Anahita Tavoosi | Tehran University of Medical Sciences (original) (raw)
Papers by Anahita Tavoosi
JACC: Cardiovascular Imaging
PubMed, 2006
Introduction: The aim of this study was to evaluate the treatment of upper ureteral calculi with ... more Introduction: The aim of this study was to evaluate the treatment of upper ureteral calculi with extracorporeal shock wave lithotripsy (SWL) in the supine and prone positions. Materials and methods: A total of 68 patients with upper ureteral calculi underwent SWL. In 35 patients, the procedure was performed in the supine position (group 1), while in the 33 remainders, it was performed in the prone position (group 2). The stone-free rate, the number of SWL sessions required, and the number of shocks per treatment session were compared between the 2 groups. Results: The mean calculus size was 12.4 +/- 3.1 mm and 12.2 +/- 2.9 mm in groups 1 and 2, respectively. The stone-free rate was 81.8% in group 1 and 82.9% in group 2 (P = .91). The number of sessions for achieving the stone-free status was similar in the patients of the 2 groups (1.9 +/- 0.8 in group 1 versus 1.9 +/- 0.8 in group 2; P = .79). The mean number of shock waves per treatment session was not significantly different between the 2 groups. No major complications were seen and none of the patients required hospitalization, placement of a ureteral catheter, or a double-J stent. Conclusion: Our study showed that in the prone position, treatment of the upper ureteral calculi by SWL is as safe and effective as the supine position.
Circulation-cardiovascular Imaging, Aug 1, 2022
Current Atherosclerosis Reports, Jun 26, 2023
Journal of Nuclear Cardiology, May 31, 2023
Background. 82 Rb PET is commonly performed using the same injected activity in all patients, res... more Background. 82 Rb PET is commonly performed using the same injected activity in all patients, resulting in lower image quality in larger patients. This study compared 82 Rb dosing with exponential vs proportional functions of body weight on the standardization of myocardial perfusion image (MPI) quality. Methods. Two sequential cohorts of N = 60 patients were matched by patient weight. Rest and dipyridamole stress 82 Rb PET was performed using 0.1 MBqÁkg 22 exponential and 9 MBqÁkg 21 proportional dosing. MPI scans were compared qualitatively with visual image quality scoring (IQS) and quantitatively using the myocardium-to-blood contrast-to-noise ratio (CNR) and blood background signal-to-noise ratio (SNR) as a function of body weight. Results. Average (min-max) patient body weight was 81 ± 18 kg (46-137 kg). Proportional dosing resulted in decreasing CNR, SNR, and visual IQS with increasing body weight (P < 0.05). Exponential dosing eliminated the weight-dependent decreases in these image quality metrics that were observed in the proportional dosing group. Conclusion. 82 Rb PET dosing as an exponential (squared) function of body weight produced consistent stress perfusion image quality over a wide range of patient weights. Dramatically lower doses can be used in lighter patients, with the equivalent population dose shifted toward the heavier patients to standardize diagnostic image quality. (J Nucl Cardiol 2023
Journal of Cardiovascular Computed Tomography
Annals of bariatric surgery, Mar 16, 2022
Background: The predictors of successful outcomes after sleeve gastrectomy are not yet well recog... more Background: The predictors of successful outcomes after sleeve gastrectomy are not yet well recognized. Therefore, the purpose of this study was to assess factors predicting successful weight loss after surgery. Methods and Materials: This was a retrospective cohort study performed in Firoozgar hospital during 2017-2019. Overall, 128 patients with morbid obesity (103 females and 25 males; BMI range: 36.05 to 58.47 kg/m 2) were included. The success of sleeve was defined either as Estimated Weight Loss (EWL) % ≥ 50% at 6 months or EWL% ≥ 65% at 12 months after surgery. We had two groups (successful and unsuccessful) at 6 and 12 months after surgery. Results: The mean±SD of age, height, baseline weight and BMI (Body Mass Index) were 36.25±11.11 year, 166.95±9.65 cm, 119.40±19.30 kg and 42.64±4.03 kg/m 2 , respectively. Male and female patients were significantly different in reaching enough EWL% at 12 months after surgery (92.9% vs 56% respectively; P=0.012). The significant difference seen in mean ages between the two groups at 6 months (P=0.017) was disappeared at 12 months. In logistic regression analysis, the only independent factor to predict success was gender. Conclusion: The patient's gender, height, weight or BMI, may have a predictive value to reach to a desirable weight after sleeve gastrectomy. Further investigations with large sample size are necessary to elucidate and predict more detailed findings.
