فهرست مطالب
Iranian Heart Journal
Volume:19 Issue: 1, Spring 2018
- تاریخ انتشار: 1397/02/11
- تعداد عناوین: 8
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Pages 6-14BackgroundPsychosocial risk factors have been associated with coronary heart disease (CHD). Social support within couples relationships has been shown to be important to health outcomes and adjustment to psychological and physical conditions in patients with CHD. Constructive interactions with the familyespecially within couples can reduce the level of perceived stress, increase perceived social support, and affect experienced emotions.MethodThis research had a pretest-posttest experimental design with 2 experimental groups and 1 control group. A sample of 45 subjects was chosen through random sampling among CHD patients at Rajaie Cardiovascular, Medical, and Research Center. The study population was then divided into 2 experimental groups and 1 control group. The measurement tools of the study were Cohens Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Emotion Regulation Questionnaire (Gross & John), and Communication Pattern Questionnaire. The data were analyzed through multivariate analysis of covariance and stepwise regression analysis.ResultsThe findings of the study indicated that metacognitive therapy and mindfulness-based cognitive therapy had an effect on the reduction of perceived stress, increase of perceived social support, and improvement of emotion regulation and couple communication patterns among the CHD patients.ConclusionsThe results of the present study can help achieve the objective of reducing stress, augmenting social support, enhancing emotion regulation and couple communication patterns, andin generalimproving mental condition. (Iranian Heart Journal 2018; 19(1):6-14)Keywords: Metacognitive therapy, Mindfulness, Couple communication pattern, Perceived stress, Perceived social support, Emotion regulation, Coronary heart disease
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Pages 15-20BackgroundTissue iron deposition is an important adverse effect in patients with major thalassemia, leading to right-sided heart failure.
This study was performed to determine the association between cardiovascular magnetic resonance using T2-weighted sequences (CMR T2) and advanced echocardiographic right ventricular (RV) function criteria in patients with major thalassemia at Rajaie Cardiovascular, Medical, and Research Center in 2014 and 2015.MethodThis comparative study assessed the association between CMR T2 and advanced echocardiographic RV function criteria in 38 patients with major thalassemia at Rajaie Cardiovascular, Medical, and Research Center in 2014 and 2015.ResultsCMR T2 was correlated with the RV E/E (echo) (P = 0.0001, r = -0.681), TAPSE (echo) (P = 0.001, r = 0.504), RVEDV (CMR) (P = 0.008, r = 0.425), and RVEDV/BSA (CMR) (P = 0.005, r = 0.443) according to the Spearman test. Additionally, CMR T2 was associated with the basal RV Sm (echo) (P = 0.0001, r = 0.626), RV strain (echo) (P = 0.034, r = 0.382), RVEDV/H (CMR) (P = 0.002, r = 0.483), LVEDV (CMR) (P = 0.022, r = 0.372), and LVEDV/H (CMR) (P = 0.017, r = 0.385) according to the Pearson test.ConclusionsTotally, according to the obtained results, it may be concluded that the RV E/E, TAPSE, basal RV Sm, and RV strain echocardiography and the RVEDV, RVEDV/BSA, RVEDV/H, LVEDV, and LVEDV/H CMR may be indicators of myocardial iron overload in patients with major thalassemia. (Iranian Heart Journal 2018; 19(1):15-20)Keywords: CMR T2, Advanced right ventricular function, Major thalassemia -
Pages 21-29BackgroundCardiovascular diseases are a major cause of death in both men and women around the world. Studies have shown that hypertriglyceridemia is an important risk factor for such diseases. While triglyceride levels after a meal increase, the relationship between postprandial triglyceride levels and the severity of coronary artery disease is still unproven. This study aimed to determine the plasma levels of triglyceride after a meal in patients with different types of coronary heart disease.MethodIn this epidemiological study, 416 patients among those referred to Golestan Hospital in Ahvaz were ed based on the results of angiography and were classified to type 1 to 4 groups comprising 69, 99, 83, and 165 individuals respectively, and their age and sex were recorded. all the individuals, a blood sample was taken 2 hours after a meal. The data were analyzed using the Tukey test.ResultsThe mean age of the patients was 58.4 years. There was only a significant difference between the patients with type 1 (normal patients) and those with type 4 (with severe coronary artery disease) (142 ± 67.1 mg/dL vs 188 ± 99.3 mg/dL; P 0.05).ConclusionsThe results showed that the mean triglyceride serum level after a meal in our patients with severe coronary artery disease (type 4) was higher than that in the other groups. Hypertriglyceridemia after a meal may be a major factor in coronary heart disease. (Iranian Heart Journal 2018; 19(1):21-29)Keywords: Triglyceride, Nonfasting, Coronary artery disease, Angiography
