Association between the risks of contrast-induced nephropathy after diagnostic or interventional coronary management and the transradial and transfemoral access approaches.

The risk of contrast-induced nephropathy (CIN) as a common and important complication of coronary procedures may be influenced by the vascular access site. We compared the risks of CIN in diagnostic or interventional coronary management between patients treated via the transradial access (TRA) and those treated via the transfemoral access (TFA). Patients undergoing invasive coronary catheterization or percutaneous coronary intervention (PCI) were enrolled.

Mitral annular calcification-related calcified amorphous tumor in a patient with normal renal function: a case report.

A calcified amorphous tumor (CAT) of the heart is a non-neoplastic mass, characterized by nodules of calcium on a background of amorphous fibrinous material. Mitral annular calcification (MAC) is one of the conditions most frequently associated with CAT. Most MAC-related CAT cases are reported in end-stage renal disease (ESRD) patients.

Left ventricular end-diastolic pressure-guided hydration for the prevention of contrast-induced acute kidney injury in patients with stable ischemic heart disease: the LAKESIDE trial.

Objectives: Contrast-induced acute kidney injury (CI-AKI) is a serious complication in patients undergoing diagnostic cardiac angiography or percutaneous coronary intervention. We aimed to evaluate the preventive effects of left ventricular end-diastolic pressure (LVEDP)-guided hydration for the prevention of CI-AKI in patients with chronic kidney disease undergoing cardiac catheterization.

Methods: This prospective randomized single-blind clinical trial enrolled 114 eligible patients with an estimated glomerular filtration rate (eGFR) of 15 < eGFR ≤ 60 mL/min/1.

Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis.

Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes of pregnant women with mitral stenosis who underwent PTMC.

Value of pathologic Q wave in surface electrocardiography in the prediction of myocardial nonviability: A cardiac magnetic resonance imaging-based study.

In surface electrocardiography (ECG), Q wave is often considered as a sign of irreversibly scarred myocardium. Cardiac magnetic resonance (CMR) imaging is an accurate mean for the detection of myocardial viability. Herein, we study the predictive value of Q wave in nonviable (scarred) myocardium by CMR study.

Comparison between rosuvastatin and atorvastatin for the prevention of contrast-induced nephropathy in patients with STEMI undergoing primary percutaneous coronary intervention.

There is some controversy over the efficacy of statins for the prevention of contrastinduced nephropathy (CIN). There have also been reports on varying efficacies of different statins. Hence, in this study the efficacy of atorvastatin and rosuvastatin for the prevention of CIN was assessed.

Effect of flaxseed consumption on flow-mediated dilation and inflammatory biomarkers in patients with coronary artery disease: a randomized controlled trial.

Background/objective: Available data indicate a possible beneficial effect of flaxseed on cardiovascular disease, but limited studies have evaluated the effects of flaxseed on endothelial dysfunction and biomarkers of inflammation in patients with coronary artery disease (CAD). The purpose of the present study was to examine the effect of flaxseed consumption on flow-mediated dilation (FMD) and inflammatory markers in CAD patients.

Subjects/method: In this randomized controlled parallel trial, 50 patients with CAD of both genders were randomly allocated to 12 weeks consumption of flaxseed (30 g/day) or usual care control.

Intracoronary versus Intravenous eptifibatide during percutaneous coronary intervention for acute ST-segment elevation myocardial infarction; a randomized controlled trial.

Although aspirin and clopidogrel seem to be quite enough during low risk percutaneous coronary intervention (PCI), the combination may need some reinforcement in complex situations such as primary PCI. By modifying the route and also the duration of administration, glycoprotein IIb/IIIa inhibitors might be a viable option. The aim of this study is to compare the benefits and disadvantages of three different methods of administration of eptifibatide in primary PCI population.

Self-Expandable Stent for Repairing Coarctation of the Left-Circumferential Aortic Arch with Right-sided Descending Aorta and Aberrant Right Subclavian Artery with Kommerell's Aneurysm.

Endovascular treatment offers a great advantage in the management of main arteries stenoses. However, simultaneous presence of a group of anomalies may complicate the situation. Here we present a case of 21-year-old man with aortic coarctation.

Acute Myocardial Infarction Following Blunt Chest Trauma and Coronary Artery Dissection.

Blunt chest traumatic coronary artery dissection is an uncommon cause of atherosclerotic and non-atherosclerotic Acute Myocardial Infarction (AMI). Injuries of the coronary artery after blunt chest trauma are caused by different mechanisms such as vascular spasm, dissection and intimal tear or rupture of an existing thrombus formation. Chest pain might be masked by other injuries in patients with multiple traumas in car accident.

In-hospital and six-month outcomes of elderly patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction.

Background: Elderly patients constitute a rapidly growing proportion of the population, and hence the increasing rises in the number of patients with ST-segment-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI), which is now established as the preferred reperfusion strategy in STEMI patients, has been inadequately investigated in this high-risk group. The aim of the present study was to investigate the in-hospital and 6-month outcomes of primary PCI in elderly patients (≥ 75 years) with STEMI.

Effect of garlic powder tablet on carotid intima-media thickness in patients with coronary artery disease: a preliminary randomized controlled trial.

