Abdolhamid Bagheri

Background: Myocardial involvement is a significant early manifestation of coronavirus pandemic (COVID-19), with studies indicating that up to 30% of patients may experience irreversible myocardial damage. Objectives: This study aimed to evaluate the echocardiographic parameters of COVID-19 patients over a two-year follow-up period. Methods: Hospitalized COVID-19 patients at Modarres Hospital, Tehran, Iran, were selected through retrospective medical record analysis. Various echocardiographic parameters were assessed at baseline and during the two-year follow-up, including left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left Atrial Volume Index (LAVi), and right ventricular end-diastolic dimension (RVEDD). A paired sample t-test was used to compare primary and secondary echocardiographic variables. Results: Echocardiographic analysis revealed significant improvements in various parameters over the two-year follow-up. The E/A ratio increased from 1.09 ± 0.27 to 1.15 ± 0.23 (P = 0.01), and left ventricular global longitudinal strain (LVGLS) improved from -19.24 ± 5.18% to -20.38 ± 3.59% (P = 0.005). Additionally, RVEDD decreased from 28.07 ± 4.31 mm to 27.32 ± 4.73 mm (P = 0.003), while the fractional area change (FAC) increased from 46.6 ± 9.16% to 47.54 ± 7.9% (P = 0.02). S-velocity increased from 12.16 ± 2.32 cm/s to 13.02 ± 2.2 cm/s (P = 0.001), systolic pulmonary artery pressure (SPAP) decreased from 28.48 ± 7.56 mmHg to 26 ± 6.7 mmHg (P = 0.001), and right ventricular global longitudinal strain (RVGLS) showed a significant change from -22.47 ± 7.22% to -23.04 ± 3.23% (P = 0.001). Conclusions: While most echocardiographic parameters remained normal, the study found notable recovery in several measures two years post-hospitalization. These findings underscore the importance of long-term cardiovascular monitoring for COVID-19 survivors, highlighting the potential reversibility of myocardial involvement associated with the infection. This study provides valuable insights into long-term echocardiographic changes in COVID-19 patients, indicating potential reversibility of myocardial involvement.

Background: The prevalence of heart failure (HF) presents a significant burden on global healthcare systems, accounting for approximately 1.2% of the total healthcare budget. Adherence to the European Society of Cardiology (ESC) guidelines is associated with improved clinical outcomes, fewer cardiovascular hospitalizations, and delayed rehospitalization. Objectives: Given the lack of studies on compliance with ESC guidelines for HF patients in Iranian hospitals, this study aimed to evaluate the compliance of HF treatment at Shahid Modarres Hospital with the ESC guidelines. Methods: This descriptive cross-sectional study was conducted on 97 patients with HF who were referred to Shahid Modarres Hospital, Tehran, in 2023. Patients were diagnosed based on their medical records and clinical evaluations by a cardiologist. Medications were reviewed for compliance with the ESC guidelines regarding drug category, type, and dosage. Results: The results showed that 42.3% of patients received treatment in compliance with the ESC guidelines, while 57.7% had non-compliance. The most common non-adherence was observed in the use of ACE/ARB, mineralocorticoid receptor antagonists (MRAs), and Empa/Dapa drug combinations. The study found that 57% of patients were already being treated at Modarres Hospital, and treatment compliance was higher among these patients (60%), compared to those who referred to the hospital for the first time (30%). Conclusions: Although the HF treatment compliance rate at Shahid Modarres Hospital is high, it still requires improvement. A thorough examination of the underlying reasons for non-adherence to HF medication guidelines is needed, with the goal of identifying and addressing potential barriers to optimal treatment.

Background: Transradial cardiac angiography offers advantages in therapeutic outcomes and economic efficiency; however, it is associated with side effects such as pain, vascular spasm, and vasovagal syndrome. Objectives: This study evaluates the efficacy of injectable lidocaine, with and without the application of topical lidocaine cream, in mitigating these adverse effects. Methods: In this single-blinded clinical trial, 80 patients aged 18 and older who referred to Shahid Modarres Hospital, Tehran, Iran, between 2022 and 2023 were enrolled. Participants met specific criteria to ensure a homogeneous study population. They were randomly assigned to receive either lidocaine cream in conjunction with a subcutaneous lidocaine injection or a placebo cream with subcutaneous lidocaine. Pain intensity was assessed using the Visual Analog Scale (VAS), and complications were recorded through pre-designed checklists. Statistical analyses were performed using SPSS version 23, employing appropriate tests to explore significant differences. Results: The mean age of participants was 58.1 years, with both groups exhibiting similar demographic characteristics. Statistical analysis indicated that the use of lidocaine cream significantly reduced pain occurrence, with none in the experimental group reporting pain compared to 7 in the control group (P = 0.006). Furthermore, lidocaine cream decreased the incidence of spasms, noted in 5 patients in the control group, with no spasms reported in the experimental group (P = 0.021). Additionally, vasovagal syndrome was significantly lower in the experimental group (P = 0.011). Conclusions: The study indicates that pre-application of lidocaine cream prior to injectable lidocaine effectively alleviates pain, vascular spasm, and vasovagal syndrome in patients undergoing transradial cardiac angiography, supporting its incorporation into routine practice to enhance patient comfort and safety.