نارسایی قلبی

 Heart failure (HF) is a global public health issue. Although numerous studies have been conducted in various regions, such as Europe and the United States, there is limited information about the characteristics of this disease in Asian regions, particularly in Iran.

This study is retrospective descriptive-analytical research. Patients over 16 years old who were hospitalized with a diagnosis of HF at the Shahid Madani Cardiovascular Center, Tabriz, Iran, from April 2021 to August 2022 were selected for the study. The exclusion criteria included patients with preserved systolic function. The variables studied included demographic characteristics, comorbidities, and the type of HF (ischemic or non-ischemic), which were collected through a researcher-designed questionnaire.

Of the 519 patients studied, 66.9% were male and 33.1% were female. The mean age of the patients was 64.08 ± 13.6 years. The most common risk factors included hypertension (57%), coronary artery disease (CAD) (52%), and diabetes mellitus (DM) (36.2%). The most common clinical symptoms were shortness of breath (88%), orthopnea (36.1%), and gastrointestinal symptoms (20%). The mortality rate of the patients was 1.54%.

This study indicates that HF patients in Iran are younger on average than those in Western countries, with non-ischemic causes being more prevalent. These differences may be due to cultural, racial, and lifestyle-related risk factors in Iran. The significance of collecting this data lies in identifying high-risk groups and planning optimal treatment strategies.

Sleep disorders are a common complication among individuals with heart failure, which can limit their ability to engage in vigorous physical activities. Therefore, this study aims to investigate the impact of balance exercises on the sleep quality of patients diagnosed with heart failure.

A clinical trial was conducted on 54 patients with heart failure at Heshmatieh Sabzevar Hospital. The patients were divided in two groups using permutation blocks of random allocation: 27 in the intervention group and 27 in the control group. The intervention group received educational on sports. After 8 weeks, the sleep of both groups was measured and the data were analyzed using Mann-Whitney, Chi-square, and Fisher's exact tests, as well as evaluation measures.

Prior to the intervention, there was no statistically significant difference in sleep quality scores between the two groups. However, after the intervention, a significant difference in sleep quality scores (P < 0.001) was observed between the intervention and control groups. Despite this, there were no found significant differences between the groups in terms of sleep adequacy, duration of restful sleep, and use of sleep medication.

Balance exercises have been shown to improve various dimensions of sleep quality in heart failure patients, including overall sleep quality, sleep onset latency, sleep disturbances, and daytime performance.

Cardiovascular diseases remain a leading global cause of mortality, with ischemic heart disease projected to account for 23.3 million deaths by 2030. Heart failure and cardiogenic shock account for a significant proportion of these deaths and require timely treatment as medical emergencies. This study aims to predict mortality within one month in patients experiencing cardiogenic shock secondary to heart failure using a concise set of predictive features.

An analytical cross-sectional study was conducted at Babol Razi Hospital, involving 201 adult patients (≥18 years) treated for cardiogenic shock in 2020. Data from 34 clinical variables, including age, history of cardiac surgery, pH levels, lactate concentration, diabetes status, and blood pressure, were meticulously analyzed. Mortality outcomes within one month were assessed via structured telephone follow-up. Logistic regression and Gradient Boosting Machine (GBM) algorithms were used for predictive modeling.

The average age of patients was 69.44 ±15.71 years. Among them, 47.7% died. The study identified age, lactate levels, diabetes, and initial confusion as significant predictors of mortality risk. Each additional year of age was associated with a 7% higher probability of mortality. Diabetic patients faced more than double the mortality risk compared to non-diabetics. Confusion at presentation increased the mortality risk fourfold, while elevated lactate levels raised it by 1.5 times.

Logistic regression and GBM algorithms demonstrated effectiveness in predicting one-month mortality among cardiogenic shock patients with heart failure based on selected features. This approach holds promise for improving referral processes and reducing costs in healthcare settings.

Heart failure patients experience a lot of emotional and psychological distress in the course of treatment and self-care, which affects all aspects of their lives. One of the basic challenges that affects most heart failure patients is the reduction of emotional self-efficacy. The present study was conducted with the aim of determining the effect of the emotion regulation program on the emotional self-efficacy of patients with chronic heart failure.

