Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 283 288 EN Elaheh Malakan Rad Department of Pediatrics, Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hassan Radmehr Department of General Surgery, Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ashkan Taghizadeh Department of Anesthesiology, Children’s Medical Center, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hamidreza Pouraliakbar Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran. Elahe Radmehr 1) Colorectal Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2) Universal Scientific Education and Research Network (USERN), Tehran, Iran. 3) School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2024 05 20 Mixed atrial septal defects (ASDs) involving inferior vena cava (IVC)-type sinus venosus and secundum types and mixed partial anomalous pulmonary, systemic, and hepatic venous drainage are rare. We describe a 3-year-old acyanotic boy who presented with a large mixed inferior sinus venosus and secundum-type ASD. He exhibited an abnormal connection between the right upper pulmonary vein and the right atrium. Additionally, the IVC and a hepatic vein drained abnormally into the left atrium. The patient also had valvular and supravalvular pulmonary stenosis, as well as a small patent ductus arteriosus. The ASD was surgically closed using a pericardial patch, positioned lower than usual to reroute the IVC and hepatic vein flow into the right atrium. The surgery was successful, with no residual lesions or complications. The patient recovered without issues and was discharged smoothly. At the 6-month follow-up, the child’s cardiac examination and oxygen saturation were normal. Furthermore, echocardiography confirmed normal drainage of the systemic and hepatic veins into the right atrium. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2099

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 230 242 Seyedeh Sahar Nazemi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Sara Samadi Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Sara Rahsepar Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Batool Zarei Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Amir Hooshang Mohammadpour 1-Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. 2- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. Farshad Abedi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Navid Omidkhoda Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Majid Sezavar Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2024 01 13 2024 09 12 Background: Early diagnosis of atherosclerosis, particularly in its subclinical phase, is crucial for reducing mortality and morbidity associated with cardiovascular diseases. This study aims to investigate the relationship between oxidative stress markers and coronary artery calcification (CAC), enhancing our understanding of the pathophysiology of CAC. Methods: In October 2022, we conducted a systematic search of the Web of Science, Scopus, PubMed, and Embase databases without language or time restrictions, screening a total of 557 records. We excluded studies involving animals, in vitro experiments, reviews, case reports, clinical trials, editorials, and clinical guidelines. Eligible human observational studies (cohort and cross-sectional) that examined the link between CAC and oxidative stress markers were included. The Newcastle-Ottawa Scale was employed to assess the quality of the included studies. Results: Our systematic review encompassed 40 studies, all of which included both male and female participants, predominantly using cross-sectional designs. Participants included individuals at low, intermediate, or high risk of coronary artery disease, patients with type 2 diabetes, those with existing cardiovascular disease, and asymptomatic individuals. The studies investigated various oxidative stress markers, including serum uric acid and 8-isoprostane, both of which showed strong correlations with CAC incidence and severity. Conclusion: Oxidative stress markers may positively correlate with CAC scores, indicating a potential avenue for identifying individuals at heightened risk. This review underscores the need for further studies to facilitate early diagnosis of cardiovascular complications and the establishment of novel pharmacological targets. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1999

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 306 309 Riyaz Charaniya Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Ahmedabad, India. Mit Chaudhari Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Ahmedabad, India. Dinesh Joshi Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Ahmedabad, India. 2023 08 25 2024 09 12 Accelerated idioventricular rhythm (AIVR) is a relatively slow ventricular rhythm that often occurs during the reperfusion phase of an acute myocardial infarction. It is generally considered a benign rhythm that does not require treatment. However, we present a case where AIVR was the presenting arrhythmia in a 41-year-old man with acute coronary syndrome, suggesting it might not be as benign as previously reported in the literature. The patient, who presented to our institute, underwent urgent coronary evaluation followed by revascularization, leading to the conversion of AIVR to normal sinus rhythm and improvement in anginal symptoms. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1920

