فهرست مطالب

Multidisciplinary Cardiovascular Annals - Volume:11 Issue: 1, 2020
  • Volume:11 Issue: 1, 2020
  • تاریخ انتشار: 1399/03/31
  • تعداد عناوین: 7
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  • Mehrab Marzban *, Ghazal Kooshk Jalali Page 1
  • Esmaeil Asdaghpour, Ramin Baghaei, Naser Jalilifar, Hassan Radmehr, Mahmoud Shirzad, MohammadReza Mirzaaghayan, MohhamadAli Yousefnia, Nicholas Austin, Alireza Alizadeh Ghavidel *, Zargham Hossein Ahmadi, AhmadAli Amirghofran, Ahmad Amin, Kamran Babazadeh, Rezayat Parvizi, Saeid Hosseini, AmirNasser Jadbabaei, A Jahangirifard, M Hekmat, M Shabani, P Sadeghipour, M Abbasi Tashnizee, M Gholampour Dehaki, A Firouzi, M Mirmohammadsadeghi, A Nikpajouh Page 2

    The effects of recent Covid-19 pandemic on this planet must be viewed with a wise eye and we should learn that human beings are interconnected chains, and that ignoring the laws of existence will undoubtedly continue with reflections similar to the way we are today. Although the community of heart surgeons is not at the forefront of the treatment of this epidemic, they are ready to rush to the aid of other colleagues if necessary. The aim of preparing this protocol is to prioritize cardiac surgery procedures, maintain blood and blood product reserves and provide the appropriate care for patients while taking precautions for the safety of medical staff. The general recommendation in this first version of protocol is to postpone all elective cardiac surgeries and perform emergent and urgent cases according to suggested personal protection strategies for Covid-19.

    Keywords: Cardiac Surgery, Outbreak, Protocol, Pandemic Covid-19, SARS-Cov-2, PPE
  • Rabeah Zamani, Maryam Chenaghlou *, Zeinab Norouzi, MohammadMostafa Ansari Ramandi, Sepideh Taghavi, Ahmad Amin, Nasim Naderi Page 3
    Background

    Mortality, morbidity and the burden of the advanced heart failure and also the cost of frequent admissions is high. Several registries were done all over the world to manage the patients with heart failure; however studies about the advanced stage are limited.

    Objectives

    The present study aimed to determine the prognostic predictors of patients with advanced heart failure.

    Methods

    In this study 178 (74.2% male) patients with advanced heart failure (stage D) from 2011 to 2016 were selected according to the following inclusion criteria; highly symptomatic heart failure patients with severe left ventricular (LV) systolic dysfunction (LV ejection fraction less than 30%) who have been admitted for at least two times in the recent year because of decompensation. The data regarding the clinical findings, readmissions, mortality, laboratory tests, electrocardiography, echocardiography, etc. of patients were all derived from Rajaie Acute Systolic Heart Failure (RASHF) data registry.

    Results

    In a 5-year follow-up, we realized that more than 70% of the patients died. The rate of mortality were significantly higher in females (P value = 0.006) and there was a significant correlation between anemia and the mortality (P value = 0.002). There was no remarkable association between the serum creatinine, sodium and uric acid levels with the mortality of the patients.

    Conclusions

    Data about stage D of heart failure are limited. The mortality rate for such patients is relatively high and there’s no clear best treatment approach. Large registries and data acquisition of these patients could be helpful for better management approaches.

    Keywords: Mortality, Clinical Outcome, Registry, Advanced Heart Failure
  • Sepideh Djafari Naeini *, Narges Sadat Razavi, Maziar Taheri, AmirReza Ehsani, Hooman Bakhshandeh, Ali Ansari Far, Ahmad Amin, Sepideh Taghavi, Nasim Naderi Page 4
    Background

    Poor adherence to treatment in heart failure patients is associated with frequent hospital readmissions, worsening of symptoms and premature death. Since the progression of heart failure is also affected by the psychological and social aspects of life, identifying psychosocial variables associated with health-promoting behaviors in these patients is essential.

    Objectives

    The aim of this study was to investigate the relationship between cardiac self-efficacy, perceived social support (PSS) and adherence to treatment in patients with heart failure reduced ejection fraction (HFrEF).

    Methods

    Among patients referred to the outpatient heart failure clinic at Rajaie Cardiovascular, Medical and Research Center, a total of 120 patients with a diagnosis of HFrEF (left ventricular ejection fraction ≤ 35%), were consecutively enrolled. They were asked to complete demographic, cardiac self-efficacy, perceived social support (PSS) and adherence to treatment questionnaires.