Journal of the American College of Cardiology, Mar 1, 2023
PubMed, Feb 1, 2017
The present study aimed to compare the serum level of uric acid in patients with and without hear... more The present study aimed to compare the serum level of uric acid in patients with and without heart failure and also to determine the association between uric acid level and clinical status by Killip class in patients with STEMI. This case-control study was conducted on 50 consecutives as control group and 50 patients with acute heart failure, (20 patients had acute STEMI), who documented by both clinical conditions and echocardiography assessment. The mean plasma level of uric acid in the case group was 7.6±1.6 milligrams/deciliter (mg/dL) and in the control group was 4.5±1.5 respectively (P<0.001). These values in patients with STEMI was about 9.2±0.86, but in patients with acute heart failure in absence of STEMI was 6.5±1.04 (P<0.001). Moreover, there was significant difference among the level of uric acid and Killip classes (P<0.001). Also there was significant difference for uric acid level between HFrEF (HF with reduced EF) and severe LV systolic dysfunction (0.049). In STEMI patients with culprit LAD, mean uric acid was significantly higher than cases with culprit LCX [(9.7±0.98 versus 8.6±0.52 respectively) P=0.012]. Regarding treatment plan in patients with STEMI, mean level of uric acid in those considered for CABG was significantly higher than who were considered for PCI, 9.9±0.82 versus 8.9±0.76 respectively, P=0.029. In STEMI patients with higher killip class, higher level of uric acid was seen. Also, the severity of LV systolic dysfunction was associated with higher level of uric acid.
Research Square (Research Square), Feb 8, 2023
Background Preoperative cardiovascular risk assessment is one of the main principles before nonca... more Background Preoperative cardiovascular risk assessment is one of the main principles before noncardiac surgeries. Cardiac stress imaging, such as myocardial perfusion scan (MPI), is one of the proposed cardiac risk evaluation methods according to the latest guidelines. Yet, its e cacy, along with the cost-effectiveness of the method, has been questioned in previous studies. Our study aims to evaluate the utility of NT-proBNP level measurement in predicting postoperative cardiovascular complications in candidates who have undergone an MPI scan before surgery and compare the results. Methods A cohort of 78 patients with an RCRI score of one or more who were scheduled for high to moderate-risk noncardiac surgeries and met the criteria to undergo an MPI scan for risk assessment were included in the study. All patients underwent an MPI scan one week before surgery. Their preoperative NT-proBNP, troponin levels, and ECGs were obtained one day before surgery. The predictive e cacy of NT-proBNP levels and MPI scans were compared. Results Seventy-eight patients underwent surgery, of which three patients exhibited a rise in troponin level, six showed ECG changes, and pulmonary edema was detected in one patient three days after surgery. There was no mortality. The sensitivity and speci city of the MPI scan for predicting postoperative adverse cardiovascular outcomes were 100% and 66%, respectively. MPI scan also had a positive predictive value (PPV) of 20% and a negative predictive value (NPV) of 100%. A 332.5 pg/ml cutoff value for NT-proBNP level yielded a sensitivity of 100%, speci city of 79.2%, PPV of 40%, and NPV of 100%. Conclusions This study reveals the incremental prognostic value of NT-proBNP level measurement in preoperative cardiac risk evaluation compared to an MPI scan. Given the low feasibility, high costs, and disappointing predictive value of MPI scans, preoperative NT-proBNP level assessment can be substituted. This method can assist anesthesiologists and surgeons with detecting at-risk patients resulting in taking proper measures to reduce morbidity and mortality in the preoperative period.
Journal of Clinical Ultrasound, Nov 12, 2018
BackgroundTo this date, effects of mental stress on cardiac function have not been clearly invest... more BackgroundTo this date, effects of mental stress on cardiac function have not been clearly investigated. Although hemodynamic and neuroendocrine adverse effects of daily mental stress on cardiovascular morbidity and mortality have been reported, its direct impact on diastolic function of the heart has not been previously studied. In this study, we aimed to assess the role of Board Exam anxiety on right and left ventricular diastolic function in medical residents.MethodsForty medical residents prior to participation in the medical board exam were enrolled in our study. Right prior to as well as 2 month after the exam, all residents underwent trans‐thoracic Doppler echocardiography. Right ventricular systolic and diastolic functions and echocardiography indices were measured. Levels of anxiety were measured using Beck Anxiety Inventory Questionnaire before and after the exam. Pre exam and post exam results of study population as well as low and high anxiety groups were evaluated.ResultsEarly to late mitral inflow velocity (E/A ratio) in LV inflow increased after board exam (P‐value <.001). E/A ratio in RV inflow increased after board exam (P‐value: .002). Early mitral inflow to its annular velocity (E/E’ ratio) in septal wall decreased after board exam (P‐value<.001). The change in E/E′ RV free wall did not reach statistical significance (P = .57). Mitral annuls velocities measured by TDI in septal and lateral wall and also tricuspid annulus velocity increased after board exam (P‐value<.05). The comparison of these changes between the high‐stress and low‐stress groups of residents revealed significant differences. Comparison of changes of E/A ratio in the mitral and tricuspid inflow as well as the E/E’ in the septum and free wall of the right ventricle before and after the Board Exam between high‐stress and low‐stress groups was not statistically significant, although there was a trend of more changes in high‐ stress group residents.ConclusionThis is the first report of comprehensive sequential assessment of left and right ventricular diastolic functions during and after a real subacute stress occasion. The finding of a decreased E/A and E′ in response to mental stress suggests that repetitive mental stress may induce diastolic dysfunction which is a mechanism of diastolic heart failure in individuals at risk.
