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Papers by Gholamreza Davoodi

Research paper thumbnail of Association between Androgenic Hormone Levels and Left Ventricular Ejection Fraction

The Journal of Tehran University Heart Center, Aug 31, 2010

Methods: The study population consisted of 515 consecutive men who were referred for angiographic... more Methods: The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF < 35%, EF = 35-45%, EF = 45-54%, and EF ≥ 55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone (fT), total testosterone (tT), and dehydroepiandrosterone sulfate (DHEAS). To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF < 35% and the ones with EF ≥ 35%.

Research paper thumbnail of Premedication for coronary angiography: effects on anxiety and hemodynamic status

Indian Heart Journal, 2007

AIM: This study was designed to compare the outcomes of two current methods of premedication, for... more AIM: This study was designed to compare the outcomes of two current methods of premedication, for coronary angiography with placebo, on the level of anxiety and hemodynamic status.METHODS AND RESULTS: In all, 151 patients referring for coronary angiography were randomized into three groups with equal populations. The first group (group M) received 0.02 mg/kg intravenous midazolam; the second (group DP7rpar; received intramuscular injection of 5mg diazepam + 25 mg promethazine; and the third (group P) received 2cc of intravenous normal saline solution. Vital signs, blood pressure, and peripheral O2 saturation were recorded in specifically-designed questionnaires. The level of anxiety before and after angiography was documented according to the Visual Analog Scale. Patients in the group M accidentally had higher pre-procedural anxiety level (p < 0.05). There was no significant difference in pulse rate, respiratory rate, and mean blood pressure (BP) between these groups prior to angiography. In the group M, diastolic BP decreased more significantly than the other 2 groups during angiography (p < 0.05). Although number of punctures, pain at catheterization site, dose of lidocaine, level of consciousness, and patient satisfaction did not show a significant difference between the three groups; midazolam induced higher level of amnesia than the other 2 groups and the physicians were more satisfied with it only compared with diazepam + promethazine (p < 0.05).CONCLUSION: Because of the importance of hemodynamic stability and comfort during angiography, non-pharmacologic approaches are preferred. In case of severity and persistence of autonomic system stimulation, the least effective dose of midazolam for a short period of time may be used.

Research paper thumbnail of Correlation between Plasma Adiponectin Levels and the Presence and Severity of Coronary Artery Disease

The Journal of Tehran University Heart Center, Jul 1, 2013

The existing evidence suggests that plasma adiponectin concentrations can be indicative of the pr... more The existing evidence suggests that plasma adiponectin concentrations can be indicative of the presence and severity of coronary artery disease (CAD). However, the results of the studies conducted hitherto on this subject are inconsistent. We sought to investigate the possible correlation between plasma adiponectin levels and the presence and severity of CAD in patients undergoing non-urgent coronary angiography. In 399 consecutive patients undergoing non-urgent coronary angiography for CAD survey, plasma adiponectin, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, and fasting blood sugar levels were measured and demographic characteristics such as age, sex, Body Mass Index, diabetes mellitus history, systemic hypertension history, and family history of CAD were collected. According to the angiography results, the patients were divided into two groups of CAD and non-CAD. The severity of coronary atherosclerosis in the CAD group was defined using the Gensini score system. Average age was 61.4 ± 9.94 years in the CAD group and 57.9 ± 10.75 years in the non-CAD group. Also, 73.7% of the CAD group and 55.4% of the non-CAD group were male. Totally, 278 (69.7%) patients were found to have CAD. Patients without CAD did not have higher mean plasma adiponectin concentrations than did those with CAD (13.38 ± 11.96 vs. 14.95 ± 14.11 mcg/ml; p value = 0. 896). After adjustment for CAD conventional risk factors, plasma adiponectin levels still were not associated with CAD. No association was found between plasma adiponectin levels and the Gensini score. Furthermore, in contrast to the fairly strong correlation previously reported, there was no correlation between adiponectin levels and conventional CAD risk factors. We could not observe any relationship between plasma adiponectin concentrations and the presence or severity of CAD in patients undergoing coronary angiography.

Research paper thumbnail of Ablation of Focal Right Upper Pulmonary Vein Tachycardia Using Retrograde Aortic Approach

The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a... more The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a main source of ectopic beats for the initiation of atrial dysrrythmias is strongly recommended. We report the case of a 13-year-old girl who was admitted to our hospital with the electrocardiogram manifestation of an ectopic atrial tachycardia. The focus of arrhythmia was inside the right upper pulmonary vein. The patient underwent successful ablation with a conventional electrophysiology catheter via the retrograde aortic approach. We showed that when the origin of atrial tachycardia is in the right upper pulmonary vein, it is possible to advance the catheter into this vein via the retrograde aortic approach and find the focus of arrhythmia. This case demonstrates that right upper pulmonary vein mapping is feasible through the retrograde aortic approach and it is also possible to ablate the arrhythmia using the same catheter and approach.

