Niloufar Samiei

Rajaie Cardiovascular, Medical & Research Center · Echo Lab

Background: The body mass index (BMI) has some limitations in identifying obesity, particularly among children and adolescents. Objectives: We sought to determine the reference percentiles of tri-ponderal mass index (TMI) for Iranian population, and its relation to BMI, waist circumference (WC), and waist circumference-to-height ratio (WHtR). M...

Background Mitral regurgitation (MR) is the most common valvular heart disease. Since delaying severe MR treatment can lead to left ventricular dysfunction, early MR diagnosis is crucial. Echocardiography is the first-line diagnostic modality for evaluating MR severity. Transesophageal echocardiography (TEE) and newer imaging modalities like cardia...

Background Cardiac problems are frequent (20 to 25%) with COVID-19 and are associated with cardiac complications and in-hospital mortality. Existing research on the echocardiographic examination of COVID-19 focuses mostly on hospitalized patients with severe symptoms and in the acute phase of the disease, leaving out of the spotlight non-hospitaliz...

Objective: Pregnancy can increase gradients across the heart valves and consequently deteriorates maternal and fetoneonatal conditions. Hence, pregnancy during heart valve diseases can be challenging and we need to risk stratify patients before conception. We tried to assess the role of preconception consultation using treadmill stress echocardiog...

Background: Various left atrium (LA) and left atrial appendage (LAA) anatomies and functions could be associated with embolic events. Aims and objectives: We aimed to investigate the impact of variation in LAA and LA functions on the occurrence of systemic embolization in normal sinus rhythm and normal echocardiography findings. Materials and m...

Childhood obesity has become a major non-communicable disease worldwide. It is associated with an increased risk of cardiometabolic factors, including diabetes and hypertension (HTN). The purpose of this study was to evaluate the association between obesity and HTN among Iranian children and adolescents. Cross-sectional data from the SHED LIGHT stu...

Background Cardiovascular complications are frequently reported among patients with pulmonary coronavirus disease 2019 (COVID-19) infection. Echocardiography has been immensely implemented for diagnosing cardiovascular involvements. We aimed to evaluate the changes in echocardiographic parameters in health care workers infected with COVID-19 during...

Carcinoid heart disease is a rare condition that occurs in less than half of patients with carcinoid syndrome. The disease mainly affects right‐sided heart valves; however, in 5%–10%, it can also involve left‐sided valves. This case illustrates the most complicated form of the disease involving four heart valves. The use of multimodality imaging in...

Background: Structural heart disease (SHD) has great impacts on healthcare systems, creating further public health concerns. Proper data are scant regarding the magnitude of the affected population by SHD. Objectives: This study aimed to determine the prevalence of SHD among children and adolescents in an Iranian population. Methods: In this p...

If tricuspid regurgitation (primary and secondary) is left untreated, it will be associated with significant complications and death, even if left ventricular dysfunctions are corrected, TR does not decrease in many cases. Since many studies have not been conducted in this area, we decided to evaluate the results of tricuspid repair. In this retros...

Objectives This study sought to compare the safety and efficacy of the balloon-expandable stent (BES) and the self-expandable stent (SES) in the endovascular treatment of coarctation of aorta. Background Coarctoplasty with stents has conferred promising results. Although several nonrandomized studies have approved the safety and efficacy of the BE...

Background: Pulmonary valve replacement (PVR) is frequently performed during the correction of various congenital heart diseases. Pulmonary valve substitutes include bioprostheses, homografts, and mechanical valves. Among these, bioprosthetic valves are probably the most widely used because they are readily available and they do not need lifelong a...

Background: The frequency of left ventricular diastolic dysfunction (DD) is overestimated by earlier recommendations. We compared the 2009 and 2016 guidelines regarding the detection of DD and explored the potential of adding left atrial (LA) strain to the current guideline. Methods: Consecutive patients with heart failure were enrolled. All the...

Carcinoid heart disease is a rare condition that occurs in half of patients with carcinoid syndrome. The disease mostly affects right-sided heart valves; however, in 5-10%, it can also involve left-sided valves. This case illustrates the most complicated form of the disease with involvement of four heart valves.

Background: Cardiomyopathies are characterized by structural and functional abnormalities of myocardium that will probably lead to premature death from arrhythmia and/or progressive heart failure. Myocarditis is an inflammatory disease of the myocardium diagnosed by histological criteria definitively. To date, most information about the natural his...

Although people with less critical symptoms should not visit hospitals in order to reduce exposure during a pandemic, it is of utmost importance that those experiencing risky symptoms visit in early stages to prevent delayed consequences. In this article, we reported three ST-segment Elevation Myocardial Infarction (STEMI) patients who would have b...

