Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 41 47 Hülya Yilmaz AK Kartal Dr Lütfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey. Yasemin Özşahin Cerrahpaşa Cardiology Institute, Istanbul University, Istanbul, Turkey. Mehmet Yeşiltaş Department of Cardiovascular Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Baris Sandal Faculty of Engineering, Istanbul University-Cerrahpaşa, Istanbul, Turkey. Ziya Salihoglu Cerrahpaşa Cardiology Institute, Istanbul University, Istanbul, Turkey. Kerem Erkalp Cerrahpaşa Cardiology Institute, Istanbul University, Istanbul, Turkey. 2021 11 08 2022 04 24 Background: In cardiac surgery, supraphysiological oxygen levels are frequently applied perioperatively. In this study, we examined the postoperative effect of perioperative hyperoxemia in cardiac surgery. Methods: All patients who underwent mitral valve replacement via the standard sternotomy method between 2010 and 2021 were analyzed by scanning the hospital data system. The patients were divided into 2 groups: the hyperoxemic group (partial pressure of oxygen/fraction of inspired oxygen [PaO2/FiO2] > 500 mmHg) (Group I) and the normoxemic group (300 mmHg < PaO2/FiO2 < 500 mmHg) (Group II) according to the mean of 3 PaO2/FiO2 values calculated by using 3 PaO2 and 3 FiO2 levels. Postoperative complications, the mechanical ventilation time, the need for noninvasive mechanical ventilator support, the length of intensive care unit (ICU) stay, the hospitalization period, and the mortality rate of the groups were compared. Results: A total of 78 patients were included in the study, and 53 of the patients (67.9%) were female. The mean age of the patients was 58.89±12.60 years.  The total mechanical ventilation time was significantly higher in the hyperoxemic group than in Group II (P<0.001) (18.18±12.90 h and 11.45±7.85 h, respectively). The amount of postoperative bleeding was significantly higher in Group I (P=0.003) (539.47±201.74 mL and 417.50±186.93 mL, respectively). The total amount of blood products administered during surgery and ICU stay was higher in Group I (P=0.041) (3.55±1.59 units and 2.87±1.89 units, respectively). Conclusion: We observed that the group with hyperoxemia during cardiopulmonary bypass had a higher amount of postoperative bleeding and the need for transfusion, as well as a longer duration of mechanical ventilation and intensive care. https://jthc.tums.ac.ir/index.php/jthc/article/view/1547 https://jthc.tums.ac.ir/index.php/jthc/article/download/1547/1005

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 86 87 Masoud Tarbiat Farshchian Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Seyed Kamaledin Hadei Farshchian Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Nakisa Khansary Farshchian Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. 2021 11 10 2022 05 18  No Abstrac No Abstrac No Abstrac https://jthc.tums.ac.ir/index.php/jthc/article/view/1552 https://jthc.tums.ac.ir/index.php/jthc/article/download/1552/1012

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 71 74 Muhammad Mansoor National Institute of Cardiovascular Disorders, Karachi, Pakistan. Waqar Khan National Institute of Cardiovascular Disorders, Karachi, Pakistan. Fakhar Abbas Mayo Hospital, King Edward Medical University, Lahore, Pakistan. Usha Kumari Dow University of Health Sciences, Karachi, Pakistan. 2022 01 23 2022 04 16 Congenital anomalous coronary arteries (CACAs) comprise an important variant of the coronary vasculature. They are benign in the vast majority of cases, whereas a small minority may be affected by serious consequences such as myocardial infarction, arrhythmia, cardiac arrest, and even death. We herein describe a 62-year-old man with sudden and severe substernal chest pain; Q waves in electrocardiographic leads II, III, and aVF; and positive serum troponin I enzyme. Left heart cardiac catheterization revealed triple coronary vessel disease with a 60% to 70% occlusion in the left main coronary artery (LMCA). The left anterior descending (LAD) and the left circumflex artery arose from the ostium of the right coronary artery. Additionally, a rudimentary type IV dual LAD originated from the LMCA. A coronary artery bypass graft surgery was performed using a left internal mammary artery graft for the LAD and a saphenous vein graft for the diagonal branches (I & II) of the LAD and the posterior descending artery. The patient was discharged after an uneventful 1-week hospital course. https://jthc.tums.ac.ir/index.php/jthc/article/view/1598 https://jthc.tums.ac.ir/index.php/jthc/article/download/1598/1008