Research paper thumbnail of Association between Traditional Risk Factors and Coronary Artery Ectasia: A Study on 10057 Angiographic Procedures among Iranian Population

The journal of Tehran Heart Center, Jan 12, 2014

Whether coronary artery ectasia (CAE) is a unique clinical finding or results from other clinical... more Whether coronary artery ectasia (CAE) is a unique clinical finding or results from other clinical entities is still unknown. We aimed to determine the CAE prevalence, investigate the relationship between CAE and patients' demographic and clinical characteristics, and assess the prognosis at follow-up in a sample of Iranian population. Totally, 10057 patients who underwent coronary angiography were divided into three categories: normal coronary arteries without co-existing coronary artery disease; CAE without co-existing coronary artery narrowing < 50%; and coronary artery stenosis with > 50% luminal narrowing (CAS). The prevalence of CAE was 1.5%. Compared to the normal individuals, the CAE patients were older, were more frequently male, and had higher rates of myocardial infarction (MI). The CAE patients had a lower frequency of diabetes and MI than the CAS group. The CAE patients were largely focused between 40 to 60 years of age. The right coronary and left anterior des...

Research paper thumbnail of Correlation between Plasma Adiponectin Levels and the Presence and Severity of Coronary Artery Disease

The journal of Tehran Heart Center, 2013

The existing evidence suggests that plasma adiponectin concentrations can be indicative of the pr... more The existing evidence suggests that plasma adiponectin concentrations can be indicative of the presence and severity of coronary artery disease (CAD). However, the results of the studies conducted hitherto on this subject are inconsistent. We sought to investigate the possible correlation between plasma adiponectin levels and the presence and severity of CAD in patients undergoing non-urgent coronary angiography. In 399 consecutive patients undergoing non-urgent coronary angiography for CAD survey, plasma adiponectin, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, and fasting blood sugar levels were measured and demographic characteristics such as age, sex, Body Mass Index, diabetes mellitus history, systemic hypertension history, and family history of CAD were collected. According to the angiography results, the patients were divided into two groups of CAD and non-CAD. The severity of coronary atherosclerosis in the CAD group was ...

Research paper thumbnail of Association between Androgenic Hormone Levels and Left Ventricular Ejection Fraction

The journal of Tehran Heart Center, 2010

Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this s... more Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this study was to compare androgenic hormone levels in patients with different left ventricular ejection fractions (EF). The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF < 35%, EF = 35-45%, EF = 45-54%, and EF ≥ 55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone (fT), total testosterone (tT), and dehydroepiandrosterone sulfate (DHEAS). To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF < 35% and the ones with EF ≥ 35%. There were statistically significant trends in some characteristics in the patients with differen...

Research paper thumbnail of Premedication for coronary angiography: effects on anxiety and hemodynamic status

Indian heart journal

This study was designed to compare the outcomes of two current methods of premedication, for coro... more This study was designed to compare the outcomes of two current methods of premedication, for coronary angiography with placebo, on the level of anxiety and hemodynamic status. In all, 151 patients referring for coronary angiography were randomized into three groups with equal populations. The first group (group M) received 0.02 mg/kg intravenous midazolam; the second (group DP7rpar; received intramuscular injection of 5mg diazepam + 25 mg promethazine; and the third (group P) received 2cc of intravenous normal saline solution. Vital signs, blood pressure, and peripheral O2 saturation were recorded in specifically-designed questionnaires. The level of anxiety before and after angiography was documented according to the Visual Analog Scale. Patients in the group M accidentally had higher pre-procedural anxiety level (p < 0.05). There was no significant difference in pulse rate, respiratory rate, and mean blood pressure (BP) between these groups prior to angiography. In the group M,...

Research paper thumbnail of The relationship between level of androgenic hormones and coronary artery disease in men

Cardiovascular journal of Africa

Previous studies have shown controversial results on the role of androgens in coronary artery dis... more Previous studies have shown controversial results on the role of androgens in coronary artery disease (CAD). We performed this study to assess the relationship between androgen levels and selective coronary angiography (SCA) findings. This study was conducted on 502 consecutive men who underwent SCA with different indications in our centre. Medical history and blood samples were taken from all subjects prior to angiography. Free testosterone (FREET) was measured with enzyme-linked immunosorbent assay, and total testosterone (TES) plus dehydroepiandrosterone sulfate (DHEA) were checked with radio-immunoassay. Total cholesterol, high- and low-density lipoprotein cholesterol (HDL and LDL), triglycerides, lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) were also tested in all patients. Angiographic results were reported by two cardiologists and checked for intra- and inter-observer reliability, then interpreted as Gensini score, and on the basis of the number of segments involved. ...

Research paper thumbnail of Homocysteine, vitamin B12 and folate levels in premature coronary artery disease

BMC cardiovascular disorders, 2006

Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable ... more Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD. We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran. After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine le...

