Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 1 14 Atefeh Nasir Kansestani 1Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mohammad Erfan Zare 1Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Jun Zhang Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2020 09 11 2021 01 18 Background: Several reports have determined that cardiovascular diseases (CVDs) are common complications in patients with coronavirus disease 2019 (COVID-19) and lead them to poor outcomes. CVD biomarkers have, thus, great potential to be used as prognostic biomarkers. We aimed to determine the accuracy of CVD biomarkers for the prognosis of the COVID-19 patient’s outcome via a diagnostic test accuracy (DTA) meta-analysis. Methods: Until September 30, 2020, we searched Web of Sciences, Scopus, and MEDLINE/PubMed databases to obtain related papers. The summary points and lines were calculated using bivariate/HSROC model. As outcomes, we considered critical conditions and mortality. Results: A total of 17 659 patients from 33 studies were included. Five biomarkers, namely increased levels of lactate dehydrogenase (LDH), cardiac troponin I (cTnI), creatine kinase (CK), D-dimer, and thrombocytopenia, met the inclusion criteria. Our results indicated that LDH and cTnI had good accuracy for the prognosis of critical condition (AUCHSROC=0.83 and 0.80, respectively), while LDH, cTnI, and D-dimer had acceptable accuracy (AUCHSROC=0.74, 0.71, and 0.72, respectively) for the prognosis of mortality. LDH and D-dimer had high sensitivity, whereas cTnI had high specificity. The other biomarkers did not have acceptable accuracy. Significant publication bias was found for D-dimer (P=0.053).   Conclusion: Among CVD biomarkers, LDH and cTnI had good accuracy for the prognosis of critical outcomes and acceptable accuracy for the prognosis of mortality, without publication bias. Given their different sensitivities and specificities, we recommend the use of these 2 biomarkers concomitantly.  https://jthc.tums.ac.ir/index.php/jthc/article/view/1348 https://jthc.tums.ac.ir/index.php/jthc/article/download/1348/945

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 15 19 EN Fariba Raygan School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. Aniseh Etminan Students’ Research Center, Kashan University of Medical Sciences, Kashan, Iran. Hanieh Mohammadi Students’ Research Center, Kashan University of Medical Sciences, Kashan, Iran. Hossein Akbari School of Public Health, Kashan University of Medical Sciences, Kashan, Iran. hassan Nikoueinejad Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2018 06 30 2021 04 19 Background: Growth differentiation factor-15 (GDF-15), a member of transforming growth factors, is a stress-responsive marker whose levels may significantly increase in response to pathological stresses associated with inflammatory tissue injuries such as unstable angina pectoris (USAP). This study evaluated the diagnostic value of GDF-15 in patients with USAP. Methods: The present cross-sectional study recruited 39 patients with USAP criteria and 30 patients with stable angina pectoris (SAP), referred to Shahid Beheshti Hospital, Kashan, Iran. All the patients with USAP had at least 1 coronary artery stenosis (>50%) in angiography. The control group comprised 42 healthy individuals. The serum levels of GDF-15 were measured in all the participants by ELISA. Also analyzed were the relationship between GDF-15 levels and thrombolysis in myocardial infarction (TIMI) and the Global Registry of Acute Coronary Events (GRACE) risk scores in the patients with USAP to determine the severity of the disease. Result: The study population consisted of 111 subjects, 62 women and 49 men, divided into 3 groups of USAP (n=39, mean age=60.07±14.10 y), SAP (n=30, mean age=67.56±9.88 y), and control (n=42, mean age=61.21±7.76 y). The mean serum level of GDF-15 in the USAP group was significantly different from the other 2 groups (P<0.001), while no significant difference was observed in this regard between the SAP and control groups (P=0.797). No correlation was found between the mean GDF-15 serum level and the GRACE (P=0.816) and TIMI (P=0.359) risk scores in the USAP group. Conclusion:  The mean serum level of GDF-15 exhibited a rise in our patients with USAP. GDF-15 may be a diagnostic biomarker of USAP and its severity. https://jthc.tums.ac.ir/index.php/jthc/article/view/914 https://jthc.tums.ac.ir/index.php/jthc/article/download/914/946

