Introduction: Heart failure(HF) related hospitalization constitutes a significant proportion of healthcare cost. Unchanging rates of readmission during recent years, shows the importance of addressing this problem. Methods: Patients admitted with heart failure diagnosis in our institution during April 2018to August 2018 were selected. Clinical, para-clinical and imaging data were recorded. All included patients were followed up for 6 months. The primary endpoints of the study were prevalence of early readmission and the predictors of that. Secondary end points were in-hospital and 6-month post-discharge mortality rate and late readmission rate. Results: After excluding 94 patients due to missing data, 428 patients were selected. Mean age of patients was 58.5 years (±17.4) and 61% of patients were male. During follow-up, 99patients (24%) were readmitted. Early re-admission (30-day) occurred in 27 of the patients(6.6%). The predictors of readmission were older age ( P=0.006), lower LVEF (P <0.0001), higher body weight (P=0.01), ICD/CRT implantation ( P=0.001), Lower sodium ( P=0.01), higher Pro-BNP(P=0.01), Higher WBC count (P=0.01) and higher BUN level (P=0.02). Independent predictors of early readmission were history of device implantation (P=0.007), lower LVEF (P=0.016), QRS duration more than 120 ms (P=0.037), higher levels of BUN (P=0.008), higher levels of Pro-BNP(P=0.037) and higher levels of uric acid (P=0.035). Secondary end points including in-hospital and 6-month post-discharge mortality occurred in 11% and 14.4% of patients respectively. Conclusion: Lower age of our heart failure patients and high prevalence of ischemic cardiomyopathy, necessitate focusing on more preventable factors related to heart failure.

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Background: Tetralogy of Fallot (TOF) is considered as the most frequent cyanotic congenital heart disorder. Right ventricular (RV) dysfunction is possible to be observed in patients with repaired TOF. Delayed enhancement (DE) is one of the recommended findings for RV dysfunction. Objectives: This study aimed at investigating the DE and its probable relationship with RV function through cardiac magnetic resonance (CMR). Patients and Methods:In this cross-sectional study, the values of cardiovascular magnetic resonance of 110 symptomatic patients, who had repaired TOF for 35 years, were gathered. We compared cardiac function indices (CFI) in patients with and without DE. Results:The patients had an average age of 21.93 ± 6.94 years (59.12% were male and 40.94% were female). 93.66% of the subjects showed DE and 6.44% of them did not have DE. 78.61% of the samples had DE of the right ventricular outflow tract (RVOT); whereas, 21.39% showed DE of the other sites. The differences between mean regurgitation fraction, average RV end-diastolic volume (RVEDV), average RV end systolic volume (ESV), and average RV ejection fraction in DE positive and negative patients were statistically significant (P values = 0.01, 0.04, 0.04, and 0.01, respectively.) Conclusion: DE commonly occurs as a complication of surgery to repair TOF and could be used as a factor for impaired RV function and other complications. Using CMR imaging for follow up of these patients could lead to diagnosis of these complications.

Pericardial tuberculosis (TB) is rare, but has particularly severe complications and a high mortality rate when not treated. Prompt treatment of pericardial TB is important and can be life-saving. We report a 13-year-old girl with massive pericardial effusion and negative workup for TB, who was empirically treated with an excellent response.

Background: Mortality, morbidity and the burden of the advanced heart failure and also the cost of frequent admissions is high. Several registries were done all over the world to manage the patients with heart failure; however studies about the advanced stage are limited. Objectives: The present study aimed to determine the prognostic predictors of patients with advanced heart failure. Methods: In this study 178 (74.2% male) patients with advanced heart failure (stage D) from 2011 to 2016 were selected according to the following inclusion criteria; highly symptomatic heart failure patients with severe left ventricular (LV) systolic dysfunction (LV ejection fraction less than 30%) who have been admitted for at least two times in the recent year because of decompensation. The data regarding the clinical findings, readmissions, mortality, laboratory tests, electrocardiography, echocardiography, etc. of patients were all derived from Rajaie Acute Systolic Heart Failure (RASHF) data registry. Results: In a 5-year follow-up, we realized that more than 70% of the patients died. The rate of mortality were significantly higher in females (P value = 0.006) and there was a significant correlation between anemia and the mortality (P value = 0.002). There was no remarkable association between the serum creatinine, sodium and uric acid levels with the mortality of the patients. Conclusions: Data about stage D of heart failure are limited. The mortality rate for such patients is relatively high and there's no clear best treatment approach. Large registries and data acquisition of these patients could be helpful for better management approaches.

Background: Limited data exist on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) presenting with ST-segment-elevation myocardial infarction (STEMI). Methods: This multicenter study, conducted in 6 centers in Iran, aimed to compare baseline clinical and procedural data between a case group, comprising STEMI patients with COVID-19, and a control group, comprising STEMI patients before the COVID-19 pandemic, and to determine in-hospital infarct-related artery thrombus grades and major adverse cardio-cerebrovascular events (MACCEs), defined as a composite of deaths from any cause (cardiovascular and noncardiovascular), nonfatal strokes, and stent thrombosis. Results: No significant differences were observed between the 2 groups regarding baseline characteristics. Primary percutaneous coronary intervention (PPCI) was performed in 72.9% of the cases and 98.5% of the controls (P=0.043), and primary coronary artery bypass grafting was performed in 6.2% of the cases and 1.4% of the controls (P=0.048). Successful PPCI procedures (final TIMI flow grade III) were significantly fewer in the case group (66.5% vs 93.5%; P=0.001). The baseline thrombus grade before wire crossing was not statistically significantly different between the 2 groups. The summation of thrombus grades IV and V was 75% in the case group and 82% in the control group (P=0.432). The rate of MACCEs was 14.5% and 2.1% in the case and control groups, respectively (P=0.002). Conclusion: In our study, the thrombus grade had no significant differences between the case and control groups; however, the in-hospital rates of the no-reflow phenomenon, periprocedural MI, mechanical complications, and MACCEs were statistically significantly higher in the case group.

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Objectivs: Tetralogy of Fallot (TOF) is a common congenital heart disease which should be corrected. The recommended time for the Tetralogy of Fallot Total Correction (TFTC) surgery is during the infancy for the possible difficulties during the surgery and the related issues. However, sometimes TOF is diagnosed and managed during the adulthood. Methods This study is a descriptive and retrospective one which included all patients who underwent TFTC at age of 15-year and older in a 10 -year period (between the years 2010 and 2020) to identify short-term (including in-hospital mortality, ICU Length of stay, respiratory complications after the surgery such as: pulmonary edema, pneumonia and etc. and bleeding after the surgery) and one-year (including left ventricle ejection fraction (LVEF), right ventricle (RV) ejection fraction, severity of tricuspid regurgitation and aortic regurgitation after surgery) outcomes. All data were taken from medical records at Shahid Rajaei Hear Center. Data were analyzed using SPSS 22. Results 94 patients with the mean age of 26.7 ± 9.6 years were enrolled. Most of them were male (59.6%) (P-value: 0.009). In-hospital mortality in our study were 5.3%. Tricuspid regurgitation (TR) was significantly resolved after the surgery (P-value: 0.006). Also, the correction of pulmonary size after the surgery was significant (P-value: 0.000). Conclusion This study showed that the surgery at older age is safe and the results are acceptable. Aging is not a contraindication for TFTC and surgery should be recommended if the patients are diagnosed with TOF at adulthood. Also, screening TOF in adult patients should be considered.