Research paper thumbnail of Hyperuricemia and the Presence and Severity of Coronary Artery Disease

Laboratory Medicine, 2009

Background: Few studies have assessed the relation of hyperuricemia with the severity of coronary... more Background: Few studies have assessed the relation of hyperuricemia with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid levels with the presence and severity of CAD.

Research paper thumbnail of 902 Normal values for ventricular synchrony measured by tissue Doppler imaging and tissue Doppler synchronization imaging in structurally normal hearts

European Journal of Echocardiography, 2006

Research paper thumbnail of Association between R353Q polymorphism for coagulative factor VII and severity of coronary artery disease in Iranian population

Cardiology Journal, 2013

Background: Recent research has supported the central role of coagulative factors in advancing at... more Background: Recent research has supported the central role of coagulative factors in advancing atherosclerosis and causing coronary artery disease (CAD). The present study, for the first time, aimed to clarify the relationship between R353Q polymorphism for factor VII and the occurrence and severity of CAD in a large sample of Iranian population. Methods: Nine hundred and nineteen consecutive patients with suspected CAD, who candidated for coronary angiography in the Tehran Heart Center between January 2006 and March 2007, were examined. The number of diseased coronary vessels was determined, and the severity of CAD was assessed by the Gensini score. Genotyping was done via the PCR-RFLP method. Results: The frequency of Q and R alleles was 74.1% and 25.9% in the patients with CAD and 75.2% and 24.8% in those without CAD, with an insignificant difference (p = 0.625). The frequency of Q allele in the patients with single-vessel, two-vessel, and three-vessel diseases was 72.8%, 71.5%, and 76.4%, respectively; the difference was also insignificant (p = 0.379). No relationship was observed between the distribution of the genotypes and the number of the involved coronary vessels. The average of the Gensini score was 43.39 ± 46.18 in the patients with QQ genotype, 38.87 ± 42.89 in those with QR genotype, and 55.61 ± 53.80 in the ones with RR genotype, with the difference not constituting any statistical significance (p = 0.084).

Research paper thumbnail of Predictive Power of the Baseline QRS Complex Duration for Clinical Response to Cardiac Resynchronisation Therapy

EUROPEAN JOURNAL OF CARDIOVASCULAR MEDICINE, 2011

Background: Determination of predictors of response to cardiac resynchronisation therapy (CRT) in... more Background: Determination of predictors of response to cardiac resynchronisation therapy (CRT) in patients with moderate to severe heart failure accompanied by a ventricular dyssynchrony can play a major role in improving candidate selection for CRT.

Research paper thumbnail of Ablation of focal right upper pulmonary vein tachycardia using retrograde aortic approach

The journal of Tehran Heart Center, 2010

The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a... more The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a main source of ectopic beats for the initiation of atrial dysrrythmias is strongly recommended. We report the case of a 13-year-old girl who was admitted to our hospital with the electrocardiogram manifestation of an ectopic atrial tachycardia. The focus of arrhythmia was inside the right upper pulmonary vein. The patient underwent successful ablation with a conventional electrophysiology catheter via the retrograde aortic approach. We showed that when the origin of atrial tachycardia is in the right upper pulmonary vein, it is possible to advance the catheter into this vein via the retrograde aortic approach and find the focus of arrhythmia. This case demonstrates that right upper pulmonary vein mapping is feasible through the retrograde aortic approach and it is also possible to ablate the arrhythmia using the same catheter and approach.

Research paper thumbnail of Scimitar Vein Anomaly with Total Right-Side Pulmonary Vein Return to Inferior Vena Cava Concomitant with Atresia of Upper Right-Side Pulmonary Vein and Secundum Atrial Septal Defect

The Heart Surgery Forum, 2009

Scimitar vein is the partial anomalous pulmonary venous connection usually draining lower pulmona... more Scimitar vein is the partial anomalous pulmonary venous connection usually draining lower pulmonary lobe to the inferior vena cava or right atrium. We present a scimitar vein anomaly in a 34-year-old woman with the uncommon association of a secundum type of atrial septal defect and atretic right upper pulmonary vein. She presented with increasing dyspnea for 2 months, however, she was asymptomatic in the past 10 years despite the presence of atrial septal defect. We describe its diagnostic and surgical approach.

Research paper thumbnail of Posteroseptal accessory pathway in association with coronary sinus diverticulum: electrocardiographic description and result of catheter ablation

Journal of Interventional Cardiac Electrophysiology, 2013

Aims A precise knowledge of the coronary sinus (CS) anatomy and its potential anomalies seems ess... more Aims A precise knowledge of the coronary sinus (CS) anatomy and its potential anomalies seems essential to increase the rate of success in patients with a prior history of multiple ablation failures of the posteroseptal accessory pathway or in whom this procedure cannot be performed easily. We aimed to describe the anatomic and electrocardiographic characteristics of the CS diverticulum in association with the posteroseptal accessory pathway and subsequent catheter ablation results. Methods We retrospectively recruited 12 patients with posteroseptal accessory pathways associated with CS diverticula from patients referred to Tehran Heart Center for electrophysiological study and ablation between January 2004 and December 2011. Results The study population consisted of eight males and four females at a mean age of 48.2±17.5 years with posteroseptal accessory pathways. The most frequent initial presentation was orthodromic atrioventricular re-entrant tachycardia and atrial fibrillation. The rate of acute success for radiofrequency ablation and the recurrence rate were 75 and 16.6 %, respectively. Larger diverticula tended to have more failure and recurrence rate, albeit not significant. None of the patient's characteristics could significantly predict the success of the ablation.

