فهرست مطالب

  • Volume:12 Issue: 4, 2018
  • تاریخ انتشار: 1397/09/04
  • تعداد عناوین: 8
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  • Starry Rampengan , * , Nancy Lampus , Johan Gunadi Pages 125-132
    Systolic heart failure is a pathophysiological state in which, an abnormality of cardiac function is responsible for the inability of the heart to pump blood at a rate commensurate with the requirements of the metabolizing tissues. It is a final condition from all heart diseases that is associated with high mortality and morbidity rates. This situation leads to the remodeling process resulting in reduced cardiac contractility as well as impaired aerobic capacity. The remodeling process is associated with an inflammatory process involving release of many inflammatory mediators as well as biomarkers. Numerous biomarkers that are released in this process can be used as a risk stratification and prognosis in patients with heart failure. One of these biomarkers is suppression of Tumorigenicity-2 (ST2). Cardiomyocytes subjected to mechanical stress express ST2 in vitro, whereas the circulating levels of soluble ST2 (sST2) are associated with left heart failure. The increased concentration of ST2 that involves Interleukin-33 (IL-33) depends on the biomechanical stress of cardiomyocytes (biomechanical strain). IL-33, as a ligand of ST2, is known to be involved in reducing tissue fibrosis and myocyte hypertrophy in mechanically strained hearts, which leads to left ventricular global strain. Thus, the present review aims to clarify the role of ST2 in systolic heart failure as a diagnostic, prognostic, and monitoring therapy
    Keywords: Systolic Heart Failure, ssT2, Strain, Functional Capacity
  • Rupesh Ranjan , * , Esra Gucuk Ipek , Hesam Mostafavi Toroghi , Nelson Schiller Pages 133-136
     
    Background
    Respiratory variation in Inferior Vena Cava (IVC) diameter is validated for estimation of Right Atrial Pressure (RAP) by echocardiogram. Although IVC flow into the Right Atrium (RA) can be appreciated in parasternal views, it is not routinely evaluated. We have observed an uninterrupted continuous wave (CW) Doppler flow signal from the IVC during sampling of the Tricuspid Regurgitation (TR) jet.
    Objectives
    The present study aimed to show that this uninterrupted signal was a surrogate for normal/low RAP.
    Methods
    This retrospective study was conducted on 500 consecutive echocardiograms and sought continuous flow from IVC into the RA in the subcostal view. RAP was then measured using IVC dynamics like size and respirophasic variation. Analysis was performed by comparison of the percentages.
    Results
    Out of the 500 echocardiograms, 60 (12%) had Doppler evidence of continuous IVC flow into the RA. Among these 60 echocardiograms, RAP was calculated in 57 patients. Accordingly, RAP was 3 mmHg in 54 (95%) and 8 mmHg in 3 (5%) patients. RAP could not be estimated in three patients due to lack of visualization of IVC. Furthermore, RA volume index was normal in 51 patients (85%), but increased in 9 ones (15%). Right Ventricular (RV) function was also normal in 48 (96%) and low in 2 (4%) patients.
    Conclusion
    The study findings supported the hypothesis that continuous flow from IVC into RA on CW Doppler is a surrogate for IVC dynamics in normal/low RAP and is particularly useful when subcostal views are suboptimal or inaccessible due to poor acoustic windows
    Keywords: Central Venous Pressure, Inferior Vena Cava, Pulsed Doppler Echocardiography
  • Samiyeh Fouladivanda, Mohammad Javad Zibaeenezhad, Ebrahim Moghimi, Iman Razeghian Jahromi * Pages 137-141

     

    Background

    People’s lives have become full of risk factors of cardiovascular diseases in the recent years. This situation mainly originates from life style changes, which affect individuals’ health particularly in developing countries. Nutritional transition in terms of high consumption of fast foods and low intake of fruits and vegetables beside insufficient physical activity and sedentary jobs are the potent factors that facilitate the occurrence of diverse disorders. Hypertension is among the most concerning disorders, which affects both physical and mental aspects of health.

    Objectives

    The present study aimed to assess the effects of hypertension, as one of the growing risk factors for diverse disorders, on quality of life. Patients and

    Methods

    In this study, 200 individuals who had referred to Shiraz Healthy Heart House and Imam Reza clinic were selected by convenient sampling. Based on their history of hypertension, relevant therapies, and measurement of blood pressure at the time of enrollment, the participants were allocated to case and control groups. In addition to a general demographic questionnaire, Oxford Happiness Questionnaire was utilized in order to estimate the participants’ happiness status and quality of life. Different statistical methods were used to check the normal distribution of the data and compare the means.

    Results

    The mean score of happiness showed that hypertensive individuals suffered from lower happiness levels compared to those with normal blood pressure (P < 0.05).

