Pub Date : 2023-07-10DOI: 10.5812/intjcardiovascpract-136286
Azadeh Tahooni, S. Eftekhari, A. Kabir
Introduction: Symptomatic chronic mesenteric ischemia (CMI) is a rare condition that usually occurs due to mesenteric artery stenosis (MAS) with a common incidence. Although the prevalence of symptomatic CMI is less than 2%, MAS is more common in the elderly. Case Presentation: A 60-year-old woman with prolonged eating-related abdominal pain and weight loss treated as cholelithiasis by endoscopic retrograde cholangiography was readmitted by recurrent epigastric pain. At this time, she was reevaluated by computed tomography angiography (CTA), and CMI was confirmed. She was treated with percutaneous mesenteric artery stenting and was discharged without pain. There were no complications or pain after 3 months of follow-up. Conclusions: The most prevalent causes of CMI are atherosclerotic processes, such as hypertension, hyperlipidemia, overweight, metabolic syndrome, and smoking. The diagnosis of CMI is confirmed by CTA. Recently, endovascular treatment by percutaneous mesenteric artery stenting is more common than the surgical approaches because of lower in- and out-hospital complications.
{"title":"Chronic Mesenteric Ischemia, More Attention is Needed in Cases with Prolonged Abdominal Pain: A Case Report and Brief Review","authors":"Azadeh Tahooni, S. Eftekhari, A. Kabir","doi":"10.5812/intjcardiovascpract-136286","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-136286","url":null,"abstract":"Introduction: Symptomatic chronic mesenteric ischemia (CMI) is a rare condition that usually occurs due to mesenteric artery stenosis (MAS) with a common incidence. Although the prevalence of symptomatic CMI is less than 2%, MAS is more common in the elderly. Case Presentation: A 60-year-old woman with prolonged eating-related abdominal pain and weight loss treated as cholelithiasis by endoscopic retrograde cholangiography was readmitted by recurrent epigastric pain. At this time, she was reevaluated by computed tomography angiography (CTA), and CMI was confirmed. She was treated with percutaneous mesenteric artery stenting and was discharged without pain. There were no complications or pain after 3 months of follow-up. Conclusions: The most prevalent causes of CMI are atherosclerotic processes, such as hypertension, hyperlipidemia, overweight, metabolic syndrome, and smoking. The diagnosis of CMI is confirmed by CTA. Recently, endovascular treatment by percutaneous mesenteric artery stenting is more common than the surgical approaches because of lower in- and out-hospital complications.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87990488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-10DOI: 10.5812/intjcardiovascpract-136592
A. Jalali, Aghdas Shadmehr, Mozghan Parsaee, Z. Khajali, Sara Adimi, Ronak Ahmadi, Amir Ghaffari, S. Saedi
Background: Ebstein anomaly (EA) is a rare congenital disorder of the tricuspid valve (TV), accounting for about one percent of congenital heart defects. Considering highly variable anatomy, diverse corrective surgical methods are currently utilized. Cone reconstruction provides a near anatomic tricuspid restoration method that has triggered enthusiasm for early repair over recent years. Objectives: In the current study, we aimed to evaluate the clinical and echocardiographic features and outcomes of patients who underwent surgical correction of EA in our referral center. Methods: In this study, we reviewed the medical records of 35 patients with EA who underwent cone repair or TV replacement and had accessible echocardiographic data before and at least one year following the corrective surgery. The patients were evaluated for residual tricuspid regurgitation (TR) severity, right ventricular (RV) size, RV fractional area change (FAC), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and 2D left ventricular ejection fraction (LVEF) before and after the operation. Results: Mean age of the patients was 29.49 ± 9.13 years, and 54.3% of them were female. Twenty-one (60%) patients underwent cone repair, and 14 were subjected to TV replacement. Seven (20%) patients required reoperation; redo TV repair was conducted in three patients (8.6%); two (5.7%) patients underwent biologic TV replacement; mechanical TV replacement was performed in one patient (2.9%) who had degenerative biologic TVs, and one patient (2.9%) was subjected to redo-operation due to mechanical TV malfunction. Positive changes in the means of RV-FAC and 2D-LVEF were statistically significant in all patients irrespective of the type of surgery (P < 0.001), but changes in the means of RV size (P = 0.38) and LVESD (P = 0.302) were not statistically significant. There was a significant increase in functional RV size in both groups of patients who underwent repair (P = 0.063) or replacement (P = 0.02). Conclusions: The present study revealed satisfactory post-op results for cone TV repair in patients with EA, evidenced by reduced TR severity and improved biventricular functional parameters. Assessing the durability of the outcomes of cone TV repair needs longer-term follow-ups.