Research paper thumbnail of Glomerular filtration rate is related to severity of obstructive coronary artery disease in patients undergoing coronary angiography

International Urology and Nephrology, 2012

Purpose Chronic kidney disease is independently associated with an increased risk of cardiovascul... more Purpose Chronic kidney disease is independently associated with an increased risk of cardiovascular events; however, the relationship between the glomerular filtration rate (GFR) and coronary artery disease (CAD) in patients undergoing coronary angiography has yet to be fully elucidated. Methods This retrospective study enrolled a total of 7968 patients who underwent diagnostic coronary artery catheterization [mean age = 54.8 ± 10.6 years, 74.4% males] and did not have any previous history of coronary revascularization, diabetes mellitus, hypertension, end-stage renal disease treated by dialysis or renal transplantation, and were not taking diuretics or drugs acting on renin angiotensin system. The severity of CAD was defined as the number of coronary arteries with a luminal stenosis C50% on the angiogram, and the GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Results There were 2133 (26.8%) patients with GFR C 90 ml/min/1.73 m 2 , 4574 (57.4%) patients with 60 B GFR \ 90 ml/min/1.73 m 2 , 1073 (13.5%) with 45 B GFR \ 60 ml/min/1.73 m 2 and 181 (2.3%) with 15 \ GFR \ 45 ml/min/1.73 m 2 . After adjustment for traditional cardiovascular risk factors (age, sex, dyslipidemia, low to high-density lipoprotein ratio, smoking status, and family history), the GFR showed a significant association with the severity of CAD and remained a significant predictor of CAD (Odds Ratio raised from 1.1 in patients with 60 B GFR \ 90 ml/min/1.73 m 2 to 1.8 in patients with 15 \ GFR \ 45 ml/min/1.73 m 2 ). Conclusions A reduced kidney function, even mildly, is significantly associated with CAD severity, independently of other traditional CAD risk factors.

Research paper thumbnail of Correlation between ABO blood groups, major risk factors, and coronary artery disease

International Journal of Cardiology, 2006

To investigate a possible association of ABO blood groups with coronary artery disease in well-do... more To investigate a possible association of ABO blood groups with coronary artery disease in well-documented patients, we designed a crosssectional study of 2026 patients, known case of coronary artery disease in angiography, who underwent coronary artery bypass graft at Tehran Heart Center, with regard to coronary artery disease major risk factors as well as ABO blood groups. Analysis did not show any significant difference between the frequency of ABO blood groups in coronary artery disease patients compared to the Iranian general population. In addition, frequency of cardiac risk factors was similar in coronary artery disease patients with different blood groups. Therefore, these finding suggest that there is no correlation between various ABO blood groups and development of coronary artery disease. Moreover, the prevalence of major risk factors was equal in patients with different blood groups, and blood groups had no impact on development of premature coronary artery disease in individual subjects. D

Research paper thumbnail of Nonlinear association between serum testosterone levels and coronary artery disease in Iranian men

European Journal of Epidemiology, 2009

Previous studies have shown controversial results about the role of androgens in coronary artery ... more Previous studies have shown controversial results about the role of androgens in coronary artery disease (CAD). We performed this study to examine and compare the relationship between androgenic hormones and CAD using conventional linear statistical techniques as well as novel non-linear approaches. The study was conducted on 502 consecutive men who were referred for selective coronary angiography at Tehran Heart Center due to different indications. We studied the relationship between androgenic hormones and CAD by using the generalized linear models, generalized additive models, and neural networks. Free testosterone (fT), total testosterone (tT) and dehydroepiandrosterone sulfate levels in patients with significant CAD versus normal individuals were 6.69 ± 3.20 pg/ml, 16.60 ± 6.66 nm/l, and 113.38 ± 72.9 lg/dl versus 7.12 ± 3.58 pg/ ml, 15.82 ± 7.26 nm/l, and 109.03 ± 68.19 lg/dl, respectively (P [ 0.05). The Generalized linear models was unable to show any significant relationship between androgenic hormones and CAD, while generalized additive model and neural networks supported the significant effect of androgenic hormones on CAD. This finding suggests a nonlinear association of tT levels with CAD: lower levels have a preventive effect on CAD, whereas higher values increase the risk of CAD. Emphasizing the non-linearity of the variables may provide new insight into the possible explanation of the effect of androgenic hormones on CAD.

