The journal of Tehran Heart Center最新文献

{"title":"Accelerated Idioventricular Rhythm: Not Always a Reperfusion Arrhythmia.","authors":"Riyaz Charaniya, Mit Chaudhari, Dinesh Joshi","doi":"10.18502/jthc.v19i4.17620","DOIUrl":"10.18502/jthc.v19i4.17620","url":null,"abstract":"<p><p>Accelerated idioventricular rhythm (AIVR) is a relatively slow ventricular rhythm that often occurs during the reperfusion phase of an acute myocardial infarction. It is generally considered a benign rhythm that does not require treatment. However, we present a case where AIVR was the presenting arrhythmia in a 41-year-old man with acute coronary syndrome, suggesting it might not be as benign as previously reported in the literature. The patient, who presented to our institute, underwent urgent coronary evaluation followed by revascularization, leading to the conversion of AIVR to normal sinus rhythm and improvement in anginal symptoms.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"306-309"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Pacemaker Dependence after Takotsubo Recovery Suggests that Complete Heart Block is the Trigger of Takotsubo.","authors":"John E Madias","doi":"10.18502/jthc.v19i4.17621","DOIUrl":"10.18502/jthc.v19i4.17621","url":null,"abstract":"","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"310-311"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the Optimal Dosage of Lisinopril in Inhibiting Myofibroblast Differentiation for Attenuating Rheumatic Heart Disease Progression: An in Vitro Study.","authors":"Achmad Lefi, Denisa Nugrahita Asmarani, Budi Baktijasa Dharmadjati, Denny Suwanto, Mahendra Eko Saputra, Vemaniarti Lian Pravitasari, Faizal Ablansah Anandita","doi":"10.18502/jthc.v19i4.17610","DOIUrl":"10.18502/jthc.v19i4.17610","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) is exacerbated by chronic inflammation that stimulates the release of proinflammatory cytokines, most notably transforming growth factor-beta 1 (TGF-β1), which promotes myofibroblast differentiation. This study aims to determine the optimal dosage of Lisinopril, an angiotensin-converting enzyme inhibitor, for mitigating the fibrotic changes associated with RHD.</p><p><strong>Methods: </strong>This in vitro, posttest-only control group study involved obtaining valvular interstitial cells from the heart valves of 25 male New Zealand rabbits (Oryctolagus cuniculus). Valvular interstitial cells were divided into 5 groups: a control group exposed to TGF-β1, and 4 experimental groups exposed to various Lisinopril doses (1 μM, 10 μM, and 100 μM) in addition to TGF-β1. The effect of Lisinopril on myofibroblast differentiation was assessed by measuring alpha-smooth muscle actin (αSMA) expression through immunocytochemical methods. Statistical significance was determined using an independent T-test with a P value of less than 0.050.</p><p><strong>Results: </strong>Independent T-tests conducted on 25 male Oryctolagus cuniculus demonstrated significantly lower αSMA expression in the groups treated with various Lisinopril doses (1 μM, 10 μM, and 100 μM) compared with the TGF-β1-induced control group (P<0.050). The most significant reduction in αSMA expression was observed in the group treated with the highest Lisinopril dose of 100 μM.</p><p><strong>Conclusion: </strong>Lisinopril demonstrates a significant ability to inhibit TGF-β1-induced myofibroblast differentiation in rabbit valve interstitial cells, with the 100 μM dose proving most effective. These results suggest that Lisinopril may have the potential to curb RHD progression, warranting further investigations in vivo.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"256-263"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Inferior Sinus Venosus and Secundum Atrial Septal Defects with Mixed Partial Anomalous Pulmonary and Systemic Venous Drainage: Key Insights and Practical Implications.","authors":"Elaheh Malakan Rad, Hassan Radmehr, Ashkan Taghizadeh, Hamidreza Pouraliakbar, Elahe Radmehr","doi":"10.18502/jthc.v19i4.17615","DOIUrl":"10.18502/jthc.v19i4.17615","url":null,"abstract":"<p><p>Mixed atrial septal defects (ASDs) involving inferior vena cava (IVC)-type sinus venosus and secundum types and mixed partial anomalous pulmonary, systemic, and hepatic venous drainage are rare. We describe a 3-year-old acyanotic boy who presented with a large mixed inferior sinus venosus and secundum-type ASD. He exhibited an abnormal