{"title":"Surgical Outcomes of Repairing Ebstein Anomaly: A Single-Center Experience","authors":"A. Jalali, Aghdas Shadmehr, Mozghan Parsaee, Z. Khajali, Sara Adimi, Ronak Ahmadi, Amir Ghaffari, S. Saedi","doi":"10.5812/intjcardiovascpract-136592","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-136592","url":null,"abstract":"Background: Ebstein anomaly (EA) is a rare congenital disorder of the tricuspid valve (TV), accounting for about one percent of congenital heart defects. Considering highly variable anatomy, diverse corrective surgical methods are currently utilized. Cone reconstruction provides a near anatomic tricuspid restoration method that has triggered enthusiasm for early repair over recent years. Objectives: In the current study, we aimed to evaluate the clinical and echocardiographic features and outcomes of patients who underwent surgical correction of EA in our referral center. Methods: In this study, we reviewed the medical records of 35 patients with EA who underwent cone repair or TV replacement and had accessible echocardiographic data before and at least one year following the corrective surgery. The patients were evaluated for residual tricuspid regurgitation (TR) severity, right ventricular (RV) size, RV fractional area change (FAC), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and 2D left ventricular ejection fraction (LVEF) before and after the operation. Results: Mean age of the patients was 29.49 ± 9.13 years, and 54.3% of them were female. Twenty-one (60%) patients underwent cone repair, and 14 were subjected to TV replacement. Seven (20%) patients required reoperation; redo TV repair was conducted in three patients (8.6%); two (5.7%) patients underwent biologic TV replacement; mechanical TV replacement was performed in one patient (2.9%) who had degenerative biologic TVs, and one patient (2.9%) was subjected to redo-operation due to mechanical TV malfunction. Positive changes in the means of RV-FAC and 2D-LVEF were statistically significant in all patients irrespective of the type of surgery (P < 0.001), but changes in the means of RV size (P = 0.38) and LVESD (P = 0.302) were not statistically significant. There was a significant increase in functional RV size in both groups of patients who underwent repair (P = 0.063) or replacement (P = 0.02). Conclusions: The present study revealed satisfactory post-op results for cone TV repair in patients with EA, evidenced by reduced TR severity and improved biventricular functional parameters. Assessing the durability of the outcomes of cone TV repair needs longer-term follow-ups.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82493692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-12DOI: 10.5812/intjcardiovascpract-133637
Saiedeh Erfanian, Zahra Hooshanginezhad, A. Hassani, M. Ghabouli, M. Shojaie
Background: Dilated cardiomyopathy (DCM) is among the most prevalent causes of heart failure and sudden cardiac death worldwide. Nuclear lamin protein coding genes are believed to have a definitive role in the DCM phenotype. The rs505058 thymine (T) to cytosine (C) polymorphism in the lamin-A gene is one of the most common mutations reported in familial DCM in previous studies. Objectives: We aimed to demonstrate the possible role of this SNP in the lamin A and C (LMNA) gene in the incidence of DCM among the south of Iran population. Methods: This case-control study included 65 patients with familial DCM and 70 healthy participants in south Iran. DNA was extracted from nucleated blood cells, and polymerase chain reaction (PCR) was performed. First, the sequence of the LMNA gene was investigated. Then the frequency of alleles C (mutated allele) and T (normal) of the LMNA gene (rs505058) was compared between the case and controls. Results: No notable differences were seen in gender and age between the case and controls. The genotype frequencies of the LMNA rs505058 T/C polymorphism were 6% (CC), 31% (CT), and 63% (TT) amongst cases, and 1% (CC), 13% (CT) and 86% (TT) in controls. For allele level comparison, the LMNA rs505058 C allele has been shown to have a statistically significant association with an enhancement in the risk of dilated cardiomyopathy (OR = 2.92; 95% CI = 1.05 to 8.15, P-value = 0.034) Conclusions: The results indicated that the rs505058 T/C SNP of the LMNA gene is associated with familial DCM patients in the Iranian population.
