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Koohsari P, Nakhaee A, Rahmanian M, Salahshour F, Parkhideh R, Larti F. Devastating fungal endocarditis involving ascending aorta in a patient with a history of aortic valve replacement: a case report. J Cardiothorac Surg 2024; 19:191. [PMID: 38589959 PMCID: PMC11003144 DOI: 10.1186/s13019-024-02733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/29/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Fungal endocarditis is a rare but serious condition associated with high mortality rates. Various predisposing factors contribute to its occurrence, such as underlying cardiac abnormalities, cardiac surgeries, prosthetic cardiac devices, and central venous catheters. Diagnosing fungal endocarditis, particularly Aspergillus, poses challenges, often complicated by negative blood cultures. CASE PRESENTATION This report details a case of extensive ascending aorta involvement in Aspergillus endocarditis (AE) in a 24-year-old man with a history of bioprosthesis aortic valve replacement (AVR). Three months post-AVR, he presented with pericardial effusion and aortic rupture, leading to a redo biological valved conduit aortic root replacement (Bentall surgery). Despite the intervention, the tubular graft exhibited extensive Aspergillus involvement, resulting in graft disruption and significant peri-aortic infection. A second redo procedure involving aortic homograft root replacement was performed. Unfortunately, the patient succumbed two days after the surgery. CONCLUSION A combined approach of medical and surgical therapies is recommended to manage fungal endocarditis. Despite efforts, the mortality rate associated with Aspergillus endocarditis remains unacceptably high, with no significant difference observed between combination therapy and antifungal treatment alone. Further research is essential to explore novel therapeutic strategies and improve outcomes for patients with this challenging condition.
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Affiliation(s)
- Parisa Koohsari
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Nakhaee
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad Rahmanian
- Cardiothoracic Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Salahshour
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Parkhideh
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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Safari S, Parsaee M, Moradi M, Hakiminejad M, Koohsari P, Larti F. The effect of significant weight loss after bariatric surgery on echocardiographic indices: an observational study focusing on left ventricular deformation by 2D speckle echocardiography and right ventricular size. Egypt Heart J 2024; 76:44. [PMID: 38587759 PMCID: PMC11001804 DOI: 10.1186/s43044-024-00474-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/29/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Obesity is a known risk factor for atherosclerosis and cardiac disease. HYPOTHESIS This study evaluated the effect of significant weight loss following bariatric surgery on myocardial deformation indices and right ventricular size (RV). This was a prospective cohort study. Morbid obese patients scheduled for bariatric surgery from July 2017 to February 2018 at Firoozgar Hospital were included in our study and referred for transthoracic echocardiography at Rajaie Cardiovascular Medical and Research Center. RESULTS Thirty-four patients entered the study. The absolute value of global longitudinal strain (GLS) at baseline, 3, and 6 months after surgery was 17.42 ± 2.94%, 18.24 ± 3.09%, and 19.52 ± 2.78%, respectively, with a statistically significant difference from baseline to after six months (P value < 0.001). The absolute value of global circumferential strain (GCS) at baseline, 3, and 6 months after surgery was 20.14 ± 4.22%, 23.32 ± 4.66%, and 24.53 ± 4.52%, respectively, with statistically significant changes (P value < 0.001) from baseline to three months and from baseline to six months and no significant difference from three months to six months. A significant decrease was reported in mechanical dispersion of circumferential strain (38.05 ± 23.81-23.37 ± 20.86 ms, P value = 0.006) 6 months after surgery. Right ventricular size three- and six-month post-surgery showed a significant decrease relative to baseline echocardiography. CONCLUSIONS Bariatric surgery could enhance cardiac function, as proven by 2D speckle echocardiography. Changes in RV size may be related to weight loss and should be considered when assessing patients who have undergone bariatric surgery.
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Affiliation(s)
- Saeed Safari
- General Surgery Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mozhgan Parsaee
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Moradi
- General Surgery Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdi Hakiminejad
- General Surgery Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Koohsari
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Farnoosh Larti
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran.
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Larti F, Geraiely B, Asli SH, Moghadam AS. Revisiting echocardiographic features of prosthetic heart valves: the necessity of correct differentiation of mono-leaflet vs. bileaflet mechanical heart valves in a case report. J Cardiothorac Surg 2024; 19:176. [PMID: 38576022 PMCID: PMC10996195 DOI: 10.1186/s13019-024-02633-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Mechanical heart valve replacement is a standard treatment for severe valvular disorders. The use of mono-leaflet valves has decreased recently. Recognizing the echocardiographic features of mono-leaflet and bileaflet valves is crucial for accurate complication diagnosis and proper management. CASE PRESENTATION A 65-year-old female with mono-leaflet mitral and bileaflet tricuspid valves underwent an echocardiographic assessment. This simple educational case provides a unique opportunity to compare the echocardiographic features of these valves within a single patient. CONCLUSION There is a crucial need for clinicians, particularly those in training, to differentiate between mono-leaflet and bileaflet mechanical heart valves adeptly. With mono-leaflet valves decreasing in prevalence, proficiency in recognizing the echocardiographic nuances of each type is imperative. Failure to do so may result in misdiagnoses and inappropriate management. This underscores the significance of continuous education and vigilance in echocardiographic assessments to ensure optimal patient care.
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Affiliation(s)
- Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran
| | - Babak Geraiely
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran
| | - Samaneh Hasanpour Asli
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran
| | - Arman Soltani Moghadam
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran.
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Rahbar Z, Tavoosi A, Bakhshandeh A, Mehrpooya M, Sardari A, Larti F, Sattarzadeh Badkoubeh R. Echocardiographic estimation of left ventricular filling pressures in heart transplant recipients. Egypt Heart J 2024; 76:12. [PMID: 38289542 PMCID: PMC10828230 DOI: 10.1186/s43044-024-00443-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Echocardiographic estimation of left ventricular filling pressure in heart transplant (HTx) recipients is challenging. The ability of echocardiography to detect elevated left ventricular end-diastolic pressure (LVEDP) in HTx patients was assessed in this study. RESULTS This descriptive cross-sectional study included 39 HTx recipients who were candidates for endomyocardial biopsy as a part of their routine post-transplantation surveillance. Doppler transthoracic echocardiography was done before the procedure, and left heart catheterization was done during the endomyocardial biopsy. Thirty-nine patients (15 female, 24 male), with a mean age of 39.6 years (range 13-70), were enrolled. A strong relation was observed between lateral E/e' and LVEDP (R = 0.64, P value < 0.001) and average E/e' and LVEDP (R = 0.6, P value < 0.001). The best cutoff value for LVEDP prediction was the average E/e' ≥ 6.8 with a sensitivity of 96.15% and specificity of 68.5% for the prediction of LVEDP more than or equal to 20 mmHg. Two predictive models comprising age, gender, and lateral E/e' or average E/e' were also proposed. A significant relationship was also found between LVEDP and left ventricular global longitudinal strain (R = - 0.31, P value < 0.01). CONCLUSIONS Lateral E/e' was the best predictor of LVEDP. The cutoff of average E/e' had the best validity for the estimation of LVEDP. Despite the strong observed association, echocardiographic parameters cannot be considered a surrogate for invasive LVEDP measurements when seeking information about left ventricle filling pressure on heart transplant recipients.
