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Cardiovascular and Thoracic Research - Volume:4 Issue: 4, Oct 2012

Journal of Cardiovascular and Thoracic Research
Volume:4 Issue: 4, Oct 2012

  • تاریخ انتشار: 1391/10/09
  • تعداد عناوین: 7
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  • Hamed-Basir Ghafouri, Shahzad Saravani, .Farhad Shokraneh Pages 89-94
    Circulatory system disease raise third highest disability-adjusted life years among Iranians and ischemic cardiac diseases are main causes for such burden. Despite available evidences on risk factors of the disease, no effective intervention was implemented to control and prevent the disease. This paper non-systematically reviews available literature on the problem, solutions, and barriers of implementation of knowledge translation in Iran. It seems that there are ignored factors such as cultural and motivational issues in knowledge translation interventions but there are hopes for implementation of started projects and preparation of students as next generation of knowledge transferors.
    Keywords: Circulatory System Disease Knowledge Translation Evidence, Based Practice
  • Alireza Yaghoubi, . Jafar-Sadegh Tabrizi, . Mir-Mousa Mirinazhad, . Saber Azami Pages 95-101
    Introduction
    Cardiovascular diseases are always one of the major causes of mortality in the world affecting all aspects of patients’ lives. Therefore, this study was conducted to summarize and provide a clear view of quality of life in these patients in Iran through a systematic review on the results of previously conducted studies.
    Methods
    In a systematic review, required information was collected by searching keywords of Iran, quality of life, heart failure, cardiac, heart, and their Persian equivalents in databases of Science Direct, Pubmed, IRAN doc, SID, Medlib and Magiran. The selected time period for searching articles was since 2000 to 2012. Inclusion criteria were: releasing of article during 2000 to 2012, articles reporting patients’ quality of life in any domains of heart diseases, and articles published in Persian and English. Extracted results first were summarized in Extraction Table, and then analyzed manually.
    Results
    Finally 18 of 1592 found articles were included in the study. A total of 3,797 cardiac patients'' quality of life was measured using six different tools, the most important one of which was SF36 questionnaire. Among eight dimensions of SF36 questionnaire, the highest mean was for social role functioning with average score of 58.37 and the lowest for physical limitation (physical role functioning) with score of 42.95. Overall, mean of eight dimensions was 53.19. Among 4 general domains of quality of life, physical activity had the lowest average of 43.63 and average of general dimensions of quality of life was 47.65. The most important factors affecting quality of life were sex, age, education, marital status, occupational status, suffering duration, number of hospitalizations etc.
    Conclusion
    The results of the studies showed relatively low quality of life of cardiovascular patients in general. Therefore, according to the introduced effective factors in this study, it is necessary to consider regular programs for improving quality of life in these patients and providing suitable and qualitative services.
    Keywords: Cardiovascular Patients Quality of Life Systematic Review Study Iran
  • Laxman Dubey, Sanjib Kumar Sharma, Amit Kumar Chaurasia Pages 103-105
    Introduction
    Heart failure (HF) is a common cardiovascular condition whose incidence and prevalence are increasing. Being a common reason for urgent hospital admission, it is a major cause of morbidity and mortality for the patients. In the developed countries coronary artery disease remains the leading cause of HF, whereas, in the underdeveloped countries, rheumatic heart disease leading to valvular lesion still remains the commonest causes of HF admission. The current study was designed to evaluate the clinical profile and medications prescribed reflecting the extent to which evidence based medicine is being practiced at our community.
    Methods
    Clinical profile and prescribed medications of patients with diagnosis of HF who were admitted in the cardiology department of College of Medical Sciences & Teaching Hospital (CMSTH), Bharatpur, Nepal, April 2010 to May 2012, were analyzed. A total of 255 patients presented with HF during the studied period were included.
    Results
    Coronary artery disease, rheumatic heart disease, dilated cardiomyopathy, hypertensive heart failure, cor-pulmonale, and congenital heart disease leading to HF were found in 93 (36.5%), 65 (25.5%), 37 (14.5%), 22 (8.6%), 31 (12.2%),and 7 (2.7%) patients respectively. The commonest presenting symptom was shortness of breath (81%) and the commonest sign was bilateral basal crepitations (68%). From all patients, 89%, 64%, 51%, 16%, 48%, and 32% received loop diuretics, angiotensin-converting enzyme inhibitor, digoxin, angiotensin receptor blocker, spironolactone, and beta-blocking agents respectively.
    Conclusion
    Coronary artery disease leading to HF was the commonest cause of HF admission in our centre. Despite current guidelines suggesting the use of beta-blocking agent in patients with HF, only 32% of our patients received this class of medications. Thus, many patients were not being managed fully in accordance with the evidencebased guidelines.
    Keywords: Heart Failure Clinical Profile Medications Hospitalization
  • Nader Tavakoli, Ali Bidari, Samad Shams Vahdati Pages 107-111
    Introduction
    Out-of-hospital cardiac arrest (OHCA) is the most stressful lifetime event for the victims and an important issue for the emergency physicians. The status of the hypothalamic pituitary- adrenal axis (HPA) function in successfully resuscitated victims of cardiopulmonary arrest has been recently of an interest for the researchers.
