Research in Cardiovascular Medicine

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Background: Several studies have been conducted on the effects of floods on the health of the affected community. We aimed to determine the effects of floods as the most common disaster on hypertension (HTN) as one of the most common noncommunicable diseases (NCDs). Materials and Methods: Four databases including Medline, Scopus, Google Scholar, and ScienceDirect were searched with the search strategy protocol up to the end of June 2021 and with the keywords of flood and high blood pressure or hypertension. Grey literature database and websites of WHO, UNDRR, and PreventionWeb were also searched. After removing duplicate articles, abstracts of the relevant titles were reviewed, and eligible articles were included for full-text review. Finally, the study variables were extracted from selected articles. Results: The search strategy resulted in eight final relevant articles from 48,980 articles. All final articles noted meaningful effect of flood on high blood pressure. There was a positive correlation between anxiety level, property loss, financial loss, physical activity, use of alcoholic beverages, interruption of medication, and medical cares with HTN. Different studies have also reported long-term effects of flooding on blood pressure. Conclusions: The flood has significant effect on high blood pressure in affected population. However, cases of unknown HTN in the affected population should also be considered, so screening is recommended in the affected community.

Background: Transcatheter pulmonary valves (TPVs) are feasible and much less invasive options for surgical right ventricular outflow tract (RVOT) repair or valve replacement in patients with degeneration of the pulmonary valve bioprosthesis or RVOT conduit failure. In 2005, the first Sapien valve was implanted in the pulmonic position, and proceeding In March 2016, the Food and Drug Administration approved the SAPIEN valve (Edwards Lifesciences) for use in malfunctioning RVOT conduits. Material and method: We describe the first ten cases of TPV-in-valve procedure conducted in our center, along with the patients' prior surgical history, procedural details, and their clinical and echocardiographic data. Result and conclusion: Our data provided safety and efficacy of transcatheter valve-in-valve procedure in degenerated pulmonary bioprotheses and our follow-up proved durability of this procedure.

Aim: Despite concerns about cardiovascular implications in coronavirus disease-2019 (COVID-19) patients, not all COVID-19 patients are visited by cardiologists and recommended to perform comprehensive cardiovascular assessments including measurement of biomarkers and echocardiography. We aimed to investigate the reasons for seeking cardiology care and to assess our cardiologists' diagnostic approaches to COVID-19 patients with potential cardiovascular involvement. Methods and Results: In this prospective, observational study, data of all consecutive COVID-19 patients admitted to six designated hospitals for COVID-19 in Iran in whom bedside cardiology consultation was requested were collected. A total of 148 patients including 105 (71%) males were included. The mean age was 57 ± 17 years. The most common reasons for cardiology consultation were dyspnea (56.7%), chest pain (12.8%), and suspected arrhythmias (10.8%). The most common comorbidities were hypertension (40.5%), diabetes mellitus (19.6%), and coronary heart disease (18.9%). A 12-lead electrocardiography (ECG) was obtained in all patients. Point-of-care ultrasonography or limited transthoracic echocardiography (TTE) was performed in 106 (71.6%) patients, and complete TTE was performed in 35 (23.4%) patients. Cardiac troponin was measured in 63 (42.6%) patients, and N-terminal pro B-type natriuretic peptide level was measured in 34 (23%) patients. Overall, 51 (34.5%) patients underwent invasive mechanical ventilation, inotropes were used in 29 (19.6%) patients, and 40 (27%) patients died. Conclusions: While preventing unnecessary investigations, the cardiologists should not overlook the lifesaving role of ubiquitous diagnostic modalities (such as ECG and TTE) in early detection and management of cardiac involvement in COVID-19.

Introduction: The prognostic significance of filling pressures and the relationship between left and right heart filling pressures have been well characterized in patients with heart failure. In the present study, we sought to evaluate the prevalence of discordance between left- and right-sided filling pressures and their relationship with clinical characteristics, laboratory data, and outcome measures (mortality and heart transplantation) in patients who were registered in right heart catheterization registry of Rajaie Heart Center (RHC-RHC registry). Methods: The hospital information system was queried for all adult patients with diagnosis of chronic heart failure who had undergone right heart catheterization between July 2009 and July 2019 in heart failure and transplantation department. The following variables were measured for each patient: mean right atrial pressure; systolic and end-diastolic right ventricular pressures; systolic, diastolic, and mean pulmonary artery pressure; pulmonary capillary wedge pressure (PCWP); mixed venous oxygen saturation; and cardiac output and cardiac index by Fick technique. The RAP/PCWP ratio was also calculated. The outcome of interest was all-cause mortality and heart transplantation after the index right heart catheterization. All of the patients were monitored for all-cause mortality or heart transplantation until July 2020. Results: Among 1941 patients, a total of 1078 patients (75% male) were selected. The mean (standard deviation) of age was 42.7 (15.7) years. Heart failure reduced ejection fraction (HFREF) was found in the majority of patients (85.1%), with nonischemic dilated cardiomyopathy and ischemic cardiomyopathy being the most frequent etiologies. The concordance between right and left filling pressures is more noticeable in patients with HFREF and heart failure mildly reduced EF than in patients with heart failure preserved EF (HFPEF). The median (interquartile range) of follow-up duration was 24 (6–48) months. During the follow-up time, 676 (62.7%) patients met the study outcomes of interest within <5 days to 96 months following the index RHC. Conclusion: The results of this study show that right and left filling pressure may be discordant in up to one-third of patients with advanced heart failure. However, the right and left heart-filling pressures would be more concordance as the disease is more advanced.

Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy and it represents the most frequent cause of coronary artery embolism.We describe a male patient with hypertrophic cardiomyopathy with persistent AF, for which he consumed rivaroxaban. The patient received implantable cardioverter-defibrillator shocks for ventricular tachycardia, but he developed acute embolic occlusion in the left main coronary artery (LMCA) following the conversion of the AF rhythm into the sinus rhythm.

In tanscatheter aortic valve replacement (TAVR) era, knowing complications related to the procedure guides interventional cardiologist in predicting the obstacles and helps them in manage these infirmities. We describe a case of TAVR which deploying the valve resulted in left ventricle outlet tract (LVOT) obstruction which was perfectly managed pacing and medical therapy.

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