Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 157 158 Abbasali Karimi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Hesameddin Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 12 02 - https://rhythm.tums.ac.ir/index.php/jthc/article/view/993 https://rhythm.tums.ac.ir/index.php/jthc/article/download/993/798

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 159 165 EN Maryam Daie 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. Abbasali Karimi 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. Abbas Salehiomran Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamid Ariannejad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Arash Jalali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2018 01 01 2018 08 26 Background: Postoperative atrial fibrillation (POAF) is probably a consequence of inflammation. Vitamin D is known for its anti-inflammatory properties. The aim of this study was to evaluate the effects of vitamin D levels on the incidence of POAF. Methods: In a prospective cohort study, patients were monitored for the occurrence of POAF during the first 5 days after coronary artery bypass grafting surgery in Tehran Heart Center. Those with concomitant valvular surgeries were excluded. Thereafter, they were divided into 2 groups: with or without POAF. Vitamin D levels were assessed in all the patients. The relationship between the vitamin D level and the incidence of POAF was evaluated and compared between the groups using the Mann–Whitney U test. Results: The study population comprised of 156 patients. The mean age was 62.8±8.6 years, and 105 (67.3%) patients were male. Of the 156 patients, 29 (19%) developed POAF. The median preoperative vitamin D level was 15.3 in the group with POAF and 25.3 in the group without POAF (P=0.07). Conclusion: Our results demonstrated no significant relationship between vitamin D levels and the occurrence of POAF. https://rhythm.tums.ac.ir/index.php/jthc/article/view/831 https://rhythm.tums.ac.ir/index.php/jthc/article/download/831/799

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 166 172 EN Zargham Hossein Ahmadi Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Farshid Salehi Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shanay Niusha Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Reza Raoufy Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Behrooz Farzaneghan Nursing and Respiratory Health Management Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ali Afshar Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Yadollah Mafhoomi Nursing and Respiratory Health Management Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Faghih Abdollahi Nursing and Respiratory Health Management Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Golnar Radmand Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Ansari Aval Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Jahangirifard Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2017 10 01 2018 08 11 Background: Extracorporeal membrane oxygenation (ECMO) provides hemodynamic and oxygenation support in critical conditions. The commencement of this modality in Iran coincided with severe economic constraints across Iran. Methods: This retrospective study was performed in Masih Daneshvari Medical Center from 2010 to 2015, during which period, sanction-related limitations in the import of equipment prompted us to integrate a Medtronic or Stöckert head pump console into a Maquet ECMO Oxygenator so as to sustain the ECMO program. Comparisons were performed between successful and unsuccessful ECMO procedures and survivors. Factors associated with unsuccessful ECMO were evaluated with a multivariate logistic regression. Results: Thirty-three (68.8%) patients were male and 15 (31.2%) were female. The mean age of the patients was 35±16.6 years. Thirty-seven (77.1%) patients were weaned off ECMO successfully; the rate was higher than that in previous studies. Totally, 35.4% of the study population survived to hospital discharge. The most common cause of death in all the ECMO patients who were successfully weaned was sepsis. The most common cause of death in the patients who underwent unsuccessful ECMO was multisystem organ failure. The mean ECMO support time was 53.37±46.26 hours. The patients who were alive at discharge were significantly younger (25.5±14.5 vs. 40.2±15.5 y; P=0.002) and had a significantly lower ECMO duration (24 [25–75% interquartile: 18.5–36] vs. 48 [25–75% interquartile: 24–72] h; P=0.044) than the non-survivors. Conclusion: An assembly of ECMO components from different companies could be done safely, at least for a short period of time. https://rhythm.tums.ac.ir/index.php/jthc/article/view/782 https://rhythm.tums.ac.ir/index.php/jthc/article/download/782/800

