ÿþ<?xml version="1.0" encoding="UTF-16"?>

<Journal>

<JournalID>13</JournalID>

<PubDate_Fa>Payiz 1386</PubDate_Fa>

<PubDate_En>Fall 2007</PubDate_En>

<Volume>8</Volume>

<Number>3</Number>

<Abstract>

<AbstractID>70</AbstractID>

<Title>Measurement of LVEF using ECG-Gated SPECT and

Angiography: a Correlation Study</Title>

<Author>H. Firouzabady MD,* A. Bitarafan-Rajabi, H. Rajabi, F. Rastgou MD,*

F. Noohi MD,** A. Mohebbi MD,** A. R. Tilekoo,* N. Yaghoobi* and H. Malek*</Author>

<Background>Left ventricular ejection fraction (LVEF) is an important clinical index in diagnosis

and treatment of myocardial diseases. There are three major methods for measurement of

LVEF: echocardiography, angiography and ECG-gated SPECT. The first method is

economical, safe and rapid. The second one is more accurate, however invasive and the third

one lies somewhere in between. Multi-gated SPECT usually suffers from low reproducibility

compared to other methods. This is due to variation in processing factors, mainly

reconstruction methods and filtration. Up to now, there is no standard method of processing of

cardiac SPECT.</Background>

<Method>In this study, we attempted to find the optimum processing protocol in which the results are consistent with the angiographic results. Forty patients (referred to our department for myocardial perfusion SPECT) who had angiography within 2 weeks of the test were included

in the study. All the patients had a positive history of myocardial infarction. All imaging

performed with a single head GE gamma camera SPECT system model DSX using 99mTc-

MIBI. Two commonly used reconstruction methods i.e., filtered back projection and ordered

subset expectation maximization with different parameters were used and the results

compared with that of echocardiography and angiography.</Method>

<Result></Result>

</Abstract>

<Abstract>

<AbstractID>71</AbstractID>

<Title>Early and Mid-Term Surgical Results of Total

Cavopulmonary Connection</Title>

<Author>A. Yaghoubi, MD and M. Yousefnia, MD*</Author>

<Background>We evaluated the early and mid-term surgical outcomes and complications of intra-atrial

lateral tunnel and extracardiac conduit total cavopulmonary connection to clarify the clinical

superiority.</Background>

<Method>Forty patients underwent total cavopulmonary connection (TCPC), 26 with lateral tunnel

(LT) and 12 with extracardiac conduit (EC) repair, from July 1992 to June 2004 in two

centers. Survival, incidence of reoperation and early complications were compared.</Method>

<Result>The hospital survival was 94.7% in the lateral tunnel group and 100% in the extracardiac

conduit group. Seven reoperations were performed in the lateral tunnel group as opposed to

three in the extra cardiac conduit group. Functional status of all survivors improved

postoperatively. Significant enhancement of O2 saturation was seen after these operations

(mean 72.3% preoperatively, reaching 91.7%). Surgical bleeding in the lateral tunnel repair

group was 5.2% and 3.8%% for extracardiac conduit repair. Pericardial and pleural effusion

was seen in 22% in the lateral tunnel and 17% in the extracardiac conduit group. In addition, whereas chylothorax occurred in 11% in the lateral tunnel, it was not seen in the extracardiac

conduit group.</Result>

<Conclusion>The early survival and complications are similar and satisfactory in both lateral

tunnel and extracardiac conduit groups. However, the incidence of  cardiac-related  events

was significantly less frequent in the extracardiac conduit group. We recommend these

procedures, especially EC-TCPC, as an alternative method for patients with complex heart

abnormalities who are not candidates for total surgical repair (Iranian Heart Journal 2007; 8

(3): 16-20).</Conclusion>

<Keywords>total cavopulmonary connection ¡ complication ¡ congenital cardiac surgery</Keywords>

</Abstract>

<Abstract>

<AbstractID>72</AbstractID>

<Title>Determination of Tetralogy of Fallot Characteristics in

Iranian Patients</Title>

<Author>Habibollah Yadollahi Farsani MD* and Mohammad Yusef Arabi Moghadam MD</Author>

<Background>Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital

heart disease (CHD). The aim of this study is determination of demography, associated

anomalies, peripheral pulmonary stenosis (PPS), blood group, Rh type, operation results and

complications in TOF.</Background>

<Method>The records of 270 patients were reviewed. These patients had been admitted during 10

years (from 1993 to 2003).</Method>

<Result>60.37% of patients were male and 39.63% were female. Incidence of patent foramen ovale

(PFO), right aortic arch (RAA), coronary artery (CA) anomalies and other anomalies were