International Journal of Cardiovascular Imaging, Oct 1, 2020
Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is es... more Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is essential for choosing the best treatment strategy. We compared AVA quantified by 4 different in vivo echocardiographic methods with AVA measured by 3D ex vivo scanning of the excised AV. The data on 38 patients who underwent aortic valve replacement were assessed. The AVA was determined by 4 echocardiographic methods of planimetry in 2D transesophageal echocardiography [planimetry (2D-TEE)], plainemetry by multiplanar reconstruction approach in 3D transesophageal echocardiography [MPR (3D-TEE)], and two continuity equation (CE) approaches; conventional CE (2D-TTE) in which left ventricular outflow tract [LVOT] area derived by LVOT diameter obtained in 2D transthoracic echocardiography and CE (3D-TEE) in which LVOT area obtained by 3D MPR. After the surgical removal of the AV, AVA was determined by 3D ex vivo scanning. Lowest AVA mean difference with 3D ex vivo scanning was found between CE (2D-TTE), followed by CE (3D-TEE). Planimetry (2D-TEE) in male patients as well as severely and non-severely calcified valves revealed a significant higher AVA mean difference with 3D ex vivo scanning than CE (2D-TTE) and CE (3D-TEE) methods. However, with a nonsignificant effect, CE (2D-TTE) and planimetry (2D-TEE) had the least mean difference with 3D ex vivo scanning possibly due to less frequent bicuspid AV in females. CE (2D-TTE) was more accurate than other methods of AVA calculation. Moreover, CE (3D-TEE) and MPR (3D-TEE) methods had acceptable accuracy in comparison with planimetry (2D-TEE) for definition of AS severity.
Cardiovascular Ultrasound, Dec 1, 2015
Unfortunately, the original version of this article [1] contained an errors. Two corrections are ... more Unfortunately, the original version of this article [1] contained an errors. Two corrections are with the author's name. In the metadata of the article Roya Sattarzadeh Badkoubeh was published instead of Roya Sattarzadeh. The second author's name recorded incorrectly was Babak Geraeli. This should be corrected to Babak Geraiely.
Journal of Research in Medical Sciences, 2022
Cardiology in The Young, Nov 18, 2020
Background: COVD-19 pandemic has overwhelmed many healthcare systems worldwide. Underlying cardio... more Background: COVD-19 pandemic has overwhelmed many healthcare systems worldwide. Underlying cardiovascular disease predisposes to greater disease susceptibility and more complications including mortality. Such data is unverified in adults with congenital heart disease (ACHD). The aim of the study is to report the Tehran experience with respect to preventative self-care measures, disease exposure, susceptibility, and outcomes after COVD-19 infection in ACHD patients. Methods: A telephone-based survey was conducted in ACHD patients, focusing on new-onset symptoms that might indicate COVID-19 infection, prevention measures, confirmed infection rates, and outcomes. Results: Three-hundred and nine ACHD patients, with a mean age of 29.13 years (range from 14 to 72 years, SD = 10.64), and 170 (55%) women were assessed. The majority (86.7%) had moderate or complex ACHD. Two-thirds (67.3%) of the patients practiced high-level preventative self-care measures. After community exposure, 33.3% developed COVID-19, and after household exposure, 43.7% developed COVID-19. There was only one mortality in a post-operative patient. Thirty-seven patients (12%) reported new symptoms including cough (10%), fatigue (8%), fever (7%), and new dyspnoea (6.5%). Amongst 18 (6%) with confirmed COVID-19, there was only 1 mortality in a post-operative patient. Age (adjusted OR = 1.19, 95% CI: 1.07-1.31, p = 0.001), contact with confirmed COVID-19 cases (adjusted OR = 59.34, 95% CI: 3.68-955.10, p = 0.004) were independently associated with COVID-19 infection. Conclusions: Mortality risk associated with COVID-19 infection in ACHD patients with moderate or severe disease appears to be relatively low, similar to the general population. Such risk appears to act through conventional risk factors, and in this cohort, we demonstrated age as a significant risk factor in addition to exposure to the development of COVID-19 infection. Preventative self-care measures are a potentially significant and impactful intervention target for intervention and for improving outcomes.
