Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 1 5 EN Maryam Sotoudeh Anvari Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mojgan Tavakoli Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Masoumeh Lotfi-Tokaldany Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammadali Broumand Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Omid Rezahosseini Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Elham Hakki-Kazzazi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Arash Jalali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 03 07 2017 09 24 Background: Standard coagulation screening tests are important constituents of basic examinations in clinical laboratories. There is no clear evidence of a relation between the type of clinical presentation and coagulation parameters in patients with suspected coronary artery disease. Methods: This cross-sectional study included 539 patients who underwent coronary angiography in Tehran Heart Center between November 2012 and January 2013. Patients presented with ST-segment-elevation myocardial infarction (STEMI), non-STEMI, unstable angina, or stable angina. Prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT) were measured before angiography and compared between the clinical presentation groups. Results: The mean age of the patients was 59.156 ± 11.05 years, and 47.7% were male. STEMI was reported in 41(7.6%) patients, non-STEMI in 42 (7.8%), unstable angina in 304 (56.4%), and stable angina in 152 (28.2%).  No difference in the mean PT and INR was found between the groups. The mean APTT was significantly lower among the patients presenting with STEMI and non-STEMI (26.58 ± 2.32 ms in the STEMI, 26.85 ± 2.41 ms in the non-STEMI, 27.64 ± 2.54 ms in the unstable, and 27.93 ± 2.53 ms in the stable angina groups, respectively, p value = 0.005). After adjustment, the association between the patients’ presentations and APTT was significant (OR for 5 ms increase in APTT = 1.661, 95% CI = 1.184 to 2.332; p value = 0.003). Conclusion: We observed that the patients who presented with STEMI had the lowest value of APTT, whereas those who presented with stable angina had the highest. The value of APTT in patients undergoing coronary angiography may have a potential to predict the extent and severity of coronary stenosis.  https://jthc.tums.ac.ir/index.php/jthc/article/view/692 https://jthc.tums.ac.ir/index.php/jthc/article/download/692/667

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 6 12 EN Mozhgan Saeidi Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Saeid Komasi Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2017 02 28 2017 10 11 Background: Based on the protective health model, one of the most important components of etiological factors leading to protective health behaviors is perceived risk or perceived susceptibility. Accordingly, the present study was conducted to assess the uncontrolled and controlled effects of some factors in predicting perceived susceptibility among coronary artery bypass graft (CABG) patients. Methods: The data for the present cross-sectional study were gathered via assessment of 1052 CABG patients who referred to an outpatient cardiac rehabilitation clinic in a hospital in Iran between 2010 and 2014. The patients completed a checklist containing demographics, risk factors, and a single closed-ended question regarding perceived susceptibility at the beginning of their rehabilitation program. Binary logistic regression analysis was applied to identify the demographic and clinical correlations related to perceived susceptibility. Results: Totally, 776 (73.8%) of the 1052 participants were male. The mean age of the patients was 58.0 ± 9.1 years. The results revealed that only 13.7% of the patients had perceived susceptibility; in addition, higher age (p value = 0.003) and family history of cardiac diseases (p value = 0.001) were able to significantly predict perceived susceptibility. When the demographic variables were controlled, once again age and family history of cardiac diseases were able to significantly increase perceived susceptibility by approximately 1.04 and 29.6 times, respectively. Conclusion: Our results revealed that higher age and family history of cardiac diseases were able to significantly predict perceived susceptibility among our CABG patients. https://jthc.tums.ac.ir/index.php/jthc/article/view/685 https://jthc.tums.ac.ir/index.php/jthc/article/download/685/668