Objective: Myocardial perfusion imaging (MPI) by gated single-photon emission computed tomography (SPECT) is a feasible method in the evaluation of left ventricular perfusion and function. The purpose of this study was to determine the threshold and grading of left ventricular (LV) diastolic dysfunction (LVDD) using gated SPECT MPI. Methods: A t...

We herein seek to expound on up-to-the-minute information regarding cardiovascular disease in the era of coronavirus disease 2019 (COVID-19) by highlighting acute myocardial injury caused by COVID-19 and probing into its pathophysiology, clinical signs, diagnostic tests, and treatment modalities. We aim to share the latest research findings vis-à-v...

Background Endovascular treatment is considered the main therapeutic approach for native coarctation of aorta (CoA) in adult patients. Balloon-expandable stents (BE) have been introduced as the primary choice for coarctoplasty. However during the recent years, self-expandable (SE) stents with acceptable radial force have been suggested as an altern...

Background: Ankylosing spondylitis (AS) is a chronic inflammatory condition associated with more cardiac manifestations than those in the normal population. In this study, we sought to determine the prevalence of cardiac involvement in patients suffering from AS without cardiovascular risk factors. Methods: The present case-control study, conducted...

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...

Introduction Tricuspid valve (TV) has a complex anatomy causing some difficulties in echocardiographic evaluation. In this study, we sought to assess the geometry of TV in patients with functional tricuspid regurgitation (TR) by the implementation of 2‐ and 3‐dimennsional (2D and 3D) echocardiography. Methods In a case–control study, the geometric...

Corona virus disease 2019(COVID-19) pandemic has caused a significant burden on the global health system. Considerable cardiovascular involvement has been reported among COVID-19 patients with higher ICU admission and mortality rates among patients with cardiovascular comorbidities. Consequently, diagnostic cardiovascular evaluations such as echoca...

Introduction: Right ventricular (RV) function in the setting of pulmonary hypertension based on different etiologies has not been well studied. In this study, we evaluated the RV function in patients with idiopathic pulmonary hypertension (IPH) versus secon-dary pulmonary hypertension (SPH) due to congestive heart failure. Material and method: F...

Postoperative atrial fibrillation (POAF) is a major complication after cardiac surgery which can lead to high rates of morbidity and mortality, an enhanced length of hospital stay, and an increased cost of care. POAF is postulated to be a multifactorial phenomenon; however, some major pathogeneses have been proposed, including inflammatory pathways...

Background The standard transthoracic echocardiography has some limitations in emergent and community-based situations. The emergence of pocket-sized ultrasound has led to influential advancements. Methods In this prospective study, in the hospital-based phase, children with suspected structural heart diseases were enrolled. In the school-based ph...

Background: Inflammatory is one of the main cause of aortic valve stenosis (AS), so discovering novel biomarkers for the targeted therapy of inflammation could be an attractive strategy in AS prevention. The objectives of our study were to clarify the modulatory role of resistin and silent information regulator 1 (SIRT1) before and after surgery a...

Background: Percutaneous mitral commissurotomy (PMC) is currently the treatment of choice for patients with symptomatic mitral stenosis (MS) that have favorable valvular characteristics. We aimed to evaluate the effect of PMC on the longitudinal strain of the right ventricular (RV) free wall in patients with severe MS. Methods: This prospective...

Introduction: Cardioembolic events are accompanied by left atrial appendage (LAA) in patients suffering from atrial fibrillation (AF); therefore, the LAA closure is implemented as a preventive strategy. The detection of LAA morphologies and function is a paramount step before establishing the LAA closure. Herein, we sought to determine the morpholo...

Introduction: Stress echocardiography is a safe and cost-effective method of evaluating the patients with suspected coronary artery disease (CAD). However, the risk factors of an adverse cardiovascular event after a normal exercise (ESE) or dobutamine (DSE) stress echocardiography are not well established. Methods: A cohort of 705 patients without...

Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes...

Background: Heart failure is the biggest cause of mortality and morbidity in people with thalassemia, and iron deposition in cardiac tissue impairs cardiovascular function. Therefore, early detection of cardiac involvement is important to improve the prognosis in these individuals. Method: Two- and three-dimensional echocardiography was performe...

Background: The metabolic syndrome (MetS), as a combination of cardiovascular risk factors, is associated with subclinical cardiovascular diseases. We sought to evaluate the subclinical myocardial dysfunctions using echocardiography in patients with normal coronary arteries. Materials and methods: In this cross-sectional study, we assessed 50 co...

