Development and validation of the first Iranian questionnaire to assess quality of life in patients with heart failure: IHF-QoL

In its Constitution of 1948, WHO defined health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity". In 1994, the Agency for Health Care Policy and Research published clinical practice guidelines recommending providers to routinely evaluate patients' HRQoL [Health Related Quality of Life] and use their assessment to modify and guide patient care. To create a valid, sensitive, disease-specific Persian health status quality of life questionnaire for patients with chronic heart failure in Iran. Considering the existing relevant inventories and scientific literature, the authors designed the first draft of questionnaire which was modified and validated, using expert opinions and finalized in a session of expert panel. The questionnaire was processed among 130 patients with heart failure. Construct validity evaluated by principle component factor analysis, and promax method was used for factor rotation. MacNew quality of life questionnaire was selected to assess convergence validity, and the agreements were measured in 60 patients. Discriminant validity was also assessed. Thirty patients were followed for 3 months and responsiveness of questionnaire was measured. Cronbach's alpha, item analysis, and Intra-class correlation coefficients [ICCs] were used to investigate reliability of questionnaire. SPSS 15 for Windows was applied for statistical analysis. Principle component factor analysis revealed 4 main components. Sub-group analysis suggested that IHF-QoL questionnaire demonstrated an acceptable discriminant validity. High conformity between this inventory and MacNew questionnaire revealed an appropriate convergence validity. Cronbach's alpha [alpha] for the overall questionnaire was equal to 0.922. Intra-class correlation coeffcients [ICCs] for all components were significant [from. 708 to. 883; all P values < 0.001]. Patients fallow-up revealed an acceptable responsiveness of our questionnaire. IHF-QoL questionnaire is a valid and reliable inventory. It can be applied in daily clinical practice and in the clinical research context

Long sheaths for endomyocardial biopsy via femoral approach

Endomyocardial biopsy has long been a useful tool to evaluate myocardial diseases. It is a gold standard in diagnosing cardiac rejection and certain types of myocarditis, but there is always a risk for related complications. We have assessed the safety and feasibility of applying long sheaths in endomyocardial biopsy via the femoral approach. We performed endomyocardial biopsy in 63 patients via the femoral approach and used a long sheath to guide bioptome from the venous access to the interventricular septum and evaluate the procedure success and complications. Success rate [acceptable endomyocardial specimen] was 96%, and there were no complications [death, no death, urgent cardiac surgery, advanced cardiac life support, hemothorax, and pneumothorax]. Using long sheaths for the femoral approach seems to be safe and feasible; it confers an acceptable room to grab the endomyocardial samples while obviating the possibility of complications