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ABSTRACT Background Right ventricular systolic dysfunction is associated with poor prognosis and increased mortality rates. Our objective was to investigate ECG changes in patients with this condition, focusing on the right‐sided precordial leads. Methods In this cross‐sectional study, 60 patients with right ventricular dysfunction were included from April 2020 to April 2021. Cardiac structure and function were assessed using 2D transthoracic echocardiography. Standard 12‐lead electrocardiograms and right‐sided precordial ECGs (V3R‐V4R) were obtained and analyzed for QRS complex configuration, ST‐segment elevation, and T‐wave morphology. Results In our study, the majority were male (70.0%) with a mean age of 58.76 years. The most common initial diagnoses were pulmonary thromboembolism (43.3%), chronic obstructive pulmonary disease (26.7%), and pulmonary hypertension (25.0%). The predominant ECG finding in the right‐sided precordial leads (V3R, V4R) was a deep negative T wave (90.0%). Patients with severe right ventricular systolic dysfunction often exhibited a qR pattern (41.2%), whereas those with nonsevere dysfunction showed rS and QS patterns (55.8%). Approximately 41.0% of severe RV dysfunction cases had ST segment depression in the right‐sided precordial leads, and 28.0% of patients displayed signs of right atrial abnormality. Conclusion The study found that qR, rS, and QS patterns were more prevalent in V3R and V4R leads among patients with severe and nonsevere right ventricular systolic dysfunction. The most common ECG feature observed was deep T‐wave inversion in these leads. The study recommends using right‐sided precordial leads in all patients with RV systolic dysfunction for early detection and risk stratification.

Background: Contrast-induced nephropathy (CIN) is associated with increased mortality and morbidity in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention. This study aimed to compare the incidence of CIN in two groups of patients with and without metabolic syndrome (Mets) with baseline normal renal function. Materials and Methods: In this case − control study, 260 patient candidates for CAG, 130 patients with Mets and 130 patients without Mets participated, and their serum creatinine (Cr) level before and the 48 and 72 h after the angiography was measured. The incidence of CIN was compared in two groups. Two-way analysis of variance with repeated measures and univariate and multivariate logistic regression models. Results: The results showed a higher chance of being Mets with raising in triglyceride (adjusted odds ratio = 1.05, 95% confidence interval = (1.03–1.06), P < 0.001), Fasting blood glucose (1.010 [1.001–1.019], P = 0.025), and diastolic blood pressure (1.07 [1.07–1.20], P < 0.001), but declining in high-density lipoprotein-cholesterol (HDL-C) (0.91 [0.85–0.98], P = 0.008). Furthermore, blood urea nitrogen (BUN) and Cr level was raised in 48 and 72 h after contrast injection in both groups (All P < 0.001). Furthermore, in 48 h (3.11 [1.12–9.93], P = 0.016) and 72 h (2.82 [1.07–8.28], P = 0.021) after injection, a total of 25 patients had an increased Cr level and a significant difference between Mets and without Mets groups. The developing Mets had a significant association with the increased risk of AKI, which increased the chance of developing nephropathy (7.14 [2.27–22.5], P = 0.001). Conclusion: Mets, together with other risk factors, increased the overall risk of CIN development. Therefore, the incidence of CIN in patients Mets is significantly higher than that of patients without Mets, indicating a more important CIN risk factor.

Abstract Background Methadone is a synthetic opioid mostly used for detoxification therapy, as its use increases; the possibility for methadone-induced cardiotoxicity may rise. The aim of this study was to determine the association of high-sensitivity troponin I levels as a predictor of cardiac injury in methadone toxicity. Methods Sixty methadone toxicity patients included in this prospective cross-sectional study from October 2018–November 2020. High-sensitivity troponin I level and electrocardiogram were assessed in patients at admission. All patients underwent echocardiography at admission and 30 days later and compared this finding between two groups based on high-sensitivity troponin I results. Results Mean age of the patients was 34.5 ± 11.1 years (males: 67%). Twenty (20%) patients had positive high sensitive-troponin results. Long QT interval and inverted T in precordial leads were mostly observed in individuals with positive high-sensitivity troponin I (75% vs. 35%, P = 0.013 and 83% vs. 16%, P