    Conclusions

    Not only hypertension imposes serious side effects on different body systems, but it also decreases the quality of life. As many underlying causes of impaired blood pressure are related to lifestyle, it could be easily prevented by addressing the modifiable risk factors

    Keywords: Hypertension, Happiness, Quality of Life
  • Iraj Ahmadi, Samira Mis Qavam, Kourosh Sayehmiri, Mohammad Golitaleb, Hamed Tavan * Pages 142-147

     

    Background

    Aortic dissection is a rare and important emergency condition, which usually involves a high mortality rate. Yet, early diagnosis of the disorder would increase the survival rate significantly.

    Objectives

    The present systematic study and meta-analysis aimed at investigating the efficiency of D-dimer test in diagnosis of aortic dissection.

    Materials and Methods

    The data used in this study were extracted from PubMed, Scopus, Elsevier, Springer, and Willey databases. Specificity, D-dimer, Sensitivity, and Aortic Dissection were the valid keywords used to extract the related articles. Totally, 11 papers published during 1998 - 2007 were selected. I2 index was used to assess heterogeneity across the studies.

    Results

    A total of 596 subjects (averagely 54.5 ones in each study) were examined in the present research and 11 articles were entered into the final meta-analysis. According to the findings, the mean of the specificity test was 0.66 (0.54 - 0.78), with I2 index = 74.9% and p-value = 0.001. Additionally, the mean of the sensitivity test was 0.98 with I2 index = 606% and p-value = 0.381. Moreover, the mean D-dimer plasma level was 18.6 ug/mL in patients suffering from aortic dissection.

    Conclusion

    This study showed the high efficiency of D-dimer test in diagnosis of aortic dissection. Thus, physicians are recommended to apply this quick and inexpensive method when a final diagnosis has not been made yet. Early diagnosis of aortic dissection via D-dimer test would result in implementation of the necessary treatments, eventually leading to a significant decrease in mortality rate

    Keywords: Meta-Analysis, Dimer, Aorta
  • abdolazim tavakoli , Mahnaz Ilkhani , * , Tahereh Ashktorab , Camelia Rohani Pages 148-153
     
    Background
    Caregivers of heart patients are regarded as one of the key health resources in healthcare systems around the world. They play a major role in guidance and continuation of care. Nonetheless, they are often neglected in interventional programs even though paying attention to caregivers and their educational needs can enrich the educational interventions designed for this group of patients.
    Objectives
    This article aimed to explain the educational needs of the family caregivers of patients with Heart Failure (HF) from the perspective of key informants as a part of a sequential exploratory mixed method study.
    Materials and Methods
    In this study, 14 in-depth semi-structured interviews were conducted with key informants selected through purposive sampling. The data were analyzed using a regular interview and analysis plan based on a qualitative content analysis approach.
    Results
    The educational needs of the family caregivers were summarized as three themes: “basic care management education”, “care with dignity”, and “resilience development”. The first theme consisted of gaining targeted knowledge and skills, crisis management, and improving patients’ quality of life, all of which pointed to the caregivers’ need for knowledge and skills in order to meet patients’ basic needs, manage their critical situations, and help them achieve a higher quality of life. The second theme consisted of respecting patients and caregivers’ accountability, which were relate to the educational needs of caregivers in terms of respecting patients’ dignity during care and meeting their transcendent needs as proposed in the higher level of Maslow’s hierarchy. The third theme dealt with maintaining caregivers’ physical and psychosocial health, challenge management using internal and external resources, and promoting participatory care, which indicated the techniques needed to empower caregivers to continue proper caregiving and adapt to their caregiving role.
    Conclusions
    Family caregivers of HF patients need to learn resilience strategies and gain targeted knowledge about generous caregiving. Therefore, identifying the educational needs of this group of caregivers will play a major role in designing programs for their empowerment
    Keywords: Heart Failure, Caregivers, Qualitative Research
  • Egl? Majauskien? , Gediminas Aucina , Palmyra Semeniene , Paulius Jurkuvenas , Pranas Serpytis Pages 154-156
    Coronary artery injury is a particularly rare complication of pacemaker implantation. Herein, we reported the case of a 76-year-old woman with sick sinus syndrome undergoing permanent pacemaker implantation who presented with chest pain a day after the procedure. During angiography, a pacemaker lead screwed into the left anterior descending coronary artery was found. The coronary artery was covered by a stent and the lead position was corrected. Based on the published research, the majority of right ventricular pacemaker leads implanted on the septum are indeed implanted on the anteroseptal junction. Since, the left anterior descending coronary artery covers this site, the risk of artery injury is higher.
    Keywords: Pacemaker, Myocardial Infarction
  • soraya siabani, Maryam Babakhani * Pages 157-158
  • Mahin Dianat, Samira Saadatfard, Mohammad Badavi, Akram Ahangarpour, Najmeh Sadeghi * Page 159