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Sahar Mirpour

Publications and source records attributed to Sahar Mirpour.

7 recordsLinked to original sources
PubMed2007

A correlative study comparing current different methods of calculating left ventricular ejection fraction.

BACKGROUND: Left ventricular ejection fraction (EF) is a major determinant of survival in patients with coronary artery disease (CAD). Comparative accuracy of numerous modalities in calculating EF is not well investigated. METHOD: We compared EF as calculated by rest and post-stress Cedars automated quantitative gated SPECT (AQGS), rest and post-stress semi-automatically processed gated SPECT (MQGS), echocardiography and contrast ventriculography (LVG) to those determined by rest and post-stress cavity-to-myocardium ratio (CMR) in 109 patients. Gated SPECT was performed based on a 2-day protocol using Tc-MIBI. RESULTS: Mean EF in LVG, echo, post-stress CMR, rest CMR, post-stress AQGS, rest AQGS, post-stress MQGS and rest MQGS were 41.8%+/-12.1, 44.8%+/-11.8, 38.1%+/-10.7, 35.7%+/-12.1, 44.5%+/-15.1, 46.9%+/-14.7, 40.1%+/-14.3 and 43.5%+/-14.3 respectively. Although significant differences were observed between some of these methods, good and excellent linear correlations were present among values (all Pearson correlations >0.63). Considering LVG as the 'gold standard', we defined two groups: EF <35% (class 1) and >35% (class 2). Discriminant analysis showed that SPECT has the ability to predict patients' classes. In 4/18 of patients with normal SPECT (on both visual and quantitative analyses, SSS <4), EF on QGS showed a significant decrease on post-stress compared with rest. CONCLUSION: There is a good correlation in calculating EF by LVG, QGS and echocardiography, regardless of EF value. Whenever QGS is impossible, CMR is a reliable indirect indicator of EF. Gating of both phases (and when impossible, CMR of both phases) has an additional value in diagnosis of CAD.

Adult↗
PubMed2006

Myocardial perfusion abnormalities in chemical warfare patients intoxicated with mustard gas.

BACKGROUND: Mustard agents are of the major chemical agents used during Iran-Iraq war. There are no reports concerning long-term cardiac effects. The aim was to assess the scintigraphic pattern of myocardial perfusion in patients intoxicated with blistering gases. METHOD: We analyzed myocardial perfusion scans of 22 consecutive intoxicated patients (21 male and 1 female, all < 44 years) and compared results with 14 controls. Only those patients and controls were entered whose 10-year risk of coronary artery disease (Framingham criteria) was <5%. Also only those patients were experimented upon that had currently other confirmed complications of intoxication (respiratory, cutaneous and ocular complications). All patients underwent a 1-day stress and rest protocol using (99m)Tc-MIBI. Images were assessed visually and quantitatively using Cedars Sinai program. RESULTS: The prevalence of nonhomogeneity of uptake and left and right ventricular enlargement in both visual and quantitative analyses were higher in the mustard exposed patients than unexposed controls. The prevalence of ischemia was higher in the exposed patients (P < 0.05). Cavity to myocardium ratio, as an established and validated measure of ejection fraction, was also significantly lower in the warfare patients than the controls. CONCLUSION: In so far it lies in our knowledge, this is the first report concerning the scintigraphic pattern of myocardial perfusion in mustard intoxicated patients. Based on the results, the pattern of myocardial perfusion in these patients is significantly different from normal controls, which could resemble either coronary artery disease or mild cardiomyopathic changes.

Adult↗
PubMed2006

The prevalence and significance of increased gastric wall radiotracer uptake in sestamibi myocardial perfusion SPECT.

BACKGROUND: Limited available data indicate that a specific pattern of increased gastric wall radiotracer uptake is associated with dyspepsia. Our purpose was to evaluate the frequency of this finding and its relation with dyspeptic evidences. METHOD: 1056 consecutive outpatients referred for myocardial perfusion SPECT were interviewed concerning the dyspeptic symptoms, current gastric medications and previous gastroduodenal interventions. The intensity of gastric wall activity was graded qualitatively as G1 or hyperactive gastric wall (equivalent to the patient's heart activity) and G2 (less than heart activity). RESULTS: The pattern of gastric wall hyperactivity was identified in 1.9% of patients. Dyspeptic symptoms were present in 80 and 18.6% of G1 and G2 patients, respectively (p<0.001). The dyspeptic symptoms were classified as ulcer-like in 37.5%, dysmotility-like in 43.75% and GERD-like in 18.75% of the dyspeptic G1 patients. Considering the classification of dyspepsia, there was no significant difference between the dyspeptic patients of groups. The history of previous gastroduodenal interventions and current use of gastric medications was significantly higher among G1 patients. CONCLUSION: The infrequent pattern of gastric wall hyperactivity could be clinically important and can identify a category of patients, who require additional diagnostic gastrointestinal investigation to specify another possible noncardiac origin of complaints.

