فهرست مطالب

  • Volume:2 Issue: 3, 2017
  • تاریخ انتشار: 1396/06/11
  • تعداد عناوین: 5
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  • Habibollah Saadat, Hossein Tajdini, Zahra Saadat, Vahid Eslami, Mehdi Sheibani, Babak Sharifkashani, Roxana Sadeghi, Isa Khaheshi Pages 55-56
  • Morteza Safi, Isa Khaheshi, Vahid Eslami, Mohammad Mehdi Beheshtian, Mohammadreza Naderian Pages 57-60
    Introduction
    The present study aimed at assessing the role of lesion length in predicting Fractional Flow Reserve (FFR) value for physiological evaluation of intermediate coronary lesions.
    Methods
    In the current study, 68 patients with 83 coronary lesions were enrolled. All of the patients in this study underwent routine coronary angiography, according to appropriate indications. To evaluate physiologically significant intermediate coronary stenosis (defined between 40% and 70% on visual estimation), the Fractional Flow Reserve (FFR) study was performed and the Quantitative Coronary Angiography (QCA) data were also assessed for measurement of lesion length. The correlation between QCA data and FFR values was also examined.
    Results
    Eighty-three lesions were evaluated from 68 patients. Stenosis was considered physiologically significant when FFR was lower than 0.75. The FFR was significant in twelve lesions (14.5%). There was a negative correlation between FFR value and lesion length (r = -0.294 and P = 0.013). Moreover, lesion length in physiologically significant FFR group (21.07 ± 6.9) was greater than that of the non-significant FFR group (15.23 ± 6.5) (P value
    Conclusions
    There is a negative correlation between lesion length and FFR value in intermediate coronary lesions. In addition, a lesion length greater than 17.5 mm is the best cut- off point for prediction of significant FFR values.
    Keywords: Coronary Artery Bypass, Fractional Flow Reserve, Myocardial, Quantitative Coronary, Angiography
  • Amir Hossein Yazdi, Parnian Kazemi, Farzaneh Esna-Ashari, Mehrnaz Olfat, Leila Najmafshar Pages 61-64
    Introduction
    As a new supplementary therapeutic option, cardiac rehabilitation (CR) is getting more attention every day. Several studies have proved its positive impact on qualitative criteria; but few studies have been done on quantitative criteria. The purpose of the present study is to evaluate the impact of CR on non-invasive measurement of maximum cardiac output by Pulse Pressure index (PPI) at the peak of exercise.
    Methods
    This is a non-randomized prospective cohort study conducted in Hamadan, Iran in 2015. One hundred eligible patients who had undergone coronary artery bypass surgery participated in our study, after obtaining cardiologist permission and informed consent. The PPI was measured at the peak of exercise before and after standard CR program.
    Results
    Mean PPI was not significantly different before and after CR. PPI was significantly increased in patients younger than 60 years old (P = 0.022). In contrast to hypertensive patients, PPI increased significantly after CR in non-hypertensive patients (P = 0.002). PPI was significantly increased in non-diabetic patients after CR (P = 0.046), but not in diabetic individuals. Other variables did not show any statistically significant effect on PPI in response to CR.
    Conclusions
    Findings from our study revealed that PPI is associated with vascular atherosclerosis, as well as cardiac output; Positive effects of CR diminish in older, diabetic and hypertensive patients with more progressive atherosclerosis.
    Keywords: Rehabilitation, Coronary Vessels, Coronary Artery Bypass
  • Khalil Alimohammadzadeh, Roxana Sadeghi, Ali Maher, Mohammad Kazem Kazemi Pages 65-69
    Introduction
    This study aimed to compare primary percutaneous coronary intervention (PPCI) versus reteplase in terms of clinical and para-clinical outcomes; as well as costeffectiveness 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 didn’t show any significant differences. But in para-clinical outcomes, patients in PPCI group showed higher LVEF, compared with reteplase group (45.9 ± 11.5% versus 42.0 ± 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
    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.
    Keywords: Primary percutaneous, coronary intervention, Reteplase, Myocardial infarction
  • Sedigheh Saedi, Mozhgan Parsaee Pages 70-72
    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 for multiple interventions faced in affected patients.
    Keywords: Congenital Heart Disease Heart Septal Defects, Ventricular, Tetralogy of Fallot