Khaheshi, Isa
International Journal of Cardiovascular Practice

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Syncope during pregnancy in a patient with permanent cardiac pacemaker, due to increased pacing threshold. Akbarzadeh, Mohammad Ali; Safi, Morteza; Khaheshi, Isa; Bahrololoumi Bafruee, Negar
International Journal of Cardiovascular Practice Vol 1, No 2 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.449 KB) | DOI: 10.21859/ijcp-010207

Abstract

A 22-year-old pregnant woman referred with syncope due to pacemaker malfunction. During the second trimester of pregnancy, the right ventricular (RV) lead pacing threshold increased and led to early generator depletion. We believe that this might happen due to lead micro-dislodgement or less probably effect of hormonal changes during pregnancy on electrode-myocardium interface.
Pulmonary Hypertension and Its Determinants in β-thalassemia Major and Intermedia Considering Left Ventricular Functional State Farahani, Behzad; Fadaii, Abbas; Khaheshi, Isa; Baktash, Forooz; Abbasi, Mohammad Amin; Mohammadi, Ronak; Paydary, Koosha
International Journal of Cardiovascular Practice Vol 1, No 1 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.68 KB) | DOI: 10.20286/ijcp-010107

Abstract

Introduction: Pulmonary hypertension (PHT) is a common complication in β-thalassemia. We aimed to determine the prevalence of PHT and its main indicators in patients with β thalassemia Major (TM) and β-thalassemia Intermedia (TI), considering left ventricular function.Methods: Pulmonary hypertension (PHT) is a common complication in β-thalassemia. We aimed to determine the prevalence of PHT and its main indicators in patients with β thalassemia Major (TM) and β-thalassemia Intermedia (TI), considering left ventricular function.Results: The overall prevalence of PHT in TM and TI group was estimated to be 35.2% and 29.3%, respectively; while reduced LVEF was evident in 22.7% and 10.1% of patients with TM and TI, respectively. No significant correlation was observed between mean PAP and LVEF in the patients with TI (Pearson coefficient = -0.096, P value = 0.345); while, an adverse association was revealed between mean PAP and LVEF in patients with TM (Pearson coefficient = -0.227, P value = 0.033). Upon univariate analysis, the only significant association was observed between LVEF and pulmonary hypertension among TM patients (P value = 0.001).Our results did not indicate that male gender and aging may affect the development of PHT.Conclusions: According to our findings, a considerable proportion of patients with TM and TI may have PHT. We detected an adverse association between mean PAP and LVEF in patients with TM. Left ventricular function was reduced in patients with PHT among TM group.
The Correlation between Serum Level of N-Terminal Pro-B-type Natriuretic Peptide and Gensini Score in Patients with Acute Coronary Syndrome Namazi, Mohammad Hassan; Vakili, Hossein; Charkhkar, Mahsa; Gachkar, Latif; Khaheshi, Isa
International Journal of Cardiovascular Practice Vol 1, No 2 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (657.629 KB) | DOI: 10.20286/ijcp-010205

Abstract

Introduction: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has emerged as an important biomarker for developing the diagnosis and prognosis of cardiovascular diseases, as several studies have shown that serum levels of NT-proBNP elevate in acute coronary syndrome (ACS) and coronary artery disease (CAD). We performed this study to find any possible correlation between serum levels of NT-proBNP and Gensini score in patients diagnosed with ACS.Methods: In a cross-sectional study, 100 consecutive patients with ACS who were candidates of angiography were recruited and their serum levels of NT-proBNP, Gensini scores, lipid profiles and troponin I levels were measured.Results: Sixty six male and 34 female patients with a mean age of 57.5 years, including 44 with unstable angina, 33 with ST-elevation myocardial infarction, and 23 with non-ST-elevation myocardial infarction were enrolled. The mean serum NT-proBNP level and the Gensini score were 1987.16 pg/mL (17.9-8841) and 31.09 (6-92.5), respectively. The serum NT-proBNP levels and Gensini scores were significantly correlated with a Spearman correlation coefficient of 0.953 (P < 0.001). Serum levels of NT-proBNP were not different in patients with single-vessel disease, 2-vessel disease and 3-vessel disease (P = 0.257). NT-Pro-BNP levels were also correlated positively with troponin I levels (correlation coefficient = 0.779) and negatively with left ventricular ejection fraction (correlation coefficient = -0.55). Smoker patients had higher NT-proBNP levels (P = 0.047). Neither Gensini scores nor NT-Pro-BNP levels had significant correlation with lipid profile or blood sugar.Conclusions: NT-proBNP is directly correlated with Gensini score in patients with ACS and might be used as an important marker for risk stratification in those patients.
Cardiac failure secondary to hypocalcemia Namazi, Mohammad Hasan; Khaheshi, Isa; Charkhkar, Mahsa; Esmaeeli, Shooka; Haybar, Habib
International Journal of Cardiovascular Practice Vol 1, No 3 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (678.646 KB) | DOI: 10.21859/ijcp-010304

