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Depression and anxiety are common events in 30-40 percent of post coronary artery bypass graft (CABG) surgery patients. Depression symptoms in patients with CAD are expected to be significantly more, comparing the public incidence rate. Impaired remedy after coronary artery events may partly be attributed to depression and anxiety. If anxiety continues, it may lead to elevate metabolism and oxygen consuming. High level of anxiety increases the pain sensation in post CABG patients. This paper aimed to review results and findings of previous studies in the field of anxiety and depression management of post coronary artery bypass graft surgery. Up to 78 credited studies collected and compared in this review. Findings revealed that depression and anxiety could more complicate medical post CABG remedy. In addition, preoperative depression and anxiety symptoms would be persisted in post CABG recovery. Therefore, prior patients training about depression and anxiety symptoms would be wise strategy to help them describe their psychological mood before and after surgery. Findings also suggest that anxiety amplified depression prevalence in post CABG patients. Among the other methods, Benson relaxation is the best complementary medicine to mitigate pre-CABG anxiety. In addition, massage and music therapy could influence on post CABG anxiety and depression. There are also some robust evidences, indicating that perceived social support could influence post CABG anxiety and depression. Furthermore, sedative (such as propofol) and opioid and non-opioid analgesics, which used in post CABG pain management, could directly reduce anxiety level. Antidepressants sertraline and citalopram are the best studied post CABG pharmacological treatments which influence on post CABG remedy and hospitalization. The results suggest that treatment for anxiety is essential for alleviating patient suffering. In addition, anxiety treatment could protect patient against depression before and after CABG surgery. [ABSTRACT FROM AUTHOR]

Background: Electrocardiography (ECG) is now proposed as a simple and cost‐effective tool to determine the location of arrhythmias before ablation. We aimed to examine the value of the QRS onset of outflow tract PVC in V1 and V2 leads recorded in fourth, third, and second intercostal spaces to differentiate two main origins for premature ventricular contraction (PVC) including right ventricular outflow tract (RVOT) and left ventricular outflow tract (LVOT). Methods: In this prospective cohort study, a total of 58 patients were studied, from whom a surface ECG was obtained using V1 and V2 leads in the fourth, third, and second intercostal spaces. ECG and Electrophysiology studie (EPS) data were then recorded and compared to determine the sensitivity and specificity of QRS onset in locating arrhythmias. The reciever operating characterictic (ROC) curve analysis was applied to test diagnostic performance. Results: Based on the time of PVC initiation in each of the V1 and V2 leads in the fourth intercostal space, if PVC is recorded earlier in the V1 lead, its source in 95.8% of the patients is RVOT and if PVC preceded the V2 lead, 70.59% of the patients had PVC from LVOT. Comparing of QRS onset in V1 and V2 leadsrecorded from third% and and second intercostal spaces had considerable sensitivity and specificity to determine the origin of the outflow tract PVC (81.82 and 94.12%, respectively) Conclusion: Simultaneous recording of outflow tract PVCs from second third and fourth intercostal spaces and comparing their onset can determine the left and right outflow tract PVCs with high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Context: Various techniques have been proposed for suturing following prosthetic aortic valve implantation, but each has its potential side effects such as patient-prosthesis mismatch (PPM) and paravalvular leak (PVL). Aims: In the present study, we aimed to compare the postoperative sequels of aortic valve replacement (AVR) following the use of two suturing techniques including from the inside of the aorta as the common and classic suturing techniques as compared to new approach including from the outside of the aorta. Settings and Design: This cross-sectional study was performed on patients suffering from symptomatic severe aortic valve disease and candidates for AVR in one of three referral hospitals for cardiovascular disease patients in Shiraz from 2019-2021. Subjects and Methods: The patients underwent one of the two considered surgical techniques for AVR including traditional approach (n = 60) or the tested approach (suturing from the outside of the aorta) (n = 30). Statistical Analysis Used: For statistical analysis, results were presented as mean ± standard deviation for quantitative variables and were summarized by frequency (percentage) for categorical variables. Results: PVL and PPM were revealed in none of the participants undergoing the tested approach, while the pointed complications were found in 41.7% and 25.0% of patients underwent traditional approach, respectively, indicating a significant difference. There was no evidence of abnormal dimensionless valve index (DVI) in the patients undergoing sutures from outside the aorta, whereas the rate of DVI abnormality in the patients undergoing traditional procedures was shown to be 18.3%. The mean aortic valve gradient was significantly higher in the group scheduling for the traditional surgical method. Conclusions: Applying new suturing method as suturing from the outside of the aorta, due to the selection of appropriate valve size, the risk for adverse consequences including PPM, PVL, or DVI can be significantly reduced. [ABSTRACT FROM AUTHOR]

