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Tehrān, Iran

Sharifpour A.,Tehran University of Medical Sciences | Ashraf H.,Tehran Heart Center
Annals of Indian Academy of Neurology | Year: 2013

Objectives: Electrocardiographic (ECG) changes are reported frequently after acute strokes. It seems that cardiovascular effects of strokes are modulated by concomitant or pre-existent cardiac diseases, and are also related to the type of cerebrovascular disease and its localization. We aimed to determine the pattern of ECG changes associated with pathophysiologic categories of acute stroke among patients with/without cardiovascular disease and to determine if specific ECG changes are related to the location of the lesion. Materials and Methods : The electrocardiographic records of 361 patients with acute stroke were studied to assess the relative frequencies of ECG abnormalities among the pathophysiologic categories of stroke. Results: In the present study, the most common ECG abnormalities associated with stroke were T-wave abnormalities, prolonged QTc interval and arrhythmias, which were respectively found in 39.9%, 32.4%, and 27.1% of the stroke patients and 28.9%, 30.7%, and 16.2 of the patients with no primary cardiac disease. We observed that other ECG changes comprising pathologic Q- wave, ST-segment depression, ST-segment elevation, and prominent U wave may also occur in selected or non-selected stroke patients; thereby simulate an acute myocardial injury. We observed an increased number of patients with abnormal T-wave and posterior fossa bleedings and more rhythm disturbances for ischemic lesions, localized in the anterior fossa. Conclusion: Ischemia-like ECG changes and arrhythmias are frequently seen in stroke patients, even in those with no history or signs of primary heart disease, which support a central nervous system origin of these ECG abnormalities. Further study is necessary to better define the brain-heart interaction. © 2013 Annals of Indian Academy of Neurology.

Ghazi P.,Research Unit | Ghazi P.,Tehran Heart Center | Haji-Zeinali A.-M.,Tehran Heart Center | Ghasemi M.,Tehran University of Medical Sciences | Pour M.Z.,Research Unit
Hellenic Journal of Cardiology | Year: 2011

We describe a Takayasu arteritis patient who was admitted because of an abdominal aortic stenosis, further complicated by the presence of a stenotic right renal artery located in the area of the aortic stenosis. After treatment of the renal stenosis with a 4 × 15 mm Driver stent, a 16 × 60 self-expandable nitinol stent (OptiMed) was deployed through the stenosis of the abdominal aorta. Even though the right renal artery was initially compromised after stent deployment through the aortic stenosis, the patient was successfully treated with renal artery re-dilation by a balloon passed through open cells of the aortic stent. During follow up, the patient suffered no procedure-related complications.

Ghaedi M.,University of California at Davis | Ghaedi M.,Tarbiat Modares University | Ghaedi M.,Iran National Institute of Genetic Engineering and Biotechnology | Soleimani M.,Tarbiat Modares University | And 6 more authors.
Journal of Gene Medicine | Year: 2011

Inhibition of tumor-induced angiogenesis may restrict tumor growth and metastasis. Long-term systemic delivery of angiogenic inhibitors is associated with toxicity, as well as other severe side-effects. The utility of cells as vehicles for gene therapy to deliver therapeutic molecules has been suggested to represent an efficient approach. Mesenchymal stem cells (MSCs) exhibit a tropism to cancer tissue, and may serve as a cellular delivery vehicle and a local producer of anti-angiogenic agents. Methods: In the present study, we attempted to assess production of the transgene, α1-antitrypsin (AAT), in lentivirus-transduced human MSCs and its cytotoxicity against human umbilical cord vein endothelial cells (HUVEC). The secreted protein from these effector cells was determined by an enzyme-linked immunosorbent assay. The cytotoxicity of hMSCs that overexpress the human AAT gene against HUVEC was evaluated with an apoptotic assay. Results: Lentivirus-transduced hMSCs produced functional AAT and displayed much higher cytotoxicity against HUVEC than untransduced hMSCs. Moreover, AAT secreted from transduced hMSCs significantly inhibited HUVEC proliferation compared to untransduced hMSCs. The data obtained demonstrate for the first time that genetically modified hMSCs released abundant and functional AAT that caused obvious cytotoxicity to HUVEC. Conclusions: hMSC may serve as an effective platform for the targeted delivery of therapeutic proteins to cancer sites. © 2011 John Wiley & Sons, Ltd.

