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, Snces, Birjand, Iran. Moein Aboobakri Makouei Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran. Farbod Hatami Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran. Reza Zeinabadi Noghabi Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, Iran. 2017 02 11 2017 02 11 Primary cardiac sarcomas are rare clinical entities with an incidence rate of 0.0001% in collected autopsy series and are regarded as very aggressive tumors. We herein describe a 21-year-old woman presenting with syncope, dyspnea, and abdominal distention. She suffered from massive ascites, plural effusion, and liver congestion demonstrated by abdominal sonography and chest X-ray. Transthoracic echocardiography revealed a heterogeneous solid mass located in the right atrium; therefore, the patient underwent radical surgical excision of the tumor and 3 cycles of adjuvant chemotherapy.  Fifteen months after surgery, she was having a favorable life quality without any evidence of recurrence. https://rhythm.tums.ac.ir/index.php/jthc/article/view/676 https://rhythm.tums.ac.ir/index.php/jthc/article/download/676/500

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 1 2017 03 05 35 38 EN Reza Mollazadeh Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Masoud Eslami Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 02 11 2017 02 11 A 29-year-old woman was referred to our hospital due to exacerbation in dyspnea on exertion and easy fatigability. A known case of congenitally corrected transposition of the great vessels and congenital complete heart block, she had already received a permanent single-chamber pacemaker. Decision was made to implant a biventricular pacemaker for the treatment of the failing heart. Excellent coronary sinus lead implantation was done, conferring amelioration of symptoms, QRS narrowing in the electrocardiogram, and improvement of systemic ventricular systolic function in echocardiography. Over a 15-month follow-up period, she had no dyspnea on exertion. This case highlights the significance of upgrading pacemakers in patients with heart failure. https://rhythm.tums.ac.ir/index.php/jthc/article/view/677 https://rhythm.tums.ac.ir/index.php/jthc/article/download/677/501

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 1 2017 03 05 39 41 EN Bahieh Moradi Day General Hospital, Tehran, Iran. Farideh Roshanali Day General Hospital, Tehran, Iran. 2017 02 11 2017 02 11 Ebstein's anomaly is defined as the significant apical displacement of the tricuspid valve causing tricuspid regurgitation. Although a variety of concomitant lesions have been previously described, we herein introduce an unusual presentation.  Our patient was an 86-year-old man with a primary presentation of typical chest pain in the setting of recently diagnosed coronary artery disease with concomitant Ebstein’s anomaly. We found mild-to-moderate tricuspid regurgitation, bicuspid aortic valve, persistent left superior vena cava, and patent foramen ovale. The patient had suffered from chest discomfort on exertion for 2 months with good functional capacity prior to diagnosis. Coronary angiography revealed two-vessel disease. The patient refused surgery. He was treated with medical anti-ischemic therapy. He had good exercise tolerance with relief of chest pain at the latest follow-up. The features demonstrated in this case report suggest that there may be several adult survivors of complex congenital heart diseases requiring individualized surgical treatment plans. https://rhythm.tums.ac.ir/index.php/jthc/article/view/678 https://rhythm.tums.ac.ir/index.php/jthc/article/download/678/524

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 1 2017 03 05 42 45 EN Tahereh Davarpasand Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Hosseinsabet Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Kyomars Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 02 11 2017 02 11 A ruptured sinus of Valsalva aneurysm rarely accompanies the aortic and tricuspid valve endocarditis. A 36-year-old woman presented with low-threshold dyspnea on exertion and fever. Transthoracic and transesophageal echocardiography showed a ruptured noncoronary sinus of Valsalva aneurysm with large vegetations on the tricuspid and aortic valves, resulting in moderately severe tricuspid regurgitation and severe aortic regurgitation. Blood culture was negative. The patient was initially treated with antibiotics and then subjected to the surgical repair of the sinus of Valsalva aneurysm and the tricuspid and aortic valve replacement. The patient's postoperative period was uneventful, and she was discharged healthy. https://rhythm.tums.ac.ir/index.php/jthc/article/view/671 https://rhythm.tums.ac.ir/index.php/jthc/article/download/671/495

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 12 1 2017 03 05 46 48 EN Yousef Rasmi Department of Clinical Biochemistry, Faculty of Medicine, Urmia University Medical Sciences (UMSU), Urmia, Iran. Maryam Majidinia Student Research Committee, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Fariba Khosravifar Department of Biology, Tehran Payam-e- Noor University, Tehran, Iran. Fatemeh Kheradmand Department of Clinical Biochemistry, Faculty of Medicine, Urmia University Medical Sciences (UMSU), Urmia, Iran. 2017