BACKGROUND: It has been proposed that left ventricular diastolic dysfunction (LVDD) is a possible physiological link between high body mass index (BMI) and future occurrence of heart failure (HF). The present cross-sectional study was aimed to analyze the association between BMI and LVDD by transthoracic echocardiography (TTE).METHODS: This study was conducted from May 2017 to September 2019 in Khorshid Hospital of Isfahan University of Medical Sciences, Isfahan, Iran. Based on the calculated BMI (kg/m²), patients were divided into three groups: group 1: subjects with BMI < 25, as a normal group (n = 75), group 2: volunteer cases with 40 > BMI ≥ 30, as an obese group (n = 98), and group 3: patients with BMI ≥ 40, as a morbidly obese group (n = 100). TTE was performed by a trained cardiologist and associated variables including left atrium (LA) volume, E, septal e’, lateral e’,andE/e’ were assessed and also subjects were characterized as normal diastolic function, abnormal diastolic function, and inconclusive diagnosis of diastolic dysfunction (DD).RESULTS: Apart from the ejection fraction (EF) and the tricuspid regurgitation velocity (TRV), there was a significant difference between the other echocardiographic variables including LA volume, E, septal e’, lateral e’, and E/e’ (P < 0.05). One patient with morbid obesity in our study revealed LVDD. There was no significant difference between three groups (P = 0.42).CONCLUSION: There is no considerable relationship between obesity and LVDD. It seems that the absence of associated comorbidities such as diabetes, coronary disorders, etc. plays a crucial role in preventing LVDD, but for realistic and definitive decision, more cellular and molecular investigations and studies with larger sample size are necessary.

BACKGROUND: Atrial fibrillation (AF) is the most common tachyarrhythmia and an important risk factor for thromboembolic stroke. CHA2DS2-VASc score was introduced for assessment of embolic events and as criteria for starting anticoagulants. This study was performed to evaluate the left ventricular diastolic dysfunction (LVDD) in patients with non-hemorrhagic stroke and AF. METHODS: This cross-sectional study consisted of 76 consecutive patients with suspected non-hemorrhagic stroke referred to the Cardiology Department of Alzahra and Ayatollah Kashani hospitals in Isfahan, Iran, during 2015-2016. Demographic, anthropometric and clinical characteristics were evaluated for all patients at baseline. CHA2DS2-VASc score was calculated for all. All eligible patients underwent transthoracic echocardiogram (TTE) and LVDD was measured in the patients. RESULTS: The mean age of the patients was 64.64 ± 5.95 years and 28 subjects (36.8%) were women. The most common underlying disease in the patients was hypertension (HTN) (65.8%). Median (range) CHA2DS2-VASc score was 4 (1-7). Four patients (5.3%) had paroxysmal AF and 16 cases (21.1%) had LVDD. Analysis showed that LVDD in patients with non-hemorrhagic stroke and coexisting AF was not associated with CHA2DS2-VASc score (r = 0.151, P = 0.192). CONCLUSION: LVDD is not associated with CHA2DS2-VASc score in patients with non-hemorrhagic stroke and coexisting AF.

BACKGROUND: With the onset of the coronavirus disease-2019 (COVID-19) pandemic, hospitalization and treatment of non-covid patients decreased worldwide. The aim of this study is to evaluate the admission and treatment of patients with coronary artery diseases (CADs) by examining coronary Cath labs activities in some centers of Iran during the COVID-19 period.METHODS: A retrospective, multi-center survey was conducted in four cites in Iran which participated in National Persian Registry Of CardioVascular diseasE (N-PROVE). Two periods of COVID-19 occurrence peak in Iran were compared with the same date in 2019. Information was collected on the number of diagnostic and therapeutic coronary catheterizations in both stable ischemic heart diseases (SIHDs) and acute coronary syndrome (ACS) settings.RESULTS: In the first peak of COVID-19 pandemic, coronary angiographies and angioplasties decreased by 37 and 38% compared to the same period in 2019, respectively. The most common indication for coronary angiography during this period was ACS [especially ST-Segment Elevation Myocardial Infarction (STEMI)]; however, at the time of peak decrease, the SIHDs were the most. In the second peak of COVID-19 pandemic in Iran, 34% and 27% decrease in diagnostic and therapeutic coronary procedures were seen, respectively. During this period, the number of elective admissions increased, although it was still lower than that in 2019. The tendency to rescue percutaneous coronary intervention increased in most centers during the COVID-19 era, especially in the second peak.CONCLUSION: A significant reduction in the coronary Cath lab activity has been observed during the COVID-19 pandemic that can indicate an increased risk of cardiovascular mortality and morbidity.

