ABSTRACT
Background: Growth retardation is a common finding in cystic fibrosis [CF] patients. Recombinant human growth hormone [rhGH] has shown promising results in improving weight, height and clinical status of CF patients. In this study we aim to evaluate efficacy of rhGH on physical growth, clinical status and pulmonary function in CF patients
Methods: In this prospective clinical trial we recruited 34 CF patients with mean age of 62.05 31.11 month. Patients were followed for 6 months and then were treated with rhGH 0.35 mg/kg/week for the next six month. Measurements included height, weight, growth velocity, pulmonary function, hospitalizations, outpatient antibiotic use and Insulin-like growth factor-1 [IgF1] before and after rhGH therapy
Results: Growth velocity, Insulin-like growth factor-1 levels, hospitalization and antibiotic therapy were significantly improved after rhGH treatment. Pulmonary function evaluations including forced vital capacity [FVC] and forced expiratory volume [FEV1] showed no significant difference, before and after rhGH therapy
Conclusions: These results show significant effects of rhGH treatment on growth and clinical status of CF patients, but didn't positive effect on Pulmonary function
ABSTRACT
Percutaneous balloon mitral valvotomy [BMV] is the gold standard treatment for rheumatic mitral stenosis [MS] in that it causes significant changes in mitral valve area [MVA] and improves leaflet mobility. Development of or increase in mitral regurgitation [MR] is common after BMV. This study evaluated MR severity and its changes after BMV in Iranian patients. We prospectively evaluated consecutive patients with severe rheumatic MS undergoing BMV using the Inoue balloon technique between February 2010 and January 2013 in Madani Heart Center, Tabriz, Iran. New York Heart Association [NYHA] functional class and echocardiographic and catheterization data, including MVA, mitral valve mean and peak gradient [MVPG and MVMG], left atrial [LA] pressure, pulmonary artery systolic pressure [PAPs], and MR severity before and after BMV, were evaluated. Totally, 105 patients [80% female] at a mean age of 45.81 +/- 13.37 years were enrolled. NYHA class was significantly improved after BMV: 55.2% of the patients were in NYHA functional class III before BMV compared to 36.2% after the procedure [p value < 0.001] MVA significantly increased [mean area = 0.64 +/- 0.29 cm[2] before BMV vs. 1.90 +/- 0.22 cm2 after BMV; p value < 0.001] and PAPs, LA pressure, MVPG, and MVMG significantly decreased. MR severity did not change in 82 [78.1 %] patients, but it increased in 18 [17.1%] and decreased in 5 [4.8%] patients. Patients with increased MR had a significantly higher calcification score [2.03 +/- 0.53 vs. 1.50 +/- 0.51; p value < 0.001] and lower MVA before BMV [0.81 +/- 0.23 vs. 0.94 +/- 0.18; p value = 0.010]. There were no major complications. In our study, BMV had excellent immediate hemodynamic and clinical results inasmuch as MR severity increased only in some patients and, interestingly, decreased in a few. Our results, underscore BMV efficacy in severe MS. The echocardiographic calcification score was useful for identifying patients likely to have MR development or MR increase after BMV
ABSTRACT
BACKGROUND AND OBJECTIVES: Coronary artery anomalies are found in approximately 1% of patients undergoing diagnostic coronary angiography (CAG). Angiographic recognition of these vessels is important because of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery. There are fairly enough reports concerning the incidence of coronary anomalies in different geographic areas, but this is the first study among the Iranian population. SUBJECTS AND METHODS: We reviewed the database of the Catheterization Laboratory of Imam Reza and Shahid Madani Hospitals, Tabriz University of Medical Sciences, Iran. Our inquiry included all patients who referred for CAG from other hospitals, between February 2007 and April 2009. Patients with congenital heart diseases, high "take off" of coronary arteries and separate origin of the conus artery from the right coronary sinus (RCS) were excluded. In total, 6065 films were reviewed. RESULTS: Seventy nine (1.30%) patients were found to have coronary anomalies. Seventy five (1.24%) patients had anomalies of origin and distribution, while four (0.06%) had coronary artery fistulae. Most common anomaly was separate ostia of the left anterior descending artery and left circumflex artery, which was found in 42 patients (53.16%) with angiographic incidence of 0.69%. The next most common anomalies were anomalous circumflex artery from RCS/right coronary artery (RCA) {n=17 (21.51%)}, and anomalous RCA arising from left coronary sinus {n=6 (7.59%)}. CONCLUSION: In general, the incidence and pattern of coronary anomalies in our study was similar to earlier reports from different parts of the world.