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 13 17 EN Akram Sardari Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Kianoosh Hosseini Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Bozorgi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Masoumeh Lotfi-Tokaldany Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hakimeh Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Nejatian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 08 21 2017 07 01 Background: Enhanced external counterpulsation (EECP) reduces angina pectoris, extends time to exercise-induced ischemia, and improves quality of life in patients with symptomatic stable angina. We aimed to evaluate the effects of EECP on heart rate recovery in patients with coronary artery disease (CAD). Methods: Between January 2011 and March 2013, a total of 34 consecutive patients (24 male, 70.6%) with symptomatic CAD, who were candidated for EECP, prospectively received 35 sessions of 1-hour EECP therapy per day, 6 days per week. The patients underwent echocardiography and a symptom-limited modified Bruce exercise test before and after EECP. Left ventricular ejection fraction (LVEF), resting and peak exercise heart rates, systolic blood pressure, heart rate at 1 and 2 minutes of recovery, exercise duration, workload, and first- and second-minute heart rate recovery were measured before EECP and compared with those after EECP. Results: The mean age of the patients (70.6% men) was 64.82 ± 8.28 years. After EECP, exercise duration increased significantly from 6.48 ± 2.76 minutes to 9.20 ± 2.71 minutes (p value < 0.001). Maximum workload increased significantly (4.44 ± 1.28 vs. 5.65 ± 1.77 METS; p value < 0.001). The LVEF increased from 42.65 ± 11.82% to 44.26 ± 11.86% (p value < 0.001). The resting systolic blood pressure decreased significantly from 125.59 ± 22.35 mmHg to 116.26 ± 14.93 mmHg (p value = 0.013). The increase in the first- and second-minute heart rate recovery after EECP was not statistically significant. Conclusion: The results of the present study showed that exercise duration, maximum workload, and the LVEF might increase significantly after EECP. The increase in the first- and second-minute heart rate recovery after EECP was not statistically significant.  https://jthc.tums.ac.ir/index.php/jthc/article/view/601 https://jthc.tums.ac.ir/index.php/jthc/article/download/601/646

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 18 23 EN Sima Rafieyian Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shahla Roodpeyma Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Kourosh Vahidshahi Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Moghadasi Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2016 04 13 2017 06 21 Background: Tissue Doppler imaging yields useful information about regional myocardial function. The purpose of this study was to investigate myocardial function by strain and strain rate in a group of patients with congenital heart disease (CHD) before and after cardiac surgery. Methods: Three consecutive tissue Doppler echocardiographic examinations were performed on 25 patients with CHD, who underwent open-heart surgery. The study was conducted from April 2013 to April 2014 in a university hospital, and the assessments were done 1 day before and 1 week and 1 month after surgery. The effects of demographic variables, types of anomalies, and cardiopulmonary bypass factors on strain were evaluated. Results: The study population comprised 13 female and 12 male patients at a mean age of 9.4 ± 9.8 years. Compared to the preoperative data, repeated measurements of strain in 9 segments of the ventricles showed a significant reduction 1 week after surgery, followed by a significant augmentation 1 month  postoperatively (p value = 0.001 for all 9 segments). The reduction in strain at the middle segment of the left ventricular free wall was significant in the cyanotic patients (p value = 0.037). The increase in strain at the middle segment of the septum and the right ventricular basal and middle segments was significant (p value = 0.021, p value = 0.015, and p value = 0.021, respectively) in the patients with a shorter pump time. Conclusion: Our patients experienced an early decline in myocardial function after cardiac surgery, but their myocardium recovered its contractility gradually. https://jthc.tums.ac.ir/index.php/jthc/article/view/532 https://jthc.tums.ac.ir/index.php/jthc/article/download/532/630

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 24 26 EN Hikmet Sahratov Department of Cardiovascular Surgery, Gulhane Military Medical School, Ankara, Turkey. Adem Guler Department of Cardiovascular Surgery, Gulhane Military Medical School, Ankara, Turkey. Mustafa Kurkluoglu Department of Cardiovascular Surgery, Gulhane Military Medical School, Ankara, Turkey. Bahadır Calişkan Department of Cardiovascular Surgery, Gulhane Military Medical School, Ankara, Turkey. Fahri Yesil Department of Cardiovascular Surgery, Etimesgut Military Medical Hospital, Ankara, Turkey. Murat Tavlasoglu Department of Cardiovascular Surgery, Gulhane Military Medical School, Ankara, Turkey. Mehmet Sahin Department of Cardiovascular Surgery, Gulhane Military Medical School, Ankara, Turkey. 2016 02 22 2017 07 12 Inflammatory myofibroblastic tumors (IMTs) of the lung are rare solid tumors and usually affect children and young adults. We describe an unusual form of an IMT of the left lower lobe invading the left atrium. A 9-year-old male patient with recurrent cough was referred for an evaluation of left-lung pneumonia. Transthoracic needle biopsy was performed, and the histopathological examination showed mixed inflammatory cells. Accordingly, an IMT was considered. Left lower lobectomy was performed. A portion of the tumor invading the left atrium was resected together with the intact atrial wall. The postoperative period was uneventful, and the patient was discharged on the sixth postoperative day. https://jthc.tums.ac.ir/index.php/jthc/article/view/500 https://jthc.tums.ac.ir/index.php/jthc/article/download/500/647

