Shervin Ziabakhsh Tabary | Mazandaran University of Medical Sciences (original) (raw)
Papers by Shervin Ziabakhsh Tabary
Health (Irvine, Calif.), 2014
This study aims to compare the quality of family and social relationships and Type D personality ... more This study aims to compare the quality of family and social relationships and Type D personality in cardiovascular patients with normal people. In this research, 300 individuals (n = 150 male, 150 female) are divided in two groups of patient (n = 150) and non-patients (n = 150) were selected as samples from the author's offices (both private and his office in Mazandaran Heart Center). They attended in this study filling the questionnaires of "Pierce Quality relations" and "Personality Inventory (DS14)". In order to analyze data, First observations were described by the help of descriptive statistics methods including tables, graphs, and indices of central tendency and distribution. Then, observations were described by inferential statistics methods such as univariate and multivariate analysis of variance and then were analyzed by SPSS. Out of the 300 participants, 108 patients (36%) had the mean age of 52 to 63 years old and 30 patients (10%) were 30 to 40 years old. This study showed that there is a significant difference between cardiovascular patients and control group in terms of quality of family and social relationships and Type D personality (P < 0.01). Cardiovascular patients have lower quality of family and social relationships, social support, as well as lower depth of relationships, and also higher relationship conflict than normal * Corresponding author. S. Z. Tabary et al. 2136 people. Also cardiovascular patients have higher type D personality than normal people (P < 0.01). In general, research findings indicate the importance of psychological factors associated with coronary artery disease.
Atrial Fibrillation is a common, usually self -limiting arrhythmia occurs after CABG
Atrial Fibrillation is a common, usually self -limiting arrhythmia occurs after CABG, but it may ... more Atrial Fibrillation is a common, usually self -limiting arrhythmia occurs after CABG, but it may lead to longer hospital stay, cerebrovascular accidents, and more hospital costs. A large number of predisposing factor have been said to be involved, the main is elder age. We want to study if smoking also is a risk factor to predispose the patients to Atrial Fibrillation. We analyzed the files of 598 patients who had undergone CABG by the author from Jan. 2008 till Dec. 2012, in Mazandaran Heart Center, Sari, Iran. Allof them except the ones who had history of arrhythmia were included in study. Among 598 patients underwent CABG by the author, There was a history of Cigarette smoking in %38 and opium addict in %33, among the addict patients %63 were cigarette smokers also. Atrial fibrillation in smokers occurred more than nonsmokers statistically significant(Pv=0.030).
Background: the aim of this study was assessment the clinical and paraclinical effects of enhance... more Background: the aim of this study was assessment the clinical and paraclinical effects of enhanced external counter pulsation (EECP) therapy in patients with coronary artery disease. Patients and Methods: We performed a retrospective analysis of data related to all patients who received EECP treatment at Shafa hospitals in Sari, Iran from 21 March 2013 to 21 March 2015. All patient’s data included demographic data, history of underlying disease, clinical sign and symptom, laboratory data (hemoglobin, triglyceride (TG), cholesterol, Low-density lipoprotein (LDL), High-density lipoprotein (HDL)) and left ventricular ejection fraction (LVEF) in before and after treatment by EECP were collected. Results: the data of 48 patients (include 25 men) with mean age of 62.20±10.15 years were collected. The mean of TG, Cholesterol, LDL and HDL were not significantly change after EECP therapy. However, the mean of hemoglobin (10.47±0.81mg/dl vs. 10.20±1.03mg/dl, P=0.019) and LVEF (40.10±5.40% vs....
Ischemic heart disease is the most common cause of mortality in the developing countries. In Iran... more Ischemic heart disease is the most common cause of mortality in the developing countries. In Iran 15 million from 70 million people suffer from cardiovascular disease. The most important risk factors are age; male sex; family history; hyperlipidemia; hypertension; diabete mellitus; obesity and smoking. Blood group was studied as a risk factor for many diseases like peptic ulcer, carcinoma of stomach, periodontal diseases and diabetes mellitus. With the background of conflicting results, the present study was done to evaluate association of ABO blood groups and Rh with IHD in our setting. This analytic comparative study was done at the department of Cardiology, Mazandaran Heart Center Sari .Total 1020 persons were included in the study. Statistical analysis was done using SPSS 16. ANOVA and Chi-square tests for significance were used. P-value less than 0.05 was taken as significant. There is not any association between ABO blood groups and Rh with ischemic heart disease (IHD) in our ...
Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood... more Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG). Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG. Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 v...