Adult↗
PubMed2006

Efficacy of radioiodine therapy in the treatment of elevated serum thyroglobulin in patients with differentiated thyroid carcinoma and negative whole-body iodine scan.

INTRODUCTION: In the management of patients with differentiated thyroid carcinoma, serum thyroglobulin levels are often well correlated with whole-body radioiodine scanning (WBS) results. However, occasionally, a mismatched result - increased thyroglobulin with negative WBS - is observed. Radioiodine therapy has been suggested as a therapeutic choice with controversial results. METHOD: We studied 32 differentiated thyroid carcinoma patients with elevated thyroglobulin level and negative WBS who had been treated with high-dose radioiodine. With a mean follow-up of 25.6 months (all follow-ups >11 months), thyroglobulin and thyroid-stimulating hormone levels, WBS, clinical, radiographic and pathological findings following treatment were recorded. RESULTS: The mean pre-therapy off-treatment thyroglobulin was 152 +/- 119.0 ng.ml(-1). Although there was a mild trend towards an increase in thyroglobulin in the first post-treatment year, the difference was not significant. At the end of the follow-ups, 22 patients (68.7%) were categorized as non-responders to radioiodine therapy (any change or elevation of thyroglobulin or radiological and pathological evidences of progression), four patients (12.5%) as partial responders (transient reduction but not a normalization of thyroglobulin) and six patients (18.7%) as responders (normalization of thyroglobulin with no evidence of remnant disease). In nine of 10 partial and complete responders, reduction or normalization of thyroglobulin had occurred in the first post-treatment year. CONCLUSION: We recommend that in differentiated thyroid carcinoma patients with elevated thyroglobulin and negative WBS, at least one course of radioiodine therapy should be undertaken and if reduction or normalization of serum thyroglobulin is not achieved, repeated courses of radioiodine therapy are not logical and other therapeutic methods should be applied.

Adolescent↗
PubMed2005

Evaluation of the profile of alopecia areata and the prevalence of thyroid function test abnormalities and serum autoantibodies in Iranian patients.

BACKGROUND: The study aimed at evaluating the prevalence of thyroid function abnormalities in patients with alopecia areata (AA) and its association with other autoimmune diseases and various autoimmune antibodies. METHOD: We retrospectively analyzed medical records of 123 patients with AA. The main site of involvement, pattern, and extent of alopecia as well as presence of the similar disease in first-degree family members and serologic status of patients were recorded. RESULTS: Participating in the study were 57 males and 66 females (6 to 59 years old). In the majority of patients (69.9%) the disease was manifested in the first two decades of life. Patients with family members having alopecia were recorded in 24.4%. Thyroid function abnormalities were found in 8.9% of patients. Positive autoimmune antibodies were associated with AA in 51.4% of patients with no significant association between the severity and duration of disease and presence of these antibodies. CONCLUSION: The incidence of positive auto-immune antibodies in Iranian patients is higher than previous reports. Concerning the female:male ratio, thyroid function tests and the prevalence of alopecia in first-degree relatives, our results are compatible with previous data obtained from different ethnic populations. Previous reports documented that a greater severity and longer duration of AA were seen in the early onset forms; however our result are relatively different which could be explained by differences in genetic factors.

Adolescent↗
PubMedDate not supplied

Unilateral pulmonary metastases from Ewing's sarcoma shown in a technetium-99m-methylene-diphosphonate bone scan.

A 32-year-old man with a history of painful swelling of the right ankle underwent bone scintigraphy, which showed increased uptake in the right ankle and also unexpected diffuse uptake throughout the right hemithorax. A single photon emission tomography scan performed after the intravenous injection of 740 MBq of technetium-99m methylene-diphosphonate ((99m)Tc-MDP) showed abnormal uptake throughout the right lung. Computed tomography (CT) revealed a large mass in the right lower lobe. CT-guided biopsy of this mass led to a diagnosis of metastatic Ewing's sarcoma. Although lung uptake on bone scans has been noted in various occasions (such as: pulmonary alveolar microlithiasis, Pneumocystis carinii pneumonia, and various tumoral lesions), increased uptake of (99m)Tc-MDP in lung metastases of Ewing's sarcoma has not been reported according to our knowledge until now. We report such a case.

Adult↗