Cardiovascular Ultrasound, Dec 1, 2015
Background: We performed comprehensive transmitral and pulmonary venous Doppler echocardiographic... more Background: We performed comprehensive transmitral and pulmonary venous Doppler echocardiographic studies to devise a novel index of diastolic function. This is the first study to assess the utility of the acceleration rate (AR) of the E wave of mitral inflow as a primary diagnostic modality for assessing diastolic function. Methods: Study group consisted of 84 patients (53 + 11 years) with left ventricle (LV) diastolic dysfunction and 34 healthy people (35 ± 9 years) as control group, who were referred for clinically indicated two-dimensional transthoracic echocardiogram (TTE) during 2012 and 2013 to Imam Hospital. Normal controls were defined as patients without clinical evidence of cardiac disease and had normal TTE. LV diastolic function was determined according to standardized protocol of American Society of Echocardiography (ASE). As our new parameter, AR of E wave of mitral inflow was also measured in all patients. It was represented by the slope of the line between onset of E wave and peak of it. Correlation between AR of E wave and LV diastolic function grade was measured using the Spearman correlation coefficient. Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of AR of E wave in diagnosing LV diastolic dysfunction in randomly selected two-thirds of population then its derived cutoff was evaluated in rest of the population. The institutional review board of the hospital approved the study protocol. All participants gave written informed consent. This investigation was in accordance with the Declaration of Helsinki. Results: The mean value of AR was 1010 ± 420 cm/s 2 in patients whereas the mean value for the normal controls was 701 ± 210 cm/s 2. There was a strong and graded relation between AR of E wave of mitral inflow and LV diastolic function grade (Spearman P ≤0.0001, r s =0.69). ROC curve analysis revealed that AR of E wave of mitral inflow =750 cm/s 2 predicted moderate or severe LV diastolic dysfunction with 89 % sensitivity and 89 % specificity (area under curve [AUC] = 0.903, P <0.0001). Application of this cutoff on test group showed 96 % sensitivity and 77 % specificity with AUC = 0.932 and P <0.0001. Conclusion: The AR of E wave of mitral inflow could be used for assessment of diastolic function, especially moderate or severe diastolic dysfunction. However, before its clinical application, external validation should be considered.
Journal of Clinical Ultrasound, Nov 14, 2016
Background. To determine reference echocardiographic values in a normal population and assess the... more Background. To determine reference echocardiographic values in a normal population and assess their correlation with body mass index (BMI) and body surface area. Methods. An expert cardiologist performed twodimensional echocardiography with triplicate right ventricle (RV) size measurements in 80 subjects with normal heart condition. Results were correlated with anthropometric data. Results. Base-to-apex length in four-chamber view (RVD3) and above-pulmonic valve in short-axis view in males, as well as mid-RV diameter in standard four-chamber view (RVD), basal RV diameter, and mid RV diameter in RV-focused four-chamber view in females, were significantly correlated with BMI. All RV variables were significantly correlated with BMI in 20-30-year-old subjects. All RV variables except RVD3 and above-aortic valve in short-axis view (proximal) were significantly correlated with BMI in 35-55-yearold subjects. All RV parameters were significantly correlated with body surface area, except for RVD and in 20-35-year-old subjects. Conclusions. RV echocardiographic values must be adjusted to anthropometric characteristics for proper diagnosis and management of cardiac disorders. V
CardioVascular Journal of Africa, 2011
Research Square (Research Square), Oct 12, 2022
LV diastolic dysfunction has often been described as a sensitive sign of early graft rejection. A... more LV diastolic dysfunction has often been described as a sensitive sign of early graft rejection. Assessment of left ventricular lling pressure by echocardiography in heart transplant (HTx) recipients is challenging. We aimed to investigate the ability of echocardiographic indices to detect elevated Left ventricular enddiastolic pressure (LVEDP) in HTx patients. Methods This descriptive cross-sectional study included 39 HTx recipients who were candidates for endomyocardial biopsy as a part of their routine post-transplantation surveillance. Doppler transthoracic echocardiography was done before the procedure, and left heart catheterization was done during the endomyocardial biopsy. Results Thirty-nine patients (15 female, 24 male), with the mean age of 39.6 years (range 13 to 70), were enrolled.