In this randomized clinical trial study; 70 patients with chronic heart failure were randomly selected into two test groups (35 people) and control (35 people). In the test group, the emotion regulation program was conducted in 6 sessions. The data collection tool was based on the demographic characteristics form and the emotional self-efficacy questionnaire of Beverly et al., which was completed by the patients in three stages before the intervention, immediately and one month after the intervention. The data were analyzed by SPSS software version 22 with descriptive and inferential statistical tests. The significance level in these tests was P < 0.05. 

The results showed that the average resilience score in the test group before, immediately and one month after the intervention was 24.29 ± 12.82, 90.37 ± 6.49 and 85.63 ± 7.77, respectively. From a statistical point of view, there was a significant difference (P < 0.001), while in the control group, the average resilience score during the mentioned time was 37.97 ± 25.10, 19.54 ± 14.80, and 20.82± 20.80, respectively. It was observed that 31.20% was not statistically significant; (P<0.05), in other words, the emotion regulation program has increased the emotional self-efficacy score in the test group compared to the control group.

The emotion regulation program is effective in improving emotional self-efficacy in patients with chronic heart failure; therefore, it is suggested that this intervention be provided for patients with chronic heart failure in a practical way by nurses working in the centers.

Rehabilitation for heart failure patients can help improve heart health, quality of life, and strengthen respiratory muscles. However, some patients do not have access to rehabilitation services in clinics and medical centers. The aim of this study was to investigate the effect of eight weeks of home-based cardio-respiratory rehabilitation on the respiratory muscle function of heart failure patients aged 40-60 years.

 In a semi-experimental design, 43 subjects (20 women and 23 men) with heart failure were divided into three groups: rehabilitation training group (13 people including 7 men and 6 women), rehabilitation training with breathing exercises (15 people including 8 men and 7 women), and the control group (15 people including 8 men and 7 women). The subjects underwent pre-test and post-test measurements of maximum inspiratory pressure (MIP), 6-minute walk test (6MWT), and dyspnea index.

The results of this research showed that breathing exercises combined with cardiac rehabilitation at home had a significant effect on the subjects' PIMax (P < 0.001). Forthermore, 6WMT mileage increased both during rehabilitation exercises and when rehabilitation exercises were combined with breathing exercises. Also, dyspnea index decreased in both experimental groups (P < 0.001).

Combining rehabilitation exercises with respiratory muscle strengthening can help patients with heart failure, at least in some cases. However, more intense and controlled exercises than home-based exercises may be needed for greater improvements in cardiovascular function.

Heart failure is one of the common causes of hospitalization in adults over 65 years old. Low health literacy is a major problem not only for patients, but also for healthcare providers and health systems.  Educating family members on disease control and even prevention can be very helpful, because there is a strong connection between the family and the health status of its members. By providing multiple resources and instant feedback, the virtual world is able to help people quickly acquire the knowledge they need. The purpose of the present study is to investigate the effect of family-oriented self-care education through smartphones on health literacy and self-care status of heart failure patients in Jahrom city.

Methods & Materials: 

This study is a double-blind clinical trial. At first, the samples were selected in the accessible way, and then they were divided into two intervention and control groups in a simple random way through computer software; each group had 30 people. The tools used include: Demographic Questionnaire, Newtbeam Heart Failure Health Literacy Questionnaire, and Rigel Heart Failure Self-Care Status Assessment Questionnaire. After all the patients completed the questionnaire, family-oriented training for the intervention group started in Soroush Messenger. One month after the end of the intervention, the relevant questionnaires completed by both intervention and control groups. Data analysis was determined using SPSS version 22 software at a significance level of 0.5%.

