Journal of the Saudi Heart Association最新文献

{"title":"Ultrasound Evaluation of Left Ventricular Function in Coronary Artery Ectasia: The Added Value of 2D Speckle-tracking Echocardiography.","authors":"Osama A Elshaer, Mahmoud Gomaa, Ramy M Elgamal, Mohamed S Fahmy, Reda N Dawoud, Reda Biomy, Ahmed M Ahmed, Mohamed K Salama","doi":"10.37616/2212-5043.1457","DOIUrl":"10.37616/2212-5043.1457","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery ectasia (CAE) is defined as abnormal dilatation of coronary arteries and may be linked to subclinical myocardial dysfunction. Conventional echocardiographic parameters may not adequately detect early left ventricular (LV) dysfunction. Two-dimensional speckle-tracking echocardiography (2D STE) has shown promise in identifying subtle myocardial changes.</p><p><strong>Methods: </strong>In this single-center observational study, 90 participants with available coronary angiography were divided into three groups: Group A (controls, n = 30), Group B (single-vessel CAE, n = 30), and Group C (multi-vessel CAE, n = 30). Standard echocardiographic indices including LV ejection fraction (LVEF), volumes, and diastolic function were assessed. Global radial, longitudinal, circumferential, and area strains were measured using 2D STE. Univariate and post-hoc analyses compared measurements across groups.</p><p><strong>Results: </strong>LVEF was preserved in all groups (p = 0.157), with conventional echocardiography detecting abnormalities only in multi-vessel CAE (Group C). In contrast, 2D STE revealed subclinical dysfunction in both CAE groups. GLS declined from -20.4 % (controls) to -17.3 % (single-vessel) and -14.6 % (multi-vessel; p < 0.001). GCS and GRS followed similar patterns.</p><p><strong>Conclusions: </strong>2D STE detected subclinical LV impairment in early CAE, whereas conventional methods revealed dysfunction only in advanced disease. This supports the value of 2D STE for early monitoring in CAE patients.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"1457"},"PeriodicalIF":1.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345922","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":"Infective Endocarditis and Meningitis in a Healthy Newborn Without Underlying Heart Disease, Due to Streptococcus <i>Agalactiae</i>-A Case Report.","authors":"Dalal S Idris, Muath M Al Ghamdi, Maria L Bello Valls, Mohammed Fararjeh","doi":"10.37616/2212-5043.1453","DOIUrl":"10.37616/2212-5043.1453","url":null,"abstract":"<p><p>Streptococcus <i>Agalactiae</i> endocarditis is a rare clinical entity in newborns with a normal structured heart. It is generally characterized by acute onset, the presence of large vegetations, rapid valvular destruction and frequent complications, particularly embolization. Mortality is high with medical therapy alone. We are reporting a rare case of infective endocarditis (IE) with mitral valve vegetation in a 9 days old healthy newborn following Streptococcus Agalactiae sepsis, complicated by meningitis and micro-abscesses. Mitral valve (MV) vegetation was removed surgically; the patient received intravenous antibiotics for six weeks. Transthoracic echocardiography after surgery showed severe MV regurgitation and severe pulmonary hypertension which was successfully managed by conservative care with cardiac medications.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"1453"},"PeriodicalIF":1.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345892","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":"Percutaneous Thromboaspiration of Left Main Coronary Artery Vegetation in a Patient With Aortic Valve Infective Endocarditis and Acute Coronary Syndrome.","authors":"Matthew B Morton, Jeremy Russo, Malanka Lankaputhra, Christopher Merry, Dion Stub","doi":"10.37616/2212-5043.1456","DOIUrl":"10.37616/2212-5043.1456","url":null,"abstract":"<p><p>Acute myocardial infarction from a vegetation is a rare complication of infective endocarditis. Thrombolysis, percutaneous coronary intervention with balloon angioplasty, stenting, and thromboaspiration, and surgery have all been described in this challenging clinical scenario. A woman with staphylococcal bioprosthetic aortic valve infective endocarditis developed acute myocardial infarction due to a vegetation invading the left main coronary artery, which was successfully managed with percutaneous thromboaspiration.