Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 49 56 EN Mohammad Javad Alemzadeh-Ansari Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Mohammad Mostafa Ansari-Ramandi Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Nasim Naderi Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. 2016 03 26 2016 10 06 Heart failure (HF) is one of the main causes of death and disability in the world. The prevalence of HF in developed countries is between 1% and 2% of the adult population and approximately between 6% and 10% in the elderly, giving rise to high costs of care and treatment. Indeed, in the United States, the direct and indirect costs exceeded 23 billion dollars in 2002.  HF is typically characterized by periods of acute symptoms followed by returns to nearly asymptomatic periods. As dyspnea and fatigue are considered the signature symptoms of HF, other symptoms such as pain go unnoticed. Awareness of the burden of pain, however, is growing in patients with chronic HF. The past 2 decades have witnessed remarkable technical headway in cardiology and many patients have survived despite the progressive impairment of their cardiovascular function. It is, therefore, of great value to investigate the prevalence and management of pain in patients with HF. To that end, we undertook a comprehensive search using the MEDLINE database for studies and guidelines on the subject of pain and HF and the complications and considerations and finally selected 65 studies for review. https://rhythm.tums.ac.ir/index.php/jthc/article/view/504 https://rhythm.tums.ac.ir/index.php/jthc/article/download/504/585

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 57 64 EN Mohammad Mohammadi Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Azita Hajhossein Talasaz Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Alidoosti Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamid Reza Pour Hosseini Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Kheirollah Gholami Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Arash Jalali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamid Aryannejad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 06 10 2017 03 09 Background: L-carnitine may prevent the incidence of AKI by its antioxidant effects and improving circulation in ischemic conditions. The goal of this trial was to evaluate the impact of L-carnitine on contrast-induced nephropathy in patients undergoing elective PCI. Methods: Totally, the patients were randomly allocated to 2 groups. The treatment group received 1 g of L-carnitine orally 3 times a day, 24 hours before the procedure (3 g before PCI) and 2 g after PCI, whereas the control group did not receive L-carnitine. In both groups, the plasma level of neutrophil gelatinase-associated lipocalin (NGAL) was measured at baseline and 12 hours after PCI. Results: Our study was conducted on 202 patients (including 91 vs. 111 patients in the treatment and the control group; 31 (34.1%) vs 33 (29.7%) female in carnitine and control group; and ages include 62.0 ± 9.0 vs 57.0 ± 11.2 years). The median plasma levels of NGAL were not different between the carnitine and control groups at baseline (57 [IQR: 22 – 255] vs. 54 [IQR: 29 – 324]; p value = 0.155) and 12 hours after PCI (71 [IQR: 52 – 129] vs. 70 [IQR: 46 – 153]; p value = 0.925), but the changes in the plasma NGAL from baseline to 12 hours after PCI were different between the 2 groups (5 [IQR:-147 – 30] vs. 17 [IQR: -21 – 41]; p value = 0.010). Conclusion: Our results showed that oral L-carnitine was able to prevent an increase in NGAL following contrast medium administration in patients undergoing PCI. More studies should be performed to fully elucidate the nephroprotective effects of L-carnitine.  https://rhythm.tums.ac.ir/index.php/jthc/article/view/565 https://rhythm.tums.ac.ir/index.php/jthc/article/download/565/586

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 65 71 EN Shahram Rabbani Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Masoud Soleimani Tarbiat Modares University, Tehran, Iran. Mohammad Sahebjam Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Imani Iran Polymer and Petrochemical Institute, Tehran, Iran. Seyed Mahdi Nassiri Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran. Amir Atashi Stem Cell and Tissue Engineering Research Center, Shahroud University of Medical Sciences, Shahroud, Iran. Morteza Daliri Joupari National Institute for Genetic Engineering and Biotechnology, Tehran, Iran. Ali Ghiaseddin Tarbiat Modares University, Tehran, Iran. Payman Latifpour Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Hossein Ahmadi Tafti Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 11 02 2017 02 09 Background: Myocardial infarction is the main cause of death worldwide. Angiogenesis, a promising new therapy for the treatment of diffuse coronary artery disease, shows a poor response to conventional revascularization techniques. This study focused on improving myocardial function using endothelial cells (ECs) and mesenchymal stem cells (MSCs) in a sheep animal model. Methods: Acute myocardial infarction was induced in 18 sheep (12 treated cases and 6 controls). Autologous MSCs and ECs were injected in the infarcted area and the border zone. Two months after transplantation, echocardiography, electron microscopy, and immunohistochemistry were performed. Results: Echocardiography in both MSC and EC groups revealed a significant improvement in the ejection fraction compared with the control group (p value < 0.05). Vascular density, estimated by antibodies against the von Willebrand factor and smooth muscle actin, increased in both study groups. The pattern of vascularity in the MSC and EC groups was diffused. The electron microscopic evaluation of the infracted areas revealed cardiomyocytes in variable stages of development in the border zone in both EC and MSC groups. Conclusion: Both ECs and MSCs were able to promote angiogenesis and improve cardiac function. Presumably, MSCs differentiate into ECs and cause angiogenesis as it occurs for ECs. https://rhythm.tums.ac.ir/index.php/jthc/article/view/624 https://rhythm.tums.ac.ir/index.php/jthc/article/download/624/587