BACKGROUND: The aim of this study was to predict significant coronary artery disease (CAD) in patients undergoing coronary angiography.METHODS: In this cross-sectional study, data of 384 patients who underwent angiography during 2015-2017 were reviewed. Electrocardiograms (ECGs) were evaluated in terms of having positive T wave in lead V1 (TV1) described as T wave with amplitude of more than 0.15 mV and angiography records were assessed for presence of significant CAD defined as presence of ≥ 70% internal diameter stenosis in at least one major epicardial coronary artery or more than 50% stenosis in left main artery (LMA).RESULTS: Out of 384 patients who participated in this study with mean age of 63.6 ± 10.2 years (40-89 years), 71.6% showed positive TV1 and significant CAD simultaneously and left anterior descending artery (LAD) and left circumflex artery (LCX) lesions were more frequently reported in coronary angiography. Based on chi-square test, the prevalence of significant CAD was obviously more in those with positive TV1 as compared to those without this finding [odds ratio (OR) = 2.74, 95% confidence interval (CI): 1.80-4.19, P < 0.001]. Mann-Whitney test showed significant difference in number of coronary arteries involved in CAD between presence of positive and negative T wave in lead V1 (P < 0.001). Great number of patients with significant CAD had remarkably higher T wave amplitude in lead V1 in comparison to lead V6 (OR = 6.22, 95% CI: 3.14-12.30, P < 0.001).CONCLUSION: Positive TV1 and TV1 > TV6 pattern can be considered as a predictor forsignificant CAD in patients with otherwise normal ECG.

BACKGROUND: Myocardial infarction (MI) is a cardiac cell death following the imbalance of supply and demand. Electrocardiography (ECG) is a diagnostic test for MI and can help the clinicians to estimate the severity and size of infarction, to suggest the artery related to the infarct and localize the pathology. The aim of this study is to evaluate the diagnostic value of ECG in posterior MI (PMI) compared with angiographic findings. METHODS: In a prospective observational study, using simple sampling patients with diagnosis of PMI (ST elevation in at least two consecutive leads V7, V8, and V9) were enrolled and all standard 12 leads and also V7, V8, V9 and right leads, including V3R and V4R were recorded and angiography was performed. ECG changes were recorded and compared with angiography findings. RESULTS: In this study, totally 138 patients were enrolled (mean ± standard deviation age of 65.00 ± 12.97 and 76.8% male). Left circumflex artery (LCX), right coronary artery (RCA) and left anterior descending artery (LAD) occlusions occurred in 65.9, 50.7, and 29 percent respectively. Patients with LCX occlusion had a significantly higher frequency of ST elevation in V5, V6, I and AVL (P ≤ 0.001). Patients with RCA occlusion had a significantly higher frequency of ST elevation in V1, V3R, and V4R and also ST depression in V5 and V6 (P ≤ 0.001). CONCLUSION: In PMI, there is a relationship between ECG findings and different coronary artery occlusions. Hence that ECG is a useful tool to predict the LCX or RCA occlusion in PMI.

Background: Numerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained — ′Which is more important for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients?′ Methods: The current study was a cross-section study conducted on a total of 126 non-diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio (UACR) was determined as an indicator of microalbuminuria. Complete two-dimensional, doppler, and tissue-doppler echocardiography was performed and the recording of the diastolic function parameters was carried out. Results: High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter. Conclusion: According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients.

