Publications by authors named "Enseyeh Dogmehchi"

3 Publications

  • Page 1 of 1

Red Cell Distribution Width and Severe Left Ventricular Dysfunction in Ischemic Heart Failure.

Crit Pathw Cardiol 2016 12;15(4):174-178

From the *Department of Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; †Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran; ‡Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran; §Department of Emergency Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran; and ¶Department of Clinical and Basic Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: The red cell distribution width (RDW), a simple and widely available marker, has been linked with an increased risk of adverse outcomes in patients with heart failure (HF) and risk of death, and cardiovascular events in those with previous myocardial infarction, but its relation with the severity of left ventricular (LV) dysfunction is not fully investigated. The aim of this study was to assess the prognostic value of the RDW in post myocardial infarction patients with typical signs and symptoms of HF and with reduced LV ejection fraction (EF).

Methods: Patients (n = 350) came from an ongoing registry of consecutive patients who admitted for ischemic heart disease at our center. All patients were followed up 1 year after the initial hospitalization by telephone interviews. The outcomes studied were mortality and hospitalization because of decompensated HF.

Results: RDW-coefficient of variation (express in percentage) was calculated from SD of mean corpuscular volume and mean corpuscular volume itself. Using logistic regression analysis, 3 variables consisting age, RDW level, and hemoglobin were identified as independent predictors of severe LV dysfunction (LVEF <30%). Levels of RDW were associated with the presence of severe LV dysfunction, with an accuracy of 61.4% (95% confidence interval: 56.2%-66.4%) and 66.9% (95% confidence interval: 61.8%-71.6%), using cut-off values of higher than 13.5 and 13.8, respectively.

Conclusion: Our results suggest that elevated RDW may be used as a prognostic tool among HF patients with the documented myocardial infarction because it is an inexpensive, rapidly calculated test that is already routinely in use in practice.
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December 2016

Comparing GlideScope Video Laryngoscope and Macintosh Laryngoscope Regarding Hemodynamic Responses During Orotracheal Intubation: A Randomized Controlled Trial.

Iran Red Crescent Med J 2014 Apr 5;16(4):e12334. Epub 2014 Apr 5.

Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran.

Background: To determine if the GlideScope® videolaryngoscope (GVL) could attenuate the hemodynamic responses to orotracheal intubation compared with conventional Macintosh laryngoscope.

Objectives: The aim of this relatively large randomized trial was to compare the hemodynamic stress responses during laryngoscopy and tracheal intubation using GVL versus MCL amongst healthy adult individuals receiving general anesthesia for elective surgeries.

Patients And Methods: Ninety five healthy adult patients with American Society of Anesthesiologists physical status class I or II that were scheduled for elective surgery under general anesthesia were randomly allocated to either Macintosh or GlideScope arms. All patients received a standardized protocol of general anesthesia. Hemodynamic changes associated with intubation were recorded before and at 1, 3 and 5 minutes after the intubation. The time taken to perform endotracheal intubation was also noted in both groups.

Results: Immediately before laryngoscopy (pre-laryngoscopy), the values of all hemodynamic variables did not differ significantly between the two groups (All P values > 0.05). Blood pressures and HR values changed significantly over time within the groups. Time to intubation was significantly longer in the GlideScope (15.9 ± 6.7 seconds) than in the Macintosh group (7.8 ± 3.7 sec) (P< 0.001). However, there were no significant differences between the two groups in hemodynamic responses at all time points.

Conclusions: The longer intubation time using GVL suggests that the benefit of GVL could become apparent if the time taken for orotracheal intubation could be decreased in GlideScope group.
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April 2014

A Limb-Saving Procedure for Treatment of Arterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report.

J Tehran Heart Cent 2013 Jan 8;8(1):61-4. Epub 2013 Jan 8.

Hazrat Rasool Hospital, Tehran University of Medical Sciences, Tehran, Iran.

As the major hazard of percutaneous vertebroplasty (PV), cement extravasation into the venous system, systemic embolism, and spinal canal has been previously reported. However, to our knowledge, only one case of the arterial migration of cement has been previously reported that is directly associated with this technique without any symptom in the immediate post-intervention and in the follow-up period. An arterial embolus of cement occurred in a 46-year-old woman undergoing lumbar PV for breast cancer metastasis. Less than one hour later, the patient complained of severe pain and numbness in her left leg. A diagnosis of acute left leg ischemia due to the acute occlusion of the infrapopliteal arteries by the cement was made. Transluminal angioplasty (PTA) for the infrapopliteal arteries was recommended because there were diffuse and long vessel involvements, leaving no distal targets for bypass vascular surgery. The patient's postoperative course was uncomplicated; the extremity tenderness and mottled skin were improved. A follow-up ultrasound 2 months later revealed an acceptable distal flow in the arteries of the affected limb, and the patient remained asymptomatic (except for a mild leg pain on exertion) at the one-year follow-up examination. In conclusion, PTA may save the limb from amputation in case of peripheral arterial embolism caused by cement during PV.
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January 2013