Infective Endocarditis: Clinical Characteristics and Echocardiographic Findings.

Purpose: Infective endocarditis (IE) remains a disease with high morbidity and mortality. The aim of this study was to determine the clinical characteristics and echocardiographic features of patients with IE. Methods: We analyzed patients with either definitive or probable diagnosis of IE who were hospitalized in a teaching hospital in Mashhad, Iran between June 2011 and January 2020. Patients who survived were followed up by echocardiography for at least 6-month after hospital discharge. Results: A total of 82 cases with IE were included of which 62 (75.6%) received definitive diagnosis. The mean age was 39.7 ± 18.7 years and 52 (63.4%) were male. The most common preexisting structural cardiac abnormality that predispose patients to IE were congenital heart diseases (28 %) of which bicuspid aortic valve was more common (n = 12, 14.6%), followed by ventricular septal defect (n = 9, 11%) and Tetralogy of Fallot (TOF) (n = 2, 2.4%). Three (3.6 %) cases had rheumatic heart disease and 12 (14.6 %) were injecting drug users. The most common causative pathogen was Staphylococcus aureus, detected in 7 (19.4%) cases. Follow-up echocardiography revealed right or left ventricular failure in 10 (12.1%) cases. Cardiac complications occurred in 41 (50%) cases and systemic complications in 63 (76.8%). All-cause mortality was 41.5% (n = 34) and 6 (18.1%) patients died due to cardiovascular complications. Conclusions: The short- and long-term prognosis in IE was poor and the predictors for in-hospital and 1-year mortality were defined as heart failure and septic shock. Congenital heart disease and intravenous illicit drug using (IVDU) were the most common predisposing condition which may necessitate a revision in the IE prophylaxis recommendations.

One-year survival cohort of patients with reduced ejection fraction heart failure in Iranian population: A single center study.

BACKGROUND: Cardiovascular diseases (CVDs) are one of the main concerns of health care systems. The aim of this study was to investigate the most important prognostic factors of heart failure (HF) and their survival outcomes in patients in Birjand, East of Iran. METHODS: A total of 194 systolic HF patients hospitalized in Birjand Valiasr hospital were followed up for 12 months in 2016, and those with reduced left ventricle ejection fraction (LVEF < 50%) were included in this study. Kaplan-Meier and Cox proportional hazard analysis were used to determine the association of each factor with events. RESULTS: The mean age of patients was 68.23 ± 13.40 (27-95) years, and 57.2% (111 out of 194) were women. Mean survival time was 294.7 ± 9.924 days. Pervious history of myocardial infarction (MI) [2.141 (1.101-4.161)] increased the risk of cardiovascular hospitalization. Elevated blood levels of potassium [2.264 (1.438-3.564)] was found to be a risk factor for all-cause and cardiovascular mortality. Moreover, there was a reverse relationship between body height [0.942 (0.888-0.999)] and cardiovascular death. Patients with opium addiction [4.049 (1.310-12.516)] are at a higher risk of cardiovascular mortality. Lower levels of LDL-C [0.977 (0.960-0.996)] and living in rural areas [3.052 (1.039-8.964)] increased all-cause mortality levels. Lack of pervious history of chronic obstructive pulmonary disease (COPD) decreased cardiovascular hospitalization [0.265 (0.062-1.122)]. CONCLUSION: In our study, serum potassium, LDL-C, and uric acid levels in patients with HF were identified as prognostic factors. The height of patients, which can be an indicator of the functional state of their respiratory system, and the history of COPD were also recognized as prognostic factors. Opium use and rural living were identified as social factors influencing patients' prognosis.

Characteristics and outcomes of hospitalized patients with cardiovascular complications of COVID-19.

Introduction: To address cardiovascular (CV) complications and their relationship to clinical outcomes in hospitalized patients with COVID-19. Methods: A total of 196 hospitalized patients with COVID-19 were enrolled in this retrospective single-center cohort study from September 10, 2020, to December 10, 2020, with a median age of 65 years (IQR, 52-77). Follow-up continued for 3 months after hospital discharge. Results: CV complication was observed in 54 (27.6%) patients, with arrhythmia being the most prevalent (14.8%) followed by myocarditis, acute coronary syndromes, ST-elevation myocardial infarction, cerebrovascular accident, and deep vein thrombosis in 15 (7.7%), 12 (6.1%), 10(5.1%), 8 (4.1%), and 4 (2%) patients, respectively. The proportion of patients with elevated high-sensitivity troponin I, N-terminal pro-B-type natriuretic peptide, left ventricular diastolic dysfunction, and heart failure with preserved ejection fraction was greater in the CV complication group. Severe forms of COVID-19 comprised nearly two-thirds (64.3%) of our study population and constituted a significantly higher share of the CV complication group members (75.9%vs 59.9%; P =0.036). Intensive care unit admission (64.8% vs 44.4%; P =0.011) and stay (5.5days vs 0 day; P =0.032) were notably higher in patients with CV complications. Among 196patients, 50 died during hospitalization and 10 died after discharge, yielding all-cause mortality of 30.8%. However, there were no between-group differences concerning mortality. Age, heart failure, cancer/autoimmune disease, disease severity, interferon beta-1a, and arrhythmia were the independent predictors of all-cause mortality during and after hospitalization. Conclusion: CV complications occurred widely among COVID-19 patients. Moreover,arrhythmia, as the most common complication, was associated with increased mortality.

Surveying the Effect of Opioid Abuse on the Extent of Coronary Artery Diseases in Diabetic Patients.

BACKGROUND: Diabetes mellitus is recognized as one of the most common, serious, and costly chronic diseases. Opium addiction is also a common health problem in Iran. Given the high prevalence of opium use in South Khorasan Province and the increasing prevalence of opioid abuse in the community, this study was performed to investigate the effect of opioid abuse on the extent of disease in diabetic patients undergoing coronary angiography in the cardiology department of Vali-e-Asr Hospital in Birjand city, South Khorasan Province, Iran. METHODS: This study recruited a total of 1051 diabetic patients who underwent coronary angiography in the cardiology department of Vali-e-Asr Hospital of Birjand city from 2011 to 2015. The collected data were analyzed using SPSS version 22.0 with the chi-square test and univariate regression analysis. P value <0.05 was considered as statistically significant. RESULTS: Among opiate-addicted diabetics, the risk of coronary artery disease was 0.44 times higher than among nonaddicted diabetics (range 0.24-0.77, P=0.004). The extent of coronary vessel involvement, when present, was not different between the two groups. CONCLUSION: Opiate-addicted diabetics appear to be more susceptible to CAD than their nonaddicted counterparts. The determinants and correlates of this interaction must be the subject of further study.