Yaminisharif A.,Tehran University of Medical Sciences | Yaminisharif A.,Tehran Heart Center | Hoseini S.M.S.,Tehran University of Medical Sciences | Shafiee A.,Tehran University of Medical Sciences
Journal of Interventional Cardiac Electrophysiology | Year: 2014

Method: We enrolled 31 consecutive patients (mean age = 50.9 ± 11.9 years; 5 [16.1 %] male) who presented with documented clinical PSVT in superficial electrocardiography but had non-inducible arrhythmia in the electrophysiology laboratory despite applying different stimulation protocols. We delivered low-power (25 W), low-temperature (45 °C) RF currents into the AV junction region to induce AVNRT.Aims: Some patients with documented episodes of paroxysmal supraventricular tachycardia (PSVT) do not have inducible tachycardia during the electrophysiological study. In this study, we describe how multiple low-temperature, low-power radiofrequency (RF) currents in the atrioventricular (AV) junction region can increase the rate of the induction of atrioventricular nodal reentrant tachycardia (AVNRT) in non-inducible cases.Results: Arrhythmia was induced in 20 (64.5 %) patients, and it was non-sustained in 3 (9.6 %) patients. RF current was delivered into the posterior region near the coronary sinus ostium and midseptal region. RF ablation target in inducible patients was the non-inducibility of the AVNRT at the end of the procedure, while the target in the non-inducible patients was slow pathway ablation with no antegrade conduction over the slow pathway. During the follow-up period, none of the patients (either with inducible or non-inducible arrhythmia) had recurrence of AVNRT.Conclusion: Multiple low-power, low-temperature RF current application into the AV junction region is a more effective method for the induction of AVNRT in comparison with a single current use into the slow pathway. © 2014, Springer Science+Business Media New York.

Ghavidel A.A.,Heart Valve Disease Research Center | Javadikasgari H.,Heart Valve Disease Research Center | Maleki M.,Shahid Rajaie Heart Hospital | Karbassi A.,Tehran Heart Center | And 2 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2014

Objectives: The aim of this study was to develop new models for prediction of short-term mortality risk in on-pump coronary artery bypass grafting (CABG) surgery using decision tree (DT) methods.Methods: Between September 2005 and April 2006, 948 consecutive patients underwent CABG surgery at Rajaie Heart Center. Potential risk factors were reviewed and univariate and multivariate analysis for short-term mortality were performed. The whole dataset was divided into mutually exclusive subsets. An entropy error fuzzy decision tree (EEFDT) and an entropy error crisp decision tree (EECDT) were implemented using 650 (68.6%) patient data and tested with 298 (31.4%) patient data. Ten times hold-out cross validation was done and the area under the receiver operative characteristic curve (AUC) was reported as model performance. The results were compared with the logistic regression (LR) model and Euro- SCORE.Results: The overall short-term mortality rate was 3.8%, and was statistically higher in women than men (P < .001). The final EEFDT selected 19 variables and resulted in a tree with 39 nodes, 20 conditional rules, and AUC of 0.90 ± 0.008. The final EECDT selected 15 variables and resulted in a tree with 35 nodes, 18 conditional rules, and AUC of 0.86 ± 0.008. The LR model selected 10 variables and resulted in an AUC of 0.78 ± 0.008; the AUC for EuroSCORE was 0.77 ± 0.003. There were no differences in the discriminatory power of EEFDT and EECDT (P = .066) and their performance was superior to LR and EuroSCORE.Conclusions: EEFDT, EECDT, LR, and EuroSCORE had clinical acceptance but the performance and accuracy of the DTs were superior to the other models. Surgery. © 2014 The American Association for Thoracic Surgery.

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