    Methods
    In a prospective cohort study, 50 successfully resuscitated OHCA victims’ serum cortisol levels were measured 5 minutes and 1 hour after return of spontaneous circulation (ROSC). The data were analyzed comparing the one-week neurologic survival.
    Results
    Fifty blood samples were obtained for serum cortisol levels after 5 minutes of ROSC. Fourteen patients (28%) pronounced death during one hour after CPR. Blood sample from living 36 patients after one hour post-CPR were obtained for second cortisol assay. Eleven patients (22%) were neurologically survived after one week. Seven patients (14%) were discharged finally from hospital with good neurologic recovery. The serum cortisol levels in both the neurologically surviving and the nonsurviving after 5 minutes of ROSC patients were 63.4 ±13.6 and 43.2±25.5(microg/ml), (mean±S.D., respectively) and after 1 hour of ROSC patients’ serum cortisol levels were 64.9±13.1 and 47.3±27.1(microg/ml), (mean±S.D., respectively). The difference was significantly higher in neurologically survived group in both 5 minutes and 1 hour after ROSC (P= 0.015 and 0.013 respectively).
    Conclusion
    serum cortisol levels after 5 minutes and one hour of ROSC in victims of cardiopulmonary arrest are significantly higher in neurologically survived than non-survived patients.
    Keywords: Cardiopulmonary Arrest Cortisol Level Neurologic Outcome
  • Ebadollah Heidari, Sanaz Nematzadeh Pakdel, Jahanbakhsh Samadikhah, Rasoul Azarfarin Pages 113-117
    Introduction
    Diabetes mellitus (DM) is associated with serious complications including macro- and microvascular problems such as diabetic retinopathy. Coronary involvement in diabetic patients is believed to be a consequence of microvascular complications. However, the available data are inconclusive and scarce. This study aimed to evaluate the probable association between diabetic retinopathy and left ventricular dysfunction in diabetic patients with unstable angina (UA).
    Methods
    In this cross-sectional study, 200 diabetic patients with UA (100 cases with diabetic retinopathy and 100 cases without diabetic retinopathy) were enrolled in a teaching hospital. Left ventricular ejection fraction (LVEF) as well as the frequency of cases with left ventricular dysfunction (LVEF<50%) were compared between the two groups and different degrees of diabetic retinopathy (proliferative and non-proliferative).
    Results
    Patients’ demographic variables were comparable between the two groups. Mean diagnosis time of DM was significantly higher in the patients with diabetic retinopathy (8.40±6.60 vs. 3.81±3.58 years; P<0.001). Mean LVEF was significantly lower in the retinopathy group (50.50±6.91% vs. 53.07±4.87%; P=0.003). Frequency of cases with left ventricular dysfunction was significantly higher in the group with diabetic retinopathy (31% vs. 12%; P=0.001, OR=3.33, 95%CI: 1.58-7.14). The frequency of cases with left ventricular dysfunction was significantly yet independently higher in patients with proliferative vs. non-proliferative diabetic retinopathy.
    Conclusion
    Left ventricular dysfunction is more common in diabetic patients with unstable angina and diabetic retinopathy compared with their counterparts without diabetic retinopathy.
    Keywords: Unstable Angina Diabetic Retinopathy Left Ventricular Ejection Fraction
  • Bc Srinivas, . Ajit Pal Singh Pages 119-122
    Thrombosis of Inferior Vena Cava (IVC) following filter insertion can occur in up to 30% of the cases. The optimal management of such cases is unknown. We describe a simple and less expensive method of achieving successful recanalization of the IVC in a 40 year old hypertensive man who developed recurrent pulmonary embolism after his orthopedic treatment. An IVC filter was inserted, which developed extensive thrombosis of the whole IVC and venous system of the lower limbs. Catheter directed thrombolysis using a multiple side-hole multipurpose catheter and balloon angioplasty was carried out in order to “crush and lyse” the IVC thrombi.
    Keywords: Inferior Vena Cava IVC Filter Thrombosis Catheter Directed Thrombolysis Balloon Angioplasty
  • Zahra Ojaghi Haghigh, Anita Sadeghpour, Azin Alizadehasl Pages 123-124
    Partial anomalous pulmonary venous connection (PAPVC) is a very rare congenital heart disease where one or more of the pulmonary veins are connected to the venous circulation. Although initially suspected with inexplicable right ventricular enlargement on transthoracic echocardiography, other modalities such as transesophageal echocardiography, CT angiography or cardiac Magnetic resonance (CMR) imaging are able to diagnosis the anatomical abnormalities. We present a 29-year-old female with moderate right ventricular enlargement and isolated right upper and middle pulmonary vein anomalous return to superior vena cava.
    Keywords: PAPVC Right Ventricular Atrial Septal Defect