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 27 31 EN Hassan Kamalzadeh Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. Shahrooz Yazdani Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. Mohammad Jalali Shahid Rajaei Hospital, Alborz University of Medical Sciences, Karaj, Iran. 2016 08 21 2017 08 01 In patients with cardiac resynchronization therapy (CRT), loss of left ventricular (LV) stimulation occurs chiefly because of LV lead dislodgement. The occurrence rate of LV lead dislodgement in different reports is between 2% and 12% of patients. LV lead dislodgement precludes clinical improvement. We describe 2 patients with heart failure, fulfilling the criteria for CRT implantation. In both patients, right ventricular and right atrial leads were implanted via the left subclavian vein in the right ventricular apex and the right atrial appendage, respectively. Repeated LV lead implantation was unsuccessful and each time after the fixation, the LV lead was dislodged with the heart motion during systole and diastole. In order to stabilize the LV lead, we decided to benefit from coronary sinus stenting and lead entrapment behind the deployed stent. LV lead stabilization was accomplished by the deployment of bare-metal stents (Multi-Link 3.5 × 8 mm and Multi-Link 3 × 8 mm, Abbott Vascular) in order to entrap the LV lead. The stents were deployed at a nominal pressure (10 atm). The pacing performance of the LV leads was satisfactory and stable at midterm in our experience. Stenting within the coronary sinus seems to be a safe method for LV lead stabilization and can substantially boost the success rate of CRT. Our device analysis during short- and midterm follow-up (4 months after implantation) revealed acceptable LV lead threshold and impedance. https://jthc.tums.ac.ir/index.php/jthc/article/view/602 https://jthc.tums.ac.ir/index.php/jthc/article/download/602/648

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 1 2018 02 24 32 34 EN Kahraman Coşansu Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya, Turkey. Mustafa Ağaç Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya, Turkey. 2019 01 16 33 36 EN Muhammed Keskin Sultan Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey. Tufan Çınar Sultan Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey. Mert İlker Hayıroğlu Sultan Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey. Ömer Kozan Sultan Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey. 2017 12 15 2018 11 22 Left ventricular aneurysms (LVAs) are characterized by a wide connection to the left ventricle and paradoxical systolic motions. Although patients with LVAs are usually asymptomatic, some may present with arrhythmias, heart failure, and even cardiac arrest. In this case report, we describe a 62-year-old male patient who presented to our emergency service with complaints of palpitation and shortness of breath of 2 hours’ duration. His blood pressure was 84/56 mm Hg, and he was in a confused state. An electrocardiogram revealed ventricular tachycardia (VT) with right bundle branch block and a ventricular rate of 188 bpm. The patient’s hemodynamic instability necessitated a direct current cardioversion, which restored the sinus rhythm. During the in-hospital course, he had numerous recurrent VT episodes despite treatment with intravenous amiodarone and magnesium sulfate as well as radiofrequency ablation. Upon consensus with a cardiovascular surgeon’s team, urgent surgery was performed due to the resistant VT episodes. The patient’s clinical course was uneventful, and he was discharged on the 11th postoperative day. We have been following up the patient for almost 1 year, during which he has not experienced palpitations or associated symptoms. Our case indicates that surgery may be a preferable treatment option for patients with heart failure and resistant VT related to LVAs. https://jthc.tums.ac.ir/index.php/jthc/article/view/823 https://jthc.tums.ac.ir/index.php/jthc/article/download/823/815

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 1 2019 01 16 37 39 EN Pezhman Farshidmehr Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Zafarghandi Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alimohammad Sadat Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Azadeh Sayarifard Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran, Iran. 2018 08 01 2018 11 11 Superior mesenteric arteriovenous fistulae are rare. A 32-year-old woman presented with abdominal pain. The angiography showed that the superior mesenteric vein was aneurysmal. The patient underwent coil embolization, during which a balloon catheter was inflated before the fistula for the protection of coil migration with a high blood flow. After the balloon inflation, one 8-mm and two 7-mm coils were deployed at the fistula site. The final angiography showed successful embolization with no visualization of the fistula and the aneurysmal vein. https://jthc.tums.ac.ir/index.php/jthc/article/view/945 https://jthc.tums.ac.ir/index.php/jthc/article/download/945/816

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 1 2019 01 16 40 41 EN Murat Akcay Department of Cardiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. 2018 07 31 2018 11 06 No Abstract https://jthc.tums.ac.ir/index.php/jthc/article/view/944 https://jthc.tums.ac.ir/index.php/jthc/article/download/944/829

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 14 1 2019 01 16 42 43 EN Tahereh Davarpasand Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Sahebjam Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Alidoosti Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 07 19 2018 12 09 -   https://jthc.tums.ac.ir/index.php/jthc/article/view/934 https://jthc.tums.ac.ir/index.php/jthc/article/d