connection between the right upper pulmonary vein and the right atrium. Additionally, the IVC and a hepatic vein drained abnormally into the left atrium. The patient also had valvular and supravalvular pulmonary stenosis, as well as a small patent ductus arteriosus. The ASD was surgically closed using a pericardial patch, positioned lower than usual to reroute the IVC and hepatic vein flow into the right atrium. The surgery was successful, with no residual lesions or complications. The patient recovered without issues and was discharged smoothly. At the 6-month follow-up, the child's cardiac examination and oxygen saturation were normal. Furthermore, echocardiography confirmed normal drainage of the systemic and hepatic veins into the right atrium.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"283-288"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Effect of Flaxseed Oil on Diazinon-Induced Cardiotoxicity in Rats in Sub-Chronic Exposure.","authors":"Akram Ranjbar, Fereshteh Mehri, Maryam Esfahani, Elham Shiri","doi":"10.18502/jthc.v19i4.17607","DOIUrl":"10.18502/jthc.v19i4.17607","url":null,"abstract":"<p><strong>Background: </strong>Diazinon (DZN), an organophosphate insecticide, exerts various adverse effects on human organs. In this study, we investigated the potential cardiotoxic effects of flaxseed oil (FS oil) on oxidative stress caused by DZN in the heart tissue of rats.</p><p><strong>Methods: </strong>Thirty male rats were divided into five groups: a control group receiving normal saline, an FS oil group administered 200 mg/kg/d of FS oil, a DZN group treated with 70 mg/kg/d of DZN, and two co-treatment groups receiving DZN alongside FS oil at 100 and 200 mg/kg/d. We assessed oxidative stress biomarkers in heart tissue, including malondialdehyde, total oxidant status, catalase, superoxide dismutase, and total thiol content. Heart tissue morphology was analyzed using hematoxylin and eosin staining.</p><p><strong>Results: </strong>DZN significantly increased the levels of malondialdehyde (12.04±1.16) and total oxidant status (0.43±0.01) and also decreased the content of catalase (23.09±1.99), superoxide dismutase (5.52±0.61), and total thiol content (6.31±0.77) in heart tissue. FS-oil + DZN decreased malondialdehyde (10.88±0.31) and total oxidant status (0.41±0.01) and also increased the content of catalase (29.34±1.77), superoxide dismutase (6.64±0.21), and total thiol content (8.20±0.15) in heart tissue. FS oil supplement consumption reversed oxidative stress status in a dose-dependent manner. Furthermore, FS oil ameliorated heart histopathological alterations induced by DZN.</p><p><strong>Conclusion: </strong>Our findings confirmed that DZN induced heart toxicity and that FS oil had protective effects. Additionally, FS oil supplementation conferred protective effects on the heart against toxicity induced by DZN.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"243-249"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Color-Coded Anatomical M-Mode, Strain Imaging, and Tissue Doppler Imaging in Assessing Myocardial Asynchrony in Normal Subjects.","authors":"Mohammad Amin Masoumi, Masoumeh Lotfi Tokaldani, Saman Sarhangzadeh, Parto Siavosh, Hakimeh Sadeghian","doi":"10.18502/jthc.v19i4.17613","DOIUrl":"10.18502/jthc.v19i4.17613","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the time-to-peak systolic contraction time (Tc) by color-coded anatomical M-mode (AMM), the time-to-peak systolic strain (Tst) by strain rate imaging (SRI), and the time-to-peak systolic velocity (Ts) by tissue Doppler imaging (TDI) in the left (LV) and right (RV) ventricular segments of normal subjects. We also sought to determine the relationship between these methods for defining asynchrony indices in normal subjects.</p><p><strong>Methods: </strong>Conventional echocardiography, color-coded AMM, SRI, and TDI were performed on 44 healthy adult volunteers (at the Tehran Heart Center and Shariati Hospital) to measure Tc, Tst, and Ts for 12 LV and 2 RV segments at mid and basal levels. Additionally, delays and standard deviations (SDs) were measured in all 12 LV segments.</p><p><strong>Results: </strong>In the assessed segments, Tc by AMM and Tst by SRI were significantly greater than Ts by TDI (P<0.001). No significant differences were noted between Tc and Tst in 8 LV and 2 RV segments (P<0.05). For the septal basal segment, the respective values were Ts=170.43±36.76 ms, Tst=372.34±72.21 ms, and Tc=374.19±42.76 ms. A moderate correlation was observed between AMM and SRI in assessing asynchrony and SD for all LV segments, but no correlation existed between AMM and TDI.