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Affiliation(s)
- Zohreh Rahbar
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Anahita Tavoosi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Alireza Bakhshandeh
- Department of Cardiothoracic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mehrpooya
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Akram Sardari
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran.
| | - Roya Sattarzadeh Badkoubeh
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, End of Keshavarz Boulevard, Tehran, 1419733141, Iran
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Mehri F, Saberi K, Salehi M, Vahdani FG, Larti F, Bakhshandeh A, Sheikhhasani S. Successful Pregnancy after a Heart Transplant in Iran: A Case Report. J Tehran Heart Cent 2023; 18:294-297. [PMID: 38680644 PMCID: PMC11053242 DOI: 10.18502/jthc.v18i4.14829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/25/2023] [Indexed: 05/01/2024] Open
Abstract
Pregnancy after a heart transplant is a concern for many female recipients, and it remains a medical challenge that raises many questions. A 24-year-old woman, gravida 3, para 0, contacted us for obstetric care in the first trimester of gestation, about 3 years after an orthotopic cardiac transplant. She was a known case of dextrocardia with congenitally corrected transposition of the great arteries. The transplant had been performed for severe retractable heart failure, manifesting during her previous lost pregnancy. The course of the current gestation was uneventful. The patient's cardiovascular function was good throughout the pregnancy. She was admitted to the hospital for dyspnea at 35 weeks and 4 days of gestational age. A cardiovascular consult and echocardiography were performed. The results were within the normal range, and labor pains explained the patient's dyspnea. Because of labor pain, a repeat Cesarean section was performed at 35 weeks and 4 days of gestational age. A male baby weighing 2700 g, with an Apgar score of 7/9, was delivered. The patient was discharged after delivery with enoxaparin (40 mg), prednisolone (5 mg), levothyroxine, and mycophenolate mofetil (500 mg) without any complications. Follow-up was carried out at 1 month, and no abnormality was found. Here, we report a case of a successful pregnancy in a young woman after a heart transplant.
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Affiliation(s)
- Fateme Mehri
- Department of Gynecology and Obstetrics, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kianoush Saberi
- Department of Anesthesiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Salehi
- Department of Cardiac Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ghotbizadeh Vahdani
- Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Bakhshandeh
- Department of Cardiac Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Sheikhhasani
- Department of Gynecology and Obstetrics, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Vali-e-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Mohammadi R, Larti F, Sattarzadeh Badkoubeh R, Mehrpooya M, Sardari A. Left ventricular strain echocardiography in advanced uremic cardiomyopathy compared to dilated cardiomyopathy. Egypt Heart J 2023; 75:67. [PMID: 37493971 PMCID: PMC10371933 DOI: 10.1186/s43044-023-00393-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/18/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Cardiac involvement is common in end-stage renal disease patients. The presenting study aimed to evaluate the global and segmental longitudinal strain in patients with advanced uremic cardiomyopathy (AUCM) and compare it to dilated cardiomyopathy (DCM). RESULTS The mean global longitudinal strain (GLS) was significantly lower in AUCM (P value = 0.045). Comparing segmental strain showed a lower strain in mid inferoseptal (P value = 0.048), base and mid anterolateral (P value = 0.026, 0.001 respectively), base and mid anteroseptal (P value = 0.005, 0.009 respectively), base and mid inferior (P value = 0.015, 0.034 respectively) and mid anterior (P value = 0.015) in patients with AUCM compared with DCM. In both groups, the segmental strain increased from base to apex. CONCLUSIONS Segmental and GLSs in advanced uremic cardiomyopathy were significantly lower than those of dilated cardiomyopathy. In both groups, the segmental strain increased from base to apex.
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Affiliation(s)
- Rizan Mohammadi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Roya Sattarzadeh Badkoubeh
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Maryam Mehrpooya
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Akram Sardari
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran.
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Esmati S, Tavoosi A, Mehrban S, Laleh Far V, Mehrakizadeh A, Shahi S, Larti F. NT-proBNP level as a substitute for myocardial perfusion scan in preoperative cardiovascular risk assessment in noncardiac surgery. BMC Anesthesiol 2023; 23:244. [PMID: 37474913 PMCID: PMC10360337 DOI: 10.1186/s12871-023-02205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Preoperative cardiovascular risk assessment is one of the main principles before noncardiac surgeries. Cardiac stress imaging, such as myocardial perfusion scan (MPS), is a proposed cardiovascular risk evaluation method according to the latest guidelines. Yet, its efficacy, along with the cost-effectiveness of the method, has been questioned in previous studies. Our study aims to evaluate the utility of N-terminal pro-b-type natriuretic peptide (NT-proBNP) level measurement in predicting postoperative cardiovascular complications in candidates who have undergone an MPS before surgery and compare the results. METHODS A cohort of 80 patients with a revised cardiac risk index score of one or more who were scheduled for moderate to high-risk noncardiac surgeries and met the criteria to undergo an MPS for risk assessment were included in the study. All of them underwent an MPS one week before surgery. Their preoperative NT-proBNP, troponin levels, and electrocardiograms were obtained one day before surgery and again on day three postoperative. The predictive efficacy of NT-proBNP levels and MPS were compared. RESULTS Seventy-eight patients underwent surgery, three of which exhibited a rise in troponin level, six showed changes on electrocardiogram, and pulmonary edema was detected in one, three days after surgery. There was no mortality in our patients. The sensitivity and specificity of the MPS for predicting postoperative cardiovascular complications were 100% and 66%, respectively. MPS also had a positive predictive value of 20% and a negative predictive value of 100% in our study. A 332.5 pg/ml cut-off value for NT-proBNP level yielded a sensitivity of 100%, specificity of 79.2%, positive predictive value of 40%, and negative predictive value of 100%. CONCLUSIONS Our study reveals the incremental specificity and positive predictive value of NT-proBNP level measurement in preoperative cardiovascular risk evaluation compared to MPS. Given the low feasibility, high costs, and disappointing predictive value of MPS, preoperative NT-proBNP level assessment can be substituted. This method can assist anesthesiologists and surgeons with precisely detecting at-risk patients resulting in taking proper measures to reduce the morbidity and mortality of the proposed patients before and during surgeries.
