The journal of Tehran Heart Center最新文献

{"title":"Neonatal Atrial Flutter: A Novel Triad for Immediate Electrocardiographic Diagnosis.","authors":"Elaheh Malakan Rad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Neonatal atrial flutter (NAF) is a rare type of macroreentrant supraventricular tachycardia. In this report, we describe a case of atrial flutter in an 8-day-old neonate with a total anomalous pulmonary venous connection. Additionally, we introduce a diagnostic triad for electrocardiographic identification of this condition. This triad comprises three components: the Similar Shapes of Inter-QRS segments (SIS) in leads II, III, and aVF, Different Shapes of Inter-QRS Segments (DIS) in lead I, and the occurrence of one or multiple stretched M or inverted V shapes in the inter-QRS (IQS) segment in leads II, III, and aVF. We assessed the effectiveness of this triad through a validation cohort, using previously reported cases of neonatal atrial flutter from the literature. The sensitivity rates for detecting SIS and DIS patterns and the singular or multiple reversed W or V signs were 100%, 81%, and 100%, respectively. Furthermore, all three components of the triad were found in 81% of neonates diagnosed with atrial flutter. The emergence of this triad can be attributed to the elimination of the isoelectric segment in electrocardiography, caused by the extended duration of flutter waves originating from macro reentry within the atrium and the rapid atrial rate characteristic of atrial flutter.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 3","pages":"220-224"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014781","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":"Concurrent Myocardial Bridging and Coronary Artery Disease: A Study of an Iranian Population.","authors":"Danial Chaleshi, Fahime Samadi, Amir Ali Ghaemi, Negin Parsa, Aysan Zareiye, Mahmood Reza Motamedzadeh, Mohammadtaghi Sarebanhassanabadi, Hossein Nough","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Myocardial bridging (MB) has been associated with acute coronary syndrome, ischemia, arrhythmia, and even sudden death. This study investigated the prevalence of MB and its complications and manifestations.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on symptomatic coronary patients who underwent angiography between March 2022 and March 2023 at Afshar or Shahid Sadoughi hospitals in Yazd, Iran. The angiographic reports of all patients were evaluated. Cases with MB were selected, and their angiographic films were assessed by an interventional cardiologist for diagnostic accuracy. Baseline, radiological, and clinical characteristics were also evaluated. Data were collected and analyzed using SPSS, version 20.0. The dependent variable was stratified based on independent variables using the χ² test.</p><p><strong>Results: </strong>Out of 3750 symptomatic patients, 165 (4.4%) were diagnosed with MB. Among these, 111 (67.3%) were male, and the mean age was 56.87±10.06 years. A total of 152 patients had MB in the left anterior descending artery, representing the highest occurrence proportion at 92.1%. The most common types of coronary artery disease (CAD) diagnosed included mono-vessel disease and slow flow, accounting for 35.1% and 25.8%, respectively. There was no significant frequency distribution of CAD co-occurrence based on baseline and radiological features (P>0.050).</p><p><strong>Conclusion: </strong>This study provides valuable insights into the prevalence of MB in Iran and its co-occurrence with CAD. While some findings align with previous research, certain discrepancies warrant further investigation.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 3","pages":"206-210"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057204","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 Effect of Traditional Iranian Music on Anxiety and Physiological Parameters of Patients before Coronary Artery Bypass Graft (CABG): A Randomized Controlled Trial.","authors":"Samere Rasoli, Ebrahim Nasiri-Formi, Heydar Dadkhah-Tirani, Mohammad Esmaeilpour-Bandboni","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery bypass graft (CABG) surgery is a primary treatment for coronary artery occlusion. Anxiety is a common preoperative concern among patients undergoing this procedure. This study aimed to investigate the effect of listening to traditional Iranian music on anxiety in patients before CABG surgery.