{"title":"Association of rs505080 Single Nucleotide Polymorphism in Lamin-A Gene with Familial Dilated Cardiomyopathy in Iranian Population; A Case-Control Study","authors":"Saiedeh Erfanian, Zahra Hooshanginezhad, A. Hassani, M. Ghabouli, M. Shojaie","doi":"10.5812/intjcardiovascpract-133637","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-133637","url":null,"abstract":"Background: Dilated cardiomyopathy (DCM) is among the most prevalent causes of heart failure and sudden cardiac death worldwide. Nuclear lamin protein coding genes are believed to have a definitive role in the DCM phenotype. The rs505058 thymine (T) to cytosine (C) polymorphism in the lamin-A gene is one of the most common mutations reported in familial DCM in previous studies. Objectives: We aimed to demonstrate the possible role of this SNP in the lamin A and C (LMNA) gene in the incidence of DCM among the south of Iran population. Methods: This case-control study included 65 patients with familial DCM and 70 healthy participants in south Iran. DNA was extracted from nucleated blood cells, and polymerase chain reaction (PCR) was performed. First, the sequence of the LMNA gene was investigated. Then the frequency of alleles C (mutated allele) and T (normal) of the LMNA gene (rs505058) was compared between the case and controls. Results: No notable differences were seen in gender and age between the case and controls. The genotype frequencies of the LMNA rs505058 T/C polymorphism were 6% (CC), 31% (CT), and 63% (TT) amongst cases, and 1% (CC), 13% (CT) and 86% (TT) in controls. For allele level comparison, the LMNA rs505058 C allele has been shown to have a statistically significant association with an enhancement in the risk of dilated cardiomyopathy (OR = 2.92; 95% CI = 1.05 to 8.15, P-value = 0.034) Conclusions: The results indicated that the rs505058 T/C SNP of the LMNA gene is associated with familial DCM patients in the Iranian population.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77857853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-24DOI: 10.5812/intjcardiovascpract-134163
Sepideh Jafari Naeini, H. Pouraliakbar, S. M. Mirhosseini, A. Bagheri
: Eosinophilic myocarditis (EM) is a rare type of myocarditis usually diagnosed by endomyocardial biopsy; however, it can also be diagnosed by cardiac magnetic resonance imaging. Different presentations cause some problems in the diagnosis and treatment. Herein, we present a middle-aged female case with eosinophilia and EM.
{"title":"Eosinophilic Myocarditis: A Case Report and Literature Review","authors":"Sepideh Jafari Naeini, H. Pouraliakbar, S. M. Mirhosseini, A. Bagheri","doi":"10.5812/intjcardiovascpract-134163","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-134163","url":null,"abstract":": Eosinophilic myocarditis (EM) is a rare type of myocarditis usually diagnosed by endomyocardial biopsy; however, it can also be diagnosed by cardiac magnetic resonance imaging. Different presentations cause some problems in the diagnosis and treatment. Herein, we present a middle-aged female case with eosinophilia and EM.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74651277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-22DOI: 10.5812/intjcardiovascpract-129928
Mehrdad Raadi, Elnaz Javanshir, Rezvaniyeh Salehi, A. Separham
Background: There are few studies about the impact of diagonal branch blood flow on echocardiographic findings in patients with first acute anterior myocardial infarction undergoing primary angioplasty. Objectives: We aimed to compare left ventricular systolic function measures in patients with first acute anterior ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty based on diagonal branch blood flow after the procedure. Methods: This study was a single-center study that enrolled patients with their first acute anterior STEMI treated with primary angioplasty in our center between October 2020 and March 2021. Patients were divided into two groups: The patients with final thrombolysis in myocardial infarction (TIMI) flow III in diagonal (sufficient diagonal flow) and patients with final TIMI flow less than III in diagonal (insufficient diagonal flow) after the procedure. The left ventricular Wall-Motion Score Index (WMSI) and left ventricular ejection fraction (LVEF) were compared between the two groups. Results: A total of 107 patients with first anterior STEMI treated with primary PCI were enrolled in the present study, of which 13 patients (12.1%) had insufficient diagonal flow after primary coronary angioplasty. The LVEF was lower in patients with insufficient diagonal flow (32.92 ± 7.29% vs. 39 ± 8.68%, P = 0.018). Also, this group had higher LV WMSI (1.68 ± 0.28 vs. 1.49 ± 0.26, P = 0.029). Conclusions: The present study showed that in patients with first acute anterior STEMI undergoing primary angioplasty, insufficient diagonal branch flow after the procedure was associated with worse left ventricular systolic function and higher LV WMSI.