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Affiliation(s)
- Saeede Esmati
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Anahita Tavoosi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Saghar Mehrban
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Vahideh Laleh Far
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Ali Mehrakizadeh
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Shayan Shahi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, 1419733141, Iran.
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Ghasim H, Rouini M, Safari S, Larti F, Khoshayand M, Gholami K, Neyshaburinezhad N, Gloor Y, Daali Y, Ardakani YH. Impact of Obesity and Bariatric Surgery on Metabolic Enzymes and P-Glycoprotein Activity Using the Geneva Cocktail Approach. J Pers Med 2023; 13:1042. [PMID: 37511655 PMCID: PMC10381895 DOI: 10.3390/jpm13071042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/08/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
The inter-individual variability of CYP450s enzyme activity may be reduced by comparing the effects of bariatric surgery on CYP-mediated drug elimination in comparable patients before and after surgery. The current research will use a low-dose phenotyping cocktail to simultaneously evaluate the activities of six CYP isoforms and P-gp. The results showed that following weight reduction after surgery, the activity of all enzymes increased compared to the obese period, which was statistically significant in the case of CYP3A, CYP2B6, CYP2C9, and CYP1A2. Furthermore, the activity of P-gp after surgery decreased without reaching a statistical significance (p-value > 0.05). Obese individuals had decreased CYP3A and CYP2D6 activity compared with the control group, although only CYP3A was statistically important. In addition, there was a trend toward increased activity for CYP1A2, CYP2B6, CYP2C9, and CYP2C19 in obese patients compared to the control group, without reaching statistical insignificance (p-value ≥ 0.05). After six months (at least), all enzymes and the P-gp pump activity were significantly higher than the control group except for CYP2D6. Ultimately, a greater comprehension of phenoconversion can aid in altering the patient's treatment. Further studies are required to confirm the changes in the metabolic ratios of probes after bariatric surgery to demonstrate the findings' clinical application. As a result, the effects of inflammation-induced phenoconversion on medication metabolism may differ greatly across persons and drug CYP pathways. It is essential to apply these results to the clinic to recommend dose adjustments.
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Affiliation(s)
- Hengameh Ghasim
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Mohammadreza Rouini
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Saeed Safari
- Department of General Surgery, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran 1417614411, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Mohammadreza Khoshayand
- Department of Drug and Food Control, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Kheirollah Gholami
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Navid Neyshaburinezhad
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Yvonne Gloor
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Youssef Daali
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Yalda H Ardakani
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
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Rahmanian M, Badkoubeh RS, Rasouli SJ, Nowroozi MR, Saberi K, Salehi M, Larti F, Tajaddini A, Fatemian H, Rad MR, Dabaghi GG, Malekhosseini H. Cardiovascular surgical experiences of IVC tumor and thrombus: Operative strategies Based on 51 consecutive patients. Asian Cardiovasc Thorac Ann 2023:2184923231177658. [PMID: 37259504 DOI: 10.1177/02184923231177658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The only beneficial treatment option for the management of inferior vena cava (IVC) tumor thrombus is complete tumor removal. The aim of this study was to report our experience in surgical and clinical outcomes in patients with tumor thrombosis in IVC. METHODS A retrospective chart review of patients who underwent surgical resection of IVC tumor at our institution over the past 10 years was performed. The patients were identified using a prospectively maintained database. RESULTS We identified 51 patients, the mean age was 53.4 ± 16.8 years, and 25.4% were female. They were divided into three groups based on tumor thrombosis level. Twenty patients (39.2%) required sternotomy, and cardiopulmonary bypass (CPB) was used in 19 (37.2%) patients, and 2 (3.9%) cases underwent coronary artery bypass graft. The perioperative complications were severe bleeding (3 patients), pulmonary embolism (2 patients), and duodenal perforation (1 patient). Three (5.8%) in-hospital deaths occurred, and all were due to severe abdominal bleeding. After a mean follow-up time of 46.5 ± 42.0 months, 29 (56.9%) patients were alive. The mean survival time was 75.2 ± 8.4 months. In multivariate analysis, higher age (p = 0.033) and male gender (p = 0.033) proved to be independent prognostic factors. CONCLUSIONS Tumor thrombus extending to the IVC is a rare and challenging event. Although using CPB may be safe and result in long-term survival with acceptable function, excessive bleeding during surgery may limit the use of this method.
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Affiliation(s)
- Mehrzad Rahmanian
- Department of Cardiovascular Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
| | | | - Seyed Jaber Rasouli
- Uro-Oncology Research Center, Tehran University of Medical Science, Tehran, Iran
| | | | - Kianoush Saberi
- Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
| | - Mehrdad Salehi
- Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Tehran University of Medical Science, Tehran, Iran
| | - Ali Tajaddini
- Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Fatemian
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Rabiee Rad
- School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | | | - Hamidreza Malekhosseini
- Department of Cardiovascular Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
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Shahmohamadi E, Sedaghat M, Rahmani A, Larti F, Geraiely B. "Recognition of heart attack symptoms and treatment-seeking behaviors: a multi-center survey in Tehran, Iran". BMC Public Health 2023; 23:875. [PMID: 37173689 PMCID: PMC10176795 DOI: 10.1186/s12889-023-15826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND In acute myocardial infarction (AMI), timely recognition of symptoms and early hospital presentation positively affect patient morbidity and mortality. Due to the high burden of ischemic heart disease in Iran, this study aimed to identify factors affecting the level of knowledge, responses at the time of AMI onset, and sources of health information among the Iranian population. METHOD This cross-sectional study was conducted in three tertiary hospitals in Tehran, Iran. An expert-validated questionnaire was used to obtain data. A total of 400 individuals were enrolled. RESULT Among the respondents, 285 people(71.3%) considered "chest pain or discomfort," and 251 (62.7%) regarded "pain or discomfort in the arm or shoulder" as MI symptoms. Approximately 288 (72.0%) respondents had poor knowledge of the AMI symptoms. Knowledge of symptoms was higher among those with higher levels of education, those with medical-associated jobs, and those who resided in the capital areas. Major risk factors identified by the participants were: anxiety (340)(85.0%), obesity (327)(81.8%), an unhealthy diet (325)(81.3%), and the presence of high LDL levels (258)(64.5%) and Diabetes Mellitus (164)(41.0%) were less appreciated. Calling an ambulance (286)(71.5%) was the most common treatment-seeking behavior in the case of a suspected heart attack. CONCLUSION It is vital to educate the general population about AMI symptoms, particularly those with comorbidities at the greatest risk for an AMI episode.