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"1456"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345936","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":"Utilization of Critical Care U/S Imaging Tools for Assessment of Cardio-pulmonary Complications in Extracorporeal Circulatory Support in Patients Post Cardiac Surgery and ECMO.","authors":"Mohamed A Ragab, Suzi F Mikhael, Amr E Elhadidy, Ihab A Abdelmoneim, Khaled A Al Faraidy, Abdulrahman I Alhusil, Mohsen S Abdelazeem, Abdelraouf Fahmy, Sarah H Yacoub, Fathia A Samter","doi":"10.37616/2212-5043.1454","DOIUrl":"10.37616/2212-5043.1454","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal life support (ECLS), including extracorporeal membrane oxygenation (ECMO), is increasingly used in patients post-cardiac surgery. However, cardiopulmonary complications and delayed weaning remain common.</p><p><strong>Objectives: </strong>This study aims to investigate the clinical course of post-cardiac surgery and extracorporeal membrane oxygenation patients using lung ultrasound and echocardiography.</p><p><strong>Patient and methods: </strong>This prospective multicenter observational study was conducted in the intensive care units of King Fahd Military Medical Complex, Saudi Arabia, and Cairo University, Egypt. A total of 103 adult patients requiring ECMO or post-cardiac surgery with cardiopulmonary bypass were enrolled.</p><p><strong>Result: </strong>Postoperative echocardiographic assessment showed significant reductions in EF, TAPSE, and VTI, with increased VTI variability. Extubation time correlated significantly with EF, LVESD, LA diameter, and postoperative VTI variability. Diaphragmatic ultrasound revealed reduced excursion and thickness fraction postoperatively, both strongly associated with prolonged ventilation. LUS detected atelectasis, pleural effusions, and diaphragmatic dysfunction earlier than conventional imaging.</p><p><strong>Conclusion: </strong>CCUS is a valuable bedside tool in post-cardiac surgery and ECMO patients. Echocardiographic parameters (EF, LVESD, and VTI variability) and diaphragmatic function indices are strong predictors of weaning success, while LUS facilitates early pulmonary complication detection. Incorporating CCUS into routine monitoring may enhance patient outcomes and optimize weaning strategies.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"1454"},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12558655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145390708","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":"Long-term Survival in Lung Cancer With Brain Metastases and Coronary Artery Stenosis: A Case Report.","authors":"Raghad O Alharbi, Shahad J AlShammary, Nasser E Alotaibi, Ruba M Aljohani, Bader A Alotaibi, Ihab F Suliman","doi":"10.37616/2212-5043.1452","DOIUrl":"10.37616/2212-5043.1452","url":null,"abstract":"<p><p>Lung cancer is among the most diagnosed cancers worldwide, and its co-occurrence with coronary heart disease is life-threatening. Osimertinib is the standard treatment for epidermal growth factor receptor (EGFR) mutations in advanced non-small cell lung cancer (NSCLC). The addition of pemetrexed and carboplatin increases not only the efficacy but also the cardiotoxicity risk. We report a 59-year-old woman with NSCLC alongside brain, liver, and spleen metastases, who developed cardiovascular events following cancer therapy. With advanced imaging and multidisciplinary intervention, remarkable remission was achieved over two years. Reporting this case contributes to the understanding of its presentation and diagnostic challenges.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206744","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":"Corrigendum to \"Saudi Heart Association Position Statement on Troponin use for Cardiovascular Risk Screening in Asymptomatic Populations.\" [<i>Journal of the Saudi Heart Association, 2025;37:32-39</i>. https://doi.org/10.37616/2212-5043.1444].","authors":"","doi":"10.37616/2212-5043.1458","DOIUrl":"https://doi.org/10.37616/2212-5043.1458","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.37616/2212-5043.1444.].</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 4","pages":"1458"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505143","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":"Aorto-septal Angle as a Predictor of Left Ventricular Outflow Tract Obstruction in Pediatric Patients With Subaortic Stenosis and Subaortic Membrane Development: A Study at Prince Sultan Cardiac Center, Buraydah, Saudi Arabia 2023.","authors":"Rehab N Alharbi, Ali A Alakhfash, Abdullah M Alqwaiee, Abdulrahman A Almesned, Abdulrahman O Alharbi","doi":"10.37616/2212-5043.1445","DOIUrl":"10.37616/2212-5043.1445","url":null,"abstract":"<p><strong>Background: </strong>The interventricular septum (IVS)/anterior aortic angle is typically measured at 120° in healthy individuals but is more acute in patients with left ventricular outflow tract (LVOT) narrowing, aortic valve anomalies, and discrete subaortic membrane (SAM).