</p><p><strong>Methods: </strong>This randomized controlled trial involved 66 patients scheduled for CABG surgery. Patients were randomly assigned to either the control or intervention group, with 33 patients in each group. The intervention group listened to traditional music on an MP3 player for 20 minutes, while the control group received an MP3 player without music. Anxiety levels were measured using the Spielberger Anxiety Questionnaire before and after the intervention. Data were analyzed using the Student's t-test, the paired t-test, and the Mann-Whitney U-test with SPSS software version 21.</p><p><strong>Results: </strong>There was no significant difference in anxiety severity between the 2 groups before the intervention (music group: 106.45±10.67 and control group: 116.36±9.78; P=0.798). However, after the intervention, there was a significant difference between the groups (music group: 65.82±7.54 vs control group: 113.72±13.04; P=0.001). There were no significant differences in physiological parameters (blood pressure, heart rate, and respiration rate) between the groups before the intervention (P<0.078). Following the intervention, systolic (P<0.013) and diastolic (P<0.003) blood pressure significantly decreased in the intervention group compared with the control group.</p><p><strong>Conclusion: </strong>Traditional Iranian music therapy can be a noninvasive, low-cost, and accessible tool to reduce anxiety in patients undergoing CABG surgery.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 3","pages":"184-191"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004833","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":"Interventional Management of a Rare Case of Complex Congenital Heart Disease in an Adult Patient: A Case Report.","authors":"Maryam Favaedi, Zahra Khajali, Mina Mohseni, Hajar Kamfiroozi, Parisa Firoozbakhsh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Congenital heart disease (CHD), which accounts for about one-third of all congenital defects and affects approximately 1% of all live births worldwide, has maintained a stable incidence rate while experiencing a decrease in mortality rates since 1990. Despite advancements in fetal cardiac ultrasound examinations and routine pulse oximetry screening of newborns, a significant proportion of CHD patients may still be undiagnosed until adulthood. This oversight can lead to considerable morbidity and mortality due to physical limitations and reduced quality of life. In this case report, we describe a 29-year-old woman who was initially misdiagnosed as having an inoperable case of CHD and was referred to our center with symptoms of palpitations and exertional dyspnea. During her evaluation, she was diagnosed with severe pulmonary hypertension associated with patent ductus arteriosus (PDA), pre-ductal aortic coarctation, ventricular septal defect (VSD), and bicuspid aortic valve, all of which had been overlooked since infancy. Following initial medical treatment for pulmonary hypertension, a simultaneous transcatheter approach was employed, during which the PDA was closed using an occluder device, and the coarctation was repaired concurrently with a self-expanding stent. Eight months later, her VSD was successfully closed using a muscular VSD occluder device through an interventional technique. This case underscores the importance of adult CHD fellowship training, which enables cardiologists specializing in this field to accurately diagnose and treat complex cases of CHD that may have been missed during infancy and early childhood. This timely intervention ultimately led to the complete relief of her symptoms and prevented progression to Eisenmenger syndrome.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 3","pages":"211-215"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047908","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":"Protocol for a Randomized Controlled Trial on the Development and Effectiveness of an Educational Mobile Application Using an Integrated Change Model to Prevent Atherosclerotic Cardiovascular Disease Risk Factors.","authors":"Afsaneh Aein, Mahnaz Solhi, Ali Vashegani Farahani, Mohammad Aljasem, Farshid Alaeddini, Leila Janani, Negar Omidi, Mohammad Hossein Taghdisi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>An effective approach to preventing cardiovascular issues is the use of mobile health applications to improve modifiable risk factors. This protocol for a randomized controlled trial aims to evaluate the development and effectiveness of an educational mobile app that employs an integrated change model to reduce risk factors for atherosclerotic cardiovascular disease (ASCVD) among individuals aged 20 to 69 years.</p><p><strong>Methods: </strong>This study will be a parallel, randomized, single-blind clinical trial utilizing the randomized block design involving 430 participants. The participants will be divided into a control group receiving standard clinical care and an intervention group receiving standard clinical care along with app-based education, over approximately 6 months.