Research paper thumbnail of Association between Androgenic Hormone Levels and Left Ventricular Ejection Fraction

The Journal of Tehran University Heart Center, Aug 31, 2010

Methods: The study population consisted of 515 consecutive men who were referred for angiographic... more Methods: The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF < 35%, EF = 35-45%, EF = 45-54%, and EF ≥ 55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone (fT), total testosterone (tT), and dehydroepiandrosterone sulfate (DHEAS). To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF < 35% and the ones with EF ≥ 35%.

Research paper thumbnail of Premedication for coronary angiography: effects on anxiety and hemodynamic status

Indian Heart Journal, 2007

AIM: This study was designed to compare the outcomes of two current methods of premedication, for... more AIM: This study was designed to compare the outcomes of two current methods of premedication, for coronary angiography with placebo, on the level of anxiety and hemodynamic status.METHODS AND RESULTS: In all, 151 patients referring for coronary angiography were randomized into three groups with equal populations. The first group (group M) received 0.02 mg/kg intravenous midazolam; the second (group DP7rpar; received intramuscular injection of 5mg diazepam + 25 mg promethazine; and the third (group P) received 2cc of intravenous normal saline solution. Vital signs, blood pressure, and peripheral O2 saturation were recorded in specifically-designed questionnaires. The level of anxiety before and after angiography was documented according to the Visual Analog Scale. Patients in the group M accidentally had higher pre-procedural anxiety level (p < 0.05). There was no significant difference in pulse rate, respiratory rate, and mean blood pressure (BP) between these groups prior to angiography. In the group M, diastolic BP decreased more significantly than the other 2 groups during angiography (p < 0.05). Although number of punctures, pain at catheterization site, dose of lidocaine, level of consciousness, and patient satisfaction did not show a significant difference between the three groups; midazolam induced higher level of amnesia than the other 2 groups and the physicians were more satisfied with it only compared with diazepam + promethazine (p < 0.05).CONCLUSION: Because of the importance of hemodynamic stability and comfort during angiography, non-pharmacologic approaches are preferred. In case of severity and persistence of autonomic system stimulation, the least effective dose of midazolam for a short period of time may be used.

Research paper thumbnail of Correlation between Plasma Adiponectin Levels and the Presence and Severity of Coronary Artery Disease

The Journal of Tehran University Heart Center, Jul 1, 2013

The existing evidence suggests that plasma adiponectin concentrations can be indicative of the pr... more The existing evidence suggests that plasma adiponectin concentrations can be indicative of the presence and severity of coronary artery disease (CAD). However, the results of the studies conducted hitherto on this subject are inconsistent. We sought to investigate the possible correlation between plasma adiponectin levels and the presence and severity of CAD in patients undergoing non-urgent coronary angiography. In 399 consecutive patients undergoing non-urgent coronary angiography for CAD survey, plasma adiponectin, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, and fasting blood sugar levels were measured and demographic characteristics such as age, sex, Body Mass Index, diabetes mellitus history, systemic hypertension history, and family history of CAD were collected. According to the angiography results, the patients were divided into two groups of CAD and non-CAD. The severity of coronary atherosclerosis in the CAD group was defined using the Gensini score system. Average age was 61.4 ± 9.94 years in the CAD group and 57.9 ± 10.75 years in the non-CAD group. Also, 73.7% of the CAD group and 55.4% of the non-CAD group were male. Totally, 278 (69.7%) patients were found to have CAD. Patients without CAD did not have higher mean plasma adiponectin concentrations than did those with CAD (13.38 ± 11.96 vs. 14.95 ± 14.11 mcg/ml; p value = 0. 896). After adjustment for CAD conventional risk factors, plasma adiponectin levels still were not associated with CAD. No association was found between plasma adiponectin levels and the Gensini score. Furthermore, in contrast to the fairly strong correlation previously reported, there was no correlation between adiponectin levels and conventional CAD risk factors. We could not observe any relationship between plasma adiponectin concentrations and the presence or severity of CAD in patients undergoing coronary angiography.

Research paper thumbnail of Ablation of Focal Right Upper Pulmonary Vein Tachycardia Using Retrograde Aortic Approach

The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a... more The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a main source of ectopic beats for the initiation of atrial dysrrythmias is strongly recommended. We report the case of a 13-year-old girl who was admitted to our hospital with the electrocardiogram manifestation of an ectopic atrial tachycardia. The focus of arrhythmia was inside the right upper pulmonary vein. The patient underwent successful ablation with a conventional electrophysiology catheter via the retrograde aortic approach. We showed that when the origin of atrial tachycardia is in the right upper pulmonary vein, it is possible to advance the catheter into this vein via the retrograde aortic approach and find the focus of arrhythmia. This case demonstrates that right upper pulmonary vein mapping is feasible through the retrograde aortic approach and it is also possible to ablate the arrhythmia using the same catheter and approach.

