Journal of the Saudi Heart Association最新文献

{"title":"Surgical Correction of a Complex Aorto-Mitral Pathology","authors":"K. Karabacak, E. Kubat, Elgin Hacızade, S. Doganci, C. Bolcal","doi":"10.37616/2212-5043.1299","DOIUrl":"https://doi.org/10.37616/2212-5043.1299","url":null,"abstract":"Pseudoaneurysm of mitral-aortic intervalvular fibrosa is a rare entity related to mostly infective endocarditis and surgical trauma of aortic valve. Its diagnosis may be missed following trans-thoracic echocardiographic assessment. Therefore, further imaging investigation such as transesophageal echocardiography and computed tomographic angiography may play a key diagnostic role. Here we present the successful surgical treatment of a 30- year-old male patient referred for surgical treatment of mixed severe calcific aortic valve disease and apparently without additional anatomical abnormalities.","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"76 1","pages":"72 - 76"},"PeriodicalIF":0.8,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76749412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Septic Pulmonary Embolism Related to Right-sided Infective Endocarditis","authors":"A. Panjwani, Nooraldaem Yousif","doi":"10.37616/2212-5043.1300","DOIUrl":"https://doi.org/10.37616/2212-5043.1300","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"22 1","pages":"70 - 71"},"PeriodicalIF":0.8,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88390354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic Recommendations to Bridge the Gaps in Awareness, Diagnosis and Prevention of Heart Failure in the Middle East Region and Africa","authors":"A. Bennis, E. Ogola, E. Klug, H. Skouri, H. A. Al Saffar, H. Ragy, K. Alghalayini, K. Alhumood, M. Abdelhamid, M. Yılmaz, R. Tabbalat, Y. Cavusoglu","doi":"10.37616/2212-5043.1294","DOIUrl":"https://doi.org/10.37616/2212-5043.1294","url":null,"abstract":"Objective With the increasing burden of heart failure (HF) in the Middle East Region and Africa (MEA), it is imperative to shift the focus to prevention and early detection of cardiovascular diseases. We present a broad consensus of the real-world challenges and strategic recommendations for optimising HF care in the MEA region. Method To bridge the gaps in awareness, prevention, and diagnosis of HF, an assembly of experts from MEA shared their collective opinions on the urgent unmet needs. Results Lack of awareness in the community, high prevalence of risk factors, poor accessibility and affordability of care and diagnostics are the major barriers for delayed or missed diagnosis of HF in MEA. Enhancing patient awareness, through digital or social media campaigns, alongside raising knowledge of healthcare providers and policymakers with training programmes, can pave the way for influencing policy decisions and implementation of robust HF programmes. Multicountry registries can foster development of guidelines factoring in local challenges and roadblocks for HF care. Region-specific guidelines including simplified diagnostic algorithms can provide a blueprint of care for early detection of at-risk patients and facilitate efficient referral, thus mitigating clinician “therapeutic inertia.” Multidisciplinary care teams and HF clinics with expanded role of nurses can streamline lifestyle modification and optimum control of dyslipidaemia, blood pressure, and glycaemia through guideline-recommended prevention therapies such as sodiumglucose co-transporter-2 inhibitors—thus supporting pleiotropic effects in high-risk populations. Conclusion Development of regional guidelines, enhancing awareness, leveraging digital technology, and commitment for adequate funding and reimbursement is pivotal for overcoming structural and health system-related barriers in the MEA region.","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"1 1","pages":"53 - 65"},"PeriodicalIF":0.8,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83067292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicability of the commonly used risk scores for coronary bypass surgery in Algeria","authors":"A. Boukhmis, M. Nouar, M. K. Guerchani","doi":"10.37616/2212-5043.1297","DOIUrl":"https://doi.org/10.37616/2212-5043.1297","url":null,"abstract":"Objectives The applicability of European system for cardiac operative risk evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons Predicted Risk Of Mortality (STS-PROM) as well as the initial logistic Parsonnet risk score, who have been developed from European and American datasets, is questionable outside these regions. We aimed to assess the performance of these three risk scores for patients undergoing isolated coronary artery bypass grafting (CABG) in Algeria. Methods Between June 2014 and June 2016, data from 235 consecutive patients, who underwent isolated CABG at a reference center in Algiers, were prospectively collected and scored according to the EuroSCORE II, STS-PROM and the Parsonnet score. Their discriminative power was evaluated by the area under the receiver operating characteristic curve (AUC) while their calibration was tested by the Hosmer–Lemeshow goodness-of-fit test. Results The mean patient age was 59.08 years and 18.3% were female. The mortality at 30 days was 3.40%. The mortality expected by EuroSCORE II, STS-PROM and by Parsonnet risk score was: 1.33%, 0.78% and 3.35%, respectively. Discriminatory ability was fair for the Parsonnet risk score, good for the STS PROM and excellent for EuroSCORE II (AUCs = 0.737, 0.788, and 0.892, respectively). Regarding calibration, EuroSCORE II and STS-PROM under estimated observed mortality (Hosmer–Lemeshow test: P< 0.001 for both scores), while the Parsonnet risk score was well calibrated (Hosmer–Lemeshow test: p = 0.395). Conclusions EuroSCORE II and STS-PROM had excellent and good discriminating power, respectively, but both underestimated the risk of 30 days mortality following isolated CABG at a reference center in Algiers. The Parsonnet risk score was well calibrated but was moderately discriminating. The development of a local risk score or the recalibration of recent international risk scores is necessary.","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"365 1","pages":"24 - 31"},"PeriodicalIF":0.8,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85464338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Contraction Fraction is Superior to Ejection Fraction in Predicting Functional Capacity in Patients with Heart Failure with Reduced Ejection Fraction","authors":"Yasser A. Abdellatif, Hassan A Addow, R. R. Elias","doi":"10.37616/2212-5043.1295","DOIUrl":"https://doi.org/10.37616/2212-5043.1295","url":null,"abstract":"Objectives In this study, we aimed to evaluate the relationship between three-dimensional echocardiography (3DE)-determined myocardial contraction fraction (MCF) and functional capacity in heart failure with reduced ejection fraction (HFrEF) patients. The MCF is a volumetric index of myocardial function, defined as stroke volume ratio to myocardial volume (MV). Functional capacity was evaluated by a 6-min walk test (6MWT), and health-related quality of life (HRQOL) was assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). In view of cardiac remodeling, we hypothesized that MCF would be superior to left ventricular ejection fraction (LVEF) in predicting functional capacity in HFrEF patients. Methods The study was conducted on thirty HFrEF patients with an LVEF of no more than 40% with NYHA functional class I–III. Each patient performed, on the same day, the MLHFQ, 6MWT (to calculate the 6-min walk distance “6MWD”), and an ECG gated echocardiographic study including 3DE-determined MCF. MV was calculated as 3DE determined LV mass divided by the specific gravity of the myocardium. Results Our results showed that MCF is inversely correlated with the Minnesota score (r 0.6, p < 0.001) and positively correlated with 6MWD (r 0.65, p < 0.001). However, no significant relationship existed between LVEF and MLHFQ score or 6MWD. In a multivariate model, MCF was shown to be an independent echocardiographic predictor (besides pulmonary artery systolic pressure) of 6MWD; however, LVEF failed to offer such potential. Conclusion Among various echocardiographic parameters, MCF can be considered a volumetric index superior to LVEF in predicting functional capacity in HFrEF patients.","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"66 1","pages":"15 - 23"},"PeriodicalIF":0.8,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75153714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Right Superior Vena Cava Drained to Left Atrium in a Child with Waardenburg Syndrome and Neurofibromatosis Type I","authors":"Omer A. Algonaid, Y. Almashham, A. Almoukirish","doi":"10.37616/2212-5043.1293","DOIUrl":"https://doi.org/10.37616/2212-5043.1293","url":null,"abstract":"Isolated right superior vena cava (SVC) draining to the left atrium (RSVC-LA) is an extremely rare cyanotic congenital heart disease (CHD). Such lesion is easily missed with improper scanning or inattentive interpretation of echocardiography. This can result in potential systemic severe complications. We report a child with RSVC-LA who has two significant non-cardiac co-morbidities, including Waardenburg syndrome and n neurofibromatosis type I (NF1). This patient was referred to cardiology assessment due to unexplained low saturation and was diagnosed as RSVC-LA; however, fortunately not yet showing complications of systemic thromboembolic phenomenon (STEP).","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"67 1","pages":"11 - 14"},"PeriodicalIF":0.8,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89363795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Outflow Tract Endocarditis as a Sequela of Pneumonia in a Patient without Valvular Abnormalities","authors":"Mohd Asyiq Raffali, Prapatricca Shanmugam, Muhammad Ishamuddin Ismail, Suria Hayati Md Pauzi, H. Hassan","doi":"10.37616/2212-5043.1290","DOIUrl":"https://doi.org/10.37616/2212-5043.1290","url":null,"abstract":"A 50-year-old woman with underlying end stage renal disease on hemodialysis developed large isolated staphylococcal infective endocarditis over the left ventricular outflow tract when she had pneumonia, without apparent valvular involvement. She subsequently had successful surgery for excision of vegetation.","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"40 1","pages":"1 - 5"},"PeriodicalIF":0.8,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78499778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enigma of Twins: Identical Presentation and Angiographic Lesion in Monozygotic Twins","authors":"A. Singh, A. Raj, Badal Bankar, R. Nath","doi":"10.37616/2212-5043.1291","DOIUrl":"https://doi.org/10.37616/2212-5043.1291","url":null,"abstract":"We present a case of monozygotic identical twins presenting with coronary artery disease (CAD), there were striking similarities in the symptoms, coronary anatomy, and lesions.","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"59 1","pages":"6 - 10"},"PeriodicalIF":0.8,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89389835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Reoperative Tricuspid Valve Surgery: Outcomes and Risk Assessment.","authors":"Tahir I Mohamed,&nbsp;Omar J Baqal,&nbsp;Abdulaziz A Binzaid,&nbsp;Hussam T AlHennawi,&nbsp;Abdulrahman R Barakeh,&nbsp;Omar M Mrayati,&nbsp;Aly M Alsanei","doi":"10.37616/2212-5043.1286","DOIUrl":"https://doi.org/10.37616/2212-5043.1286","url":null,"abstract":"<p><strong>Objective: </strong>To describe patient characteristics and post-operative outcomes, including early and late mortality, defined by death within 30 days and after 30 days post-surgery, respectively, as well as 20-year survival after isolated reoperative tricuspid surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed 169 patients who underwent isolated reoperative tricuspid valve surgery at our institution (between 1997 and 2000) and describe post-surgical outcomes including intraoperative, early and late mortality. All patients included completed 21 years of follow-up.</p><p><strong>Results: </strong>The majority of our patients were females 147 (87%) with the mean age of 45.9 ± 12.9 years. The mean body mass index (BMI, kg/m²) was 27.4 ± 6.0. Previous cardiac surgeries included tricuspid valve surgeries in 169 (100%) patients, with bioprosthetic valves, mechanical valves, annual rings and tricuspid repair surgeries utilized in 37 (21.9%), 21 (12.4%), 38 (22.4%) and 73 (43.2%) patients, respectively. The indication for previous tricuspid surgery was rheumatic heart disease in 154 (91.5%) patients.The most common cause of reoperative valvular surgery was tricuspid regurgitation (TR) in 139 (82.2%), with 66% of patients having severe TR. Other reasons for reoperative surgery included tricuspid stenosis 22 (13%) and dehiscence 8 (4.7%). For the redo surgery, 125 (74%) patients underwent Tricuspid Valve Replacement (TVR), 90 (53%) of whom received bioprosthetic valves while 35 (21%) received mechanical valves. Forty-four patients (26%) underwent Tricuspid Valve Repair. Mortality within 30 days of surgery was 11.3% (20 patients) and 11.4% after 30 days, with 20 years survival being about 80%.</p><p><strong>Conclusions: </strong>Based on our experience, reoperation for failed isolated tricuspid valve replacement or repair was associated with reasonable mortality and good survival rate over long period of time.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"366-373"},"PeriodicalIF":0.8,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/53/sha-366-373.PMC8765034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39955769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speckle Tracking Echocardiographic Assessment of Left Ventricular Function by Myocardial Strain Before and After Aortic Valve Replacement.","authors":"Gajinder Pal Singh Kaler,&nbsp;Rakesh Mahla,&nbsp;Himanshu Mahla,&nbsp;Sarita Choudhary,&nbsp;Gurdarshan Singh,&nbsp;Raghuveer Prasad Patel,&nbsp;Navjot Kaur Kaler","doi":"10.37616/2212-5043.1288","DOIUrl":"https://doi.org/10.37616/2212-5043.1288","url":null,"abstract":"<p><strong>Background & objectives: </strong>In patients of aortic stenosis and regurgitation, pressure and volume effects on left ventricular function are occult and missed by routine echocardiography markers like ejection fraction (EF). Speckle tracking analysis by measuring global longitudinal strain and global circumferential strain seems to ascertain this occult LV function parameters at an early phase in a more comprehensive manner. Limited studies have examined these parameters pre/post aortic valve replacement (AVR).</p><p><strong>Methods: </strong>94 consecutive patients with symptomatic severe aortic stenosis (AS) or aortic regurgitation (AR), planned for AVR were included (as per set inclusion criteria) along with 15 normal controls-15 months prospective study. Routine echocardiography and speckle tracking imaging was done at baseline (pre AVR) and post AVR at 1st week, 1st month and 3rd month of follow up.</p><p><strong>Results: </strong>90 patients completed study (70 in AS and 20 in AR group). In AS group mean values (± 2 standard deviations) of global longitudinal strain (GLS) improved from a baseline -10.9% (± 3.9) to -19.4% (±3.8) at 3rd month (p value < 0.0001). Mean values of global circumferential strain (GCS) too improved from -17.3% (±4.5) to -21.4% (±3.6) respectively (p value < 0.0001). In AR group too mean values of global longitudinal strain progressed from a baseline -12.6% (±3.9) to -19.4% (±3.4) at three months of follow (p value < 0.0001) and mean values of global circumferential strain also progressed from -15.3% (±3.4) at baseline to -21.7% (±3.1) respectively (p value < 0.0001).</p><p><strong>Conclusion: </strong>Magnitude of recovery of GLS and GCS after AVR was more as compared to recovery in EF. Poor GLS/GCS values at baseline were associated with lesser recovery pressing need for an earlier intervention.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"353-363"},"PeriodicalIF":0.8,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/7d/sha-353-363.PMC8765039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39955767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}