Abstract

Hypocalcemic cardiomyopathy due to hypoparathyroidism is a very atypical and rare circumstance, which is usually intractable to conventional therapy for cardiac failure, but responds satisfactorily to restoration of normocalcemia.We describe a young woman who developed clinical signs of hypocalcemia due to hypoparathyroidism, reduced left ventricular ejection fraction and polymorphic ventricular tachycardia as consequences of hypocalcemia.This case underscores the importance of biochemical abnormalities like hypocalcemia as a rare cause of secondary cardiomyopathy and emphasizes on the need for effective and immediate treatment of hypocalcemia and its related causes.
Value of Admission HbA1c Level in Non-diabetic Patients With Unstable Angina Alipour Parsa, Saeed; Khaheshi, Isa; Parsa Mahjoob, Mohammad; Akbarzadeh, Mohammad Ali; Esmaeeli, Shooka
International Journal of Cardiovascular Practice Vol 1, No 1 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.211 KB) | DOI: 10.20286/ijcp-010103

Abstract

Introduction: There have been incompatible evidences about the prognostic value of HbA1c on the adverse outcomes in acute coronary syndrome. Also, these data are so limited in nondiabetic patients with unstable angina.Methods: In this cross-sectional study, HbA1c level of 231 nondiabetic patients admitted with unstable angina, was measured using high performance liquid affinity chromatography (HPLC) at admission. Then transthoracic echocardiography (TTE) was performed for evaluation of ejection fraction (EF) using Simpson method.Results: Our data revealed that HbA1c was significantly higher in patients with EF≤ 50% in comparison with EF>50% group (P value=0.01).Conclusions: HbA1c may be a helpful prognostic marker in nondiabetic patients admitted in emergency department with diagnosis of unstable angina.
The Effect of Hyperuricemia on the Rate of Contrast-Induced Nephropathy in Patients with Coronary Angiography Vakili, Hossein; Chaghazardi, Sara; Khaheshi, Isa; Naderian, Mohammadreza
International Journal of Cardiovascular Practice Vol 1, No 3 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (150.198 KB) | DOI: 10.21859/ijcp-010305

Abstract

Introduction: There is little information about the relationship between hyperuricemia and contrast induced nephropathy. The present study aimed to evaluate the relationship between hyperuricemia and contrast induced nephropathy among patients, who had undergone coronary angiography.Methods: In the current study, 200 consecutive patients with coronary artery disease, who underwent coronary angiography in Modarres hospital, were enrolled. According to the available data, the upper limit normal level of uric acid was defined as 7 mg/dl in males and 6.5 mg/dl in females. By increasing level of serum creatinine to 0.5 mg/dl (or 25% enhancement) from basic level of creatinine during 48 hours of introduction of contrast agent, diagnosis of Contrast Induced Nephropathy (CIN) was established. The relationship between hyperuricemia and CIN was then assessed.Results: There is a significant difference between normouricemic patients and hyperuricemic patients, in aspect of weight (P = 0.011) and uric acid (P = 0.001); however, other quantitative and qualitative variables including age, volume of contract agent, creatinine level after angiography, hemoglobin level, gender, arterial access type, number of involved vessels, were insignificant between the two groups (P > 0.05). Moreover, as an essential finding, CIN was shown in 9% of normouricemic patients and 10% of hyperuricemic  patients with no significant difference between the two groups (P = 0.6).Conclusions: Our study suggests that hyperuricemia may not significantly increase the rate of the contrast-induced nephropathy in patients, who had undergone angiography
Acute Myocardial Infarction in a Patient With Elevated ST-Segment in aVR Lead and Diffuse ST Segment Depression in Other Leads: A Case Report Safi, Morteza; Khaheshi, Isa; Memaryan, Mehdi
International Journal of Cardiovascular Practice Vol 1, No 1 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (128.401 KB) | DOI: 10.20286/ijcp-010102