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 20 25 Hilal Erken Pamukcu Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey. Veysel Ozan Tanık Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey. Barış Şimşek Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey. İbrahim Hakan Güllü Dışkapı Yıldırım Beyazıt Training and Research Hospital, University of Health Sciences, Ankara, Turkey. 2020 08 13 2021 05 05 Background: Atrial fibrillation (AF) is associated with increased morbidity in myocardial infarction (MI), especially thromboembolic risk increases. The PRECISE-DAPT (The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy) score was created to predict the bleeding risk of dual antiplatelet therapy. The purpose of this study was to evaluate the association between new-onset AF and the PRECISE-DAPT score in ST-segment-elevation myocardial infarction (STEMI). Methods: This retrospective study enrolled patients who developed STEMI within 12 hours of the onset of symptoms and underwent primary percutaneous coronary intervention. The study population was divided into 2 groups of PRECISE-DAPT scores of 25 or greater and PRECISE-DAPT scores of below 25 and their baseline characteristics, as well as laboratory and echocardiography results, were compared. In-hospital new AF and related events were compared between the 2 PRECISE-DAPT score groups. Results: From February 2015 to December 2017, this study enrolled 2234 patients with STEMI at a mean age of 54.4 years. The new-onset AF incidence rate was higher in the higher PRECISE-DAPT group than in the lower PRECISE-DAPT group (62 [28.7 %] vs 58 [2.9%]; P<0.001). According to the multivariate logistic regression analysis, the factors associated with new-onset AF were the left atrial diameter (OR =1.98, 95% confidence interval= 1.34–2.93; P=0.001) and the PRECISE-DAPT score (OR =1.04, 95% confidence interval= 1.10–1.18; P<0.001). Conclusion: The PRECISE-DAPT score was associated with the development of new-onset AF in our patients with STEMI. Further follow-up of these patients will provide clearer information. https://jthc.tums.ac.ir/index.php/jthc/article/view/1332 https://jthc.tums.ac.ir/index.php/jthc/article/download/1332/948

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 26 30 Yaser Jenab Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamid Ariannejad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Rabbani School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Faezeh Soveyzi School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ali HosseinSabet Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Shapour Shirani Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2020 08 15 2021 05 08 Background: The right heart thrombus (RHT) embolizes from deep venous thrombi and sits in the right atrium or the right ventricle. We aimed to determine the occurrence and prognosis of the RHT in patients with pulmonary embolism. Methods: We reviewed the cohort data of 622 patients with acute pulmonary embolism obtained from the registry of Tehran Heart Center. Demographic, physiological, clinical, and echocardiographic data, as well as clinical outcomes, were compared between patients with and without the RHT. Results: The study population comprised 622 patients, including 329 men (52.8%). The mean age of the patients was 60.2±17.0 years. Thirty patients (4.8%) had echocardiographically proven RHT. Baseline demographic and clinical characteristics were not different between the 2 groups. Right ventricular dysfunction was more prevalent in the RHT (+) group, and more patients in this group were treated with thrombolysis (P=0.013 and P<0.001, respectively). Overall, 3 out of 21 patients (14.2%) in the RHT (+) group vs 29 out of 306 patients (9.4%) in the RHT (−) group died at 1 month (P=0.445) and 5 out of 21 patients (23.8%) in the RHT (+) group vs 56 out of 307 patients (18.2%) in the RHT (−) group died at 1 year (P=0.562). Conclusion: The RHT is an influential complication in patients with pulmonary emboli, and it seems to increase the mortality rate of patients with acute pulmonary embolism. https://jthc.tums.ac.ir/index.php/jthc/article/view/1333 https://jthc.tums.ac.ir/index.php/jthc/article/download/1333/949

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 31 33 Hakimeh Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Afsaneh Sadeghian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Bahare Eslami Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Hesameddin Abbasi 1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2Bernard Lown Scholar in Cardiovascular Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Masoumeh Lotfi-Tokaldany Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2020 09 07 2021 01 30 Mucopolysaccharidosis (MPS) syndrome is an inherited metabolic disorder. In more than half of the patients with MPS syndrome, heart valve involvement is reported; however, combined aortic and mitral valve stenosis in MPS syndrome type I-S is very rare. We describe a 39-year-old man with severe mitral and aortic valve stenosis due to MPS syndrome type I-S. Transthoracic and transesophageal echocardiography revealed severe thickening and calcification in the aortic and mitral valves with severe left ventricular hypertrophy. The coronary arteries were normal in angiography. https://jthc.tums.ac.ir/index.php/jthc/article/view/1342 https://jthc.tums.ac.ir/index.php/jthc/article/download/1342/960

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 34 37 Noor Mohamad Noori Children and Adolescents Health Research Center, Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. Seyed Hosein Solemanzadeh Mousavi Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. Changiz Azadi Ahmadabadi Ali-Ibn-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. 2020 10 09 2021 01 28 Sharp-object penetration into the chest is rare and may lead to life-threatening complications, hence the significance of early detection and removal. We present an uncommon case of the accidental penetration of a sewing needle into the chest of a 5-year-old girl, with the needle traveling from the entrance site to the right ventricle through the lung tissue. Due to the possibility of cardiovascular accidents, the patient was transferred to a special ward. For positioning and correct actions, TTE and CT scan of the chest with and without contrast were performed and the presence of a tangential needle with the right ventricular wall and inside the pericardium was reported. The patient was taken to the operating room, and after exploring, a 2 cm needle was inserted into the right ventricle and removed. The patient was discharged after 5 days. https://jthc.tums.ac.ir/index.php/jthc/article/view/1361 https://jthc.tums.ac.ir/index.php/jthc/article/download/1361/950

