Introduction: To address cardiovascular (CV) complications and their relationship to clinical outcomes in hospitalized patients with COVID-19. Methods: A total of 196 hospitalized patients with COVID-19 were enrolled in this retrospective single-center cohort study from September 10, 2020, to December 10, 2020, with a median age of 65 years (IQR, 52-77). Follow-up continued for 3 months after hospital discharge. Results: CV complication was observed in 54 (27.6%) patients, with arrhythmia being the most prevalent (14.8%) followed by myocarditis, acute coronary syndromes, ST-elevation myocardial infarction, cerebrovascular accident, and deep vein thrombosis in 15 (7.7%), 12 (6.1%), 10(5.1%), 8 (4.1%), and 4 (2%) patients, respectively. The proportion of patients with elevated high-sensitivity troponin I, N-terminal pro-B-type natriuretic peptide, left ventricular diastolic dysfunction, and heart failure with preserved ejection fraction was greater in the CV complication group. Severe forms of COVID-19 comprised nearly two-thirds (64.3%) of our study population and constituted a significantly higher share of the CV complication group members (75.9%vs 59.9%; P=0.036). Intensive care unit admission (64.8% vs 44.4%; P=0.011) and stay (5.5days vs 0 day; P=0.032) were notably higher in patients with CV complications. Among 196patients, 50 died during hospitalization and 10 died after discharge, yielding all-cause mortality of 30.8%. However, there were no between-group differences concerning mortality. Age, heart failure, cancer/autoimmune disease, disease severity, interferon beta-1a, and arrhythmia were the independent predictors of all-cause mortality during and after hospitalization. Conclusion: CV complications occurred widely among COVID-19 patients. Moreover,arrhythmia, as the most common complication, was associated with increased mortality.

Background COVID19 patients may suffer from multiple cardiovascular complications. Recently, N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) was a potentially independent risk factor for COVID-19 in-hospital death. The present study aimed to find new optimal cut points for NT-proBNP across censored survival failure time outcomes in hospitalized COVID-19 patients. Results This cohort study was conducted on 272 patients with COVID-19 whose initial records were recorded from March 2020 to July 2020. Demographic characteristics, clinical examinations, and laboratory measurements were collected at the beginning of the admission registered in the patient record system located in the hospital. We used the maximally selected rank statistics to determine the optimal cut points for NT-proBNP (the most significant split based on the standardized log-rank test). Survival time was defined as the days from hospital admission to discharge day. In this cohort study, two optimal cut points for NT-proBNP were 331 (pg/mL) and 11,126 (pg/mL) based on a survival model. The adjusted HR of NT-proBNP for in-hospital death was 3.41 (95% CI: 1.22–9.51, P = 0.02) for medium against low category, and 3.84 (95% CI: 1.30–11.57, P = 0.01) for high in comparison with low group. Conclusions We reported a dramatically increased concentration of NT-proBNP among COVID-19 patients without heart failure in both severe and non-severe cases. Moreover, our study showed that a high level of NT-proBNP was highly associated with the prolonged survival time of patients with COVID-19. NT-proBNP is a strong prognostic indicator of in-hospital death in the second week of admission.

Background: Myocardial infarction (MI) is amongst medical emergency situations. Decline of heart rate and blood pressure during the initial days after admission due to myocardial infarction are the main goals of treatment that decrease the pressure on the myocardium. Objectives: This study was performed to determine the effects of patients early mobilization program on heart rate and blood pressure of patients with MI hospitalized at the coronary care unit (CCU). Patients and Methods: This study was a clinical trial that was performed on 38 patients with myocardial infarction at the CCU of Shahid Beheshti hospital of Babol. Samples were selected using purposive sampling and were randomly allocated into experimental and control groups. Patients in the experimental group, within 12 -18 hours after admission to the CCU, were mobilized with a specified program while in the control group, patients got out of bed on the basis of routine care within 48 hours after admission. Heart rate and blood pressure was measured every six hours during the first and third day of admission and were compared between the two groups. Results: In the experimental group, mean heart rate during the first day was 82.16 ± 13.83 and on the third day was 75.37 ± 9.73. In the control group, mean heart rate during the first day was 70.67 ± 13.76 and on the third day was 73.84 ± 12.69. The difference between the mean heart rates of the first and third day was 6.79 ± 11.2 for the experimental group and -3.16 ± 7.3 for the control group. The findings showed that there was a significant difference between differences of mean heart rate during the first and third days in the two groups (P = 0.003). Analysis showed that there was no significant difference between changes of mean systolic blood pressure (P = 0.1) and diastolic blood pressure (P = 0.11) on the first and third day, in the two groups. Conclusions: This study showed that the early mobilization program could reduce heart rate. Therefore, based on the results of this study, use of the early mobilization program in the treatment and care program of patients with myocardial infarction is suggested.

Introduction: Mitral stenosis (MS) causes structural and functional abnormalities of the left atrium (LA) and left atrial appendage (LAA), and studies show that LAA performance improves within a short time after percutaneous transvenous mitral commissurotomy (PTMC). This study aimed to investigate the effects of PTMC on left atrial function by transesophageal echocardiography (TEE). Methods: We enrolled 56 patients with severe mitral stenosis (valve area less than 1.5 CM2). All participants underwent mitral valvuloplasty; they also underwent transesophageal echocardiography before and at least one month after PTMC. Results: Underlying heart rhythm was sinus rhythm (SR) in 28 patients and atrial fibrillation (AF) in remainder 28 cases. There was no significant change in the left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), or the left ventricular end systolic dimension (LVESD) before and after PTMC in both groups. However, both groups showed a significant decrease in the left atrial volume index (LAVI) following PTMC (P=0.032 in SR and P=0.015 in AF group). LAA ejection fraction (LAAEF) and the LAA emptying velocity (LAAEV) were improved significantly after PTMC in both groups with SR and AF (P<0.001 for both). Conclusion: Percutaneous transvenous mitral commissurotomy improves left atrial appendage function in patients with mitral stenosis irrespective of the underlying heart rhythm.

This Study describes eleven patients positive for severe acute respiratory syndrome coronavirus 2. In our cases, females and younger patients developed more severe disease. In contrast, improvement in left ventricular ejection fraction and N‐terminal prohormone brain natriuretic peptide within the first week of treatment contributed to promising outcomes.