Journal of the Saudi Heart Association最新文献

{"title":"National Heart Center/Saudi Heart Association 2023 Guidelines on the Management of Hypertension.","authors":"Waleed Alhabeeb, Adel A Tash, Mostafa Alshamiri, Mohamed Arafa, Mohammed A Balghith, Ali ALmasood, Abdulla Eltayeb, Hossam Elghetany, Taher Hassan, Owayed Alshemmari","doi":"10.37616/2212-5043.1328","DOIUrl":"10.37616/2212-5043.1328","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a highly prevalent disease in Saudi Arabia with poor control rates. Updated guidelines are needed to guide the management of hypertension and improve treatment outcomes.</p><p><strong>Methodology: </strong>A panel of experts representing the National Heart Center (NHC) and the Saudi Heart Association (SHA) reviewed existing evidence and formulated guidance relevant to the local population, clinical practice and the healthcare system. The recommendations were reviewed to ensure scientific and medical accuracy.</p><p><strong>Recommendations: </strong>Hypertension was defined and a new classification was proposed as relevant to the Saudi population. Recommendations on diagnosis, clinical evaluation, cardiovascular assessment were detailed, along with guidance on measurement modalities and screening/follow-up. Non-pharmacological management is the first line of hypertension treatment. Pharmacological therapy should be used appropriately as needed. Treatment priority is to control blood pressure regardless of the drug class used. The choice of treatment should be tailored to the patient profile in order to achieve treatment targets and ensure patient compliance. Recommendations were provided on pharmacological options available in Saudi Arabia, as well as guidance on the treatment of special conditions.</p><p><strong>Conclusion: </strong>Hypertension management should be based on appropriate screening, timely diagnosis and lifestyle changes supplemented with pharmacological therapy, as needed. Clinical management should be individualized, and careful consideration should be given to special conditions and patient groups.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"16-39"},"PeriodicalIF":0.7,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/81/sha16-39.PMC10069676.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9250923","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":"Case of Bilateral Atrial Myxomas in Carney Syndrome.","authors":"Anwar A Alhulaibi,&nbsp;Abdulrahman M Alruwaili,&nbsp;Zahra M Albahar,&nbsp;Wiam T Abdelsalam,&nbsp;Mohamed A Elasheri,&nbsp;Abdullah S Alotaibi","doi":"10.37616/2212-5043.1326","DOIUrl":"https://doi.org/10.37616/2212-5043.1326","url":null,"abstract":"<p><p>Carney complex is rare neoplastic disorder. Intracardiac myxoma presenting the most common non-cutaneous lesions in this complex. We are reporting a 31-year-old Saudi female known case of Carney complex presented with asymptomatic biatrial myxoma that was identified on routine transthoracic echocardiogram, and was successfully excised. However, these patients need a careful surveillance in order to detect any new masses and prevent their complications.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"1-6"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/4a/sha1-6.PMC10069668.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257651","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":"The Role of Neutrophil to Lymphocyte Ratio and its Common Clinical Outcomes Among Patients with Non-ST Elevation Acute Coronary Syndrome.","authors":"Javed Jalbani,&nbsp;Khalid I Bhatti,&nbsp;Muhammad T Sallar,&nbsp;Ahsan M Baig,&nbsp;Palwasha Tariq,&nbsp;Faisal Ahmed,&nbsp;Ali Ammar,&nbsp;Vicky Kumar","doi":"10.37616/2212-5043.1340","DOIUrl":"https://doi.org/10.37616/2212-5043.1340","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the admission neutrophil-to-lymphocyte ratio (NLR) for risk stratification for in-hospital outcomes and complications in non-ST-elevation acute coronary syndrome (non-ST-ACS) patients.</p><p><strong>Methods: </strong>We recruited consecutive patients with non-ST-ACS. The NLR was obtained and stratified as low, intermediate, and high-risk based on <3.0, 3.0-6.0, and >6.0, respectively. The new ST-T changes, arrhythmias, contrast-induced nephropathy (CIN), and mortality were recorded.