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Affiliation(s)
- Elnaz Shahmohamadi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, 1419733141, Iran
| | - Mojtaba Sedaghat
- Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Arash Rahmani
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, 1419733141, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, 1419733141, Iran
| | - Babak Geraiely
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, 1419733141, Iran.
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11
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Faramarzpour M, Jafari S, Rahmanian M, Sardari A, Larti F. A large intracardiac hydatid cyst with concomitant cervical and hepatic involvement: A case report. Clin Case Rep 2023; 11:e7307. [PMID: 37192854 PMCID: PMC10182008 DOI: 10.1002/ccr3.7307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 05/18/2023] Open
Abstract
Key Clinical Message Cardiac hydatidosis is a relatively rare complication of echinococcosis. Understanding the atypical manifestations, potential associated risk factors, and epidemiology leads to optimal and timely management. Abstract Cardiac hydatidosis is a relatively rare complication of echinococcosis, with a potentially life-threatening condition. Here, we reported a large interventricular septal hydatid cyst bulging in the left ventricle accompanied by a huge cervical lamp with recurrent hepatic cysts that underwent cardiac surgery to excise the cyst uneventfully.
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Affiliation(s)
- Maryam Faramarzpour
- Department of CardiologyImam Khomeini Hospital Complex, Tehran University of Medical SciencesTehranIran
| | - Sirous Jafari
- Department of Infectious DiseaseImam Khomeini Hospital Complex, Tehran University of Medical SciencesTehranIran
| | - Mehrzad Rahmanian
- Department of Cardiac SurgeryImam Khomeini Hospital Complex, Tehran University of Medical SciencesTehranIran
| | - Akram Sardari
- Department of CardiologyImam Khomeini Hospital Complex, Tehran University of Medical SciencesTehranIran
| | - Farnoosh Larti
- Department of CardiologyImam Khomeini Hospital Complex, Tehran University of Medical SciencesTehranIran
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12
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Sherafati A, Rahmanian M, Sattarzadeh Badkoubeh R, Khoshavi M, Foroumandi M, Peiman S, Shahi F, Sardari A, Pourkia R, Larti F. Hyepereosiniphilic syndrome and COVID-19: 2 case reports. J Cardiothorac Surg 2023; 18:158. [PMID: 37085890 PMCID: PMC10121068 DOI: 10.1186/s13019-023-02241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/02/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Nearly half of the patients with hypereosinophilic syndrome (HES) have cardiovascular involvement, a major cause of mortality. COVID-19 infection can lead to cardiac involvement, negatively impacting the clinical course and prognosis. We reported two patients with HES complicated by COVID-19, with cardiac involvement and valve replacement. CASE PRESENTATION Our first patient was a 27-year-old woman admitted due to dyspnea and signs of heart failure. She had severe mitral stenosis and mitral regurgitation on the echocardiogram. Corticosteroid therapy improved her symptoms initially, but she deteriorated following a positive COVID-19 test. A repeated echocardiogram showed right ventricular failure, severe mitral regurgitation, and torrential tricuspid regurgitation and, she underwent mitral and tricuspid valve replacement. Our second patient was a 43-year-old man with HES resulted in severe tricuspid stenosis, which was improved with corticosteroid treatment. He underwent tricuspid valve replacement due to severe valvular regurgitation. He was admitted again following tricuspid prosthetic mechanical valve thrombosis. Initial workups revealed lung involvement in favor of COVID-19 infection, and his PCR test was positive. CONCLUSION COVID-19 infection can change the clinical course of HES. It may result in a heart failure exacerbation due to myocardial injury and an increased risk of thrombosis in prosthetic valves or native vessels due to hypercoagulability.
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Affiliation(s)
- Alborz Sherafati
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Mehrzad Rahmanian
- Department of Cardiovascular Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sattarzadeh Badkoubeh
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Meysam Khoshavi
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Morteza Foroumandi
- Anesthesiology and Intensive Care Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farhad Shahi
- Department of Hematology and Medical Oncology, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Sardari
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran
| | - Roghayeh Pourkia
- Department of Cardiology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Farnoosh Larti
- Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran.
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13
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Moghaddasfar T, Vahidi H, Faramarzpour M, Larti F. Echocardiography in left atrial thrombosis. Clin Case Rep 2023; 11:e7153. [PMID: 37006848 PMCID: PMC10062306 DOI: 10.1002/ccr3.7153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/14/2023] [Indexed: 04/01/2023] Open
Abstract
Atrial fibrillation is one of the major predisposing factors in developing left atrial thrombosis, leading to morbidity and mortality. Echocardiography plays a paramount role in this condition's detection and subsequent treatment. Atrial fibrillation is one of the major predisposing factors in developing left atrial thrombosis, leading to morbidity and mortality. Echocardiography plays a paramount role in this condition's detection and subsequent treatment.
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Affiliation(s)
- Tara Moghaddasfar
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Hamed Vahidi
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Maryam Faramarzpour
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
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14
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Nakhaee A, Koohsari P, Rahmanian M, Sardari A, Parkhideh R, Larti F. Extensive right-sided endocarditis in double-chamber right ventricle presented with leukocytoclastic vasculitis. Clin Case Rep 2023; 11:e7108. [PMID: 36937640 PMCID: PMC10017406 DOI: 10.1002/ccr3.7108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Congenital heart disease is a risk factor for infective endocarditis (IE). Ventricular septal defects and ventricular outflow tract obstructions are this population's most common causes of endocarditis. We present a patient diagnosed with leukocytoclastic vasculitis, renal, and pulmonary involvement with right-sided IE as an etiology for vasculitis.