</p><p><strong>Conclusion: </strong>Tc by AMM and Tst by SRI were significantly higher than Ts by TDI in the LV and RV segments. There was no correlation between AMM and TDI in defining asynchrony indices.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"270-275"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexplained Multi-Site Thrombosis: A Step-by-Step Strategy for Factor V Leiden Detection in a Hypercoagulable Patient.","authors":"Venus Shahabi Raberi, Ozra Kahourian, Reza Faramarzzadeh, Razieh Parizad, Oliver McConnell, Alireza Rostamzadeh","doi":"10.18502/jthc.v19i4.17618","DOIUrl":"10.18502/jthc.v19i4.17618","url":null,"abstract":"<p><p>Thrombotic manifestations involve the development of blood clots within blood vessels. These conditions can occur unexpectedly in different areas and are often linked to life-threatening situations, presenting challenges for both diagnosis and treatment. We present a case of multi-site thrombosis in a patient with a confirmed hypercoagulable state, resulting from a positive factor V Leiden mutation. The patient's medical history included hypertension, chronic obstructive pulmonary disease, previous thrombotic events, and changes in anticoagulant therapy. This case highlights the challenges associated with multisystem thrombosis and underscores the necessity of employing various diagnostic techniques, such as echocardiography, computed coronary angiography, and Doppler ultrasonography. In this instance, the patient presented with a history of unprovoked lower limb deep vein thrombosis and multiple arterial thromboses. The patient's treatment regimen comprised anticoagulants, antiplatelet drugs, and vasodilators. While a reduction in thrombus size was noted, complete revascularization could not be attained. Effective diagnosis and treatment of venous and arterial thrombosis often require multimodal imaging. Selective blood test screening can be beneficial in diagnosing or detecting inherited or acquired abnormalities linked to thrombosis development.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"295-301"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed Tomography Angiography Indications in the Follow-Up of Kawasaki Disease Patients.","authors":"Parvin Akbariasbagh, Seyed Reza Raeeskarami, Massoumeh Asgarshirazi, Sahar Naderi, Mehrnaz Adib","doi":"10.18502/jthc.v19i4.17616","DOIUrl":"10.18502/jthc.v19i4.17616","url":null,"abstract":"<p><p>Kawasaki disease (KD), or mucocutaneous lymph node syndrome, is a vasculitis that primarily affects young children and results in coronary artery abnormalities. Echocardiography is the standard imaging modality for monitoring KD patients; however, this method does not detect some coronary artery anomalies. This case report demonstrates the significance of computed tomography (CT) angiography in identifying previously undiagnosed coronary abnormalities in a KD patient. We herein describe a 7-year-old male who presented with symptoms consistent with KD and was treated subsequently with intravenous immune globulin (IVIG). Follow-up echocardiography showed no significant coronary artery abnormalities. Three years later, the patient presented with flu-like symptoms, and an ECG revealed anterolateral ischemic changes. Echocardiography showed normal coronary arteries. Nonetheless, a CT angiogram was performed due to the ischemic changes on ECG, and it identified a myocardial bridge in the left anterior descending artery, which had not been detected by echocardiography or ECG. This case report emphasizes the importance of considering CT angiography as an adjunct imaging modality in the evaluation and follow-up of KD patients, particularly when echocardiographic findings are inconclusive or when clinical presentation raises concerns for potential coronary artery abnormalities. Further research is needed to establish evidence-based guidelines for the optimal timing and clinical indications for CT angiography in KD patients.