</p><p><strong>Results: </strong>Median NLR was 3 [2.1-5.3] for 346 patients with 19.9% and 30.6% in high- and intermediate-risk group. New ST-T changes were observed in 3.5% (12) out of which 8, 3, and 1 patient in low, intermediate, and high-risk group (p = 0.424), respectively. Arrhythmias were observed in 5.8% (20) with 7, 5, and 8 patients in low, intermediate, and high-risk group (p = 0.067), respectively. CIN was observed in 4.9% (17) with 5, 5, and 7 in low, intermediate, and high-risk group (p = 0.064), respectively. In-hospital mortality was recorded in 1.4% (5) with 2 and 3 patients in high and low-risk group (p = 0.260), respectively.</p><p><strong>Conclusion: </strong>A significant number of non-ST-ACS patients fall in the high-risk category of NLR. Although, the association between NLR and in-hospital mortality and adverse events was not statistically significant but relatively higher rates of events were observed in high risk group.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 2","pages":"177-182"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/96/sha177-182.PMC10405906.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9968134","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":"Unexpected Course of Left Ventricular Thrombus after COVID-19 Infection in a Woman with Peripartum Cardiomyopathy Single Shield Against Double Shock.","authors":"Kutluhan E Hazir,&nbsp;Ersin Ç Şïmşek,&nbsp;Gizem Çabuk,&nbsp;Cenk Sari","doi":"10.37616/2212-5043.1331","DOIUrl":"https://doi.org/10.37616/2212-5043.1331","url":null,"abstract":"<p><p>Peripartum cardiomyopathy (PPCMP) is defined as heart failure that develops in the last trimester of pregnancy or in the first few months after delivery without an underlying cause. Altought it is seen rarely, it can lead to thromboembolic events and can be life-threatening. Similarly, COVID-19, which is a viral pneumonia agent, is known to cause thrombogenesis. In this case report, the unexpected course of left ventricular thrombus developing in a patient with peripartum cardiomyopathy accompanied by COVID-19 infection is presented.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"55-58"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/d2/sha55-58.PMC10069704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257650","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":"Culprit Lesion Morphology on Optical Coherence Tomography in ST-elevation Myocardial Infarction vs Non ST-elevation Myocardial Infarction - A Systematic Review of 7526 Patients.","authors":"Avinash Mani,&nbsp;Vineeta Ojha,&nbsp;Harikrishnan Sivadasanpillai,&nbsp;Bijulal Sasidharan,&nbsp;Sanjay Ganapathi,&nbsp;Ajit K Valaparambil","doi":"10.37616/2212-5043.1329","DOIUrl":"https://doi.org/10.37616/2212-5043.1329","url":null,"abstract":"<p><strong>Background: </strong>Patients with STEMI are postulated to have different culprit lesion morphology compared to NSTEMI. The use of OCT in ACS can help delineate lesion morphology. The aim of this systematic review was to analyze the available data on culprit plaque morphology in ACS patients.</p><p><strong>Methods: </strong>The available literature was systematically screened for studies on culprit lesion morphology in ACS patients. Data was extracted from the selected studies and analyzed for baseline characteristics as well as culprit lesion morphology on OCT. Lesion characteristics between STEMI and NSTEMI groups were compared.</p><p><strong>Results: </strong>A total of 32 studies were selected for the final analysis. The average age of the study population was 62.4 years. Majority of patients (66.6%) had STEMI on presentation. NSTEMI patients had a higher prevalence of diabetes compared to STEMI. Both STEMI and NSTEMI patients had similar prevalence of thin-cap fibroatheroma (44.9%). The mean fibrous cap thickness was 84.2 μm in the study. STEMI patients had higher prevalence of lipid plaques, macrophages and luminal thrombus as compared to NSTEMI patients. Plaque rupture was the predominant culprit lesion morphology in both STEMI and NSTEMI groups, with higher prevalence in STEMI patients. Plaque erosion was also more common in STEMI patients (34.4% vs 13.2%).</p><p><strong>Conclusion: </strong>Plaque rupture is the predominat culprit lesion morphology in both STEMI and NSTEMI patients, despite having differences in baseline characteristics. Use of OCT to determine plaque morphology in ACS patients can help guide management strategy in select cases. [PROSPERO CRD42021249742].</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"40-49"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/ed/sha40-49.PMC10069671.