Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 07 06 157 158 EN Ali Hosseinsabet Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 19 2016 05 25 - https://jthc.tums.ac.ir/index.php/jthc/article/view/401 https://jthc.tums.ac.ir/index.php/jthc/article/download/401/483

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 11 08 105 110 EN Elaheh Malakan Rad Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Yazdan Ghandi Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran. Armen Kocharian Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammadreza Mirzaaghayan Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 10 25 2016 10 25 Background: The late postoperative course for children with transposition of the great arteries (TGA) with an intact ventricular septum (IVS) is very important because the coronary arteries may be at risk of damage during arterial switch operation (ASO). We sought to investigate left ventricular function in patients with TGA/IVS by echocardiography. Methods: From March 2011 to December 2012, totally 20 infants (12 males and 8 females) with TGA/IVS were evaluated via 2-dimensional speckle-tracking echocardiography (2D STE) more than 6 months after they underwent ASO. A control group of age-matched infants and children was also studied. Left ventricular longitudinal strain (S), strain rate (SR), time to peak systolic longitudinal strain (TPS), and time to peak systolic longitudinal strain rate (TPSR) were measured and compared between the 2 groups. Results: Mean ± SD of age at the time of study in the patients with TGA/IVS was 15 ± 5 months, and also age at the time of ASO was 12 ± 3 days. Weight was 3.13 ± 0.07 kg at birth and 8.83 ± 1.57 kg at the time of ASO. Global strain (S), Time to peak strain rate (TPSR), and Time to peak strain (TPS) were not significantly different between the 2 groups, whereas global strain rate (SR) was significantly different (p value < 0.001).  In the 3-chamber view, the values of S in the lateral, septal, inferior, and anteroseptal walls were significantly different between the 2 groups (p value < 0.001), and SR in the posterior wall was significantly different between the 2 groups (p value < 0.001). There were no positive correlations between S and SR in terms of the variables of heart rate, total cardiopulmonary bypass time, and aortic cross-clamp time. There were no statistically significant differences between the 2 groups regarding S, SR, TPS, and TPSR in the anteroseptal and posterior walls in the 3-chamber view and in the lateral and septal walls in the 4-chamber view. Conclusion: We showed that between 6 and 18 months after a successful ASO, the parameters of S, SR, and global TPS were normal in our patients with TGA/IVS. However, LV myocardial TPSR did not normalize in this time period. https://jthc.tums.ac.ir/index.php/jthc/article/view/617 https://jthc.tums.ac.ir/index.php/jthc/article/download/617/472

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 11 08 139 142 EN Vahid Mohammad Karimi Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz Iran. Amir Anushiravani Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz Iran. Mohammad Hossein Dabbaghmanesh Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz Iran. Massood Hosseinzadeh Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz Iran. Ali Reza Rasekhi Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz Iran. Mahmoud Zamirian Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz Iran. 2016 10 25 2016 10 25 The Budd–Chiari syndrome (BCS) is a rare disorder caused by the obstruction of the hepatic veins or the inferior vena cava (IVC) at the suprahepatic level. This syndrome is developed by either hepatic vein thrombosis or mechanical venous obstruction and leads to centrilobular hepatic congestion with the subsequent development of fibrosis and cirrhosis. Intracardiac tumors have been rarely reported as a cause of the BCS. These tumors usually originate from the atrial septum. Very rarely, they arise either from the junction of the IVC and the right atrium or from the Eustachian valve. There are a few case reports in the literature where atrial tumors have caused the BCS. In these cases, the tumors were malignant, and the patients died shortly after being diagnosed. We describe a 71-year-old female patient who presented with a 3-month history of abdominal pain and protrusion. On physical examination, blood pressure and pulse rate were normal. Jugular venous pressure was about 10 cm. Cardiac examination revealed a systolic murmur, grade IV/VI, in the left sternal border without radiation. Echocardiography showed a large mass (about 6×4 cm) in the right atrium with close contact to the origin of the IVC, obstructing it. Cardiac magnetic resonance imaging, with and without gadolinium, also confirmed the diagnosis. The patient underwent surgery, and the myxoma was removed. The tumor was a large solid mass, 5×4 cm in size, which originated immediately above the entrance of the IVC. The patient is in good condition 1 year afterward. We emphasize that atrial myxomas should be considered in the differential diagnosis of tumors that cause chronic BCS. https://jthc.tums.ac.ir/index.php/jthc/article/view/620 https://jthc.tums.ac.ir/index.php/jthc/article/download/620/481

