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BACKGROUND: There is considerable disagreement over the effects of percutaneous coronary intervention (PCI) on left ventricular diastolic function that has necessitated the investigation of diastolic indices. The present study was conducted to evaluate left ventricular diastolic function and its indices, three months after performing the PCI procedure in patients with coronary artery disease (CAD). METHODS: In a quasi-experimental clinical trial study (before and after), 51 patients with CAD scheduled for elective PCI were investigated provided that their Ejection Fraction (EF) was > 30%. Before and three months after PCI, echocardiography was carried out to evaluate left ventricular diastolic indices including the E/Ea as the most important criteria for diagnosis of diastolic heart failure (DHF). RESULTS: Based on the E/Ea indices and after PCI, the number of patients with DHF decreased significantly: 40 patients (78.4%) before PCI versus 28 patients (54.9%) after PCI (p CONCLUSION: The E/Ea ratio as an important criterion for diagnosis of DHF was improved after PCI. Improvement of several other diastolic indices was observed after the PCI procedure. It can be concluded that PCI can be an effective treatment modality in patients with left ventricular diastolic indices.

Background: Cardiac rehabilitation is known as a powerful non-pharmacological approach for improving functional capacity, and left ventricular systolic function; however, some limited data have suggested an attenuation of the decline in diastolic function with this program. This study investigated the effect of high intensity aerobic exercise following coronary artery bypass surgery (CABG) on diastolic dysfunction.Materials and Methods: Forty four patients with different levels of diastolic dysfunction who underwent CABG surgery were included. The participants attended the complete cardiac rehabilitation program three times per week for two months (totally 24 sessions). The patients underwent complete transthoracic echocardiographic studies including two-dimensional and spectral Doppler echocardiography immediately before attending rehabilitation program and also after the completion of rehabilitation sessions.Results: There was a significant decrease of isovolumic relaxation time (IVRT) after participating complete cardiac rehabilitation (94.0 to 89.0; P=0.001). The diastolic function parameters of early diastolic mitral inflow peak velocity to late diastolic mitral inflow peak velocity (E/A) ratio (0.94 to 1.04; P=0.001), deceleration time (DT) of the mitral E wave (192.7 to 219.0; P=0.011), and velocity of early diastolic mitral annular motion (Ea) (5.9 to 6.7; P=0.026) were improved after the rehabilitation, whereas mitral A duration to pulmonary A duration (MAD/PAD) ratio was slightly improved (1.07 to 1.12; P=0.056) and pulmonary veins systolic flow to pulmonary vein diastolic flow (PVS/PVD) ratio (0.89 to 1.04; P=0.345) remained unchanged.Conclusion: A complete cardiac rehabilitation program with high intensity aerobic exercise approach can reverse diastolic impairment in patients undergoing CABG.

Introduction: Atrial septal defect (ASD) is a common congenital heart disease and causes left-to-right shunting and significant right ventricular (RV) volume overload. The goal of this study was to evaluate the influence of these hemodynamic changes on pulmonary venous flow pattern in young adults.Methods: Complete echocardiographic examination was performed in a group of 40 young adults (aged < 40 years) who had secundum type ASD and was compared to 40 age-matched individuals in control group who had no cardiac abnormality. Systolic and diastolic flow velocities in pulmonary veins (PV), superior vena cava (SVC), inferior vena cava (IVC) and RV functional parameters were recorded and evaluated.Results: As opposed to healthy young individuals who showed distinct S and D waves with diastolic predominance in pulmonary vein Doppler, in patients with ASD a continuous flow with increased systolic peak that began in systole and continued to the late diastole was observed. The RV systolic function increased compared to the control group.Conclusions: In patients with ASD, the pattern of pulmonary veins flow transforms into a single continuous antegrade wave with systolic dominance due to persistent shunting of left atrial blood in to right heart chambers as well as increased RV pump function on pulmonary vein (by means of ASD), SVC and IVC, and could be used as a screening method for the presence of secundum type ASDs in young adults.