</p><p><strong>Objectives: </strong>This study aimed to assess this angle in pediatric patients with abnormal aortic valves and/or LVOT obstruction and evaluate its association with SAM development.</p><p><strong>Methodology: </strong>A prospective cohort observational study was conducted in the pediatric cardiology department at PSCC-Qassim from September 2022 to June 2023. Echocardiographic assessments were performed on pediatric patients (neonates to 14 years) with bicuspid aortic valve (BAV), with or without SAM. Patients with ventricular septal defect (VSD), atrioventricular septal defect (AVSD), or single ventricle pathology were excluded. The Aortoseptal angle was measured in the long-axis parasternal view.</p><p><strong>Result: </strong>Among 319 cases, 153 served as controls with normal cardiac anatomy. The remaining 194 cases included 104 (53 %) with isolated BAV, 51 (26 %) with isolated SAM, and 11 (6 %) with BAV and SAM. The male-to-female ratio was 2.2:1. SAM was observed in 64 (33 %) cases, and significant aortic stenosis in 13 (6.7 %). Cardiac surgery was performed in SAM resection (4.1 %). The Aortoseptal angle ranged from 110° to 135° across groups, with no statistically significant differences between patients with SAM and controls. However, ROC analysis indicated that an angle <116° predicted SAM presence with 97 % sensitivity and 87 % specificity.</p><p><strong>Conclusion: </strong>While a more acute Aortoseptal angle was common in SAM patients, no statistically significant differences were found. An angle <115° may warrant close monitoring for SAM development.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 3","pages":"13"},"PeriodicalIF":1.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206785","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":"Conservative Management of an Iatrogenic Left Ventricular Pseudo Aneurysm After Type A Aortic Dissection Surgery.","authors":"Wiem Feki, Amal Kchaou, Rania Gargouri, Hichem Denguir","doi":"10.37616/2212-5043.1450","DOIUrl":"10.37616/2212-5043.1450","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular pseudo aneurysm is a rare but potentially fatal complication after surgery for type A aortic dissection, due to the fragile nature of the pseudo aneurysm wall. This case highlights the critical role of cardiac magnetic resonance imaging (CMR) in diagnosis, monitoring, and guiding treatment decisions.</p><p><strong>Case presentation: </strong>A 69-year-old male was readmitted 14 days post-ascending aortic replacement for type A dissection. Surveillance CT angiography revealed a 29 × 24 mm apical lesion with wall thinning, initially indeterminate on TTE but confirmed as a pseudoaneurysm by CMR. Initially undetected on transthoracic echocardiography due to limited acoustic windows, the pseudoaneurysm was definitively diagnosed and characterized by cardiac magnetic resonance imaging, which provided high-resolution tissue delineation and dynamic assessment of the ventricular apex. Given the patient's stable clinical status and comorbidities, a conservative approach was adopted with close follow-up using echocardiography and contrast-enhanced computed tomography angiography. The patient showed favorable evolution over time.</p><p><strong>Conclusion: </strong>While surgical repair constitutes the gold-standard treatment for acute Stanford type A aortic dissections, conservative management may represent a viable alternative in select cases of post-surgical left ventricular pseudoaneurysm development, particularly in asymptomatic patients with stable hemodynamic parameters and no evidence of expansion or rupture. Cardiac magnetic resonance imaging provides critical diagnostic and prognostic value by identifying high-risk features-thereby guiding individualized therapeutic decision-making.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 3","pages":"12"},"PeriodicalIF":1.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474222","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":"Transcatheter Pulmonary Valve Replacement (TPVR): A Saudi Consensus Statement.","authors":"Khalid AlNajashi, Ahmed Al Zahrani, Atif Al Qabani, Mohamed Al Humaid, Mishael Binobaidan, Ahmed Krimley, Ahmed Al Omrani, Dhafer Al Shahrani, Ahmed Al Samman, Abdullah Al Quei, Khalid Al Twirqi, Wail Alkashkari, Adel Tash","doi":"10.37616/2212-5043.1448","DOIUrl":"10.37616/2212-5043.1448","url":null,"abstract":"<p><strong>Objectives: </strong>To provide an expert consensus on the appropriate use of transcatheter pulmonary valve replacement (TPVR) in managing chronic pulmonary regurgitation (PR), particularly in patients with congenital heart defects such as Tetralogy of Fallot (TOF). The consensus aims to address current practices, patient selection criteria, procedural planning, and device-specific considerations to guide clinicians in optimizing outcomes.