This study aimed to examine the presence of anxiety in patients before and after coronary artery ... more This study aimed to examine the presence of anxiety in patients before and after coronary artery bypass grafting surgery (CABG). Additionally, its relationship to patient's quality of life (QOL), because of effects of psychological factors such as anxiety on CABGs outcomes. Comprehensive data on 187 patients who underwent CABGs were prospectively collected in Fatemeh Zahra university hospital in Sari/Iran preoperative and 18 months follow-up anxiety and QOL in functional status were measured using the state portion of the Spielberger State-Trait anxiety inventory (STAI) and Short Form Health Survey (SF-36) questionnaire respectively. State anxiety scores ranged from 23-67 with a mean of 38±-9.95 before and 20-65 with a mean of 32±-9.40 in 18 months after CABGs. This study demonstrated that most patients (N=108, 57.8 and N=115, 61.5) had low levels of anxiety at both time, respectively. The present study showed significant positive association between pre and postoperative state ...
Medical Archives
Introduction: Integrity of the great saphenous vein (GSV) endothelium is the most important key e... more Introduction: Integrity of the great saphenous vein (GSV) endothelium is the most important key element for long-term patency rate of grafts in coronary artery bypass graft (CABG). Storage solutions play an important role in maintaining viability of vein endothelium. Diminished nitric oxide (NO) because of endothelial dysfunction may facilitate vascular inflammation and formation of atherosclerotic plaque. Aim: So, we decided to find a reasonable alternative preservative solution instead of heparinized blood (HB) by measuring NO concentration with Griess assay. Material and Method: SVG samples were obtained from 54 patients undergoing elective CABG. 3 mm rings were stored in solutions: heparinized blood (HB), Krebs (K), Krebs + Propranolol (K+P) 6.66 g/l, Krebs + Adrenaline (K+A) 200 µl/l, and Krebs + Verapamil (K+V) 200 µl/l for 30, 45, 60 and 90 min. Nitrite concentration was measured by Griess assay at 540 nm. H&E staining was performed for histologic test. Statistical analysis was performed using SPSS (V16). Results were expressed as (Means ± SE) followed by One-Way ANOVA for finding best preservative solution. Repeated measurement test was used to investigate best time. In all analysis, (P<0.05) was considered significant. Results: Average concentration of NO in (K+V) compare with HB (1 st control), K (2 nd control), (K+A) and (K+P) showed higher rate in all times from 30 to 90 min (16.55±1.85) and in (K+A, K+P) compare with (HB) and (K) there was no statistically significant difference in the same times. Comparing the average concentration of (NO) between (HB) and (K) showed no significant difference (K+V>HB=K=K+A=K+P). Also, our investigations showed that NO concentration in (K+V) has the highest rate in time 90 min (10.07±0.56, p=0.002). More than 50 percent of endothelial cells stay normal in (K+V) compare with other solutions. Conclusion: It seems that (K+V) is the best solution for the maintenance of normal physiology of SVGs endothelial cells. The most appropriate SVGs endothelial function is within 90 minutes after harvesting.
Multidisciplinary Cardiovascular Annals
Medical Archives, 2014
Introduction: Although blood transfusion is life saving for patients, it is responsible for a ser... more Introduction: Although blood transfusion is life saving for patients, it is responsible for a series of complications and exposes the patients to a variety of risks. Therefore knowing different adverse effects of blood transfusion represents a great issue in managing recipient patients. Aim: The aim of the present work was to study the prevalence of blood transfusion complications among patients in the Mazandaran Heart Center, Sari, Iran, during a period of 2 years. Material and Methods: A retrospective review of all reported and evaluated acute transfusion reactions during a 2 years period in Mazandaran Heart Center was performed. Associated clinical signs and symptoms were evaluated. Results: In 9193 transfused blood products, there was 34 (0.4%) acute transfusion reactions. The commonest were discomfort and restlessness(0.16%),dyspnea(0.16%), rigors (0.13%), fever (0.08%),chest pain(0.06%), rash or urticaria (0.04%), nausea and vomiting(0.03%),palpitation(0.03%),hypertension(0.03%)flashing(0.02%),hypotension(0.02%). Conclusion: Acute transfusion reaction is seen in %0.4 of transfused patients therefore, we recommend a well-structured program for monitoring adverse reactions associated with blood transfusion and blood product administration (Hemovigilance program).
