Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 How to avoid oversizing Perceval sutureless aortic valve: Technique 1 3 32991 10.48305/arya.2025.43498.3031 EN Pouya Nezafati Department of Cardiothoracic Surgery, John Hunter Hospital, Newcastle, NSW, Australia Discipline of Biomedical Sciences and Molecular Biology, College of Medicine and Dentistry, Australian Institute of Tropical Medicine and Health, Centre for Molecular Therapeutics, James Cook University, Townsville, QLD, Australia Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-2551-8335 Sumit Yadav Department of Cardiothoracic Surgery, Mater Private Hospital, Townsville, QLD, Australia College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia 0000-0002-9985-0931 Journal Article 2025 02 17 Aortic valve replacement surgery technique has been revolutionised with the introduction of sutureless valves. Perceval sutureless aortic valve (PSV) is one of the most widely used examples. However, oversizing the PSV has been reported to be an issue. After a case of PSV stent recoil in our institution, a new technique was developed, where only the white obturator is used to size the valve. Recently, this technique was also mentioned by different authors. With this technique, we achieved low rates of paravalvular leaks and pacemaker implantation, with good transvalvular gradients. Therefore, we recommend this technique over the manufacturer’s instructions.

https://arya.mui.ac.ir/article_32991_c64c545aff0d17ad713c907fdada37d1.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 Successful percutaneous closure of a large ventricular septal defect (VSD) in a 9-month-old Infant: A case report 4 8 32921 10.48305/arya.2025.43587.3042 EN Reza Derakhshan Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran 0000-0001-6630-8161 Fatemeh Doost Mohammadi Clinical Research Development Unit, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0003-3867-4214 Journal Article 2025 03 25 Ventricular septal defect (VSD) is a common congenital heart defect. In large VSDs with significant left-to-right shunting, percutaneous closure can be an effective alternative to surgical repair. In some cases, percutaneous closure of septal defects is a successful treatment. Our main objective in this case report is to discuss the transcatheter closure of ventricular septal defects in a low-birth-weight infant. We are presenting the case of a 9-month-old male infant who is experiencing failure to thrive (FTT) alongside a significant ventricular septal defect (VSD). The patient successfully underwent percutaneous closure of the VSD using an antegrade approach with a symmetric device. Follow-up evaluations after the procedure confirmed that the closure was effective, the device was in the correct position, and pulmonary hypertension had resolved. As far as we know, this case represents one of the youngest and lowest-weight infants reported in Iran for successful percutaneous VSD closure instead of open surgery.

https://arya.mui.ac.ir/article_32921_08faa15558a741e7cc59f718a5cc6213.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 Assessing hemodynamic changes before and after pump in CABG surgery and its factors 9 20 33032 10.48305/arya.2025.45348.3068 EN Mehdi Dehghani Firoozabadi Department of Anesthesiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran Soz Hiwa Mahmood Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Afzal Shamsi Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran 0000-0001-6231-0547 Mohamad Sorani Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2025 06 09 BACKGROUND: One of the main complications after coronary artery bypass grafting (CABG) is postoperative clinical and para-clinical changes, which present a significant challenge. METHODS: This descriptive cross-sectional study included 109 patients who were candidates for CABG and were admitted to the surgical intensive care unit at Tehran Heart Center Hospital, selected using random sampling and a checklist. Relationships between variables were analyzed with the Kolmogorov-Smirnov (K-S) test, paired t-test, and regression. RESULTS: The findings from the mean changes before and after the pump showed that blood sugar (28.23 ± 33.43), lactate (6.59 ± 5.63), potassium (0.75 ± 0.47), and heart rate (12.36 ± 15.46) increased significantly after the pump compared to before the pump (p < 0.05), while hemoglobin (-2.5 ± 1.28), hematocrit (-6.61 ± 3.44), pH (-0.03 ± 0.06), PaO₂ (-92.95 ± 94.01), bicarbonate (-1.83 ± 2.38), and mean blood pressure (-2.25 ± 13.01) decreased significantly (p < 0.05). Gender had a significant effect on cerebral oximetry values on both the right (β = 5.461, p = 0.002) and left (β = 4.835, p = 0.004) sides, hemoglobin (β = 0.644, p = 0.017), and hematocrit (β = 2.055, p = 0.004). In addition, patients’ comorbidities also had a positive effect on PaO₂ (β = 11.340, p = 0.044). CONCLUSION: The clinical and para-clinical status in patients undergoing CABG surgery changes after on-pump surgery. In addition, comorbidities of patients have a positive and significant effect on PaO₂, as well as gender, on cerebral oximetry, hemoglobin, and hematocrit values.