Background: There is some evidence of the association between ST‐segment elevation in the V4R chest lead and the likelihood of anterior wall myocardial infarction; however, the link of this phenomenon with the location and the severity of the coronary involvements in such patients remains uncertain. We aimed to investigate the ST‐segment elevation in V4R leads in patients with anterior myocardial infarction and also its effect on prognosis as well as the detection and prediction of the location of arterial stenosis in coronary angiography. Methods: Data collection was performed by reviewing the hospital recorded files of 195 patients' suspicion of acute myocardial infarction who have been referred within 2 h of the onset of cardiac symptoms. The patients were then categorized into two groups with and without ST elevation in the V4R chest lead. Results: Comparing two groups showed a significantly higher rate of concurrent ST‐segment elevation in V1 lead in those with ST‐segment elevation in V4R. Echocardiography on the day after anterior myocardial infarction showed LVEF <40% in 74% and 35.2% of patients with and without ST‐segment elevation in V4R, respectively, indicating a significant difference. The lesions on proximal LAD were more common in the group with ST‐segment elevation in V4R. Conclusion: Our study emphasized a high likelihood of ST‐segment elevation in V4R lead concurrently with ST‐elevation in V1 lead. Also, the appearance of ST‐segment elevation in V4R lead can be accompanied with a lower LVEF, myocardial infarct size, involvement of proximal part of LAD, and Wrap around LAD. [ABSTRACT FROM AUTHOR]

Background: Early repolarization (ER) pattern is diagnosed when the J‐point is elevated on the patient's electrocardiogram. The aim of this study was to evaluate signal‐averaged electrocardiography (SAECG) in patients with ER pattern. Methods: Subjects were divided into three groups: 1‐patients with normal ECG pattern (control group); 2‐patients with J‐point elevation in the inferior leads; and 3‐patients with J‐point elevation in non‐inferior leads. Results: The mean filtered QRS duration in groups with J‐point elevation in inferior leads and non‐inferior leads and in the control, was 86.4 ± 23.4 msec, 84.8 ± 26.6 msec, and 85.8 ± 24.8 msec, respectively, indicating no significant difference across the three groups. The mean duration of terminal QRS < 40µV was 21.2 ± 4.2 msec, 22.8 ± 4.6 msec, and 23.1 ± 4.5 msec in the mentioned groups, respectively, without a significant difference between the groups. Additionally, the mean root‐mean‐square voltage of terminal 40 msec was 34.5 ± 8.3 µV, 35.3 ± 8.6µV, and 35.7 ± 9.2 µV in patients with increased J‐point in inferior leads, non‐inferior leads, and the control group, respectively, showing no difference between the groups. Conclusion: In conclusion, we found that parameters in SAECG did not have any significant difference between patients with ER pattern and healthy individuals. Moreover, we concluded that SAECG cannot distinguish the patients with elevated J‐point in inferior leads from non‐inferior leads. Overall, SAECG does not appear to be a reliable diagnostic tool for the assessment of ER pattern. [ABSTRACT FROM AUTHOR]

