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  Background & Objectives: Acute myocardial infarction (AMI) is one of the most common causes of admissions in industrialized countries and each year a lot of deaths occur due to this disease. AMI is commonly associated with leukocytosis and an elevated neutrophil count. It is not clear whether neutrophilia is a cause or effect of acute myocardial injury and heart failure. Nevertheless, proving such a correlation will have a lot of clinical utilities.

  Methods: From among 146 patients hospitalized by AMI diagnosis in the CCU ward of Shahid Madani hospital, 68 patients (having our inclusion criteria) took part in this cross-sectional and analytical study. The criteria for AMI were clinical symptoms, ECG criteria and paraclinical findings. CBCH₁ was performed for the patients. All the patients were evaluated for presence or absence of congestive heart failure (CHF) in first 4 days of hospitalization. The data were analyzed with SPSS software using t-test and Chi-square.

  Results: Mean neutrophil count was 11291 in patients with evidence of congestive heart failure (CHF) and 8440 in those without it (P =0.01). This difference was statistically significant. Among 23 patients with CHF, 16 had neutrophil counts >8500, but among 45 patients without CHF only 19 cases showed this value (Odds ratio=3.12, P=0.03). Also among 35 patients with neutrophil counts >8500, 24 patients had ejection fraction (EF) of less than 45% and 11 cases had EF>45%(P=0.015).

Conclusion: In this study we found a direct correlation between neutrophilia on admission and the presence of CHF and echocardiographic left ventricular dysfunction in first 4 days of hospitalization. So the patients with high neutrophilia need more invasive treatments to reduce the possibility of CHF.

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  Background & Objectives: Heart failure (HF) is a pathophysiologic state in which cardiac dysfunction leads to insufficient pumpage of blood for metabolic needs of body. One of the important problems in primary approach to patients with HF, is estimation of HF severity. The present research is an attempt to investigate the accuracy of CXR in diagnosis of HF severity especially in emergency wards.

  Methods: This sensitivity analysis study was conducted on 59 patients admitted to emergency ward of Buali Hospital during March–September 2003, with primary diagnosis of HF. One randiologist used to observe and report radiologic findings without knowing the results of each cardiography.Then cardiologists used to check on the reports and selected patients whose EF was under 50% and eventually sensitivity and specificity of radiologic findings in diagnosing severity of HF (EF ≤ 35%) were calculated.

  Results: 59 patients (53% female and the rest male) were investigated whose age mean was 65.6±10.9 EF mean was 33.4±9.09. In the diagnosis of pulmonary arterial hypertension, CXR had 72% sensivity and 18% specifity, considering the reliance on the CXR in diagnosis of severe HF (EF ≤ 35%) findings were: cardiomeglay (94%), pulmonary artery congestion (75%), interstitial edema (78%) and alveolar edema (76%) with high specifity the reliance on the combination of pulmonary cephalization, interstitial edema and pleural effusion was to have 92% sensivity and 10% specifity.

  Conclusion: According to high sensitivity of cardiomegaly, pulmonary arterial congestion, interstitial edema and pleural effusion, lack of there findings in CXR reduce probability of severe HF. Alveolar edema because of its high specificity increases probability of severe HF. CXR also has high sensivity in diagnosis and R/O of PAH.

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  Background & objectives: Heart failure is considered as a major cause of hospitalization. Many studies have shown association between sleep-related breathing disorders and heart failure. It has been shown that the relationship between nocturnal hypoxia and left ventricular dysfunction can cause significant morbidity and mortality in patients with congestive heart failure (CHF ). Accordingly, treatment of sleep related breathing disorders (SRBD) can give rise to improvement in CHF treatment too. This study surveys the prevalence of sleep disorder in stable heart failure patients regardless of ejection fraction.

  Methods : This study was a descriptive-analytical study. One hundred and eight patients with heart failure disease were studied. A questionnaire consisting of two parts (part I consistent of demographic information and part II consistent of sleep disorders) and clinical examination (pulse oximetery and echocardiography) were used for collection of data. The data were analyzed with SPSS statistical software using descriptive and analytical tests including the chi-square, Pearson correlation and ANOVA.

  Results: Fifty six persons (51.9%) of patients were female and 52 persons (48.1%) were male with mean age of 65.42 ± 11 years. In total sleep duration, 95 patients (88%) had nocturnal hypoxemia . There was correlation between arterial oxygen desaturation at night and ejection fraction .

  Conclusion : This study confirmed strong associations between nocturnal hypoxia and left ventricular dysfunction and SRBD should be considered in clinical treatment of systolic heart failure.

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