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257653","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":"Leiomyosarcoma of the Inferior Vena Cava Extending to the Right Atrium and Ventricle.","authors":"Naif S Alghasab,&nbsp;Mohammad Alruwayeh,&nbsp;Abdulaziz A AlGharras,&nbsp;Amin Mulji","doi":"10.37616/2212-5043.1344","DOIUrl":"https://doi.org/10.37616/2212-5043.1344","url":null,"abstract":"<p><p>Primary tumors originating from the inferior vena cava (IVC), namely leiomyosarcoma, present significant challenges due to their poor prognostic features, including extensive extension and a substantial tumor burden. In this case, we present a 55-year-old female patient complaining of abdominal discomfort and vague abdominal pain. Additionally, we provide a comprehensive summary encompassing key aspects related to symptomatology, diagnostic approaches, treatment, and prognostic indicators. We also discuss the complexities involved in managing primary tumors of the inferior vena cava, emphasizing the critical significance of adopting a multidisciplinary team-based approach.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 3","pages":"200-204"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/e8/sha200-204.PMC10462254.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111520","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":"Heart Failure Burden in Oman as a Mid-East Exemplar Versus Global Perspectives: An Integrative Review.","authors":"Maryam Alharrasi,&nbsp;Chandrani Isac,&nbsp;Joy K Kamanyire","doi":"10.37616/2212-5043.1345","DOIUrl":"https://doi.org/10.37616/2212-5043.1345","url":null,"abstract":"<p><p>Heart failure (HF), a clinical syndrome caused by a structural and functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and pulmonary congestion. This study intends to investigate the state of heart failure (HF) in Oman and assess it in comparison of global trends. Ten published literatures from the past 20 years were included after a thorough search of databases (Arab World Research Source, EBSCOhost, Medline, and Google Scholar). These studies were reviewed considering the global literature. We have observed an increase in HF cases especially in older adults, over the past two decades in Oman. Acute coronary syndrome and non-compliance with medication are two factors that contribute to acute HF, according to recent research. Ischemic heart disease is the leading cause of HF in the Omani population. The mortality rate for HF patients in Oman was reported to be 25% after a one-year follow-up. The younger population that is diagnosed with HF in Oman is significantly worse than in other nations, according to these data, which are consistent with global trends. The lack of published studies and data sets hampered our understanding of heart failure (HF); yet prevalence of HF is rising and is anticipated to surge with the rise in diabetes mellitus and hypertension and other related cardiovascular precursors. Therefore, HF requires more investigation. In terms of worldwide trends, HF in Oman appears to be even worse; additional information is required to grasp the full picture on HF.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 3","pages":"214-225"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/6d/sha214-225.PMC10495046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294529","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":"Novel Cause of Late Atrial Septal Defect Devices Embolization.","authors":"Wejdan Ba-Atiyah,&nbsp;Hala Gabel,&nbsp;Ahmad Jamjoom,&nbsp;Jameel Al-Ata","doi":"10.37616/2212-5043.1330","DOIUrl":"https://doi.org/10.37616/2212-5043.1330","url":null,"abstract":"<p><p>Transcatheter closure of septal defects using specialized devices is a common procedure that has a high success rate. Embolization of Atrial septal defect devices is a known complication seen at a rate of 0.5%. We report a case of late ASD device occluder embolization immediately after brain MRI with clinical consequences and intraoperative evidence of right atrial wall thermal injury. To our knowledge Atrial septal occluder (ASO) device embolization post magnetic resonance imaging (MRI) was not reported before, although theoretically possible and that's why six to eight weeks post device implantation MRI is prohibited even with current MRI compatible devices.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"50-54"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/5c/sha50-54.PMC10069705.