Hassan Djavadzadegan

... Payman Vahedi, MD, Department of Neurological Surgery, Imam Hospital, Tabriz University of Medical Sciences, Tabriz, Iran (e-mail: payman.vahedi@gmail ... rare case of multiple intracranial hydatid cysts secondary to the embolism of cardiac echinococcosis in a 17-year-old girl ...

... Payman Vahedi, MD, Department of Neurological Surgery, Imam Hospital, Tabriz University of Medical Sciences, Tabriz, Iran (e-mail: payman.vahedi@gmail ... rare case of multiple intracranial hydatid cysts secondary to the embolism of cardiac echinococcosis in a 17-year-old girl ...

Introduction : Literature has shown the effects of intravenous/intracoronary nicorandil on increased myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) treated with mechanical reperfusion. However, the possible cardioprotective effect of oral nicorandil on the clinical outcome prior to primary coronary angioplasty is not well documented. Our aim was to assess the effect of oral nicorandil on primary percutaneous coronary intervention (PPCI). Methods: A total of 240 patients with acute STEMI undergoing PPCI were randomly assigned to oral nicorandil (Intervention, n=116) and placebo (Control, n=124) groups. The intervention group received 20 mg oral nicorandil at the emergency department and another 20 mg oral nicorandil in the catheterization laboratory just before the procedure. The control group received matched placebo. Our primary outcome was ST-segment resolution ≥50% one hour after primary angioplasty. Secondary outcome was in-hospital major ...

Introduction: Mitral stenosis is a narrowing or blockage of the opening of the mitral valve. Symptoms usually develop between the ages of 20 and 50. It most commonly occurs in people who have had rheumatic faver. The purpose of this study was to determine the clinical, characteristics of mitral stenosis in men and women and their reactions to Balloon Mitral Valvotomy (BMV).  Materials and Methods: 300 patients who suffered from mitral stenosis (moderate or severe) and admitted for BMV were studied during four years in Madani Heart Hospital (Tabriz-Iran). Echocardiography was performed before and after BMV in all patients trough Transthorasic and Transesophagial. Selective or nonselective coronary angiography in most of the cases was carried out and data were compared between two genders. Results: 218 female (72.5%) and 82 male (27.5%) aged 38.7±1.4 years old (13 to 72) were studied. Higher CAD rate was observed in men than women (P= 0.002). Mitral Valve Surface Area (MVSA) was smaller and the morphology of the valve score was not suitable for BMV in men (P=0.0025 and P<0.0001 respectively). Symptoms of heart failure at FC III-IV level and diuretic prescription were higher in women than men (P=0.058 and P=0.053 respectively). There was no significant difference in hemodynamic variables, BMV side effects and other echocardiographic results between men and women. Conclusion: The incidence of mitral stenosis in women was higher than men. These findings confirmed that pathophysiology of mitral valve stenosis are different between men and women and the changes and the gender should be considered in treatment methods.

monary-myocardial reperfusion activates the immune system. The extent of this im-mune reaction has been correlated to clini-cal and post-operative complications. (3,4) It has been proposed that avoiding CPB and myocardial ischemia-reperfusion signifi-cantly reduces the postoperative systemic complications which negatively affect the perioperative course after surgical myocar-dial revascularization (5-7). The aim of this study is to evaluate differ-ences in high-sensitivity C-reactive protein (hs-CRP) and tumor necrotizing factor-alpha (TNF-α) between on-pump and off-pump coronary surgery.

Objective: Prosthetic valve thrombosis (PVT) is an obstruction of a valve prosthesis by non-infective thrombotic material. A number of studies have reported an association between ABO blood groups and thromboembolic events. Little is known about impact of ABO groups on prosthetic valve thrombosis. Therefore, we studied the distribution of ABO blood groups in patients with PVT. Material and Methods: This was a single center retrospective cohort of patients with PVT during ten years period in the northwest of Iran. All patients received intensified anticoagulation or thrombolysis or redo surgery according to physician decision. Then, all patients divided into two blood group: O and non-O group, and in-hospital adverse events and mortality were compared between groups. Results: During 10-year period, there were 85 episodes of PVT in 80 patients. Number of patients who developed PVTaccording to ABO group were: 23 (27%) in group A, 23 (27%) in group B, 12 (14.1%) in group AB and 27 (31.7...