Background: early diagnosis of left ventricular mass (LVM) inappropriateness and left ventricular hypertrophy (LVH) can result in preventing diastolic left ventricular dysfunction and its related morbidity and mortality. This study was performed to determine if diastolic dysfunction is associated with LVH and inappropriate LVM. Materials and Methods: one hundred and twenty five uncomplicated hypertension from Isfahan Healthy Heart Program underwent two-dimensional echocardiography. Inappropriate LVM was defined as an LVM index greater than 88 g/m2 of body-surface area in women and greater than 102 g/m2 in men. LVH-defined septal and posterior wall thickness greater than 0/9 cm in women and greater than 1 cm in men, respectively. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), and E/early mitral annulus velocity (E′) were measured. Results: the mean systolic and diastolic blood pressure at the patients′ admission day were 142.87 ± 18.12 and 88.45 ± 9.18 mmHg, respectively. Totally, 21.7% of subjects had inappropriate LV mass that moderate and severe abnormal LV mass was revealed in 5.6% and 5.6%, respectively. The mean of age and BMI was significantly higher in patients with moderate left ventricular hypertrophy (P < 0.05). Adjusted by age, gender, BMI, and systolic and diastolic blood pressures, both E/A ratio and deceleration time were higher in those with the severer ventricular hypertrophy. Subjects with severe showed significantly higher BMI 33. 7 ± 3.7 (P < 0.001). There was a slight difference between the grade of diastolic dysfunction and the severity of inappropriate LV mass (P = 0.065). But no significant difference was found between E/A, E/E′, and deceleration time and the level of inappropriate LV mass (P > 0.05). Spearman′s Rank test was used to test the correlation between diastolic dysfunction and LV mass (P = 0.025). Conclusion: LVH is correlated with the severity of diastolic dysfunction manifested by the E/A value and deceleration time, but inappropriate LVM can slightly predict diastolic dysfunction severity in uncomplicated hypertension.

Background: In stent restenosis (ISR) following endovascular interventions is the main limitation of their long-term success. Despite advances have been made during recent years to decrease restenosis, it remains a challenging clinical problem.The aim of this study was to evaluate the relationship between angiographic coronary in stent restenosis, inflammation after successful stent implantation. Methods: This study included 78 patients, 35year old and higher who underwent coronary angiography more than 1 year after drug-eluting stent (DES) implantation because of symptoms suggestive ischemia. Patients were divided into ISR group (case) and patent stent group (control) according to angiography results. For all patients blood lipids and high sensitivity C-Reactive Protein (hsCRP) were measured simultaneously. Results: Age, sex, hypertension, current smoking, and lipid profile other than High Density Lipoprotein (HDL-C) of patients in the case and control groups were similar .However, HDL-C < 40mg/L was more prevalent with ISR (66.7% vs. 30.8%, p=0.002). The hsCRP level was 2.98±2.06 mg/L in the case group and 2.50±1.80 mg/L in the control group. There were no significant differences in mean hsCRP concentration between the two groups (p=0.14), however mean hsCRP level was significantly higher in men of case group than control group (3.35mg/L vs. 2.21mg/L, p

BACKGROUND: The association between epicardial fat and coronary in-stent restenosis hasnot been evaluated. The objective of the present study was to evaluate the relationship ofechocardiographic epicardial fat thickness (EFT) with restenosis in drug eluting stents (DES).METHODS: In this study, 117 patients who underwent coronary angiography due to recurrentclinical symptoms or findings of non-invasive cardiac tests one year after stent implantationwere selected. According to angiographic results, they were divided into two groups, 65 patientswith in-stent restenosis (case group) and 52 patients without such finding (control group). EFTwas measured perpendicularly on the free wall of the right ventricle at the end of systole in twoechocardiographic views (parasternal short and long axis) at least in three cardiac cycles. Theaverage of obtained values was determined and recorded as EFT. Furthermore, the history ofhypertension, smoking and diabetes, age and sex were investigated and body mass index (BMI)of each patient was also calculated.RESULTS: There were no significant differences in the baseline characteristics (P = 0.812).Patients with in-stent restenosis did not have statistically significant difference (4.6 ± 1.8 mm)in EFT compared to subjects with patent stents (4.5 ± 1.8 mm; P = 0.88). The above results werealso confirmed using multiple linear regressions. No significant correlation was found betweenEFT and other clinical variables (P > 0.05).CONCLUSION: In this selected population, the risk of restenosis was not correlated withepicardial fat thickness. Future studies for determining the role of epicardial fat in developmentof in-stent restenosis are warranted.Keywords: Epicardial Fat Thickness, Echocardiography, In-stent Restenosis (ISR).