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 243 249 Akram Ranjbar Nutrition Health Research Center, Institute of Health Sciences and Technologies, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran. Fereshteh Mehri Nutrition Health Research Center, Institute of Health Sciences and Technologies, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran. Maryam Esfahani Nutrition Health Research Center, Institute of Health Sciences and Technologies, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran. Elham Shiri Department of Anatomical Sciences, School of Medicine Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. 2023 08 07 2024 09 12 Background: Diazinon (DZN), an organophosphate insecticide, exerts various adverse effects on human organs. In this study, we investigated the potential cardiotoxic effects of flaxseed oil (FS oil) on oxidative stress caused by DZN in the heart tissue of rats. Methods: Thirty male rats were divided into five groups: a control group receiving normal saline, an FS oil group administered 200 mg/kg/d of FS oil, a DZN group treated with 70 mg/kg/d of DZN, and two co-treatment groups receiving DZN alongside FS oil at 100 and 200 mg/kg/d. We assessed oxidative stress biomarkers in heart tissue, including malondialdehyde, total oxidant status, catalase, superoxide dismutase, and total thiol content. Heart tissue morphology was analyzed using hematoxylin and eosin staining. Results: DZN significantly increased the levels of malondialdehyde (12.04±1.16) and total oxidant status (0.43±0.01) and also decreased the content of catalase (23.09±1.99), superoxide dismutase (5.52±0.61), and total thiol content (6.31±0.77) in heart tissue. FS-oil + DZN decreased malondialdehyde (10.88±0.31) and total oxidant status (0.41±0.01) and also increased the content of catalase (29.34±1.77), superoxide dismutase (6.64±0.21), and total thiol content (8.20±0.15) in heart tissue. FS oil supplement consumption reversed oxidative stress status in a dose-dependent manner. Furthermore, FS oil ameliorated heart histopathological alterations induced by DZN. Conclusion: Our findings confirmed that DZN induced heart toxicity and that FS oil had protective effects. Additionally, FS oil supplementation conferred protective effects on the heart against toxicity induced by DZN. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1907

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 302 305 EN Sriram Veeraraghavan Department of Cardiology, SRM Medical College and Research Centre, Potheri, Chengalpattu, Tamilnadu, India. Bharat Raj Kidambi Department of Cardiology, Al-Dhannah hospital, Aldhannah, Abu Dhabi, UAE. Vasundhara Ponnaganti Department of Cardiology, SRM Medical College and Research Centre, Potheri, Chengalpattu, Tamilnadu, India. 2024 04 04 2024 09 24 No Abstract No Abstract No Abstract https://rhythm.tums.ac.ir/index.php/jthc/article/view/2063

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 310 311 John Madias Icahn School of Medicine at Mount Sinai, Division of Cardiology, Elmhurst Hospital Center, Elmhurst, USA. 2024 05 03 2024 09 03 No Abstract No Abstract No Abstract https://rhythm.tums.ac.ir/index.php/jthc/article/view/2084

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 250 255 Hojjat Mortezaeian Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Reza Abbaszadeh Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Hamidreza Ghaemi Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Farshad Jafari Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Zeinab-Al-sadat Mirhaghjoo Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 2024 02 21 2024 09 03 Background: Although several studies have examined patients who have undergone transcatheter fenestration closure, comprehensive evaluations of its long-term outcomes remain scarce. Therefore, this study aimed to evaluate the clinical status of these patients after a long-term follow-up period. Methods: This cross-sectional analytical study evaluated the records of all children with congenital heart diseases admitted for transcatheter fenestration closure at Rajaie Cardiovascular Medical and Research Center, a tertiary care hospital specializing in congenital heart diseases in Tehran, Iran. We included patients with a history of fenestration following Fontan surgery who required fenestration closure between January 2012 and August 2020. Cardiac function data, such as ejection fraction (EF), pulmonary artery pressure (PAP), and O2 saturation, were extracted from electronic medical records. Results: We assessed 26 patients (11 female and 15 male) with a mean age of 13.88±3.73 years. Comparing EF before and after fenestration closure revealed a significant difference (P=0.011), with only 2 patients (7.7%) experiencing a slight reduction (5.0%) in EF. No significant difference was observed in PAP before and after closure (P=0.068), although most patients (n=16, 61.5%) had a postprocedural reduction. Our results demonstrated a significant difference before and after the procedure (P<0.001), with all patients exhibiting increased O2 saturation after closure. Conclusion: Our study demonstrated improvements in cardiovascular function and desirable organ function among patients. These findings suggest that transcatheter fenestration closure could serve as a beneficial complementary approach for patients with patent fenestration. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2030

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 4 2024 10 30 289 294 Parvin Akbariasbagh Department of Pediatrics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Seyed-Reza Raeeskarami Department of Pediatrics, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Masoumeh Asgarshirazi Departmens can mark a paradigm shift; however, significant weaknesses persist in diagnostic and therapeutic areas. Further progress depends on phenotype-specific, multimodal, and patient-centered strategies that combine clinical care, digital innovation, and molecular research. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2377 https://rhythm.tums.ac.ir/index.php/jthc/article/download/2377/1250

