International Journal of Cardiovascular Practice

Original Articles

Prevalence of Non-Thromboembolic Incidental Findings on Computed Tomography-Pulmonary Angiography for Pulmonary

Rama Bozorgmehr, Mehdi Pishgahi, Pegah Mohaghegh, Marziye Bayat, Parastou Khodadadi, Ahmadreza Ghafori

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 100-104

Introduction: Computed Tomography-Pulmonary Angiography (CTPA) is a noninvasive imaging modality for direct diagnosis of pulmonary thromboembolism. The potential advantage of CTPA is possible alternative and incidental findings in cases that PTE is ruled out. This study was performed to determine the prevalence of incidental findings in CTPA in patients suspected to have PTE.

Methods: This cross-sectional retrospective study was performed in patients with suspected PTE admitted to Shohada-e-Tajrish Hospital in 2014 and 2015 and underwent CTPA for final diagnosis. Incidental findings in CTPA and associated clinical symptoms were assessed.

Results: According to CTPA performed in 188 patients, PTE was diagnosed in 61 cases (32.4%). Prevalence of incidental abnormal findings in the two groups with and without PTE were 93.7% and 90.9%, respectively. The most common incidental finding was pleural effusion (42%). There was no significant association between clinical symptoms and incidental findings in CTPA in patients with suspected pulmonary embolism (P > 0.05). The only significant finding was association between lung mass and tachypnea (P=0.007).

Conclusion: In patients with primary clinical symptoms of suspected pulmonary embolism, in most cases there was a wide range of incidental findings and simultaneous pathologies in CTPA mimicking the primary symptoms of pulmonary embolism. However, in this study there was no significant association between clinical symptoms and incidental findings. Determination of definite indications of CTPA in patients with suspected pulmonary embolism is necessary.

Cardiogenic Shock Following Acute Myocardial Infarction: A Retrospective Observational Study

Roxana Sadeghi, Naser Kachoueian, Zohreh Maghsoomi, Mohammad Sistanizad, Zahra Soroureddin, Mohammad Ali Akbarzadeh

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 105-110

Introduction: Cardiogenic shock is a sudden complication that occurs in 5 to 10% of patients with acute myocardial infarction. According to statistics, mortality and morbidity from this event, despite all hospital care, are approximately 70-80%.

Methods: This study was conducted over three years (2012 to 2014) in 28 cases of acute myocardial infarction, which was complicated by cardiovascular shock, before or after admission. We compared the outcomes of patients according to the treatment strategy, thrombolytic therapy, primary percutaneous coronary intervention (PCI), or other medical stabilization. The 30-day follow-up was the first endpoint, and the 3- month follow up was the second endpoint of the study.

Results: 28 patients with cardiogenic shock included in this study. The mean (± SD) age of the patients was 62.99 ± 13.99 years. The median time to the onset of shock was 648.75 ± 1393.58 minutes after infarction. Most of the patients who underwent coronary angiography had 3-vessel or left main involvement. Two patients missed in follow up and five (80%) patients who received thrombolytic therapy passed away. Nine (100%) patients in the medical stabilization group and six patients (50%) underwent primary PCI group passed away too. The mortality in the primary PCI group was significantly lower than the other groups (P = 0.04).

Conclusion: Although cardiogenic shock is a potential risk of early death, it is important that the thrombolytic in these patients doesn't increase survival and the primary PCI is more effective than thrombolytic agents.

Different Polymorphisms of Placental Growth Factor (PLGF) Gene in Iranian Women's Population with Pre-eclampsia

Parisa Pourroostaei Ardakani, Arezoo Ramezani, Zeinab Piravar, Nastaran Asgharimoghadam, Roudabeh Behzadi, Mehrdad Jafari Fesharaki

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 111-116

Introduction: Preeclampsia is a complication affecting pregnant women worldwide, which leads to maternal and fetal morbidity and mortality. Due to the importance of mutations in the PLGF (Placental Growth Factor) gene and the association with the incidence of preeclampsia, this study aimed to evaluate the association of polymorphisms of the PLGF gene with the prevalence of preeclampsia in Iranian women.

Methods: Fifty pregnant women with pre-eclampsia diagnosis and 50 healthy pregnant women for determination of genotypes rs1464547123, rs12411, rs1399853427, and rs1312670436 were evaluated using the Sanger sequencing method.

Results: There was no significant difference in the frequency of alleles of
rs1464547123, rs1399853427 and rs1312670436 polymorphisms between case and control groups (P > 0.05), but the rate of recessive allele A in rs12411 polymorphism was significantly higher in the case group than in the control group (case = 24%, control = 8%, P-Value = 0.04), while the frequency of the allele T in the control group was higher than that of the patient group (case = 76%, control = 92%, P-Value = 0.04) The frequency of AT genotype in the patient group was a none significantly higher than the control group (case = 8%, control = 4%, P-Value = 0.1) and the frequency of AA genotypes in the case group was none significantly higher than that of the control group (case = 16%, control = 4%, P-Value = 0.1).

Conclusions: The results revealed that polymorphism rs12411 of the gene encoding PLGF has a significant difference among individuals with and without pre-eclampsia and can affect the incidence of pre-eclampsia among Iranian women.

