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Background: Warfarin is a common anticoagulant agent which is widely used in many countries. However, Warfarin is one of those drugs which requires close monitoring and dosing while inappropriate could lead to hemorrhagic epoxides. Achieving a desirable international normalized ratio (INR) range depends on various demographic factors and genetic factors are now becoming an emerging area of interest in cardiovascular research. CYP2C9 is a gene encoding a member of cytochrome P450 enzyme which metabolizes many drugs. Genetic variation in this gene has been linked to abruption in Warfarin drug response. In present study the effect of genetic polymorphisms in CYP2C9 gene and its response to Warfarin is investigated. Methods: Total of 95 patients who had cardiovascular diseases and were using Warfarin for at least 3 months were enrolled in this cross sectional study. Their DNA was extracted and the genetic polymorphisms in CYP2C9 gene (RS1799853 as CYP2C*2 and RS1057910 as CYP2C9*3) were evaluated by using polymerase chain reaction and sequencing. Kruskal-Wallis test were used for comparing the Warfarin values between the genotype groups. The SPSS software 22v was used for data analysis. Results: Among the study population the prevalence of genotypes were as follow: CC/AA: 61.1, CT/AA: 17.9, CT/AC: 1.1, CC/AC: 3.6, TT/AA: 2.3, CC/CC: 0%. The CC/AA and CC/AC variants were related to Warfarin dose (P

Background and Aims: Warfarin is an anticoagulant agent used for many years in treating various clinical conditions such as thromboembolisms in cardiovascular disease. Some patients require different doses of warfarin to reach the therapeutic international normalized ratio ratio. These patients have specific demographic characteristics. Genetic polymorphisms in specific genes have been reported to be an essential factor in response to warfarin. The present study investigated the effect of these polymorphisms of genes on warfarin dose necessities in pediatric of VCORC1 gene in patients. Material and Methods: Ninety-five patients with cardiovascular disease, who were receiving warfarin for at least three months, enrolled in the present cross-sectional study. Their genomic DNA was extracted from their peripheral blood, and the VKORC1 (rs9923231) polymorphism was evaluated by polymerase chain reaction and sequencing. Results: Among the study population, 48 patients (50.5%) had TC genotype and, 21 (22.1%) and 9 (9.5%) patients have TT and CC genotype, respectively. There was no significant relation between Warfarin dose and VCORC1 genotype in our population (p

Background: Ordinary pressure dressing for hemostasis after cardiac catheterization is time consuming and might cause some problems, such as pain or loss of blood, which has to be controlled, particularly in pediatric patient. Using Celox® (chitosan) powder dressing might cause quicker initial hemostasis. Methods: In this prospective study, we assessed Celox® powder among patients in hospitals affiliated with Shiraz University of Medical Sciences, from November 2017 to February 2018. The patients were stratified in two groups. The case group included patients for whom Celox® powder was used along with sterile gauze pressure at the puncture site to achieve hemostasis, and the control group those in whom hemostasis was achieved by standard sterile gauze pressure method. Results: Sixty patients under 16 years of age with congenital heart diseases were evaluated and underwent cardiac catheterization. We stratified the patients in two groups called case (30 patients) and control group (30 patients). Considering both arterial and venous initial hemostasis, in the case group, the minimum and maximum, median and mean coagulation time were less than those in the control group; however, the initial hemostasis was statistically significant only in venipuncture site. Also, the venous coagulation time was shorter among the patients weighing less than 10 kilograms in comparison to those with higher weight. In the case group, using Celox® stirred hemostasis toward the lower percentiles, but based on 50th percentile, the distribution in each group was identical. Conclusions: Celox® powder dressing in children led to reduced coagulation time in venipuncture site, and we might recommend utilizing this type of dressing for venous hemostasis in children after venipuncture.

Background: Congenital heart diseases (CHD) constitute a wide range of heart abnormalities. Major advances in surgical treatments have led to a rapidly growing number of surviving individuals. Living well to most people is as important as living longer. Currently, there are few studies on this group of patients regarding their satisfaction with life. Objectives: This study attempts to compare satisfaction with life among CHD patients. Methods: In this cross-sectional study, patients with cyanotic and acyanotic CHD were enrolled. Satisfaction with Life was assessed using SWLS. Results: Eighty patients (52.05% females) with cyanotic (21.3%) and acyanotic CHD were enrolled. The patients with cyanotic CHD were as satisfied with their life as the patients with acyanotic CHD. There were no statistical significant differences between cyanotic and acyanotic patients regarding satisfaction with life. Younger age was associated with a higher degree of satisfaction with life. Women and patients with a history of corrective cardiac surgery were more satisfied with their life. Correlations between satisfaction with life and age and sex were not statistically significant. Conclusions: We found that the patients with cyanotic CHD were as satisfied with their life as acyanotic patients. The results of our study indicate that life satisfaction was not associated with age, sex, and the history of corrective cardiac surgery.

