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International Journal of Cardiovascular Practice

ijcp
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Published by Shahid Beheshti University of Medical Sciences

ISSN : 24767174 EISSN : 2476468X DOI : -

Core Subject : Health,

Medicine & Pharmacology

International Journal of Cardiovascular Practice(IJCP) is an international quarterly journal dedicated to a broad spectrum of topics in cardiology. All manuscripts must be prepared in English, and are subject to a rigorous and fair peer-review process. Accepted papers will immediately appear online followed by printed hard copy.

Arjuna Subject : -

Articles 198 Documents

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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

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.

Association of Serum Vitamin D Level and Serum Lipids Profile Sadeghi, Roxana; Eidi, Mohammad Reza; Zamani, Nasim
International Journal of Cardiovascular Practice Vol 3, No 2 (2018)
Publisher : International Journal of Cardiovascular Practice

Introduction: High level of vitamin D is associated with a better health status. The role of vitamin D deficiency in the incidence of cardiovascular events is demonstrated in previous studies. The current study aimed at evaluating the eï¬ect of vitamin D supplement therapy on serum lipids profile, as a risk factor for cardiovascular diseases.Methods: The current prospective cohort study included 221 patients admitted to a university hospital from March 2014 to March 2015. The baseline levels of the patients serum vitamin D and lipid profile of the study subjects were recorded. After three months treatment with vitamin D, the patients serum vitamin D level and lipid profile were re-evaluated. The results before and after the supplement therapy were compared using statistical methods.Results: The mean age of the patients was 48.2 Â± 14.0 years. The mean vitamin D level was 21.0 Â± 16.6 ng/mL at baseline, which increased to 35.8 Â± 32.7 ng/mL (P = 0.001) after a three-month vitamin D supplement therapy. Mean low-density lipoprotein (LDL) decreased from 112.1 Â± 30.0 to 98.7 Â± 31.7 mg/dL (P = 0.003) after the supplement therapy. Mean high-density lipoprotein (HDL) increased from 42.8 Â± 11.2 to 44.5 Â± 9.0 mg/dL, but the diï¬erence was insignificant before and after the treatment (P = 0.2). Mean cholesterol reduced from 183.8 Â± 42.3 to 169.5 Â± 41.9 mg/dL (P = 0.02) and the mean TG dropped from 147.5 Â± 98.7 to 134.7 Â± 71.1 mg/dL, (P = 0.1) after vitamin D intake.Conclusions: The mean levels of LDL and cholesterol significantly decreased during the three-month intervention; in addition, although some changes were observed in the level of HDL and TG, the diï¬erences were statistically insignificant. Further studies on larger sample sizes and longer follow-ups are recommended.

Pulmonary Hypertension and Its Determinants in Î²-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

Introduction: Pulmonary hypertension (PHT) is a common complication in Î²-thalassemia. We aimed to determine the prevalence of PHT and its main indicators in patients with Î² thalassemia Major (TM) and Î²-thalassemia Intermedia (TI), considering left ventricular function.Methods: Pulmonary hypertension (PHT) is a common complication in Î²-thalassemia. We aimed to determine the prevalence of PHT and its main indicators in patients with Î² thalassemia Major (TM) and Î²-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.

Short-term Cost-effectiveness of Reteplase versus Primary Percutaneous Coronary Intervention in Patients with Acute STEMI a Tertiary Hospital in Iran Alimohammadzadeh, Khalil; Sadeghi, Roxana; Maher, Ali; Kazemi, Mohammad Kazem
International Journal of Cardiovascular Practice Vol 2, No 3 (2017)
Publisher : International Journal of Cardiovascular Practice

Â Â Introduction: This study aimed to compare primary percutaneous coronary intervention (PPCI) versus reteplase in terms of clinical and para-clinical outcomes; as well as cost-effectiveness in patients with ST-segment-elevation myocardial infarction (STEMI).Primary percutaneous coronary intervention is the method of choice in all patients especially those at higher risks. But an on-site professional team in a 24/7 facilitated system is a difficult goal to achieve in many areas and countries, therefore the cost-effectiveness of these two treatment strategies (PPCI and reteplase) needs to be discussed.Methods: This prospective cohort study included 220 patients presented with STEMI who were admitted to a university hospital between January 2014 to July 2016. Patients were divided into two groups of 120, either receiving reteplase or PPCI. Clinical outcomes were considered duration of hospital stay and MACE (Major Advanced Cardiovascular Events) including death, cerebrovascular accident, need for repeat revascularization, and major bleeding. LVEF (Left ventricular ejection fraction) was considered as a para-clinical outcome. The outcomes and total hospital cost were compared between two treatment groups.Results: Demographic characteristics between two groups of PPCI or reteplase didnât show any significant differences. But in para-clinical outcomes, patients in PPCI group showed higher LVEF, compared with reteplase group (45.9 Â± 11.5% versus 42.0 Â± 11.8%; P = 0.02). Complication rates were similar in both groups but repeat revascularization or coronary artery bypass surgery was more prevalent in those who received thrombolytic therapy (P < 0.05). Length of hospital stay in both groups was similar in two groups but total cost was higher in patients who have received PPCI. (147769406.9 Â± 103929358.9 Tomans vs. 117116656.9 Â± 67356122.6 Tomans; respectively, P = 0.01).Conclusions: In STEMI patients who present during off-hours, thrombolytic therapy seems to represent a safe alternative to PPCI. Higher costs for patients with PPCI may be decreased with shorter duration of hospital stays according to guidelines.

