Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 187 190 Hossein Ahmadi Tafti Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran Ehsan Fayazzadeh Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. 2015 10 03 https://rhythm.tums.ac.ir/index.php/jthc/article/view/63 https://rhythm.tums.ac.ir/index.php/jthc/article/download/63/61

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 191 200 Leila Moezi School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Shahram Ejtemaei Mehr School of Medicine, Medical Sciences/University of Tehran, Tehran, Iran. Ahmad Reza Dehpour School of Medicine, Medical Sciences/University of Tehran, Tehran, Iran. 2015 10 03 Cirrhosis is characterized by marked abnormalities in the cardiovascular system. A hyperdynamic splanchnic and systemic circulation is typical of cirrhotic patients and has been observed in all experimental forms of portal hypertension. The hyperdynamic circulation is most likely initiated by arterial vasodilatation, leading to central hypovolemia, sodium retention, and an increased intravascular volume. Despite the baseline increase in cardiac output, ventricular inotropic and chronotropic responses to stimuli are blunted, a condition known as cirrhotic cardiomyopathy. This review briefly examines the major mechanisms that may underlie these cardiovascular abnormalities, concentrating on nitric oxide, endocannabinoids, prostaglandins, carbon monoxide, endogenous opioids, and adrenergic receptor changes. Future work should address the complex interrelationships between these systems. https://rhythm.tums.ac.ir/index.php/jthc/article/view/64 https://rhythm.tums.ac.ir/index.php/jthc/article/download/64/62

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 201 206 Mojtaba Salarifar Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Kamran Ali Moghaddam Shariati Hospital, Medical Sciences/University of Tehran, Tehran, Iran. Seyed Ebrahim Kassaian Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Mohammad Alidoosti Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Ali Mohammad Haji Zeinali Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Hakimeh Sadeghian Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Jalil Majd Ardakani Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Elham Hakki Kazazi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Ardeshir Ghavamzadeh Shariati Hospital, Medical Sciences/University of Tehran, Tehran, Iran. 2015 10 03 Background: Early clinical investigations indicate that an infusion of autologous bone-marrow cells into the infarct-related coronary artery is feasible after acute myocardial infarction. There is increasing evidence that cell transplantation may improve the perfusion and contractile function of the ischemic myocardium. The present study reports primarily the safety of intracoronary bone marrow mononuclear cell (BMMNC) injections and secondarily the hypothesis that intracoronary injections of autologous BMMNC in patients with acute myocardial infarction may have a favorable impact on tissue perfusion and contractile performance. Methods: Twelve patients with acute ST-elevation myocardial infarction of the anterior wall treated with percutaneous coronary intervention were enrolled in this prospective, nonrandomized, open-label study. Left ventricular function and number of nonviable segments were assessed with the use of echocardiography and Technetium-sestamibi single photon emission tomography respectively at baseline and after a 4-month follow-up. Results: At 4 months’ follow-up, global left ventricular ejection fraction in echocardiography increased from a mean of 31.78±7.56% at baseline to 38.89±6.97% (p=0.018). Mean wall motion score in rest echocardiography was 29.5±6.67 in basal and 26.75±5.44 at 4 months’ follow-up (p=0.05). Nuclear perfusion imaging studies in the patients for the mean number of nonviable segments were 6.5 at baseline and 6 in 4 months’ follow-up (p=0.17). Three patients were lost to follow-up and did not undergo the 4-month evaluations. Conclusion: This study is small and very preliminary. Data from large, randomized, controlled trials are needed to clarify the effect of stem-cell injection in myocardial function.     https://rhythm.tums.ac.ir/index.php/jthc/article/view/65 https://rhythm.tums.ac.ir/index.php/jthc/article/download/65/63

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 207 212 Tahereh Dehdari 1Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Ir Alireza Heidarnia Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Ira Ali Ramezankhani Department of Public Health, Shahid Beheshti University, Tehran, Iran. Saeed Sadeghian Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Fazlollah Ghofranipour Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Ira Gholamreza Babaei Ruchi Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Ira Soraya Etemadi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. 2015 10 03 Background: Patients with psychological problems after coronary artery bypass graft surgery (CABG) show poorer outcomes; nevertheless, there is a paucity of research into the effects of cardiac rehabilitation programs on such patients. The purpose of this study was to determine the effect of phase III cardiac rehabilitation programs on the anxiety and quality of life of anxious patients who had undergone CABG in Iran.             Methods: Six weeks after CABG, 83 anxious patients participated in an 8-week cardiac rehabilitation program that consisted of formal supervised exercise training and educational sessions. The state/trait anxiety inventory and SF-36 questionnaire were two instruments for collecting data in the present study. Of the total of 83, 66 participants saw out the eight-week period.             Results: With the exception of the mental health aspect, significant improvements were noted in the following components of the quality of life measures after the cardiac rehabilitation program: physical functioning (P<0.001), role-physical (P<0.001), bodily pain (P<0.001), social functioning, (P=0.003), general health (P=0.020), vitality (P=0.006), and role-emotional (P=0.003). Additionally, significant reductions were observed in state anxiety (P=0.010) and trait anxiety (P=0.010(.             Conclusion: These findings suggest that phase III cardiac rehabilitation may be an effective therapy for improving psychological outcomes of patients with psychological problems after CABG. https://rhythm.tums.ac.ir/index.php/jthc/article/view/66 https://rhythm.tums.ac.ir/index.php/jthc/article/download/66/64