Health, 2014
This study aims to compare the quality of family and social relationships and Type D personality ... more This study aims to compare the quality of family and social relationships and Type D personality in cardiovascular patients with normal people. In this research, 300 individuals (n = 150 male, 150 female) are divided in two groups of patient (n = 150) and non-patients (n = 150) were selected as samples from the author's offices (both private and his office in Mazandaran Heart Center). They attended in this study filling the questionnaires of "Pierce Quality relations" and "Personality Inventory (DS14)". In order to analyze data, First observations were described by the help of descriptive statistics methods including tables, graphs, and indices of central tendency and distribution. Then, observations were described by inferential statistics methods such as univariate and multivariate analysis of variance and then were analyzed by SPSS. Out of the 300 participants, 108 patients (36%) had the mean age of 52 to 63 years old and 30 patients (10%) were 30 to 40 years old. This study showed that there is a significant difference between cardiovascular patients and control group in terms of quality of family and social relationships and Type D personality (P < 0.01). Cardiovascular patients have lower quality of family and social relationships, social support, as well as lower depth of relationships, and also higher relationship conflict than normal * Corresponding author. S. Z. Tabary et al. 2136 people. Also cardiovascular patients have higher type D personality than normal people (P < 0.01). In general, research findings indicate the importance of psychological factors associated with coronary artery disease.
European review for medical and pharmacological sciences, 2013
Coronary artery bypass grafting (CABG) is a revascularization technique that has been reported as... more Coronary artery bypass grafting (CABG) is a revascularization technique that has been reported as having satisfactory survival rates in Hemodialysis (HD) dependent patients. The aim of this study was to determine morbidity and mortality of isolated CABG in HD-dependent patients and compare with non- renal failure (RF) patients. We performed a retrospective analysis of data related to all patients who underwent first time, on-pump, isolated CABG surgery between May 23, 2004 to September 22, 2012, we selected 32 CRF patients with history of chronic hemodialysis (group HD) and 32 non renal failure patients (group non-HD). The preoperative data of two groups were matched completely. We collected all data of intraoperative and postoperative. Data were analyzed by SPSS version 16. the mean age of HD group and non-HD group were 52.46±3.24 and 52.12±3.54 years (p = 0.68). Low cardiac output syndrome was occurred in 4 patients (12.5%) of HD group and one patient (3.12%) of non-HD group (p = ...
The Journal of cardiovascular surgery
Mitral regurgitation (MR) is considered as an independent factor in determining prognosis of pati... more Mitral regurgitation (MR) is considered as an independent factor in determining prognosis of patients with myocardial infarction and impacts of untreated insufficiency on long-term results of patients undergoing CABG is well recognized. Regarding proper treatment of mild to moderate regurgitation of mitral valve is controversial and there is little research in this field in our country, we attempted to examine this issue by planning and executing the present study. 40 patients were studied in Mazandaran Heart Center, Sari, Iran in 2012. Echocardiography was done before surgery and ones with mild to moderate ischemic mitral regurgitation were studied. Patients were underwent echocardiography 3 times after surgery. Average score of LVEF in the studied patients increased from 21±2.4% to 32.3±4.8% in a manner that average increasing variation of LVEF in patients, 2 months after surgery was 3.8±10.8%, not showing significant statistic difference, but 6 months after surgery it was increas...
We appreciate the comments of Hilal Olgun Kucuk, Ugur Kucuk et al on our investigation. Actually ... more We appreciate the comments of Hilal Olgun Kucuk, Ugur Kucuk et al on our investigation. Actually we had done that study to show the outcome of CABG in patients who were dependent on hemodialysis in comparison with the other patients that are not dependent to hemodialysis. But in response to the opinion of these Authors that mentioned OPCAB is a way to prevent most of the complications of On-pump CABG we decided to review all previous studies that had compared the On-pump CABG with Off-pump CABG.
Journal of Medical Sciences(Faisalabad), 2008
ABSTRACT From August 1997 to December 2000, 19 patients with aortic regurgitation due to congenit... more ABSTRACT From August 1997 to December 2000, 19 patients with aortic regurgitation due to congenital aortic valve underwent aortic valve repair (17 men and 2 women with a mean age of 42 ± 17 years; range, 16 to 70 years). The mean preoperative aortic regurgitation grade was 3.1 ± 0.8 on a scale of 1 to 4. Mean preoperative New York Heart Association functional class was 1.9 ± 0.8. Fourteen patients had pure aortic regurgitation, 2 also had infectious endocarditis, 1 had angina pectoris and 2 had an ascending aortic aneurysm. There was 1 hospital death (5.2%) and 1 patient required re-operation due to recurrent infectious endocarditis. Mean aortic regurgitation grade at discharge was 1.1 ± 0.9 and functional class was 1.1 ± 0.2. All patients were followed for a mean duration of 40 ± 23 months (range, 0.5 to 84 months). There was 1 late death and two patients required aortic valve replacement. The 5-year survival rate was 90 ± 7%. The 1 and 5-year re-operation-free rates were 87 ± 12 and 76 ± 23%. Bicuspid aortic valve repair is a safe procedure with good early postoperative results. However midterm results are not satisfactory. Re-operation is a promising alternative and progress aortic regurgitation were complications. Bicuspid aortic valve repair to valve replacement that requires additional study to individualize treatment.