背景:对于首次急性前壁心肌梗死行初级血管成形术的患者，斜支血流对超声心动图表现的影响研究较少。目的:我们的目的是比较首次急性st段前抬高型心肌梗死(STEMI)患者在手术后基于斜支血流的初级血管成形术中左心室收缩功能的测量。方法:本研究是一项单中心研究，纳入了2020年10月至2021年3月期间在我们中心接受初级血管成形术治疗的首次急性前路STEMI患者。将患者分为两组:术后最终溶栓心肌梗死(TIMI)血流呈对角线III级(充分对角线血流)和最终TIMI血流小于对角线III级(不足对角线血流)的患者。比较两组患者左室壁运动评分指数(WMSI)和左室射血分数(LVEF)。结果:本研究共纳入107例经PCI治疗的首次前路STEMI患者，其中13例(12.1%)患者在初次冠状动脉成形术后出现对角血流不足。斜流不足组LVEF较低(32.92±7.29% vs. 39±8.68%，P = 0.018)。此外，该组lvwmsi较高(1.68±0.28∶1.49±0.26,P = 0.029)。结论:本研究表明，在首次急性前路STEMI患者行初级血管成形术后，斜支血流不足与左室收缩功能恶化和左室WMSI升高有关。
{"title":"Association of Left Ventricular Systolic Function with Diagonal Branch Flow in Patients with First Anterior ST-Elevation Myocardial Infarction Treated with Primary Angioplasty","authors":"Mehrdad Raadi, Elnaz Javanshir, Rezvaniyeh Salehi, A. Separham","doi":"10.5812/intjcardiovascpract-129928","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-129928","url":null,"abstract":"Background: There are few studies about the impact of diagonal branch blood flow on echocardiographic findings in patients with first acute anterior myocardial infarction undergoing primary angioplasty. Objectives: We aimed to compare left ventricular systolic function measures in patients with first acute anterior ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty based on diagonal branch blood flow after the procedure. Methods: This study was a single-center study that enrolled patients with their first acute anterior STEMI treated with primary angioplasty in our center between October 2020 and March 2021. Patients were divided into two groups: The patients with final thrombolysis in myocardial infarction (TIMI) flow III in diagonal (sufficient diagonal flow) and patients with final TIMI flow less than III in diagonal (insufficient diagonal flow) after the procedure. The left ventricular Wall-Motion Score Index (WMSI) and left ventricular ejection fraction (LVEF) were compared between the two groups. Results: A total of 107 patients with first anterior STEMI treated with primary PCI were enrolled in the present study, of which 13 patients (12.1%) had insufficient diagonal flow after primary coronary angioplasty. The LVEF was lower in patients with insufficient diagonal flow (32.92 ± 7.29% vs. 39 ± 8.68%, P = 0.018). Also, this group had higher LV WMSI (1.68 ± 0.28 vs. 1.49 ± 0.26, P = 0.029). Conclusions: The present study showed that in patients with first acute anterior STEMI undergoing primary angioplasty, insufficient diagonal branch flow after the procedure was associated with worse left ventricular systolic function and higher LV WMSI.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90686887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
: Immune checkpoint inhibitors (ICIs) prevent the immune escape of tumor cells, which helps immune cells such as T lymphocytes to continuously monitor and kill tumor cells, and play powerful anti-tumor role. Immune checkpoint inhibitor-associated myocarditis has been rarely reported; however, its latent, rapidly developed, and lethal onset has gradually attracted the attention of clinicians. This study aimed to report cases of fulminant myocarditis in three patients with thymoma who were treated with pembrolizumab, one of the programmed cell death protein 1 inhibitors (PD-1 inhibitors).