This study has been conducted to compare one-year survival rate of patients who underwent coronary artery bypass sur- gery (CABG) vs. percutaneous coronary intervention (PCI) in general as well as considering the number of diseased coro- nary vessels. In this retrospective study, we reviewed the medical records of patients who underwent CABG (484 cases) or PCI (292 cases) at out university heart center from 2009 to 2012. The mortality and survival was compared between the two studied groups based on left ventricular function and number of diseased coronary vessels. Twenty-seven patients (5.57%) died in CABG group which was significantly higher than in PCI group (8 cases, 2.73%); P= 0.04. However, no significant dif- ference was observed regarding mortality between CABG and PCI groups in one- diseased vessel (5.15% vs. 2.22%, P= 0.28), two- diseased vessel (6.12% vs. 3.57%, P= 0.41), and three-vessel disease (5.41% vs.0, P= 0.4). Although PCI was associated with a better one-year survival rate compared to CABG, but number of the diseased coronary vessels did not af- fect survival rate significantly.

To determine short-term (in-hospital) outcome and complications of surgical and interventional procedures performed for patients with coarctation of the aorta (CoA) in the age range of 5 to 25 year. Medical records of 64 patients (48 males and 16 females) with CoA who underwent surgical treatment March 2002 to March 2012 were reviewed. Surgical operation was done for 26 patients and interventional procedures were done for 18 cases. The data gathered included type of CoA, anatomic type, hospitalization duration, and complications occurred during hospitalization such as hypertension, persistent CoA, surgical wound infection, and death. Both surgery and interven- tional procedures restored pre-operative hypertension significantly. The safest method regarding in-hospital complications was balloon angioplasty (1 patient had systemic hypertension after the procedure, 25%) followed by Dacron patch (3 cases had hypertension and one patient had persistent coarctation). However, no significant difference was observed between different surgical and interventional procedures. Pre-operative systolic blood pressure, age group, peak systolic gradient, simple or complex CoA, discrete or segmental CoA had no significant relationship with in-hospital complications/outcome. In conclusion, we suggest considering all aspects of patients with CoA to choose the best surgical treatment. Based on our experience balloon angioplasty and Dacron patch were the safest method with acceptable rate of restoration in blood pressure during in-hospital follow-up period.

Considering the importance of cardiovascular disease and the role that platelets have in thrombosis formation in the coronary arteries, this study was done in order to assess platelet-related indices in patients who suffered acute myocardial infarction (MI) and compare them with those who had normal coronary angiography results.In this descriptive-analytical study, 200 patients who were admitted to our university hospital due to chest pain were included. The patients were divided into five groups including ST-segment elevation MI (STEMI), non-STEMI, unstable angina (UA), stable angina (SA), and healthy subjects (as control group). Platelet-related indices including platelet count as well asmean platelet volume (MPV) was determined. For this purpose, blood samples were taken from the patients upon admission and platelet count and volume were measured within three hours of admission.There was no statistically significant difference regarding MPV between the study groups (P> 0.05).MPV did not have any role in diagnosing various types of coronary artery disease (CAD).

Background: In patients who undergoing PCI, association between right ventricular function and outcome of the procedure remained unclear. The present study aimed to determine association between echocardiography findings of systolic right ventricular function and functional status of patients following PCI. Methods: In a cross-sectional study conducted at Imam Ali hospital and heart center in Kermanshah, Iran in 2013, 40 patients with history of inferior wall myocardial infarction (Inf MI) according to previous electrocardiography (ECG) in past hospitalization for MI who were candidate for percutaneous coronary intervention (PCI) on right coronary artery (RCA) and had left ventricle ejection fraction (LVEF) less than 40% were included. The subjects underwent echocardiography on admission to assess echocardiography indices of systolic right ventricular function including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), Tei-index (Myocardial performance index), and RV fractional area (RVFA) change that was repeated one month later. Baseline functional status was assessed based on the New York Heart Association functional classification score (NYHA score) that divided to 4 grades. Results: NYHA score improved following PCI procedure (from 2.20±0.46 to 1.10±0.30, P