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Comparing measurements of mitral valve area by two-dimensional planimetry and continuity equation in patients with mitral stenosis
R Sattarzadeh Badkoobeh,L Derakhshan,A Farhang Zand Parsa,A Pasha Meysamie
Tehran University Medical Journal , 2012,
Abstract: Background: Measurements of mitral valve area (MVA) are essential to determine the severity of mitral stenosis (MS) and adopt the best management strategies. The aim of the present study was to compare MVA determined by two-dimensional (2D) planimetry to MVA measured by continuity equation (CE) in patients with moderate to severe MS. Methods: We evaluated 73 consecutive patients with the diagnosis of MS scheduled for balloon mitral valvuloplasty or with moderate to severe rheumatic MS admitted at the echocardiography clinic of Imam Khomeini Hospital in 2010. Using 2D images of mitral valve obtained from paraesternal short axis view, 2D planimetry of the mitral orifice area was performed by an experienced cardiologist. MVA by CE was calculated from aortic forward stroke volume divided by transmitral time-velocity integral.Results: The mean value of MVA by 2-D planimetry was 1.0±0.3 cm2. The average values of MVA measured by PHT and CE were 1.0±0.3 cm2 and 0.9±0.4 cm2, respectively. The MVA determined by planimetry correlated well with CE (r=0.832, standard error of estimation [SEE]= 0.166, P<0.001). The mean values of MVA calculated by CE highly correlated with those calculated by 2-D planimetry in patients presenting with both non-significant (r=0.701) and significant (r=0.761) AIs. Conclusion: When planimetry is not feasible, such as in severe calcification of mitral valve or after percutaneous balloon valvuloplasty, CE could be an alternative method for MVA measurement in comparison with PHT.
Abstract monotone operators representable by abstract convex functions
H. Mohebi,A. R. Sattarzadeh
Applied Mathematical Sciences , 2012,
Abstract:
Allopurinol effects on diastolic dysfunction in ESRD patients with hyperuricemia
Sattarzade Badkoobeh R,Nozari Y,Larti F,Safari S
Tehran University Medical Journal , 2011,
Abstract: "n 800x600 Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} Background: The role of reactive oxygen species (ROS) in the pathogenesis of different cardiac diseases has been documented. Recently, effect of allopurinol in decreasing the production of ROS and improving cardiovascular pathogenesis has come into scientific interest. Animal studies have documented the benefit of allopurinol in improving left ventricular dilatation, hypertrophy and fibrosis, and myocardial contractility and in the prevention of systemic vasoconstriction. The aim of this study was to evaluate the effect of allopurinol in improving diastolic dysfunction in ESRD patients with hyperuricemia."n"nMethods: This was an interventional study on 28 patients (19 males and 9 females) with ESRD and hyperuricemia. At the end of a one-month course of allopurinol therapy (100 mg daily), echocardiographic indices of diastolic dysfunction were measured and compared to the baseline indices."n"nResults: The mean level of uric acid was 7.5±0.96 mg/dl. The mean EF before and after the study were %44.28±%9.8 and %44.64±%9.7, (no significant difference), Respectively. The two indices of IVCT and A reversal were shown to have significant improvement after therapy (p=0.028 and 0.012, respectively). The grading of diastolic dysfunction didn't improve significantly after treatment with allopurinol."n"nConclusion: Significant improvement in some of studied indices, reproduced only in male subgroup of patients that might be related to a better response of males to allopurinol, however, a longer course of treatment may result in more favorable responses. Better patient selection in terms of "EF"s with normal distribution and repeating the study in non-dialysis hyperuricemic patients may result in more accurate information.