JACC: Cardiovascular Imaging
PubMed, 2006
Introduction: The aim of this study was to evaluate the treatment of upper ureteral calculi with ... more Introduction: The aim of this study was to evaluate the treatment of upper ureteral calculi with extracorporeal shock wave lithotripsy (SWL) in the supine and prone positions. Materials and methods: A total of 68 patients with upper ureteral calculi underwent SWL. In 35 patients, the procedure was performed in the supine position (group 1), while in the 33 remainders, it was performed in the prone position (group 2). The stone-free rate, the number of SWL sessions required, and the number of shocks per treatment session were compared between the 2 groups. Results: The mean calculus size was 12.4 +/- 3.1 mm and 12.2 +/- 2.9 mm in groups 1 and 2, respectively. The stone-free rate was 81.8% in group 1 and 82.9% in group 2 (P = .91). The number of sessions for achieving the stone-free status was similar in the patients of the 2 groups (1.9 +/- 0.8 in group 1 versus 1.9 +/- 0.8 in group 2; P = .79). The mean number of shock waves per treatment session was not significantly different between the 2 groups. No major complications were seen and none of the patients required hospitalization, placement of a ureteral catheter, or a double-J stent. Conclusion: Our study showed that in the prone position, treatment of the upper ureteral calculi by SWL is as safe and effective as the supine position.
Circulation-cardiovascular Imaging, Aug 1, 2022
Current Atherosclerosis Reports, Jun 26, 2023
Journal of Nuclear Cardiology, May 31, 2023
Background. 82 Rb PET is commonly performed using the same injected activity in all patients, res... more Background. 82 Rb PET is commonly performed using the same injected activity in all patients, resulting in lower image quality in larger patients. This study compared 82 Rb dosing with exponential vs proportional functions of body weight on the standardization of myocardial perfusion image (MPI) quality. Methods. Two sequential cohorts of N = 60 patients were matched by patient weight. Rest and dipyridamole stress 82 Rb PET was performed using 0.1 MBqÁkg 22 exponential and 9 MBqÁkg 21 proportional dosing. MPI scans were compared qualitatively with visual image quality scoring (IQS) and quantitatively using the myocardium-to-blood contrast-to-noise ratio (CNR) and blood background signal-to-noise ratio (SNR) as a function of body weight. Results. Average (min-max) patient body weight was 81 ± 18 kg (46-137 kg). Proportional dosing resulted in decreasing CNR, SNR, and visual IQS with increasing body weight (P < 0.05). Exponential dosing eliminated the weight-dependent decreases in these image quality metrics that were observed in the proportional dosing group. Conclusion. 82 Rb PET dosing as an exponential (squared) function of body weight produced consistent stress perfusion image quality over a wide range of patient weights. Dramatically lower doses can be used in lighter patients, with the equivalent population dose shifted toward the heavier patients to standardize diagnostic image quality. (J Nucl Cardiol 2023
Journal of Cardiovascular Computed Tomography
Annals of bariatric surgery, Mar 16, 2022
Background: The predictors of successful outcomes after sleeve gastrectomy are not yet well recog... more Background: The predictors of successful outcomes after sleeve gastrectomy are not yet well recognized. Therefore, the purpose of this study was to assess factors predicting successful weight loss after surgery. Methods and Materials: This was a retrospective cohort study performed in Firoozgar hospital during 2017-2019. Overall, 128 patients with morbid obesity (103 females and 25 males; BMI range: 36.05 to 58.47 kg/m 2) were included. The success of sleeve was defined either as Estimated Weight Loss (EWL) % ≥ 50% at 6 months or EWL% ≥ 65% at 12 months after surgery. We had two groups (successful and unsuccessful) at 6 and 12 months after surgery. Results: The mean±SD of age, height, baseline weight and BMI (Body Mass Index) were 36.25±11.11 year, 166.95±9.65 cm, 119.40±19.30 kg and 42.64±4.03 kg/m 2 , respectively. Male and female patients were significantly different in reaching enough EWL% at 12 months after surgery (92.9% vs 56% respectively; P=0.012). The significant difference seen in mean ages between the two groups at 6 months (P=0.017) was disappeared at 12 months. In logistic regression analysis, the only independent factor to predict success was gender. Conclusion: The patient's gender, height, weight or BMI, may have a predictive value to reach to a desirable weight after sleeve gastrectomy. Further investigations with large sample size are necessary to elucidate and predict more detailed findings.