In line with the many problems that heart failure patients face, providing education in the field of self-care can be an important step towards improving their physical health and increasing their health literacy. Considering the benefits of education through smartphones and the fact that the research has been done, it has been done in the field of self-care education in a family-oriented and face to face manner; But so far, no research based on family-oriented self-care training through smartphones for heart failure patients has been found; Therefore, the current research was conducted with the aim of the effect of self-care education in a family-oriented way, through a smartphone.Clinical trial code: IRCT20210114050037N2

Wolff-Parkinson-White syndrome is a rare but well-known disease that predisposes a person to cardiac arrhythmias. But sometimes this syndrome is accompanied by heart failure in the affected person. Several causes have been proposed for this complication including recurrent or incessant tachyarrhythmias that are frequently found in symptomatic (especially children) Wolf-Parkinson-White syndrome patients causing heart dysfunction and dilation and dilated cardiomyopathy, and also pre-excitation-related dyssynchrony leading to progressive ventricular remodeling and dilation. In this report, a patient is introduced who has improved his heart failure by radio-frequency ablation of free wall type of this syndrome.

A 35-year-old man who had a history of Wolff-Parkinson-White syndrome from 8 years ago and suffered from dilatation and reduced left ventricular ejection fraction in recent years was presented with a pre-excited atrial fibrillation attack at the emergency department. The initial surface ECG showed positive delta wave in all precordial leads and negative QRS complexes in interior leads with QRS duration of about 200 ms. He had undergone electrophysiology study and ablation at the left postero-lateral accessory pathway. After ablation of accessory pathway within the months (from November 2022 until June 2023), left ventricular function was gradually improved and the symptoms of the patient's shortness of breath were also decreased.

The existence of heart failure in patients with Wolff-Parkinson-White syndrome can be due to various reasons including the presence of an accessory pathway and the dyssynchrony of intraventricular contraction which is caused by premature excitation of the connected part of the left ventricle by accessory atrioventricular pathway. Although in order to rule out the possibility of the incidental association of the accessory pathway with primary dilated cardiomyopathy and to investigate the segmental dyskinesia, it is necessary to perform diagnostic measures such as echocardiography and cardiac computerized tomography and magnetic resonance imaging, ablation of such accessory pathway not only controls arrhythmic attacks but also leads to the improvement of the left ventricular systolic function even in a middle age patient.

Patients with heart failure need to do their self-care behaviors to cope with the complications of their illness. Self-efficacy and self-control are the most important determinants of compliance with proper self-care behaviors in patients. This study aimed to determine the correlation between self-care, self-efficacy, and self-control in patients with heart failure in the specialized Farshchian Heart Center of Hamadan province.

This descriptive correlational study was performed on 181 patients with heart failure who were referred to the specialized Farshchian Heart Center of Hamadan. Data were collected using a demographic questionnaire and three questionnaires of self-care behaviors questionnaire, self-efficacy questionnaire (SUPPH), and Julian Rater's Self-Control Questionnaire. After determining the validity and reliability of the tools, the data were collected and analyzed by statistical software Spss/16.

55.2% of the samples were in the age group of 45-60 years old and 82.9% of them were male. The mean self-care score 4.44 ± 0.512 (good), self-efficacy 3.88 ± 0.533 (good), and self-control 3.15 ± 0.306 (good) was obtained. In correlation between all three components, there was only a direct correlation between self-care and self-efficacy (r = 0.376, p < 0.001).

Self-care, self-efficacy, and self-control in patients with heart failure are good and acceptable. Regarding the relationship between self-care and self-efficacy, proper measures are needed to improve these patients' self-efficacy and strengthen self-care behaviors.

Heart failure is a clinical syndrome resulting from structural or functional abnormalities of the heart, leading to reduced cardiac output or increased intracardiac pressure. When combined with cardiogenic shock, it becomes an emergency condition with a high mortality rate, necessitating immediate diagnosis and treatment. Accurate prediction of 30-day mortality in these patients is vital for timely care and patient survival. This study aimed to optimize the Random Forest algorithm by adjusting hyperparameters to more accurately predict 30-day mortality in heart failure patients with cardiogenic shock.

