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

"en_US">Department of Psychology and Educational Sciences, Semnan University, Semnan, Iran. Shahrzad Hoveida Alborz Azad University of Sciences and Research, Karaj, Iran. 2015 12 17 2015 12 17 Background: Healthy lifestyle and ineffective coping strategies are deemed significant variables among patients with hypertension. This study attempted to determine the status of these variables following intervention via the mindfulness-based stress-reduction program (MBSRP) in patients with hypertension. Method: This study was a randomized clinical trial. The study sample, consisting of 30 patients referring to the Hypertension Clinic of Imam Hossein Hospital in 2013, was assigned either to the intervention (recipient of the MBSRP and conscious yoga) or to the control group (recipient of yoga training). The intervention group had 8 training sessions over 8 weeks. Lifestyle and coping strategies as well as blood pressure were measured in the intervention group before intervention and then immediately thereafter and at 2 months' follow-up and were compared to those in the control group at the same time points. Result: The mean age of the patients in the intervention (40% women) and control (53% women) groups was 43.66 ± 5.14 and 43.13 ± 5.04 years, respectively. The results showed that the mean scores of lifestyle (p value < 0.05), emotion-focused coping strategies (p value < 0.001), problem-focused coping strategies (p value < 0.001), diastolic blood pressure (p value < 0.001), and systolic blood pressure (p value < 0.001) were significantly different between the intervention and control groups after the intervention. Conclusion: Applying an intervention based on the MBSRP may further improve the lifestyle and coping strategies of patients with hypertension. https://jthc.tums.ac.ir/index.php/jthc/article/view/428 https://jthc.tums.ac.ir/index.php/jthc/article/download/428/378

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 3 2015 12 17 149 151 EN Mustafa Karaçelik Department of Pediatric Cardiac Surgery, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. Pelin Öztürk Department of Pediatric Cardiac Surgery, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. Onur Doyurgan Department of Pediatric Cardiac Surgery, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. Uğur Karagöz Department of Pediatric Cardiac Surgery, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. Murat Muhtar Yilmazer Department of Pediatric Cardiology, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. Timur Meşe Department of Pediatric Cardiology, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. Osman Nejat Sariosmanoğlu Department of Pediatric Cardiac Surgery, Dr. Behçet Uz Children’s Hospital, Izmir, Turkey. 2015 12 17 2015 12 17 Today, congenital heart diseases may be treated without surgery through advances in interventional cardiology. However, complications such as infection and thrombus formation may develop due to foreign materials used during these procedures. Surgical intervention may be required for the removal of the device utilized for the procedure. In this case report, we present the surgical treatment of a residual ventricular septal defect (VSD) that had developed in a 6-year-old patient with an apical muscular VSD closed with the Amplatzer muscular VSD device. The patient was admitted to the emergency room with complaints of abdominal pain and high fever 5 days after discharge without any cardiac symptoms. When she arrived at our clinic, she had a heart rate of 95 bpm, blood pressure of 110/70 mmHg, and temperature of 38.5ºC. Examinations of the other systems were normal, except for a 3/6 pan-systolic murmur at the mesocardiac focus on cardiac auscultation. Echocardiography showed a residual VSD, and the total pulmonary blood flow to the total systemic blood flow ratio (Qp/Qs) of the residual VSD was 1.8. In the operating room, the Amplatzer device was removed easily with a blunt dissection. The VSD was closed with an autologous fresh pericardial patch. Following the pulmonary artery debanding procedure, the postoperative period was uneventful. The condition of the patient at the time of discharge and in the first postoperative month’s follow-up was good. There was no residual VSD or infection.  https://jthc.tums.ac.ir/index.php/jthc/article/view/434 https://jthc.tums.ac.ir/index.php/jthc/article/download/434/384

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 10 3 2015 12 17 152 155 EN Hamid Amoozgar Neonatology and Cardiac Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Maryam Ahmadipoor Neonatology and Cardiac Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Ahmad Ali Amirghofran Cardiac Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran. 2015 12 17 2015 12 17 Total anomalous pulmonary venous connection (TAPVC) is an anomaly in which the pulmonary veins are directly connected to one of the systemic veins or drain into the right atrium. Management of pulmonary hypertension after the total correction of this congenital cardiac anomaly is very important. Unligation of the vertical vein in the supracardiac type of this anomaly can be a draining pathway for the prevention of postoperative pulmonary hypertension crisis. Late onset transcatheter closure of the unligated vertical vein after a decrease in pulmonary pressure with the Amplatzer vascular plug type 1can prevent residual left-to-right shunting. Here we describe two patients who previously underwent surgical correction of supracardiac TAPVC and their vertical veinwas partially ligated due to severe pulmonary hypertension. Consequently, because of increased left-to-right shunting in the follow-up period, transcatheter occlusion of the vertical vein was done for them and this procedure seemed safe and less invasive compared to the surgical approach.At 2 years'follow-up, there was marked pulmonary artery pressure and clinical improvement. https://jthc.tums.ac.ir/index.php/jthc/article/view/435