Cardiovascular system is severely influenced with chronic renal failure Although dialysis and renal transplantation have been improved the survival of the patients with chronic renal failure in past 30 years, but cardiovascular disease is the most common cause of their death yet. Dialysis could regress many of the changes accompanied with chronic renal failure, if begins soon enough.This study was an analytical time series study that 40 patients with chronic renal failure that were on maintenance dialysis, were studied by echocardiography, before and after one of their dialysis cession and LEFT VENTRICULAR EJECTION FRACTION (EF) of before and after and the results were compared.The mean of EF before and after echocardiography were 58.08%±9.18 and 64.67±8.01 respectively. After analysis with Paired samples test, this difference was obviously significant (P=0.00).It was concluded that hemodialysis can increase the LEFT VENTRICULAR EJECTION FRACTION in hemodialysis patients.

Background: Efficacy of xanthine oxidase inhibitors on the improvement of cardiac performance is not clearly defined. This study was designed to study the efficacy of allopurinol on the improvement of LEFT VENTRICULAR EJECTION FRACTION (LVEF) in patients with chronic heart failure.Methods: A randomized, double blind, placebo controlled clinical trial was performed on two groups of patients suffered from class II to III heart failure of New York Heart Association classification. 16 cases were in intervention group who intake allopurinol (100 mg/day in the first three days, 200 mg/day in the second three days and 300 mg/day for one month); 15 cases were in control group and intaked placebo like case group. LEFT VENTRICULAR EJECTION FRACTION was measured by echocardiography with Simpson's method and compared before and after the intervention. Findings: The mean of LVEF before and after intervention, in case group were 38.8±9.9 and 41.9±9.7 respectively (p<0.05); and in control group were 37.05±5.7 and 37.1±5.6 respectively (p>0.05). In intervention group EF was increased 3.1% from base level.Conclusion: Allopurinol can be effective in improvement of cardiac performance. However its clinical use for heart failure patients needs to be approved by more trials, in various situations and longer periods.

Background: Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this study was to compare androgenic hormone levels in patients with different LEFT VENTRICULAR EJECTION FRACTIONs (EF).Methods: The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF<35%, EF=35-45%, EF=45-54%, and EF³55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone (fT), total testosterone (tT), and dehydroepiandrosterone sulfate (DHEAS). To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF<35% and the ones with EF ≥ 35%.Results: There were statistically significant trends in some characteristics in the patients with different levels of EF. The subjects with higher EF levels were less likely to have diabetes (p value<0.001), coronary artery lesion (p value<0.001), or high levels of C-reactive protein (CRP) (p value<0.001). As regards the patients with severe heart failure, our regression analysis revealed that the fT level was significantly lower in those with EF<35% than in the ones with EF³35% (5.82±2.73 pg/mL vs. 6.88 ± 3.34 pg/mL, p value<0.05).Conclusion: A significant association was found between the level of fT and EF<35%. There is a need for further controlled prospective studies to delineate any possible causal relationship accurately.

Introduction: Radionuclide scanning of the heart has incremental value in diagnosis and risk stratification of coronary artery disease. Gated myocardial perfusion SPECT is a new method and the state of the art in coronary artery disease detection. This study was done to evaluate estimation of LV volume, wall motion diameters and EJECTION FRACTION by gated myocardial perfusion scan and make a comparison with trans thoracic echocardiography.Material and Methods: In this cross-sectional descriptive study during Sep 2001-Dec 2002, 68 patients suspected of IHD who were referred to nuclear Medicine Department of Imam Reza Hospital in Mashhad University of Medical Sciences were under taken gated myocardial perfusion SPECT, and then referred to echocardiography unit for trans thoracic echocardiography. LV volume, EJECTION FRACTION, regional wall motion in different views of 2D-echo was recorded and the results were compared by descriptive statistics.Results: This study was performed on 68 patients. The mean age of patients was 52.8 (min: 38, Max: 75). 54% of patients were male and 46% were female. Mean end systolic volumes of LV was 32.4ml (sd: 37.1) estimated by echocardiography and 68.3ml (sd: 52.2) stimated by radionuclide scan (pv: 0.00). Mean end diastolic volume of LV was l29.6ml (sd: 45.8) in echocardiography and l43.7ml (sd: 46.23) in radionuclide scanning (pv: 0.00). Mean EJECTION FRACTION value of LV was 54.6 (sd: 12.44) estimated by echocardiography and 54 (sd: 12.94) by radionuclide scan (pv: 0.00).Conclusions: LEFT VENTRICULAR end systolic and diastolic volumes and EJECTION FRACTION, obtained by gated myocardial perfusion scan and echocardiography, had significant statistic correlations and estimation of LV wall motions and EJECTION FRACTION by gated SPECT was as echocardiography.

Objectives: LEFT VENTRICULAR (LV) dysfunction heart failure is one of the causes of morbidity and mortality following ST elevation myocardial infarction (STEMI). This study was done to determine the clopidogrel effect in preventing reduced LV function in patients with STEMI.Methods: In this study, 144 patients with STEMI admitted to the Isfahan University of Medical Sciences hospitals were followed in two groups for one month. The case group received Clopidogrel, 300 mg, on admission and then, 75 mg daily, while the control group received routine therapy for STEMI without Clopidogrel. LEFT VENTRICULAR EJECTION FRACTION (LVEF) on the 4th day and one month after STEMI was measured by echocardiography. The results of LVEF were compared within and between groups.Results: The mean LVEF in the case group on the 4th day and one month after STEMI were 45.92 and 52.15%, respectively (P<0.001). The mean LVEF in the control group on 4th day and one month after STEMI were 44.72 and 42.71%, respectively.Conclusions: We suggest that Clopidogrel is effective in prevention of LVEF reduction in patients with STEMI.

Background: Recently, the deleterious effects of LEFT bundle branch block (LBBB) on LEFT VENTRICULAR systolic function have been taken into consideration.Objectives: The present study aimed to identify underlying factors that predict LEFT VENTRICULAR EJECTION FRACTION (LVEF) deterioration in patients suffered from complete LBBB.Patients and Methods: In a retrospective case-control study, the data of 220 consecutive patients diagnosed with LBBB on their electrocardiograms were assessed. They were referred to Isfahan Heart Center in Isfahan Province, Iran in 2013. LVEF deterioration was defined as a decrease in LVEF at least 10% between the baseline and follow-up echocardiography study. Thus, achieving the LVEF values≤40% in patients with an initial EF of>50% was considered LVEF deterioration.Results: Among 220 patients, 40% of LBBB patients suffered LVEF deterioration within 3 months of initial assessment. The group with LVEF deterioration had higher male to female ratio, had higher NYHA score, and suffered more from systolic hypertension than another group. Those with coronary artery disease (CAD) had also significantly lower LVEF than non-CAD ones. Adverse associations were revealed between systolic blood pressure and LVEF measurement (r=-0.193, P=0.006) as well as between NYHA score and LVEF (r=-0.215, P=0.002). A multivariable logistic regression model showed that among baseline variables, male gender (OR=3.218, P<0.001), history of systolic hypertension (OR=2.012, P=0.029), higher NYHA score (OR=1.623, P=0.005), and the presence of coronary artery disease (OR=2.475, P=0.028) could effectively predict LVEF deterioration in patients with LBBB.Conclusions: Male gender, history of hypertension, high NYHA score, and the presence of CAD predict LVEF deterioration in patients with LBBB.