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Affiliation(s)
- Akram Nakhaee
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Parisa Koohsari
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Mehrzad Rahmanian
- Department of Cardiac Surgery, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Akram Sardari
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Roya Parkhideh
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
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15
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Peymani Z, Tafakhori A, Farzanehfar S, Larti F, Hosseini A, Abbasi M. Comparison of myocardial perfusion between the users of two antiepileptic medications: valproate vs. carbamazepine. Asia Ocean J Nucl Med Biol 2023; 11:122-127. [PMID: 37324229 PMCID: PMC10261687 DOI: 10.22038/aojnmb.2023.67084.1465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/23/2023] [Accepted: 03/26/2023] [Indexed: 06/17/2023]
Abstract
Objectives The prevalence of coronary artery disease (CAD) is high in patients with epilepsy using antiepileptic drugs (AED). Epilepsy, AED, or the type and duration of AED use , may contribute to higher CAD risk.In this study, myocardial perfusion imaging (MPI) was compared between patients using carbamazepine and valproate. Method Out of 73 patients receiving carbamazepine or valproate monotherapy for more than 2 years, visited at a tertiary referral clinic, 32 patients participated in a 2-day stress and rest phases MPI. For each phase, 15-25 mCi 99mTc-MIBI was injected, at peak exercise or by pharmacologic stimulation for the stress phase. SPECT with cardiac gating was done by a dual-head gamma camera and processed and quantified. Scans with at least one definite reversible hypo-perfusion segment were considered abnormal. Results Seventeen patients received carbamazepine monotherapy and 15 valproates. Age and duration of AED use were similar between the groups. Two scans were abnormal (6.3%) both in valproate group (13.3%). Duration of AED use was higher in patients with abnormal scans. In patients receiving monotherapy >2 years, the frequency of abnormal MPI was similar between groups (P-value=0.12). In patients receiving monotherapy > 5 years, prevalence of abnormal MPI was higher in the valproate group (28.6% vs. 0.0%; P-value=0.042). Considering valproate subgroup, ischemic patients had higher duration of AED use, comparing with the normal patients (17.0±4.2 vs. 6.4±4.8, P-value=0.014). Conclusion MPIs were abnormal in patients receiving valproate after 5 years compared to patients receiving carbamazepine. Long-term valproate use may increase the risk of CAD.
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Affiliation(s)
- Zeinab Peymani
- Department of Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Department of Neurology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Farzanehfar
- Department of Nuclear Medicine, Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hosseini
- Department of Nuclear Medicine, Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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16
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Nakhaee A, Parkhideh R, Rahmanian M, Pouraliakbar H, Sardari A, Larti F, Badkoubeh RS. Re-emphasis on the role of echocardiography in diagnosis of aortic root surgery complications. Echocardiography 2022; 39:1344-1347. [PMID: 36198100 DOI: 10.1111/echo.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/01/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Aortic pseudoaneurysm is an infrequent complication of ascending aorta surgery. CASES This is a report of two cases that underwent the Bentall procedure that presented with large pseudoaneurysms. CONCLUSION Use of multimodality imaging after Bentall surgery has been advocated for the detection of surgical complications. Although 3D CT angiography has the highest diagnostic accuracy, familiarity with transthoracic echocardiographic finding in these patients will lead to earlier diagnosis.
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Affiliation(s)
- Akram Nakhaee
- Department of Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Parkhideh
- Department of Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrzad Rahmanian
- Department of Cardiovascular Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Department of Radiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Sardari
- Department of Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sattarzadeh Badkoubeh
- Department of Echocardiography, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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17
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Lalehfar V, Larti F, Mehrakizadeh A, Bakhshandeh A, Badkoubeh RS, Mohammadzadeh S, Sardari A. COVID-19 Infection in Heart Transplant Recipients: Results of a Six-Month Prospective Survey-Based Study. ACTA 2022. [DOI: 10.18502/acta.v60i6.10037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Solid-organ transplantation recipients were assumed highly vulnerable to coronavirus disease 2019 (COVID-19). However, the results of previous studies in patients with orthotopic heart transplantation (OHT) under immunosuppressive therapy are contradictory. Therefore, we aimed to assess the prevalence of COVID-19 infection and associated risk factors, along with the six-month outcomes in COVID-19 positive OHT patients. This single-center telephone-based survey was conducted on OHT patients. Using a detailed questionnaire, exposure to COVID-19, related symptoms, and preventive self-care measures were collected. Outcomes of COVID-19-positive patients were reassessed using another survey six months later. 118 OHT patients (male: n=87, 73.7%) were included with a mean age of 45.3±13.1 years. Sixteen patients (13.5%) reported one or more symptoms compatible with COVID-19, of whom 12 (10.2%) tested positive. Our results indicated no statistically significant association between COVID-19 and comorbidities. Poor adherence to self-care measures and contact with positive index cases were both significantly associated with COVID-19 infection (P<0.001). A later six months follow-up showed that two out of 12 (16.6%) COVID-19 positive OHT patients died. There was no statistically significant difference between the prevalence of COVID-19 in our patients compared to Iran’s general population (P=0.152). Non-compliance with personal protective protocols and a history of contact with COVID-19 cases were the most risk factors for COVID-19 infection in OHT patients.
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18
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Zand M, Sattarzadeh R, Larti F, Mansouri P, Tavoosi A. Right ventricular diastolic function predicts clinical atrial fibrillation after coronary artery bypass graft. J Res Med Sci 2022; 27:35. [PMID: 35968213 PMCID: PMC9374141 DOI: 10.4103/jrms.jrms_816_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 06/07/2020] [Accepted: 11/25/2021] [Indexed: 11/04/2022]
Abstract
Background Patients with moderate-severe left ventricular systolic dysfunction undergoing coronary artery bypass graft (CABG) surgery are at high risk of mortality and morbidity. Our aim is to evaluate the right ventricular (RV) diastolic function in these patients, and monitor its effects on postoperation outcomes. Materials and Methods In a cohort study, patients with moderate-severe left ventricular systolic dysfunction (ejection fraction ≤35%) who were candidate for CABG were included. Baseline transthoracic echocardiography (TTE) was performed, and RV diastolic function measures were obtained. After CABG, the length of intubation, inotrope dependency, hospital stay in intensive care unit and ward, in-hospital and after discharge mortality, postoperative atrial fibrillation (POAF) were evaluated in all patients. Results Sixty-seven patients were prospectively included in the study. The mean ± standard deviation age of our patients was 61.4 ± 9.3. There was no difference between grades of RV diastolic function and postoperative outcomes. However, we found significant difference between grades of RV diastolic function and onset of in hospital, and total POAF (P-value = 0.017). Multivariate analysis demonstrated that preoperative tricuspidEt/E't (ratio of peak early-diastolic flow rate across the tricuspid valve orifice to peak early-diastolic velocity at the lateral tricuspid annulus), left atrial volume and "high risk" Euroscore II were independent predictors for POAF during hospitalization and total POAF in patients with moderate to severely impaired left ventricular systolic function (P-values were 0.04, 0.003 and 0.001, respectively). Conclusion We believe that patients with increased tricuspid Et/E't are high risk for POAF; therefore, any risk score for POAF should include a comprehensive TTE including evaluation of RV diastolic function before surgery.