Journal of Medical Sciences(Faisalabad), 2008
ABSTRACT The aim of this study was to evaluate the effects of Plavix on blood loss and blood and ... more ABSTRACT The aim of this study was to evaluate the effects of Plavix on blood loss and blood and blood products usage following CABG. Three hundred and ninety two patients underwent urgent or emergent CABG, 364 of those met with inclusion criteria, 56 patients had Plavix exposure (group 1), 98 patients had both ASA and Plavix exposure (group 2) and 136 patients had ASA exposure (group 3) within a week of operation. The remaining 74 patients were on no antiaggregant therapy (group 4). Total chest tube drainage during the first 24 h, the incidence of reoperation for bleeding, blood and blood products usage and the early outcome (duration of mechanical ventilation, the intensive care unit stay and total hospital stay), were assessed. Total chest tube drainage was significantly higher in the patients with Plavix exposure and increased amount of transfusions with blood products were also observed in those patients. The patients with Plavix exposure required significantly more reoperation for bleeding. The duration of controlled ventilation and intensive care unit stay were also significantly longer in the patients with Plavix exposure. Present results support the recent history of Plavix treatment associated with increased blood loss, transfusion and reoperation requirement after CABG.
Caspian journal of internal medicine, 2014
Primary intra cardiac tumors are rare. In this article, we present papillary fibroelastoma of mit... more Primary intra cardiac tumors are rare. In this article, we present papillary fibroelastoma of mitral valve chordae. A 35-year old man presented with atypical chest pain and palpitation. Physical examination and electrocardiogram were normal. Transesophageal echocardiography (TEE) revealed a mass of 1015 mm attached to chordae of anteromedial papillary muscle of mitral valve. The tumor was completely resected and the mitral valve chordae tendineae was preserved successfully. The pathological diagnosis was papillary fibroelastoma. In any patient with atypical chest pain and palpitation, valvular tumor should be considered in differential diagnosis.
Medical Archives, 2014
Hepatitis B virus (HBV) infection is a major global health problem in the worldwide that associat... more Hepatitis B virus (HBV) infection is a major global health problem in the worldwide that associated with significant morbidity and mortality in cardiac surgery. The available data on HBV distribution and genotyping of HBV are very heterogeneous. Therefore in this study, we tried to indicate the prevalence of HBV infections in cardiac catheterization patients referred to health centers in the north of Iran and identified the HBV genotypes using polymerase chain reaction (PCR). In this cross-sectional study, we studied 2650 patients who underwent selective coronary artery angiography and coronary artery bypass grafting in Mazandaran heart center, Sari, Iran from 2011 to 2013. All serum samples were examined to detect HBsAg by ELISA test. HBV-DNA was extracted from HBsAg positive samples using Mini Elute Kit from Qiagen and determined the genotypes of HBV by PCR using the Master Mix kit with Taq-DNA polymerase enzyme and with type of specific primers. All samples were examined in the virology laboratory of Sari Medical School. The mean age of patients was 59.7±10.9 (range, 20 to 81) year that 1590 (60%) patients were male and 1060 (40%) were female. Seventeen cases (0.08 %) were found with hepatitis B virus infection, and the highest rates of infection were reported among those aged 40-60 years old in this study. We found genotype D the predominant type in this study. This study indicates that the prevalence of HBV endemicity in the north of Iran is low and genotype D is the only genotype in patients infected with HBV.