Abstract

ST elevation in aVR in conjunction with diffuse ST depression in precordial leads may indicate occlusion of very proximal portion of the left anterior descending artery. We present a 54-year old man, with crushing retrosternal pain and ST-segment elevation only in aVR lead and diffuse ST-segment depression in inferior, lateral and precordial leads. The patient was scheduled for emergent coronary angiography, which showed that left anterior descending (LAD) artery was cut off at very proximal portion and urgent CABG was performed for the patient.
Chronic Total Occlusion-Angioplasty with Antegrade Approach: A two-Year Experience in “Modarres Hospital”, A Tertiary University Hospital, Tehran, Iran Safi, Morteza; Namazi, Mohammad Hasan; Sadeghi, Hamid; Saadat, Habibollah; Vakili, Hossein; Alipour Parsa, Saeed; Khaheshi, Isa; Ataeinia, Bahar
International Journal of Cardiovascular Practice Vol 1, No 3 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.925 KB) | DOI: 10.21859/ijcp-010307

Abstract

Introduction: New techniques for the percutaneous treatment of coronary chronic total occlusions (CTO) have had a high success rate since a few years ago, so the interest for this treatment has been increasing these days.Methods: The current observational study was performed in Modarres hospital as a tertiary referral center. All the patients with documented stable angina who had failed to response to full guideline-mediated medical therapy, referred to our hospital, were candidates for coronary angiography. Antegrade strategy was applied for all these patients. The length of the lesion, the fluoroscopy time of the CTO angioplasty, consumed contrast volume, the number of guide wires used, whether a corsair or tornus micro-catheter was used or not, and the success rate of the angioplasty were documented for further analysis.Results: A total of 47 patients with documented stable angina were finally included. The median age was 59 (45-78) and 70.2% were male. The mean length of the lesion was 34.0 ± 1.1 .The mean fluoroscopy time and contrast volume were 57.9 ± 3.2 minutes and 525.9 ± 20.9 mL, respectively. In average, 2.2 guide wires were used. Corsair and tornus micro-catheters were applied in 30 (63.8%) and 5 (10.6%) of the cases, respectively. Seven complications (all including coronary dissection) occurred. In-hospital major adverse cardiac events (MACE) rate was 10.6%, all of which were non-Q wave myocardial infarction. The success rate was 85.1%. The higher number of used wires, use of corsair, and tornus micro-catheter were not significantly concordant with success rate (P-value > 0.05); in addition, longer lesion was not concordant with unsuccessfulness rate (P-value > 0.05).Conclusions: Patient selection for CTO-angioplasty should be performed more carefully. Patients’ quality of life and risk of probable procedural complications and future cardiac events should be assessed to decide the best treatment approach. Radiation exposure, contrast consumption and fluoroscopy time are recommended to be monitored during the procedure and thresholds should be defined to enhance safety and efficacy.
The role of the history of coronary heart disease among second degree relatives for predicting coronary artery disease Alipour Parsa, Saeed; Saemifar, Farzam; Khaheshi, Isa; Naderian, Mohammadreza
International Journal of Cardiovascular Practice Vol 1, No 2 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (85.642 KB) | DOI: 10.20286/ijcp-010202

Abstract

Introduction: The history of atherosclerotic disease among second degree family members of patients as a risk factor has not been properly explained. The present study aimed to assess this role in the Iranian population.Methods: This case-control study was performed on 500 consecutive patients, who were candidates for coronary angiography. The presence of Coronary Heart Disease (CHD) history among first and second degree relatives were determined by interviewing the participants.Results: In total, 450 patients were shown to have CHD as the case group and 50 without CHD as the control group. Family history of CHD among first degree relatives was 39.1% for cases and 22.0% for the controls with a significant difference (P = 0.018), however the history of CHD among second degree relatives was not statistically different in the case group and the control group (17.8% vs. 8.0%, P = 0.079). In total, 80 patients had CHD with simultaneous history of disease among their second degree relatives, while 370 with CHD had no history of disease among their second degree relatives. Our study could not find a significant difference between the two CHD groups with and without history of disease among second degree relatives in terms of cardiovascular risk profile.Conclusions: Despite the powerful effect of the presence of family history of CHD in first degree relatives on risk of CHD and its severity, the presence of this history among second degree relatives cannot predict the risk for CHD.