Basic life support (BLS) following by Advanced cardiac life support (ACLS) is intended to rescue the patients with acute circulatory or respiratory failure or both. The most important determinant of short and long-term neurologically intact survival is the interval from the onset of the cardiac or respiratory onset to restoration of effective spontaneous functions of these vital activities.It is commonly accepted that every physician, regardless of specialty, should be able to  perform CPR. It must be also emphasized that CPR, almost invariably, necessitates a rapid interventional follow-care with ACLS procedure.Without well-performed basic life support, advanced cardiac life support is of no remark-: able benefit, BLS and ACLS are processes that must be performed step by step and with respect to the patient's condition.

This issue of the Journal of Tehran University Heart Center features three papers which focus on non-invasive methods to investigate various aspects of cardiovascular function. The history of cardiology and medicine is replete with examples of the contribution of non-invasive observations to our understanding of cardiac and vascular function, starting at the bedside using our natural senses of visual inspection, palpation, and auscultation.

The diagnosis of an enlarged or hypertrophied heart has important implications for the treatment of children with congenital or acquired heart disease. To this end, cardiac MRI has evolved as an important noninvasive diagnostic tool, particularly in the noninvasive quantitative assessment of the right ventricle. cardiac MRI is generally considered the reference standard for the assessment of ventricular dimensions, function, and mass in terms of accuracy and reproducibility, and this is reflected by class I– II recommendations for the clinical use of cardiac MRI by recent consensus panels. However, a general problem in the interpretation of such data is the fact that cardiac growth is known to be allometric, that is, the relation between the size of the heart and the body changes from infancy to adulthood. Moreover, such allometric growth is likely to be different between the sexes. This renders any age group definition somewhat arbitrary because sex differences in the speed of maturation and cardiac growth are not accounted for, thus limiting the scientific and clinical value of age group– based reference data. The relation between the size of the heart and the body is known to be allometric, which means that this relation changes from infancy to adulthood. This makes the generation of normative data challenging. However, the ability to accurately measure volumetric and mass parameters of right and left ventricular function, adequately scaled to body size, is of critical importance both for clinical care and for cardiovascular health research. Comparison between axial and short-axis volumetry demonstrated no relevant differences, as reported by Jauhiainen et al and in contrast to Alfakih et al, who found short-axis volumes of the right ventricle to be larger in adult volunteers. Axial acquisition had the advantage of allowing for additional phasic volumetry of the atria for further studies and has also recently be reported to be more reproducible than short-axis slices for ventricular volumetry in patients with corrected tetralogy of Fallot.

Background: Nephrotic syndrome (NS) is a common pediatric glomerular disorder traditionally considered renal-limited. Nonetheless, growing evidence suggests systemic implications, including subclinical cardiovascular involvement. This study aimed to evaluate early myocardial dysfunction in children with idiopathic NS using Doppler tissue echocardiography (DTE). Methods: In a case-control study, 87 children with idiopathic NS and 87 age-and sex-matched healthy controls were enrolled between 2021 and 2023 at Ali Asghar Pediatric Hospital in Zahedan, Iran. All participants underwent comprehensive DTE from apical four-chamber views to assess systolic and diastolic function. Key parameters included S′, E′, and A′ velocities,isovolumetric contraction time (ICT),isovolumetric relaxation time (IRT),ejection time (ET),myocardial performance index (MPI),and E/E′ and A/A′ ratios. Laboratory data and treatment response were also analyzed. Data were analyzed using SPSS version 26, with a significance level set at 0. 05. Results: Children with NS demonstrated significantly reduced S′, E′, and A′ velocities,prolonged left ventricular IRT,shortened ICT and ET,and elevated MPI values, indicating early biventricular dysfunction. The right ventricular E/E′ ratio was significantly lower in treatment responders, suggesting improved diastolic function. MPI and timing parameters showed strong correlations with renal and metabolic markers, including blood urea nitrogen, serum albumin, and lipid levels. Conclusions: DTE-derived MPI serves as a valuable noninvasive marker for the early detection of subclinical cardiac dysfunction in pediatric NS. Incorporating MPI into routine cardiac assessments may improve risk stratification and guide therapeutic monitoring in this population.