</p><p><strong>Conclusion: </strong>This application has been designed to enhance motivation, awareness, and positive habits to reduce risk factors in individuals at increased risk of ASCVD. Consequently, the results could improve cardiovascular health knowledge, manage biological risk factors, and modify cardiac behaviors through mobile applications. This research is expected to present a promising approach to utilizing mobile apps for managing cardiovascular health and contribute to the growing body of research on digital health interventions.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 3","pages":"170-183"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034888","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 Future of CPR: Leveraging Artificial Intelligence for Enhanced Cardiopulmonary Resuscitation Outcomes.","authors":"Payam Emami, Mohammad Sistani, Ameneh Marzban","doi":"10.18502/jthc.v19i2.16194","DOIUrl":"https://doi.org/10.18502/jthc.v19i2.16194","url":null,"abstract":"","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 2","pages":"77-78"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059537","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":"Comparing the Hemodynamic Effects of Midazolam, Etomidate, and Propofol following Anesthesia Induction in Coronary Artery Bypass Graft Surgery: A Double-Blind Randomized Clinical Trial.","authors":"Parsa Afghaniyan, Maryam Farhadian, Masoud Tarbiat, Mohammad Hossein Bakhshaei, Seyed Ahmadreza Salimbahrami","doi":"10.18502/jthc.v19i2.16197","DOIUrl":"https://doi.org/10.18502/jthc.v19i2.16197","url":null,"abstract":"<p><strong>Background: </strong>Hemodynamic disorders during anesthesia lead to complications. To reduce hemodynamic complications, this study was conducted to compare midazolam, etomidate, and propofol following anesthesia induction in patients undergoing coronary artery bypass grafting surgery (CABG).</p><p><strong>Methods: </strong>A double-blind, randomized clinical trial was conducted involving 90 patients with coronary artery disease. These patients were randomly assigned to 1 of 3 groups receiving propofol, etomidate, or midazolam. Hemodynamic variables, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), and heart rate (HR), were measured at baseline, before intubation, and 1 and 5 minutes after intubation.</p><p><strong>Results: </strong>Ninety patients with coronary artery disease (mean age: 60.83 y) were included in the study. Women and men comprised 74.4% and 25.6% of the study population. HR, SBP, DBP, and MABP exhibited significant decreases in all 3 groups after intubation. The etomidate group demonstrated the least change in SBP (P<0.001) and MABP (P<0.001), followed by the midazolam group. Concerning HR, the least change was observed in the midazolam group, followed by the propofol group (P=0.688). After intubation, blood pressure increased almost equally in the etomidate and midazolam groups compared with the levels during intubation. In contrast, the propofol group exhibited a downward trend in blood pressure during intubation, a significant difference across all 3 groups (P<0.001).</p><p><strong>Conclusion: </strong>This study, conducted on candidates for CABG, demonstrated that anesthesia induction with etomidate and midazolam resulted in less variation in hemodynamic variables compared with propofol.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 2","pages":"89-95"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060496","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":"Pediatric Cardiac Surgery Complications and the Risk Factors: A Single-Center Study.","authors":"Mohammadreza Mirzaaghayan, Zahra Vahdati, Hossein Nematian, Sara Memarian, Morteza Heidari, Mohammad Hossein Askari, Behdad Gharib","doi":"10.18502/jthc.v19i2.16202","DOIUrl":"https://doi.org/10.18502/jthc.v19i2.16202","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine postoperative cardiac and noncardiac complications and their association with the use of cardiopulmonary bypass (CPB), surgical outcomes (length of hospital and ICU stays), dependence on mechanical ventilation, and mortality.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted on pediatric patients aged 0 to 18 who underwent open or closed cardiac surgery over a 1-year period. The use of CPB support, CPB duration, cardiac surgery complexity according to the risk-adjusted classification for congenital heart surgery (RACHS-1), and demographics were examined as potential risk factors associated with an increased number of postoperative complications. The study was performed at the Children's Medical Center, a teaching hospital affiliated with Tehran University of Medical Sciences in Iran.