Search

Background The speed of heart failure progression as well as the debilitating mental problems caused by this disease highlights the need for palliative care with a focus on mental health by an inter-professional team. In this regard, the present study aimed to determine the effectiveness of the mental health-based palliative care program on anxiety and depression in patients with heart failure. Methods This quasi-experimental study was conducted on 50 patients with heart failure hospitalized at Shahid Chamran Hospital in Isfahan, Iran. First, the case and control groups were selected using the convenience sampling method and according to the inclusion criteria. The patients in the case group received the mental health-based palliative care program, which was performed by an inter-professional team, three times a week for 6 consecutive weeks in a combination of in-person sessions at home/hospital, virtual online via Google Meet and offline via Eitaa. The patients in the control group only received the routine care program of the Hospital. The data were collected using the demographic characteristics questionnaire and the hospital anxiety and depression scale before and after the intervention in both groups, and then analyzed using SPSS 23 and descriptive and inferential statistics. Results The results showed that the mean age of the control group and the case group was 60.16±11.24 and 59.52±10.46, respectively. Most patients in both case and control groups were male (76% and 64%). The two groups were homogenous in terms of demographic variables (P0.05). However, after the intervention, the anxiety and depression scores significantly reduced (PConclusions Considering the effectiveness of a "mental health-based palliative care program" on the improvement of anxiety and depression in patients with heart failure, it can be included in the routine programs of these patients, in addition to the care for relieving physical pain, to improve their mental condition and obtain better treatment, care, support, and palliative results. Trial registration: Not applicable, because this study was not a randomized clinical trial

BACKGROUND Atrial fibrillation (AF) is the most common tachyarrhythmia in patients with cardiovascular diseases (CVDs) and may have significant complications such as stroke. The present study aims to evaluate endothelial dysfunction in patients with lone atrial fibrillation (LAF) through flow-mediated dilation (FMD) in the brachial artery, as a non-invasive method for evaluating functional and structural markers of endothelial dysfunction. METHODS In this case-control study, 43 patients with LAF were selected. 51 age and sex-matched healthy individuals were selected as the control group. The brachial artery diameter of the subjects in both groups was measured through FMD. The obtained data were analyzed by SPSS software. RESULTS Patients with LAF and healthy subjects did not have any difference in terms of gender, heart rate (HR), and systolic blood pressure (SBP) (P > 0.05 for all). FMD of the patients with AF was significantly lower (P = 0.04) than FMD of the healthy controls. CONCLUSION Our findings showed that LAF was associated with systemic endothelial dysfunction. AF plays an important and independent role in reducing FMD.

BACKGROUND Considering the high concentrations of pollutants in large cities of Iran and the high prevalence of heart failure (HF) among Iranians, especially with increasing life expectancy, this study investigated the relationship between airborne contaminants with a diameter < 2.5 µm or particulate matter 2.5 (PM2.5) and hospitalization and mortality in patients with HF in Isfahan, Iran, during 2011. METHODS This ecological study was carried out on a part of data from the CAPACITY study. A total of 275 patients with HF were randomly selected from 840 subjects with International Statistical Classification of Diseases, 10th Revision (ICD-10) diagnosis code I50 in the CAPACITY study. Patients’ records were evaluated and their clinical characteristics, disease history, and laboratory and echocardiographic findings were extracted. Air pollution and climatic data were extracted from the CAPACITY study. Poisson regression was used in crude and adjusted models to evaluate the association between PM2.5 and study outcomes. All analyses were performed using crude models and models adjusted for temperature, dew point, and wind speed. RESULTS 54.9% (n = 151) were men with mean age of 70.4 ± 13.7 years. While most patients (85.8%) were discharged after recovery, 14.2% of the patients died in the hospital. Blood glucose, heart rate, and ejection fraction (EF) were significantly higher on unhealthy days than normal days. Regression analysis revealed no significant relationships between hospitalization and mortality rates and PM2.5 concentrations on healthy days, unhealthy days for sensitive people, and unhealthy days. CONCLUSION The model used in our study revealed no significant relationships between PM2.5 concentrations and hospital admission on healthy days, unhealthy days for sensitive people, and unhealthy days.

Febrile congestive heart failure is a rare first manifestation of pheochromocytoma. Herein, the case of a 31-year-old female with febrile congestive heart failure and subsequent cardiogenic shock is presented. After intensive care unit (ICU) admission and further evaluating the right adrenal mass observed in abdominal ultrasonography, the diagnosis of pheochromocytoma was confirmed. Then, she was scheduled for the right adrenalectomy. Before surgery, she complained of acute-onset progressive muscle weakness in the lower limbs, followed by the upper limbs. After further investigation, she was diagnosed with Guillain–Barré syndrome and treated with intravenous immunoglobulin (IVIG). She recovered well after the right adrenalectomy, and during the subsequent 18 months, the follow-up did not reveal any complications, and left ventricular function recovered to normal.

The pericardium is an uncommon site for manifestation of pheochromocytoma. Herein, the case of a 57-year-old man with cardiac tamponade is presented. Pericardiocentesis was performed, and the vital signs were stabilized afterwards. An abdominal computed tomography (CT) scan illustrated a nonhomogeneous right adrenal mass suspicious of pheochromocytoma, planned for right adrenalectomy. He recovered well after surgery, and his subsequent follow-ups did not reveal any complications.