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"289-294"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Predictive Value of Heart Rate Variability for Long-Term Outcomes in Patients Undergoing Coronary Artery Bypass Grafting and ICU Referrals.","authors":"Mohammad Javad Mehrabanian, Mehdi Dehghani Firoozabadi, Behrang Nooralishahi, Afarin Zamani, Naser Kachoueian","doi":"10.18502/jthc.v19i4.17611","DOIUrl":"10.18502/jthc.v19i4.17611","url":null,"abstract":"<p><strong>Background: </strong>Heart rate variability (HRV) is known to play a significant role in predicting poor prognosis after acute myocardial infarction. Nonetheless, its potential for predicting long-term adverse outcomes following revascularization procedures remains unclear. This study aims to elucidate this relationship.</p><p><strong>Methods: </strong>This prospective cohort study included 258 consecutive patients undergoing elective isolated coronary artery bypass grafting (CABG). All patients required ICU referral before hospital discharge. A 3-week cardiac rehabilitation program with 24-hour ECG Holter monitoring was planned for all patients. HRV was analyzed by computer and manually over-read. During a follow-up period ranging from 1 to 3 years, patients were contacted via phone to assess long-term outcomes, including death and major adverse cardiovascular events (MACE), such as myocardial infarction, reoperation, or brain stroke.</p><p><strong>Results: </strong>Out of 258 patients (177 males and 81 females) with an average age of 58.80±9.60 years, 4.3% of patients died due to cardiovascular events, and 15.1% experienced long-term MACE. A comparison of HRV indicators between the non-surviving and surviving subgroups revealed significantly lower mean RR, mean standard deviation of normal-to-normal HRV interval (SDNN), and low and high-frequency values in the former group. However, when comparing HRV indicators between the subgroups with and without long-term MACE, no significant differences were observed. Cox proportional hazard analysis demonstrated that decreased HRV (SDNN) effectively predicted long-term mortality in patients who underwent CABG.</p><p><strong>Conclusion: </strong>Lower postoperative HRV serves as a valuable predictor of long-term mortality after CABG in ICU patients, with reduced SDNN values particularly relevant for anticipating long-term adverse events.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"264-269"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Fenestration Closure after Fontan Surgery.","authors":"Hojjat Mortezaeian, Reza Abbaszadeh, Hamidreza Ghaemi, Farshad Jafari, Zeinab Sadat Mirhaghjoo","doi":"10.18502/jthc.v19i4.17609","DOIUrl":"10.18502/jthc.v19i4.17609","url":null,"abstract":"<p><strong>Background: </strong>Although several studies have examined patients who have undergone transcatheter fenestration closure, comprehensive evaluations of its long-term outcomes remain scarce. Therefore, this study aimed to evaluate the clinical status of these patients after a long-term follow-up period.</p><p><strong>Methods: </strong>This cross-sectional analytical study evaluated the records of all children with congenital heart diseases admitted for transcatheter fenestration closure at Rajaie Cardiovascular Medical and Research Center, a tertiary care hospital specializing in congenital heart diseases in Tehran, Iran. We included patients with a history of fenestration following Fontan surgery who required fenestration closure between January 2012 and August 2020. Cardiac function data, such as ejection fraction (EF), pulmonary artery pressure (PAP), and O₂ saturation, were extracted from electronic medical records.</p><p><strong>Results: </strong>We assessed 26 patients (11 female and 15 male) with a mean age of 13.88±3.73 years. Comparing EF before and after fenestration closure revealed a significant difference (P=0.011), with only 2 patients (7.7%) experiencing a slight reduction (5.0%) in EF. No significant difference was observed in PAP before and after closure (P=0.068), although most patients (n=16, 61.5%) had a postprocedural reduction. Our results demonstrated a significant difference before and after the procedure (P<0.001), with all patients exhibiting increased O₂ saturation after closure.</p><p><strong>Conclusion: </strong>Our study demonstrated improvements in cardiovascular function and desirable organ function among patients. These findings suggest that transcatheter fenestration closure could serve as a beneficial complementary approach for patients with patent fenestration.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 4","pages":"250-255"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}