OBJECTIVE: To investigate the relation between major depressive disorder and metabolic risk factors of coronary heart disease. INTRODUCTION: Little evidence is available indicating a relationship between major depressive disorder and metabolic risk factors of coronary heart disease such as lipoprotein and apolipoprotein. METHODS: This case-control study included 153 patients with major depressive disorder who fulfilled the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), and 147 healthy individuals. All participants completed a demographic questionnaire and Hamilton rating scale for depression. Anthropometric characteristics were recorded. Blood samples were taken and total cholesterol, high-and low-density lipoproteins and apolipoproteins A and B were measured. To analyze the data, t-test, χ2 test, Pearson correlation test and linear regression were applied. RESULTS: Depression was a negative predictor of apolipoprotein A (β = -0.328, p

Background: We aimed to evaluate subepicardial and subendocardial left ventricular (LV) functions in patients with single coronary artery lesion at early stage after percutaneous coronary intervention (PCI). Methods: Patients with left anterior descending (LAD) lesion (n = 40) were evaluated. Patients un-derwent PCI and at least one coronary stent was placed. After PCI, the pulsed-wave tissue doppler im-aging (pw-TDI) parameters taken from subepicardial and subepicardial layers were compared among the them. Finding: The systolic and diastolic pw-TDI parameters were apparently different between the patient after PCI, while the systolic pw-TDI parameters did not change. The diastolic pw-TDI parameters taken from both subepicardial (circumferential contraction) and subendocardial layers (longitudinal contraction) improved after PCI. After PCI, it was shown that while Ea velocity (P = 0.012) taken from the subendocardial layer increased, IVRa velocity (P < 0.001) taken from the subepicardial layer decreased. Conclusion: In our study, left ventricular, left atrium, and aortic valve diameter increase in patients with coronary artery disease. The systolic and diastolic functions were impaired at subendocardial and subepicardial layers. These dysfunctions can be easily presented with pw-TDI. Although systolic dys-function persists, diastolic dysfunction improves at early stage after PCI. Key words: Angioplasty, Percutaneous Coronary, Echocardiography, Doppler, Tissue doppler imag-ing.

BACKGROUND: One of the causes of mortality in acute myocardial infarction (AMI) is ventricular tachycardia. Abnormal serum Potassium (K) level is one of the probable causes of ventricular tachycardia in patients with AMI. This study carried out to determine the relationship between serum potassium level and frequency of ventricular tachycardia in early stages of AMI. METHODS: Ina cross-sectional study on 162 patients with AMI in the coronary care unit (CCU) of Nour Hospital (Isfahan, Iran), the patients' serum potassium level was classified into three groups: 1) K RESULTS: The frequency of ventricular tachycardia in the first 24 hours after AMI in K< 3.8 mEq/l, 3.8≤K CONCLUSION: Hypokalemia increased the probability of ventricular tachycardia in patients with AMI. Thus, the follow up and treatment of hypokalemia in these patients is of special importance. Keywords: Acute Myocardial Infarction, Ventricular Tachycardia, Hypokalemia, SerumPotassium Level.

Objectives: Left ventricular (LV) dysfunction heart failure is one of the causes of morbidity and mortality following ST elevation myocardial infarction (STEMI). This study was done to determine the clopidogrel effect in preventing reduced LV function in pa-tients with STEMI. Methods: In this study, 144 patients with STEMI admitted to the Isfahan University of Medical Sciences hospitals were followed in two groups for one month. The case group received Clopidogrel, 300 mg, on admission and then, 75 mg daily, while the control group received routine therapy for STEMI without Clopidogrel. Left ventricular ejection fraction (LVEF) on the 4 th day and one month after STEMI was measured by echocardiography. The re-sults of LVEF were compared within and between groups. Results: The mean LVEF in the case group on the 4 th day and one month after STEMI were 45.92 and 52.15%, respectively (P