In this work, we present the detailed results of magnetic, structural, and magnetocaloric measurements in Ni–Mn–In-based Heusler alloys, namely, Ni51Mn32.8In16.2, Ni50.2Mn33.6In16.2, and Ni51Mn33.4In15.6. The characteristics of magnetostructural coupling play an important role in the magnetic field-driven behavior of these alloys. A small variation in the stoichiometry composition broadens the magnetic entropy change curve and shifts the critical temperatures by as much as 48 K. The effect of cobalt doping on the magnetic, structural, and magnetocaloric properties in these multifunctional alloys is investigated through characterizing Ni50Co2Mn35In13 and Ni45Co5Mn37In13 samples. Cobalt doping affects the martensitic and magnetic transformation temperatures and enhances the ferromagnetic properties of the parent austenitic phase. Therefore, the magnetization change accompanying the martensitic transformation is significantly improved, resulting in a large magnetic entropy change of 21.6 J kg $^{-1}\,\,\text{K}^{-1}$ at 1.5 T. Additionally, Co doping broadens the operating temperature window to 21 K around room temperature. Consequently, a significant effective refrigeration capacity of 254 J kg−1 for 1.5 T is obtained which is comparable or even superior to that of the high-performance, though expensive, rare-earth-based magnetocaloric refrigerants. The high performance, low cost, nontoxicity, and tunability make these alloys of great interest and promising prospect for an affordable magnetic refrigeration system. [ABSTRACT FROM AUTHOR]

Introduction: Gradual painful loss of active and passive range of motion in shoulder joint was introduced as adhesive capsulitis (AC). Disabilities in patients with AC are absenteeism from work, loss to leisure time, and recurrent seeking to health care services. The aim of this study was to evaluate the incidence of AC following pacemaker implementation. The effect of physical therapy and exercise education was also evaluated to prevent AC following pacemaker implementation. Methods: This study is a randomized clinical controlled trial. It was conducted on 62 pacemaker candidates. Patients with no shoulder pain and without any motion limits were enrolled in the study consecutively. The patients randomly were divided into two groups after pacemaker implementation. One group was treated with physical therapy (group A, n = 28) and the other group did not (group B, n = 34). The incidence of AC was assessed in both groups after 4 months. Results: A total of 62 patients were enrolled in the study. The mean age was 63.2 ± 12.1 years in the group A and 67.1 ± 17.6 years in the group B. Age was not significantly different between groups. A total of 11 patients (17.7%) had AC 16 weeks after the initial visit (two patients in group A and nine patients in group B; P =.004). Conclusions: Incidence of AC is 17.7% following device implantation. Exercise education and physical therapy significantly reduces AC incidence following pacemaker implantation. [ABSTRACT FROM AUTHOR]

Background: Cardiac Resynchronization Therapy (CRT) is one of the suggested managements in patients with Left Bundle Branch Block (LBBB) and heart failure with reduced ejection fraction. Finding a predictor for poor response to CRT may help better candidate selection for device implantation and better final outcome. Objective: This retrospective study aimed to assess QRS left axis deviation as a novel indicator of clinical and echocardiographic response to CRT. Methods: This retrospective single-center analysis was done on 95 CRT patients with LBBB in their electrocardiograms (47 patients had normal QRS axis and 48 had left QRS axis deviation). These patients were followed up for 19 ± 3 months after CRT implantation. Response to CRT was evaluated by assessment of New York Heart Association (NYHA) functional class, echocardiographic examination, and number of hospitalizations within six months before and after CRT implantation. Results: The response rate to resynchronization was 65.9% in the left axis group and 77.3% in the normal axis group, and the difference was statistically significant (P = 0.013). Improvement in echocardiographic findings, including increase in the left ventricular ejection fraction (P = 0.004), decrease in the end diastolic volume (P = 0.010), and decrease in the end systolic volume (P = 0.014), were also noted. However, improvement in NYHA class was reported in both groups without any statistically significant difference (P = 0.066). Conclusion: Left axis deviation was associated with a lower rate of CRT response in patients with CRT implantation and LBBB. [ABSTRACT FROM AUTHOR]