{"title":"Fulminant Myocarditis Complicated with Immune Checkpoint Inhibitor in Patients with Thymoma: Report of Three Cases","authors":"Daozheng Huang, Feier Song, Weidai Zhang, Huan Ma, Xingtao Lin, Tiehe Qin, Shouhong Wang","doi":"10.5812/intjcardiovascpract-130990","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-130990","url":null,"abstract":": Immune checkpoint inhibitors (ICIs) prevent the immune escape of tumor cells, which helps immune cells such as T lymphocytes to continuously monitor and kill tumor cells, and play powerful anti-tumor role. Immune checkpoint inhibitor-associated myocarditis has been rarely reported; however, its latent, rapidly developed, and lethal onset has gradually attracted the attention of clinicians. This study aimed to report cases of fulminant myocarditis in three patients with thymoma who were treated with pembrolizumab, one of the programmed cell death protein 1 inhibitors (PD-1 inhibitors).","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"241 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136356989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-16DOI: 10.5812/intjcardiovascpract-133219
Z. Ahmadi, M. Keshmiri, B. Sharif kashani, Sima Noorali, Somayeh Lookzadeh, Sina Aghdasi, Mahsa Riahi, Aylar Fazlzadeh, A. Mohamadifar, A. Serati, S. Shafaghi
: Since thrombosis occurrence among coronavirus disease 2019 (COVID-19) patients is a critical complication, this study aimed to describe the clinical characteristics and outcomes of COVID-19-associated pulmonary thromboembolism (PTE). This case series of 39 venous thromboembolism (VTE) patients represents clinical characteristics, laboratory data, imaging data, and outcomes. The mean age of the patients was 55 ± 15 years. Moreover, 25 patients (64.10%) were male. The most frequent COVID-19 clinical presentations were dyspnea and cough in 22 (56.41%) and 19 (48.71%) patients, respectively. Additionally, the most frequent PTE clinical presentations were palpitation and anxiety in 28 (71.79%) and dyspnea in 24 (61.53%) patients. Additionally, eight patients (20.51%) showed deep vein thrombosis in color Doppler ultrasound. The mean measures of D-dimer, erythrocyte sedimentation rate and C-reactive protein were 3680 ng/mL, 53 mm/hour, and 44 mg/L, respectively. Supplemental oxygen and a ventilator were required in 29 (74.35%) and 2 (5.12%) patients, respectively. One patient died from PTE complications, and others improved without any complications. The VTE is a potentially life-threatening complication that frequently occurs in patients with COVID-19. Therapeutic doses of anticoagulants, extended thromboprophylaxis, meticulous assessments, follow-up, and high clinical suspicion to the early detection of PTE are necessary in this regard.
{"title":"Venous Thromboembolism in COVID-19 Patients: A Single-Center Case Series","authors":"Z. Ahmadi, M. Keshmiri, B. Sharif kashani, Sima Noorali, Somayeh Lookzadeh, Sina Aghdasi, Mahsa Riahi, Aylar Fazlzadeh, A. Mohamadifar, A. Serati, S. Shafaghi","doi":"10.5812/intjcardiovascpract-133219","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-133219","url":null,"abstract":": Since thrombosis occurrence among coronavirus disease 2019 (COVID-19) patients is a critical complication, this study aimed to describe the clinical characteristics and outcomes of COVID-19-associated pulmonary thromboembolism (PTE). This case series of 39 venous thromboembolism (VTE) patients represents clinical characteristics, laboratory data, imaging data, and outcomes. The mean age of the patients was 55 ± 15 years. Moreover, 25 patients (64.10%) were male. The most frequent COVID-19 clinical presentations were dyspnea and cough in 22 (56.41%) and 19 (48.71%) patients, respectively. Additionally, the most frequent PTE clinical presentations were palpitation and anxiety in 28 (71.79%) and dyspnea in 24 (61.53%) patients. Additionally, eight patients (20.51%) showed deep vein thrombosis in color Doppler ultrasound. The mean measures of D-dimer, erythrocyte sedimentation rate and C-reactive protein were 3680 ng/mL, 53 mm/hour, and 44 mg/L, respectively. Supplemental oxygen and a ventilator were required in 29 (74.35%) and 2 (5.12%) patients, respectively. One patient died from PTE complications, and others improved without any complications. The VTE is a potentially life-threatening complication that frequently occurs in patients with COVID-19. Therapeutic doses of anticoagulants, extended thromboprophylaxis, meticulous assessments, follow-up, and high clinical suspicion to the early detection of PTE are necessary in this regard.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90342195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-13DOI: 10.5812/intjcardiovascpract-131154
M. Mahjoob, Roxana Sadeghi, Mohammad Haji Aghajani, Naser Kachoueian, Pardis Jolfaei, M. Nosrati, Mahshid Haghi
Background: Mitral valve stenosis (MS), which could be progressive, is one of the most important valvular disorders in developing countries. Percutaneous transvenous mitral commissurotomy (PTMC) is a well-accepted treatment option for dealing with symptomatic MS. Brain natriuretic peptide (BNP) has been used as a prognostic marker for clinical outcomes in patients with heart failure and acute coronary syndrome routinely. Objectives: This study aimed to determine the relationship between BNP levels and hemodynamic parameters in patients with MS who underwent PTMC. Methods: In this case-control study, 90 patients with severe isolated rheumatic mitral stenosis and undergoing PTMC were enrolled. In the study group, BNP levels were measured by performing radioimmunoassay on all participants 30 minutes before PTMC and 24 hours after PTMC. Data were analyzed using SPSS, and P-value < 0.05 was considered significant. Results: Fifty patients with MS who underwent PTMC were included in this study. The level of BNP before PTMC was 473.78 ± 66.95 pg/dL in patients with MS. The level of BNP in patients after PTMC reached 341.54 ± 48.3 pg/dL, which was indicative of a significant reduction in the level of BNP after PTMC (P-value = 0.006). Conclusions: A considerable decline was observed in the serum level of BNP following a successful PTMC, which was indicative of an improvement in clinical and hemodynamic status; hence, it was reasonably suggested that the serum level of BNP was effective in evaluating the response from patient with severe MS to PTMC.