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Pages 30-36BackgroundCoronary computed tomography angiography (CCTA) is a noninvasive imaging method with a high diagnostic value and minimal complications for evaluating coronary arteries. Therefore, in cases with low and moderate probabilities of coronary artery disease, CCTA can be a good alternative to conventional coronary angiography (CCA). Previous studies with 64- slice CTA have tried to determine its diagnostic accuracy compared with CCA as the gold standard. In this survey, we compared the results of 256-slice CCTA with CTA.MethodThe present cross-sectional descriptive study evaluated 53 patients (36 men) undergoing CCTA and then CCA (except for 4 patients with pervious CCAs). Our primary goal was to compare the 2 imaging methods for the evaluation of coronary lesions and their runoff.ResultsIn the coronary artery bypass graft group, the diagnostic accuracy of CCTA for the arterial graft lesions (left internal mammary artery to left anterior descending) had 72.73% sensitivity, 100% specificity, 100% positive predictive value, and 84.2% negative predictive value and its diagnostic accuracy for the venous graft lesions had 100% sensitivity, 80% to 100% specificity, 80% to 100% positive predictive value, and 66.4% to 100% negative predictive value. Apropos runoff (adequacy of perfusion), CCTA had 100% sensitivity, 63.64% specificity, 80% positive predictive value, and 100% negative predictive value in the arterial grafts and 54% to 100% sensitivity and 100% specificity in the venous grafts. In the percutaneous coronary intervention group, CCTA had 90% specificity, and 75% positive predictive value, and 0% negative predictive value in the differentiation of significant nonsignificant in-stent restenoses.ConclusionsThe diagnostic accuracy of CCTA in determining the severity of arterial graft stenoses and their runoff was similar to that reported in previous studies with 64-slice CTA. Strikingly, CCTA had low sensitivity for significant in-stent restenosis. (Iranian Heart Journal 2018; 19(1):30-36)Keywords: Coronary CT angiography, Conventional coronary angiography
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Pages 37-43BackgroundProviding and maintaining normovolemic condition during major surgeries is a major challenge, especially in children. In this respect, third-generation hydroxyethyl starches seem to be more cost-effective than human albumin. However, the efficacy of 6% hydroxyethyl starch (HES) 130/0.4 compared to other alternatives such as human albumin 5% remains uncertain in children. The present study aimed to assess the efficacy and safety of replacing human albumin 5% with 6% HES 130/0.4 for volume replacement therapy in children undergoing ive open cardiac surgery.MethodThis randomized double-blinded clinical trial was performed on 59 children aged less than 2 years and ASA I-III who were candidated for ive open-heart surgery and referred to a children medical center in 2014. The patients were randomly assigned via the block randomization method to the case group (n = 30) receiving a solution of 6% HES 130/0.4 and the control group (n = 29) receiving 5% human albumin. There were no between-group differences in hemodynamic parametersincluding pulse rate, systolic and diastolic blood pressures, and mean blood pressureat the time points of before anesthesia induction, before and after pump ion, and 24 hours after surgery.ResultsComparisons of the laboratory indices indicated no differences between the 2 groups at the different time points. The volume of packed cell and colloid fluids infused in the case and control group was also similar.ConclusionsCompared to human albumin 5%, 6% HES 130/0.4 is a safe alternative to fluid supply during cardiac surgery among children. (Iranian Heart Journal 2018; 19(1):37-43)Keywords: Hydroxyethyl, Human albumin, Pediatric open, heart surgery