Background: Although aortic dissection is a rare disease, it causes high level of mortality. If ascending aorta gets involved in this disease, it is known as type A. According to small number of studies about this disease in Iran, this study conducted to detect the factors related to acute aortic dissection type A, its surgery consequences and the factors affecting them. Materials and Methods: In this historical cohort study, all patients having acute aortic dissection type A referring to Chamran Hospital from 2006 to 2012 were studied. The impact of two surgical methods including antegrade cerebral perfusion (ACP) and retrograde cerebral one (RCP) on surgical and long-term mortality and recurrence of dissection was determined. The relation of mortality rate and hemodynamic instability before surgery, age more than 70 years old, ejection fraction lower than 50%, prolonged cardiopulmonary bypass pump (CPBP) time and excessive blood transfusion, was assessed. Results: Surgery and long-term mortality and recurrence of dissection were 35.3%, 30.8% and 30.4%. Surgical and long-term death in the patients being operated by ACP method was lower than those one being operated by RCP (P < 0.001). Excessive blood transfusion and unstable hemodynamic condition had significant effect on surgical mortality (P = 0.014, 0.030, respectively). CPBP time and unstable hemodynamic condition affected long-term mortality significantly (P = 0.002). Conclusion: The result found that ACP is the preferable kind of surgery in comparison with RCP according to the surgical and long-term mortality.

BACKGROUND: Despite conventional treatment methods of acute myocardial infarction, its complications and mortality rates are still very high. Finding new cost-effective treatments like regulation of ischemic muscle metabolism at the time of thrombolytic therapy can meet this requirement to some extent. This study investigated the efficacy of the pharmaceutical combination of glucose, insulin, potassium (GIK) and magnesium along with thrombolytic therapy.METHODS: In a double-blind, controlled clinical trial, 200 patients with acute myocardial infarction who had the indication for thrombolytic treatment were selected and divided to 6 groups of almost 30 people. A specific treatment protocol was designed for each group. The patients in the first 5 groups were compared with the ones in the sixth group as the control group in terms of frequency of complications and in-hospital mortality and also mortality during 3 and 6 months after the treatment.RESULTS: Mean age of the patients was 58.77 ± 2.6 years. Males constituted 77% of the study population. Heart failure, in-hospital arrhythmia and ejection fraction (EF) at discharge showed favorable results in the five groups which received metabolic regulations as compared to the control group. In-hospital mortality of no groups was different from that of the control group (P > 0.05). Three months after the treatment, mortality of the group that received GIK and magnesium was lower than that of the control group (P < 0.05). After 6 months, none of the patients who received high-dose GIK and magnesium along with thrombolytic therapy died while the mortality rate of the control group was 44.4% (P < 0.05).CONCLUSION: The infusion of GIK and magnesium solution along with thrombolytic therapy can lead to a decrease in the long-term mortality and complications in patients with acute myocardial infarction.Keywords: Acute Myocardial Infarction, Glucose, Insulin, Potassium, Magnesium, Thrombolytic Therapy, Cardiovascular Diseases, Clinical Trial

BACKGROUND: We aimed to evaluate subepicardial and subendocardial left ventricular (LV)functions in patients with single coronary artery lesion at an early stage after percutaneouscoronary intervention (PCI).METHODS: Patients with left anterior descending (LAD) lesion (n = 40) were evaluated.Subjects underwent PCI and at least one coronary stent was placed. Before and one month afterPCI, patients underwent echocardiography. The ordinary Doppler indicators including E wavedeceleration time, A velocity and E velocity as well as the pulsed-wave tissue Doppler imaging(PW-TDI) parameters (Aa, Ea and Sa velocity) were measured. The findings before and afterintervention were compared.RESULTS: E wave deceleration time was the only factor that significantly improved in ordinaryDoppler and other parameters such as A velocity and E velocity did not show any changes.Among TDI parameters, Aa velocity and Ea velocity in septum area improved significantly butdespite an increase in Sa velocity in septum, it was not statistically significant. Ea velocitysignificantly improved in lateral area but Aa and Sa velocity insignificantly increased.CONCLUSION: In patients with coronary artery disease, the systolic and diastolic function isimpaired. It is simply diagnosable by TDI. Although the systolic function impairment isremained after PCI, the diastolic function considerable improved after angioplasty. Our studyshowed that diastolic function of left ventricle improved over time. In contrast with otherstudies, in this study, Aa velocity significantly improved one month after revascularization.Keywords: Angioplasty, Percutaneous Coronary, Echocardiography, Doppler, Tissue Doppler