کچ هدی شيپ هنيمز و فده : رفن ی ت سوپول ی ی ک ی زا تارهاظت اش ی ع و دش ی د ب ی رام ي سوپول را ی سوتامت س ی متس ی تسا ک هک م ی دناوت رجنم هب اسران یی لک ی ه و تح ی گرم ب ی رام .ددرگ لقادح 30 20 دصرد زا دراوم رفن ی ت سوپول ی لورپ ی تارف ی و هب نامرد درادناتسا خساپ من ی دنهد . ارب ي نامرد ا ی ن ب ی نارام شور اه ي فلتخم ی پ ی نش هدشداه لو ی رد دروم ه ی چ مادک زا نآ اه قفاوت مومع ی دوجو درادن . فده زا ا ی ن هعلاطم سررب ی اتن ی ج نامرد اب س ی روپسولک ی ن رد نامرد رفن ی ت سوپول ی لورپ ی تارف ی و مواقم هب نامرد تسا . شور و داوم راک : رد ی ک هعلاطم هتشذگ رگن ب ی نارام لاتبم هب رفن ی ت سوپول ی لورپ ی تارف ی و مواقم هب نامرد درادناتسا هک تحت نامرد اب س ی روپسولک ی ن رارق هتفرگ ،دندوب سررب ی دندش . ا ی ن ب ی نارام رظنزا مر ی س ی نو لک ی ،ه تارک ی ن ی ن ،مرس م ی ناز ئتورپ ی ن روا ي ، ضراوع بناج ی ،نامرد لاتروم ی ت ی و لاعف ی ت ب ی رام ي م هعلاطمدرو رارق دنتفرگ . هتفاي اه : 25 ب ی رام لاتبم هب رفن ی ت سوپول ی تحت نامرد اب س ی روپسولک ی ن اب م ی گنا ی ن نس ی 9 / 6 ± 30 لماش 5 درم ) 20 دصرد ( و 20 ن...

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by various autoantibodies formation and immune complex deposition in various organs. Lupus nephritis is a common and severe manifestation of SLE that can lead to end stage renal disease and death. The aim of this study was to evaluate the long-term efficacy of cyclosporine A in the treatment of resistant proliferative lupus nephritis. Materials & Methods: In a retrospective study, patients with proliferative lupus nephritis that were resistant to treatment with mycophenolate mofetil and/or cyclophosphamide and treated with cyclosporine A were entered to the study. They were evaluated according to the remission of the renal disease, SLE disease activity index, occurrence of end stage renal disease, mortality and side effects of treatment. Results: Twenty-five patients with biopsy proven proliferative lupus nephritis with the mean age of 30±6.9 years including 5 men (20%) and 20 women (80%) were studied. ...

Introduction: Mitral stenosis is a narrowing or blockage of the opening of the mitral valve. Symptoms usually develop between the ages of 20 and 50. It most commonly occurs in people who have had rheumatic faver. The purpose of this study was to determine the clinical, characteristics of mitral stenosis in men and women and their reactions to Balloon Mitral Valvotomy (BMV).  Materials and Methods: 300 patients who suffered from mitral stenosis (moderate or severe) and admitted for BMV were studied during four years in Madani Heart Hospital (Tabriz-Iran). Echocardiography was performed before and after BMV in all patients trough Transthorasic and Transesophagial. Selective or nonselective coronary angiography in most of the cases was carried out and data were compared between two genders. Results: 218 female (72.5%) and 82 male (27.5%) aged 38.7±1.4 years old (13 to 72) were studied. Higher CAD rate was observed in men than women (P= 0.002). Mitral Valve Surface Area (MVSA) was small...

Although valve repair is applied routinely nowadays, particularly for mitral regurgitation (MR) or tricuspid regurgitation (TR), valve replacement using prosthetic valves is also common especially in adults. Unfortunately the valve with ideal hemodynamic performance and long-term durability without increasing the risk of bleeding due to long-term anticoagulant therapy has not been introduced. Therefore, patients and physicians must choose either bioprosthetic or mechanical valves. Currently, there is an increasing clinical trend of using bioprosthetic valves instead of mechanical valves even in young patients apparently because of their advantages. Seventy patients undergone valvular replacement using bioprosthetic valves were evaluated by ECG and Echocardiography to assess the rhythm and ejection fracture. Mean follow-up time was 33 months (min 9, max 92). Mortality rate was 25.9% (n=18) within 8 years of follow-up. Statistical analysis showed a significant relation between atrial ...

Coronary artery bypass grafting (CABG) is one of the most frequently performed operations around the world. The aim of this study is to evaluate high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-alpha) differences between on-pump and off-pump coronary surgery. In this prospective study, 90 patients with coronary artery disease referred for CABG were enrolled from July 2006-November 2007. Levels of hs-CRP and TNF-alpha were measured by ELISA using commercial kits hs-CRP levels significantly (p<0.001) increase after CABG. But no difference between off-pump and on-pump groups was noted for hs-CRP and TNF-alpha levels (p=0.4, p=0.8). There was no difference in high-sensitivity C-reactive protein (hs-CRP) and TNF-alpha between on-pump and off-pump CABG surgery.