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Affiliation(s)
- Mehdi Zand
- Department of Cardiology, Imam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sattarzadeh
- Department of Cardiology, Imam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Pejman Mansouri
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Tavoosi
- Department of Cardiology, Imam Khomeini Complex, Tehran University of Medical Sciences, Tehran, Iran
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19
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Ghasim H, Rouini M, Gholami K, Larti F, Safari S, Ardakani YH. Evaluation of phenoconversion phenomenon in obese patients: the effects of bariatric surgery on the CYP450 activity "a protocol for a case-control pharmacokinetic study". J Diabetes Metab Disord 2021; 20:2085-2092. [PMID: 34900844 DOI: 10.1007/s40200-021-00852-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
Personalized therapy suggests the appropriate drug at the right dose for the first time through genotype-based individualized therapy, instead of prescribing medicines by the traditional one-size-fits-all manner, thereby claiming that it will make medicines safer and more effective. Accordingly, polymorphisms of drug metabolizing enzymes (DMEs), which induce inter-individual variability in the pharmacokinetics of a drug, have attracted great interest in the context of personalized medicine. Obesity is one of the most common chronic diseases in the world, including Iran, and the prevalence is increasing according to predictions. The remarkable role of P450 cytochromes has been verified in the metabolism of numerous drugs, toxins, carcinogen compounds, and the synthesis of some intrinsic compounds, such as steroid hormones. Thus, evaluating the activity of these enzymes is of great importance because any functionality variation can lead to failure in the treatment or unwanted side effects of some drugs. Therefore, any change in the activity of these enzymes in obese patients can also be problematic in the treatment process of these patients in comparison to normal weighted ones. Since only a few human studies have examined the role of inflammation in altering the function of these enzymes, it seems to be necessary to investigate the effect of obesity on the expression and activity of these enzymes; in which the role of inflammatory processes has been proven. Most importantly, it is worth evaluating changes in the activity levels of cytochrome P450 (CYP450) and the inflammatory cytokines after a course of post-surgical treatment and weight loss. To evaluate the activity of CYPs, a multi-drug cocktail is prescribed to obese patients before and after obesity surgery, as well as to healthy volunteers, to provide simultaneous evaluation of different isoforms. A complete demographic data, medical examinations, laboratory tests, and the CYPs genotype of all participants can be extremely important during this investigation.
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Affiliation(s)
- Hengameh Ghasim
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, P. O. Box 1417614411, Tehran, Iran
| | - Mohammadreza Rouini
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, P. O. Box 1417614411, Tehran, Iran
| | - Kheirollah Gholami
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Safari
- Department of General Surgery, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Yalda H Ardakani
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, School of Pharmacy, Tehran University of Medical Sciences, P. O. Box 1417614411, Tehran, Iran
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20
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Larti F, Khadembashiri MA, Abbasi M, Sherafati A. Additive value of positron emission tomography/computed tomography scan for detection of aortic tube graft infection: a case report. Eur Heart J Case Rep 2020; 5:ytaa512. [PMID: 33738397 PMCID: PMC7954257 DOI: 10.1093/ehjcr/ytaa512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/17/2020] [Accepted: 11/24/2020] [Indexed: 11/12/2022]
Abstract
Background Diagnosis of aortic graft infection is challenging, and delayed diagnosis is associated with poor prognosis. Positron emission tomography/computed tomography (PET/CT) has improved diagnostic accuracy. Case summary A patient with a history of congenital heart disease was admitted due to fever. He had a history of four cardiac surgeries, including the Bentall procedure for endocarditis. Blood cultures were negative. A semi-mobile mass was detected in the distal portion of the aortic tube graft in echocardiography. PET/CT scan was used to confirm tube graft infection and to support proceeding to cardiac surgery. Discussion Using multimodality imaging, including PET/CT scan in combination with echocardiography, can improve diagnostic accuracy for the detection of aortic tube graft infection, infection of prosthetic valves, or intra-cardiac devices, especially in high-risk surgical cases.
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Affiliation(s)
- Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tohid Square, Tehran 1419733141, Iran
| | - Mohammad Amin Khadembashiri
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tohid Square, Tehran 1419733141, Iran
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Vali-asr Hospital, Tehran University of Medical Sciences, Tohid Square, Tehran:1419733141, Iran
| | - Alborz Sherafati
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tohid Square, Tehran 1419733141, Iran
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21
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Shirazi S, Golmohammadi F, Tavoosi A, Salehi M, Larti F, Sardari A, Geraiely B, Rahmanian M, Saberi K, Sattarzadeh Badkoubeh R. Quantification of aortic valve area: comparison of different methods of echocardiography with 3-D scan of the excised valve. Int J Cardiovasc Imaging 2020; 37:529-538. [PMID: 33001325 DOI: 10.1007/s10554-020-02035-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/18/2020] [Indexed: 12/31/2022]
Abstract
Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is essential for choosing the best treatment strategy. We compared AVA quantified by 4 different in vivo echocardiographic methods with AVA measured by 3D ex vivo scanning of the excised AV. The data on 38 patients who underwent aortic valve replacement were assessed. The AVA was determined by 4 echocardiographic methods of planimetry in 2D transesophageal echocardiography [planimetry (2D-TEE)], plainemetry by multiplanar reconstruction approach in 3D transesophageal echocardiography [MPR (3D-TEE)], and two continuity equation (CE) approaches; conventional CE (2D-TTE) in which left ventricular outflow tract [LVOT] area derived by LVOT diameter obtained in 2D transthoracic echocardiography and CE (3D-TEE) in which LVOT area obtained by 3D MPR. After the surgical removal of the AV, AVA was determined by 3D ex vivo scanning. Lowest AVA mean difference with 3D ex vivo scanning was found between CE (2D-TTE), followed by CE (3D-TEE). Planimetry (2D-TEE) in male patients as well as severely and non-severely calcified valves revealed a significant higher AVA mean difference with 3D ex vivo scanning than CE (2D-TTE) and CE (3D-TEE) methods. However, with a nonsignificant effect, CE (2D-TTE) and planimetry (2D-TEE) had the least mean difference with 3D ex vivo scanning possibly due to less frequent bicuspid AV in females. CE (2D-TTE) was more accurate than other methods of AVA calculation. Moreover, CE (3D-TEE) and MPR (3D-TEE) methods had acceptable accuracy in comparison with planimetry (2D-TEE) for definition of AS severity.