The echocardiographic estimation of left ventricular filling pressures in patients with mitral valve stenosis
Sattarzadeh Badkoubeh R,Tavoosi A,Heidari K,Rezaei Hemami M
Tehran University Medical Journal , 2010,
Abstract: "nBackground: Estimation of Left Ventricular End Diastolic Pressure (LVEDP) among patients with Mitral Stenosis (MS) helps to diagnose diastolic dysfunction and to explain their symptoms. However, Conventional Doppler measurements have limitation in predicting of LVEDP. This study sought to establish whether the correlation between measurements derived from Tissue Doppler echocardiography and LVEDP remains valid in the setting of severe mitral stenosis. "n"nMethods: Thirty three patients with moderate to severe MS who had indication for left heart catheterization enrolled during 1387-88 in Imam Khomeini Hospital in Tehran, Iran. The mean diastolic transmitral pressure gradient and mitral valve area (MVA) were calculated, and Two-dimensional, M-mode, color Doppler and tissue Doppler Imaging indices such as: early diastolic mitral inflow velocity (E), annular early diastolic velocity (Ea), E/A ratio, Isovolemic relaxation time (IVRT), Pulmonary Vein systolic and diastolic flow velocities, Velocity Propagation, LA size, TE-Ea, Tei Index were obtained in maximum three hours before cardiac catheterization. The echocardiography analysis was performed offline without knowledge of hemodynamic data Linear correlation and multiple linear regression were used for analysis. p< 0.05 was considered significant. "n"nResults: In univariate analysis, E/Ea was associated with LVEDP significantly (p = 0.04, r = 0.38). There was also a significant correlation between TE-Ea and LVDP (p = 0.01, r = -0.44). In multiple linear regression Tei Index ( = 0.4, p< 0.02), and TE-Ea ( = 0.5, p = 0.02) were showed as independent predictors of LVEDP (R2 = 49%). "n"nConclusion: Although we observed a moderate correlation between Doppler measurements and LVEDP in patients with severe MS, more similar studies are required.
"Oral ascorbic acid in combination with beta blockers in prevention of atrial fibrillation after Coronary Artery Bypass Graft "
Mousavi M,Eslami M,Sattarzadeh Badkoubeh R,Radmehr H
Tehran University Medical Journal , 2007,
Abstract: Background: Adrenergic beta antagonists are not sufficient to prevent atrial fibrillation after coronary artery bypass graft (CABG). This study was designed to evaluate the effect of ascorbic acid as an adjunct to beta-blockers in prevention of post-CABG atrial fibrillation Methods: Patients who were more than 50 years old and scheduled to undergo CABG were included if they were treated with beta-blockers at least 1 week before surgery. Patients with previous history of atrial fibrillation, AV block, heart rate <50 /min, end-stage renal disease, severe pulmonary or liver disease and those who were taking digoxin or class I and III anti-arrhythmics or had pacemakers were not included. Ascorbic acid group were prescribed 2 gm of ascorbic acid, the night before the surgery, and 1 gm twice daily for 5 days after surgery. Beta blockers continued in both group after surgery. Telemetry monitoring was performed in ICU and Holter monitoring was performed for 4 days. Results: Fifty patients completed the study as ascorbic acid and 50 as control group. The population was 60.19 ± 7.14 years old and 67% were male. The incidence of postoperative atrial fibrillation was 4% in the ascorbic acid group and 26% in control group (odds ratio=0.119, 95% confidence interval: 0.025 to 0.558, P=0.002) Conclusion: Ascorbic acid is well-tolerated, relatively safe and seems effective. Therefore it can be prescribed as an adjunct to beta-blockers for prophylaxis of post-CABG atrial fibrillation.
Pulmonary allograft stenosis after Ross procedure: risk factors
Sattarzadeh R, Radmehr H, Soleimani A, Salehi M
Tehran University Medical Journal , 2008,
Abstract: "nBackground: The Ross procedure has been known as a good method for aortic valve replacement. Pulmonary allograft postoperative stenosis subsequent to the Ross procedure has been noted as an important disadvantage of this technique, although risk factors related to this complication are not clearly recognized. In this study we evaluate the risk factors of pulmonary allograft stenosis after Ross procedure."n"nMethods: This retrospective cohort study was carried out on 42 patients who underwent the Ross procedure. Left ventricular outflow tract obstruction was repaired using pulmonary allografts 22.7±2.5 mm in diameter. Echocardiographic and clinical examinations were performed for all patients at six and 12 months after surgery. Echocardiographic data as well as data related to the allografts were recorded."n"nResults: The mean age of the patients was 28.5±10 years. Postoperative pulmonary valve stenosis was detected in 13 patients (31%). Nine patients (21.4%) had mild stenosis and four patients (9.5%) had moderate stenosis. No relationship was detected between the degree of stenosis and the size of allograft (p=0.08). There was a significant correlation between postoperative pulmonary stenosis and donor age (p=0.04). Predictive variables of pulmonary allograft stenosis after the Ross procedure were low donor and recipient age (p=0.03 and 0.05, respectively)."n"nConclusions: This study shows that the Ross procedure has a rather low incidence of postoperative stenosis and is a suitable substitute for aortic valve replacement. Low donor age is associated with pulmonary allograft stenosis formation, perhaps due to greater viability of tissue cells from younger donors.