Instruction. We investigated the correlation between atherosclerosis and tissue and serum levels of endothelin-1 in patients with chronic kidney disease (CKD). MATERIALS AND METHODS. Arterial samples were obtained from 35 patients with CKD during arteriovenous fistula placement. Thirty-one patients with cardiovascular disease who underwent coronary artery bypass graft (CABG) were selected as the atherosclerotic group, and a piece of their aorta punched during CABG was obtained. Also, a small piece of the renal artery was dissected during donation in 24 kidney donors (control group). Tissue endothelin-1 level was measured and atherosclerosis grading was determined by pathologic examination. Serum levels of endothelin-1 were also measured in the three groups. Results. The mean tissue endothelin-1 levels were 10.73+/-7.57 pg/mL, 12.16 +/- 3.95 pg/mL, and 0.93 +/- 1.06 pg/mL in the patients with CKD, those with CABG, and donors, respectively (P < .001). The mean serum endothelin-1 le...

To examine the dose response of TNFα in an ex vivo rat model of myocardial ischemia reperfusion. Seventy-two rat hearts were mounted on Langendorff apparatus and perfused with oxygenated Krebs-Henseleit solutions. Ischemia was induced by reducing the perfusate flow rate. During reperfusion, incremental doses of recombinant TNFα were infused as a part of perfusate. TNFα was blocked with monoclonal TNFα antibody. Myocardial function was measured by dP/dT and relaxation time (IVRT). Cellular injury was assessed by released myoglobin and tissue concentration of malondialdehyde activity of the heart homogenates. Baseline +dP/dT was 1645 ± 125 mmHg/sec, -dP/dT was 945 ± 73 mmHg/sec and IVRT was 65 ± 5 msec. At the conclusion of reperfusion period, lower doses of TNFα increased +dP/dT and lowered IVRT. In contrast, the higher doses of TNFα decreased +dP/dT and prolonged IVRT. Pretreating the hearts with monoclonal TNFα antibody completely abolished the effects of TNFα on myocardial contractility and relaxation comparable to ischemia controls. Low dose TNFα improved myocardial function and decreased resultant cellular injury while high dose TNFα decreased myocardial function and increased myocardial injury following ischemia and reperfusion.

A 63-year-old male with history of hypertension, dyspnea on exertion, and chronic chest pain was admitted for elective cardiac angiography. Arterial blood pressure was 160/90 mmHg in both arms. Femoral and popliteal pulses were extremely weak, and third (S3) and fourth (S4) heart sounds were audible. Aortography showed a mildly dilated aortic root with double brachiocephalic trunk and interruption of aortic arch at isthmus. Profuse and well-developed collaterals appeared at neck and thorax. The patient was recommended to take medical treatment for his hypertension and advanced heart failure. The aim of this paper, is to review the diagnostic and therapeutic options for treatment of the interrupted aortic arch.

Both surgical and percutaneous closures of atrial septal defects have been successful in reversal of atrial dilatation. We compared the effects of surgical and percutaneous transvenous device closure of atrial septal defect on post-operative changes of P-wave duration, PR segment, and PR interval. Electrocardiographic data were prospectively collected from 30 patients following either surgical (n equal to 16) or percutaneous (n equal to 16) repair of atrial septal defects between 2004 and 2010. A cardiologist blinded to the closure technique performed the electrocardiographic analyses. P-wave duration (98.5 plus or minus 15.4 to 86.4 plus or minus 13.2 milliseconds, p-value less than 0.05) and PR interval (162.9 plus or minus 18.5 to 140.6 plus or minus 15.2 milliseconds, p-value less than 0.05) were reduced after percutaneous transvenous device closure. P-wave duration (104.5 plus or minus 24.7 versus 83.2 plus or minus 13.3 milliseconds, p-value less than 0.05) and PR interval (17...

Larger mean platelets volumes (MPV) are thrombogenic and frequently seen after ST-segment elevation myocardial infarction (STEMI). This study aimed to examine the association of MPV and resolution of ST-segment after thrombolysis in STEMI patients as and its impact on clinical outcome. Patients presenting to the emergency department with the diagnosis of first STEMI and were referred to thrombolysis were screened. Patients with ≥50% ST-segment resolution (STR) 90minutes after thrombolysis were assigned as "Responder" and those with <50% STR were assigned as "Non-Responders". Demographic, clinical comorbidities and risk factor were recorded along with and angiographic data. In-hospital occurrence of major adverse cardiac events (MACE), including acute heart failure (AHF), reinfarction and death were investigated. Additionally, the patients were followed for 6 additional months after their discharge from the hospital. STR≥50% was seen in 60.2% of patients after thrombolysis. Responders had significantly lower MPV (P=0.001) and the critical MPV values were 8.0 femtoliter (fL) and 8.2fL in predicting STR and MACE. Patients with MPV ≥8.2fL had lower probability of STR and higher rates of AHF (P<0.001), and MACE (P=0.001) compared to the patients with lower platelet volume. In multivariate regression, MPV was an independent predictor of STR (P<0.001) as well as MACE (HR=4.8, 95% CI of 1.8-12.4; P=0.001). Triple vessel disease was another independent factor that predicted MACE. Higher MPV's at admission were associated with lower STR and higher occurrence of major adverse cardiac events in patients receiving thrombolytic therapy for first time STEMI.