Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 43 51 EN Soulmaz Rahbar School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sedigheh Sadat Naimi School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Asghar Reza Soltani School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Abbas Rahimi School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Akbarzadeh Baghban School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Nasrin Khorami Imam Hospital, Hamedan University of Medical Sciences, Hamedan, Iran. 2017 05 15 2017 09 02 Background: Diabetes is a chronic disease that reduces cardiorespiratory fitness and increases systolic and diastolic blood pressures as well as resting heart rate due to the activity level of the sympathetic nervous system. The aim of this study was to assess the effectiveness of 2 types of aerobic exercise, with and without external loading, on cardiac parameters in diabetic patients. Methods: This randomized controlled trial was carried out on 45 volunteers. These individuals were randomly divided into aerobic, weighted vest, and control groups. The aerobic protocol comprised 24 sessions of aerobic exercise. The exercise program for the weighted vest group was identical to that of the aerobic group, except that the subjects wore a weighted vest. The parameters were measured before and after the 24 sessions. Results: The mean age of the study population was 48.30 ± 5.02 years in the aerobic group, 48.33 ± 5.74 years in the weighted vest group, and 48.60 ± 4.79 years in the control group. Males comprised 7 (53.8%) patients in the aerobic group, 7 (58.3%) in the weighted vest group, and 8 (53.3%) in the control group.  After 8 weeks, maximum oxygen consumption in the aerobic group (mean ± SD = 37.54 ± 8.02 mL/kg/min, 95% CI: 5.48 to 11.60; p value < 0.001) and the weighted vest group (mean ± SD = 35.92 ± 3.96 mL/kg/min, 95% CI: 4.36 to 9.64; p value < 0.001) was increased, similar to metabolic equivalent of task in the aerobic group (mean ± SD = 11.60 ± 1.62 kcal/kg×h, 95% CI: 1.48 to 2.72; p value < 0.001) and the weighted vest group (mean ± SD = 11.21 ± 1.11 kcal/kg×h, 95% CI: 1.23 to 2.28; p value < 0.001). Furthermore, resting heart rate decreased significantly in the aerobic group (mean ± SD = 90.23 ± 8.90 bpm, 95% CI: -13.93 to -1.29; p value = 0.022) and the weighted vest group (mean ± SD = 90.58 ± 9.19 bpm, 95% CI: -0.16 to -12.33; p value = 0.045). Conclusion: These findings suggest that 24 aerobic exercise sessions might improve cardiac parameters in type 2 diabetes.  https://rhythm.tums.ac.ir/index.php/jthc/article/view/725 https://rhythm.tums.ac.ir/index.php/jthc/article/download/725/651

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 52 57 EN Khosro Barkhordari Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ali Mohammad Fakhre Yasseri Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fardin Yousefshahi Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Akbar Shafiee Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 04 30 2017 10 11 Background: Acute kidney injury (AKI) after coronary artery bypass graft surgery (CABG) is a common complication. The present study sought to determine AKI risk factors based on the Acute Kidney Injury Network (AKIN) classification. Methods: In a cross-sectional study, performed from March 2010 to April 2012 at Tehran Heart Center, affiliated with Tehran University of Medical Sciences, 29 independent risk factors for AKI based on the AKIN criteria were examined in isolated post-CABG patients. The patients’ demographic data and risk factors were extracted from the Electronic Database of Tehran Heart Center. According to restricted inclusion and exclusion criteria as well as a creatinine rise to AKI Stage 1, the patients were divided into 2 groups of AKI-negative and AKI-positive and the risk factors were compared between these groups. Results: Out of 3473 included patients at a mean age of 60.78 (± 9.46) years, the majority (2474 [71.23%]) were male. Totally, 958 (27.7%) patients had AKI, according to a creatinine rise to AKI Stage 1. Logistic regression analysis demonstrated that higher age (OR = 1.021; p value < 0.001), higher body mass index (OR = 1.035; p value < 0.001), lower preoperative creatinine level (OR = 0.417; p value < 0.001), longer cardiopulmonary bypass time (OR = 1.004; p value = 0.007), blood transfusion in the ICU (OR = 1.408; p value = 0.001), and lack of intraoperative blood transfusion (OR = 0.823; p value = 0.044) were the independent risk factors for AKI after CABG. Conclusion: Based on the findings of the current study, older age, higher body mass index, lower preoperative creatinine level, more blood transfusion in the intensive care unit (ICU), lack of intraoperative blood transfusion, and high cardiopulmonary bypass time may serve as risk factors for the development of AKI in CABG patients. https://rhythm.tums.ac.ir/index.php/jthc/article/view/717 https://rhythm.tums.ac.ir/index.php/jthc/article/download/717/652

