Mehri Assistant Professor of Toxicology, Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. 2020 07 06 2020 11 28 In  this letter we have focused on two important issues, possible risk of MI in patients who are infected with SARS- Cov-2 and different therapeutic protocols that are currently applying for management of them which may be harmful in this group of patients with heart disorders who are infected with SARS- Cov-2 patients and must be replaced with safer ones. So, Calcineurin inhibitor and cyclosporine are more likely to have less cardiac side effects in these patients. Finally, it should be considered that Calcineurin inhibitor and cyclosporine require extensive clinical trial for evaluation of their effects in patients with heart disorders who are infected with SARS- Cov-2 patients. https://jthc.tums.ac.ir/index.php/jthc/article/view/1313 https://jthc.tums.ac.ir/index.php/jthc/article/download/1313/940

od enables the accurate localization of the LA focal tachycardia, and a high success rate is achieved with ablation therapy. https://jthc