Thrombotic and Thromboembolic Complications in Patients with Adult Congenital Heart Disease Bikdeli, Behnood; Green, Phillip; Lewis, Matthew J.; Rosenbaum, Marlon S.
International Journal of Cardiovascular Practice Vol 2, No 2 (2017)
Publisher : International Journal of Cardiovascular Practice

Improved medical and surgical interventions have increased the longevity of patients with congenital heart defects and most such patients live into adulthood. Thrombotic and thromboembolic complications constitute a major cause of mortality and morbidity in patients with adult congenital heart disease (ACHD). Such events include acute coronary syndromes, ischemic stroke (cardioembolic due to thrombus formation in the systemic ventricle, secondary to atrial arrhythmias, or due to paradoxical embolism), and venous thromboembolism. Some thrombotic phenomena are also specific to patients with ACHD, such as those related to Fontan circulation. We provide a succinct overview of thrombotic and thromboembolic complications in patients with ACHD, focusing on stroke and venous thromboembolic events.

Association of Anticardiolipin Antibodies and Extent of Coronary Artery Disease in Military Personnel and Non Military Population With Acute Coronary Syndrome Hajibaratali, Bahareh; Baharvand, Shahram; Yazdani, Shahrooz
International Journal of Cardiovascular Practice Vol 1, No 3 (2016)
Publisher : International Journal of Cardiovascular Practice

Introduction: Cardiac involvement is one of the chief complications considerably contributing to the morbidity and mortality of patients with systemic autoimmune diseases. Anticardiolipin antibody is a marker of elevated myocardial infarction risk and it also predicts post cardiac intervention risk. In the current study, we aimed to evaluate the association between anticardiolipin IgM and IgG levels and atherosclerotic involvement of coronary arteries.Methods: Patients with acute coronary syndrome admitted to a military hospital were included in the study. Patients were categorized to military personnel and non-military personnel. Laboratory data including lipid profile, blood sugar, anticardiolipin IgM and anticardiolipin IgG were verified. Existence and the extent of Coronary Artery Disease (CAD) were defined according to angiographic findings. The relationship between anticardiolipin antibody levels and the number of vessels were evaluated.Results: According to our sample population calculation, we performed the study on a total of 92 patients. Measurement of both anticardiolipin antibodies (IgM and IgG) in military personnel and non personnel patients showed no significant difference. In both military personnel and non personnel groups, there was a significant association between anticardiolipin IgM and IgG levels and number of coronary arteries with significant stenosis. The C Reactive Protein (CRP) level was significantly higher in military personnel.Conclusions: According to the study results, anticardiolipin antibody levels were the same in both military personnel and non personnel. Also systolic and diastolic blood pressures were not significantly different in both groups. Increased CRP level in military personnel may be a warning signal about the possibility of premature CAD in this population, hence aggressive risk factor modification is recommended. Paradoxically lipid profile and FBS levels were more favorable in military personnel, which indirectly reflects their higher state of physical activity.

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

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.

Intramural Ventricular Septal Defect Saedi, Sedigheh; Parsaee, Mozhgan
International Journal of Cardiovascular Practice Vol 2, No 3 (2017)
Publisher : International Journal of Cardiovascular Practice

Intramural ventricular septal defects (VSDs) are less frequently encountered but clinically significant type of residual interventricular communications seen after complex congenital heart surgeries. Hemodynamically significant intramural VSDs can lead to higher postoperative morbidity and mortality. This case highlights the clinical challenges including the need multiple interventions faced in affected patients.

Frequency of HLA-B27 in Patients With Conductive System Disturbance and Implanted Permanent Pacemaker in Iran Sayah, Sima; Ebrahimi, Morteza; Piroozmand, Poorya
International Journal of Cardiovascular Practice Vol 2, No 1 (2017)
Publisher : International Journal of Cardiovascular Practice

Introduction: HLA-B27 is considered as one of the causes of heart conductive disorders. We studied the frequency of HLA-B27 among Iranian patients who had undergone permanent pacemaker implantation.Methods: This descriptive and analytical study was performed among patients who underwent permanent pacemaker implantation. The questionnaire contains demographic data, underling diseases, and history of heart disease or heart surgery. The type of conductive heart disorder was mentioned there, too. We determined the regurgitation of aorta valve and its severity. Finally, HLA-B27 was accessed. All the data was entered in SPSS software and analyzed.Results: From a total of 103 patients entered in this study, only 6 (5.8%) were HLAB-27 positive. The disturbance of conductive heart disorders based on the HLA-B27 positive or negative patients was not statistically different. Patients with HLA-B27 mostly had regurgitation of the aorta valve.Conclusions: We concluded that the frequency of positive HLA-B27 genotype in patients with permanent pacemakers did not have any significant difference with the ones with negative HLA-B27 genotype. However; this genotype was associated with regurgitation of the aorta valve.

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

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.

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