Introduction: The restrictive mitral valve annuloplasty (RMA) is the treatment of choice for degenerative mitral regurgitation (MR), but postoperative functional mitral stenosis remains a matter of debate. In this study, we sought to determine the impact of mitral stenosis on the functional capacity of patients. Methods: In a cross-sectional stu...

Background: Double-orifice mitral valve (DOMV) is an extremely rare cardiac malformation. It has been found to be accompanied by congenital anomalies (CAs), however, it can be detected as an isolated anomaly. The clinical findings of a DOMV are variable and depend predominantly on the associated cardiac abnormalities, particularly atrioventricular...

Left atrial (LA) calcification is mostly observed in patients with rheumatic mitral valve (MV) diseases who underwent surgical treatment. We report a case of LA calcification in a 69-year-old woman presented with dyspnea and cyanosis. Admission electrocardiogram showed atrial fibrillation and biventricular hypertrophy. Her chest roentgenogram revea...

Introduction: The mitral valve area (MVA) poorly reflects the hemodynamic status of (MS). In this study, we compared the MVA with mitral valve resistance (MVR) with regard to the determination of hemodynamic consequences of MS and the immediate outcomes of percutaneous balloon mitral valvuloplasty (PBMV). Methods: In a prospective study, 36 pati...

Background It has been well documented that reduced left ventricular ejection fraction (LVEF) has adverse effect on the outcome of patients with severe mitral regurgitation (MR) after mitral valve repair (MVr). However, the best method for early detection of LV dysfunction in asymptomatic or mildly symptomatic patients with MR still has not been es...

We read with great interest the article by Yamamoto et al. [1] published in Atherosclerosis, reporting the prognostic value of leukocyte subtype counts in patients with coronary artery disease. The authors concluded that, of leukocyte differentials, elevated monocyte count before angiography independently predicted mid-term cardiovascular events in...

Physiologic changes during pregnancy can deteriorate or improve patients’ hemodynamic status in the setting of valvular heart disease. There is sparse data regarding the effect of pregnancy on valve hemodynamics in normal pregnant women with known valvular heart disease. In a prospective study between July 2014 and January 2016, a total of 52 norma...

A pregnant patient presented with symptomatic ventricular tachycardia. Echocardiography revealed a large intramyocardial mass. Surgical resection was attempted in conjunction with cryoablation of the surrounding myocardial tissue. Histologic examination of the resected mass revealed cardiac neurofibroma. To the best of our knowledge, this is the fi...

Postoperative atrial fibrillation (POAF) is a major complication occurring in 10 to 65% of patients undergoing cardiothoracic surgeries.The incidence of POAF differs among cardiac surgeries from 40% after isolated heart valve surgeries to 60% following combined coronary and valvular surgeries. Of all the pharmacological options for preventing POAF,...

Background: Caring for a patient with heart failure can be a challenging and stressful situation. However, researchers have paid less attention to caregiving outcomes in heart failure caregivers. This study was conducted to investigate the relationship between perceived life changes and mental health of family caregivers of heart failure patients....

Background: Patients with Chronic Heart Failure (CHF) have been shown to have enhanced risk of Erectile Dysfunction (ED) due to low cardiac output, endothelial dysfunction, medications, co-morbid conditions, and psychogenic factors. Objectives: The present study aimed to evaluate the effects of sildenafil on erectile function of patients with stab...

Background: Left ventricular (LV) twist is due to oppositely directed apical and basal rotation and has been proposed as a sensitive marker of LV function. We sought to assess the impact of chronic pure mitral regurgitation (MR) on the torsional mechanics of the left human ventricle using tissue Doppler imaging. Methods: Nineteen severe MR patie...

Cardiac surgery during pregnancy is rarely required and potentially increases feto-maternal mortality. The study aim was to evaluate pregnancy outcomes in females who underwent open-heart surgery with cardiopulmonary bypass (CPB) during pregnancy. Between 1999 and 2014, a total of 16 pregnant women (mean age 27 ± 7 years; mean gestational age 13 ±...

Background and aimIschemic mitral regurgitation (IMR) is among the most serious complications of myocardial infarction which doubles the late mortality; mainly treated by undersizing ring annuloplasty. To find some preoperative echocardiographic indices that predict immediate failure of mitral valve annuloplasty (MVA), we designed the present study...

Introduction: Mitral valve stenosis and mitral valve regurgitation still result in significant morbidity and mortality. It has been shown that atrial remodeling and atrial fibrillation may occur in these patients. We sought to investigate how pressure or volume overload in the left atrium could impact atrial deformation properties obtained via Dopp...

Heart valve disease is a significant and increasing global problem in the developing world. The aim of this study is to evaluate the incidence of postoperative complications and mortality in patients who underwent heart valve replacement. In this prospective study, 320 adult cases (186 females and 134 males, mean age of: 45.7 ± 15.0) with valvular...