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Affiliation(s)
- Samira Shirazi
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran
| | - Fatemeh Golmohammadi
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran
| | - Anahita Tavoosi
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran
| | - Mehrdad Salehi
- Cardiac Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran
| | - Akram Sardari
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran
| | - Babak Geraiely
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran
| | - Mehrzad Rahmanian
- Cardiac Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Kianoush Saberi
- Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sattarzadeh Badkoubeh
- Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O.Box: 1419733141, Tehran, Iran.
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Sherafati A, Mehrpooya M, Sattarzadeh Badkoubeh R, Larti F, Shahi F, Mirzania M, Esfandbod M, Saadat M, Ghasemi M, Zebardast J. Assessment of Carvedilol Therapy in Prevention of Heart Failure in HER2 Positive Breast Cancer Patients Receiving Trastuzumab. ACTA 2019. [DOI: 10.18502/acta.v57i3.1820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Abstract- Breast cancer is the most common cancer among the female population, and its prevalence is increasing worldwide. Trastuzumab (Herceptin) therapy improves prognosis in HER2 positive patients, but Heart Failure (HF) is one of its known complications. In this study, we aimed to assess the potential benefits of prophylactic carvedilol therapy in patients receiving Herceptin. Sixty five patients with HER2 positive breast cancer were enrolled in the study. All of the patients received Herceptin. Twenty seven patients also received carvedilol 6.25 mg twice daily, and 38 patients had usual care. Echocardiography was performed at baseline, and after three months in both groups and changes in cardiac function, parameters were compared between two groups. After 3 months, LA volume index (P=0.012), TAPSE (P=0.009), Tei index (P=0.015) and Lateral Longitudinal Strain (P=0.024) were significantly better in patients receiving carvedilol. Carvedilol can be effective in the prevention of systolic and diastolic dysfunction following Herceptin therapy.
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Peiman S, Mirzazadeh A, Alizadeh M, Mortaz Hejri S, Najafi MT, Tafakhori A, Larti F, Rahimi B, Geraiely B, Pasbakhsh P, Hassanzadeh G, Nabavizadeh Rafsanjani F, Ansari M, Allameh SF. A Case Based-Shared Teaching Approach in Undergraduate Medical Curriculum: A Way for Integration in Basic and Clinical Sciences. Acta Med Iran 2017; 55:259-264. [PMID: 28532138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2017] [Indexed: 06/07/2023] Open
Abstract
To present a multiple-instructor, active-learning strategy in the undergraduate medical curriculum. This educational research is a descriptive one. Shared teaching sessions, were designed for undergraduate medical students in six organ-system based courses. Sessions that involved in-class discussions of integrated clinical cases were designed implemented and moderated by at least 3 faculties (clinicians and basic scientists). The participants in this study include the basic sciences medical students of The Tehran University of Medical Sciences. Students' reactions were assessed using an immediate post-session evaluation form on a 5-point Likert scale. Six two-hour sessions for 2 cohorts of students, 2013 and 2014 medical students during their two first years of study were implemented from April 2014 to March 2015. 17 faculty members participated in the program, 21 cases were designed, and participation average was 60 % at 6 sessions. Students were highly appreciative of this strategy. The majority of students in each course strongly agreed that this learning practice positively contributed to their learning (78%) and provided better understanding and application of the material learned in an integrated classroom course (74%). They believed that the sessions affected their view about medicine (73%), and should be continued in future courses (80%). The percentage demonstrates the average of all courses. The program helped the students learn how to apply basic sciences concepts to clinical medicine. Evaluation of the program indicated that students found the sessions beneficial to their learning.
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Affiliation(s)
- Soheil Peiman
- Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences. Tehran, Iran
| | - Azim Mirzazadeh
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Internal Medicine, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Alizadeh
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Mortaz Hejri
- Department of Medical Education, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Taghi Najafi
- Department of Nephrology, Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Department of Neurology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurology, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Department of Pulmonary and Critical Care Medicine, Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Geraiely
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Parichehr Pasbakhsh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanzadeh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Ansari
- Department of Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farshad Allameh
- Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Mehrpooya M, Larti F, Nozari Y, Sattarzadeh-Badkoobeh R, Zand Parsa AF, Zebardast J, Tavoosi A, Shahbazi F. Study of Serum Uric Acid Levels in Myocardial Infarction and Its Association With Killip Class. Acta Med Iran 2017; 55:97-102. [PMID: 28282705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 06/06/2023] Open
Abstract
The present study aimed to compare the serum level of uric acid in patients with and without heart failure and also to determine the association between uric acid level and clinical status by Killip class in patients with STEMI. This case-control study was conducted on 50 consecutives as control group and 50 patients with acute heart failure, (20 patients had acute STEMI), who documented by both clinical conditions and echocardiography assessment. The mean plasma level of uric acid in the case group was 7.6±1.6 milligrams/deciliter (mg/dL) and in the control group was 4.5±1.5 respectively (P<0.001). These values in patients with STEMI was about 9.2±0.86, but in patients with acute heart failure in absence of STEMI was 6.5±1.04 (P<0.001). Moreover, there was significant difference among the level of uric acid and Killip classes (P<0.001). Also there was significant difference for uric acid level between HFrEF (HF with reduced EF) and severe LV systolic dysfunction (0.049). In STEMI patients with culprit LAD, mean uric acid was significantly higher than cases with culprit LCX [(9.7±0.98 versus 8.6±0.52 respectively) P=0.012]. Regarding treatment plan in patients with STEMI, mean level of uric acid in those considered for CABG was significantly higher than who were considered for PCI, 9.9±0.82 versus 8.9±0.76 respectively, P=0.029. In STEMI patients with higher killip class, higher level of uric acid was seen. Also, the severity of LV systolic dysfunction was associated with higher level of uric acid.