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 213 216 Mahmood Mirhoseini Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Shahram Rabbani Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Sirus Darabian Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Saeed Sadeghian Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Abbasali Karimi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Seyed Hesameddin Abbasi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. 2015 10 03 Background: Dilated cardiomyopathy is associated with a progressive deterioration in cardiac function and eventually death. Initial interest in this hypothesis was to create another large animal model for dilated cardiomyopathy in addition to pigs and dogs. Methods: After the induction of anesthesia to 10 female sheep, a carotid-jugular shunt was created in all the animals via a 1-cm fistula between the carotid artery and jugular vein. Six sheep out of the total of 10, were given intravenous Doxorubicin. Echocardiographic studies were performed before surgery and 3 months after that. The 4 animals not injected with Doxorubicin were evaluated for echocardiographic parameters after one year. Results: There was no abnormality in echo parameters in the 4 sheep that had not received Doxorubicin; in addition, their valves and cardiac output were normal. As regards the six sheep injected with Doxorubicin, 4 received a dose of 2 mg/kg weekly and expired after the second injection due to the toxicity of the drug, 1 was given Doxorubicin 1 mg/kg and died after one week, and 1 had Doxorubicin 0.5 mg/kg but showed no abnormality in terms of dilated cardiomyopathy. Conclusion: We conclude that the sheep is sensitive to Doxorubicin and that the dosage that is enough for creating dilated cardiomyopathy in dogs is very toxic for the sheep.      https://rhythm.tums.ac.ir/index.php/jthc/article/view/67 https://rhythm.tums.ac.ir/index.php/jthc/article/download/67/65

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 217 222 Mohammad Ali Ostovan Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Reza Mollazadeh Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. 2015 10 03 Background: Small side branches, albeit less important than their larger counterparts, have not yet received due attention in the literature. Nor has there ever been a comparison between drug-eluting stents and bare metal stents apropos side branch occlusion. The aim of this study was to compare the patency of small (≥0.5 and ≤1.5 mm in diameter) side branches with respect to bare metal vs. drug-eluting stents immediately after their deployment. Methods: This prospective bi-center study, conducted between June 2005 and January 2007, enrolled 82 patients treated with ≥1 of two stents (TAXUSTM LiberteTM or LiberteTM). Side branches ≥0.5 and <1.5 mm in diameter arising from the main vessel at the lesion site were evaluated. Results: Thirty-eight patients were treated with 42 LiberteTM stents (58 side branches) and forty-four patients with 50 TAXUSTM LiberteTM (102 side branches). The rate of small side branch occlusion was 35.3% (36) in the TAXUSTM LiberteTM group compared to 29.31% (15) in the LiberteTM group (P-value= 0.7). The presence of type 1 side branch morphology (Lefevre classification) was the most powerful predictor of small side branch occlusion (P-value=0.03). Conclusion: This study shows that drug-eluting stents are not inferior to bare metal stents as regards small side branch occlusion during coronary stenting.   https://rhythm.tums.ac.ir/index.php/jthc/article/view/68 https://rhythm.tums.ac.ir/index.php/jthc/article/download/68/66