In this research, data from 201 cardiac patients aged over 18 years who experienced cardiogenic shock at Rouhani Hospital in Babol in 2020, were used. Thirty-four selected features such as age, history of cardiac surgery, pH, lactate levels, diabetes, etc., were examined, and their one-month mortality was tracked through telephone follow-ups.

The results showed that increasing age (above 57 years), decreasing pH (below 7.3), and elevating lactate levels (above 2) significantly increased the risk of 30-day mortality. By optimizing the hyperparameters of the Random Forest algorithm (ntree=1000 and mtry=14), prediction accuracy improved from 66.0% to 71.8%.

This study demonstrates that the accuracy of the Random Forest algorithm depends on its input hyperparameters and that optimizing these parameters can lead to a more precise prediction of mortality in heart failure patients with cardiogenic shock. With appropriate optimization, this algorithm can serve as an effective tool for the early detection of high-risk patients and timely provision.

Influenza virus is scattered around the world and causes epidemics of varying severity annually. Mortality caused by influenza is more common in cardiovascular patients than in other chronic diseases. Paying attention to this is very important in preventing the disease and its complications in children and adults with cardiovascular diseases. Therefore, this study was conducted with the aim of epidemiological investigation of hospitalized cases caused by influenza in cardiovascular patients and its effect on the health of these patients in Mazandaran Heart Center.

The present study is a cross-sectional descriptive study that was conducted on patients who were admitted to the Mazandaran Heart Center between 2016 and 2018. All patients who were hospitalized with the initial and final diagnosis of influenza and were treated with all flu medicine were included in the study. Since the PCR test was not available for all these patients, as the value of clinical diagnosis was based on symptoms and initial laboratory findings during the epidemic, in addition to PCR-positive cases, cases with clinical diagnosis were also included in the study. All data analysis with SPSS version 16 software was used.

In this study, 113 patients with an average age and standard deviation of 63.3+15 years were included. Among these patients, the highest frequency of history of heart disease was related to congestive heart failure (35.4%) and angioplasty (292%), and the lowest frequency was related to valve replacement 8.0%. Among other underlying diseases, the highest frequency was related to hypertension (65.5%), diabetes mellitus (41.6%), and hyperlipidemia (31.0%), and the lowest frequency was related to thyroid disorders (2.7%). Also, 31.9% of patients had diabetes and hypertension and 16.8% had diabetes and hyperlipidemia. Examining the signs and symptoms of influenza among the patients also showed that the highest frequency related to fever (76.1%), sputum (66.4%), cough (64.6%), shortness of breath (611%) and myalgia (548%) and the lowest frequency was related to diarrhea (5.3%). Only 7% of patients had a recent history of flu vaccination. In the chest radiography report, 25.7% of the patients had increased bronchial marking and 17.7% had evidence of pneumonia. Finally, 82.3% of patients were discharged after complete recovery. Also, only 12 cases (10.6%) of the patients died. Heart failure was the most common underlying disease among deceased patients.

The results of this study revealed that the symptoms of influenza in heart patients are similar to other patients and the type of underlying disease has no effect on the disease presentation and its initial manifestations, but persisting of the symptoms and progression towards severe disease were more common. Most of the deaths were due to heart failure, and this issue highlights the importance of these patients' adherence to the flu vaccine. Unfortunately, the results of the study indicated that this high-risk population had little adherence to influenza and pneumococcal vaccinations.

The treatment processes and complications of heart failure are associated with tension, mood problems, anxiety and feeling of hopelessness. Due to the importance of psychological health and hope in dealing with the consequences of the disease and the effect of mindfulness-based interventions on them, the aim of this study was to compare the effect of mindfulness-based cognitive therapy with acceptance and commitment therapy on psychological distress and hope in males with heart failure.

This research was semi-experimental with a pretest-posttest design with a control group on three-month follow-up. 45 males aged 35 to 55 with stage B heart failure in Isfahan city, were purposefully selected and placed in three groups of 15 (two experiment groups and one control group) by simple random method. Data were collected with depression, anxiety and stress scale, Loybond & Loybond's (1995) and Hope scale Snyder et al. (1991), in the three stages of pre-test, post-test and follow-up. The interventions performed for test groups. The control group did not receive any intervention. Data analysis was done with mixed analysis of variance and Bonferroni's post hoc test.