Subject(s)
Humans , Angiography , Angioplasty , Arteries , Catheterization , Catheters , Conus Snail , Coronary Angiography , Coronary Sinus , Coronary Vessels , Fistula , Heart Diseases , Incidence , Iran , Thoracic SurgeryABSTRACT
Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention [PCI]. The prognosis of patients with diabetes mellitus and chronic total occlusion [CTO] treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15 +/- 3 months, were evaluated for the occurrence of major adverse cardiac events [MACE] comprising death, acute myocardial infarction, and need for repeat revascularization. No differences were found in baseline clinical and procedural variables between patients with [n=34] and without diabetes [n=129], unless for hypertension [p=0.03]. Hospitalization period after PCI in diabetics [3.26+0.61 days] and non-diabetics[2.86+0.52 days] was similar. In-hospital MACE occurred in 8 [23.5%] individuals of diabetics and 10 [7.8%]individuals of non-diabetics [p=0.02] among them revascularization was significantly higher in diabetics [20.6% vs. 7%, p=0.04]. Follow-up events in diabetic and non-diabetic groups were 12 [35.3%] and 37 [28.5%], respectively [p was not significant]. In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients
ABSTRACT
Renal failure predisposes patients to adverse outcome after coronary artery bypass grafting [CABG] Renal dysfunction is a predictor of increased morbidity and mortality after CABG, whether it is dialysis-dependent or not. In a retrospective study from April 2000 to December 2010, seventy-six patients [60 male and 16 female with the mean age of 58.57+7.93 years] with different categories of chronic renal failure undergoing CABG in Shahid Madani Hospital, were studied. The cardiac disease leading to the operation was coronary artery disease [CAD] in all patients. Patients demographic, surgical and laboratory data were gathered from hospital records. Data were then analyzed. Mean hospital stay was 10.16+7.16 days. The preoperative mortality rate was 10.5% [15% in non dialysis and 5.6% in dialysis dependant patients with no significant difference]. Morbidity rate was 28.9% [respectively 30% and 27.8% in dialysis and non dialysis patients with no significant difference] including in-hospital myocardial infarction [MI] [10.5%], in-hospital stroke [2.6%], in-hospital bleeding [21.1%] and in-hospital infection, pneumonia, [5.3%]. Mean creatinine and blood urea nitrogen [BUN] levels were significantly increased after surgery [p0.001]. Postoperative hemodialysis rate was 33.3%. Chronic renal failure whether dialysis-dependant or not increases in-hospital mortality and morbidity in patients undergoing CABG. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of postoperative dialysis
ABSTRACT
Peripheral arterial disease is associated with an excessive risk for cardiovascular events and mortality. Peripheral arterial disease is usually measured with ankle brachial index [ABI]. It is previously shown that the ABI would reflect LV systolic function, as well as atherosclerosis; however, these results are not shown in non-diabetic individuals. In this study, we aim to evaluate this relation in non-diabetic individu-als. In a prospective study, 73 non-diabetic individuals [38.4% male with mean age of 59.20 +/- 14.42 years] referred for ABI determination who had had the left ventricular ejection fraction determined using trans-thoracic echocardiography were studied. Participants were compared in normal and low ABI groups. The mean left ventricular ejection fraction [LVEF] was 52.34 +/- 7.69, mean ankle brachial index for the right leg was 1.08 +/- 0.13, and the mean ankle brachial index for the left leg was 1.07 +/- 0.12. Low ABI incidence was 12.32%. Individuals with low ABI significantly were older [p<0.001] and had lower left ventricular ejection fraction [p<0.001]. ABI had significantly inverse correlation with LVEF [r=-0.53, p<0.001] and positive correlation with age [r=0.43, p<0.001]. The ABI correlated inversely with LVEF in the patients with [r =-0.52, p=0.008] and without [r=-0.55, p<0.001] IHD. Results showed that ankle brachial index would be influenced by left ventricular ejection fraction in non-diabetics and to evaluate and monitor cardiovascular risk in patients these should be considered together