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263674","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":"A Clot in Transit: A Cause of Death or a Bystander?","authors":"Al-Zahraa Almahlawi,&nbsp;Mohammad Alghamdi,&nbsp;Mutaz Althobaiti,&nbsp;Duha Alahmadi,&nbsp;Yazeed Almalki,&nbsp;Rahaf Alsahli,&nbsp;Hamdan A Aljahdali,&nbsp;Jinan Shamou,&nbsp;Salim Baharoon","doi":"10.37616/2212-5043.1337","DOIUrl":"https://doi.org/10.37616/2212-5043.1337","url":null,"abstract":"<p><strong>Introduction: </strong>The clot in transit is a rare manifestation of thromboembolic disease occurring usually in the setting of PE and frequently associated with poor outcomes. The best therapeutic option is not well established. We describe a series of 35 patients diagnosed with clots in transit including their therapeutic interventions and outcome between the period January 2016 to December 2020.</p><p><strong>Methods: </strong>a retrospective chart review of all patients with an Echocardiogram showing thrombi in the right heart chambers including patients with thrombus in the presence of central lines or other devices. We exclude patients where masses were described as tumors or vegetation and masses in the presence of bacteremia.</p><p><strong>Results: </strong>There were 35 patients with echocardiographic evidence of a thrombus in the right heart chambers. In 12 of those patients, the thrombus was related to an intracardiac catheter. 37.1% of CT chest was done along with Echocardiogram and showed a concomitant PE in 77%. On echocardiogram, 66% of the thrombi were mobile. RV strain was present in 17% while abnormal RVSP (>30 mmHg) was present in 74%. Respiratory support was required in 37.1% and only 17% required inotropic support. There was a total or partial resolution in 80% those who had repeated echocardiogram after four weeks of therapy. Heparin was started in the majority of patients (74%). Warfarin was the most frequently used follow-up anti-coagulant in 51.4%. The mortality rate was significantly higher in those patients with RVSP >50, UFH group, O2 or inotropic support. 26% of patients died within the first 28 days after the diagnosis, while first 7 days mortality was 6% only.</p><p><strong>Conclusion: </strong>a clot in transit in our study was not directly associated with poor outcomes in the first week of therapy, UFH is still the most frequently used initial method to treat clots in transit. However, only 26% had a total resolution of clot within 4 weeks of treatment.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 2","pages":"135-143"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/49/sha135-143.PMC10263120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660566","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":"Better Survival in Morbidly Obese Patients with Atrial Fibrillation Treated with Non-vitamin K-dependent Oral Anticoagulants.","authors":"Monirah A Albabtain,&nbsp;Zaid Alanazi,&nbsp;Nawaf Al Mutairi,&nbsp;Yahya Al Hebaishi,&nbsp;Ola Alyafi,&nbsp;Haneen Alghasoon,&nbsp;Amr A Arafat","doi":"10.37616/2212-5043.1327","DOIUrl":"https://doi.org/10.37616/2212-5043.1327","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of non-vitamin K-dependent anticoagulants (NOAC) are not well investigated in the obese population, and fixed dosing could lead to under-anticoagulation. Our objective was to evaluate the effect of obesity on anticoagulation outcomes and survival in non-valvular atrial fibrillation (AF) patients.</p><p><strong>Methods: </strong>We enrolled 755 patients who required anticoagulation for AF from 2015 to 2016. We grouped the patients into four groups. Group 1 (n = 297) included patients with BMI< 40 kg/m2 treated with NOACs, Group 2 (n = 358) included patients on warfarin with BMI< 40 kg/m2, Group 3 (n = 57) had patients on NOACs with BMI≥ 40 kg/m2 and Group 4 (n = 43) included patients on warfarin and BMI≥ 40 kg/m2. Study outcomes were the composite endpoint of stroke, bleeding, and survival.</p><p><strong>Results: </strong>Competing risk regression showed that stroke and bleeding were not affected by obesity or treatment (SHR: 1.09 (95% CI: 0.79-1.51); P = 0.62). Older age was the predictor of stroke/bleeding (HR:1.03 (95% CI:1.01-1.06); P = 0.02). Predictors of mortality were heart failure (HR:2.23 (95% CI:1.25-3.97); P = 0.007), lower creatinine clearance (HR: 0.98 (95% CI:0.97-0.98): P < 0.001), non-obese patients on warfarin (HR:3.51 (95%CI:1.6-7.7): P = 0.002) and obese patients on warfarin (HR: 6.7 (95% CI:2.51-17.92); P < 0.001).</p><p><strong>Conclusion: </strong>NOACs could have a similar risk profile to warfarin in obese and non-obese patients with non-valvular AF but could have better survival. Larger randomized trials are recommended.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"35 1","pages":"7-15"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/08/sha7-15.PMC10069674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263673","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}