Journal of Cardiothoracic Surgery, 2013
ABSTRACT Background: Erythropoietin (EPO) is known as a regulating hormone for the production of ... more ABSTRACT Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG). Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG. Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 vs. 45.90±4.97; P=0.334) and 30 days after surgery (47.27±28 vs. 46.62±5.7; P=0.69). There were no differences between the EPO and control groups in the wall motion score index at 4 (P=0.83) and 30 days after surgery (P=0.902). In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters (LVESD and LVEDD, respectively), as compared to the control group. Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG. Trial Registration Number: 138809102799N1
Health (Irvine, Calif.), 2014
This study aims to compare the quality of family and social relationships and Type D personality ... more This study aims to compare the quality of family and social relationships and Type D personality in cardiovascular patients with normal people. In this research, 300 individuals (n = 150 male, 150 female) are divided in two groups of patient (n = 150) and non-patients (n = 150) were selected as samples from the author's offices (both private and his office in Mazandaran Heart Center). They attended in this study filling the questionnaires of "Pierce Quality relations" and "Personality Inventory (DS14)". In order to analyze data, First observations were described by the help of descriptive statistics methods including tables, graphs, and indices of central tendency and distribution. Then, observations were described by inferential statistics methods such as univariate and multivariate analysis of variance and then were analyzed by SPSS. Out of the 300 participants, 108 patients (36%) had the mean age of 52 to 63 years old and 30 patients (10%) were 30 to 40 years old. This study showed that there is a significant difference between cardiovascular patients and control group in terms of quality of family and social relationships and Type D personality (P < 0.01). Cardiovascular patients have lower quality of family and social relationships, social support, as well as lower depth of relationships, and also higher relationship conflict than normal * Corresponding author. S. Z. Tabary et al. 2136 people. Also cardiovascular patients have higher type D personality than normal people (P < 0.01). In general, research findings indicate the importance of psychological factors associated with coronary artery disease.
Atrial Fibrillation is a common, usually self -limiting arrhythmia occurs after CABG
Atrial Fibrillation is a common, usually self -limiting arrhythmia occurs after CABG, but it may ... more Atrial Fibrillation is a common, usually self -limiting arrhythmia occurs after CABG, but it may lead to longer hospital stay, cerebrovascular accidents, and more hospital costs. A large number of predisposing factor have been said to be involved, the main is elder age. We want to study if smoking also is a risk factor to predispose the patients to Atrial Fibrillation. We analyzed the files of 598 patients who had undergone CABG by the author from Jan. 2008 till Dec. 2012, in Mazandaran Heart Center, Sari, Iran. Allof them except the ones who had history of arrhythmia were included in study. Among 598 patients underwent CABG by the author, There was a history of Cigarette smoking in %38 and opium addict in %33, among the addict patients %63 were cigarette smokers also. Atrial fibrillation in smokers occurred more than nonsmokers statistically significant(Pv=0.030).
Background: the aim of this study was assessment the clinical and paraclinical effects of enhance... more Background: the aim of this study was assessment the clinical and paraclinical effects of enhanced external counter pulsation (EECP) therapy in patients with coronary artery disease. Patients and Methods: We performed a retrospective analysis of data related to all patients who received EECP treatment at Shafa hospitals in Sari, Iran from 21 March 2013 to 21 March 2015. All patient’s data included demographic data, history of underlying disease, clinical sign and symptom, laboratory data (hemoglobin, triglyceride (TG), cholesterol, Low-density lipoprotein (LDL), High-density lipoprotein (HDL)) and left ventricular ejection fraction (LVEF) in before and after treatment by EECP were collected. Results: the data of 48 patients (include 25 men) with mean age of 62.20±10.15 years were collected. The mean of TG, Cholesterol, LDL and HDL were not significantly change after EECP therapy. However, the mean of hemoglobin (10.47±0.81mg/dl vs. 10.20±1.03mg/dl, P=0.019) and LVEF (40.10±5.40% vs....
Ischemic heart disease is the most common cause of mortality in the developing countries. In Iran... more Ischemic heart disease is the most common cause of mortality in the developing countries. In Iran 15 million from 70 million people suffer from cardiovascular disease. The most important risk factors are age; male sex; family history; hyperlipidemia; hypertension; diabete mellitus; obesity and smoking. Blood group was studied as a risk factor for many diseases like peptic ulcer, carcinoma of stomach, periodontal diseases and diabetes mellitus. With the background of conflicting results, the present study was done to evaluate association of ABO blood groups and Rh with IHD in our setting. This analytic comparative study was done at the department of Cardiology, Mazandaran Heart Center Sari .Total 1020 persons were included in the study. Statistical analysis was done using SPSS 16. ANOVA and Chi-square tests for significance were used. P-value less than 0.05 was taken as significant. There is not any association between ABO blood groups and Rh with ischemic heart disease (IHD) in our ...
Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood... more Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG). Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG. Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 v...