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 72 81 EN Mehrdad Sheikhvatan Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammadali Boroumand Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Behmanesh Department of Human Genetics, Tarbiat Modares University, Tehran, Iran. Seyed Hesameddin Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Davoodi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Shayan Ziaee Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Sara Cheraghi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 09 10 2017 01 17 Background: The C1019T polymorphism of the connexin-37 (GJA4) gene is a single-nucleotide polymorphisms involved in atherosclerotic plaque rupture and atherosclerosis predisposition. We examined the association between the C1019T polymorphism of the GJA4 gene and the occurrence of myocardial infarction (MI) in patients with premature coronary artery disease (CAD). Methods: Our study recruited 1000 patients with the final diagnosis of premature CAD and classified them into 2 groups: with a history of MI (n = 461) and without it (n = 539). The polymorphism variants were determined via the PCR–RFLP, and then genotyping was conducted through the high-resolution melting method. From a total of 1000 patients, 554 patients, who had been previously followed-up with a median follow-up time of 45.74 months vis-à-vis long-term major adverse cardiac events, were enrolled in this retrospective cohort phase. Results: The frequencies of the wild, heterozygous, and mutant genotypes of the C1019T polymorphism were 54.0%, 40.6%, and 5.4% in the MI group and 49.2%, 43.2%, and 7.6% in the non-MI group (p value = 0.187). After adjustment for the baseline covariates, no difference was found between the MI and non-MI groups apropos the frequency of the heterozygous genotype (p value = 0.625) and the mutant genotype (p value = 0.452). Regarding the level of human connexin-37, the serum level of this marker was not different between the MI and non-MI groups. Conclusion: The C1019T polymorphism of the GJA4 gene may not be useful for predicting the occurrence of MI in patients with premature CAD. The presence of this polymorphism in such patients may also have a low value for predicting long-term CAD complications. https://rhythm.tums.ac.ir/index.php/jthc/article/view/607 https://rhythm.tums.ac.ir/index.php/jthc/article/download/607/626

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 82 84 EN Reza Ghanavati Rasoul Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran. Mehran Arab Ahmadi Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Behdad Behnam Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 12 26 2016 04 16 Transradial coronary angiography has been known as an alternative to the transfemoral approach with fewer serious complications. Radial artery pseudoaneurysms present as a rare complication of transradial catheterization. Although some methods have been applied for the obliteration of pseudoaneurysms, the use of radial bands such as the TR Band® (Terumo Medical Corporation, Somerset, NJ) is a novel efficient technique only suggested by a few reports. We describe a 34-year-old man, who underwent transradial primary coronary angiography due to ST-elevation myocardial infarction. Two months later, he noticed a pulsatile mass on his hand where the catheterization was done. Ultrasonography proved the diagnosis of a pseudoaneurysm. Consequently, a TR Band® was applied to compress the mass. Interestingly, 24 hours later, ultrasonography confirmed a thrombosed pseudoaneurysm and the pulsatile mass had completely disappeared gradually without recurrence at 2 months’ follow-up. Hence, this case report aims to propose the TR Band® as an effective noninvasive method for the treatment of pseudoaneurysms following catheterization. https://rhythm.tums.ac.ir/index.php/jthc/article/view/462 https://rhythm.tums.ac.ir/index.php/jthc/article/download/462/589

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 85 87 EN Mohammad Masoumi Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran. Khadije Mohammadi Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran. 2017 03 18 2017 03 18 The coronary slow flow phenomenon (CSFP) is characterized by a delayed coronary blood flow in the absence of an obstructive coronary artery disease. Although the relation between the CSFP and myocardial ischemia has been reported previously, there is no knowledge about the relationship between the CSFP and the conduction system disorder. In this case report, we describe a patient with the CSFP presenting with complete heart block (CHB). The patient was a middle-aged woman with a history of diabetes, hypertension, and prior Coronary Care Unit admission presenting with dizziness, lightheadedness, and presyncope. Electrocardiography revealed CHB with no significant ST-T change. Cardiac enzymes and other routine lab tests were normal. The patient underwent temporary pacemaker implantation. Due to persistent atrioventricular block and suspicion of ischemic heart disease, she underwent coronary angiography, which showed the CSFP and no significant stenosis. The patient was discharged after permanent pacemaker implantation and remained asymptomatic at 3 months' follow-up. https://rhythm.tums.ac.ir/index.php/jthc/article/view/697 https://rhythm.tums.ac.ir/index.php/jthc/article/download/697/590