Journal of the American College of Cardiology, Mar 1, 2023
PubMed, Feb 1, 2017
The present study aimed to compare the serum level of uric acid in patients with and without hear... more The present study aimed to compare the serum level of uric acid in patients with and without heart failure and also to determine the association between uric acid level and clinical status by Killip class in patients with STEMI. This case-control study was conducted on 50 consecutives as control group and 50 patients with acute heart failure, (20 patients had acute STEMI), who documented by both clinical conditions and echocardiography assessment. The mean plasma level of uric acid in the case group was 7.6±1.6 milligrams/deciliter (mg/dL) and in the control group was 4.5±1.5 respectively (P<0.001). These values in patients with STEMI was about 9.2±0.86, but in patients with acute heart failure in absence of STEMI was 6.5±1.04 (P<0.001). Moreover, there was significant difference among the level of uric acid and Killip classes (P<0.001). Also there was significant difference for uric acid level between HFrEF (HF with reduced EF) and severe LV systolic dysfunction (0.049). In STEMI patients with culprit LAD, mean uric acid was significantly higher than cases with culprit LCX [(9.7±0.98 versus 8.6±0.52 respectively) P=0.012]. Regarding treatment plan in patients with STEMI, mean level of uric acid in those considered for CABG was significantly higher than who were considered for PCI, 9.9±0.82 versus 8.9±0.76 respectively, P=0.029. In STEMI patients with higher killip class, higher level of uric acid was seen. Also, the severity of LV systolic dysfunction was associated with higher level of uric acid.
Research Square (Research Square), Feb 8, 2023
Background Preoperative cardiovascular risk assessment is one of the main principles before nonca... more Background Preoperative cardiovascular risk assessment is one of the main principles before noncardiac surgeries. Cardiac stress imaging, such as myocardial perfusion scan (MPI), is one of the proposed cardiac risk evaluation methods according to the latest guidelines. Yet, its e cacy, along with the cost-effectiveness of the method, has been questioned in previous studies. Our study aims to evaluate the utility of NT-proBNP level measurement in predicting postoperative cardiovascular complications in candidates who have undergone an MPI scan before surgery and compare the results. Methods A cohort of 78 patients with an RCRI score of one or more who were scheduled for high to moderate-risk noncardiac surgeries and met the criteria to undergo an MPI scan for risk assessment were included in the study. All patients underwent an MPI scan one week before surgery. Their preoperative NT-proBNP, troponin levels, and ECGs were obtained one day before surgery. The predictive e cacy of NT-proBNP levels and MPI scans were compared. Results Seventy-eight patients underwent surgery, of which three patients exhibited a rise in troponin level, six showed ECG changes, and pulmonary edema was detected in one patient three days after surgery. There was no mortality. The sensitivity and speci city of the MPI scan for predicting postoperative adverse cardiovascular outcomes were 100% and 66%, respectively. MPI scan also had a positive predictive value (PPV) of 20% and a negative predictive value (NPV) of 100%. A 332.5 pg/ml cutoff value for NT-proBNP level yielded a sensitivity of 100%, speci city of 79.2%, PPV of 40%, and NPV of 100%. Conclusions This study reveals the incremental prognostic value of NT-proBNP level measurement in preoperative cardiac risk evaluation compared to an MPI scan. Given the low feasibility, high costs, and disappointing predictive value of MPI scans, preoperative NT-proBNP level assessment can be substituted. This method can assist anesthesiologists and surgeons with detecting at-risk patients resulting in taking proper measures to reduce morbidity and mortality in the preoperative period.
Journal of Clinical Ultrasound, Nov 12, 2018
BackgroundTo this date, effects of mental stress on cardiac function have not been clearly invest... more BackgroundTo this date, effects of mental stress on cardiac function have not been clearly investigated. Although hemodynamic and neuroendocrine adverse effects of daily mental stress on cardiovascular morbidity and mortality have been reported, its direct impact on diastolic function of the heart has not been previously studied. In this study, we aimed to assess the role of Board Exam anxiety on right and left ventricular diastolic function in medical residents.MethodsForty medical residents prior to participation in the medical board exam were enrolled in our study. Right prior to as well as 2 month after the exam, all residents underwent trans‐thoracic Doppler echocardiography. Right ventricular systolic and diastolic functions and echocardiography indices were measured. Levels of anxiety were measured using Beck Anxiety Inventory Questionnaire before and after the exam. Pre exam and post exam results of study population as well as low and high anxiety groups were evaluated.ResultsEarly to late mitral inflow velocity (E/A ratio) in LV inflow increased after board exam (P‐value <.001). E/A ratio in RV inflow increased after board exam (P‐value: .002). Early mitral inflow to its annular velocity (E/E’ ratio) in septal wall decreased after board exam (P‐value<.001). The change in E/E′ RV free wall did not reach statistical significance (P = .57). Mitral annuls velocities measured by TDI in septal and lateral wall and also tricuspid annulus velocity increased after board exam (P‐value<.05). The comparison of these changes between the high‐stress and low‐stress groups of residents revealed significant differences. Comparison of changes of E/A ratio in the mitral and tricuspid inflow as well as the E/E’ in the septum and free wall of the right ventricle before and after the Board Exam between high‐stress and low‐stress groups was not statistically significant, although there was a trend of more changes in high‐ stress group residents.ConclusionThis is the first report of comprehensive sequential assessment of left and right ventricular diastolic functions during and after a real subacute stress occasion. The finding of a decreased E/A and E′ in response to mental stress suggests that repetitive mental stress may induce diastolic dysfunction which is a mechanism of diastolic heart failure in individuals at risk.