Findings showed a significant difference for depression, anxiety, stress and hope in both interventions compared to the control group in the post-test and follow-up (P˂0.05). Comarsion of mindfulness-based cognitive therapy with acceptance and commitment therapy showed a significant difference in the treatment of depression (P=0.005), anxiety (P=0.034) and hope (P=0.007). However no significant difference was observed for Stress (P=0.451).

Both interventions reduced depression, anxiety, stress, and increased hope in males with heart failure. Therefore the suggested treatments should be used in medical centers along with common medical treatments as complementary interventions. For anxiety problems, the preferred method is mindfulness-based cognitive therapy and for hope, mood and depression problems, acceptance and commitment therapy.

Heart failure is one of the common chronic diseases in old age and is considered as a progressive and debilitating disorder. Nowadays, the use of supportive and non-pharmacological methods in disease management and empowerment of elderly patients is of increasing importance. This study was aims to assess the effect of a 5A model-based self-management program on self-management ability and dyspnea severity in the elderly with chronic heart failure.

This is a randomized controlled clinical trial that was conducted on 75 eligible elderly people with heart failure (Class II or III) in Babol, Iran. They were randomly divided into two groups of intervention and control. The intervention group received the self-management training program based on the 5A model for 12 weeks. The control group received the usual training. The data before and immediately after the intervention were collected using the self-management ability scale (SMAS) and the five-item modified Medical Research Council (MMRC) dyspnea scale. The collected data was analyzed in SPSS software version 24. 

The mean age of patients was 68.026±3.956 in the intervention group and 69.595±4.079 in the control group. There were no statistically significant differences between the two groups in terms of demographic and clinical characteristics. After the intervention, the total SMAS score and severity of dyspnea in the intervention group were significantly higher than in the control group (P<0.001). The difference was also significant in all subscales of SMAS between the two groups (P<0.001). 

Considering the positive effect of the 5A model-based self-management program on improving self-management ability and reducing the severity of dyspnea in the elderly with chronic heart failure, it can be used as a simple, low-cost, effective method, without the need to go to medical centers, to improve the quality of life of these patients.

Heart failure is one of the most common chronic, progressive and debilitating heart disorders that has a destructive effect on self-care and quality of life of these patients. This study was conducted with the aim of Comparing the effects of self-care education by two in-person and virtual methods on Self‐care and quality of life among patients with heart failure.

This three-group clinical trial study was conducted with the participation of 120 patients with heart failure in Farshchian Hospital at Hamadan.Demographic, self-care and quality of life questionnaires of heart failure patients were completed by self-report before the intervention. The control group received only the routine training of the clinic, the in-person education group received self-care training in 4 one-hour group sessions, one day apart., and the virtual group received the same amount of education in the form of educational clip, and two months after intervention, the questionnaires were completed.

The results showed that before the intervention, there was no statistically significant difference between the demographic variables, self-care and quality of life of the patients in the three groups (p > 0.05). After the intervention, no statistically significant difference was observed between the virtual and in-person education groups in terms of self-care and quality of life (p>0.05).

Both virtual and in-person education methods had the same effect on self-care and quality of life. If the conditions for in-person education are not available, virtual training can be substituted for it.

Chronic hypertension causes structural and functional changes in the heart, ultimately leading to heart failure (HF), which further increases mortality. The aim of the present study was to determine the effect of a period of intermittent aerobic exercise on the serum level of apelin 17 and factors related to blood pressure in patients with HF.

In this semi-experimental study, 20 men with HF were selected based on the conditions of entering the study and were randomly divided into 2 exercise and control groups. The exercise program included interval aerobic training that were performed three sessions a week for eight weeks of training. Blood sample and physiological variables were measured fasting 48 hours before and after the intervention.

After eight weeks of training, there was a significant increase in the levels of Apelin 17 (P = 0.039), Ang I (P = 0.005) and FMD (P = 0.008) and a significant decrease in the levels of Ang II (P < 0.001) and SBP (P < 0.001) were observed, but no significant difference was observed in the values of ACE-2 (P = 0.234) and DBP (P = 0.363).

