Search published articles


Showing 46 results for Cardia
Effect of cardiac rehabilitation on endothelial function in smoker patients with ischemic heart disease
Ahmad Reza Assareh , Marzieh Jafarpor, Mohammad Hossein Haghighzadeh, Nehzat Akiash,
Volume 80, Issue 6 (9-2022)
Abstract
Background: smoking enhances the risk of cardiac events in patients with coronary artery disease. So, it is necessary to evaluate the effects of exercise-based cardiac rehabilitation on endothelial function and functional capacity among smoker patients.
Methods: This randomized clinical trial study was conducted on 56 non-diabetic smokers with a history of percutaneous coronary intervention or coronary artery bypass graft surgery in Imam Khomeini Hospital from May to August 2015. Based on cardiac rehabilitation, patients were divided into intervention and control groups. Before rehabilitation, fasting blood sugar (FBS), lipid profile (LDL, HDL, triglyceride, and total cholesterol), and Ankle-Brachial Index (ABI) were measured for endothelial function. Besides, METs were measured based on the Duke activity status index. After 24 rehabilitation sessions (3 sessions of 1 hour each week for 2 months), all values were checked again and compared with the initial values.
Results: The mean age of the subjects in the cardiac rehabilitation and control groups were 61.18 and 52.32, respectively. Before the intervention, there were no significant differences between the two groups in terms of the ABI variables, BMI, systolic and diastolic blood pressure, LDL, triglyceride, total cholesterol and FBS; only HDL and  METs showed significant differences. After exercise-based cardiac rehabilitation, the mean rate of ABI changes was +0.078 on the right side of the body and +0.084 on the left side of the body. In the control group, these values were 0.002 and 0.003, respectively (P=0.001). The amount of changes in increasing METs as well as decreasing body mass index (BMI), and systolic and diastolic blood pressure in the rehabilitation group were statistically significant compared to the control group. In addition, there were no significant differences in terms of FBS and lipid profiles either (P>0.05).
Conclusion: Two months of cardiac rehabilitation with regular exercise was associated with improved ABI as an indicator of endothelial function and prognosis of cardiovascular disease, as well as improved cardiac functional capacity among smoker patients.

Frequency of cardiopulmonary resuscitation levels in the neonates delivered in Moheb Yas hospital of Tehran
Mahbod Kaveh, Mohammad Kaji-Yazdi , Mohsen Jafari, Armen Malekiantaghi, Seyed Yousef Mojtehedi , Kambiz Eftekhari,
Volume 80, Issue 7 (10-2022)
Abstract
Background: The neonate's Cardiopulmonary resuscitation (CPR) is the most important and common emergency condition in the delivery room. Approximately 10% of newborns are unable to initiate effective breathing and require assistance. The aim of this study was to evaluate the frequency of CPR levels of the neonates delivered during a year in Moheb Yas Hospital who were resuscitated.
Methods: This was a retrospective cross-sectional descriptive study. The sampling method in this study was census. In this study, all the live neonates born during the year (April, 2010 to April, 2011) in Moheb Yas Hospital who were resuscitated, were enrolled in the study. The information of these infants was recorded in separate checklists. This checklist included the following information: mother's age, gestational age, gender of the baby, method of the delivery, multiple births, complications of the placenta and umbilical cord, amount of amniotic fluid, fetal presentation, meconium excretion, fetal heart rate pattern, Apgar of the baby, resuscitation levels, underlying diseases of the mother, maternal diseases during pregnancy, drug use by the mother and premature rupture of the amniotic sac. Finally, the data were analyzed by SPSS software. P-values less than 0.05 were considered statistically significant.
Results: There were 2,176 live births during the study. Of these infants , a total of 322 neonates (15.27%) underwent CPR. 51.8% were male. The mean gestational age was 36.08 weeks. The first minute Apgar was less than 5, between 5-7, and above 8 respectively in 10.5%, 33.4%, and 56% of neonates. About 42% of neonates needed initial resuscitation (warming, drying, and respiratory stimulation). 48% required respiratory ventilation with bag and mask, 5% endotracheal tube, 2.7% cardiac massage, and 1.3% needed medication. In 96.7% of cases, the CPR team was ready for resuscitation before delivery.
Conclusion: If resuscitation is performed in a timely and appropriate manner, very few of these infants will need advanced resuscitation. On the other hand, the high need for resuscitation by bags and masks can be secondary to the educational nature of this hospital.