https://arya.mui.ac.ir/article_33032_ad2c9e0a9c46d5f3de817714c17d64cd.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 Developing in hospital mortality prediction model tools for patients with acute myocardial infarction (STEMI) using Yazd cardiovascular disease registry, YCDR data 21 33 32922 10.48305/arya.2025.43144.3004 EN Seyedeh Mahdieh Namayandeh Afshar Research Development Center, Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0003-3616-2864 Mohsen Mohammadi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0001-5016-2436 Masoud Mirzaei Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0001-6455-0747 Mohsen Askarishahi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Hamidreza Dehghani Health Assessment Technology Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 0000-0002-6772-7170 Seyed Mahmoud Sadr Bafghi Yazd Cardiovascular Research Center, Department of Cardiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Journal Article 2024 12 05 BACKGROUND: An acute ST-elevation myocardial infarction (STEMI) is a medical event characterized by transmural myocardial ischemia that leads to myocardial injury or necrosis. This study was undertaken to develop, evaluate, and compare models for assessing the risk of hospital mortality in patients with acute myocardial infarction. METHODS: The study made use of data from the Yazd Cardiovascular Diseases Registry (YCDR), which is a cohort study of inpatient records of ischemic heart disease in Yazd province, Iran. A total of 1,861 patients who had experienced a STEMI were included in the analysis. Decision tree analysis was conducted using R software with the rpart package. Additionally, to analyze the data and adjust for any confounding variables, logistic regression was performed using the glm2 package. To compare the effectiveness of the two models, accuracy measures were used, and the Receiver Operating Characteristic (ROC) curve was applied. RESULTS: In this study, three clinical, laboratory, and clinical-laboratory models were created. In a clinical-laboratory model, variables such as blood sugar (BS), triglycerides, HDL cholesterol, peak myocardial band (MBpick), CVA history, and low ejection fraction (EF) were found to increase the risk of in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI). Conversely, higher levels of hemoglobin, low HDL-C, and previous myocardial infarction (MI) were associated with a protective effect against the risk of in-hospital mortality from acute myocardial infarction. The performance of the models in terms of Receiver Operating Characteristic (ROC) curve was 86.5%, 79.5%, and 90.2% for logistic regression model in three different models: clinical, laboratory, and combined clinical-laboratory. The accuracy of these models was calculated to be 88.3%, 81.3%, and 93%, respectively. Important variables influencing the prediction of in-hospital mortality in STEMI patients included Killip class, triglycerides, blood sugar, creatinine levels, the need for treatment due to ventricular fibrillation or ventricular tachycardia (VF/VT), age, and hemoglobin (HB). In the ROC curve analysis of the decision tree algorithm across the clinical, laboratory, and combined clinical-laboratory models, the performance levels were 74.6%, 69.8%, and 81.7%, respectively. The accuracy of the decision tree was 93.0%, 92.5%, and 95.8%. CONCLUSION: The findings of this study indicated that the decision tree algorithm had higher accuracy across all three models: clinical, laboratory, and combined clinical-laboratory compared to logistic regression. However, logistic regression showed higher sensitivity and better ROC curve performance than the decision tree algorithm.