According to the results, it can be said that one of the adaptations of exercise that improves blood flow and lowers blood pressure in patients with HF is increasing the level of apelin-17 in these patients.

Heart failure is one of the common and significant diseases worldwide, associated with serious outcomes such as mortality and hospitalization. Sodium restriction in patients’ diet is a common intervention in managing this condition. This systematic review examines the impact of sodium restriction on the rate of mortality and hospitalization in heart failure patients.

Through a systematic search, international databases including PubMed, Embase, and Cochrane were searched for relevant articles without time restrictions. The quality of the articles was assessed using the Cochrane Risk of Bias tool. Data were statistically analyzed using a random-effects model and the CMA software version 3.

Six studies with a total sample size of 2450 individuals were included in the analysis. Sodium restriction in the diet did not have a significant impact on mortality among heart failure patients. The odds ratio for mortality in this group was 2.2, with a 95% confidence interval ranging from 0.9 to 5.4. Furthermore, sodium restriction did not have a significant effect on the occurrence of hospitalization due to heart failure (odds ratio 1.2 with a 95% confidence interval of 0.4 to 3.3).

Based on the results of this study, sodium restriction in the diet of heart failure patients did not have a significant impact on the rate of mortality and hospitalization. These findings can assist healthcare professionals and nutritionists in providing better recommendations to patients. Additionally, these results can contribute to significant decision-making in improving the care of heart failure patients.

 Patients suffering from End-stage renal disease (ESRD), which means complete dysfunction of kidneys can experience medical disorders due to important rules of kidneys in Hemostasis and electrolyte balance. In ESRD patients, treated with conventional hemodialysis, cardiac involvement is a serious consequence and is the most important cause of death among ESRD patients. The most common cardiac involvement in these patients is heart failure ،Pericarditis and cardiomyopathy (1). Echocardiography is a powerful tool for the diagnosis and evaluation of the severity of these disorders. Structural and functional changes can be detected by Echocardiography. Left ventricular mass, Size of chambers, and size of valves are structural parameters. Left ventricular ejection fraction, Global longitudinal strain are functional parameters.In a study performed by Liu YW, et al, they observed no significant difference in gender, age, and LVEF among groups. Compared with controls, global peak systolic longitudinal strain (GLS), circumferential strain, and strain rate were decreased in the CKD group. Along with the decline of renal function, GLS deteriorated (2).Ventricular systolic function is determined by echocardiographic findings including Ejection fraction and anatomical findings like LV mass. GLS is an echocardiographic parameter that can determine Subclinical heart failure before EF is reduced. In a study done by Krishnasamy et al, it is found that GLS is a superior predictor of heart failure and can be used instead of LVEF. This study aims to determine the effect of Different factors such as Time of hemodialysis, Diabetes, Smoking, Etiology of ESRD, and duration of CKD before ESRD on the severity of heart disease among ESRD patients at first. And we want to find if there is a significant association between LV mass and GLS.

 In a cross-sectional study 55 adult patients were enrolled among all of ESRD patients who underwent hemodialysis in Hazrat-e Rasool Hospital of Tehran since September 2021 until August 2022. Complete 2-D, 3-D, M-mode, Doppler and color Doppler study were performed by a single operator for each patient and the abnormalities were recorded. Echocardiographic parameters like LV mass, LVEF, E/e , GLS were calculated. Inclusion criteria are: all the ESRD patients over 18 years old who were referred to echocardiography department for cardiac evaluation as a part of pre operation check-up. Exclusion criteria include: Low quality of Echocardiography images, obvious Arrhythmia, congenital heart disease, pericardial effusion, Infective endocarditis, and serious pulmonary or hepatic disease, Pulmonary artery hypertension (secondary to lung disease). In the beginning, 64 patients were referred but 9 patients were excluded due to having exclusion criteria. And finally, 55peoples were chosen. The procedure was explained to patients, General information like Age, Gender, weight, and height was collected by checklist, and Ethical code no IR.IUMS.REC.1402.106 was registered in Iran university of medical sciences committee of ethics. Echocardiography was performed by Philips IE33 device and X5-1 probe in 2D and 3D echocardiographic images from different views for evaluating size and function of left ventricle and the size and function of valves. Full volume image was performed in an Apical 4 chamber in 7 Beat-Breath hold cycle at first 24 hours after hemodialysis. Volumes and LVEF were calculated by Q-lab image arena software. Apical 4,2,3 chamber views were calculated for detecting left ventricular GLS by cardiac motion quantification (CMQ) method. and data were analyzed by IBM SPSS statics version 26 by 95% meaningfulness.