</p><p><strong>Results: </strong>A total of 283 surgeries were included in our study. Seventy-six (26.9%) of the study population experienced at least 1 complication. Our analysis revealed that increased CPB durations were associated with higher odds of cardiac complications, with an odds ratio of 1.02 (P=0.002). Moreover, higher RACHS-1 levels were significantly associated with greater numbers of cardiac and noncardiac complications. Additionally, prolonged mechanical ventilation and open-heart surgery intensive care unit (OH-ICU) stays were significantly associated with cardiac and noncardiac complications. Our logistic regression analysis found no association between demographic and clinical risk factors, the number of complications, and mortality.</p><p><strong>Conclusion: </strong>Postoperative complications occurred in 27% of pediatric heart surgeries. Prolonged mechanical ventilation and OH-ICU stays were significantly associated with cardiac and noncardiac complications. However, no significant association was found between postoperative complications and mortality.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 2","pages":"124-131"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016227","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":"Heart Stiffening in Pediatric Dilated Cardiomyopathy: Causes of Severity.","authors":"Noor Mohammad Noori, Alireza Teimouri","doi":"10.18502/jthc.v19i2.16201","DOIUrl":"https://doi.org/10.18502/jthc.v19i2.16201","url":null,"abstract":"<p><strong>Background: </strong>Cardiomyopathy, characterized by heart stiffness, can lead to heart failure. This study aimed to investigate aortic stiffness in children with dilated cardiomyopathy (DCM) to better understand its contribution to disease severity.</p><p><strong>Methods: </strong>This case-control study compared 48 children with DCM with 96 healthy children over a 10-year period starting in 2011. Aortic strain, aortic stiffness index, aortic distensibility, and pressure strain elastic modulus were measured. These parameters, along with several echocardiographic measures, were compared between the DCM and control groups. Statistical analyses were performed using SPSS 18, with a significance threshold set at a P value below 0.05.</p><p><strong>Results: </strong>The participants included 57.6% boys, with 58.3% in the DCM group and 57.35% in the control group (χ²=0.014, P=0.905). The age range was 2 to 18 years, with mean ages of 11.08±4.63 years for the DCM group and 10.77±2.82 years for the control group (P=0.691). Significant differences between groups were observed in aortic distensibility (P=0.004), aortic stiffness β index (P=0.001), and pressure strain elastic modulus (P=0.004). Post-treatment analyses based on ejection fraction and fractional shortening cutoffs indicated no changes in elasticity parameters except for the aortic stiffness β index, which varied according to the Ross classification.</p><p><strong>Conclusion: </strong>Children with DCM exhibited reduced aortic strain and aortic distensibility, as well as elevated aortic stiffness β index and pressure strain elastic modulus.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 2","pages":"116-123"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061397","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":"Impact of Yoga beyond Physical Training on the Cardiovascular System: An Updated Review.","authors":"Samman Verma, Juniali Hatwal, Akash Batta","doi":"10.18502/jthc.v19i2.16195","DOIUrl":"https://doi.org/10.18502/jthc.v19i2.16195","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) poses a significant health challenge in both developing and developed nations, with unparalleled morbidity, mortality, and economic tolls. Primary prevention of CVD through lifestyle modifications has been emphasized to address this issue. Yoga, an ancient practice dating back thousands of years with roots in the Harappan and Mohenjo-Daro civilizations, offers a potential solution. Hatha yoga, which includes physical movements and breathing techniques, is the most commonly practiced form today. The health benefits of yoga have recently gained attention and are being researched globally. Yoga is beneficial in both primary and secondary prevention of diseases, particularly CVD and its risk factors. This review aims to explore the physiology of yoga, recent studies on its effect on the prevention and control of CVD, and the clinical implications of these findings.</p>","PeriodicalId":510886,"journal":{"name":"The journal of Tehran Heart Center","volume":"19 2","pages":"79-88"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004549","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}