This study aimed to examine the presence of anxiety in patients before and after coronary artery ... more This study aimed to examine the presence of anxiety in patients before and after coronary artery bypass grafting surgery (CABG). Additionally, its relationship to patient's quality of life (QOL), because of effects of psychological factors such as anxiety on CABGs outcomes. Comprehensive data on 187 patients who underwent CABGs were prospectively collected in Fatemeh Zahra university hospital in Sari/Iran preoperative and 18 months follow-up anxiety and QOL in functional status were measured using the state portion of the Spielberger State-Trait anxiety inventory (STAI) and Short Form Health Survey (SF-36) questionnaire respectively. State anxiety scores ranged from 23-67 with a mean of 38±-9.95 before and 20-65 with a mean of 32±-9.40 in 18 months after CABGs. This study demonstrated that most patients (N=108, 57.8 and N=115, 61.5) had low levels of anxiety at both time, respectively. The present study showed significant positive association between pre and postoperative state ...
Medical Archives
Introduction: Integrity of the great saphenous vein (GSV) endothelium is the most important key e... more Introduction: Integrity of the great saphenous vein (GSV) endothelium is the most important key element for long-term patency rate of grafts in coronary artery bypass graft (CABG). Storage solutions play an important role in maintaining viability of vein endothelium. Diminished nitric oxide (NO) because of endothelial dysfunction may facilitate vascular inflammation and formation of atherosclerotic plaque. Aim: So, we decided to find a reasonable alternative preservative solution instead of heparinized blood (HB) by measuring NO concentration with Griess assay. Material and Method: SVG samples were obtained from 54 patients undergoing elective CABG. 3 mm rings were stored in solutions: heparinized blood (HB), Krebs (K), Krebs + Propranolol (K+P) 6.66 g/l, Krebs + Adrenaline (K+A) 200 µl/l, and Krebs + Verapamil (K+V) 200 µl/l for 30, 45, 60 and 90 min. Nitrite concentration was measured by Griess assay at 540 nm. H&E staining was performed for histologic test. Statistical analysis was performed using SPSS (V16). Results were expressed as (Means ± SE) followed by One-Way ANOVA for finding best preservative solution. Repeated measurement test was used to investigate best time. In all analysis, (P<0.05) was considered significant. Results: Average concentration of NO in (K+V) compare with HB (1 st control), K (2 nd control), (K+A) and (K+P) showed higher rate in all times from 30 to 90 min (16.55±1.85) and in (K+A, K+P) compare with (HB) and (K) there was no statistically significant difference in the same times. Comparing the average concentration of (NO) between (HB) and (K) showed no significant difference (K+V>HB=K=K+A=K+P). Also, our investigations showed that NO concentration in (K+V) has the highest rate in time 90 min (10.07±0.56, p=0.002). More than 50 percent of endothelial cells stay normal in (K+V) compare with other solutions. Conclusion: It seems that (K+V) is the best solution for the maintenance of normal physiology of SVGs endothelial cells. The most appropriate SVGs endothelial function is within 90 minutes after harvesting.
Multidisciplinary Cardiovascular Annals
Medical Archives, 2014
Introduction: Although blood transfusion is life saving for patients, it is responsible for a ser... more Introduction: Although blood transfusion is life saving for patients, it is responsible for a series of complications and exposes the patients to a variety of risks. Therefore knowing different adverse effects of blood transfusion represents a great issue in managing recipient patients. Aim: The aim of the present work was to study the prevalence of blood transfusion complications among patients in the Mazandaran Heart Center, Sari, Iran, during a period of 2 years. Material and Methods: A retrospective review of all reported and evaluated acute transfusion reactions during a 2 years period in Mazandaran Heart Center was performed. Associated clinical signs and symptoms were evaluated. Results: In 9193 transfused blood products, there was 34 (0.4%) acute transfusion reactions. The commonest were discomfort and restlessness(0.16%),dyspnea(0.16%), rigors (0.13%), fever (0.08%),chest pain(0.06%), rash or urticaria (0.04%), nausea and vomiting(0.03%),palpitation(0.03%),hypertension(0.03%)flashing(0.02%),hypotension(0.02%). Conclusion: Acute transfusion reaction is seen in %0.4 of transfused patients therefore, we recommend a well-structured program for monitoring adverse reactions associated with blood transfusion and blood product administration (Hemovigilance program).