Research paper thumbnail of Association between Traditional Risk Factors and Coronary Artery Ectasia: A Study on 10057 Angiographic Procedures among Iranian Population

The journal of Tehran Heart Center, Jan 12, 2014

Whether coronary artery ectasia (CAE) is a unique clinical finding or results from other clinical... more Whether coronary artery ectasia (CAE) is a unique clinical finding or results from other clinical entities is still unknown. We aimed to determine the CAE prevalence, investigate the relationship between CAE and patients' demographic and clinical characteristics, and assess the prognosis at follow-up in a sample of Iranian population. Totally, 10057 patients who underwent coronary angiography were divided into three categories: normal coronary arteries without co-existing coronary artery disease; CAE without co-existing coronary artery narrowing < 50%; and coronary artery stenosis with > 50% luminal narrowing (CAS). The prevalence of CAE was 1.5%. Compared to the normal individuals, the CAE patients were older, were more frequently male, and had higher rates of myocardial infarction (MI). The CAE patients had a lower frequency of diabetes and MI than the CAS group. The CAE patients were largely focused between 40 to 60 years of age. The right coronary and left anterior des...

Research paper thumbnail of Correlation between Plasma Adiponectin Levels and the Presence and Severity of Coronary Artery Disease

The journal of Tehran Heart Center, 2013

The existing evidence suggests that plasma adiponectin concentrations can be indicative of the pr... more The existing evidence suggests that plasma adiponectin concentrations can be indicative of the presence and severity of coronary artery disease (CAD). However, the results of the studies conducted hitherto on this subject are inconsistent. We sought to investigate the possible correlation between plasma adiponectin levels and the presence and severity of CAD in patients undergoing non-urgent coronary angiography. In 399 consecutive patients undergoing non-urgent coronary angiography for CAD survey, plasma adiponectin, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, and fasting blood sugar levels were measured and demographic characteristics such as age, sex, Body Mass Index, diabetes mellitus history, systemic hypertension history, and family history of CAD were collected. According to the angiography results, the patients were divided into two groups of CAD and non-CAD. The severity of coronary atherosclerosis in the CAD group was ...

Research paper thumbnail of Association between Androgenic Hormone Levels and Left Ventricular Ejection Fraction

The journal of Tehran Heart Center, 2010

Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this s... more Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this study was to compare androgenic hormone levels in patients with different left ventricular ejection fractions (EF). The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF < 35%, EF = 35-45%, EF = 45-54%, and EF ≥ 55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone (fT), total testosterone (tT), and dehydroepiandrosterone sulfate (DHEAS). To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF < 35% and the ones with EF ≥ 35%. There were statistically significant trends in some characteristics in the patients with differen...

Research paper thumbnail of Premedication for coronary angiography: effects on anxiety and hemodynamic status

Indian heart journal

This study was designed to compare the outcomes of two current methods of premedication, for coro... more This study was designed to compare the outcomes of two current methods of premedication, for coronary angiography with placebo, on the level of anxiety and hemodynamic status. In all, 151 patients referring for coronary angiography were randomized into three groups with equal populations. The first group (group M) received 0.02 mg/kg intravenous midazolam; the second (group DP7rpar; received intramuscular injection of 5mg diazepam + 25 mg promethazine; and the third (group P) received 2cc of intravenous normal saline solution. Vital signs, blood pressure, and peripheral O2 saturation were recorded in specifically-designed questionnaires. The level of anxiety before and after angiography was documented according to the Visual Analog Scale. Patients in the group M accidentally had higher pre-procedural anxiety level (p < 0.05). There was no significant difference in pulse rate, respiratory rate, and mean blood pressure (BP) between these groups prior to angiography. In the group M,...

Research paper thumbnail of The relationship between level of androgenic hormones and coronary artery disease in men

Cardiovascular journal of Africa

Previous studies have shown controversial results on the role of androgens in coronary artery dis... more Previous studies have shown controversial results on the role of androgens in coronary artery disease (CAD). We performed this study to assess the relationship between androgen levels and selective coronary angiography (SCA) findings. This study was conducted on 502 consecutive men who underwent SCA with different indications in our centre. Medical history and blood samples were taken from all subjects prior to angiography. Free testosterone (FREET) was measured with enzyme-linked immunosorbent assay, and total testosterone (TES) plus dehydroepiandrosterone sulfate (DHEA) were checked with radio-immunoassay. Total cholesterol, high- and low-density lipoprotein cholesterol (HDL and LDL), triglycerides, lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) were also tested in all patients. Angiographic results were reported by two cardiologists and checked for intra- and inter-observer reliability, then interpreted as Gensini score, and on the basis of the number of segments involved. ...

Research paper thumbnail of Homocysteine, vitamin B12 and folate levels in premature coronary artery disease

BMC cardiovascular disorders, 2006

Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable ... more Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD. We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran. After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine le...

