Correlation between hyponatremia and high risk clinical and echocardiographic features in patients with acute heat failure

Background and purpose: Heart failure (HF) is characterized by decreased ability of the heart to provide sufficient blood flow or fill with the blood. Hyponatremia is the most commonly seen electrolyte abnormality in patients with heart failure that is associated with increased morbidity and mortality. The aim of this study was to assess the correlation between hyponatremia and high risk clinical and echocardiographic features in patients with acute HF. Materials and methods: This cross-sectional analytic study was performed in 271 patients with acute systolic heart failure admitted to Sari Fatemeh Zahra hospital, 2018-2019. Patients were divided into two groups: hyponatremic and normonatremic groups. Vital signs, echocardiographic variables, body mass index (BMI), and common cardiovascular risk factors were compared between the two groups using SPSS V18. Results: This study included 130 males (48) and 141 females (52) and the patients� mean age was 69.90±14.02 years. Patients with hyponatremia had lower BMI and systolic and diastolic blood pressure levels and higher platelet counts compared to other group (P =0.01, 0.002, 0.005, and 0.047, respectively). Also, these patients, were found with higher frequency of moderate to severe functional mitral regurgitation (P= 0.076). Linear regression analysis showed hyponatremia as an independent predictor of hypotension and hemodynamic instability in patients with hyponatremia. Conclusion: This study showed that patients with acute HF and hyponatremia are at higher risk of developing hypotension, cachexia, and increased platelet counts which put them at greater risk for cardiovascular morbidity and mortality. © 2020, Mazandaran University of Medical Sciences. All rights reserved

The Effect of Cerebellar tDCS on Static and Dynamic Balance of Inactive Elderly Men

The aim of this study was investigating the effect of cerebellar transcranial direct current stimulation (tDCS) on static and dynamic balance of inactive older adults. Twenty-four older adults participated in this study. All participants underwent static and dynamic balance tests. In the Experimental group, anode electrode was positioned at the O point in the cerebellum and cathode electrode was positioned on the left eye socket (FP1). In the control group, the anode and cathode electrodes were positioned at O and FP1 points, respectively, but the current stimulation was stopped after 30 s. Then, the posttest was performed. Data analysis was done using MANCOVA. There was a significant difference between the Experimental and control groups in static balance (p = .12) and dynamic balance (p = .18) and the performance was better in the experimental group. It can be concluded that tDCS can improve static and dynamic balance in inactive older adults

Peri-mitral ventriculoatrial fistula after blunt thoracic trauma

Blunt trauma to the chest can damage any thoracic organ. Heart valve damage and particularly mitral apparatus occurs relatively rare, and the patients are expected to become acutely symptomatic. However, in patients with multiple traumas, other dominant severe damages tend to draw away the attention of the physicians resulting in neglect of less salient heart injuries. Here, we present a patient with history of blunt chest trauma and incidental finding of posttraumatic severe mitral regurgitation. © 2018 Wiley Periodicals, Inc

Peri-mitral ventriculoatrial fistula after blunt thoracic trauma

Blunt trauma to the chest can damage any thoracic organ. Heart valve damage and particularly mitral apparatus occurs relatively rare, and the patients are expected to become acutely symptomatic. However, in patients with multiple traumas, other dominant severe damages tend to draw away the attention of the physicians resulting in neglect of less salient heart injuries. Here, we present a patient with history of blunt chest trauma and incidental finding of posttraumatic severe mitral regurgitation. © 2018 Wiley Periodicals, Inc

Correlation between albuminuria and tissue Doppler-derived left ventricular myocardial performance index in patients with type 2 diabetes