Health, 2014
This study aims to compare the quality of family and social relationships and Type D personality ... more This study aims to compare the quality of family and social relationships and Type D personality in cardiovascular patients with normal people. In this research, 300 individuals (n = 150 male, 150 female) are divided in two groups of patient (n = 150) and non-patients (n = 150) were selected as samples from the author's offices (both private and his office in Mazandaran Heart Center). They attended in this study filling the questionnaires of "Pierce Quality relations" and "Personality Inventory (DS14)". In order to analyze data, First observations were described by the help of descriptive statistics methods including tables, graphs, and indices of central tendency and distribution. Then, observations were described by inferential statistics methods such as univariate and multivariate analysis of variance and then were analyzed by SPSS. Out of the 300 participants, 108 patients (36%) had the mean age of 52 to 63 years old and 30 patients (10%) were 30 to 40 years old. This study showed that there is a significant difference between cardiovascular patients and control group in terms of quality of family and social relationships and Type D personality (P < 0.01). Cardiovascular patients have lower quality of family and social relationships, social support, as well as lower depth of relationships, and also higher relationship conflict than normal * Corresponding author. S. Z. Tabary et al. 2136 people. Also cardiovascular patients have higher type D personality than normal people (P < 0.01). In general, research findings indicate the importance of psychological factors associated with coronary artery disease.
European review for medical and pharmacological sciences, 2013
Coronary artery bypass grafting (CABG) is a revascularization technique that has been reported as... more Coronary artery bypass grafting (CABG) is a revascularization technique that has been reported as having satisfactory survival rates in Hemodialysis (HD) dependent patients. The aim of this study was to determine morbidity and mortality of isolated CABG in HD-dependent patients and compare with non- renal failure (RF) patients. We performed a retrospective analysis of data related to all patients who underwent first time, on-pump, isolated CABG surgery between May 23, 2004 to September 22, 2012, we selected 32 CRF patients with history of chronic hemodialysis (group HD) and 32 non renal failure patients (group non-HD). The preoperative data of two groups were matched completely. We collected all data of intraoperative and postoperative. Data were analyzed by SPSS version 16. the mean age of HD group and non-HD group were 52.46±3.24 and 52.12±3.54 years (p = 0.68). Low cardiac output syndrome was occurred in 4 patients (12.5%) of HD group and one patient (3.12%) of non-HD group (p = ...
The Journal of cardiovascular surgery
Mitral regurgitation (MR) is considered as an independent factor in determining prognosis of pati... more Mitral regurgitation (MR) is considered as an independent factor in determining prognosis of patients with myocardial infarction and impacts of untreated insufficiency on long-term results of patients undergoing CABG is well recognized. Regarding proper treatment of mild to moderate regurgitation of mitral valve is controversial and there is little research in this field in our country, we attempted to examine this issue by planning and executing the present study. 40 patients were studied in Mazandaran Heart Center, Sari, Iran in 2012. Echocardiography was done before surgery and ones with mild to moderate ischemic mitral regurgitation were studied. Patients were underwent echocardiography 3 times after surgery. Average score of LVEF in the studied patients increased from 21±2.4% to 32.3±4.8% in a manner that average increasing variation of LVEF in patients, 2 months after surgery was 3.8±10.8%, not showing significant statistic difference, but 6 months after surgery it was increas...
We appreciate the comments of Hilal Olgun Kucuk, Ugur Kucuk et al on our investigation. Actually ... more We appreciate the comments of Hilal Olgun Kucuk, Ugur Kucuk et al on our investigation. Actually we had done that study to show the outcome of CABG in patients who were dependent on hemodialysis in comparison with the other patients that are not dependent to hemodialysis. But in response to the opinion of these Authors that mentioned OPCAB is a way to prevent most of the complications of On-pump CABG we decided to review all previous studies that had compared the On-pump CABG with Off-pump CABG.
Journal of Medical Sciences(Faisalabad), 2008
ABSTRACT From August 1997 to December 2000, 19 patients with aortic regurgitation due to congenit... more ABSTRACT From August 1997 to December 2000, 19 patients with aortic regurgitation due to congenital aortic valve underwent aortic valve repair (17 men and 2 women with a mean age of 42 ± 17 years; range, 16 to 70 years). The mean preoperative aortic regurgitation grade was 3.1 ± 0.8 on a scale of 1 to 4. Mean preoperative New York Heart Association functional class was 1.9 ± 0.8. Fourteen patients had pure aortic regurgitation, 2 also had infectious endocarditis, 1 had angina pectoris and 2 had an ascending aortic aneurysm. There was 1 hospital death (5.2%) and 1 patient required re-operation due to recurrent infectious endocarditis. Mean aortic regurgitation grade at discharge was 1.1 ± 0.9 and functional class was 1.1 ± 0.2. All patients were followed for a mean duration of 40 ± 23 months (range, 0.5 to 84 months). There was 1 late death and two patients required aortic valve replacement. The 5-year survival rate was 90 ± 7%. The 1 and 5-year re-operation-free rates were 87 ± 12 and 76 ± 23%. Bicuspid aortic valve repair is a safe procedure with good early postoperative results. However midterm results are not satisfactory. Re-operation is a promising alternative and progress aortic regurgitation were complications. Bicuspid aortic valve repair to valve replacement that requires additional study to individualize treatment.