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 16 1 2021 01 14 38 41 Safieh Boroumand 1Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Hossein Ahmadi-Tafti Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Saeed Davoodi Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Khalil Forouzannia Research Center for Advanced Technologies in Cardiovascular Medicine, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2020 11 28 2021 02 18 12 31 40 55 Hamid Pourasghari : Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. Samad Azari Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. Negar Omidi Cardiovascular Imaging Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran Heart Center, Tehran, Iran. Jalal Arabloo Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. Soheila Rajaie : Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran. Mohammad Ali Rezaei Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. Masoud Behzadifar Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran. Masih Tajdini Postdoctoral Research Fellow, Division of Cardiology, Johns Hopkins School of Medicine Peyman Saberian Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2024 07 06 2025 03 16 Background: Icosapent ethyl (IPE) has demonstrated efficacy and safety in reducing the risk of ischemic cardiovascular disease. This study aimed to systematically gather and synthesize existing cost-effectiveness analyses of IPE combined with statin therapy for cardiovascular risk reduction in primary and secondary prevention settings. Methods: Comprehensive electronic searches were conducted across PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the NHS Economic Evaluation Database (NHS EED), and the Health Technology Assessment (HTA) database to identify relevant literature (up to May 2024). From an initial pool of 580 studies, 11 met the predefined inclusion criteria. Results: The findings demonstrated that IPE significantly decreased hospitalization and mortality rates compared to standard treatments. The study indicated that IPE provided greater quality-adjusted life years and life-years gained than statin therapy alone. However, IPE is more expensive than conventional medications, such as statins. For instance, the 1-year cost of IPE is $3768 in Australia and $3497 in the United States per patient. Additionally, the results revealed that the threshold for assessing the effectiveness of IPE ranged from $50,000 to $150,000 in the United States and AUD 50,000 ($39,000) in Australia. Conclusion: Based on the current study, IPE is cost-effective, with a higher probability of cost-effectiveness in patients undergoing secondary prevention than those in primary prevention. https://jthc.tums.ac.ir/index.php/jthc/article/view/2113 https://jthc.tums.ac.ir/index.php/jthc/article/download/2113/1185

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 S1 2024 05 03 56 59 Ahmadali Khalili Cardiovascular Research Center, Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran Sohrab Negargar 2Department of Anesthesia, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Jalil Vaez Gharamaleki Hematology and Oncology Research Center, Tabriz University of Medical Science, Tabriz, Iran Amir Faravan Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran 2024 05 22 2024 09 03 Ewing sarcoma, a highly aggressive round-cell neoplasm of unknown origin, rarely occurs as a primary cardiac tumor. In this intriguing case, we describe an instance of primary Ewing sarcoma in an adult patient’s right ventricle (RV). The patient, a 27-year-old man, presented with symptoms including epigastric pain, fever, tachycardia, nausea, vomiting, shortness of breath, and a dry cough. Imaging studies, including a computed tomography scan and echocardiogram, revealed an anterior mediastinal mass arising from the free wall of the RV and extending into the pericardium. The mass exerted pressure on the RV outflow tract and the pulmonary artery. Surgical intervention was deemed necessary based on the clinical presentation and paraclinical findings. The mass was meticulously dissected from the cardiac tissue, and the RV outflow tract was resected, along with the pulmonary valve and the main pulmonary artery. These structures were replaced with a composite Dacron graft, anastomosed to the bifurcation of the main pulmonary artery. Additionally, the mass near the superior vena cava and the pulmonary vein region was carefully excised. The patient was successfully weaned off the cardiopulmonary bypass pump in stable condition and transferred to the ICU. Histopathological analysis confirmed the diagnosis of small round cell sarcoma, specifically Ewing sarcoma. Following recovery, the patient was discharged and scheduled for regular follow-up appointments. Following discharge, the patient was referred to a radiotherapy center and underwent radiotherapy. During a follow-up examination 1 year later, no signs of disease recurrence or progression were observed, offering a promising outlook. This case underscores the importance of timely referral and treatment for cardiac Ewing sarcoma, which may significantly improve prognosis. https://jthc.tums.ac.ir/index.php/jthc/article/view/2101 https://jthc.tums.ac.ir/index.php/jthc/article/download/2101/1179

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 S1 2024 09 07 60 62 Pratyaksha Rana UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Megha Sheth UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Archit Dikshit UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Saurabh Deshpande UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Milin Garachh UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE Samir Patel UN MEHTA INSTITUTE OF CARDIOLOGY AND RESEARCH CENTRE </