https://arya.mui.ac.ir/article_32922_f9476968629e1163bd4a3ba839d60925.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 Serum levels of C1q/TNF-related protein-1 (CTRP1) and CTRP3 in patients with coronary artery disease 34 41 32925 10.48305/arya.2025.43204.3006 EN Gholamreza Namazi Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran Department of Clinical Biochemistry, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran 0000-0002-4485-1347 Maryam Mehranian Department of Clinical Biochemistry, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran Alireza Mafi Department of Clinical Biochemistry, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran Razieh Salami Department of Clinical Biochemistry, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran Fariba Raygan Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran Journal Article 2024 11 18 BACKGROUND: Research suggests that C1q/TNF-related proteins (CTRPs) play a role in inflammation and may impact coronary artery disease (CAD). This study aimed to measure their levels in CAD patients and assess their correlation with disease severity. METHODS: This study involved 88 individuals (50 men and 38 women) who underwent coronary angiography. Among them, 47 patients had significant coronary obstruction and were selected as the case group, and 41 individuals without significant obstruction were considered as the control group. Serum levels of CTRP1 and CTRP3 were quantified using the ELISA method, whereas other parameters were assessed by standard laboratory techniques. Multiple logistic regression analysis was used to examine the association between CTRP1 and CTRP3 levels with CAD. RESULTS: The mean age of CAD patients was 62.1 ± 11.5 years. Thirty-one patients were male and sixteen were female. The control group comprised nineteen men and twenty-two women, with a mean age of 62.3 ± 12.7 years. The concentrations of CTRP1 and CTRP3 proteins were significantly higher in individuals with CAD relative to controls. Except for serum HDL levels, which were lower in the CAD group than in the control group, there were no significant differences in the demographic or clinical features between the studied groups. A direct and significant association was discovered between the amounts of assessed adipokines and the severity of CAD. CONCLUSION: A greater concentration of both CTRP1 and CTRP3 was strongly associated with the presence and severity of CAD, indicating that these adipocytokines may serve as markers for CAD.

https://arya.mui.ac.ir/article_32925_e276f77f5eb4b51b5852dc9a08092d47.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 Moderate to severe aortic stenosis: Unraveling risk factors, clinical manifestations, and one-year cardiovascular outcomes 42 50 32989 10.48305/arya.2025.42971.2993 EN Azam Soleimani Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences. Isfahan, Iran Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-2529-5223 Nastaran Karimi Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran 0009-0000-7455-7184 Marjan Jamalian Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-2455-9867 Zahra Soleimani Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran 0000-0003-3937-3800 Journal Article 2024 08 20 BACKGROUND: Aortic stenosis (AS), a progressively degenerative cardiac condition, poses a substantial burden on morbidity and mortality. This study responds to the scarcity of comprehensive data on moderate to severe AS, focusing on risk factors, clinical manifestations, and one-year outcomes. METHODS: A retrospective cross-sectional study was conducted at Chamran Hospital (2021–2022) involving 97 patients with moderate-to-severe AS. Exclusion criteria included infiltrative diseases, radiotherapy history, cardiogenic shock, ejection fraction <20%, fever, sepsis, and active infections. Data were collected using a standardized checklist with three sections: baseline demographics and risk factors, echocardiographic parameters, and outcomes (in-hospital events, surgical aortic valve replacement [AVR], and one-year mortality). RESULTS: Among the patients, 29 (29.9%) were classified as moderate AS and the remainder were severe AS. Severe AS patients exhibited higher systolic pulmonary artery pressure (sPAP) and higher prevalence of moderate to severe diastolic dysfunction and three-vessel disease (3VD). Echocardiographic parameters such as mean pressure gradient (MG), peak velocity (PV), and high sPAP were related to the severity of AS (moderate to severe) by odds ratios of 1.13, 6.09, and 1.15 folds, respectively. CONCLUSION: AS imposes a significant burden of cardiovascular risk on the population. Patients with severe AS showed higher prevalence of increased filling pressures, moderate to severe diastolic dysfunction, 3VD, and higher sPAP compared with the moderate group, with no difference in clinical presentation and one-year outcome.