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 173 179 EN Maryam Nabati Crdiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran. Zahra Dehghan Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Bahareh Kalantari Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Jamshid Yazdani Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 2017 11 17 2018 06 18 Background: The presence of different risk groups among patients with the non–ST-elevation acute coronary syndrome indicates the need for new tools to establish early diagnoses and prognostic stratifications. The role of prolonged corrected QT (QTc) intervals in myocardial ischemia has yet to be thoroughly assessed. The purpose of our study was to assess the significance of QTc prolongations during acute non–ST-segment elevation myocardial infarction (NSTEMI) or unstable angina. Methods: The QTc interval was measured in 205 patients admitted with NSTEMI or unstable angina to the Coronary Care Unit of Fatemeh Zahra Hospital between 2014 and 2015. On that basis, the patients were divided into those with normal (<440 ms) and the ones with prolonged (≥440 ms) QTc intervals. Echocardiography and coronary angiography were performed within 48 to 72 hours after hospitalization. A logistic regression model was applied to assess the predictors of left ventricular systolic dysfunction. Results: The mean age of the patients was 58.21±10.72 years, and men comprised 51% of the participants. Overall, a QTc interval prolongation of ≥440 ms was present in 45 subjects (21.95% of the patients), which was significantly associated with a previous myocardial infarction (MI) (P=0.024), a minimum ST depression of 1 mm in the inferior leads (P=0.006), and a maximum left ventricular ejection fraction of 35% (P=0.018). Furthermore, among the different electrocardiographic variables, only a prolonged QTc interval (OR=0.275, 95% CI=0.078–0.976; and P=0.046) was inversely associated with the left ventricular systolic function. Conclusion: Our study showed that prolonged QTc intervals can be used as a useful risk marker for identifying high-risk patients with the acute coronary syndrome. https://rhythm.tums.ac.ir/index.php/jthc/article/view/814 https://rhythm.tums.ac.ir/index.php/jthc/article/download/814/809

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 180 182 EN Ertan Demirdaş Department of Cardiovascular Surgery, Faculty of Medicine, Bozok University, Yozgat, Turkey. Kıvanç Atılgan Department of Cardiovascular Surgery, Faculty of Medicine, Bozok University, Yozgat, Turkey. Cengiz Er Department of Cardiovascular Surgery, Faculty of Medicine, Bozok University, Yozgat, Turkey. Süleyman Akın Yozgat State Hospital, Yozgat, Turkey. 2017 11 17 2018 07 18 Behçet's Disease (BD) is a multisystemic vasculitis which usually affects optical, genital, and oral mucosae and often reoccurs intermittently. Chylothorax is a very rare complication of BD which usually causes thrombosis in the major venous system. A 27-year-old man with a 10-year history of BD referred to our cardiovascular surgery department with symptoms of serious aches in the left arm, edema, and apparent veins on the left anterior chest wall. A total thrombosis of the left internal and external jugular veins and the left subclavian vein was observed. One month after a successful treatment and discharge, the patient returned to our clinic with symptoms of dyspnea and coughs. A chest radiograph showed a consolidated region. A milky liquid was aspirated through thoracocentesis from the left thorax, and its biochemical analysis helped us arrive at a diagnosis of chylothorax. The patient was hospitalized and administered corticosteroids and immunosuppressive therapy with a high-carbohydrate and low-fat dietary regimen for BD. Thereafter, a left thoracic drainage system was established. On the seventh day of hospitalization, due to a progressing cheilosis flow, a pleurodesis process was applied with talcum powder. However, the chylous drainage was continued and 60 mL of venous autologous blood was injected into the left thorax through a drainage tube. The treatment was successful, and the patient was discharged from the hospital uneventfully. At 1 month’s follow-up, the chest radiograph was normal. https://rhythm.tums.ac.ir/index.php/jthc/article/view/815 https://rhythm.tums.ac.ir/index.php/jthc/article/download/815/801

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 183 185 EN Mert İlker Hayıroğlu Haydarpaşa Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey. Tufan Çınar Haydarpaşa Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey. Ahmet Öz Öz Haydarpaşa Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey. Muhammed Keskin Haydarpaşa Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey. 2018 01 03 2018 08 11 The concertina phenomenon is the occurrence of new and transient angiographic series of pseudolesions in a tortuous vessel induced mainly by a stiff guide wire. Here, we describe a 53-year-old man who experienced a concertina effect in the left anterior descending coronary artery (LAD) during an elective percutaneous coronary intervention. After the diagnosis of the concertina phenomenon in the LAD, a percutaneous coronary intervention was performed following the withdrawal of the soft guide wire to the mid level of the LAD. After the intervention, the patient remained in very good clinical status and was discharged on the third postprocedural day. https://rhythm.tums.ac.ir/index.php/jthc/article/view/832 https://rhythm.tums.ac.ir/index.php/jthc/article/download/832/802

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 13 4 2018 10 15 186 190 EN Ali Mohammad Haji Zeinali Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Yaser Jenab Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamid Ariannejad Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Ebrahim Kassaian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Alidoosti Tehran Heart Center, ion 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 posto