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 11 08 111 114 EN Maryam Beigom Mobasheri Medical Genetics Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hossein Modarressi Medical Genetics Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Cirus Darabian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Akbar Zeinalou Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran. 2016 10 25 2016 10 25 Background: Hypertrophic cardiomyopathy is a genetic disorder with a prevalence rate of 0.2% in the general population. It comes from mutations in sarcomeric proteins. Cardiac myosin-binding protein C3 is one of the critical genes in hypertrophic cardiomyopathy (HCM) and sudden cardiac death, accounting for about 20% of HCM-causing mutations. Genetic testing is recommended in patients with HCM. The aim of the current study was to find possible disease-causing mutations in 3 exons of the gene myosin-binding protein C (MYBPC3) in patients with HCM. Methods: Fifty subjects with documented known HCM were enrolled in the study. The patients were referred to the hospitals affiliated to Tehran University of Medical Sciences between 2008 and 2011. Peripheral blood samples were collected, as well as clinical and demographic data. The nucleotide sequences of the exons number 7, 16, and 18 of MYBPC3, whose relevance to the disease was previously reported, were amplified by polymerase chain reaction. Direct DNA sequencing was applied, and the Chromas software was used to analyze the sequences to find possible disease-causing mutations. Results: The study population comprised 73% male and 27% female patients. The mean age of the patients was 33.9 ± 20.08 years. Family history of sudden cardiac death was reported in 48.2% of the patients. About 79% of the studied subjects had a history of at least 1 other affected relative in their families. Laboratory findings did not show mutations or any nucleotide changes in the sequences of the 3 target exons in the genomic DNA of the studied patients with HCM. Conclusion: The nucleotide sequences of the exons number 7, 16, and 18 of MYBPC3 were not mutated in the 50 studied subjects with HCM.    https://jthc.tums.ac.ir/index.php/jthc/article/view/618 https://jthc.tums.ac.ir/index.php/jthc/article/download/618/473

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 11 08 143 148 EN Saeed Alipour-Parsa Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Elham Farahani Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2016 10 25 2016 10 25 The acute coronary syndrome due to the left main coronary artery (LMCA) thrombosis is a clinically rare and catastrophic event.  We describe a young man (smoker, alcoholic, and drug abuser) with a history of recent surgery and typical chest pain who had non-occlusive LMCA thrombosis in coronary angiography. The thrombosis was successfully treated with two 180 µ/kg intracoronary boluses of eptifibatide, which was continued through an intravenous infusion at 2 µ/kg/min for 48 hours postprocedurally. Control angiography, performed 3 days later, revealed that the LMCA was free of thrombosis. The patient had no complaints, including chest pain, and remained completely asymptomatic during the next 30 days' follow-up. https://jthc.tums.ac.ir/index.php/jthc/article/view/621 https://jthc.tums.ac.ir/index.php/jthc/article/download/621/476

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 07 06 115 122 EN Hakimeh Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Aliasghar Kousari Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Shahla Majidi Emam Khomeini Hospital, Ahvaz University of Medical Sciences, Ahvaz, Iran. Mehrnaz Rezvanfard Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Kazemisaeid Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Ali Moezzi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Vasheghani Farahani Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Morteza Abdar Esfahani Isfahan University of Medical Sciences, Isfahan, Iran. Mohammad Sahebjam Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Arezoo Zoroufian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Afsaneh Sadeghian Shahroud University of Medical Sciences, Shahroud, Iran. 2016 10 25 2016 10 25 Background: It is not clear whether the latest activation sites in the left ventricle (LV) are matched with infracted regions in patients with ischemic cardiomyopathy (ICM). We aimed to investigate whether the latest activation sites in the LV are in agreement with the region of akinesia in patients with ICM. Methods: Data were analyzed in 106 patients (age = 60.5 ± 12.1 y, male = 88.7%) with ICM (ejection fraction ≤ 35%) who were refractory to pharmacological therapy and were referred to the echocardiography department for an evaluation of the feasibility of cardiac resynchronization therapy. Wall motion abnormalities, time to peak systolic myocardial velocity (Ts) of 6 basal and 6 mid-portion segments of the LV, and 4 frequently used dyssynchrony indices were measured using 2-dimensional echocardiography and tissue Doppler imaging (TDI). To evaluate the influence of the electrocardiographic pattern, we categorized the patients into 2 groups: patients with QRS ≤ 120 ms and those with QRS >120 ms. Results: A total of 1 272 segments were studied. The latest activation sites (with longest Ts) were most frequently located in the mid-anterior (n = 32, 30.2%) and basal-anterior segments (n = 29, 27.4%), while the most common sites of akinesia were the mid-anteroseptal (n = 65, 61.3%) and mid-septal (n = 51, 48.1%) segments. Generally, no significant concordance was found between the latest activated segments and akinesia either in all the patients or in the QRS groups. Detailed analysis within the segments indicated a good agreement between akinesia and delayed activation in the basal-lateral segment solely in the patients with QRS duration ≤ 120 ms (Φ = 0.707; p value ≤ 0.001). Conclusion: The akinetic segment on 2-dimensional echocardiogram was not matched with the latest activation sites in the LV determined by TDI in patients with ICM.  https://jthc.tums.ac.ir/index.php/jthc/article/view/619 https://jthc.tums.ac.ir/index.php/jthc/article/download/619/484