    Results

    A total of 120 heart failure patients (70% male, 67% with ischemic etiology) were enrolled. Most patients were between 40 - 59 years old. The mean (SD) score of cardiac self-efficacy was 30.6 (2.4), which shows a fair self-efficacy in our study population. The mean (SD) score for PSS was 94.6 (10) which showed more than 75% of heart failure patients have enjoyed high levels of PSS. The mean (SD) scores for the three domains of adherence to treatment were 7.4 (1.5) for diet, 13.2 (2) for physical activity and 10 (1.4) for medications which shows a poor adherence to the diet. Both PSS and adherence to treatment were significantly correlated with NYHA function class. Multivariable logistic regression indicated that cardiac self-efficacy might be a better independent predictor of treatment adherence than PSS in patients with HFrEF.

    Conclusions

    According to the analyzed data of this study, social support, treatment adherence and self-efficacy among all patients with HFrEF were in acceptable levels. However, both patients and their care givers should be more educated in this regard.

    Keywords: Heart Failure, Perceived Social Support, Self- Efficacy, Treatment Adherence
  • Fahimeh Ghasemi, Rasoul Azarfarin, Sarvenaz Salahi, Bahador Baharestani, Alireza Alizadeh Ghavidel * Page 5
    Background

    Minimizing ischemic-reperfusion injury following valvular heart surgeries is very important with the goal of providing appropriate cardiac systolic function, preventing arrhythmic events as well as inhibiting ischemic related processes. Due to the protective effects of adenosine, this chemical has been used as an additive to a cardioplegic solution for achieving this purpose.

    Objectives

    The present study aimed to assess the effects of cold blood cardioplegia with adenosine on hemodynamic status of patients undergoing mitral valve surgery.

    Methods

    This randomized single-blinded clinical trial was performed on 40 consecutive patients who were candidates for mitral valve surgery. The patients were randomly assigned to receive cold blood cardioplegia in combination with or without adenosine or hyperkalemic cardioplegia as the control. Primary endpoints were returning sinus rhythm, requiring inotropes after cardiopulmonary bypass and secondary endpoints were the change in hemodynamic parameters and postoperative complications.

    Results

    Except for mean time required for induction of cardiac arrest that was significantly shorter in intervention group, no differences were found between the two groups regarding cardiopulmonary bypass time, cross clamp duration, and rhythm return time. In assessment of postoperative consequences, there were no differences in post-procedural events with respect to returning sinus rhythm, requiring inotropes, requiring DC shock, mean intubation time, length of ICU stay and also left ventricular systolic function.

    Conclusions

    Except for reducing the time for inducing cardiac arrest within mitral valve surgery, adding adenosine to cold blood cardioplegia may not be beneficial regarding the improvement of postoperative outcome.

    Keywords: Adenosine, Cardiopulmonary Bypass, Mitral Valve Surgery, Cardioplegia Solution
  • Azin Alizadehasl, Fatemeh Zohrian *, MohammadReza Hashemimanesh, Hamidreza Pouraliakbar, Arezoo Mohamadifar, Rasool Azarfarin, MohammadMehdi Peighambari, Solmaz Valizadeh Page 6

    Thrombus formation is an important prognostic factor in all cardiovascular diseases. Early diagnosis and treatment of intra-cardiac thrombus is critical. When a patient presents with cardiac thrombus, not only cardiac disorders but also other diseases such as malignancies, thrombophilia, rheumatologic disorders and hypercoagulable state should be considered. While regarding various hypercoagulable conditions, hyperhomocysteinemia should be evaluated. In this case report we report a case of left ventricular (LV) thrombosis in a patient with hyperhomocysteinemia.

    Keywords: Myocarditis, Hyperhomocysteinemia, Left Ventricular Thrombus
  • Azin Alizadehasl, Fatemeh Zohrian*, Seifolah Abdi, Freidoon Noohi Bezanjani, Bahram Mohebbi, Arezoo Mohamadifar, Mohsen Ziyaeifard, Rasoul Azarfarin, Solmaz Valizadeh Page 7

    Central venous access is commonly performed in the care of critically ill patients, for administration of repeated drug treatments. This routine procedure has multiple complications such as catheter malposition, migration, obstruction, infection, thrombosis and catheter fraction. We must recognize, consider and be able to manage these complications. We report a successful endovascular technique using a snare for retrieving broken venous port in a 36-year-old female.

    Keywords: Port, Fracture Central Venous Access