Ethical considerations in non-heart beating donation: a narrative review article
Keihan Mostafavi, Fariba Ghorbani, Mojtaba Mokhber Dezfuli , Mahdieh Hazrati , Ehsan Alibeigi , Nafise Mohamadizade,
Volume 80, Issue 8 (11-2022)
Abstract
Background: Considering the high death rate of patients on the transplant waiting list, one of the most important ethical challenges of organ transplantation is the lack of transplant organs and different approaches to cover it.
Methods: The ethical issues of organ transplantation have been frequently reviewed recently.
Results: Currently, there are 4 sources for organ transplants, which are: a) organ transplant from animal to human b) transplant from a living donor c) transplant from a brain-dead donor d) transplant from a cardiac-dead donor or donors without a heartbeat, and tissue engineering research continues to prepare a transplantable organ. Each of them has its own limitation and specific consideration. In Iran, organ procurement from brain-dead donors and living donors are the most important sources. Many approaches have been considered to increase the number of procured organs from brain-death cases in the world, but have not yet been able to reduce the gap between supply and demand. Therefore, since the 1980s, the program of organ transplantation from cardiac death (donors with irreversible cardiac arrest) in the world has been reviewed again. Based on the classification of cardiac arrest patients, they are placed in two general categories: uncontrolled and controlled. In a controlled condition, death is predictable, and organ removal is possible by eliminating planned medical interventions and patient support. But in the uncontrolled state, death occurs accidentally, which is more likely to prolong the duration of hot ischemia. Italy's organ donation group has recently introduced type 6 deaths in patients on ECMO, which is mentioned as a semi-controlled group. This group is called donors with abnormal blood flow versus brain-dead donors with normal blood flow. In this study, ethical considerations for organ donation from NHBD were discussed. Regarding the procurement of organs from non-heart beating donors, there are many ethical considerations that include both the donors and the recipients. Considering that the clinical conditions of the brain-dead donors are sometimes very unstable, cardiac arrest may occur before organ harvesting. In these cases, donation after cardiac death is an option.
Conclusion: It is necessary to regulate the ethical considerations for organ procurement from NHBD

Examining the results of cardiopulmonary resuscitation and its influencing factors with emphasis on the cause of cardiac arrest and 1-year prognosis of rescued patients
Siros Norozi , Paniz Poursiabidi ,
Volume 80, Issue 12 (3-2023)
Abstract
Background: Cardiopulmonary resuscitation is a quick and immediate intervention to prevent death in a person who has suddenly suffered cardiorespiratory arrest. This study aims to investigate the results of cardiopulmonary resuscitation and the factors affecting it with emphasis on the cause of cardiac arrest and 1-year prognosis of the saved patients.
Methods: Materials and methods: This research is a retrospective descriptive-analytical study that was conducted for 24 months, from April 1, 2017 to the end of March 2018, in Shahid Mostafa Khomeini Hospital in Ilam, from July 2022 to September 2022. The necessary information was collected based on the data available in the patients' files. Data analysis was done using SPSS24 software.
Results: Out of 152 patients, 64(42.1%) were men and 88(57.9%) were women. The average in the group that had a successful CPR was 60.75 years and in the group that had an unsuccessful CPR was 68.27 years. 13.7% of all CPRs occurred during shift change. The number of CPR was 11 cases (7.2%) in changing night shift to morning, six cases (3.9%) in changing evening shift to night, and four cases (2.6%) in changing evening to night shift. Most of the patients who underwent CPR were patients with internal diseases.
Conclusion: In this study, the final success rate of CPR was close to other studies. These results indicate that performing CPR is considered at any time. However, the reasons for the failure of the rehabilitation operation should be looked for in other factors. These factors can include updating nursing and medical team’s knowledge in the field of resuscitation, experience and skills of the resuscitation team, and periodic training of the resuscitation team, which should be considered regularly in order to reduce unsuccessful cases.

