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Hajhossein-Talasaz A, Dianatkhah M, Ghaeli P, Salehiomran A, Dianatkhah M. Possible effects of melatonin on reperfusion injury following coronary artery bypass graft surgery. ARYA Atheroscler 2022; 18:1-7. [PMID: 36819839 PMCID: PMC9931614 DOI: 10.48305/arya.v18i0.2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 06/15/2021] [Indexed: 02/24/2023]
Abstract
BACKGROUND Although coronary artery bypass graft (CABG) surgery has been reported to be one of the most effective internentions in terms of myocardial salvage, reperfusion itself can cause additional damage to the myocardium. Since there is strong evidence that free radicals are the principal offender in ischemia-reperfusion (I/R) injury, it has been suggested that treatment with antioxidant agents can be protective. Investigations have shown that melatonin secretion is partially disturbed in CABG patients. The aim of this study was to evaluate the protective effect of melatonin as an antioxidant agent on I/R injury. METHODS 164 elective CABG candidates participated in this randomized clinical trial during the preoperative period. The candidates were randomized to receive 3 mg of melatonin tablets (physiologic dose) from 3 days before surgery until the day of discharge. Cardiac biomarkers [troponin and creatine kinase myocardial band (CKMB)] were assessed once before surgery (24 hours before surgery), and 8 and 24 hours after surgery. RESULTS Finally, 130 patients, 65 (50%) patients in the melatonin group and 65 (50%) in the control arm finished our study. Mean age of melatonin and control groups was 59.90 ± 9.59 and 60.80 ± 8.00 years, respectively; moreover, 47 (72.30%) in melatonin and 45 (69.23%) in control group were men. No significant difference was seen in baseline cardiac biomarkers between two groups (P > 0.05). In both groups, cardiac biomarkers (CKMB and troponin) elevated after surgery in comparison to their preoperative values. There was no statistically significant difference between the control and melatonin groups regarding the 8-hour and 24-hour troponin and CKMB when adjusted for interacting factors (P > 0.05). CONCLUSION Although physiological concentration of melatonin is protective against I/R injury, substitution of endogenous melatonin with the oral supplement which creates physiologic concentration may not prevent I/R injury. In order to have antioxidant effect, pharmacologic doses of melatonin should be employed.
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Affiliation(s)
- Azita Hajhossein-Talasaz
- Professor, Department of Clinical Pharmacy, School of Pharmacy AND Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoush Dianatkhah
- Fellowship of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy AND Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran ,Address for correspondence: Mehrnoush Dianatkhah; Fellowship of Clinical Pharmacy, Department of Clinical Pharmacy, School of
Pharmacy AND Chamran Hospital, Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Padideh Ghaeli
- Professor, Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbass Salehiomran
- Professor, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Dianatkhah
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Boyenle ID, Oyedele AK, Ogunlana AT, Adeyemo AF, Oyelere FS, Akinola OB, Adelusi TI, Ehigie LO, Ehigie AF. Targeting the mitochondrial permeability transition pore for drug discovery: Challenges and opportunities. Mitochondrion 2022; 63:57-71. [PMID: 35077882 DOI: 10.1016/j.mito.2022.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/22/2021] [Accepted: 01/17/2022] [Indexed: 12/29/2022]
Abstract
Several drug targets have been amenable to drug discovery pursuit not until the characterization of the mitochondrial permeability transition pore (MPTP), a pore with an undefined molecular identity that forms on the inner mitochondrial membrane upon mitochondrial permeability transition (MPT) under the influence of calcium overload and oxidative stress. The opening of the pore which is presumed to cause cell death in certain human diseases also has implications under physiological parlance. Different models for this pore have been postulated following its first identification in the last six decades. The mitochondrial community has witnessed many protein candidates such as; voltage-dependent anion channel (VDAC), adenine nucleotide translocase (ANT), Mitochondrial phosphate carrier (PiC), Spastic Paralegin (SPG7), disordered proteins, and F1Fo ATPase. However, genetic studies have cast out most of these candidates with only F1Fo ATPase currently under intense argument. Cyclophilin D (CyPD) remains the widely accepted positive regulator of the MPTP known to date, but no drug candidate has emerged as its inhibitor, raising concern issues for therapeutics. Thus, in this review, we discuss various models of MPTP reported with the hope of stimulating further research in this field. We went beyond the classical description of the MPTP to ascribe a 'two-edged sword property' to the pore for therapeutic function in human disease because its inhibition and activation have pharmacological relevance. We suggested putative proteins upstream to CyPD that can regulate its activity and prevent cell deaths in neurodegenerative disease and ischemia-reperfusion injury.