{"title":"The Effect of Balloon Mitral Valvuplasty on BNP Plasma Level in Mitral Stenosis","authors":"M. Mahjoob, Roxana Sadeghi, Mohammad Haji Aghajani, Naser Kachoueian, Pardis Jolfaei, M. Nosrati, Mahshid Haghi","doi":"10.5812/intjcardiovascpract-131154","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-131154","url":null,"abstract":"Background: Mitral valve stenosis (MS), which could be progressive, is one of the most important valvular disorders in developing countries. Percutaneous transvenous mitral commissurotomy (PTMC) is a well-accepted treatment option for dealing with symptomatic MS. Brain natriuretic peptide (BNP) has been used as a prognostic marker for clinical outcomes in patients with heart failure and acute coronary syndrome routinely. Objectives: This study aimed to determine the relationship between BNP levels and hemodynamic parameters in patients with MS who underwent PTMC. Methods: In this case-control study, 90 patients with severe isolated rheumatic mitral stenosis and undergoing PTMC were enrolled. In the study group, BNP levels were measured by performing radioimmunoassay on all participants 30 minutes before PTMC and 24 hours after PTMC. Data were analyzed using SPSS, and P-value < 0.05 was considered significant. Results: Fifty patients with MS who underwent PTMC were included in this study. The level of BNP before PTMC was 473.78 ± 66.95 pg/dL in patients with MS. The level of BNP in patients after PTMC reached 341.54 ± 48.3 pg/dL, which was indicative of a significant reduction in the level of BNP after PTMC (P-value = 0.006). Conclusions: A considerable decline was observed in the serum level of BNP following a successful PTMC, which was indicative of an improvement in clinical and hemodynamic status; hence, it was reasonably suggested that the serum level of BNP was effective in evaluating the response from patient with severe MS to PTMC.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83797897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-25DOI: 10.5812/intjcardiovascpract-133752
Ehsan Razeghi1, Mohammadhosein Akhlaghpasand, Ashkan Majidi, Setayesh Farahani, Sam Zeraatian Nejad, F. Eghbali
Introduction: Ascending aortic pseudoaneurysm (AAP) rupture is a surgical emergency that needs immediate medical and surgical attention and treatment. This rupture can be caused by a variety of risk factors. Prior cardiovascular surgery is a common cause, and prior aortic valve operation is a rare cause. Case Presentation: In this case report, we describe a 47-year-old male with AAP who had a history of aortic valve replacement because of aortic stenosis.
