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Iranian Heart Journal - Volume:18 Issue: 4, winter 2017

Iranian Heart Journal
Volume:18 Issue: 4, winter 2017

  • تاریخ انتشار: 1396/11/11
  • تعداد عناوین: 7
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  • Reza Kiani, Mohammad Javad Alemzadeh-Ansari, Hamid Reza Sanati *, Reza Hashemi, Ata Firouzi, Farshad Shakerian, Ali Zahedmehr, Mohammad Mehdi Peighambari, Safar Ali Abdolrahimi Pages 6-11
    Background
    Facilitating radial artery cannulation is important among patients undergoing cardiac catheterization. The aim of this study was to evaluate the efficacy of periarterial injections of nitroglycerin by inexperienced operators in facilitating radial artery cannulation.
    Method
    This randomized clinical trial study was conducted on patients who underwent transradial cardiac catheterization for coronary artery disease evaluation. The patients were randomly divided into 2 groups: Group I was the control and Group II received an additional 500 μG of nitroglycerin subcutaneously. The procedure was done by cardiologists trained for the fellowship of interventional cardiology (inexperienced operators). All the participants were monitored for the occurrence of radial artery spasm, number of punctures before successful cannulation, and the radial artery access time.
    Results
    After the exclusion of 16 patients, 144 patients (118 men and 26 women) at an average age of 55.7 ± 10.2 years were randomly divided into 2 groups: Group I (control, n = 73) and Group II (n = 71). The number of punctures before cannulation was markedly lower in Group II than in the control group (1.9 ± 0.64 vs 2.2 ± 1.04; P = 0.045). The radial artery access time was shorter and radial artery spasm was less prevalent in Group II, but these parameters were not statistically significantly different between the 2 groups.
    Conclusions
    Periarterial injections of nitroglycerin (500 μG subcutaneously) by inexperienced operators significantly reduced the number of punctures during transradial cardiac catheterization. (Iranian Heart Journal 2017; 18(4):6-11)
    Keywords: Nitroglycerin, Radial artery, Angiography
  • Afshin Amirpour *, Reihane Zavar, Ali Ramezani Nejad Pages 12-20
    Background
    Atherosclerosis is one of the major causes of cardiovascular mortality. Inflammation has been proven to have a role in this process, and inflammatory markers can predict the prognosis of atherosclerotic events such as acute coronary syndrome and ST-elevation myocardial infarction.
    Method
    We sought to assess the prognostic value of the blood cell count and its components— platelets, C-reactive protein, cholesterol, triglycerides, creatinine, and troponin—in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.
    Results
    Significant prognostic values were found for the neutrophil count, platelet count, fasting blood sugar, cholesterol, triglycerides, low-density lipoprotein, creatinine, and C-reactive protein.
    Conclusions
    The platelet-to-lymphocyte ratio had prognostic value for predicting reflow after primary percutaneous coronary intervention. Nevertheless, C-reactive protein, platelet count, fasting blood sugar, cholesterol, triglycerides, low-density lipoprotein, and creatinine were more valuable in terms of predicting the outcome of percutaneous coronary intervention in patients with ST-elevation myocardial infarction. (Iranian Heart Journal 2017; 18(4):12-20)
    Keywords: Platelet, Lymphocyte, No, reflow, STEMI, TIMI
  • Farshad Shakerian, Hamid-Reza Sanati, Hosein Hoseinzadeh, Ata Firouzi, Ali Zahedmehr, Reza Kiani, Mahdieh Doaee, Akbar Nikpajouh * Pages 21-28
    Background
    Large numbers of patients are faced with mechanical complications after myocardial infarction (MI). Such complications occur when the patient does not receive immediate treatment, leading to adverse consequences and even death. The present study was conducted to determine the short- and long-term prognoses of this group of mechanical complications.
    Method
    The present case-series study recruited all patients (N = 88) who had a diagnosis of cardiac mechanical complications following acute MI at Rajaie Cardiovascular, Medical, and Research Center between 2005 and 2011. The short-term prognosis of the study population was recorded before discharge (hospital mortality rate), and the patients were followed up 6 months later through phone calls. The results and 6 months’ prognosis—including mortality, survival rate, and hospitalization—were recorded again.
    Results
    The mean age of the study population was 70.50 ± 10.23 years (31–95 y) and 46.6% were male. The most common complications were apical ventricular septal rupture (VSR) (67.1%), ventricular free-wall rupture (14.8%), basal VSR (7.9%), pseudoaneurysm (4.5%), VSR with pseudoaneurysm (3.4%), and papillary muscle rupture (2.3%)–respectively. The rate of death caused by mechanical complications was 4.61%. The rate of re-hospitalization was 6.8%. In this study, 36.3% of the patients died after reconstructive surgery and 34.1% of them died after medical treatment in the hospital. The 6-month survival rate of the patients was 34.1%.
    Conclusions
    The mechanical complications of the heart occur mainly in women and older patients. In this regard, apical VSR and ventricular free-wall rupture are the most common complications. However, in the case of timely medical interventions such as reconstructive surgery, the survival rate improves significantly. (Iranian Heart Journal 2017; 18(4):21-28)
    Keywords: Myocardial infarction, Angiography, Echocardiography, Ventricular septal rupture, Coronary angiography
  • Mohsen Ziyaeifard, Rasoul Azarfarin, Zahra Faritous *, Ehsan Dehdashtian, Amir Baghestani, Parisa Ziyaeifard, Zeynab Yousefi Pages 29-33
    Background
    Hemodynamic changes are among the side effects of diagnostic cardiovascular procedures. Hypothesizing that the anxiolytic effects of lavender oil inhalation could alleviate anxiety among patients undergoing diagnostic cardiovascular modalities, we conducted the present study on patients undergoing coronary angiography with the aim of assessing the effects of lavender oil inhalation on hemodynamic changes.