Effect of Retrograde Autologous Priming on Clinical Outcome of Cardiopulmonary Bypassing on Patients Undergoing Coronary Artery bypass Grafting

Musa Rafiee, Mohammad Zia Toutounchi, Rezvan Yazdani, Nooredin Mohammadi

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 117-122

Introduction: Cardiopulmonary bypass is a standard and low mortality-associated method used across the world. This method allows cardiac surgery to be performed in a bloodless environment. The study aimed to compare Conventional priming and Retrograde autologous prime (RAP) on patients undergoing coronary artery bypass grafting (CABG).

Methods: The study population was patients undergoing CABG using cardiopulmonary bypass in Rajaei Hospital, of whom 80 patients were selected by simple random sampling convenience sampling and then were randomly assigned to two groups: Conventional priming and RAP. Demographic information, blood components transfused in the operating room and the intensive care unit, ejection fraction (EF) of left ventricle and changes in blood gases were collect.

Results: The mean requirement for red blood cell transfusion bags to the patient during surgery was lower in the RAP group than the conventional priming group (P = 0.002). But the difference after surgery in both groups was not significant statistically (P = 0.2). The difference amount of platelet transfusion during operation the difference was not statistically significant (P = 0.4). The difference postoperative platelet transfusion was not statistically significant (P = 0.7). The fresh frozen plasma transfusion during surgery in the RAP group lower than the usual prime group, but the difference was not statistically significant (P = 0.406). The Fresh frozen plasma (FFP) transfusion after surgery in the two groups was not statistically significant (P = 0.217).

Conclusion: RAP is compared with conventional priming a safe and low-cost technique in reducing the priming volume of the CPB system, causes less hemodilution, and reduces the need for intra- and postoperative blood transfusion. Therefore, it is recommended to consider RAP as an effective and low-cost technique of priming Cardiopulmonary bypass circuits.

The Relationship between Sleep Quality and Happiness in Men with Coronary Artery Disease

Davoud Ezzati, Naimeh Mashinchi Abbasi, Hossein Namdar, Naser Khezerlou Aghdam, Touraj Hashemi Nosrat-abad, Ali Shiri, Babak Sadeghi, Marzie Salehi

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 123-127

Background and Aim: Good sleep quality has beneficial effects on happiness and being unhappy is significantly associated with negative cardiac outcomes. The present research aimed at studying the relationships between sleep quality and happiness in male coronary patients.

Methods: One hundred male coronary patients that having been referred to Madani Heart Hospital, Tabriz, Iran, completed the Pittsburgh Sleep Quality Index (PSQI) and Oxford Happiness Questionnaire (OHQ). All participants were selected by purposive sampling (aged 37 to 67 years). Data were analyzed by multiple regression (simultaneous method) through the SPSS 18 software.

Results: There was a significant negative difference between happiness with sleep disturbances and use of sleeping medication in coronary patients.

Conclusion: This study showed that poor sleep quality in coronary patients has negative effects on their happiness. Therefore, the quality of sleep in these patients should be given more consideration by community health care providers.

Keywords: Sleep Quality, Happiness, Coronary Artery Disease.

Case report

Endovascular Repair of an Isolated Iliac Artery Aneurysm in a Patient with Liver Cirrhosis

Azadeh Tahooni, Milad Vahedinezhad

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 128-130

Endovascular repair is increasingly becoming the main strategy for management of aortic and peripheral aneurysms. Several methods have been introduced to treat aneurysms based on anatomy, coexisting nearby aneurysms and available tools. We presented a 60-year-old man with an isolated large iliac artery aneurysm found incidentally treated using an endovascular approach and obliterating internal iliac artery without early and late complications at 3-year follow-up.

Acute Myocarditis Mimicking an Acute Coronary Syndrome: Case Report and Mini-Review of the Literature

Fatima Ezzahraa Talhi, Monia Elmourid, Anass Maaroufi, Zakaria Qechchar, Salim Arous, El Ghali Bennouna, Leila Azzouzi, Rachida Habbal

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 131-133

Acute myocarditis is often a challenging diagnosis due to a lack of specific clinical or paraclinical signs. It can be presented by a severe chest pain and localized ST elevation on Electrocardiogram, in rare cases, misleading the diagnosis towards acute coronary syndrome. After routine coronary angiography, a cardiac magnetic resonance imaging is imposed to correct the diagnosis towards acute myocarditis. We report the observation of a 19 year-old Moroccan male admitted to the cardiology department of IBN ROCHD University hospital of Casablanca, for acute myocarditis misdiagnosed initially as an acute myocardial infarction ST elevation and confirmed by cardiac magnetic resonance imaging.

Pulmonary Capillary Hemangiomatosis: A Rare Cause of Pulmonary Arterial Hypertension, Presenting as Supraventricular Tachycardia

Ganganpalli Dattaprasad, Umesh Kumar Chandra, Sumit Kumar Vishwakarma, V.P. Pandey, Sanjay Dubey

International Journal of Cardiovascular Practice, Vol. 4 No. 4 (2019), 31 December 2019, Page 134-135

With a prevalence of less than 1/million, Pulmonary Capillary Hemangiomatosis is a rare disorder of capillary proliferation in the alveolar septae leading to pulmonary arterial hypertension and mimics pulmonary veno-occlusive disease.