{"title":"Ascending Aortic Pseudoaneurysm Following Aortic Valve Replacement: A Case Report and Literature Review","authors":"Ehsan Razeghi1, Mohammadhosein Akhlaghpasand, Ashkan Majidi, Setayesh Farahani, Sam Zeraatian Nejad, F. Eghbali","doi":"10.5812/intjcardiovascpract-133752","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-133752","url":null,"abstract":"Introduction: Ascending aortic pseudoaneurysm (AAP) rupture is a surgical emergency that needs immediate medical and surgical attention and treatment. This rupture can be caused by a variety of risk factors. Prior cardiovascular surgery is a common cause, and prior aortic valve operation is a rare cause. Case Presentation: In this case report, we describe a 47-year-old male with AAP who had a history of aortic valve replacement because of aortic stenosis.","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90926706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-12DOI: 10.5812/intjcardiovascpract-131707
M. Shojaeifard, S. Keshavari, Saideh Jamshidi, H. Bakhshandeh, Mohammad Ali Ghaznavai, Hossein Dehghani Mohammad Abadi, S. Erami
Background: Atrial septal defect (ASD) is a common congenital heart disease in adults. Concomitant mitral valve disease in patients with ASD could have significant hemodynamic effects whit a great impact on managing this congenital defect. Objectives: This study evaluated the prevalence of mitral valve abnormalities and the hemodynamic burden associated with different types of ASD. Methods: This retrospective study reanalyzed 1,006 consecutive patients referred to Rajaie Heart Center in Tehran from March 2019 to February 2022. We evaluated adult patients with the diagnosis of a shunt at the atrial level. Diagnoses were made with 2D and 3D transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). 3D analysis was performed with 3D zoom, mitral valve navigation (MVN), and full-volume and multi-planar reconstruction (MPR) modalities. We performed statistical analysis by SPSS version 22.0. The qualitative data were expressed as frequency and percentage. Data were compared between subgroups via Mann-Whitney U/Kruskal-Wallis tests for the interval variables, Pearson's chi-square test for nominal variables, and chi-square for trends test for ordinal variables. Results: The distribution of different ASD types was ostium secundum in 88.8% of cases, primum ASD in 0.9%, SVC-type sinus venosus ASD in 9%, IVC-type sinus venosus in 0.4%, and unroofed coronary sinus in 0.9%. We found mitral valve abnormalities in 21.1% of cases, and the most common mitral valve abnormality were prolaptic lesions (17.4%). Conclusions: Age, ASD size, estimated Systolic Pulmonary Artery Pressure (SPAP), and severity of mitral regurgitation (MR) were markedly higher were markedly higher among patients with MV anomalies, more over left ventricular ejection fraction (LVEF) was significantly lower among this group (P-value < 0.05).
{"title":"Prevalence and Hemodynamic Consequences of Mitral Valve Abnormalities in Atrial Septal Defect","authors":"M. Shojaeifard, S. Keshavari, Saideh Jamshidi, H. Bakhshandeh, Mohammad Ali Ghaznavai, Hossein Dehghani Mohammad Abadi, S. Erami","doi":"10.5812/intjcardiovascpract-131707","DOIUrl":"https://doi.org/10.5812/intjcardiovascpract-131707","url":null,"abstract":"Background: Atrial septal defect (ASD) is a common congenital heart disease in adults. Concomitant mitral valve disease in patients with ASD could have significant hemodynamic effects whit a great impact on managing this congenital defect. Objectives: This study evaluated the prevalence of mitral valve abnormalities and the hemodynamic burden associated with different types of ASD. Methods: This retrospective study reanalyzed 1,006 consecutive patients referred to Rajaie Heart Center in Tehran from March 2019 to February 2022. We evaluated adult patients with the diagnosis of a shunt at the atrial level. Diagnoses were made with 2D and 3D transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). 3D analysis was performed with 3D zoom, mitral valve navigation (MVN), and full-volume and multi-planar reconstruction (MPR) modalities. We performed statistical analysis by SPSS version 22.0. The qualitative data were expressed as frequency and percentage. Data were compared between subgroups via Mann-Whitney U/Kruskal-Wallis tests for the interval variables, Pearson's chi-square test for nominal variables, and chi-square for trends test for ordinal variables. Results: The distribution of different ASD types was ostium secundum in 88.8% of cases, primum ASD in 0.9%, SVC-type sinus venosus ASD in 9%, IVC-type sinus venosus in 0.4%, and unroofed coronary sinus in 0.9%. We found mitral valve abnormalities in 21.1% of cases, and the most common mitral valve abnormality were prolaptic lesions (17.4%). Conclusions: Age, ASD size, estimated Systolic Pulmonary Artery Pressure (SPAP), and severity of mitral regurgitation (MR) were markedly higher were markedly higher among patients with MV anomalies, more over left ventricular ejection fraction (LVEF) was significantly lower among this group (P-value < 0.05).","PeriodicalId":31436,"journal":{"name":"International Journal of Cardiovascular Practice","volume":"94 1-2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85273603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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