International Journal of Cardiovascular Imaging, Oct 1, 2020
Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is es... more Accurate determination of severity of aortic valve stenosis (AS) by aortic valve area (AVA) is essential for choosing the best treatment strategy. We compared AVA quantified by 4 different in vivo echocardiographic methods with AVA measured by 3D ex vivo scanning of the excised AV. The data on 38 patients who underwent aortic valve replacement were assessed. The AVA was determined by 4 echocardiographic methods of planimetry in 2D transesophageal echocardiography [planimetry (2D-TEE)], plainemetry by multiplanar reconstruction approach in 3D transesophageal echocardiography [MPR (3D-TEE)], and two continuity equation (CE) approaches; conventional CE (2D-TTE) in which left ventricular outflow tract [LVOT] area derived by LVOT diameter obtained in 2D transthoracic echocardiography and CE (3D-TEE) in which LVOT area obtained by 3D MPR. After the surgical removal of the AV, AVA was determined by 3D ex vivo scanning. Lowest AVA mean difference with 3D ex vivo scanning was found between CE (2D-TTE), followed by CE (3D-TEE). Planimetry (2D-TEE) in male patients as well as severely and non-severely calcified valves revealed a significant higher AVA mean difference with 3D ex vivo scanning than CE (2D-TTE) and CE (3D-TEE) methods. However, with a nonsignificant effect, CE (2D-TTE) and planimetry (2D-TEE) had the least mean difference with 3D ex vivo scanning possibly due to less frequent bicuspid AV in females. CE (2D-TTE) was more accurate than other methods of AVA calculation. Moreover, CE (3D-TEE) and MPR (3D-TEE) methods had acceptable accuracy in comparison with planimetry (2D-TEE) for definition of AS severity.
Cardiovascular Ultrasound, Dec 1, 2015
Unfortunately, the original version of this article [1] contained an errors. Two corrections are ... more Unfortunately, the original version of this article [1] contained an errors. Two corrections are with the author's name. In the metadata of the article Roya Sattarzadeh Badkoubeh was published instead of Roya Sattarzadeh. The second author's name recorded incorrectly was Babak Geraeli. This should be corrected to Babak Geraiely.
Journal of Research in Medical Sciences, 2022
Cardiology in The Young, Nov 18, 2020
Background: COVD-19 pandemic has overwhelmed many healthcare systems worldwide. Underlying cardio... more Background: COVD-19 pandemic has overwhelmed many healthcare systems worldwide. Underlying cardiovascular disease predisposes to greater disease susceptibility and more complications including mortality. Such data is unverified in adults with congenital heart disease (ACHD). The aim of the study is to report the Tehran experience with respect to preventative self-care measures, disease exposure, susceptibility, and outcomes after COVD-19 infection in ACHD patients. Methods: A telephone-based survey was conducted in ACHD patients, focusing on new-onset symptoms that might indicate COVID-19 infection, prevention measures, confirmed infection rates, and outcomes. Results: Three-hundred and nine ACHD patients, with a mean age of 29.13 years (range from 14 to 72 years, SD = 10.64), and 170 (55%) women were assessed. The majority (86.7%) had moderate or complex ACHD. Two-thirds (67.3%) of the patients practiced high-level preventative self-care measures. After community exposure, 33.3% developed COVID-19, and after household exposure, 43.7% developed COVID-19. There was only one mortality in a post-operative patient. Thirty-seven patients (12%) reported new symptoms including cough (10%), fatigue (8%), fever (7%), and new dyspnoea (6.5%). Amongst 18 (6%) with confirmed COVID-19, there was only 1 mortality in a post-operative patient. Age (adjusted OR = 1.19, 95% CI: 1.07-1.31, p = 0.001), contact with confirmed COVID-19 cases (adjusted OR = 59.34, 95% CI: 3.68-955.10, p = 0.004) were independently associated with COVID-19 infection. Conclusions: Mortality risk associated with COVID-19 infection in ACHD patients with moderate or severe disease appears to be relatively low, similar to the general population. Such risk appears to act through conventional risk factors, and in this cohort, we demonstrated age as a significant risk factor in addition to exposure to the development of COVID-19 infection. Preventative self-care measures are a potentially significant and impactful intervention target for intervention and for improving outcomes.