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 3 2016 11 08 149 152 EN Arash Gholoobi Atherosclerosis Prevention Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2016 10 25 2016 10 25 The anomalous origin of the right coronary artery (RCA) as a branch from the left anterior descending artery (LAD) is a very rare variation of the single coronary artery anomaly. The anomalous vessel arises from the proximal or midportion of the LAD and courses anterior to the pulmonary artery trunk in most instances. In this case report, a 61-year-old woman is introduced who underwent coronary angiography following inferoposterior myocardial infarction, in which an anomalous RCA was seen originating from the midportion of the LAD. There was also a separate small artery originating from the right coronary sinus, which was most probably a right atrial branch. https://jthc.tums.ac.ir/index.php/jthc/article/view/622 https://jthc.tums.ac.ir/index.php/jthc/article/download/622/478

FirstName>Afrasyab Altaf Cardiology Department, Rehman Medical Institute, Peshawar, Pakistan. 2018 03 04 2019 03 25 Air inside the pericardial cavity is called “pneumopericardium”, which is a rare complication of pericardiocentesis. Pneumopericardium may resolve spontaneously or can complicate into tension pericardium, requiring urgent aspiration. We herein describe a 55-year-old man with pericardial effusion who underwent pericardiocentesis. The patient was completely asymptomatic after the procedure. Chest radiograph and computed tomography scan accidentally detected pneumopericardium, which was subsequently complicated by atrial fibrillation and necessitated pharmacological cardioversion. We found no case of asymptomatic pneumopericardium complicated by atrial fibrillation after pericardiocentesis in our literature review. Clinicians and cardiologists should do a post pericardiocentesis chest X-ray to diagnose pneumopericardium and prevent the catastrophic complications of tension pneumopericardium. https://jthc.tums.ac.ir/index.php/jthc/article/view/857 https://jthc.tums.ac.ir/index.php/jthc/article/download/857/851

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 3 2019 06 15 138 140 Seifollah Abdi Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran. Mohammad Reza Baianati Madaen Hospital, Tehran Iran. Mahmood Momtahen Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran. Bahram Mohebbi Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran. 2019 01 05 2019 04 10 Intramural esophageal dissection is a condition that typically presents with chest pains and may be associated with hematemesis, odynophagia, and hematemesis. The role of antiplatelet/anticoagulant agents in the development of intramural esophageal hematoma is controversial. The management of intramural esophageal dissection is generally conservative with low mortality and morbidity. The case described here is a 66-year-old woman who presented with chest pains, odynophagia, and dysphagia 1 month after percutaneous coronary intervention while taking ASA (80 mg daily) and clopidogrel (75 mg daily) for dual antiplatelet therapy. The patient was diagnosed as intramural esophageal dissection and underwent successful conservative medical management. The relative contribution of dual antiplatelet therapy with ASA and clopidogrel after percutaneous coronary intervention in this case is, albeit uncertain, a possibility.  https://jthc.tums.ac.ir/index.php/jthc/article/view/1015 https://jthc.tums.ac.ir/index.php/jthc/article/download/1015/852

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 3 2019 06 15 141 145 EN Murat Akcay Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. Ilkay Camlıdag Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. Okan Gulel Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. 2018 08 24 2019 04 23 Coronary artery anomalies (CAAs) are defined as variants of normal epicardial coronary arteries. They are mostly detected incidentally during coronary angiography. Clinical studies have shown that abnormal origins and courses of coronary arteries make them more prone to atherosclerosis. Percutaneous treatment for atherosclerotic occlusions in anomalous coronary arteries has some difficulties, including inadequate guiding-catheter support and the need for an experienced operator. Here, we describe successful percutaneous coronary interventions for critical stenoses in 2 different CAAs and present a brief literature review. https://jthc.tums.ac.ir/index.php/jthc/article/view/954 https://jthc.tums.ac.ir/index.php/jthc/article/download/954/853

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 3 2019 06 15 146 147 EN Tahereh Davarpasand Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Reza Mohseni Badalabadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Soheil Mansourian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Rahnamoun Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 06 27 2019 03 25 - https://jthc.tums.ac.ir/index.php/jthc/article/view/911 https://jthc.tums.ac.ir/index.php/jthc/article/download/911/861

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 3 2019 06 15