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Affiliation(s)
- Ibrahim Damilare Boyenle
- Membrane Biochemistry and Biophysics Research Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria; Computational Biology/Drug Discovery Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Abdulquddus Kehinde Oyedele
- Computational Biology/Drug Discovery Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Abdeen Tunde Ogunlana
- Computational Biology/Drug Discovery Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Aishat Folashade Adeyemo
- Membrane Biochemistry and Biophysics Research Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | | | - Olateju Balikis Akinola
- Membrane Biochemistry and Biophysics Research Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Temitope Isaac Adelusi
- Computational Biology/Drug Discovery Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Leonard Ona Ehigie
- Computational Biology/Drug Discovery Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Adeola Folasade Ehigie
- Membrane Biochemistry and Biophysics Research Laboratory, Department of Biochemistry, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
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Abstract
PURPOSE Novel paradigms have broadened our understanding of mechanisms through which complement mediates allograft inflammation/injury. Herein we review advances in the field and highlight therapeutic implications. RECENT FINDINGS Pre-clinical and translational human trials have elucidated complement-dependent mechanisms of post-transplant ischemia-reperfusion (I/R) injury. Immune cell-derived, and intracellular, complement activation are newly linked to proinflammatory T cell immunity relevant to allograft rejection. Complement-induced immune regulation, including C5a ligation of C5a receptor 2 on T cells, C5a/C5a receptor 1 interactions on regulatory myeloid cells, and C1q binding to CD8+ T cells can inhibit proinflammatory T cells and/or prolong murine allograft survival. Pilot trials of complement inhibition to treat/prevent human I/R- or antibody-initiated allograft injury show promise. SUMMARY The complement system participates in allograft injury through multiple context- dependent mechanisms involving various components and receptors. These new insights along with development and implementation of individualized complement inhibitory strategies have potential to improve transplant outcomes.
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Affiliation(s)
- Nicholas Chun
- Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai
- Division of Nephrology in the Department of Medicine, Icahn School of Medicine at Mount Sinai
| | - Julian Horwitz
- Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai
- The Precision Institute of Immunology, Icahn School of Medicine at Mount Sinai
| | - Peter S Heeger
- Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai
- Division of Nephrology in the Department of Medicine, Icahn School of Medicine at Mount Sinai
- The Precision Institute of Immunology, Icahn School of Medicine at Mount Sinai
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Qiu L, Zhang ZJ. Therapeutic Strategies of Kidney Transplant Ischemia Reperfusion Injury: Insight From Mouse Models. Biomed J Sci Tech Res 2019; 14:002617. [PMID: 31093605 PMCID: PMC6513342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Ischemia/reperfusion injury (IRI) is inherent to all transplanted organs and is adversely associated with early renal graft function and graft longevity. Despite the progress in immunosuppressive regimens and perioperative care, no FDA-approved treatment for kidney transplant IRI is available to date. In recent years, by utilizing the modified and clinically-relevant mouse models of kidney transplantation (KTx) in which extended IRI is induced by the prolonged warm or cold ischemic time, studies have identified several potential therapeutic approaches for KTx IRI, including the hormone supplement, promoting tubular repair and regeneration, and targeting complement system, inflammation, and necroptosis. This review describes some of the lessons learned from mouse models of KTx with regard to factors that influence the severity of transplant IRI and the potential therapeutic targets.
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Affiliation(s)
| | - Zheng Jenny Zhang
- Comprehensive Transplant Center, USA,Department of Surgery, USA,Corresponding author: Zheng Jenny Zhang, Department of Surgery, Comprehensive Transplant Center, Feinberg School of Medicine, USA
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Banaei S, Ahmadiasl N, Alihemmati A. Comparison of the Protective Effects of Erythropoietin and Melatonin on Renal Ischemia-Reperfusion Injury. Trauma Mon 2016; 21:e23005. [PMID: 27921018 PMCID: PMC5124127 DOI: 10.5812/traumamon.23005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 02/11/2016] [Accepted: 02/21/2016] [Indexed: 01/16/2023] Open
Abstract
Background Renal ischemia-reperfusion (IR) contributes to the development of acute renal failure (ARF). Oxygen free radicals are considered to be the principal components involved in the pathophysiological tissue alterations observed during renal IR. Objectives In this study, we compared the effects of melatonin (MEL) and erythropoietin (EPO), both known antioxidant and anti-inflammatory agents, on IR-induced renal injury in rats. Materials and Methods Wistar albino rats were unilaterally nephrectomized and then subjected to 45 minutes of renal pedicle occlusion followed by 24 hours of reperfusion. MEL (10 mg/kg, i.p) and EPO (5000 U/kg, i.p) were administered prior to the onset of ischemia. After 24 hours of reperfusion and following decapitation, blood samples were collected for the determination of the hemoglobin (Hb) and hematocrit (Hct) levels. Additionally, renal samples were taken for histological evaluation. Results Ischemia-reperfusion significantly decreased the observed Hb and Hct values. The histopathological findings in the IR group confirmed that there was an increase in the hyaline cast and thickening of the Bowman capsule basement membrane. Treatment with EPO or MEL significantly increased the Hb and Hct values. In the MEL + IR group, the histopathological changes were lower than those found in the EPO + IR group. Conclusions Treatment with EPO and MEL had a beneficial effect on renal IR injury. The results may also indicate that MEL protects against morphological damage better than EPO in renal IR injury.