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 48 55 Faysal Şaylık Van Training and Research Hospital, Health Sciences University, Van, Turkey. Murat Selçuk Sultan II. Abdulhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey. Tayyar Akbulut Van Training and Research Hospital, Health Sciences University, Van, Turkey. Tufan Çınar Sultan II. Abdulhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey. 2021 07 28 2022 04 30 Background: In current practice, establishing the potential predictors of high thrombus burden (HTB) before primary percutaneous coronary intervention (PCI) is crucial for its management. In this research, we aimed to investigate the association between vitamin D levels and HTB in patients with ST-elevation myocardial infarction (STEMI). Methods: This prospective, observational study was conducted on 257 STEMI patients undergoing primary PCI in Van Education and Research Hospital between March 2020 and March 2021. The thrombus burden grade was determined for each subject. The study population was divided into 2 groups: patients with HTB and those with low thrombus burden (LTB) based on the thrombus burden grade. Demographic, laboratory, and angiographic features were compared between the groups. Results: In total, 154 patients (mean age±SD=63.42±11.53 y, 65.6% male) had HTB and 103 patients had LTB (mean age±SD=61.50±10.23 y, 70.9% male). The patients stratified into the HTB group had lower vitamin D levels than those in the LTB group (8.0 ng/mL vs 17.9 ng/mL, respectively; P<0.001). The patients with HTB and low vitamin D levels had lower post-PCI thrombolysis in myocardial infarction (TIMI) flow, TIMI myocardial perfusion grade, and post-PCI ST resolution. In a multivariable analysis, vitamin D was an independent predictor of HTB among the STEMI patients (OR: 0.76, 95%CI: 0.70–0.82; P<0.001). The ideal value of vitamin D to predict HTB was >17.6 ng/mL with a sensitivity of 81.8% and a specificity of 90.3%. Conclusion: The study results showed that vitamin D levels were an independent predictor of HTB in STEMI patients treated by primary PCI. https://jthc.tums.ac.ir/index.php/jthc/article/view/1498 https://jthc.tums.ac.ir/index.php/jthc/article/download/1498/1004

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 75 77 EN Rezvanieh Salehi Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Naser Khezerlouy-Aghdam Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Elnaz Javanshir Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Babak Zanjani Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Razieh Parizad Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. 2021 10 20 2022 05 11 An accessory mitral valve (AMV) is a rare anomaly of the mitral valve (MV) that often causes left ventricular outflow tract (LVOT) obstruction. We describe a young woman presenting with infrequent palpitations to our outpatient clinic. She was evaluated for mid-systolic murmur at the left sternal border. At the initial transthoracic echocardiography, vegetation on the MV was suspected. The patient was referred to our advanced echocardiography lab, where transesophageal echocardiography revealed an AMV with mild LVOT obstruction. The findings, along with extensive laboratory tests, ruled out vegetation. Additionally, she had a bicuspid aortic valve. At follow-up after 1 year, the patient was asymptomatic regarding the AMV with LVOT obstruction, and the repeat echocardiography depicted no changes compared with the previous echocardiography. Distinguishing AMVs from other MV masses, including vegetation, sometimes poses a challenge and can lead to unnecessary diagnostic and therapeutic measures. This rare MV anomaly is associated with bicuspid aortic valves. https://jthc.tums.ac.ir/index.php/jthc/article/view/1535 https://jthc.tums.ac.ir/index.php/jthc/article/download/1535/1009

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 62 70 Parisa Janjani Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Sayeh Motevaseli Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Nahid Salehi Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Reza Heidari Moghadam Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Soraya Siabani Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mahdi Nalini Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2021 12 28 2022 05 23 Background: Identifying the long-term predictors of recurrent cardiovascular events may help improve the quality of care and prevent subsequent events. We aimed to investigate the predictors of 1-year major cardiovascular events (MACE) in patients discharged after ST-elevation myocardial infarction (STEMI) in a tertiary hospital in Iran. Methods: This registry-based cohort study included consecutive STEMI patients between 2016 and 2019 in Imam-Ali Hospital, Kermanshah, Iran. All patients discharged alive from STEMI hospitalization were followed up for 1 year for MACE, consisting of all-cause mortality, nonfatal MI, and nonfatal stroke. We estimated the hazard ratio (HR) and the 95% confidence interval (95% CI) using Cox proportional-hazard models to evaluate potential predictors, including demographic characteristics, medical history, cardiovascular risk factors, laboratory tests, reperfusion therapy, and medications. Results: During 2187.2 person-years, 21 patients were lost to follow-up (success rate =99.1%). Of 2274 post-discharge STEMI patients (mean age =60.26 y; 21.9% female), 151 (6.6%) experienced MACE, including, all-cause mortality (n=115, 5.1%), nonfatal MI (n=20, 0.9%), and nonfatal stroke (n=16, 0.7%). Independent predictors of MACE were age (HR:1.02; 95% CI: 1.00–1.04), no education vs ≥12 years of formal schooling (HR: 2.07; 95% CI: 1.17–3.67), stroke history (HR: 2.37; 95% CI: 1.48–3.81), the glomerular filtration rate (HR: 0.98; 95% CI: 0.97–1.00), the body mass index (HR: 0.94; 95% CI:, 0.89–0.99), peak creatine kinase-MB (HR: 1.00; 95% CI: 1.00–1.002), thrombolysis vs primary percutaneous coronary intervention (HR: 1.85; 95% CI: 1.21–2.81), and left ventricular ejection fraction <35% vs ≥50% (HR: 2.82; 95% CI: 1.46–5.47). Conclusion: Age, education, stroke history, the glomerular filtration rate, the body mass index, peak creatine kinase-MB, reperfusion therapy, and left ventricular function can be independently associated with 1-year MACE. https://jthc.tums.ac.ir/index.php/jthc/article/view/1586 https://jthc.tums.ac.ir/index.php/jthc/article/download/1586/1007