Background: Albuminuria is considered as a significant predictor of cardiovascular morbidity and mortality in patients with diabetes mellitus. The main purpose of this study was to determine the correlation between albuminuria and global left ventricular (LV) function in patients with type 2 diabetes (T2D). Methods: This observational study was conducted on 80 consecutive asymptomatic patients with T2D and an LV ejection fraction �55. The patients were divided into two groups depending on the presence or absence of albuminuria. Echocardiography-derived indices of the LV function were then compared between these groups. Results: The patients with albuminuria were older (mean ± SD: 60.37 ± 9.05 vs 54.52 ± 10.26 years of age, P =.01) and had higher hemoglobin A1c (HbA1c) levels (8.45 ± 1.97 vs 7.25 ± 1.93 mg/dL, P =.012) than those without albuminuria. Among the echocardiographic variables, the patients with albuminuria had higher LV Tei-index (median lower-upper quartile: 0.620 0.455-0.824 vs 0.441 0.336-0.586, P <.001), more prolonged early filling (E)-wave deceleration time (274.87 ± 75.97 vs 239.40 ± 61.35 ms, P =.032), increased interventricular septal wall thickness (1.11 ± 0.31 vs 0.95 ± 0.21 cm, P =.012), and lower mean early diastolic mitral annular velocity (7.57 ± 2.34 vs 8.68 ± 2.46 cm/s, P =.046) than those without albuminuria. Among risk factors, only albuminuria and HbA1c levels were associated with a significant increase in LV Tei-index (Beta = 0.426 and P <.001, Beta = 0.226 and P =.042, respectively). Conclusion: The LV Tei-index was significantly higher in diabetic patients with than without albuminuria. Low HbA1c levels were correlated with a decrease in LV Tei-index. © 2021 Wiley Periodicals LL

Is there concordance between CMR and echocardiography in assessing aortic stenosis severity?

Background: Although echocardiography has constituted the primary method of evaluating cardiac disease for many years now, using another method to complete the examination-especially in dubious situations such as calcified valvular diseases or poor echocardiography window-seems necessary. In studies in different countries, cardiac magnetic resonance imaging (CMR) has been introduced as an acceptable noninvasive complementary method for the evaluation of the severity of aortic stenosis (AS) with good reproducibility and reliable results in comparison with echocardiography. Methods: In a cross-sectional survey in Rajaie Cardiovascular, Medical, and Research Center�s CMR Department between 2009 and 2014, all patients with a diagnosis of AS were evaluated for the severity of AS in terms of peak velocity and peak gradients via both echocardiography and CMR (velocity-encoded method), and the results were analyzed by SPSS using the t-test and ANOVA. Results: After the exclusion of patients with insufficient data, 26 patients were included and evaluated. There were no significant differences between the 2 groups (CMR vs. echocardiography) or between the subgroups (considering cardiovascular risk factors, ejection fraction, and valvular features). Conclusions: CMR was comparable with echocardiography in evaluating AS severity in our study and was not inferior to echocardiography, although more studies are recommended for a more in-depth evaluation. © 2016, Iranian Heart Association. All rights reserved

Postoperative outcome of the Transcatheter closure of atrial septal defects using the AMPLATZER septal occluder

Background: The AMPLATZER Septal Occluder (ASO) has successfully replaced surgery for the repair of atrial septal defects (ASDs) within the last decade. However, the outcome and clinical consequences of this procedure have not been fully assessed. Hence, the present study aimed to determine the results of the application of the ASO in the nonsurgical transcatheter closure of ASDs. Methods: Forty-seven consecutive patients were assessed via transesophageal echocardiography to determine secundum ASDs. The study end points were the assessment of the echocardiographic consequences of ASD closure using the ASO and also the determination of the presence of postoperative complications. The patients were reassessed via transthoracic echocardiography 1 day, 1 month, and also 6 months after the intervention. Results: An assessment of the trend of the changes in right ventricular dimension and functional status showed a significant decrease in right ventricular size as well as improvement in function within 6 months after ASD closure using the ASO. The mean pulmonary artery pressure was also significantly decreased. Unsuccessful ASD closure was detected in only 3 patients, with an overall failure rate of 6.4. Regarding postoperative complications, device displacement was found in 2.1, interatrial septum rupture in 12.8, small pericardial effusion in 12.8, tamponade in 2.1, and small residual ASDs in 12.8, all of which were resolved procedurally within the following month. Conclusions: The clinical efficacy of the nonsurgical transcatheter closure of ASDs with the ASO was underlined in our experiment, indicating that it is a good and standard alternative to surgical repair. © 2017, Iranian Heart Association. All rights reserved