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Pages 44-51BackgroundCoronary artery bypass graft surgery (CABG) is a common surgical operation usually performed under cardiopulmonary bypass. Although the relationship between the transfusion of blood products during and after surgery with the incidence of arrhythmia has been studied, contradictory results have been achieved. In the current study, we investigated the correlation between blood products transfusion during and after surgery with the incidence of postoperative arrhythmia.MethodPatients candidated for CABG were entered into the present cross-sectional study. The incidence of arrhythmia (supraventricular and ventricular, transient or permanent), history of medications and renal diseases, and transfusion of blood products during or after the operation were recorded and analyzed.ResultsTwenty-two (8.2%) patients experienced atrial fibrillation and 50 (18.7%) experienced premature ventricular contractions. The use of packed red blood cells in the operating room was inversely correlated with the odds of the incidence of at least one of the arrhythmias (OR = 0.5, 95% CI: 0.28 to 0.87; P = 0.015). The number of grafts, high blood pressure, duration of mechanical ventilation in the ICU, and the potassium level upon admission to the ICU were directly correlated with the incidence of arrhythmia. Moreover, the transfusion of platelets in the ICU and the use of cryoprecipitate in the operating room were inversely correlated with the incidence of atrial fibrillation (not all arrhythmias).ConclusionsAccording to the findings of the present study, conditionings to maintain the normal hematocrit level and platelet count is associated with decreased odds of arrhythmia incidence during and after CABG. (Iranian Heart Journal 2018; 19(1):44-51)Keywords: Blood transfusion, Coronary artery bypass grafting, Postoperative arrhythmia, Transfusion
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Pages 52-60BackgroundComprehensive cardiac rehabilitation programs constitute a treatment method in patients with coronary artery disease and can prolong patients lifespan and reduce the frequency of readmission. The present study aimed to determine the effects of changes in myocardial dysfunction on quality of life after cardiac rehabilitation.MethodThe present interventional case-control study randomly assigned patients with coronary artery disease undergoing percutaneous coronary intervention to a case group (n = 40) and a control group (n = 40). A demographic questionnaire, the Beck Depression Inventory (BDI), the Baecke Physical Activity Inventory, and the MacNew Quality of Life Questionnaire were completed for all the patients before and after the study. Echocardiography and laboratory tests were also conducted. The case group underwent the cardiac rehabilitation program. The data collected were analyzed in SPSS 21 using measures of the independent and paired t-test, as well as the χ2 test.ResultsThe mean age of the study patients was 57.71 years. Moreover, 92.5% of the patients were male in both groups. The 2 groups were matched in terms of demographic characteristics. Cholesterol, fasting blood sugar, and smoking status were found to show statistically significant differences in the case and control groups after the intervention compared to before the intervention, as the difference in the mean scores of myocardial dysfunction was statistically insignificant at both time points. The intervention also improved the quality of life of the participants in the emotional, physical, and social dimensions (PConclusionsCardiac rehabilitation programs are recommended with a view to improving quality of life in patients undergoing coronary angioplasty. (Iranian Heart Journal 2018; 19(1):52-60)Keywords: Cardiac rehabilitation, Quality of life, Myocardial dysfunction, Coronary angioplasty
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Pages 61-67BackgroundsMyocardial phosphodiesterase 5 (PDE5) inhibitors are documented for use in various disease states. The efficacy of PDE5 inhibitors is less determined in heart failure patients without pulmonary hypertension. The aim of the present study was to evaluate the efficacy of PDE5 inhibitors in heart failure patients without pulmonary hypertension.MethodSeventy-six cases with heart failure were participated in this study. The ion criteria were systolic heart failure according to the New York Heart Association (NYHA) functional classifications I and IV, echocardiographically determined left ventricular ejection fraction less than 50%, and stability for at least 3 months. The participants were randomly divided into case and control groups. Both case and control groups received 50 mg of sildenafil and a placebo for 3 months, respectively. Transthoracic echocardiography (TTE) was performed using the Vingmed 800 CSF. All the ejection fraction measurements were done using the Simpson method. Before the initiation of the trial and then 3 months afterward, TTE was obtained the participants. Changes in the functional class and the left ventricular ejection fraction before and after the trial were assessed and the data were analyzed using SPSS, version 16.ResultsIn the case group, the ejection fraction after the trial with an average of 41.53 ± 7.53 was considerably more significant than that before the trial with an average of 37.92 ± 6.92 (PKeywords: Heart failure, Left ventricular ejection fraction, PDE5I