Background/objectives: This study was designed to investigate whether garlic powder tablets in adjunct to conventional medical treatment could have an effect on carotid intima-media thickness (CIMT) and plasma lipoproteins and lipids in patients with coronary artery disease (CAD).

Subjects/methods: A randomized, placebo-controlled, clinical trial was conducted on 56 patients with CAD between the ages of 25 and 75 years. The patients were randomly divided into two groups: garlic group (n = 27), receiving garlic powder tablet (1200 µg allicin/tab) twice daily and the placebo group (n = 29), receiving placebo for 3 months.

Intravenous magnesium sulfate: new method in prevention of contrast-induced nephropathy in primary percutaneous coronary intervention.

Background: Contrast-induced acute kidney injury (CI-AKI) is an adverse consequence of percutaneous coronary interventions which results in significant morbidity and mortality and adds to the costs of diagnostic and interventional cardiology procedures. Various pathophysiological mechanisms have been proposed for CI-AKI and various agents tested for its prevention. There is currently a general agreement that adequate pre-procedural hydration constitutes the cornerstone of prevention, yet there are reports of the use of some other agents with various efficacies.

Difficult management of coronary artery disease in a patient with thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura (TTP) is a rare syndrome affecting multiple organs. There is no sufficient evidence regarding the clinical cardiac manifestations of TTP. Nonetheless, pathologic cardiac involvement is quite frequent in acute TTP, which is predominantly manifested as myocardial necrosis due to coronary arteriolar microthrombosis.

Intracoronary adenosine to prevent myonecrosis in patients with stable angina undergoing percutaneous interventions: a double-blinded randomized controlled trial.

Background: Significant elevation of cardiac biomarkers after percutaneous coronary intervention (PCI) is associated with increased mortality. However, clinical importance of lesser degrees of cardiac enzyme elevation has not been well understood. Multiple factors might have an etiologic role, and the incidence of myonecrosis has not changed dramatically despite pharmacological and technological advances in PCI.

Impella 2.5 in a patient with left main coronary artery occlusion.

Short-term assist devices have been indicated in many clinical settings mostly as a bridge to the next step. In this article, we report a case of cardiogenic shock due to acute occlusion of left main coronary artery who was scheduled to be transferred from Iran to Germany for the next treatment (permanent assist device implantation). Impella 2.

Application of the health belief model in promotion of self-care in heart failure patients.

Heart failure (HF) is a condition due to a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs. In developing countries, around 2% of adults suffer from heart failure, but in people over the age of 65, this rate increases to 6-10%. In Iran, around 3.

Percutaneous device closure for secundum-type atrial septal defect: short and intermediate-term results.

Background: Device closure of an isolated secundum type atrial septal defect (ASD) has been used as an alternative method for open surgical closure with comparable success and lower morbidity. In this study we evaluated the procedural success and mid-term follow-up results of percutaneous closure of secundum ASD with an Amplatzer™Septal Occluder(ASO) device or a Figula ASD occluder device.

Methods: From June 2001 to January 2009, 74 consecutive patients were scheduled for percutaneous device closure in two centers in Tehran, Iran.

Percutaneous mitral valvuloplasty using echocardiographic intercommissural diameter as reference for balloon sizing: a randomized controlled trial.

Background: Percutaneous balloon mitral valvuloplasty is the preferred therapeutic strategy in patients with mitral stenosis, but it has shortcomings in a subset of patients.

Hypothesis: A new method of balloon sizing through echocardiographic measurement of the intercommissural diameter would be safe and effective and lead to better outcomes.

Methods: Eighty-six mitral-stenosis patients were randomly assigned to undergo balloon mitral valvuloplasty either with height-based balloon reference sizing (HBRS group, n = 43) or with balloons sized by the echocardiographic measurement of intercommissural diameter (EBRS group, n = 43).

Immediate results of percutaneous trans-luminal mitral commissurotomy in pregnant women with severe mitral stenosis.

Background: Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms.

Comparison of the clinical and morphologic characteristics of culprit lesions in unstable angina and non-ST-elevation myocardial infarction.

Objective: The aim of the study was to assess the differences in clinical and morphologic characteristics of culprit lesions among patients with unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI).

Methods: The authors included 174 consecutive patients who have been admitted due to UA or NSTEMI. All patients underwent coronary angiography during hospitalisation and angiographic characteristics were determined.

Efficacy of pentoxifylline in prevention of contrast-induced nephropathy in angioplasty patients.

Background: Contrast-induced nephropathy (CIN) is an adverse consequence of contrast media use that results in significant morbidity and mortality and adds significant costs to diagnostic and interventional cardiology procedures. Various pathophysiological mechanisms have been proposed for CIN and various agents have been tested for its prevention. There is currently a general agreement that adequate pre-procedure hydration constitutes the cornerstone of prevention, yet there are reports of the use of some other agents with various efficacies.

Induction and aggravation of atrioventricular valve regurgitation in the course of chronic right ventricular apical pacing.

Aims: Valvular regurgitation, especially on the right side of the heart, is a common finding even in patients without endocardial pacing leads. The severity of valvular regurgitation can change after permanent pacemaker (PPM) implantation. Ventricular pacing has been shown to cause ventricular dysfunction.