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 2 2022 04 30 78 81 EN Reza Mohseni Badalabadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Parto Siavosh Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hakimeh Sadeghian Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2021 07 09 2022 05 26 Injuries to the heart and great vessels should always be considered after blunt chest trauma. Valvular damage rarely occurs after blunt trauma, but symptoms may be delayed. A 58-year-old woman was referred to our hospital with exertional dyspnea (functional class III) and palpitations for elective transesophageal echocardiography. Her symptoms had exacerbated in the preceding 2 or 3 months. Physical examination showed holosystolic murmurs (IV/VI) at the lower sternal border with extension to the apex. Transesophageal echocardiography revealed avulsion of the base of the posterior mitral valve leaflet (P3) from the annulus. In the past medical history, there was a history of a motor vehicle accident 9 months earlier. The patient was recommended for mitral valve surgery. Mitral valve replacement was performed, and the dntion whether percutaneous or surgical. We describe an 89-year-old woman with an SCA from the right sinus of Valsalva presenting with chest pain and acute myocardial infarction. We succeeded in performing percutaneous coronary intervention and stenting on the ostial lesion of the SCA, and there were no further complications. The patient was discharged 2 days later with no adverse complications. https://jthc.tums.ac.ir/index.php/jthc/article/view/811 https://jthc.tums.ac.ir/index.php/jthc/article/download/811/783

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 3 2018 07 15 136 139 EN Amer Harky Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK. AND Department of Vascular Surgery, Countess of Chester Hospital, Chester, UK. Mohamad Bashir Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK. Ciaran Grafton-Clarke School of Medicine, University of Liverpool, Cedar House, Liverpool, UK. Martin Lees School of Medicine, University of Liverpool, Cedar House, Liverpool, UK. Sarah Fendius Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK. Neil Roberts Department of Cardiothoracic Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, UK. 2017 03 09 2018 05 10 Intraventricular conduction abnormalities following cardiac surgery have been thoroughly described, especially after valvular surgery. It is also widely known that several anesthetic factors can cause autonomic disturbances resulting in the unmasking of sinus node dysfunction, significant bradycardia, and cardiovascular collapse during the intraoperative period. However, little is known about asymptomatic episodes, especially those occurring prior to coronary artery bypass grafting (CABG). We report a rare occurrence of an intraventricular conduction defect that presented in an asymptomatic patient following non–ST-elevation myocardial infarction prior to urgent CABG. Our patient presented with sudden-onset chest pain, and following coronary angiography he was found to have triple-vessel coronary disease. During anesthetic induction for inpatient CABG surgery, he developed episodes of acute sinus tachy-brady episodes, requiring a stat dose of adrenaline to maintain the heart rate prior to the establishment of cardiopulmonary bypass. The arrhythmia persisted postoperatively, necessitating the insertion of a permanent dual-chamber pacemaker for complete heart block. The patient was later discharged without further complications, and upon follow-up 12 months later, he remains in good health. https://jthc.tums.ac.ir/index.php/jthc/article/view/694 https://jthc.tums.ac.ir/index.php/jthc/article/download/694/796

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 3 2018 07 15 144 152 EN Mahdi Moshki Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. Haydeh Hashemizadeh Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. Abdoljavad Khajavi Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran. Shima Minaee Department of Cardiovascular Diseases, Razavi Hospital, Mashhad, Iran. Farveh Vakilian Preventive Atherosclerotic Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2017 10 08 2018 04 29 Background: Unraveling the relationship between health-related quality of life (HRQOL) instruments and the International Classification of Functioning, Disability, and Health (ICF) seems essential due to the increasing importance of quality of life evaluations in patients with heart failure (HF) and the use of the ICF for comparative purposes. The aim of this study is to identify and compare the content of HRQOL instruments for HF using the ICF coding system. Methods: In a 2-stage design, first we will identify all measures used to assess HRQOL for patients with HF and second we will compare the content of those measures using the ICF coding system.  Systematic search will be performed in in MEDLINE, CINAHL, and Scopus databases using a combination of free texts and MeSH terms between January 1960 and January 2017. All instruments will be linked to the ICF separately by 2 reviewers according to 10 linking