Background: Tissue Doppler imaging evaluates the ventricular function in both systolic and diastolic assessments. Objectives: This study aimed to determine the level of cardiac function in children with Down syndrome without structural cardiac lesions using conventional and tissue Doppler echocardiography. Methods: From September 2013 to August 2014 in Mashhad, Iran, a group of 36 children with Down syndrome aged between 4 months and 19 years without anatomic heart disease had their ventricular function assessed by both 2D echocardiography and tissue Doppler imaging. The following were measured: velocity of systolic waves (S), traditional Doppler imaging of early diastolic waves (E), traditional Doppler imaging of late diastolic waves (A), tissue Doppler imaging early diastolic waves (E’), and tissue Doppler imaging late diastolic waves (A’) at the mitral and tricuspid valve levels. Other data, such as fractional shortening, heart rate, and ejection fraction, were also measured. Results: At the time of the examination, the mean age of the participants was 6.4 ± 5.5 years. An association was found between children’s age and the tricuspid A-wave. The A-wave velocity of the tricuspid annulus increased when the body surface area decreased. In addition, compared with the normal subjects, the large age group presented with considerable differences in wave speed, including E, A, and E/E’, at the mitral and tricuspid annulus levels. Conclusions: Despite the Down syndrome children having an apparently normally structured heart, tissue Doppler imaging reveals different findings than those of normal children. The findings of this modality can be used to explain the reason behind the limited physical functioning of children with Down syndrome and may be considered as predictive factors for future cardiac events in these children. © 2016, Growth & Development Research Center.

Background: Recently, Tissue Glue or Octyl 2-Cyanoacrylate (OCA) has been extensively used in cardiac surgeries as surgical adhesives to replace sutures. Since the binder is in contact with live tissues, its tissue compatibility and non-cytotoxicity have major effect on enhancing the healing process. Objectives: The purpose of this study was to evaluate the cytotoxicity of OCA on rat cardiomyoblast cell (H9C2) using MTT assay. Materials and Methods: Cells were cultured in the presence of various concentrations of the OCA extract. Then, morphological changes of the cultured cells were observed by light microscopy and their cytotoxicity by MTT assay. The morphology quality of the cells and their quantity were examined after 24- hour incubation up to 72 hours. Data were analyzed statistically by the ANOVA. Results: The results showed that the percentage of survived cells amount of extract dilution ratio (1:4; 1:2; 1) were 80.4%; 79.6%, 77.5% respectively. Analysis of statistical test results does not show any significant differences between the optical density of the extract dilutions, and the control group indicating; consequently it has no significant cytotoxicity effect on the cells. Conclusions: The outcome of this study is that the OCA has no toxic effect on H9C2 cells.

Myocarditis is a well-recognized component of Kawasaki disease, with left ventricular dysfunction occurring in more than half of patients during the acute phase. The purpose of this study was to evaluate myocardial function in patients with Kawasaki disease using pulsed tissue Doppler imaging (TDI). Twenty-five patients with the diagnosis of acute Kawasaki disease were enrolled in the study. All patients underwent echocardiographic studies at the time of diagnosis of the disease, in its acute phase, prior to treatment, and then 4 weeks later. For an aged-matched control group with fever and no cardiac disease, the same echocardiographic evaluations were performed. Peak velocities of systolic (Sa), early diastolic (Ea), and late diastolic (Aa) motion of the annulus were obtained at the lateral and septal sides in apical four-chamber view, and TDI-derived myocardial performance index (TDI-MPI) was also calculated. Peak Ea velocity of lateral mitral annulus was decreased significantly during the acute phase of illness (14 +/- 4.40 vs. 17.67 +/- 4.41; P = 0.028). In seven patients with carditis, changes in Ea-to-Aa ratio of septum (1.28 +/- 0.278 vs. 1.78 +/- 0.49; P = 0.018) and lateral mitral annulus (1.23 +/- 0.496 vs. 2.11 +/- 0.822; P = 0.014) were statistically significant but TDI-MPI showed no statistically significant changes. This study showed that peak mitral annular Ea velocities obtained by TDI were significantly altered in the acute phase of Kawasaki disease. TDI- MPI does not add an incremental benefit to other indexes of myocardial performance for comprehensive myocardial function in the acute phase of Kawasaki disease.