https://arya.mui.ac.ir/article_32989_3e15bc5fa2dc63605c64a2afbee14366.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 Prevalence and contributing factors of nosocomial bloodstream infections in pediatric cardiac ICU patients at chamran hospital, Isfahan 51 59 32990 10.48305/arya.2025.43595.3043 EN Ladan Salamati Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-0860-3386 Chehreh Mahdavi Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0003-3629-7865 Mohaddeseh Amini Harandi Department of Pediatrics, Division of Neonatology, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Reza Sabri Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-9726-6144 Alireza Ahmadi Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran Mehdi Ghaderian Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0001-6140-7750 Bahar Dehghan Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran 0000-0002-1302-8825 Silva Hovsepian Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Journal Article 2025 04 10 BACKGROUND: Congenital heart disease (CHD) profoundly impacts pediatric health, leading to increased morbidity and complex care requirements, often resulting in prolonged hospital stays. Nosocomial infections, particularly bloodstream infections (BSIs), pose a significant risk in the Pediatric Cardiac Intensive Care Unit (PCICU). This study aims to evaluate the prevalence of nosocomial BSIs in children with CHD within the PCICU and to identify associated risk factors. METHODS: A retrospective analysis was conducted on data recorded from patients under 18 years of age who had confirmed positive blood cultures and were hospitalized for a minimum of 48 hours from March 2019 to March 2022. Demographic, clinical, and microbiological information was collected, and statistical analyses were performed to determine the relationships between various risk factors and positive blood cultures. RESULTS: In this analysis of 510 patients evaluated, positive blood cultures were found in 16.7% of patients. Patients with positive cultures were significantly younger and had lower mean weights (P<0.05). Recovery status was a significant predictor of blood culture results (p<0.001). Device utilization, including urinary catheters and central venous lines, was notably higher in the positive culture group (P<0.05). Additionally, a higher proportion of patients with positive cultures had acyanotic CHD, with significant associations for Patent Ductus Arteriosus (PDA), Ventricular Septal Defect (VSD), and Atrial Septal Defect (ASD) (P<0.001). Improved recovery status decreased the likelihood of positive blood cultures by approximately 52.2% (odds ratio 0.478, p=0.0021). CONCLUSION: Our findings reveal a high prevalence of BSIs in the PCICU, highlighting some associated risk factors such as recovery status, use of central vein catheters, dialysis and Foley catheters, younger age, and lower weight. This study emphasizes the necessity for rigorous infection control measures, particularly regarding the management of invasive devices and prompt clinical interventions, to improve patient outcomes in this high-risk population. Enhanced surveillance and tailored guidelines are essential for reducing the risks of nosocomial infections in pediatric cardiac care settings.

https://arya.mui.ac.ir/article_32990_1d5acea22de068fb6e18a7e2de543002.pdf

Cardiovascular research institute, Isfahan University of Medical Sciences ARYA Atherosclerosis Journal 1735-3955 21 Issue 5 2025 06 01 The interplay between diabetes and atherosclerosis: A review of pathophysiological mechanisms 60 82 32923 10.48305/arya.2025.43558.3037 EN Mostafa Cheraghi Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran 0000-0004-0612-1516 Arash Karimi Department of Anesthesia, Faculty of Medicine, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khoramabad, Iran Mehrnoosh Sedighi Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran 0000-0002-2002-2413 Solmaz Jabarzare LMCC, Independent Research, Toronto, Canada Journal Article 2025 04 19 Atherosclerosis, characterized by lipid accumulation in arterial walls, is a leading cause of cardiovascular morbidity and mortality, with increased prevalence among individuals with diabetes mellitus. Diabetes is a chronic condition marked by persistently high blood glucose levels, a condition that can potentially result in long-term complications, including heart, blood vessel, eye, kidney, and nerve damage. Diabetes, marked by chronic hyperglycemia, contributes to atherogenesis through mechanisms including endothelial dysfunction, oxidative stress, formation of advanced glycation end-products (AGEs), and chronic inflammation. This study provides a synopsis of the predominant characteristics of diabetes that may potentially impact the atherogenic process, including oxidative stress, altered protein kinase signaling, and the role of select microRNAs and epigenetic modifications. This review comprehensively examines literature from 1969 to 2025, focusing on the molecular and cellular pathways linking diabetes to atherosclerosis. Effective glycemic control and management of associated risk factors remain pivotal in mitigating atherosclerotic progression in diabetic patients. Understanding these interconnected mechanisms is essential for developing targeted therapies to reduce cardiovascular complications associated with diabetes.

https://arya.mui.ac.ir/article_32923_81fc53c51059936bda7ac43bdcb32449.pdf