    Method
    This clinical trial enrolled 80 patients hospitalized for coronary angiography. The patients were randomly divided into 2 groups: the lavender group (n = 40), who inhaled lavender oil during angiography, and the control group (n = 40), who received only 1 mg of lorazepam on the night before the procedure (similar to the lavender group). Demographic data and hemodynamic variables (blood pressure and heart rate) were recorded in all the patients before and after lavender oil aromatherapy.
    Results
    Demographic parameters had no statistically significant differences between the 2 groups (P > 0.05). After lavender oil aromatherapy, hemodynamic parameters such as systolic and diastolic blood pressures and heart rate were significantly reduced (within normal ranges) in the intervention group by comparison with the control group (P ≤ 0.05).
    Conclusions
    By reducing the stress response, lavender oil inhalation had efficacy in controlling blood pressure and heart rate in our patients undergoing coronary angiography. (Iranian Heart Journal 2017; 18(4):29-33)
    Keywords: Lavender oil, Anti, anxiety agents, Hemodynamics, Coronary angiography
  • Atoosa Mostafavi, Leila Aliabadi, Khosro Sadeghniyat, S. A. Hussein Tabatabaei * Pages 34-41
    Background
    The risk of cardiovascular diseases is known to be increased in obstructive sleep apnea (OSA), the mechanism of which can be explained by the observation that the sympathetic tone increases during sleep due to repetitive apnea accompanied by hypoxia and arousal. Heart rate variability (HRV) represents the cardiac autonomic function and is mediated by respiratory sinus arrhythmia, baroreflex-related fluctuation, and thermoregulation-related fluctuation. The aim of the present study was to determine whether treatment by continuous positive airway pressure (CPAP) or O2 could produce significant changes in HRV, especially in the time domain of HRV (SDNNs and RMSSDs), in patients with OSA.
    Method
    Fifty-seven patients with OSA were participated in the current single-center randomized parallel-group clinical trial study. The patients were randomly divided into 2 groups: the CPAP group and the O2 therapy group. Before treatment, the apnea-hypopnea index (AHI) was measured by polysomnography in each patient. HRV was assessed via 24-hour Holter monitoring, before and after 2 weeks of CPAP titration or O2 therapy, and subsequently compared between the 2 groups. The Wilcoxon test and the T-test were used for the statistical analyses.
    Results
    Our results demonstrated a reduction in the nocturnal SDNNs (P
    Conclusions
    Our findings demonstrated that CPAP was an effective treatment in comparison with O2 therapy in improving HRV in our patients with OSA. Furthermore, correction of hypoxia by using nocturnal O2 therapy was not sufficient to improve HRV indices. (Iranian Heart Journal 2017; 18(4):34-41)
    Keywords: Obstructive sleep apnea, Heart rate variability, SDNNs, RMSSDs, CPAP, Oxygen therapy
  • Zahra Faritous, Somayeh Madadipoor, Behshid Ghadrdoost, Evaz Heidarpour, Maryam Moradian, Mohsen Ziyaeifard * Pages 42-47
    Background
    Recovery anesthesia may be defined as a state of the patient’s consciousness that consists of awareness of surroundings and identity. Prompt recovery of consciousness anesthesia is essential for the evaluation of central nervous system dysfunction after cardiac surgery. The present study aimed to investigate the factors associated with recovery of consciousness following cardiac surgery.
    Method
    In this study, 665 patients who underwent cardiac surgery were enrolled. Patient and surgery- related factors were collected through data sheets. Univariate and multivariable logistic regression models were used to identify factors related to prolonged recovery of consciousness.
    Results
    The mean age of all the patients was 55.74 ± 13.85 years, and most of the patients were male (61.8%). There were significant associations between recovery of consciousness time and age (P = 0.001), neurological diseases (P = 0.001), respiratory diseases (P = 0.001), history of cerebrovascular accident (P
    Conclusions
    This study showed that old age, cigarette smoking, diabetes mellitus, longer pump time, longer intubation time, and history of cerebrovascular accident were risk factors for prolonged recovery of consciousness after cardiac surgery. These findings provide valuable information for effective patient care and anesthetic management after cardiac surgery. (Iranian Heart Journal 2017; 18(4):42-47)
    Keywords: Recovery of consciousness, General anesthesia, Cardiac surgery
  • Behshad Naghshtabrizi, Nasrin Matinnia *, Ali Ghaleiha, Manoochehr Karami, Vida Faramarzi Pages 48-54
    Background
    Choosing unsuitable therapeutic methods affects patients’ quality of life. The present study aimed to compare quality of life between patients treated with coronary artery bypass graft surgery (CABG) and those treated with percutaneous coronary intervention (PCI).
    Method
    This cohort study sought to assess quality of life in 290 patients with 3-vessel or left main coronary artery disease, who were referred to Ekbatan Hospital, Hamedan, Iran, to undergo either CABG or PCI. Health-related quality of life was investigated at baseline and subsequently at 6 and 12 months postprocedurally with the 36-Item Short-Form Health Survey (SF-36). The patients’ quality of life was evaluated based on a scoring system 0 to 100, with higher scores representing a better health status. The primary outcomes were the physical component summary and mental component summary scores the SF-36.
    Results
    The study results revealed a significant difference between the 2 groups regarding physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role- emotional, and mental health at baseline as well as at 6 and 12 months after the procedures (P 0.05).
    Conclusions
    Our investigation of quality of life in the CABG and PCI groups using the SF-36 questionnaire revealed that quality of life was better in the PCI group.(Iranian Heart Journal 2017; 18(4):48-54)
    Keywords: Quality of life, Coronary artery bypass graft, Percutaneous coronary intervention