44.81%, 21.11%, 9.25% and 36.30%, respectively. Single ostium coronary artery (SOCA) was

the most CA anomaly. The most common PPS was bifurcation stenosis. TOF was more

common in blood group O patients. The mean age at the first palliative operation was 5.21 years

and for total correction (TC), it was 7.19 years. Postsurgical mortality rate was about 3% and

morbidity rate was 12.18% (excluding right bundle branch block, RBBB).</Result>

<Conclusion>The trend toward earlier total correction and single stage early total correction of TOF

should be recommended as the preferred management strategy (Iranian Heart Journal 2007;

8 (3): 21-26).</Conclusion>

<Keywords>Tetralogy of Fallot, congenital heart disease, cardiac surgery</Keywords>

</Abstract>

<Abstract>

<AbstractID>73</AbstractID>

<Title>Assessment of Left Ventricular Systolic Function Using

Pulsed-Wave Systolic Mitral Annular Velocities (Sm):

The Preliminary Results - Simple and Relevant</Title>

<Author>A.A. Dadgar MD,1 A. Hamedanchi MD,2 H.Barakpour MD3 and A. Arghami 4</Author>

<Background>Echocardiography has evolved as a well-established part of the evaluation of global

myocardial function. Tissue Doppler echocardiography is a novel technique with wide

applications, including estimation of myocardial systolic function. We hypothesized that

velocity time integral (VTI) of systolic mitral annular velocity had a better correlation with

systolic function in comparison to peak velocity. Consequently, for the first part of our

investigation, we selected a population with near normal systolic function to show initially the

linear correlation and secondly to obtain the normal values.</Background>

<Method>We conducted a cross-sectional study at the echo lab with prospective simple nonrandom

data collection on 50 consecutive patients (26 % normal, 38% CAD, 20% HTN, 10%

MVP and 6% miscellaneous), mean age 45.6 yrs. (range: 18-80 yrs.) and 42% female. The

exclusion criteria were prosthetic valves, LV systolic dysfunction, and/or severe regional wall

motion abnormality, significant regurgitation (MR and/or AR), severe mitral annular

calcification (MAC), non-sinus rhythm, paradoxical septal motion and poor endocardial line

definition. All underwent complete echocardiographic study including TDI; some of the

indexes of PW-TDI, with special attention to the systolic velocity of mitral annulus (Sm),

were correlated with three different methods of EF measurement.</Method>

<Result>The mean ejection fraction and VTI of Sm were 61.68% and 1.6594, respectively. Of TDI

indices, linear regression analysis showed that VTI of Sm had the strongest statistical

correlation with EF measured by Simpson s method (p=0.014, EF= 50.1 + 6.96 X VTI).</Result>

<Conclusion>Despite some inevitable limitations, our preliminary data suggest that peak velocity

and particularly VTI of Sm in PW-TDI can be considered as reliable, rapid and reproducible

indicators of preserved LV systolic function. However, we are currently conducting another

complementary study to compare PW-TDI of Sm in patients with LV systolic dysfunction

with or without mitral regurgitation (Iranian Heart Journal 2007; 8 (3): 27-31).</Conclusion>

<Keywords>left ventricular systolic function, tissue Doppler imaging</Keywords>

</Abstract>

<Abstract>

<AbstractID>74</AbstractID>

<Title>Evaluation of Post-Exercise Test Hematuria in Hamadan,

Iran</Title>

<Author>Hooshang Babalhavaeji MD, Seyed Habibollah Mosavi Bahar MD,

Farzad Imami MD* and Mohammad Ali Amir Zargar MD</Author>

<Background>Hematuria associated with sports activity is a well-recognized entity in subjects who

participate in a variety of sports. This study was designed to determine the incidence of postexercise

hematuria in patients participating in exercise test.</Background>

<Method>120 patients who were referred by cardiologists from August to October 2003 to

participate in treadmill exercise tests were randomly selected. The first urine sample was

taken before exercise and the second urine sample after the completion of the exercise test. In

those patients who had post-exercise hematuria, ultrasound studies were performed to rule out

other potential causes of hematuria.</Method>

<Result>85% of the participants in the exercise-test had post-exercise test hematuria (59.8%

microscopic, 25.2% macroscopic). Regarding age, there was no statistically significant

difference between the mean age of the patients who had hematuria and those who did not

(55.2 vs. 55.8 yrs, P&gt;.05). Regarding gender, the incidence of post-exercise test hematuria

was higher in women, but the difference was again not statistically significant (87.2% vs.

