فهرست مطالب
International Cardiovascular Research Journal
Volume:5 Issue: 3, Sep 2011
- تاریخ انتشار: 1391/01/27
- تعداد عناوین: 6
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Page 79BackgroundOne of the most common complaints after coronary artery bypass graft (CABG) is postoperative pain. Gabapentin is an anticonvulsant and antineuralgic agent.ObjectiveTo evaluate the analgesic effect of preemptive gabapentin on post-operative pain and morphine consumption after cardiac surgery.MethodsA double-blind randomized clinical trial was conducted on 60 male candidates for CABG. The patients were divided into two groups—the gabapentin (n=30) and the control group (n=30). The test group received 800 mg gabapentin orally two hours before the surgery followed by 400 mg of the drug two hourspost-extubation. The control group received placebo instead. Then severity of pain was recorded according to an 11-point visual analog pain scale. The amount of morphine consumed, its side effects and hemodynamic changes were also recorded during and at 2, 6, 12, 18 and 24 hours after extubation.ResultsThe mean±SD cumulative morphine consumption at the first 24 hours after extubation in gabapentin group was 0.9±1.5 mg while it was 1.5±4 mg for the control group. Therefore, gabapentin group consumed 38% less than the control group (P=0.01). The pain scores during rest and coughing at 2, 6, and 12 hoursafter extubation were also significantly lower in the gabapentin group compared with the control group (P=0.02). The mean±SD mechanical ventilation time was 5.4±1.7 hours for gabapentin group and 1.6±4.4 hours for the control group (P=0.035). The other variables including hemodynamic changes (HR, SBP and DBP), and incidence of nausea, vomiting and respiratory depression showed no significant difference between the studied groups within 24 hours after extubation.ConclusionOral pre-medication with gabapentin before CABG significantly reduces post-operative pain and morphine consumption in adult cardiac surgery.
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Page 82BackgroundWith a prevalence of almost 7% of all congenital heart diseases, atrial septal defect (ASD) is a common condition. Patent foramen ovale (PFO) is also a congenital heart disease which is frequently sustained into adulthood.ObjectiveTo study the feasibility of closure of ASD and PFU by Starway septal occluder device and the incidence of its inherent complications and procedural failure in 62 patients referred to our center.MethodsStarway septal occluder device was used for closure of ASD and PFO in 62 patients. After left and right heart catheterization, transesophageal echocardiography-guided closure was done for the patients with immediate recording of the results. Patients were followed for 6 months by transesophageal echocardiography for observing short- and mid-term complications.ResultsThe 62 studied patients were categorized into 2 groups. Group 1 included 31 patients (64% females) with ASD (mean±SD age: 26.7±7.6 years). Group 2 consisted of 31 patients (35.6% females) with PFO (mean±SD age: 53.5±12.4 years). Size of the right ventricle (RV) annulus was significantly (P=0.005) decreased after the intervention in the ASD group. Overall 5 (8%) patients developed post-intervention complications (transient ischemic attack, leg edema, and residual shunt) and procedural failure—4 (13%) in ASD group and 1 (3%) in PFO group. None of the patients developed device-related thrombosis, significant arrhythmia, aortic regurgitation and pericardial effusion after intervention.ConclusionStarway occluder device is effective and safe with very low short- and mid-term complication rates.
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Page 87BackgroundIt is believed that occupation influences cardiovascular risk factors. To assess blood pressure (BP) and other cardiovascular risk factors in three occupation groups—teachers, military personnel and female housekeepers residing in Shiraz, southern Iran.MethodsWe studied 2783 teachers, 366 military personnel, and 1896 female housekeepers who attended various medical education centers in Shiraz. BP, anthropometric parameters as well as fasted lipid profile and blood glucose level were measured determined for each participant.ResultsThe mean values of all analyzed cardiovascular risk factors were higher among female housekeepers compared to female teachers. The mean systolic and diastolic BP was significantly (P<0.001, and P=0.047, respectively) higher in female housekeepers than female teachers. Neither systolic nor diastolic BP had association with the type of occupation in men (military personnel vs. male teachers).ConclusionHousekeeping compared to teaching, may increase both systolic and diastolic BP in women
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Page 92BackgroundThe Pulmonary Vascular Resistance (PVR) index is an important hemodynamic variable in making determinations regarding cardiopulmonary diseases and can be measured echocardiographically. The objective of this report is to examine the relationship between echocardiographic parameters of ventricular function using PVR measurements.Materials And MethodsThis study included 40 patients. PVR and left ventricular function indexes (left ventricle diastolic function and Systolic Pulmonary Arterial Pressure (SPAP)) were measured echocardiographically and analyzed using a linear regression test. The relationship between the right ventricular Tricuspid Annular Plane Systolic Excursion (TAPSE) index and the mean PVR index was assessed with the Mann–Whitney test using SPSS Ver. 15.ResultsA comparison between PVR and TAPSE showed that the mean PVR was significantly reduced when TAPSE increased, with a cut-off point of 1.8 (P= 0.026). Examination of the relationship between SPAP and PVR made it clear that increased SPAP (mean PAP>25 mmHg) caused PVR to significantly increase (P<0.0001). Analysis of the relationship between LVEF and PVR showed that PVR decreased significantly in parallel with an increasing ejection fraction (P= 0.004). Determination of the mean PVR in the LV Diastolic dysfunction group showed that the mean difference between the PVR indexes of the LV diastolic ysfunction group and the restrictive pattern group was significantly higher han the mean difference between the PVR indexes of the LV diastolic dysfunction roup and the normal group(P<0.0001).ConclusionConsidering the significance of PVR measurement in reating cardiovascular diseases, we recommend echocardiography as a simple, ccessible and noninvasive method for determining this metric. In this study, we emonstrated that the strongest relationship between echocardiographically etermined measurements exists for the correlation between PVR and diastolic ysfunction and the grades thereof. This method can be used as an accessible ethod for determining PVR and as an index for assessing prognosis.
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Page 97BackgroundHypertension (HTN) affects nearly 26% of the adult population worldwide. Assessment of factors which influence blood pressure is a major topic for public health. One of these preventable risk factors is smoking.MethodsThis cross-sectional study was conducted on 3115 (1842 [59.1%] females) teachers from Shiraz. The participants aged between 21 and 73 years. A questionnaire was used to collect data on several cardiovascular disease risk factors including smoking and blood pressure.ResultsThe prevalence of smoking in our study group was 5.85%; 1.52% of the studied participants were ex-smokers. The prevalence of pre-HTN and HTN (JNC VII) was 42.6% and 18.2%, respectively. HTN was more prevalent among men and elderly people. Pre-HTN was more prevalent in smokers but HTN was more frequent in non-smokers. The mean rang of systolic and diastolic HTN, and pulse pressure was greater in heavy smokers than those who smoked <20 packs year, although the difference was not statically significant.ConclusionThe relation between the smoking status and blood pressure is not yet obvious. However, it seems that cessation or at least reduction in the amount of smoking would significantly decrease blood pressure.
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Page 103Coronary sinus (CS) diverticulum is one the different types of malformations of the right atrium and CS. It can be the primary focus of supraventricular arrhythmias and complicate CS lead implantation during cardiac resynchronization therapy (CRT) device implantation. Herein, we report on a case of CS diverticulum that caused difficulty in CS lead insertion during CRT implantation.