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 21 1 2024 06 22 111 115 Farnaz Ahmadi Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Raha Parnia Simon Fraser University, Vancouver, British Columbia, Canada Bahamin Astani Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad-Sadegh Keshmiri Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shakiba Khodadad Department of Gynecology Oncology, Erfan Hospital, Tehran, Iran Hakimeh Sheikhzadeh Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Daneshmandi Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faezeh Ansari Mofid Children’s Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahsa Riahi Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sima Noorali Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hannaneh Yousefi-Koma Masih Daneshvari Hospital, Tehran, Iran Babak Sharif-Kashani Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shadi Shafaghi Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2024 07 04 2024 09 22 Background: Pregnancy in women with pulmonary hypertension (PH) is contraindicated because of high mortality rates associated with physiological changes, particularly in the peripartum and postpartum periods. Termination is recommended early if pregnancy occurs. Consequently, clinical experience with continued pregnancy in patients with PH is scarce. Case Presentation: A 31-year-old woman was diagnosed with multiple bilateral pulmonary and right ventricular hydatid cysts. After surgical and pharmacologic treatments, she developed PH due to pulmonary artery obstruction 8 years later. Because of her condition, she was ineligible for surgery and received medical therapy, including tadalafil, bosentan, and eplerenone. After 3 years, she conceived despite advice to avoid pregnancy. At 37 weeks’ gestation, she underwent successful emergency cesarean delivery because of maternal dyspnea and tachycardia. Conclusion: Prompt treatment and regular follow-up in a tertiary care center using a multidisciplinary approach are crucial for managing pregnant patients with PH. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2118 https://rhythm.tums.ac.ir/index.php/jthc/article/download/2118/1252

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 21 1 2026 04 26 20 31 Rizki Hilman Department of Cardiology, Faculty of Medicine, Dr. Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia Adi Purnawarman Department of Cardiology, Faculty of Medicine, Dr. Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia Haris Munirwan Department of Cardiology, Faculty of Medicine, Dr. Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia Muhammad Ridwan Department of Cardiology, Faculty of Medicine, Dr. Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia Herlina Dimiati Department of Pediatric, Faculty of Medicine, Dr. Zainoel Abidin Hospital, Universitas Syiah Kuala, Banda Aceh, Indonesia 2025 12 26 2026 02 03 Background: Arrhythmia is a common and clinically significant complication during hospitalization for ST-segment elevation myocardial infarction (STEMI). This study aimed to identify factors associated with the occurrence of arrhythmia in the acute phase of STEMI. Methods: This single-center cross-sectional study was conducted among adult patients hospitalized with STEMI. Demographic and clinical variables, including cardiovascular risk factors and disease severity (Killip class, Thrombolysis in Myocardial Infarction [TIMI] score, and Global Registry of Acute Coronary Events [GRACE] score), were obtained from medical records. The primary outcome was in-hospital arrhythmia, defined as documented atrial or ventricular tachyarrhythmia or clinically significant bradyarrhythmia. Factors associated with arrhythmia were assessed using bivariate analyses followed by multivariable logistic regression. Results: This study involved 113 patients, with a mean age of 56.4 (11.1) years. Arrhythmia occurred in 26.5% (30 patients) during hospitalization. In bivariate analyses, arrhythmia was associated with higher Killip class (P<0.001), higher TIMI score (P=0.005), higher GRACE score (P=0.001), lower tricuspid annular plane systolic excursion (P=0.002), elevated serum potassium level (P=0.010), and impaired renal function, reflected by higher urea (P=0.005) and creatinine levels (P = 0.004). After multivariable adjustment, only Killip class remained independently associated with arrhythmia: patients presenting with Killip class I had a significantly lower risk of arrhythmia than those with higher Killip classes (adjusted OR, 0.404; 95% CI, 0.20 to 0.80; P=0.009). Conclusion: In hospitalized patients with STEMI, arrhythmic risk is chiefly driven by early clinical severity. Killip class is a simple bedside predictor of in-hospital arrhythmia and can aid early risk stratification and monitoring. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2417 https://rhythm.tums.ac.ir/index.php/jthc/article/download/2417/1242

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 21 1 2026 04 26 32 39 Ali Mirzaei Department of Pharmacology & Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran Maryam Mehrpooya Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran Akram Ranjbar Department of Pharmacology & Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran Sajad Naghdi Farshchian Cardiovascular Subspecialty Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran Afsaneh Familmotaghi Farshchian Cardiovascular Subspecialty Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran Seyed Saman Talebi Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Seyed Kianoosh Hosseini Department of Cardiology, School of Medicine, Farshchian Cardiovascular Subspecialty Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran 2025 07 26 2025 12 16 Background: Ischemic heart disease is the leading cause of death worldwide. Oxidative stress plays a key role in myocardial infarction (MI). Ferroptosis, a type of iron-dependent regulated cell death caused by lipid peroxide accumulation, has been identified as a key mechanism in ischemic injury. This study aimed to investigate the association between oxidative stress and ferroptosis in patients with non–ST-segment-elevation myocardial infarction (NSTEMI). Methods: In this case-control study, 25 patients with NSTEMI and 25 controls were included. In serum samples, cardiac markers (troponin I and CK-MB), oxidative stress biomarkers including lipid peroxidation (LPO), total antioxidant capacity (TAC), total thiol groups (TTG), superoxide dismutase (SOD) activity, glutathione peroxidase (GPx) activity, and iron and ferritin levels were measured. Results: In patients with NSTEMI, serum levels of cardiac markers (troponin I and CK-MB), LPO, iron, and ferritin were significantly higher than in controls. In contrast, TAC, TTG, and SOD and GPx activities were significantly lower in patients with NSTEMI. Conclusion: This study demonstrated a possible role of oxidative stress in the pathophysiology of NSTEMI. Elevated iron and LPO levels and reduced GPx activity may contribute to cardiac cell death through ferroptosis. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2319 https://rhythm.tums.ac.ir/index.php/jthc/article/download/2319/1243

