ABSTRACT
The anomalous origin of the left coronary artery from the pulmonary artery [ALCAPA] is a rare congenital anomaly. The usual clinical course is severe left-sided heart failure and mitral valve insufficiency presenting during the first months of life. However, in some cases, the collateral blood supply from the right coronary artery is sufficient and symptoms may be subtle or even absent. We describe a 49-year-old woman presenting with atypical chest pain during physical exertion. The exercise tolerance test and then coronary angiography by indication revealed an anomalous origin of the left coronary artery. The patient underwent surgical treatment, whereby a pulmonary artery tube graft from the aorta to the left coronary artery was created and the main pulmonary artery was reconstructed with a bovine pericardial patch. The patient was discharged from the hospital without any chest pain and dyspnea and was symptom free during a follow-up period of 18 months. Clinicians should consider ALCAPA as a differential diagnosis in adults with presentations similar to exercise-related asthma
ABSTRACT
Introduction: Body mass index [BMI] can affect cardiac morphology; however, the relationship between BMI and valvular heart diseases has not been thoroughly evaluated. This study aimed to determine the relationship between BMI and mitral valve prolapse [MVP] as one of the most common valve diseases worldwide. It can help us to better understand pathophysiology of this common disease
Materials and Methods: In this descriptive study we enrolled 200 patients with isolated MVP. This patient was referred from 2014 to 2015 to our cardiology clinic in Mashhad, Iran, with chief complaint of chest pain, dyspnea, and palpitation. patients underwent transthoracic echocardiography. We document the patients' height, weight, and demographics data. BMI distribution was categorized as higher and lower than 18.5 kg/m[2]. Chi-square and independent samples t-test were performed using SPSS version 19 to analyze the data
Results: The results showed that 92 [46%] and 108 [54%] of the samples were male and female, respectively, and their mean age was 24.29 +/- 3.75 years. Most of the patients [n=110] had low BMI [55% of the patients had BMI lower than 18.5 kg/m2]. Left atrial and ventricular diameters had a significant relationship with BMI of all the underweight patients [n=110] [P=0.026 and 0.032, respectively]. The main complaints were chest pain [n=55,50%] and dyspnea [n=58,64.44%] in the patients with low and normal BMI, respectively
Conclusion: Symptoms and echocardiographic features in MVP patients vary with BMI. While mitral valve annulus diameter was the same in both BMI groups, the results showed that left atrial and ventricular diameters in the underweight patients were less than those with normal BMI
ABSTRACT
Introduction: The correlation between right and left ventricular ejection fractions [RVEF and LVEF, respectively] has been studied in only a small number of patients with a marked decrease in RVEF and LVEF. The aim of the present study was to compare LVEF and RVEF in patients with ischemic heart disease. RVEF and LVEF were measured by Cardiovascular Magnetic Resonance [CMR] imaging
Materials and Methods: This observational study was done in Ghaem general hospital in 2014. LVEF and RVEF were measured in a series of 33 patients with ischemic heart disease, undergoing CMR for the evaluation of myocardial viability. The correlation between RVEF and LVEF in patients with ischemic heart disease was studied, using Pearson product-moment correlation coefficient analysis
Results: Right ventricular end diastolic volume [186.33 +/- 58.90] and left ventricular end diastolic volume [121.72 +/- 61.64] were significantly correlated [r=0.223, P=0.005]. Moreover, there was a significant correlation between right ventricular end systolic volume [88.18 +/- 40.90] and left ventricular end systolic volume [140.96 +/- 35.33] [r=0.329, P=0.000]. The most significant association was observed between RVEF and LVEF [r=0.913, P=0.000]
Conclusion: Based on the findings, RVEF and LVEF were significantly correlated in patients with ischemic heart disease, although this association was not always present in all cardiac patients. The cause of this discrepancy is still unknown
ABSTRACT
