The participants with cardiac iron overload had a lower GLS than those without one. This suggests that GLS may be a useful method to predict myocardial iron overload particularly in β-thalassemia patients with subclinical cardiac involvement.

Background: The superior type of sinus venosus atrial septal defect (SVASD) is a rare form of the atrial septal defect (ASD) in which the upper part of the atrial septum does not exist. The presence of other cardiac anomalies such as anomalous pulmonary venous connections has been reported in this type of congenital heart disease. This study aimed to assess the presence of the patent foramen ovale (PFO) in patients with the superior type of SVASD. Methods: This retrospective case-control study on 387 patients, consisting of 187 patients with a definite SVASD and 200 patients with problems other than the ASD, was conducted in Rajaie Cardiovascular Medical and Research Center between February 2005 and July 2014. Seven patients with inadequate data were excluded from the analysis. The presence/absence of the PFO was also evaluated in the case and control groups. Results: The analyses were performed on 182 male and 198 female patients at a mean age of 39.07±14.41 and 51.01±15.80 years in the case and control groups, respectively. The PFO was significantly more frequent in the patients with the superior type of SVASD than in those without the condition (P<0.001). The persistence of the left superior vena cava was seen in 34 out of 180 patients with SVASD and in 1 out of 200 patients without the condition (18.9% vs 0.5%; P<0.001). Conclusion: This study was the first to highlight the coexistence of the PFO and the superior type of SVASD. Physiological, genetic, or fetal factors may play an important role in the association between the PFO and the SVASD.

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Background: Cardiovascular diseases are leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Cardiac involvement in SLE can often go undetected. Three-dimensional (3D) speckle tracking echocardiography (STE) is a noninvasive imaging technique that can assess the function of the heart’s ventricles in an accurate and reproducible way. This makes it an attractive option for detecting early signs of heart disease in SLE patients. By identifying these subclinical cardiac abnormalities, 3D-STE may help reduce the negative impact of cardiovascular diseases in SLE population. Methods: This cross-sectional study was undertaken to compare the left ventricular (LV) function between patients with SLE compared to age- and gender-matched controls using Two-dimensional (2D) and 3D-STE. A total of 52 SLE patients and 53 controls without any known cardiovascular events were included in the study. Patients’ past medical and drug history were collected through evaluating medical records and questionnaires. 2D and 3D-STE measured various left ventricular parameters. Results: The current study found no significant differences in left ventricle ejection fraction, left ventricle end-diastolic volume, left ventricle end-systolic volume, left ventricle end-diastolic mass, and left ventricle end-systolic mass between the two groups. However, the SLE group exhibited a a significantly lower global longitudinal strain (GLS) compared to the control groupaccording to all types of echocardiographic assessments, including 3D and 2D long-axis strain (LAX), apical 2-chamber (A2C), and apical 4-chamber (A4C) assessments (all P-values<0.05). Furthermore, a good inter- intra-rater reliability was observed regarding the GLS measurement with 3D-STE. Additionally, the study identified a significant correlation between GLS and SLE duration (r (50) = 0.46, P= 0.04). The use of prednisolone and nephrology disorders were also found to impact GLS measurements. Conclusion: Despite a normal LVEF in patients with SLE, GLS measuemetns indicated that LV systolic dysfunction was observed more frequently in SLE patients compared to their healthy counterparts. Therefore, advanced 3D-STE techniques may be useful in identifying subtle abnormalities in LV function in SLE patients.

A 48-year-old male with a history of secundum type atrial septal defect (ASD) closure in childhood presented to our outpatient clinic complaining of palpitation for six months. Interestingly, transthoracic and transesophageal echocardiography exams showed an undiagnosed partially unroofed coronary sinus associated with persistent left superior vena cava (LSVC) and Cor triatriatum.

A 30-year-old woman was referred to our department for a cardiology visit. She had a medical history of ophthalmologic disorders. Her chief complaints were dyspnea, lightheadedness, and fainting after the Valsalva maneuver. Physical examination showed systolic murmurs at the left upper sternal border as well as corneal thinning and bulging in the 2 eyes. Transthoracic echocardiography revealed local significant hypertrophy in the base of the interventricular septum with significant left ventricular outflow obstruction and severe mitral regurgitation.

Background: Heart problems are one of the main causes of death in patients with idiopathic inflammatory myopathies, such as polymyositis (PM) and dermatomyositis (DM). Speckle tracking echocardiography (STE) and global longitudinal strain (GLS) are non-invasive, accurate, repeatable, and angle-independent imaging techniques that facilitate a full global and regional evaluation of the left ventricular (LV) function. Objectives: This study aimed to evaluate myocardial dysfunction in DM and PM patients using STE and GLS methods. Methods: The present control-case study was conducted on 30 polymyositis and dermatomyositis patients and 40 healthy people as the control group. Both groups showed no symptoms of cardiovascular diseases. Both groups underwent two-dimensional STE and GLS evaluation. The GLS value was taken as a marker of LV systolic dysfunction. Results: The 2D GLS value of LV was significantly lower in the DM and PM patients, compared to the control group. A mild diastolic dysfunction was observed in seven (23.3%) patients, and 23 (76.7%) patients had a normal state. The patients’ age and duration of the disease were found to be significantly correlated with the left ventricular diastolic dysfunction. No significant difference was observed between the DM and PM patients with the control group in terms of pulmonary artery pressure level. Conclusion: Although the DM and PM patients had normal left ventricular ejection fraction values, there was a significant difference between the patients in these two groups and the control group in terms of LV dysfunction using GLS. Therefore, GLS is a useful variable that can be used to diagnose sustained and subclinical disorders in LV systolic function of DM and PM patients.

10.30699/jambs.31.144.100Partial muscular inter-ventricular septal defect (VSD) or Pacman heart is a rare congenital or occasionally acquired anomaly. Concurrent Pacman heart and Shone's complex are extremely rare and have never been reported until now. We described a 37-year-old male patient with congenital Pacman heart, flail mitral valve (FMV), and a history of multiple congenital anomalies, including subvalvular aortic stenosis, bicuspid aortic valve (AV), and coarctation of the aorta compatible with the incomplete form of Shone's complex. Cardiac surgery was not necessary to perform for this anomaly due to the absence of a left-to-right shunt through this partial defect.