In this work the magnetocaloric effect (MCE) and hysteresis losses of Ni45Co5Mn(37-x)In(13+x) alloy (x= 0, 0.4) are studied. Also we propose a new approach in calculating the average entropy change to eliminate the overestimation of the magnetic entropy change calculation using Maxwell's relations which is commonly seen in the indirect MCE calculation in the literature. The attributes of magnetostructural coupling have an important role in the magnetic behavior of these magnetofunctional alloys. This work exhibits that a strong magnetostructural coupling can be achieved over a wide temperature range in this alloy family which results in a higher MCE and relative cooling power (RCP) compared to other Ni-Mn-In based Heusler alloys. It's shown that by increasing the applied field the peak of the entropy change curves shifts to lower temperatures. Additionally, a small variation in the stoichiometry composition broadens the magnetic entropy change curve and shifts the critical temperatures by about 36 K to around room temperature. Furthermore, due to the enhancement in ferromagnetic exchange interactions in austenite, the magnetization change accompanying the martensitic transformation is greatly improved, resulting in a large magnetic entropy change of 31 Jkg-1K-1 under 5T field. The broadened and higher peak of the entropy change curves produced a significantly high relative cooling power in Ni45Co5Mn36.6In13.4 (488 JKg-1) and Ni45Co5Mn37In13 (317 JKg-1) under 5T field. These results are especially promising in finding low-cost, high-performance magnetocaloric material for magnetic refrigeration systems. [ABSTRACT FROM AUTHOR]

Background: Sotalol is the most effective anti-arrhythmic drug in patients with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). Objective: This retrospective study aimed to evaluate the effect of sotalol on Signal Averaged ECG (SAECG) parameters in patients with ARVC. Methods: This retrospective study was performed on 11 ARVC patients who were recruited from the cardiology clinic. SAECG was performed in all patients at baseline and six weeks after treatment with sotalol. To assess the effects of sotalol on SAECG, the three following parameters were taken into account: 1) filtered QRS duration, 2) duration of terminal QRS < 40 µv, and 3) Root Mean Square (RMS) voltage of terminal 40 ms. Patients with coronary artery disease, dilative or hypertrophic cardiomyopathy, congenital heart disease, and significant valvular heart disease were excluded from the study. Results: In total, 11 patients with confirmed ARVC were included. The mean age of the participants was 28 ± 11 years and all patients were male. History of syncope was reported in four patients, ventricular tachycardia in three patients, positive family history of cardiac disorders in two patients, and Epsilone wave in four patients. Besides, Implantable Cardioverter Defibrillators (ICDs) were implanted in five patients. No significant change was detected in the filtered QRS duration following the use of sotalol (P = 0.542). However, a significant reduction was observed in the Low Amplitude Signal (LAS) duration below 40 µv (P = 0.002). Additionally, a significant increase was found in the RMS voltage in the last 40 ms of the QRS (P = 0.043). Conclusion: Sotalol decreased the duration of terminal QRS < 40 µv. Because of this valuable effect, sotalol should be considered as the first-line therapy for treating ARVC patients. [ABSTRACT FROM AUTHOR]

To make nanoparticles useful to fit various applications, the fundamental understanding of their magnetic and structural behavior is essential. A systematic in-depth study of the effect of field, temperature, and nanoparticles size on the critical points, and the magnetic properties of chemically synthesized Y2Fe17 nanoparticles have been performed. The blocking temperature varies with the change in the applied magnetic field as well as nanoparticles’ size variations. The Curie temperature was mostly influenced by particles’ size. Saturation magnetization and coercivity were shown to be temperature, size, and shape dependent. The results are significant and especially of interest in material science as they pave the path to a better understanding of different phenomena in nanomaterials in order for them to be used in diverse scientific applications. [ABSTRACT FROM AUTHOR]

A systematic study of the magnetocaloric effect of a Ni51Mn33.4In15.6 Heusler alloy converted to nanoparticles via high energy ball-milling technique in the temperature range of 270 to 310 K has been performed. The properties of the particles were characterized by x-ray diffraction, electron microscopy, and magnetometer techniques. Isothermal magnetic field variation of magnetization exhibits field hysteresis in bulk Ni51Mn33.4In15.6 alloy across the martensitic transition which significantly lessened in the nanoparticles. The magnetocaloric effects of the bulk and nanoparticle samples were measured both with direct method, through our state of the art direct test bed apparatus with controllability over the applied fields and temperatures, as well as an indirect method through Maxwell and thermodynamic equations. In direct measurements, nanoparticle sample’s critical temperature decreased by 6 K, but its magnetocaloric effect enhanced by 17% over the bulk counterpart. Additionally, when comparing the direct and indirect magnetocaloric curves, the direct method showed 14% less adiabatic temperature change in the bulk and 5% less adiabatic temperature change in the nanostructured sample. [ABSTRACT FROM AUTHOR]