Research paper thumbnail of Hyperuricemia and the Presence and Severity of Coronary Artery Disease

Laboratory Medicine, 2009

Background: Few studies have assessed the relation of hyperuricemia with the severity of coronary... more Background: Few studies have assessed the relation of hyperuricemia with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid levels with the presence and severity of CAD.

Research paper thumbnail of 902 Normal values for ventricular synchrony measured by tissue Doppler imaging and tissue Doppler synchronization imaging in structurally normal hearts

European Journal of Echocardiography, 2006

Research paper thumbnail of Association between R353Q polymorphism for coagulative factor VII and severity of coronary artery disease in Iranian population

Cardiology Journal, 2013

Background: Recent research has supported the central role of coagulative factors in advancing at... more Background: Recent research has supported the central role of coagulative factors in advancing atherosclerosis and causing coronary artery disease (CAD). The present study, for the first time, aimed to clarify the relationship between R353Q polymorphism for factor VII and the occurrence and severity of CAD in a large sample of Iranian population. Methods: Nine hundred and nineteen consecutive patients with suspected CAD, who candidated for coronary angiography in the Tehran Heart Center between January 2006 and March 2007, were examined. The number of diseased coronary vessels was determined, and the severity of CAD was assessed by the Gensini score. Genotyping was done via the PCR-RFLP method. Results: The frequency of Q and R alleles was 74.1% and 25.9% in the patients with CAD and 75.2% and 24.8% in those without CAD, with an insignificant difference (p = 0.625). The frequency of Q allele in the patients with single-vessel, two-vessel, and three-vessel diseases was 72.8%, 71.5%, and 76.4%, respectively; the difference was also insignificant (p = 0.379). No relationship was observed between the distribution of the genotypes and the number of the involved coronary vessels. The average of the Gensini score was 43.39 ± 46.18 in the patients with QQ genotype, 38.87 ± 42.89 in those with QR genotype, and 55.61 ± 53.80 in the ones with RR genotype, with the difference not constituting any statistical significance (p = 0.084).

Research paper thumbnail of Predictive Power of the Baseline QRS Complex Duration for Clinical Response to Cardiac Resynchronisation Therapy

EUROPEAN JOURNAL OF CARDIOVASCULAR MEDICINE, 2011

Background: Determination of predictors of response to cardiac resynchronisation therapy (CRT) in... more Background: Determination of predictors of response to cardiac resynchronisation therapy (CRT) in patients with moderate to severe heart failure accompanied by a ventricular dyssynchrony can play a major role in improving candidate selection for CRT.

Research paper thumbnail of Ablation of focal right upper pulmonary vein tachycardia using retrograde aortic approach

The journal of Tehran Heart Center, 2010

The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a... more The use of diagnostic and therapeutic methods for assessing pulmonary vein due to its status as a main source of ectopic beats for the initiation of atrial dysrrythmias is strongly recommended. We report the case of a 13-year-old girl who was admitted to our hospital with the electrocardiogram manifestation of an ectopic atrial tachycardia. The focus of arrhythmia was inside the right upper pulmonary vein. The patient underwent successful ablation with a conventional electrophysiology catheter via the retrograde aortic approach. We showed that when the origin of atrial tachycardia is in the right upper pulmonary vein, it is possible to advance the catheter into this vein via the retrograde aortic approach and find the focus of arrhythmia. This case demonstrates that right upper pulmonary vein mapping is feasible through the retrograde aortic approach and it is also possible to ablate the arrhythmia using the same catheter and approach.

Research paper thumbnail of Scimitar Vein Anomaly with Total Right-Side Pulmonary Vein Return to Inferior Vena Cava Concomitant with Atresia of Upper Right-Side Pulmonary Vein and Secundum Atrial Septal Defect

The Heart Surgery Forum, 2009

Scimitar vein is the partial anomalous pulmonary venous connection usually draining lower pulmona... more Scimitar vein is the partial anomalous pulmonary venous connection usually draining lower pulmonary lobe to the inferior vena cava or right atrium. We present a scimitar vein anomaly in a 34-year-old woman with the uncommon association of a secundum type of atrial septal defect and atretic right upper pulmonary vein. She presented with increasing dyspnea for 2 months, however, she was asymptomatic in the past 10 years despite the presence of atrial septal defect. We describe its diagnostic and surgical approach.

Research paper thumbnail of Posteroseptal accessory pathway in association with coronary sinus diverticulum: electrocardiographic description and result of catheter ablation

Journal of Interventional Cardiac Electrophysiology, 2013

Aims A precise knowledge of the coronary sinus (CS) anatomy and its potential anomalies seems ess... more Aims A precise knowledge of the coronary sinus (CS) anatomy and its potential anomalies seems essential to increase the rate of success in patients with a prior history of multiple ablation failures of the posteroseptal accessory pathway or in whom this procedure cannot be performed easily. We aimed to describe the anatomic and electrocardiographic characteristics of the CS diverticulum in association with the posteroseptal accessory pathway and subsequent catheter ablation results. Methods We retrospectively recruited 12 patients with posteroseptal accessory pathways associated with CS diverticula from patients referred to Tehran Heart Center for electrophysiological study and ablation between January 2004 and December 2011. Results The study population consisted of eight males and four females at a mean age of 48.2±17.5 years with posteroseptal accessory pathways. The most frequent initial presentation was orthodromic atrioventricular re-entrant tachycardia and atrial fibrillation. The rate of acute success for radiofrequency ablation and the recurrence rate were 75 and 16.6 %, respectively. Larger diverticula tended to have more failure and recurrence rate, albeit not significant. None of the patient's characteristics could significantly predict the success of the ablation.