Abstract INTRODUCTION: Studies on the association between the plasma concentration of lipoprotein (a) and coronary heart disease (CHD) have reported conflicting findings. METHOD AND MATERIALS: The objective of the present study was to evaluate the association between serum levels of lipoprotein (a) and ischemic heart disease as well as other cardiovascular risk factors in a population-based study. Lipoprotein (a) serum was measured in 142 patients with chronic stable angina undergoing clinically indicated coronary angiography. Lipid profile, fasting blood glucose, anthropometric and clinical parameters were analyzed. RESULTS: Lipoprotein (a) levels were significantly associated with coronary artery stenosis in men, but not in women. Also, an direct association between mean levels of lipoprotein (a) and coronary artery stenosis in men younger than 55 years old and an inverse association in men older than 55 years old were observed. CONCLUSION: Multivariate analysis revealed that lipoprotein (a) was considered an independent predictor for severity of CAD in men, especially in younger ages. Keywords: Lipoprotein (a), cardiovascular risk factors, Ischemic heart disease, coronary angiography.

BACKGROUND: Nephropathy is one of the serious adverse effects in administration of contrast media in percutaneous coronary intervention (PCI). This study was designed in order to evaluate the effect of ACEI and diuretics on contrast- induced nephropathy. METHODS: This randomized clinical trial was conducted in Isfahan University of Medical Sciences in 2006. Overall, 60 persons were randomly assigned for each group. Groups A and B were treated by angiotensin converting enzyme inhibitors (ACEI) and groups C and D were treated by diuretics. In group A, ACEI was discontinued from 36 hours before PCI and in group C diuretics were discontinued as well. The post-intervention and the amount of increase in the serum creatinin (Cr) level were compared by ANOVA between groups. FINDINGS: The increase in Cr level was not significantly different between groups A and B (0.07±0.22 vs.,0.06±0.13 mg/dL , respectively, p=0.7). Similarly, this difference was not significant between groups C and D (0.08±0.17vs. 0.05±0.14mg/dL, respectively, p=0.2). CONCLUSION: Regarding to non- significant difference of Cr level between the groups either continuing or discontinuing ACEI and diuretics,in the presence of normal kidney function, these drugss,have no side effect in patients undergoing PCI. KEY WORDS: Contrast induced nephropathy, percutaneous coronary intervention

BACKGROUND: Cigarette smoking and hypertension (HTN), are both major risk factors for premature atherosclerosis. Currently, limited information is available from the effect of these risk factors on the Pattern of vessel involvement and also on the left ventricular ejection fraction (LVEF) at coronary angiography. Our study compared their effects on angiography of patients with premature atherosclerosis. METHODS: The study included 240 consecutive patients, under age of 45 years old, cigarette smoker or hypertensive hospitalized with a diagnosis of acute coronary syndrome. These patients underwent coronary angiography. Number and type of vessel involvement and also LVEF were studied. Logistic regression was used for data analysis. FINDINGS: Of patients, 24 were both smoker and hypertensive, and were excluded from this study. In addition, 142 of 216 patients (65.7%) were smoker and 74 (33.4%) were hypertensive. Left anterior descending coronary artery (LAD) involvement was more common in smoker young patient and low LVEF was more common in these patients compared with hypertensive young patients (28.2% versus 17.6%, respectively). CONCLUSION: Our findings indicate that smoking is more prevalent risk factor for premature coronary artery disease. Smoking has a significant effect on the pattern of vessel involvement and LVEF at coronary angiography of young patients. Our study emphasized on the importance of modifying in young active population. KEY WORDS: Smoking, hypertension, premature coronary artery disease.