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Affiliation(s)
- Shokofeh Banaei
- Department of Physiology, Ardabil University of Medical Sciences, Ardabil, IR Iran
- Corresponding author: Shokofeh Banaei, Department of Physiology, Ardabil University of Medical Sciences, Ardabil, IR Iran. Tel: +98-4512245526, E-mail:
| | - Nasser Ahmadiasl
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Alireza Alihemmati
- Department of Histology and Embryology, Tabriz University of Medical Sciences, Tabriz, IR Iran
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Shahbazi N, Haeri H, Nasiri Toosi M, Jafarian A, Shahsiah R, Talebian Moghadam M, Poursaleh SS, Azmoudeh-Ardalan F. Correlation of Histopathologic Findings of Non-Graft Threatening Preservation/Reperfusion Injury in Time-Zero Liver Needle Biopsies With Short-Term Post-transplantation Laboratory Alterations. Hepat Mon 2015; 15:e30008. [PMID: 26288638 PMCID: PMC4532786 DOI: 10.5812/hepatmon.30008v2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/10/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Early post-transplantation alterations in liver tests are caused by a variety of etiologies including rejection, biliary or vascular complications, and preservation/reperfusion injury (PRI). OBJECTIVES The aim of this study was to show the correlation between histopathologic changes of PRI and the alterations in liver tests in the early post-transplantation period. MATERIALS AND METHODS Between April 2013 and August 2014, histopathologic findings of protocol, time-zero, Tru-Cut, liver needle biopsies were evaluated in 94 cases of cadaveric liver transplantation. The histopathologic changes included ballooning degeneration, micro- and macro-vesicular steatosis, bilirubinostasis, apoptotic cells, bile plugs and neutrophilic infiltration. These histopathologic changes were compared with the early (15 days) post-transplantation liver laboratory findings. RESULTS Clinico-pathologic evaluation of all 94 cases was done by assessment of PRI findings in time-zero biopsies and possible causes of allograft injury were appraised. In 21 patients, a specific cause for allograft injury was found including rejection and/or surgical complications. In the remaining 73 cases, there was no specific cause for allograft injury and histopathologic findings of time-zero liver needle biopsies supported PRI. We classified liver laboratory tests alterations as: hepatocellular damage (elevation of transaminases and lactate dehydrogenase), cholestatic damage (elevation of alkaline phosphatase and total bilirubin) and mixed. Hepatocellular and cholestatic alterations in liver function tests were associated with the presence of marked apoptotic bodies and neutrophilic aggregates in time zero biopsies, respectively. On the other hand, macrovesicular steatosis was dominantly associated with mixed (hepatocellular and cholestatic) laboratory alterations of liver tests. CONCLUSIONS Any discrepancy between histopathologic changes in time-zero biopsies and pattern of early liver laboratory alterations may be considered as a warning for causes other than PRI.