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 21 1 2026 04 26 40 49 Fadhlan Rahman Citra Husada Jember Hospital Suryono Suryono Department of Cardiology and Vascular Medicine, Faculty of Medicine, Jember University, Jember, Indonesia; Dr. Soebandi General Hospital, Jember, Indonesia Aditha Maulana Department of Cardiology and Vascular Medicine, Faculty of Medicine, Jember University, Jember, Indonesia; Dr. Soebandi General Hospital, Jember, Indonesia Pipiet Wulandari Department of Cardiology and Vascular Medicine, Faculty of Medicine, Jember University, Jember, Indonesia; Dr. Soebandi General Hospital, Jember, Indonesia 2025 12 15 2026 02 02 Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with substantial morbidity and mortality. AF occurring in individuals without structural heart disease or conventional risk factors, currently referred to as AF without overt comorbidity, remains poorly understood. Genetic susceptibility is thought to contribute, but the underlying molecular mechanisms are incompletely defined. This study aimed to identify key genes and biological processes associated with AF without overt comorbidity using an in-silico bioinformatics approach. Methods: Genes associated with AF without overt comorbidity were retrieved from the GeneCards database using a knowledge-based, database-driven strategy. Functional enrichment analysis of Gene Ontology biological processes was performed using WebGestalt. Protein-protein interaction (PPI) analysis was conducted using STRING and visualized in Cytoscape. Hub genes were identified exclusively using the Density of Maximum Neighborhood Component (DMNC) algorithm via the CytoHubba plugin. Three-dimensional protein structures of selected hub genes were modeled using SWISS-MODEL and evaluated using PROCHECK for exploratory structural characterization. Results: Eighty-one genes associated with AF without overt comorbidity were identified. PPI analysis demonstrated significant interaction enrichment (P<1.0×10⁻¹⁶), indicating a nonrandom and biologically coherent network. Functional enrichment analysis revealed cardiac muscle cell action potential and cardiac muscle contraction as the most significantly enriched biological processes. Ten hub genes were identified based on DMNC ranking. Among these, GPD1L, SCN1B, SCN4B, and KCNE2 showed central network positions and acceptable stereochemical quality in exploratory structural evaluation. Conclusion: This in silico study identifies candidate genes and biological processes potentially involved in AF without overt comorbidity. The findings are hypothesis generating and warrant further functional and clinical validation. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2407 https://rhythm.tums.ac.ir/index.php/jthc/article/download/2407/1244

Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 21 1 2026 04 26 50 70 Mohammadsadegh Talebi Kahdouei Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Tehran, Iran, Islamic Republic Of Hosein Ghasempour Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Tehran, Iran, Islamic Republic Of Fatemeh Aghaei Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Tehran, Iran, Islamic Republic Of Elaheh Vafaei Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Tehran, Iran, Islamic Republic Of Behnaz Sohrabi School of Medicine, Isfahan University of Medical Science, Isfahan, Iran, Islamic Republic of Ehsan Aghaei Moghadam Fetal and Pediatric Cardiovascular Research Center, Children’s Medical Center, Tehran, Iran, Islamic Republic Of Negin Rahimidanesh School of Medicine, Islamic Azad University, Tehran Medical Branch, Tehran, Iran, Islamic Republic of, Ali Dahmarde Ei Department of General Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of Mojtaba Shurmij Department of General Surgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of 2025 11 17 2026 01 11 Background: Rheumatic heart disease (RHD) remains a major cause of preventable cardiovascular morbidity and mortality, particularly in low- and middle-income countries. Despite the World Health Organization’s 2018 resolution calling for global elimination of RHD, substantial disparities in disease burden persist across regions and levels of socio-economic development. While previous studies have reported global trends, a clear comparative assessment of long-term changes in both fatal and non-fatal RHD burden across socio-demographic and geographic regions remains limited. This study aimed to assess long-term