A systematic study of the size effect on the magnetic and structural properties of a Ni51Mn33.4In15.6 Heusler alloy converted to nanoparticles has been performed. We present new data to explain the enhanced magnetic properties of the nanostructured Heusler alloy synthesized through a high-energy ball-milling technique. The properties of the particles were characterized by X-ray diffraction, electron microscopy, and magnetometer techniques. Isothermal magnetic field variation of magnetization exhibits field hysteresis in bulk Ni51Mn33.4In15.6 alloy across the martensitic transition. As the size of the nanoparticles is reduced, there is an increase in the magnetization per unit of applied magnetic field, and a decrease in the coercivity as well as a substantial reduction in hysteresis. [ABSTRACT FROM PUBLISHER]

A systematic study of the size effect on the magnetic and structural properties of Y2Fe17< nanoparticles has been performed.We present newdata to explain the enhanced magnetic properties of nanostructured yttrium-iron alloy synthesized through alkalide reduction chemical synthesis. The properties of the particles were characterized by x-ray diffraction, electron microscopy, and magnetometer techniques. As the size of the nanoparticles is reduced, there is an increase in magnetization per unit of applied magnetic field, a decrease in the coercivity and a substantial reduction in hysteresis. [ABSTRACT FROM AUTHOR]

A new experimental test bed has been designed, built, and tested to evaluate the effect of the system's parameters on a reciprocating Active Magnetic Regenerator (AMR) near room temperature. Bulk gadolinium was used as the refrigerant, silicon oil as the heat transfer medium, and a magnetic field of 1.3 T was cycled. This study focuses on the methodology of single stage AMR operation conditions to get a high temperature span near room temperature. Herein, the main objective is not to report the absolute maximum attainable temperature span seen in an AMR system, but rather to find the system's optimal operating conditions to reach that maximum span. The results of this research show that there is a optimal operating frequency, heat transfer fluid flow rate, flow duration, and displaced volume ratio in any AMR system. By optimizing these parameters in our AMR apparatus the temperature span between the hot and cold ends increased by 24%. The optimized values are system dependent and need to be determined and measured for any AMR system by following the procedures that are introduced in this research. It is expected that such optimization will permit the design of a more efficient magnetic refrigeration system. [ABSTRACT FROM AUTHOR]

Background: Paroxysmal atrial tachyarrhythmias, especially atrial fibrillation is a fatal complication that occur more frequently in patients with β-thalassemia major (β-TM) than normal population. This study aimed to compare P-wave dispersion (PWD) in patients with β-thalassemia major with control subjects for the early prediction of arrhythmia risk. Methods: Sixty-six adult patients with β-TM referring to Shahid Motahari hospital of Marvdasht in winter 2015 were compared to 50 non-thalassemic adults. All participants underwent routine 12-leads electrocardiography (ECG) for cardiac evaluation. ECGs were scanned and PWD was calculated as the difference between the maximum and the minimum P-wave duration. Results: Patients with β-TM aged between 18 to 47 years old and were matched by age and gender to the control group. There was a statistically significant difference between the study and control groups in minimum P-wave duration (44.8±9.8 vs 49.1±5.3 ms, p=0.006), maximum P-wave duration (105.3±12.5 vs 97.6±6.4 ms, p<0.001) and PWD (60.5±11.00 vs 48.6±78 ms, p<0.001). Conclusion: PWD increased in β-TM patients, thus, these patients should be closely followed up for risk of atrial fibrillation which can be life threatening. [ABSTRACT FROM AUTHOR]