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Affiliation(s)
- Narges Shahbazi
- Department of Pathology and Laboratory Medicine, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Hayedeh Haeri
- Department of Pathology and Laboratory Medicine, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Nasiri Toosi
- Department of Internal Medicine, Gastroenterology and Hepatology Division, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
- Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ali Jafarian
- Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Department of General Surgery, Hepatobiliary and Liver Transplantation Division, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Reza Shahsiah
- Department of Pathology and Laboratory Medicine, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
- Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Sedigheh S. Poursaleh
- Iranian Tissue Bank and Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Farid Azmoudeh-Ardalan
- Department of Pathology and Laboratory Medicine, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
- Liver Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Farid Azmoudeh-Ardalan, Department of Pathology and Laboratory Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, P. O. Box: 14197-33141, Tehran, IR Iran. Tel: +98-9121055232, Fax: +98-2188953010, E-mail:
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Ahmadiasl N, Banaei S, Alihemmati A. Combination antioxidant effect of erythropoietin and melatonin on renal ischemia-reperfusion injury in rats. Iran J Basic Med Sci 2013; 16:1209-16. [PMID: 24570825 PMCID: PMC3933796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 11/02/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVE(S) Renal ischemia reperfusion (IR) contributes to the development of acute renal failure (ARF). Oxygen free radicals are considered to be principal components involved in the pathophysiological tissue alterations observed during renal IR. The purpose of this study was to investigate the effect of co-administration of melatonin (MEL) and erythropoietin (EPO), potent antioxidant and anti-inflammatory agents, on IR-induced renal injury in rats. MATERIALS AND METHODS Wistar albino rats were unilaterally nephrectomized and subjected to 45 min of renal pedicle occlusion followed by 24 hr reperfusion. MEL (10 mg/kg, IP) and EPO (5000 U/kg, IP) were administered prior to ischemia. After 24 hr reperfusion, following decapitation, renal samples were taken for the determination of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) levels and histological evaluation. The level of urea was measured in serum samples. RESULTS Ischemia reperfusion significantly increased urea, and MDA levels, and decreased CAT and SOD activities. Histopathological findings of the IR group confirmed that there was renal impairment in the tubular epithelium. Treatment with EPO and MEL markedly decreased urea level and increased SOD and GPx activities. CONCLUSION Treatment with EPO and MEL had a beneficial effect on renal IR injury. These results may show that the co-administration of MEL and EPO cannot exert more beneficial effects than either agent alone.
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Affiliation(s)
- Nasser Ahmadiasl
- Drug Applied Research Center, Tabriz University of Medical Sciences, Medical Faculty, Tabriz, Iran
| | - Shokofeh Banaei
- Department of Physiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Alihemmati
- Department of Histology & Embryology, Tabriz University of Medical Sciences, Medical Faculty, Tabriz, Iran
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Alizadeh-Ghavidel A, Nabavi S, Haghjoo M, Toutonchi Z, Mirmesdagh Y, Javadikasgari H. Amiodarone versus lidocaine for the prevention of reperfusion ventricular fibrillation: A randomized clinical trial. ARYA Atheroscler 2013; 9:343-9. [PMID: 24575137 PMCID: PMC3933055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 08/06/2013] [Indexed: 11/01/2022]
Abstract
BACKGROUND Reperfusion ventricular fibrillation after aortic cross clamp is one of the important complications of open cardiac surgery and its prevention could reduce myocardial injuries. This study aimed to evaluate the efficacy of single dose of amiodarone or lidocaine by the way of pump circuit three minutes before aortic cross clamp release and compare the results with normal saline as placebo in a randomized double blinded controlled trial. METHODS One hundred fifty patients scheduled for first time elective coronary artery bypass graft surgery were randomly assigned to receive either single dose of amiodarone (150 mg), lidocaine (100 mg), or normal saline (5 ml) three minutes before aortic cross clamp release. The incidence of ventricular fibrillation and the need for reuse of drug were compared between these groups by chi-square, Student's t-test, Mann-Whitney test, and One-way ANOVA. SPSS software was used for statistical analysis. RESULTS The incidence of ventricular fibrillation is higher in the placebo group (15.9%) compare to lidocaine (11.8%) and amiodarone (8.9%) groups; however, there was no statistical difference among the three groups (P = 0.41). Moreover, the reuse of amiodarone (22.7%) was statistically higher (P < 0.05) than lidocaine (5.9%). CONCLUSION This study showed no difference among lidocaine, amiodarone, and placebo in preventing ventricular fibrillation after aortic cross clamp release.
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Affiliation(s)
- Alireza Alizadeh-Ghavidel
- Associate Professor, Heart Valve Disease Research Center AND Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Salaheddin Nabavi
- Cardiac Surgery Fellow, Heart Valve Disease Research Center AND Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Haghjoo
- Associate Professor, Cardiac Electrophysiology Research Center AND Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zia Toutonchi
- Associate Professor, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yalda Mirmesdagh
- Research Fellow, Heart Valve Disease Research Center AND Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hoda Javadikasgari
- Research Fellow, Heart Valve Disease Research Center AND Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran,Correspondence to: Hoda Javadikasgari,
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