</p><p><strong>Methods: </strong>A multidisciplinary panel reviewed existing literature, clinical guidelines, and real-world practices. Key domains covered include epidemiology, anatomical and hemodynamic evaluation, pre- and post-procedural imaging, device characteristics, and patient selection. Imaging modalities such as echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) were critically appraised for their role in procedural planning. Recommendations were structured to reflect best practices across varied healthcare settings.</p><p><strong>Results: </strong>TPVR is increasingly adopted as a less invasive alternative to surgical pulmonary valve replacement. Devices such as Melody, SAPIEN, Harmony, and Venus P-valve are used based on RVOT anatomy and size. Pre-procedural imaging and multidisciplinary assessment are critical for safe deployment and optimal valve positioning. TPVR demonstrated favourable outcomes in terms of RV remodelling, PR and PS reduction, functional improvement, and reduced hospital stay compared to surgical approaches. Complications such as tricuspid valve injury, stent fracture, and infective endocarditis remain concerns.</p><p><strong>Conclusions: </strong>TPVR offers a safe and effective treatment for selected patients with PR or PS following congenital heart disease repair. A standardized, imaging-guided approach with multidisciplinary oversight is essential. Further research is needed to assess long-term valve durability and to refine strategies for high-risk and paediatric populations.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 3","pages":"14"},"PeriodicalIF":1.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474250","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":"Impact of Aspiration Thrombectomy on Microvascular Obstruction in Patients With ST-segment Elevation Myocardial Infarction.","authors":"Mahmoud Ismaiel, Mohamed Shehata, Tamer Elwasify, Mohamed Hosny, Amir Anwar, Tarek A N Ahmed, Abdalla Elagha","doi":"10.37616/2212-5043.1447","DOIUrl":"10.37616/2212-5043.1447","url":null,"abstract":"<p><strong>Background: </strong>Primary percutaneous coronary intervention (PPCI) is the gold standard for myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI). Numerous studies have shown that thrombus aspiration can prevent distal embolization and reducing the risk of microvascular obstruction (MVO). Cardiac magnetic resonance (CMR) is considered the gold standard for the evaluation of MVO.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the effect of thrombus aspiration in STEMI patients as an adjunctive technique to primary PCI in reducing both incidence and extent of MVO evaluated by CMR.</p><p><strong>Methods: </strong>Ninety-three patients with heavy thrombus burden were enrolled in this study; sixty-five patients met our inclusion criteria. After failed trial of restore the artery patency, aspiration thrombectomy was done followed by PCI for thirty-one patients (aspiration group), while conventional PCI without aspiration thrombectomy was performed for 34 patients (conventional group). The primary end points were both occurrence and extent of microvascular obstruction (MVO) evaluated mainly by CMR, in addition to angiographic data (MBG and TIMI flow grade).</p><p><strong>Results: </strong>The incidence of microvascular obstruction (MVO) was significantly higher in conventional group (18 patients, 52.9 %) when compared with aspiration group (7 patients, 22.6 %; p-value = 0.012). Moreover, significant differences existed between the studied groups regarding MVO extent. For instance, MVO extended to >4 segments in only 3 patients (9.7 %) in aspiration group, but in 13 patients in conventional group (38.2 %; p-value = 0.007).</p><p><strong>Conclusions: </strong>Aspiration thrombectomy substantially reduces both the incidence and extent of microvascular obstruction as an adjunctive technique to PPCI in STEMI patients with heavy thrombus burden.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"37 3","pages":"9"},"PeriodicalIF":1.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784603","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}