Research paper thumbnail of Glomerular filtration rate is related to severity of obstructive coronary artery disease in patients undergoing coronary angiography

International Urology and Nephrology, 2012

Purpose Chronic kidney disease is independently associated with an increased risk of cardiovascul... more Purpose Chronic kidney disease is independently associated with an increased risk of cardiovascular events; however, the relationship between the glomerular filtration rate (GFR) and coronary artery disease (CAD) in patients undergoing coronary angiography has yet to be fully elucidated. Methods This retrospective study enrolled a total of 7968 patients who underwent diagnostic coronary artery catheterization [mean age = 54.8 ± 10.6 years, 74.4% males] and did not have any previous history of coronary revascularization, diabetes mellitus, hypertension, end-stage renal disease treated by dialysis or renal transplantation, and were not taking diuretics or drugs acting on renin angiotensin system. The severity of CAD was defined as the number of coronary arteries with a luminal stenosis C50% on the angiogram, and the GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Results There were 2133 (26.8%) patients with GFR C 90 ml/min/1.73 m 2 , 4574 (57.4%) patients with 60 B GFR \ 90 ml/min/1.73 m 2 , 1073 (13.5%) with 45 B GFR \ 60 ml/min/1.73 m 2 and 181 (2.3%) with 15 \ GFR \ 45 ml/min/1.73 m 2 . After adjustment for traditional cardiovascular risk factors (age, sex, dyslipidemia, low to high-density lipoprotein ratio, smoking status, and family history), the GFR showed a significant association with the severity of CAD and remained a significant predictor of CAD (Odds Ratio raised from 1.1 in patients with 60 B GFR \ 90 ml/min/1.73 m 2 to 1.8 in patients with 15 \ GFR \ 45 ml/min/1.73 m 2 ). Conclusions A reduced kidney function, even mildly, is significantly associated with CAD severity, independently of other traditional CAD risk factors.

Research paper thumbnail of Correlation between ABO blood groups, major risk factors, and coronary artery disease

International Journal of Cardiology, 2006

To investigate a possible association of ABO blood groups with coronary artery disease in well-do... more To investigate a possible association of ABO blood groups with coronary artery disease in well-documented patients, we designed a crosssectional study of 2026 patients, known case of coronary artery disease in angiography, who underwent coronary artery bypass graft at Tehran Heart Center, with regard to coronary artery disease major risk factors as well as ABO blood groups. Analysis did not show any significant difference between the frequency of ABO blood groups in coronary artery disease patients compared to the Iranian general population. In addition, frequency of cardiac risk factors was similar in coronary artery disease patients with different blood groups. Therefore, these finding suggest that there is no correlation between various ABO blood groups and development of coronary artery disease. Moreover, the prevalence of major risk factors was equal in patients with different blood groups, and blood groups had no impact on development of premature coronary artery disease in individual subjects. D

Research paper thumbnail of Nonlinear association between serum testosterone levels and coronary artery disease in Iranian men

European Journal of Epidemiology, 2009

Previous studies have shown controversial results about the role of androgens in coronary artery ... more Previous studies have shown controversial results about the role of androgens in coronary artery disease (CAD). We performed this study to examine and compare the relationship between androgenic hormones and CAD using conventional linear statistical techniques as well as novel non-linear approaches. The study was conducted on 502 consecutive men who were referred for selective coronary angiography at Tehran Heart Center due to different indications. We studied the relationship between androgenic hormones and CAD by using the generalized linear models, generalized additive models, and neural networks. Free testosterone (fT), total testosterone (tT) and dehydroepiandrosterone sulfate levels in patients with significant CAD versus normal individuals were 6.69 ± 3.20 pg/ml, 16.60 ± 6.66 nm/l, and 113.38 ± 72.9 lg/dl versus 7.12 ± 3.58 pg/ ml, 15.82 ± 7.26 nm/l, and 109.03 ± 68.19 lg/dl, respectively (P [ 0.05). The Generalized linear models was unable to show any significant relationship between androgenic hormones and CAD, while generalized additive model and neural networks supported the significant effect of androgenic hormones on CAD. This finding suggests a nonlinear association of tT levels with CAD: lower levels have a preventive effect on CAD, whereas higher values increase the risk of CAD. Emphasizing the non-linearity of the variables may provide new insight into the possible explanation of the effect of androgenic hormones on CAD.