83.8%, P&gt;.05).</Result>

<Conclusion>The incidence of post-exercise hematuria is high, and it is very important to be

familiar with this entity in patients who participate in treadmill exercise tests to properly deal

with them and avoid unnecessary work-ups, especially if they are young and have transient

hematuria (Iranian Heart Journal 2007; 8 (3): 32-35).</Conclusion>

<Keywords>exercise test, hematuria, Hamedan, Iran</Keywords>

</Abstract>

<Abstract>

<AbstractID>75</AbstractID>

<Title>Efficacy and Safety of Primary Stenting in Takayasu

Arteritis: Report of Four Cases</Title>

<Author>Mahmoud Mohammadzadeh Shabestari MD, Leila Alizadeh, Mehri Nikdoust,

Mojtaba Talaei-Khoei</Author>

<Background>Takayasu arteritis (TA), an inflammatory disease of unknown origin, frequently

affects major aortic branch vessels and causes many symptoms, including brain and retinal

ischemia and hypertension.</Background>

<Method>Four patients with Takayasu arteritis (TA) underwent angioplasty and stent placement in

the renal arteries due to uncontrolled hypertension. Complications of the procedure include

transient bradycardia and mild hypotension, probably due to contrast agent; however, there was

no major complication.</Method>

<Result>No restenosis has been reported in the six-month follow up of the patients with

angiography. Serum creatinine levels remained unchanged in the four patients. The difference

between pre- and post-interventional arterial blood pressures was measured. Mean systolic blood

pressure changed from 227.5mmHg to 150mmHg and mean diastolic pressure dropped from

122mmHg to 85mmHg.</Result>

<Conclusion>The stenotic lesions in TA can be managed successfully with angioplasty and stent

placement. Short-term follow up showed stenting had increased the success rate of the procedure,

achieved larger luminal diameters and it seemed to decrease the incidence of restenosis. However

long-term follow up is suggested to determine the restenosis rate (Iranian Heart Journal 2007; 8

(3): 36-40).</Conclusion>

<Keywords>renovascular hypertension, stent, Takayasu arteritis</Keywords>

</Abstract>

<Abstract>

<AbstractID>76</AbstractID>

<Title>Measurement of Anticardiolipin Antibody in Patients with

Acute Coronary Syndrome (ACS)</Title>

<Author>M. T. Salehi Omran and F. Mirzaei</Author>

<Background>Elevated levels of anticardiolipin antibody may be associated with the high

prevalence of coronary artery disease. In this study, we measured the anticardiolipin antibody

level in patients with acute coronary syndrome (ACS) and a control group.</Background>

<Method>63 patients with ACS (unstable angina - U/A, and acute myocardial infarction - AMI)

presenting to our department were studied. Diagnosis of ACS was confirmed by clinical exam,

history, ECG and cardiac enzyme determinations. Anticardiolipin antibody level was

measured with the ELISA method in 63 patients with ACS and 130 healthy controls matched

for sex and age, and samples were analyzed using SPSS and t-test.</Method>

<Result>The mean age of the patients and control group were 61.59 and 51.27 years, respectively.

Mean anticardiolipin antibody level in patients with ACS was higher than that in the control

group (P = 0.038). In men with ACS, the mean anticardiolipin antibody level was also higher

than that in the control group (P= 0.002). In patients above 45 years of age, the mean

anticardiolipin antibody level was higher than that in the control group (P = 0.012).</Result>

<Conclusion>Our study shows that there are higher anticardiolipin antibody levels in patients with

ACS compared to controls. Thus, the evaluation of anticardiolipin antibody level in patients

with ACS is necessary (Iranian Heart Journal 2007; 8 (3): 41-43).</Conclusion>

<Keywords>anticardiolipin antibody, acute coronary syndrome, antiphospholipid syndrome, atherosclerosis,

antiphospholipid antibody</Keywords>

</Abstract>

<Abstract>

<AbstractID>77</AbstractID>

<Title>Hypertension in Primary School Children of Alvand City,

Iran</Title>

<Author>Abolfazl Mahyar MD*, Seid Ghasem Ghoreishi MD**,

Morteza Ebrahemi MD*** and Ramin Daneshi MD****</Author>

<Background>Currently little is known about the prevalence of high blood pressure among Iranian

children. Early identification of children at risk for hypertension is a key approach to prevent

serious complications. Our goal in this study is to determine the prevalence of hypertension in

primary school children of Alvand city, Iran.</Background>

<Method>In this cross-sectional study, the levels of systolic and diastolic blood pressure were

measured and the prevalence of hypertension among 840 primary school children (7-12 years)

determined. The children were selected through a double-stage randomized sampling method

while divided into six different age groups. The blood pressure was measured by means of

standard equipment. Data were analyzed using statistical methods.</Method>

<Result>Out of 840 children, 410 (48.8%) were male and 430 (51.2%) female. The average systolic

and diastolic blood pressure among both sexes increased with increasing age. Except in one age

group, there was no significant difference between the systolic blood pressure between the two

genders; however, a significant difference was found when the diastolic pressure in 4 age groups

was compared (P&lt;0.05). The prevalence of systolic and diastolic hypertension among boys and

girls was 6.15% and 3.4%, respectively.</Result>

<Conclusion>This study revealed that the prevalence of hypertension in primary school children in

the city of Alvand is noticeable. Hence, it is necessary to measure the blood pressure on a regular

basis for early detection of hypertension (Iranian Heart Journal 2007; 8 (3): 44-47).</Conclusion>