 Considering the probable effect of the Time of hemodialysis on the cardiac findings in Echocardiography we evaluate correction between the Time of hemodialysis with LV mass, GLS, and LVEF. In pearson correlate, in SPSS we found a significant relationship between time on hemodialysis and increasing LV mass/BSA (P value<0.01) and decreasing GLS and LVEF. We hypothesized that the duration of CKD before initiating Hemodialysis may be a probable factor that can affect cardiac function. Hence, we use the Pearson correlation again for evaluating the relation between the time of CKD before starting hemodialysis and LV mass, GLS, LVEF, E/e’. Strangely we found there is not a significant relationship between CKD and these parameters (P value=0.07 for LVEF, 0.197 for LV mass/BSA, 0.541 for E/e’, 0.059 for GLS). An increase in LV mass in ESRD patients can be related to several different causes like: increasing Afterload, Volume overload, and other factors. We hypothesize increase on LV mass can affect ventricular systolic dysfunction and GLS. So, we check their relation using the pearson correlation.We exclude the effect of confounding variants like smoking, Diabetes, Hypertension, Hyperlipidemia. And We found there is a significant relation between LV mass with GLS. In other word: an increase in mass can be a cause of decreasing GLS.

 According to the statistical studies, it seems that End-stage renal disease, which means requirement of regular dialysis, can lead to cardiac complications in terms of subclinical heart failure, increased LV mass, and decreased ventricular ejection fraction. In the next phase of investigations, increase in the duration of the disease and the progression of ESRD can be significantly related to the increase in LV mass and the decrease in GLS. We found that increase in ventricular mass can be independent of the influence of other cofounder factors. Reduce the amount of GLS. In fact, left ventricular hypertrophy can be a determining factor for patients to progress to subclinical heart failure. Therefore, based on the available findings, it can be concluded that in the early stages of hemodialysis, it is necessary to perform cardiovascular evaluations and echocardiography of patients dependent on hemodialysis and to measure criteria such as GLS and LV mass, before causing obvious ventricular failure. With the least decrease in GLS or increase in LV mass, kidney transplant should be performed.

There is a growing interest in telenursing's effect in reducing the burden of chronic diseases.

In this study, a comprehensive review of systematic reviews of the effect of telenursing interventions on primary care of cardiovascular diseases was performed. The reviewed English articles were published between 2000 and 2018. International databases, including CINAHL, Web of Sciences, Science direct ERIC, Google Scholar, PubMed, SCOPUS, Wiley, Springer, Cochrane, EMBASE, Education Index British, were used to search for studies. Articles were evaluated for quality using relevant checklists. Data were extracted by a researcher. The second researcher reviewed the data using a standardized form. Then, two evaluators evaluated the quality of each study using a review quality assessment questionnaire.

Out of 85 articles, 13 studies were included, four studies focused on telecommunication interventions performed on blood pressure, and 9 studies focused on telecommunication and management of heart failure. Seven studies received a score of 5 or higher and were of good quality.

The findings show that telenursing reduces blood pressure, reduces overall hospitalization and HF-induced hospitalization, reduces overall mortality, and improves the quality of life. It also improves disease outcomes and reduces health costs. However, we need more research to examine the components of telephoning interventions to determine these components' relative value. Also, the methods of influencing telecommunication on health outcomes need further investigation to show the desired results.