Introduction: Atrial arrhythmia is a common complication in patients with gastro esophageal reflux disease [GERD]. The treatment of palpitation is relatively problematic in these patients, especially if there is not enough evidence of cardiovascular or systemic diseases. The esophagus is in close proximity to the left atrium posterior wall. Hypothetically, locally released cytokines from esophageal injuries could stimulate the left atrium and produce premature atrial contractions. In this study we aimed to evaluate the effects of pantoprazole on palpitation in patients with reflux palpitation
Materials and Methods: This study was conducted on patients presented with palpitation and symptom of GERD from January 2014 to June 2014 in the General Clinic of Imam Reza Hospital. In order to establish the precise effects of pantoprazole on the treatment of palpitation in GERD patients, pantoprazole was added to the beta-blockers during treatment, and the patients were followed-up for one month
Results: In total, 10 patients within the age range of 21-35 years with a history of palpitation were enrolled in this study. The mean age of the subjects was 25 years, and the study group consisted of 6 men and 4 women. After a one-month follow-up, a significant reduction was observed in the palpitation of these patients [P<0.001]
Conclusion: According to the results of this study, addition of pantoprazole to the treatment of palpitation was effective in patients with a history of GERD. Therefore, pantoprazole could be used as an effective adjunctive treatment for palpitation
ABSTRACT
Introduction: This study aimed to evaluate the effects of four-time inflation of the stent balloon at nominal pressure on optimal stent expansion in resistant lesions
Materials and Methods: This interventional study was conducted on 39 patients with coronary artery lesions, in whom Zotarolimus-eluting stents [N=20], Paclitaxel-eluting stents [N=11] and other stents [N=8] were deployed four times at nominal inflation pressure and increased inflation times [5, 15, 30 and 45 seconds]. After the deployments, enhanced stent visualization imaging technique [IC stent] was used to assess stent placement and artery expansion
Results: In this study, early success rate was estimated at 79.5% using the enhanced stent visualization imaging technique. In addition, major adverse cardiac event [MACE] was determined at 2.6%. Also, conventional methods resulted in lower success rate and higher MACE in resistant lesions
Conclusion: According to the results of this study, four-time stent balloon inflation at nominal pressure could allow adequate stent expansion in resistant lesions leading to lower MACE
ABSTRACT
The most effective and accurate treatment of hypertensive patients reduces cardiovascular events and improves the quality of life. This study compared the efficacy and safety of combined [combination therapy] with an angiotensin-receptor blocker [ARB] a calcium-channel blocker [CCB] [Losartan / Amloidipine 50/10mg] vs maximal combination doses of ARB with hydrochlorothiazide [Losartan /HCTZ 100/25 mg] and maximal combination doses of CCB with HCTZ [Amlodipine /HCTZ 10/25 mg] in the management of stage 2 hypertension. This randomized clinical trial [RTC] comprised 478 hypertensive patients with mean age 50.5 +/- 5.21 years, and took place between January 2010 and December 2011 in Vasei Hospital clinic in Sabzevar. Antihypertensive drugs were washed out after 5 days of discontinuation of drugs and the patients with mean blood pressure in sitting position >/= 160 and <200 mmHg in systole and >/= 100 and <110 mmHg in diastole were randomized into three groups: Losartan / Amlodipine 50/10 mg [n =164], Losartan / HCTZ 100/25 mg [n =155] and Amlodipine / HCTZ 10/25 mg [n =159]. The end point was reaching the blood pressure below 140/90 within 56 days of treatment in each group. There was a significant difference in systolic blood pressure reductions between treatment groups [P<0.001] and also there was a significant difference between groups in reducing diastolic blood pressure [P<0.01]. The highest systolic and diastolic blood pressure reduction respectively was found in Amlodipine/losartane and losartane/HTCZ group. The ANCOVA analysis revealed that only treatment regimen had a significant effect [P=0.01] and other factor including Age, Gender, Diabetes Mellitus, Smoking and High serum cholesterol didn't have significant effect on blood pressure reduction. ARB/CCB combination therapy reduced blood pressure more effectively than the maximal doses of ARB or CCB with HCTZ in stage 2 hypertensive patients within this period of study