Evaluation of the relationship between the severity of depression, anxiety and stress with nuclear scan in Urmia
Sara Hassanzadeh, Mahmonir Haghighi, Hojjat Shafipour, Maryam Faramarzpour,
Volume 81, Issue 1 (4-2023)
Abstract
Background: Some negative psychological factors such as depression, anxiety, and stress have been identified as serious risk factors for the final adverse outcome of ischemic heart disease. Given the high prevalence of psychiatric disorders, in this study, we aimed to determine the relationship between the severity of depression, anxiety, and stress, with nuclear scan results in patients referred to Imam Khomeini Hospital in Urmia.
Methods: In this cross-sectional-analytical study, 163 patients with the possibility of ischemic heart disease from various clinics and medical centers referred to Imam Khomeini Hospital in Urmia for nuclear heart scanning from April to July 1400, were assessed by the DASS-21 questionnaire in terms of depression, anxiety, and stress scores. Finally, the data obtained from the DASS-21 questionnaire, nuclear scan, and demographic characteristics were analyzed with SPSS20 software.
Results: According to the results, the mean age of the patients was 54.78±11.54 years, 73% of whom were women. The prevalence of depression, anxiety, and stress was high (72.4, 80.3, and 59.5%, respectively). Although the prevalence of depression, anxiety, and stress in patients with a negative report of ischemia was higher and evaluated as 73.2, 78.7, and 58.3% respectively, there was not a significant difference with the subjects whose heart scan results were positive (P>0.05). Moreover, a weak positive correlation was observed between the severity of depression, anxiety, and stress with the severity of cardiac ischemia in study patients.
Conclusion: The results of this study revealed that the depressive, anxiety, and stress symptoms in patients before a cardiac nuclear scan are often moderate to mild. Likewise, among the different demographic characteristics of patients, only gender played an important role in these disorders. Regardless of the negative nuclear scan results in most patients (77.9%), the prevalence of these psychological symptoms in the studied patients was high. Therefore, considering the possibility of psychological disorders with clinical manifestations mimicking cardiovascular can prevent additional costs for diagnostic and therapeutic procedures in these patients.

Management of left ventricular thrombus: diagnostic and therapeutic methods: a review article
Maryam Mehrpooya, Zahra Sadeghi,
Volume 81, Issue 8 (11-2023)
Abstract
Left ventricular thrombosis (LVT) is a very serious condition and life-threatening complication that usually occurs after acute occlusion of the left anterior descending (LAD) coronary artery followed by acute myocardial infarction with ST-segment elevation (STEMI), which leads to significant regional wall motion abnormality (RWMA). It should be noted that its diagnosis, treatment, and management are challenging now and depend on various factors such as the type of thrombus, time of percutaneous coronary intervention (PCI), and underlying disease. The preferred diagnostic method is cardiovascular magnetic resonance imaging (CMR), but transthoracic echocardiography (TTE) is routinely used for diagnostic and screening purposes also follow-up of response to treatment. It is worth mentioning that when the diagnosis of left ventricular thrombus is not clear with conventional echocardiography, contrast echocardiography is used for more resolution and detailed information. Left ventricular thrombosis can appear in both acute and chronic forms and lead to significant complications, the most important of them are stroke and systemic arterial embolism (SE). According to previous studies, vitamin K antagonist (warfarin) by keeping INR within the therapeutic range currently used to treat left ventricular thrombosis. Although the use of direct oral anticoagulants (DOAC) has brought excellent outcomes, but due to the lack of large clinical trials, the routine use of these agents is controversial, and only in case of warfarin intolerance or contraindications, DOACs can be used as an alternative. Generally, the best way to prevent left ventricular thrombosis is primary percutaneous coronary angioplasty (primary PCI) which preserves left ventricular function. Depending on the sensitivity of the diagnostic method, thrombus will likely resolve in >50% of patients by six months after the MI. On the other hand, in rare cases, surgery is indicated if a thrombosis remains despite the medical treatment especially if it is accompanied by a left ventricular aneurysm. The purpose of this narrative review is to evaluate the latest evidence in the field of left ventricular thrombosis management and to adopt the best approach for these patients.

Page 3 from 3     

© 2025 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb