Abstract
Aim. The aim of this study was to examine the effect of changing position on back pain after cardiac catheterization.
Background. Prolonged bed rest after coronary angiography produces back pain.
Methods. This was a quasi-experimental study conducted on 98 patients who had been admitted for coronary angiography in Shahid Beheshti Hospital of Kashan, Iran, in the year 2014. Patients were randomly allocated to intervention and control group. In this study, data collection form consisted of three sections including demographic information, numerical pain scale, and bleeding and hematoma control checklist. Patients in the control group received routine care after coronary angiography including bed rest for 6 hours without movement of effected limb. However, patients’ position in the intervention group was intermittently changed during the first 6 hours after catheterization. Patients in the intervention and control group were assessed in terms of severity of pain, and bleeding and hematoma, immediately after moving to the ward, and then two, four and six hours after angiography. The data were analyzed in SPSS version 11.5 using descriptive and inferential statistics.
Findings. The result showed that there were statistically significant differences between the intervention and control group in terms of mean score of back pain immediately after moving to the ward (p≤0.0001), and 4 hours (p≤0.0001) and 6 hours (p≤0.0001) after angiography.
Conclusion. In this study, changing position of patients after angiography reduced back pain in patients without causing any complication like hematoma and bleeding; therefore, it can be concluded that applying this intervention could be considered as a convenient way to relieve back pain in patients after coronary angiography.

Abstract
Aim. This review aimed to explore the issue of cardiac arrhythmias in people with subarachnoid hemorrhage. 
Background. Intracranial injuries may cause cardiac arrhythmia and structural changes. Between 25-90% of patients with subarachnoid hemorrhage experience cardiac arrhythmia. In case of inappropriate diagnosis, unnecessary workup and treatment may be done.
Method. The studies published between 2000 and 2017 were searched for in databases and search engines Google Scholar, Pumped, Science Direct, Magiran, and SID by the keywords electrocardiogram, arrhythmia, ECG abnormalities, intracranial hemorrhage, subarachnoid hemorrhage and their Persian equals.
Findings. Provoking the autoimmune system by stimulating the hypothalamus and increasing the circulating catecholamines in patients with cerebrovascular bleeding are two significant mechanisms responsible for cardiac arrhythmias and myocardial damage.
Conclusion. The timely diagnosis of electrocardiographic changes in patients with cerebral hemorrhage is one of the effective factors in determining the prognosis and deterioration of clinical status. It seems that taking the exact medical history, recording ECG at the time of patient admission, and diagnosing the cerebral hemorrhage, in particular subarachnoid hemorrhage, are necessary measures in the health care centers.

Abstract
Aim. The aim of this study was to analyze the concept of heart risk perception from healthcare staff perspective using hybrid method of concept analysis.
Background. In the discussion of behavior, awareness of risk factors for cardiovascular disease is very important in helping individuals to make informed decisions about continuing certain behaviors that increase the risk of the disease, but what matters more is the perception of a person at risk of a disease that affects his or her health functions.
Method. Hybrid model of concept analysis was used to clarify the meaning of perception of risk of heart disease. Three phases of a hybrid concept analysis include theoretical, fieldwork, and final analysis. In theoretical phase, different databases including PubMed, CINAHL, Science Direct, Google Scholar, SID and Magiran were searched for related articles published from 1990 to 2018). The search keywords were perception of risk; heart disease in titles and abstracts of the papers. In the fieldwork phase, semi-structured in -depth interviews were conducted with 18 nurses who were selected by purposive sampling. In next step, by combining the two previous stages the final analysis was performed.
Findings. The combination of theoretical and fieldwork findings resulted in definition of heart risk perception from healthcare staff perspective: “Understanding the risk of heart disease is a form of acquiring awareness of the risk of heart disease that is influenced by beliefs, values, culture and attitudes of individuals, and it stimulates learning and changing self-care behaviors for efficacy in promoting heart health and avoiding risk factors.”
Conclusion. The results of this study will help to clarify the concept of perception of risk of heart disease among healthcare system staff. This clarification may lead to offering comprehensive view and better understanding for use in the research and practice.

Abstract
Aim. The aim of this study was to compare the quality of life in military and non-military people with and without hypertension.
Background. Hypertension is one of the most important causes of chronic disability in the world that its progressive course may affects various aspects of quality of life.
Method. This was a cross-sectional study with a descriptive comparative design in which 200 men with hypertension (100 military and 100 non-military) and 200 men without hypertension (100 military and 100 non-military)  were recruited to the study by convenience sampling method in Tehran. Data were collected by short form (SF36) quality of life questionnaire and demographic form.
Findings. The mean score of quality of life in the group of people without hypertension (military people, 82.20±12.72; non-military people, 84.83±8.01) were significantly higher than the group with hypertension (military people, 76.72±16.60; non-military people, 68.58±17.77)
Conclusions. Quality of life in military and non-military men with hypertension is lower than the military and non-military men without hypertension. It is necessary to pay more attention to people with hypertension for promoting their quality of life.

Abstract
Aim. This study was carried out to compare the effect of trinitroglycerin (TNG) spray and sublingual pearl on chest pain severity and some physiological indices of people with chest pain visited by emergency medical services.
Background. Glyceryl trinitrate is used as an anti-anginal vasodilating agent with various forms including spray and pearl with probable different therapeutic effects.
Method. In this quasi-experimental study, 80 patients with chest pain were recruited through convenience sampling and then allocated to pearl and spray groups by minimization method. After arriving at the patient's bedside, vital signs and chest pain severity were measured and recorded, then the drug was administered every 5 minutes for 3 times; thereafter, the measurements were repeated. The data analyzed in SPSS software 1) using descriptive and inferential statistics.
Findings. The results showed that after intervention, the mean score of pain in pearl and spray groups were 6.05±0.98 and 5.60±1.25, respectively. There was no statistically significant difference between groups in terms of pain score. Whereas after intervention, the mean systolic and diastolic pressure in pearl group was significantly lower than the spray group, the heart rate in both groups were increased.  
Conclusion. Nitroglycerin in the pearl form has the same effect as spray form in relieving chest pain. According to the circumstances and drug accessibility, emergency staff might use every two forms of Nitroglycerin.

Abstract
Aim. This review study was designed to identify the benefits of cardiac rehabilitation and the factors affecting the participation of cardiac patients in cardiac rehabilitation programs.
Background. Cardiovascular diseases are the main cause of death and hospitalization in developed countries. Given that cardiac rehabilitation is as an important component of care for all patients with acute cardiac events, the knowledge of the benefits of cardiac rehabilitation for the prevention of secondary complications of these conditions may reinforce the patients to participate in cardiac rehabilitation programs.
Method. This study is a review of the papers related to cardiac rehabilitation searched out by databases PubMed, Scopus, Google Scholar and Persian articles published in this subject.
Findings. The evidence has shown that those who have participated in cardiac rehabilitation programs are less likely to experience death and morbidity. In general, cardiac rehabilitation can prevent deaths due to heart disease, reduces the possibility of surgery and angiography and reduces the need for hospitalization. Studies over the last 30 years indicate that participating in cardiac rehabilitation programs improve functional capacity, risk factors, quality of life related to health and reduce cardiovascular mortality.
Conclusion. Cardiac rehabilitation is beneficial for patients with cardiovascular disease. It leads to reduction of mortality and morbidity, need for cardiac surgery, and re-hospitalization, and increases functional capacity, and quality of life.

Abstract
Aim. This study compares the effect of foot reflexology and stroke massage on depression in people with acute myocardial infarction.
Background. Depression is a common complication of myocardial infarction and could increase the likelihood of further attacks. Medication as a common therapy for treating depression has many side effects. So interventions performed with minimal risk is of great importance when managing depression in these people.
Method. In this randomized clinical trial (IRCT2016060817756N2), 60 people with myocardial infarction, admitted to CCU in Valiasr hospital in Birjand, were selected using convenience sampling and randomly allocated into three groups; intervention with reflexology (n=20), intervention with stroke massage (n=20),  and control group (n=20). Massage therapy was implemented for 5 weeks (three days a week) . Data collection tool was Beck Depression Inventory. Beck Depression Inventory was completed before and after intervention by participants in all three groups. Data were analyzed in SPSS 16 software using Chi-square test, t-test, ANOVA and Tukey.
Findings. Before intervention, there was no statistically significant difference between the groups in the mean score of depression (p=0.453), but a statistically significant difference was found after intervention (p <0.001). Tukey's post hoc test showed that after intervention, the mean scores of depression significantly decreased in foot reflexology group (23.65±3.50) compared with that of stroke massage   group (27.55±3.42) (p=0.006) and  control group (30.05±4.50) (p<0.001), but not statistically significant difference seen between stroke massage and control groups in terms of mean score of depression. Changes in mean depression scores before and after intervention was significantly higher in the foot reflexology massage group compared with stroke massage and control groups, and also, these changes was significantly higher in the stroke massage group compared with control group.
Conclusion. Both types of massage were effective in reducing depression, and the effect of the foot reflexology was greater. So, it is recommended to apply these interventions in routine nursing care for people with myocardial infarction experiencing depression.

Abstract
Aim. This study aimed to investigate the effects of a Turkish, family-oriented multimedia application on adherence to therapeutic regimen in people with recent myocardial infarction.
Background. Using native language in education of people experiencing myocardial infarction may have an effect on their adherence to therapeutic regimen.
Method. This study is a clinical trial. The research was conducted in Post-CCU wards of Zanjan hospitals in 2016. In this study, 80 patient with myocardial infarction were randomly allocated to experimental  (n=40) and control (n=40) group during a 6 month period. Data collection tools consisted of demographic form and a questionnaire measuring adherence to therapeutic regimen in domains diet, physical activity, and medication. Data were analyzed in SPSS V.20 by statistical tests (Chi-square, Mann-Whitney and T-Test.
Findings. Comparison of the groups indicated a statistical significant difference between the mean score change of adherence to medication regimen of experimental and control group (3.52±0.2 versus 2.79±0.73) (P≤0.0001), adherence to diet (3.91±0.3 versus 3.63±0.6) (P≤0.0001), and adherence to physical activity (3.57±0.4 versus 3.11±0.7) (P≤0.0001).
Conclusion. Family-centered family education through multimedia application (in Turkish) is effective on patients’ adherence to therapeutic regimen and in turn, may reduces the costs and complications.

Abstract
Aim. The purpose of this study was to review the nursing care and education of patients with Ventricular Assist Device (VAD).
Background. Heart failure is one of the most important noncommunicable diseases. There are many pharmacological and non-pharmacological approaches for treatment of heart failure. These treatments have contributed to the survival of people with this disease. Nursing care of patients with VADs can prolongs patient’s quality of life and survival. 
Method. This review study was conducted in 2018 using the keywords heart failure, intraventricular assist devise, cardiovascular disease, survival rate, complications of heart failure and nursing care, by searching in the search engines/ databases Google Scholar, OVID, Up-to-date, Springer, PubMed, SID, MagIran, Web of Sciences, Cochrane Library, CINHAL, and Scopus without time limit. A total of 63 articles were found related to the subject under study, out of which, 10 duplicate articles were omitted from the list and 4 articles were excluded because they were not available; this way, 49 papers were included in the study.
Findings. The role of the nurse in teaching patients with VADs is very important. Patient education can be a help for improving quality of life and increasing patient’s survival.
Conclusion. Familiarity with the new approaches to manage heart failure is very important for nurses. VADs have complications such as infection, bleeding, and arrhythmias; recognition, prevention and management of these complications can improve patient’s quality of life and survival.

Abstract
Aim. The aim of this review was to investigate the effects of Crocus sativus (Saffron) on cardiovascular diseases from Iranian traditional medicine to modern phytotherapy.
Background. Cardiovascular disease (CVD) presently accounts for almost half of non-communicable diseases (NCDs) and causes deaths of 17.3 million per year. Crocus sativus is one of the various traditional herbs that have been demonstrated to have therapeutic effects on cardiovascular disease. Crocus sativus, commonly known as Saffron, is a species of flowering plant of the Crocus genus in the Iridaceae family.
Method. Data were obtained from searching the scientific databases including Pubmed, ScienceDirect, Scopus, Web of Science, Google Scholar and related Iranian traditional medicine books. The keywords included "Crocus sativus", "saffron", "cardiovascular diseases", "heart disease" and "therapeutic properties of saffron". Finally, searching in databases detected 58 records that 37 sources had the inclusion criteria and their full texts were carefully reviewed.
Findings. Crocus sativus shows antispasmodic, eupeptic, gingival sedative, anticatarrhal, nerve sedative, carminative, diaphoretic, expectorant, stimulant, stomachic, aphrodisiac, and emmenagogue activities. In addition, it is effective in treating cardiovascular disease. Crocus sativus extract has an anti-arrhythmic effect, vascular smooth muscle relaxant, blood pressure reducing effect and protective role on ischemic heart disease. Also, it can play an important role in stopping ischemic heart damage and be used as a new preventive tool for ischemic heart disease.
Conclusion. Many studies confirm that Crocus sativus has a wide range of pharmacological activities, but it seems more research is needed to evaluate these mechanisms.

Abstract
Aim. The purpose of this study was to compare the effect of clinically-indicated replacement and routine replacement of peripheral venous catheters on catheter-related complications and satisfaction in patients undergoing cardiac surgery.
Background. The insertion of peripheral vein catheter is one of the most commonly used minimally invasive measures in hospitalized patients. Catheters can be maintained until they are working well.
Methods. A randomized controlled clinical trial was conducted in intensive care units of Rajaie Cardiovascular Medical and Research Center in 2017. After ethical Approval, 104 Patients were randomly allocated to either clinically-indicated replacement or routine replacement of peripheral venous catheters (every 96 hours) (52 Patients in each group). Data collection tools included demographic form, catheter placement data sheet and a researcher-made patients’ satisfaction questionnaire. Data were analyzed in SPSS using descriptive and inferential statistics.
Findings. There were no statistically significant difference in terms of the incidence of complications between the groups. Also, there were no statistically significant difference between the scores of satisfaction of the patients of the control and experimental group.
Conclusion. No evidence was found of superiority of routine replacement of peripheral venous catheters over clinically-indicated replacement. Caregivers may consider changing the protocol of catheter replacement from routine replacement to clinically-indicated replacement. This would protects patients from the unnecessary pain of routine replacement in the absence of clinical indications.

Abstract
Aim. The purpose of this study was to determine the effect of teaching health-promoting behaviors on self-care behaviors in people with hypertension.
Background. Hypertension is one of the chronic diseases that causes serious complications on the organs of the body and requires self-care behaviors to be managed and controlled. Education increases self-care capacity in these patients and may help reducing complications and promote disease control.
Method. In this quasi-experimental study, 106 patients who referred to the clinic of Shahid Rahimi Hospital in Khorramabad, affiliated to Lorestan University of Medical Sciences, were recruited based on inclusion criteria and allocated to experimental (n=53) and control group (n=53). The experimental group received three training sessions of health-promoting behaviors in three consecutive weeks. The control group received only the routine treatments. Data were collected using a demographic form and self-care behaviors questionnaire, before and one month after intervention. Data were analyzed by SPSS version 22 using descriptive and inferential statistics.
Findings. The groups did not differ significantly in terms of demographic variables and disease characteristics. Before intervention, the mean score of self-care in the control and experimental group were 8.33±1.79 and 9.7 ±2.41, respectively, and there was a statistically significant difference between the groups (P=0.002). After intervention, the mean score of self-care in the control and experimental group were respectively reported as 8.43±1.84 and 14.46±2.13. Analysis of covariance showed that after intervention, the mean score of self-care in experimental group was significantly higher than that of control group (P≤0.0001).
Conclusion. Education improved self-care in people with hypertension. Providing education for people with hypertension can be effective in promoting their self-care behaviors.

Abstract
Aim. The purpose of this study was to compare the effect of “acceptance and commitment therapy” and “stress inoculation training” on stress symptoms in people with broken heart syndrome.
Background. Stress is considered to be the main driving force of broken heart syndrome, while broken heart syndrome also causes stress. It seems that training the patient for correct use of coping strategies during stressful events is effective in preventing recurrence.
Method. In this quasi-experimental pre-test post-test design with control group, 62 people referred to Tohid Hospital in Sanandaj during 2016-2017 and had been diagnosed as with broken heart syndrome were considered as accessible population, out of which 30 patients were recruited by convenience sampling method and randomly assigned to three groups. Research tool was the stress syndrome scales in Persian language.  For intervention groups, the acceptance and commitment therapy and stress inoculation training interventions was conducted in weekly sessions. The questionnaire were filled out before intervention, after intervention and one month after intervention by the three groups. Data were analyzed in SPSS using descriptive and inferential statistics.
Findings. Compared with control group, acceptance and commitment therapy (F=87.65, P≤0.0001) and stress inoculation training (F=61.18, P≤0.0001) were effective in reducing stress symptoms and the effect of the acceptance and commitment therapy was remarkable. In addition to the stability of the effect of both interventions one month after intervention, the effect of acceptance and commitment therapy was found to be superior to stress inoculation training.
Conclusion. Both modalities; especially acceptance and commitment therapy, can be used as effective methods with wide applicability in preventing and reducing symptoms of stress and improving the status of people with broken heart syndrome.

Abstract
Aim. This study reviews the role of vitamin E in cardiovascular diseases.
Background. Cardiovascular diseases are among the most common health-related problems, and the number of the patients with cardiovascular diseases increases each year. Long-term manifestations of cardiovascular disease bears a lot of cost to the family and society.
Method. This review study was conducted by searching out the related literature in the databases Google Scholar, PubMed, PMC, Springer, and Elsevier, for papers published from 2014 to 2018. Initially, a total of 72 articles were found and the number of articles was reduced to 42 by removing duplicates and articles that were only accessible as abstract. Finally, a review by 21 articles was carried out.
Findings. α-Tocopherol is the most common form of vitamin E in human tissues. Increased oxidative stress is an important mediator of endothelial injury in hypertension pathology, associated with increased oxidant protein production, such as hydrogen peroxide super oxidation, decreased nitric oxide synthesis, and decreased biological capacity of antioxidants. Oxidative stress may lead to endothelial dysfunction, inflammation, hypertrophy, fibrosis, and angiogenesis associated with hypertensive vascular changes. Vitamin E deficiency can provide a constraint for micro ribonucleic acids (miRNAs) networks, and this may lead to the progression of atherosclerosis. Vitamin E deficiency causes adverse effects in cardiovascular systems. However, the effect of its use in the treatment of diseases is still not fully understood.
Discussion. A good amount of Vitamin E should be provided and it should be replaced before the complications occur.