Background: Coronary artery disease (CAD) as a chronic disease can affect physical, mental, and social aspects of health as well as the perception of wellbeing. Advanced treatments of the disease emphasize on functionality and quality of life (QOL). Objectives: The present study aimed to investigate the QOL and its related factors among women wi...

Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria) is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluat...

A 57-year-old man underwent multiple-arterial revascularization including a sequential left internal mammary artery graft to the diagonal branch and left anterior descending coronary artery. Twenty-one months later, repeat angiography due to a new onset of chest discomfort confirmed string sign and nonfunctional proximal left internal mammary arter...

Coarctation complicated with mycotic pseudo-aneurysm is very rare. We are reporting a case of a 26-year-old man suffered from this pathology. As the incidence of mycotic pseudo-aneurysm is very rare in patients with aortic coarctation, the choice of this pathology for a patient presenting with unexplained fever is the only way to reduce the mortali...

Background & Aim: Family caregivers of patients with heart failure (HF) deal with a wide range of problems related to caregiving that influence their mental health. The aim of this study was to investigate the mental health status of the family caregivers of patients with HF. Methods & Materials: In this descriptive cross-sectional study, 90 family...

Background: Aortic valve stenosis (AS) is the most common valvular disease in adults with variable clinical course. Many recent studies have suggested that calcified aortic stenosis is related to the same risk factors as coronary artery disease (CAD). Therefore, in this study, we aimed to determine the prevalence of risk factors for atherosclerosis...

Identifying end-diastole (ED) and end-systole (ES) frames is highly important in the process of evaluating cardiac function and measuring global parameters accurately, such as ejection fraction (EF), cardiac output (CO) and stroke volume (SV). The aim of this study is to develop a new method based on measuring volume changes in left ventricle (LV)...

The exact length of neochordae loops plays the major role in the success of mitral valve repair. The Neochordae Loop Maker is a novel device that models the left ventricular structure in an individual patient. Preoperative transthoracic echocardiography is used to identify the geometry of each papillary muscle and set up the device for the patient....

According to previous studies on the deformation properties of the left atrium, the systolic strain and strain rates represent the atrial reservoir function and the early and late diastolic strain rates show the conduit and booster functions, respectively. We sought to evaluate the intra and interatrial asynchrony using strain/strain rate imaging i...

Background. Mitral valve repair has shown superior results compared to mitral valve replacement in patients with mitral valve prolapse. Using premeasured neochordae (the loop technique) has been proposed for both anterior and posterior leaflet repair. However, there are two major problems that are usually experienced using this method. One is decid...

Introduction: Coronary artery disease (CAD) is the leading cause of dead and a major health priority among women. It has influence on physical, mental and social aspects of health and individual's perception of wellbeing. This study aimed to investigate the general health and related factors in women with CAD. Materials and Methods: In this cross-s...

A 42-year-old woman presented to our outpatient department with complaints of atypical chest pain and palpitation. On physical examination, the patient's blood pressure was 140/95 mm Hg, and there was a systolic cardiac murmur on the left sternal border. A transthoracic echocardiography examination was performed, and a left-to-right shunt ratio (Qp...

Identifying End-Diastole (ED) and End-Systole (ES) frames is highly important in the process of evaluating cardiac function and measuring global parameters accurately, such as Ejection Fraction (EF), Cardiac Output (CO) and Stroke Volume. The current study aimed to develop a new method based on measuring volume changes in Left Ventricle (LV) during...

Pregnant patients with mechanical heart valves require anticoagulation. The risk of bleeding and embryopathy associated with oral anticoagulants must be weighed against the risk of valve thrombosis. In this prospective study, undertaken between 1999 and 2009, 53 pregnancies (47 women with mechanical mitral valves; 29.8 ± 4.8 years old) were studied...

Background: Pregnant patients with mechanical heart valves require anticoagulation. The risk of bleeding and embryopathy associated with oral anticoagulation must be weighed against the risk of valve thrombosis. Objectives: This study attempted to find the fatal outcome between warfarin and heparin regiments throughout pregnancy. Patients and Metho...

This study aimed at evaluating the early effects of successful elective percutaneous coronary intervention (PCI) on systolic and diastolic function. We consecutively studied the systolic and diastolic function in 21 patients with stable coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) > 40% before and 48 hours after succe...

Background: Pregnancy is associated with a hypercoagulable state, therefore the optimal anticoagulants for potential use in pregnant women with prosthetic heart valves are controversial. The aim of this study is to investigate the effect of anticoagulants on pregnancy outcomes and their potential risks in pregnant women with mechanical heart valve...