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 2 2017 05 15 88 91 EN Mohammad Ali Ostovan Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Javad Kojuri Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Pooyan Dehghani Cardiovascular Research Center, Shiraz University of Medical Sciences, Sion and left ventricular ejection fraction (LVEF) of 35-40%, which was 45-50% two years before. Selective coronary angiography performed 8 years previously was normal but a new one revealed the cut-off of the left anterior descending artery at the proximal portion, for which percutaneous coronary intervention was performed and showed no significant lesion in the other vessels. One should consider coronary artery disease in uncontrolled heart failure with LVEF reduction, even in the absence of typical chest pain. It may not be the natural course of the underlying disease. https://rhythm.tums.ac.ir/index.php/jthc/article/view/649 https://rhythm.tums.ac.ir/index.php/jthc/article/download/649/515

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 4 2017 02 11 195 197 EN Maryam Sotoudeh Anvari Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Farzad Masoudkabir Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Kyomars Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ali Boroumand Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Manijeh Zarghampour Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamidreza Goodarzynejad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 01 07 2017 01 07 Takayasu’s arteritis (TA) is a rare case of granulomatous arteritis which mainly involves the aorta and its large branches. Although arterial hypertension is the most common feature of the disease in both adults and children, patients with TA may present with numerous clinical manifestations. Our patient was a 45-year-old woman, known to have hypertension from 3 years earlier following assessments made for severe headache. One year after the diagnosis of hypertension, she developed a left-sided lower motor neuron facial palsy, which was treated with oral corticosteroids (Prednisolone). Notably, the patient's headache was relieved after she took corticosteroid therapy. Transthoracic echocardiography revealed severe aortic insufficiency and aneurysmal changes in the ascending aorta, and she was referred to our center for further evaluation. In multi-slice computed-tomography angiography, significant long stenosis of the left subclavian artery was seen and the diameter of the ascending aorta was 50 mm. The patient underwent the Bentall operation. The pathologic examination of the aortic wall specimen was compatible with giant cell aortitis and more in favor of TA with the ascending aortic aneurysm. At 6months' follow-up, the patient was in good condition and had almost recovered from facial palsy.  https://rhythm.tums.ac.ir/index.php/jthc/article/view/650 https://rhythm.tums.ac.ir/index.php/jthc/article/download/650/516

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 4 2017 02 11 198 202 EN Hassan Aghajani Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Shahrooz Yazdani Shahid Rajaei Hospital Medical Center, Alborz University of Medical Sciences, Karaj, Iran. Seyed Khalil Forouzan Nia Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamed Vahidi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Faezeh Aghajani Tehran University of Medical Sciences, Tehran, Iran. 2016 02 10 2016 08 24 Cardiac manifestations of the hydatid cyst are relatively uncommon. Cardiac involvement may lead to the compression of vital organs, pulmonary hypertension, pericardial effusion, and even anaphylaxis. A 45-year-old woman presented to the Emergency Department of Tehran Heart Center with chest pain. Cardiac examination revealed relatively muffled heart sounds. Echocardiography demonstrated a round echolucent well-defined mass (47 × 25 mm) on the base and the mid lateral wall of the left ventricle (LV) without septation. Computed tomography angiography and cardiac magnetic resonance imaging revealed a large (52 mm) exophytic mass originating from the lateral wall of the LV with upward growth between the left anterior descending artery (LAD) and the left circumflex artery with no LV cavity obliteration. Coronary angiography showed upward displacement in the LAD with significant compressive narrowing. The patient underwent mass resection and grafting of the LAD. During surgery after the incision of the pericardium, the hydatid cyst entity of the mass was revealed. Hydatid cysts covered the anterolateral surface of the LV with adhesion to the pericardium. The patient recovered from the surgery uneventfully. Pathology report and immunological assays confirmed the diagnosis. During a 6-month postoperative follow-up period, she remained asymptomatic with complete recovery and no recurrence. https://rhythm.tums.ac.ir/index.php/jthc/article/view/487 https://rhythm.tums.ac.ir/index.php/jthc/article/download/487/517

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 4 2017 02 11 203 205 EN Arash Gholoobi Atherosclerosis Prevention Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Vojdanparast Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2017 01 07 2017 01 07 Large intercoronary communications in the absence of obstructive coronary artery disease constitute a very rare coronary artery anomaly in which there is a readily visible connection between the 2 coronary arteries with a unidirectional or bidirectional blood flow; consequently, this anomaly may be misinterpreted as a functioning collateral vessel, indicative of an unrecognized proximal coronary artery occlusion. In contrast to collateral vessels that are seen in the presence of critical coronary artery stenosis and total occlusions, these arterial communications are vessels that are single, extramural, straight, and large in diameter. Myocardial ischemia could result from the coronary steal phenomenon by a unidirectional intercoronary communication. Herein, we describe a 57-year-old female with chest pain who was found in coronary angiography to have a single large intercoronary channel between the posterolateral branch of the right coronary artery and the distal left circumflex artery with a unidirectional flow. https://rhythm.tums.ac.ir/index.php/jthc/article/view/651 https://rhythm.tums.ac.ir/index.php/jthc/article/download/651/518

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 11 4 2017