8-Hydroxy-2-methylquinolinium dichlorido(2-methylquinolin-8-olato-κ2N,O)zincate(II) methanol solvate
Elham Sattarzadeh,Gholamhossein Mohammadnezhad,Mostafa M. Amini,Seik Weng Ng
Acta Crystallographica Section E , 2009, DOI: 10.1107/s1600536809014202
Abstract: The reaction of zinc chloride and 2-methyl-8-hydroxyquinoline in methanol yielded the title monosolvated salt, (C10H10NO)[ZnCl2(C10H8NO)]·CH3OH, which has the Zn atom within a distorted Cl2NO tetrahedral coordination geometry. Supramolecular chains feature in the crystal structure, comprising all components of the structure stabilized by a combination of O—H...O, N—H...O and O—H...Cl hydrogen bonding.
Bis(μ-2-methylquinolin-8-olato)-κ3N,O:O;κ3O:N,O-bis[(acetato-κO)(methanol-κO)zinc(II)]
Elham Sattarzadeh,Gholamhossein Mohammadnezhad,Mostafa M. Amini,Seik Weng Ng
Acta Crystallographica Section E , 2009, DOI: 10.1107/s1600536809014214
Abstract: The reaction of zinc acetate and 2-methyl-8-hydroxyquinoline in methanol yielded the centrosymmetric dinuclear title compound, [Zn2(C10H8NO)2(CH3CO2)2(CH3OH)2], which has the Zn atom within a distorted NO4 trigonal–bipyramidal coordination geometry. Methanol–acetate O—H...O hydrogen bonds link the dinculear units into a linear supramolecular chain extending parallel to [100].
Bis(acetato-κO)bis(μ3-quinolin-8-olato-κ4N,O:O:O)tetrakis(μ2-quinolin-8-olato-κ3N,O:O)tetrazinc(II) dihydrate
Elham Sattarzadeh,Gholamhossein Mohammadnezhad,Mostafa M. Amini,Seik Weng Ng
Acta Crystallographica Section E , 2009, DOI: 10.1107/s1600536809020157
Abstract: In the centrosymmetric title compound, [Zn4(C9H6NO)6(C2H3O2)2]·2H2O, the ZnII atom that is bonded to one O atom of the acetate group is chelated by a quinolin-8-olate anion. This Zn atom is also bonded to the oxide O atoms of two other quinolin-8-olate anions, which themselves engage in chelation to the other ZnII atoms. The ZnII atom is five-coordinate in a square-pyramidal coordination geometry. The second ZnII atom is six-coordinate as it is linked to two oxide O atoms of the anions that chelate to the acetate-bound metal atom, and is chelated by two quinolin-8-olate ligands. The uncoordinated water molecule is disordered over two positions in a 4:1 ratio. O—H...O hydrogen bonds between the water molecules and the free O atoms of the carboxylate groups consolidate the crystal packing.
Doppler Tissue Imaging: A Non-Invasive Technique for Estimation of Left Ventricular End Diastolic Pressure in Severe Mitral Regurgitation
Roya Sattarzadeh Badkoubeh,Yaser Jenab,Arezou Zoroufian,Mojtaba Salarifar
Journal of Tehran University Heart Center , 2010,
Abstract: Background: Conventional Doppler measurements, including mitral inflow and pulmonary venous flow, are used to estimate left ventricular end diastolic pressure (LVEDP). However, these parameters have limitations in predicting LVEDP among patients with mitral regurgitation. This study sought to establish whether the correlation between measurements derived from tissue Doppler echocardiography and LVEDP remains valid in the setting of severe mitral regurgitation.Methods: Thirty patients (mean age: 57.37 ± 13.29 years) with severe mitral regurgitation and a mean left ventricular ejection fraction (EF) of 46.0 ± 14.95 were enrolled; 16 (53.4%) patients were defined to have EF < 50% and 14 (46.6%) patients had EF ≥ 50%. Doppler signals from the mitral inflow, pulmonary venous flow, and Doppler tissue imaging indices were obtained, and LVEDP was measured invasively through cardiac catheterization.Results: The majority of the standard Doppler and Doppler tissue imaging indices were not significantly correlated with LVEDP in the univariate analysis. In the multiple linear regression, however, early (E) transmitral velocity to annular E' (E/E') ratio ( = 1.09, p value < 0.01), E wave velocity to propagation velocity (E/Vp) ratio ( = 7.87, p value < 0.01), and isovolumic relaxation time ( = 0.21, p value = 0.01) were shown as independent predictors of LVEDP (R2 = 91.7%).Conclusion: The ratio of E/Vp and E/E' ratio and also the isovolumic relaxation time could be applied properly to estimate LVEDP in mitral regurgitation patients even in the setting of severe mitral regurgitation.
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