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 58 64 EN Afsaneh Shafiei Department of Biochemistry, Payame Noor University of Tehran, Tehran, Iran. Younes Pilehvar-Soltanahmadi Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Shayan Ziaee Tehran Heart Center, Tehran Unversity of Medical Sciences, Tehran, Iran. Mohsen Mofarrah Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. Nosratollah Zarghami Department of Medical Biotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran. 2016 08 01 2017 06 22 Background: Recently, rs9289231 genetic variations of kalirin (KALRN) have been introduced as potential genetic markers for coronary artery disease (CAD). However, the influence of KALRN single-nucleotide polymorphisms (SNPs) on serum kalirin levels has not been investigated in CAD patients so far. Thus, the present study aimed to survey whether SNP T > G (rs9289231) was associated with the risk of early-onset CAD and serum kalirin levels among the study subjects. Methods: The rs9289231 polymorphism of the KALRN was genotyped in 512 subjects (61.5% male, mean age = 46.3 ± 7.1 y), comprising 268 subjects with angiographically diagnosed CAD and 244 controls using an HRM assay. Also, the levels of serum kalirin were compared between 133 CAD subjects and 123 controls using a sandwich ELISA assay.  Results: The CAD subjects had more frequently GG genotypes than the controls. The odds ratio (OR) remained significant after adjustment for known CAD risk factors (OR = 4.13, 95% CI: 2.48–9.10; p value < 0.001). A significant difference was also observed in that the G allele was more frequent among the CAD subjects. The G allele at the rs9289231 polymorphism was associated with a higher risk of CAD (OR = 2.11, 95% CI: 1.27–2.59; p value = 0.001). The mean kalirin level of the CAD patients was higher than that of the controls (p value = 0.041). No significant correlation was seen in the different genotypes with serum kalirin levels. Conclusion: The KALRN rs9289231 T > G variant was considerably related with an increased risk of early-onset CAD.  High kalirin levels were found in young CAD patients compared to the control subjects, with the levels not affected by the different genotypes of rs9289231. https://rhythm.tums.ac.ir/index.php/jthc/article/view/594 https://rhythm.tums.ac.ir/index.php/jthc/article/download/594/653

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 65 72 EN Bahram Pakzad Internal Medicine Department, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Mojtaba Akbari Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran. Fatemeh Baberi Department of Occupational Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran. 2017 01 16 2018 01 15 Background: Hypertension is a major risk factor for premature disability and death and is the leading risk factor for global disease burden. The present study aimed to assess the rates of prevalence, awareness, treatment, and control of hypertension in a sample of teachers, staff, and students at Isfahan University of Medical Sciences (IUMS). Methods: This cross-sectional survey was conducted from January to September 2015 on the staff, teachers, and students at IUMS. A total of 1500 subjects were randomly selected and were invited to participate in the survey. Hypertension was defined as an average of 2 blood pressure measurements of at least 140/90 mmHg. The rate of awareness was determined based on self-reports, treatment was defined as the regular use of blood pressure-lowering medications, and control was defined as the maintenance of blood pressure below 140/90 mmHg. Results: The study population comprised 1317 individuals (45.9% female) at a mean age of 41.4 ± 9.5 years. The prevalence rate of hypertension was 17.5% (231 of 1317 participants), and the rate of awareness was 54.5% (126 of 231 hypertensive patients). Seventy-nine (62.7%) patients were undergoing treatment, and 51.9% (41 of 79) controlled their disease. Institutional position (p value < 0.017), age (p value < 0.001), body mass index (p value < 0.001), education level (p value < 0.001), smoking status (p value < 0.001), and history of diabetes mellitus (p value < 0.001) were the most frequent risk factors associated with hypertension. Conclusion: The percentage of the hypertensive subjects who were aware, treated, and controlled was unacceptably low in our sample at IUMS. Hypertension is, therefore, a major health problem in this state institution. https://rhythm.tums.ac.ir/index.php/jthc/article/view/660 https://rhythm.tums.ac.ir/index.php/jthc/article/download/660/654

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 73 75 EN Alexander Chen Cardiology Department, East Surrey Hospital, Redhill, UK. Kaveh Yazdani Cardiovascular Intervention Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Luciano Candilio Cardiology Department, East Surrey Hospital, Redhill, UK. 2017 03 31 2017 11 16 Upper limb deep vein thrombosis (DVT) is a less common phenomenon than lower limb DVT.  Repeated trauma secondary to sport- or job-related arm movements and positions has been recognized as the predisposing factor for upper limb DVT. We describe a 38-year-old male computer programmer admitted with swelling and pain in his left upper limb. Venous duplex ultrasound confirmed the presence of axillary vein thrombosis. Coagulation studies for secondary thrombosis were unremarkable. The patient was treated with full anticoagulation using low molecular weight heparin and warfarin. On subsequent follow-up at 3 months, the patient was symptom free and duplex sonography showed no evidence of thrombosis. https://rhythm.tums.ac.ir/index.php/jthc/article/view/704 https://rhythm.tums.ac.ir/index.php/jthc/article/download/704/656

