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Abstract Background and Aims Atrial fibrillation (AF) is a common arrhythmia that occurs following ST‐elevation myocardial infarction (STEMI) and can significantly impact clinical outcomes. We investigated the incidence and predictors of AF following STEMI in patients, as well as its association with major adverse cardiac and cerebrovascular events (MACCE). Methods We conducted a retrospective cohort study, including all STEMI patients who presented under code 247 to Tehran Heart Center between 2016 and 2020 and completed a 1‐year follow‐up. Patients were divided into two groups based on the development of AF during follow‐up, and their baseline and clinical characteristics were compared. We used multivariable regression models to identify predictors of MACCE. Results Out of 3647 STEMI patients, 84 (2.3%) developed new‐onset AF (NOAF). Patients with AF were significantly older and had lower levels of total and low‐density lipoprotein cholesterol, triglyceride, and hemoglobin, but higher levels of fasting blood sugar and creatinine. AF patients were also more likely to have a history of hypertension, chronic kidney disease (CKD), congestive heart failure, and cerebrovascular accidents. The multivariable logistic regression model identified the CHA2DS2‐VASc score and CKD as independent predictors of NOAF following primary percutaneous coronary intervention. Furthermore, the incidence of MACCE was higher in the AF group, and AF independently predicted MACCE with a hazard ratio of 2.766. Conclusion The CHA2DS2‐VASc score and the presence of CKD can serve as useful predictors of NOAF among patients with STEMI. Early detection and appropriate management are crucial to improve outcomes.

Abstract Background Hypertrophic cardiomyopathy (HCM) affects millions of individuals worldwide. In severe cases, it can cause life‐threatening conditions such as left ventricular outflow tract (LVOT) obstruction, mitral regurgitation (MR), and sudden cardiac death, making surgical treatment necessary. This study aimed to report the long‐term outcomes of HCM patients undergoing septal myectomy or mitral valve replacement (MVR) and compare the results between different types of surgeries. Methods This was a retrospective cohort study on HCM patients who underwent surgical treatment in an Iranian referral center between 2005 and 2021. Patients were divided into three groups according to the type of surgery received: septal myectomy, MVR, or a combination of both surgeries. Patient characteristics, surgical and echocardiographic features, and in‐hospital and long‐term outcomes were reported and compared between the three groups. Results A total of 102 patients with an average age of 53.3 ± 16.9 were included. Twenty‐six patients had septal myectomy, 23 had MVR, and 53 had combined septal myectomy and MVR surgery. All surgeries were associated with a significant reduction in interventricular septum thickness and LVOT gradients. After a median of 6.8‐year follow‐up time, patients with an isolated septal myectomy had significantly lower mortality and major adverse cardiac and cerebrovascular events rates than the other groups. Conclusion Isolated septal myectomy showed better long‐term survival rates and can correct HCM‐related MR, while MVR should be preserved only for intrinsic valve defects. More extensive studies are needed to confirm these findings and achieve a comprehensive guideline on surgical treatment of HCM.

Background: Radiation protection plays a key role in medicine, due to the considerable usage of radiation in diagnosis and treatment. The protection against radiation exposure with inappropriate equipment is concerning. Objective: The current study aimed to investigate the efficiency and quality of the radiation protection gowns with multi-layered nanoparticles compositions of Bismuth, Tungsten, Barium, and Copper, and light non-lead commercial gowns in angiography departments for approval of the manufacturers’ declarations and improve the quality of gowns.Material and Methods: In this case study, physicians, physician assistants, radiology technologists, and nurses were asked to wear two commercial and proposed gowns in the angiography departments. Dosimetry of personnel was conducted using a Thermoluminescent Dosimeter (TLD) (GR-200), and the radiation dose received by personnel was compared in both cases. The participants were asked to fill out a questionnaire about the quality and comfort of two radiation protection gowns. Results: However, both gowns provide the necessary radiation protection; the multi-layer proposed gown has better radiation protection than the commercial sample (2 to 14 percent reduction in effective dose). The proposed gown has higher flexibility and efficiency than the commercial sample due to the use of nanoparticles and multi-layers (2.3 percent increase in personnel satisfaction according to the questionnaires). Conclusion: However, the multi-layer gown containing nanoparticles of Bismuth, Tungsten, Barium, and Copper has no significant difference from the non-lead commercial sample in terms of radiation protection, it has higher flexibility and comfort with more satisfaction for the personnel.

Introduction: Evidence showed that cardiac complications may occur in coronavirus disease-19 (COVID-19) during the acute and post-infection phases. This study aimed to evaluate the association between the echocardiographic characteristics and in-hospital mortality of COVID-19 patients as well as the changes after one-month follow-up. Method: All adult (≥18 years old) hospitalized COVID-19 patients in need of echocardiography based on the guideline of the Iranian Society of Echocardiography for performing various types of echocardiography during the COVID-19 pandemic were included in this study. An expert cardiologist performed the echocardiography on all patients and also on all available patients one month after discharge. Results: 146 hospitalized cases of COVID-19 and 81 cases available for 1-month follow-up echocardiography were studied in this prospective study. Left ventricle wall hypokinesia, aorta valve stenosis, dilated Inferior Vena Cava (IVC), and Pulmonary Artery Systolic Pressure (PASP) of more than 35 were associated with 3.59 (95% CI: 1.19-10.79, p = 0.02), ‎11 (95% CI: 3.3 – 36.63, p = 0.001), ‎5.58 (95% CI: 1.04-29.41, p = 0.041)‎, and 2.91 (95% CI: 1.35 – 6.3, p = 0.001) times higher odds of mortality than healthy subjects. In 1-month follow-up of patients, deterioration in LVEF (p = 0.03) was detected in the not-fully vaccinated patients, and a significant decrease in PASP was observed in all cases (p = 0.04); but these changes were not clinically important. Conclusion: Left ventricle wall hypokinesia, aorta valve stenosis, dilated IVC, and PASP ≥ 35 were predictors of in-hospital mortality in our study. There were not any potential clinically significant differences in one-month echocardiographic follow-ups of the studied patients.

BackgroundContrast medium–induced acute kidney injury (CIAKI) is a leading cause of acquired renal impairment. The effects of antioxidants have been conflicting regarding the prevention of CIAKI. We performed a study of vitamin E use to decrease CIAKI in patients undergoing elective coronary angiography. Methods and ResultsIn a placebo‐controlled randomized trial at 2 centers in Iran, 300 patients with chronic kidney disease—defined as estimated glomerular filtration rate