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 2 4 2007 10 18 223 228 Hakimeh Sadeghian Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Masoumeh Lotfi-Tokaldany Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Nader Fallah Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Seyed Hesameddin Abbasi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Seyed Hossin Ahmadi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Abas Ali karimi Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Mojtaba Salarifar Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran. Salehi Rezvanyieh Cardiology Department, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 03 Background: This study was designed to investigate the accuracy of dobutamine stress echocardiography (DSE) in detecting the post-revascularization recovery rate of contractile reserve (CR) in ischemic myocardium. Methods: A total of 112 segments from seven patients with low ejection fraction (<35%) and coronary artery disease were evaluated with DSE one week before and 12 weeks after coronary artery bypass graft surgery (CABG). Sensitivity, specificity, and positive and negative predictive values of DSE for detecting the recovery rate of CR were calculated based upon their standard definition and were presented with 95% confidence intervals (CI). Results: The mean baseline left ventricular ejection fraction was 31±4%, which reached 35±7% after CABG unremarkably. The recovery rates of resting function and CR were 18.2% and 50% for hypokinetic and 15.6% and 24.1 for akinetic segments respectively. Specificity, sensitivity, and positive and negative predictive values of DSE for detecting the recovery of CR were 83% (CI=69-97), 89% (CI=83-96), 94% (CI = 88-99), and 73 % (CI = 55-88), respectively.   Conclusion: Despite acceptable sensitivity, specificity, and positive predictive value, DSE has a relatively lower negative predictive value for detecting the recovery of CR in ischemic myocardium and, consequently, the full extent of myocardial viability. Further sensitive techniques may, therefore, be needed to provide complementary information regarding long-term functional outcome. https://rhythm.tums.ac.ir/index.php/jthc/article/view/69 38 42 EN Abdol Rasoul Moulodi Imam Ali Cardiovascular Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Gholam Reza Sheibat-Zadeh Imam Ali Cardiovascular Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Feridoun Sabzi Imam Ali Cardiovascular Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2015 10 11 2015 10 11 The optimal treatment method for right ventricular failure after valve surgery complicated by a low cardiac output has not been determined, although several case reports have been published on patients with ventricular failure and arrhythmia who were bridged to cardiac transplantation using biventricular or left ventricular assist devices. This case series illustrates successful circulatory support of 4 patients with prolonged low cardiac outputs and right ventricular failure and arrhythmias after valvular heart surgery with or without severe pulmonary hypertension. In-hospital death occurred in one patient and 3 patients were discharged from the hospital with good general condition. At two years' follow-up, 2 patients were in functional class one but another patient underwent laparotomy for multiple splenic abscesses and died from multiple organ failure. https://rhythm.tums.ac.ir/index.php/jthc/article/view/322 https://rhythm.tums.ac.ir/index.php/jthc/article/download/322/315

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 9 1 2015 10 11 43 45 EN Mohammad Masoumi Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran. Maryam Aliramezany Research Center for Health Services Management, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 2015 10 11 2015 10 11 The left ventricular aneurysm is one of the most significant complications of myocardial infarction and is defined as the expansion of the ventricular wall. The coronary artery aneurysm is characterized by an abnormal dilation of the localized portion of the coronary artery, and its main cause is atherosclerosis. We herein report an unusual case of coronary artery and left ventricular aneurysms in a mitral stenosis patient with normal coronary arteries and no sign of atherosclerosis. This patient was a known case of mitral stenosis due to rheumatic heart disease and was symptomatic despite optimal medical therapy. Laboratory tests were normal, and electrocardiography showed sinus rhythm and left atrium abnormality without pathologic Q wave. Angiographic view illustrated left circumflex artery and left ventricular apical aneurysms. Percutaneous transvenous mitral commissurotomy was performed successfully and the patient was discharged with Warfarin and a beta blocker. No symptom was observed at six months' follow-up. https://rhythm.tums.ac.ir/index.php/jthc/article/view/323 https://rhythm.tums.ac.ir/index.php/jthc/article/download/323/316

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 9 1 2015 10 11 46 51 EN Seyed Ebrahim Kassaian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Arsha Karbassi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Sahebjam Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hassan Aghajani Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Amin Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Niloufar Ahmadbeigi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Kyomars Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Abbasi Salehiomran Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hamidreza Poorhosseini Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mojtaba Salarifar Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 2015 10 11 Mitral regurgitation (MR) is a common valvular lesion in the general population with considerable impact on mortality and morbidity. The MitraClip System (Abbot Laboratories, Abbot Park, IL, USA) is a novel percutaneous approach for treating MR which involves mechanical edge-to-edge coaptation of the mitral leaflets. We present our initial experience with the MitraClip System in 5 patients. In our series, the cause of MR was both degenerative and functional. Two patients received two MitraClips due to unsatisfactory results after the implantation of the first clip. Acute procedural success was seen in 4 patients. Blood transfusion was required for 2 patients. All the patients, except one, reported improvement in functional status during a 2-month follow-up period. Our initial experience with MitraClip implantation indicates that the technique seems feasible and promising with acceptable results and that it could be offered to a broader group of patients in the near future. https://rhythm.tums.ac.ir/index.php/jthc/article/view/324 https://rhythm.tums.ac.ir/index.php/jthc/article/download/324/317

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 9 1 2015 10 11 52 53 EN Mahmood Hosseinzadeh-Maleki Assistant Professor of Cardiac Surgery Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences,Valiassr Hospital, Ghaffari Street, Birjand, Iran. Toba Kazemi Professor of Cardiology, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences,Valiassr Hospital, Ghaffari Street, Birjand, Iran. Hamid Reza Mashraghi-Moghaddam Assistant Professor of Cardiology,Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences,Valiassr Hospital, Ghaffari Street, Birjand,Iran. 2015 10 11 2015 10 11