Cardiovascular Ultrasound, Dec 1, 2015
Background: We performed comprehensive transmitral and pulmonary venous Doppler echocardiographic... more Background: We performed comprehensive transmitral and pulmonary venous Doppler echocardiographic studies to devise a novel index of diastolic function. This is the first study to assess the utility of the acceleration rate (AR) of the E wave of mitral inflow as a primary diagnostic modality for assessing diastolic function. Methods: Study group consisted of 84 patients (53 + 11 years) with left ventricle (LV) diastolic dysfunction and 34 healthy people (35 ± 9 years) as control group, who were referred for clinically indicated two-dimensional transthoracic echocardiogram (TTE) during 2012 and 2013 to Imam Hospital. Normal controls were defined as patients without clinical evidence of cardiac disease and had normal TTE. LV diastolic function was determined according to standardized protocol of American Society of Echocardiography (ASE). As our new parameter, AR of E wave of mitral inflow was also measured in all patients. It was represented by the slope of the line between onset of E wave and peak of it. Correlation between AR of E wave and LV diastolic function grade was measured using the Spearman correlation coefficient. Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of AR of E wave in diagnosing LV diastolic dysfunction in randomly selected two-thirds of population then its derived cutoff was evaluated in rest of the population. The institutional review board of the hospital approved the study protocol. All participants gave written informed consent. This investigation was in accordance with the Declaration of Helsinki. Results: The mean value of AR was 1010 ± 420 cm/s 2 in patients whereas the mean value for the normal controls was 701 ± 210 cm/s 2. There was a strong and graded relation between AR of E wave of mitral inflow and LV diastolic function grade (Spearman P ≤0.0001, r s =0.69). ROC curve analysis revealed that AR of E wave of mitral inflow =750 cm/s 2 predicted moderate or severe LV diastolic dysfunction with 89 % sensitivity and 89 % specificity (area under curve [AUC] = 0.903, P <0.0001). Application of this cutoff on test group showed 96 % sensitivity and 77 % specificity with AUC = 0.932 and P <0.0001. Conclusion: The AR of E wave of mitral inflow could be used for assessment of diastolic function, especially moderate or severe diastolic dysfunction. However, before its clinical application, external validation should be considered.
Journal of Clinical Ultrasound, Nov 14, 2016
Background. To determine reference echocardiographic values in a normal population and assess the... more Background. To determine reference echocardiographic values in a normal population and assess their correlation with body mass index (BMI) and body surface area. Methods. An expert cardiologist performed twodimensional echocardiography with triplicate right ventricle (RV) size measurements in 80 subjects with normal heart condition. Results were correlated with anthropometric data. Results. Base-to-apex length in four-chamber view (RVD3) and above-pulmonic valve in short-axis view in males, as well as mid-RV diameter in standard four-chamber view (RVD), basal RV diameter, and mid RV diameter in RV-focused four-chamber view in females, were significantly correlated with BMI. All RV variables were significantly correlated with BMI in 20-30-year-old subjects. All RV variables except RVD3 and above-aortic valve in short-axis view (proximal) were significantly correlated with BMI in 35-55-yearold subjects. All RV parameters were significantly correlated with body surface area, except for RVD and in 20-35-year-old subjects. Conclusions. RV echocardiographic values must be adjusted to anthropometric characteristics for proper diagnosis and management of cardiac disorders. V
CardioVascular Journal of Africa, 2011
Research Square (Research Square), Oct 12, 2022
LV diastolic dysfunction has often been described as a sensitive sign of early graft rejection. A... more LV diastolic dysfunction has often been described as a sensitive sign of early graft rejection. Assessment of left ventricular lling pressure by echocardiography in heart transplant (HTx) recipients is challenging. We aimed to investigate the ability of echocardiographic indices to detect elevated Left ventricular enddiastolic pressure (LVEDP) in HTx patients. Methods This descriptive cross-sectional study included 39 HTx recipients who were candidates for endomyocardial biopsy as a part of their routine post-transplantation surveillance. Doppler transthoracic echocardiography was done before the procedure, and left heart catheterization was done during the endomyocardial biopsy. Results Thirty-nine patients (15 female, 24 male), with the mean age of 39.6 years (range 13 to 70), were enrolled.