<Keywords>blood pressure, hypertension, children</Keywords>

</Abstract>

<Abstract>

<AbstractID>78</AbstractID>

<Title>Left Atrial Myxoma and Descending Aortic Dissection in a

Patient with Cerebrovascular Accident:

an Incidental Coexistent Finding</Title>

<Author>M. Esmaeilzadeh MD, A. Sadat Naseri MD, H. Azarnik MD,

R. Baghaei MD and K. Mozaffari MD.</Author>

<CaseReport>Cardiac myxomas are benign tumors of the heart with a surgical incidence of about 0.5/million

population/year. They usually present during the 4th to 6th decades and are more commonly seen in

females. About 75% arise in the left atrium (LA) and most are singly pedunculated, although

multiple and villous forms have been described. Echocardiography has greatly facilitated the

diagnosis of cardiac tumors. We report a case of left atrial myxoma as a source of emboli and an

incidental finding of localized descending aortic dissection subsequent to a remote traumatic

deceleration injury of the thoracic aorta. This is the first case of coexistence of LA myxoma and

aortic dissection (Iranian Heart Journal 2007; 8 (3): 48-51).</CaseReport>

<Keywords>myxoma, aortic dissection, echocardiography</Keywords>

</Abstract>

<Abstract>

<AbstractID>79</AbstractID>

<Title>Acute Superior Vena Cava Syndrome During Drainage of

Pericardial Effusion: A Case Report</Title>

<Author>Ramin Baghaee MD, Mostafa Alavi MD and Mehdi Hadadzadeh MD</Author>

<CaseReport>The syndrome of superior vena cava (SVC) compression is not an uncommon entity, but acute

SVC syndrome presenting in surgical patients is relatively uncommon. The case of a 64-year-old

male who developed acute SVC syndrome due to mediastinal lymph node enlargement is

presented here and management and special considerations are discussed (Iranian Heart Journal

2007; 8 (3): 52-55).</CaseReport>

<Keywords>words: superior vena cava syndrome, mediastinal lymph node</Keywords>

</Abstract>

<Abstract>

<AbstractID>80</AbstractID>

<Title>Isolated Left Main Ostial Coronary Stenosis in a Young

Woman</Title>

<Author>Abbas Ali Rafighdoust MD,* Sepideh Afzalnia MD,** Hoorak Pourzand MD**

and Amir Hossein Rafighdoust MD  </Author>

<CaseReport>Coronary arteritis is a rare but potentially fatal condition either by itself or in conjunction with other

diseases in all age groups. Coronary arteritis is most closely associated with the polyarteritis

syndromes and other collagen vascular diseases, immune system dysfunction, Mediterranean fever,

Kawasaki disease, fibrous pericarditis and staphylococcal septicemia.

Isolated left main coronary arteritis may be associated with specific and non-specific aortoarteritis

or in some cases after mediastinal irradiation.

In this young woman, with regard to her age of 22 years old, sex, absence of familial and personal

risk factors, and elevated CRP and ESR and the report of severe left main stem inflammation at

open heart surgery and negative response to intracoronary injection of nitrate during angiography,

the diagnosis of isolated left main stem coronary arteritis is very high in probability (Iranian Heart

Journal 2007; 8 (3): 56-59).</CaseReport>

<Keywords>left main stem, arteritis, coronary artery</Keywords>

</Abstract>

<Abstract>

<AbstractID>81</AbstractID>

<Title>Interrupted Aortic Arch Associated with Complex

Congenital Heart Disease</Title>

<Author>Maryam Esmaeilzadeh, MD, Alireza Moarref* MD

and Akbar Shamohammadi* MD</Author>

<CaseReport>Interrupted aortic arch (IAA) is a rare congenital malformation of the aortic arch, which occurs in 3

per million live births. This anomaly is defined as a loss of luminal continuity between the

ascending and descending portions of the aorta which entails a very poor prognosis without surgical

treatment. In most cases, IAA is associated with intracardiac malformations such as VSD, PDA,

bicuspid aortic valve, left ventricular outflow tract obstruction or aortopulmonary window. We

report a 16-year-old boy with IAA associated with double inlet left ventricle, aneurysmal dilatation

of pulmonary artery, giant PDA and severe pulmonary hypertension. To our knowledge, there is no

previous report of IAA associated with complex congenital heart disease such as that seen in our

case (Iranian Heart Journal 2007; 8 (3): 60-63).</CaseReport>

<Keywords>interrupted aortic arch, complex congenital heart disease</Keywords>

</Abstract>

</Journal>