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Affiliation(s)
- Maryam Mehrpooya
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Younes Nozari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sattarzadeh-Badkoobeh
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Farhang Zand Parsa
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Jayran Zebardast
- Department of Electronic Learning in Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Tavoosi
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Sattarzadeh R, Tavoosi A, Jabbari M, Parsa AFZ, Geraiely B, Saadat M, Larti F, Meysamie AP, Salehi M. Erratum to: 'Acceleration rate of mitral inflow E wave: a novel transmitral doppler index for assessing diastolic function'. Cardiovasc Ultrasound 2016; 14:26. [PMID: 27460465 PMCID: PMC4962506 DOI: 10.1186/s12947-016-0070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 07/11/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Roya Sattarzadeh
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Tavoosi
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Jabbari
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Farhang Zand Parsa
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Geraiely
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saadat
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Pasha Meysamie
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Salehi
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Badkoubeh RS, Tavoosi A, Jabbari M, Parsa AFZ, Geraeli B, Saadat M, Larti F, Meysamie AP, Salehi M. Acceleration rate of mitral inflow E wave: a novel transmitral doppler index for assessing diastolic function. Cardiovasc Ultrasound 2016; 14:24. [PMID: 27287228 PMCID: PMC4902964 DOI: 10.1186/s12947-016-0067-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/04/2016] [Indexed: 12/03/2022] Open
Abstract
Background We performed comprehensive transmitral and pulmonary venous Doppler echocardiographic studies to devise a novel index of diastolic function. This is the first study to assess the utility of the acceleration rate (AR) of the E wave of mitral inflow as a primary diagnostic modality for assessing diastolic function. Methods Study group consisted of 84 patients (53 + 11 years) with left ventricle (LV) diastolic dysfunction and 34 healthy people (35 ± 9 years) as control group, who were referred for clinically indicated two-dimensional transthoracic echocardiogram (TTE) during 2012 and 2013 to Imam Hospital. Normal controls were defined as patients without clinical evidence of cardiac disease and had normal TTE. LV diastolic function was determined according to standardized protocol of American Society of Echocardiography (ASE). As our new parameter, AR of E wave of mitral inflow was also measured in all patients. It was represented by the slope of the line between onset of E wave and peak of it. Correlation between AR of E wave and LV diastolic function grade was measured using the Spearman correlation coefficient. Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of AR of E wave in diagnosing LV diastolic dysfunction in randomly selected two-thirds of population then its derived cutoff was evaluated in rest of the population. The institutional review board of the hospital approved the study protocol. All participants gave written informed consent. This investigation was in accordance with the Declaration of Helsinki. Results The mean value of AR was 1010 ± 420 cm/s2 in patients whereas the mean value for the normal controls was 701 ± 210 cm/s2. There was a strong and graded relation between AR of E wave of mitral inflow and LV diastolic function grade (Spearman P ≤0.0001, rs =0.69). ROC curve analysis revealed that AR of E wave of mitral inflow =750 cm/s2 predicted moderate or severe LV diastolic dysfunction with 89 % sensitivity and 89 % specificity (area under curve [AUC] = 0.903, P <0.0001). Application of this cutoff on test group showed 96 % sensitivity and 77 % specificity with AUC = 0.932 and P <0.0001. Conclusion AR of E wave of mitral inflow could be used for assessment of diastolic function, especially moderate or severe diastolic dysfunction. However, before its clinical application, external validation should be considered.
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Affiliation(s)
| | - Anahita Tavoosi
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Jabbari
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Farhang Zand Parsa
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Geraeli
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saadat
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Larti
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Pasha Meysamie
- Department of community medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Salehi
- Cardiology Department of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Fang F, Santoro C, Hristova K, Yoon HJ, Abid L, Poller A, Erdei T, Ahmed T, Geraeli B, Gascuena R, Li YJ, Yang J, Bartel T, Erbel R, Ya Y, Yu CM, Schiano Lomoriello V, Esposito R, Casaretti L, Ilardi F, Fazio V, De Simone G, Trimarco B, Galderisi M, Hristova K, Marinov R, Marinov R, Katova TZ, Katova TZ, Kostova V, Kostova V, Simova I, Kim KH, Cho JY, Park JC, Ben Kahla S, Bech-Hanssen O, Sunderji I, Sanchez-Martinez S, Edwards J, Braim D, Price C, Bijnens B, Fraser AG, Mohmed LA, Abd-Elhady B, Abdellaha M, Mazen A, Sattarzadeh Badkoubeh R, Hassanbeigy HR, Tavoosi A, Larti F, Saberi K, Rubio L, Terol B, Rico C. Moderated Posters session: diastolic function in clinical perspectiveP1260Coronary flow reserve in patients with chest pain but without significant coronary stenosis: the role of hypertensionP1261Diastolic bicycle exercise: normal reference values and determinantsP1262Prediction of left ventricular diastolic dysfunction in breast cancer patients after chemotherapyP1263Impaired diastolic recovery is associated with adverse events in the patients with hypertensive heart failureP1264Diastolic strain parameters in hypertensive heart disease: Insights from a speckle tracking imagingP1265Standard echocardiographic parameters to assess right ventricular diastolic function does not detect increased end diastolic right ventricular pressure in pulmonary vascular diseaseP1266In heart failure with preserved ejection fraction carotid arterial stiffness is increased and may contribute to reduced functional reserveP1267Study of left atrial function by speckle tracking in young Egyptian females with unexplained dyspnea; pilot reportP1268stress effect on diastolic functionP1269Diastolic function and adjusted diastolic index in apparently healthy obese patients. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Khaledi A, Larti F, Safari S. Post-infarction myocardial rupture : a case of pericardial tamponade salvaged by auto-blood transfusion. Cardiovasc J Afr 2012; 23:e12-3. [DOI: 10.5830/cvja-2011-026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 06/01/2011] [Indexed: 11/06/2022] Open
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Fazeli MS, Kazemeini A, Safari S, Larti F. Fever and diarrhea after laparoscopic bilioenteric anastomosis. Saudi J Gastroenterol 2011; 17:360-2. [PMID: 21912066 PMCID: PMC3178927 DOI: 10.4103/1319-3767.84499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Bile duct injuries are well-known complications of laparoscopic and open cholecystectomies. Here, we report anastomosis of the common bile duct to the transverse colon that occurred as a complication of laparoscopic cholecystectomy. To the best of our knowledge, a similar case has not been reported in the literature so far. As in our patient, persistent diarrhea (in addition to fever and icterus) can be a warning sign of complication after these procedures. Surgeons who do advanced laparoscopic techniques must be familiar with this complication.
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Affiliation(s)
- Mohammad S. Fazeli
- Department of General Surgery, Imam Khomeini Hospital Complex, Tehran University Of Medical Sciences, Tehran, Iran
| | - Alireza Kazemeini
- Department of General Surgery, Imam Khomeini Hospital Complex, Tehran University Of Medical Sciences, Tehran, Iran
| | - Saeed Safari
- Department of General Surgery, Imam Khomeini Hospital Complex, Tehran University Of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Saeed Safari, Division of Colorectal Surgery, Department of General Surgery, Imam Khomeini Hospital Complex, End of Keshavarz Boulevard, Tehran, Iran. E-mail:
| | - Farnoosh Larti
- Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University Of Medical Sciences, Tehran, Iran
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