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Background. Bioprosthetic mitral valves (MV) have limited durability. Dysfunction and degeneration of these valves can lead to reoperation and progressive heart failure. We investigated the frequency and predictors of MV bioprosthesis early degeneration within three years following MV replacement surgery. Methods. In this retrospective cohort study, we retrieved the data of consecutive patients who underwent bioprosthetic MV replacement through midsternotomy at Tehran Heart Center between 2013 and 2019. Based on the reviewed parameters of the bioprosthetic MV in the follow-up echocardiography, the patients were divided into two groups to compare the variables respecting early degeneration. Finally, the predictors of early degeneration were recognized using the Cox regression hazards model. Results. We reviewed and analyzed data of 177 patients from our hospital database. The mean age of the patients was 63.9 ± 11.7 years and 100 (56.5%) were women. 39 (22.0%) patients had experienced early degeneration and two (1.1% of the total) had died during the follow-up period. Patients in the degeneration group tended to have a history of stroke and renal failure, although not statistically significant. The sole independent predictor of early degeneration of bioprosthetic MV was a high MV mean gradient in the first postoperative echocardiography study (HR = 11.01, 95% CI: 4.80–25.24; P < 0.001). Conclusion. About 22.0% of our patients had echocardiographic criteria for early degeneration, and according to our results, increased MV gradients (without considering the reason) in the first postoperative echocardiography were the sole independent predictor for it. Careful valve selection can be essential in reducing early degeneration. [ABSTRACT FROM AUTHOR]

Background: Although several studies are available regarding baseline Electrocardiographic (ECG) parameters and major and minor ECG abnormalities, there is considerable controversy regarding their age and gender differences in the literature. Methods: Data from 7630 adults aged ≥ 35 from the Tehran Cohort Study registered between March 2016 and March 2019 were collected. Basic ECG parameters values and abnormalities related to arrhythmia, defined according to the American Heart Association definitions, were analyzed and compared between genders and four distinct age groups. The odds ratio of having any major ECG abnormality between men and women, stratified by age, was calculated. Results: The average age was 53.6 (± 12.66), and women made up 54.2% (n = 4132) of subjects. The average heart rate (HR) was higher among women(p < 0.0001), while the average values of QRS duration, P wave duration, and RR intervals were higher among men(p < 0.0001). Major ECG abnormalities were observed in 2.9% of the study population (right bundle branch block, left bundle branch block, and Atrial Fibrillation were the most common) and were more prevalent among men compared to women but without statistical significance (3.1% vs. 2.7% p = 0.188). Moreover, minor abnormalities were observed in 25.9% of the study population and again were more prevalent among men (36.4% vs. 17% p < 0.001). The prevalence of major ECG abnormalities was significantly higher in participants older than 65. Conclusion: Major and minor ECG abnormalities were roughly more prevalent in male subjects. In both genders, the odds of having major ECG abnormalities surge with an increase in age. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders (MHD) impose a considerable burden on public health systems. With an increasing worldwide trend in urbanization, urban mental health stressors are affecting a larger population. In this study, we evaluated the epidemiology of mental health disorders in the citizens of Tehran using the Tehran Cohort Study (TeCS) data. Methods: We utilized data from the TeCS recruitment phase. A total of 10,247 permanent residents of Tehran metropolitan (aged 15 years and older) were enrolled in the study from March 2016 to 2019 via systematic random sampling from all 22 districts of Tehran. The participant's demographic, socioeconomic, and medical characteristics were evaluated by conducting comprehensive interviews. The standardized Persian version of the General Health Questionnaire version 28 was utilized to assess the mental status of the patients according to four central mental health disorders. Results: Almost 37.1% of Tehran residents suffered mental health problems (45.0% of women and 28.0% of men). The greatest incidence of MHDs was seen in the 25–34 and over 75 age groups. The most common mental health disorders were depression (43%) and anxiety (40%), followed by somatization (30%) and social dysfunction (8.1%). Mental health disorders were more frequent in the southeast regions of the city. Conclusions: Tehran residents have a significantly higher rate of mental health disorders compared to nationwide studies, with an estimated 2.7 million citizens requiring mental health care services. Awareness of mental health disorders and identifying vulnerable groups are crucial in developing mental health care programs by public health authorities. [ABSTRACT FROM AUTHOR]

Background and Aims: Coronary artery disease is high‐risk comorbidity of COVID‐19 infection. Nonelective coronary artery revascularization in COVID‐19 patients carries substantial risk. Therefore, it is essential to understand the risk factors and outcomes fully. This study aims to evaluate the prognosis of coronary artery bypass grafting (CABG) surgery in patients with COVID‐19. Methods: This retrospective cohort study assesses 171 patients who underwent urgent and emergent CABG in Tehran Heart Center from March 2020 to September 2021. The patients were allocated to cases and controls based on COVID‐19 infection status. Demographic and clinical features, alongside the complications and outcomes, were compared between the two groups. Results: According to diagnostic criteria, 62 patients were diagnosed with COVID‐19 (Case) and 109 patients had no COVID diagnosis (Control). Regarding the demographics and risk factors, hypertension was more prevalent among patients with COVID‐19 (64.5% compared to 43.1% p= 0.007). Length of hospital stay, ventilation time, and intensive care unit (ICU) stay time were significantly higher in patients infected with COVID‐19. Postoperative complications, including stroke, atrial fibrillation, pleural effusion, blood transfusion, and Inotrope use, were significantly higher in the case group. Mortality rates were also higher in COVID‐19 patients with an odds ratio of 1.53; however, this difference is not statistically significant (p: 0.44, 95% CI = 0.50–4.01). Conclusion: COVID‐19 is associated with a significantly higher hospital stay, ventilation time, and ICU stay. Mortality rates are also higher, albeit insignificantly. Various postoperative complications are also higher with COVID‐19. [ABSTRACT FROM AUTHOR]

Background: Endometrial scratch (ES) has been suggested to improve assisted reproductive techniques success rates by investigating implantation failure. Objective: In this study, we evaluated the effect of ES on the outcomes of frozen embryo transfer (FET) in women with at least 2 failed embryo transfer cycles. Materials and Methods: In this historical cohort study, medical data of 236 infertile women who underwent in-vitro fertilization-FET at Ebne-sina Infertility Center, Tehran, Iran, from January 2015-December 2021 was extracted from their medical records. Based on having ES before FET, they were assigned to either the scratch (n = 118) or the no-scratch group (n = 118). We compared these groups regarding pregnancy rates and outcomes. Results: The demographic characteristics were similar in both groups regarding weight, body mass index, the number of previous embryo transfers, and the duration of infertility. However, the scratch group had a slightly higher mean age (32.31 vs. 29.96 yr, p < 0.001). No statistically significant difference was observed between groups regarding pregnancy rate (p = 0.89). No significant association was observed between scratch, infertility duration, the number of previous FET attempts, and the likelihood of pregnancy in a logistic regression model. No major complications were observed. Conclusion: Hysteroscopic endometrial scratching with scissors probably has no effect on FET outcomes, including pregnancy or live birth rates. [ABSTRACT FROM AUTHOR]