Journal of Medical Sciences(Faisalabad), 2008
ABSTRACT The aim of this study was to evaluate the effects of Plavix on blood loss and blood and ... more ABSTRACT The aim of this study was to evaluate the effects of Plavix on blood loss and blood and blood products usage following CABG. Three hundred and ninety two patients underwent urgent or emergent CABG, 364 of those met with inclusion criteria, 56 patients had Plavix exposure (group 1), 98 patients had both ASA and Plavix exposure (group 2) and 136 patients had ASA exposure (group 3) within a week of operation. The remaining 74 patients were on no antiaggregant therapy (group 4). Total chest tube drainage during the first 24 h, the incidence of reoperation for bleeding, blood and blood products usage and the early outcome (duration of mechanical ventilation, the intensive care unit stay and total hospital stay), were assessed. Total chest tube drainage was significantly higher in the patients with Plavix exposure and increased amount of transfusions with blood products were also observed in those patients. The patients with Plavix exposure required significantly more reoperation for bleeding. The duration of controlled ventilation and intensive care unit stay were also significantly longer in the patients with Plavix exposure. Present results support the recent history of Plavix treatment associated with increased blood loss, transfusion and reoperation requirement after CABG.
Caspian journal of internal medicine, 2014
Primary intra cardiac tumors are rare. In this article, we present papillary fibroelastoma of mit... more Primary intra cardiac tumors are rare. In this article, we present papillary fibroelastoma of mitral valve chordae. A 35-year old man presented with atypical chest pain and palpitation. Physical examination and electrocardiogram were normal. Transesophageal echocardiography (TEE) revealed a mass of 1015 mm attached to chordae of anteromedial papillary muscle of mitral valve. The tumor was completely resected and the mitral valve chordae tendineae was preserved successfully. The pathological diagnosis was papillary fibroelastoma. In any patient with atypical chest pain and palpitation, valvular tumor should be considered in differential diagnosis.
Medical Archives, 2014
Hepatitis B virus (HBV) infection is a major global health problem in the worldwide that associat... more Hepatitis B virus (HBV) infection is a major global health problem in the worldwide that associated with significant morbidity and mortality in cardiac surgery. The available data on HBV distribution and genotyping of HBV are very heterogeneous. Therefore in this study, we tried to indicate the prevalence of HBV infections in cardiac catheterization patients referred to health centers in the north of Iran and identified the HBV genotypes using polymerase chain reaction (PCR). In this cross-sectional study, we studied 2650 patients who underwent selective coronary artery angiography and coronary artery bypass grafting in Mazandaran heart center, Sari, Iran from 2011 to 2013. All serum samples were examined to detect HBsAg by ELISA test. HBV-DNA was extracted from HBsAg positive samples using Mini Elute Kit from Qiagen and determined the genotypes of HBV by PCR using the Master Mix kit with Taq-DNA polymerase enzyme and with type of specific primers. All samples were examined in the virology laboratory of Sari Medical School. The mean age of patients was 59.7±10.9 (range, 20 to 81) year that 1590 (60%) patients were male and 1060 (40%) were female. Seventeen cases (0.08 %) were found with hepatitis B virus infection, and the highest rates of infection were reported among those aged 40-60 years old in this study. We found genotype D the predominant type in this study. This study indicates that the prevalence of HBV endemicity in the north of Iran is low and genotype D is the only genotype in patients infected with HBV.
Journal of Cardiothoracic Surgery, 2013
ABSTRACT Background: Erythropoietin (EPO) is known as a regulating hormone for the production of ... more ABSTRACT Background: Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG). Methods: Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG. Results: Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 vs. 45.90±4.97; P=0.334) and 30 days after surgery (47.27±28 vs. 46.62±5.7; P=0.69). There were no differences between the EPO and control groups in the wall motion score index at 4 (P=0.83) and 30 days after surgery (P=0.902). In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters (LVESD and LVEDD, respectively), as compared to the control group. Conclusion: Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG. Trial Registration Number: 138809102799N1