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 76 79 EN Mitra Golmohammadi Department of Cardiac Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran. Shahyad Salehi Department of Cardiac Surgery, Urmia University of Medical Sciences, Urmia, Iran. Rozita Haghi Department of Cardiac Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran. Mohammad Radvar Department of Pediatrics, Urmia University of Medical Sciences, Urmia, Iran. 2017 08 09 2017 12 12 Intrapericardial teratomas are rare primary cardiac tumors. These tumors, albeit benign in essence, can be fatal if they exert pressure on the cardiovascular and/or respiratory system. We describe a 34-day-old infant, who needed emergent surgery due to cardiovascular structure compromise. Proper anesthetic and surgical techniques conferred an uneventful postoperative course. Histologic examination confirmed the tumor as an intrapericardial teratoma. At 8 months’ postoperative follow-up, the child had a good developmental status and a normal echocardiogram. https://rhythm.tums.ac.ir/index.php/jthc/article/view/762 https://rhythm.tums.ac.ir/index.php/jthc/article/download/762/657

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 80 83 EN Ahmet Taha Alper Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey. Mert İlker Hayıroğlu Department of Cardiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey. Hakan Barutça Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey. Ahmet İlker Tekkeşin Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey. Ceyhan Türkkan Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey. 2017 08 22 2018 02 26 The coronary sinus, whose electrical features play an important role in cardiac arrhythmias, is the integral part of the cardiac venous system. Here we describe a 67-year-old male patient with congestive heart failure who was referred to our hospital after the failure of the first cardiac resynchronization therapy defibrillator (CRT-D) implantation. During the cannulation of the coronary sinus, the separate orifice of the posterior cardiac vein was demonstrated by the retrograde filling of the coronary sinus via contrast injection into the posterior cardiac vein. Due to the serious tortuosity of the coronary venous sinus, a multipolar left ventricular lead was implanted using the separate ostium of the posterior cardiac vein. In our patient, the posterior cardiac vein directly drained into the right atrium. At 3 months’ follow-up with the CRT-D, he was asymptomatic (New York Heart Association functional class I). https://rhythm.tums.ac.ir/index.php/jthc/article/view/765 https://rhythm.tums.ac.ir/index.php/jthc/article/download/765/658

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 84 87 EN Maryam Moradian Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran. Hojjat Mortezaeian Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran. Ramin Baghaei Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Behshid Ghadrdoost Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran. 2016 08 06 2017 05 24 An isolated right superior vena cava (RSVC) draining into the left atrium represents a very rare congenital malformation, especially in the absence of a partial anomalous pulmonary venous return. This condition leads to hypoxemia, cyanosis, and clubbing without any other signs of heart defects. We describe an 8-year-old girl, who was referred to our hospital due to unexplained cyanosis. Segmental approach in transthoracic echocardiography showed left atrial drainage of the RSVC, which was subsequently confirmed by contrast echocardiography and angiography. Surgical repair via trans-section and anastomosis of the superior vena cava to the right atrium was performed to prevent the complications of right-to-left shunting and cyanosis. During a 4-year follow-up, the patient remained in very good clinical status and her serial echocardiography was normal except for very mild left atrial and left ventricular enlargement. https://rhythm.tums.ac.ir/index.php/jthc/article/view/597 https://rhythm.tums.ac.ir/index.php/jthc/article/download/597/659

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 88 98 EN Ali Mohammad Haji Zeinali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Kyomars Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mahmmod Shirzad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2017 03 04 2018 03 17 Endovascular treatment of aortic diseases has improved in recent years. More complex thoracoabdominal and juxtarenal abdominal aortic aneurysms can now be treated with new stent grafts and techniques. Fenestrated endovascular aortic aneurysm repair (FEVAR) with fenestrated stent grafts was commenced in our center after hundred cases of endovascular aortic repair, and so far 4 serial complex cases deemed inoperable (2 juxtarenal abdominal aortic aneurysms, 1 thoracoabdominal aneurysm, and 1 thoracoabdominal pseudoaneurysm) have been treated with FEVAR. All these patients needed custom-made stent grafts, which were designed and implanted successfully under general anesthesia in the catheterization laboratory. They were followed up for more than 1 year, with a median follow-up period of 23.0 months. There were no major in-hospital or short-term complications. Only 1 patient had midterm unilateral iliac artery thrombosis, which was successfully managed interventionally. Computed tomography angiography at 1 year’s follow-up showed that the stent grafts were patent and their visceral branch cover stents had no endoleak. https://rhythm.tums.ac.ir/index.php/jthc/article/view/689 https://rhythm.tums.ac.ir/index.php/jthc/article/download/689/662

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 99 100 EN Ahmet Güner Department of Cardiology, University of Health Sciences, Division of Kosuyolu Heart & Research Hospital, Istanbul, Turkey. 2017 09 23 2018 01 11 --- https://rhythm.tums.ac.ir/index.php/jthc/article/view/778 https://rhythm.tums.ac.ir/index.php/jthc/article/download/778/663

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 2 2018 05 23 101 102 EN Samer Kassem Department of Cardiovascular Surgery, Centro Cardiologico Monzino, Milan, Italy. 2017 03 13 2017 10 03 - https://rhythm.tums.ac.ir/index.php/jthc/article/view/695 https://rhythm.tums.ac.ir/index.php/jthc/article/download/695/666