The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology最新文献

{"title":"Reversing the irreversible? A case of successful surgical repair in a late-presenting aortopulmonary window with severe pulmonary hypertension.","authors":"Rido Mulawarman, Ericko Ongko Joyo, Muhamad Adrin Aefiansyah Putra, Aditya Agita Sembiring, Sisca Natalia Siagian, Oktavia Lilyasari","doi":"10.1186/s43044-026-00726-7","DOIUrl":"10.1186/s43044-026-00726-7","url":null,"abstract":"<p><strong>Background: </strong>Aortopulmonary window (APW) is a rare congenital heart defect, accounting for only 0.2-0.6% of all congenital cardiac anomalies, and is usually identified and surgically corrected within the first year of life to prevent irreversible pulmonary hypertension (PH). Once pulmonary vascular resistance (PVR) becomes fixed, surgical repair is generally considered contraindicated. However, emerging evidence suggests that pulmonary vascular reactivity may persist in select adolescents, opening a potential therapeutic window beyond infancy.</p><p><strong>Case presentation: </strong>We report a 15-year-old male with a large APW diagnosed in infancy but lost to follow-up, who presented in adolescence with exertional dyspnea. Initial cardiac catheterization revealed a high indexed PVR (10.89 WU·m²) and absent oxygen vasoreactivity, indicating inoperability. Despite this, preserved biventricular function and lack of cyanosis prompted a trial of targeted medical therapy with sildenafil, spironolactone, lisinopril, and digoxin. After 12 months, repeat catheterization showed dramatic haemodynamic improvement: baseline PVRi decreased to 8.84 WU·m² and fell further to 0.76 WU·m² after 100% oxygen, with a reduction in PVR/SVR ratio from 0.58 to 0.04. The calculated Qp/Qs increased to 16.77, although this extreme value was considered likely overestimated because systemic and pulmonary arterial oxygen saturations were almost identical. Definitive surgical repair was undertaken with excellent early results. On follow-up, the patient remained asymptomatic with preserved biventricular function, low estimated pulmonary artery pressures and no residual APW on echocardiography.</p><p><strong>Conclusion: </strong>This case suggests that operability in APW may not be irrevocably lost beyond infancy in carefully selected adolescents. It underscores the importance of individualized assessment, medical preconditioning and serial haemodynamic reassessment to unmask latent pulmonary vasoreactivity. Larger series are needed to define which late-presenting patients with APW and PH may safely benefit from definitive surgical repair.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391880","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":"Heyde syndrome secondary to hypertrophic obstructive cardiomyopathy: a case report.","authors":"Abraham Castellanos-Maldonado, Gustavo Abraham Canales-Azcona, José Luis Martínez-Arroyo, Miguel Maldonado-Valdéz, Héctor Raúl Ibarra-Sifuentes","doi":"10.1186/s43044-026-00727-6","DOIUrl":"10.1186/s43044-026-00727-6","url":null,"abstract":"<p><strong>Background: </strong>Heyde syndrome is an uncommon clinical condition characterized by the triad of aortic stenosis, gastrointestinal angiodysplasia, and acquired von Willebrand syndrome. Its occurrence in the context of hypertrophic obstructive cardiomyopathy is rare. Common in individuals over 65, diagnosis is challenging due to the prevalence of these conditions. Hypertrophic obstructive cardiomyopathy increases shear stress, leading to von Willebrand Factor degradation and a higher risk of gastrointestinal bleeding.</p><p><strong>Case presentation: </strong>A 69-year-old male presented to the outpatient clinic with melena, abdominal cramping, and fatigue, along with a history of anemia requiring blood transfusions. Despite a negative upper gastrointestinal endoscopy, further tests revealed angiodysplasias with recent bleeding. He was also diagnosed with hypertrophic cardiomyopathy with left ventricular outflow tract obstruction. After being treated with octreotide and nadolol, his condition improved markedly, with hemoglobin levels rising and no further episodes of bleeding.</p><p><strong>Conclusion: </strong>Recognizing hypertrophic obstructive cardiomyopathy as a new variant of Heyde syndrome broadens our understanding of this complex disorder. It emphasizes the need to consider hypertrophic obstructive cardiomyopathy in patients with unexplained gastrointestinal bleeding and cardiac murmurs, prompting a more tailored approach to diagnosis and treatment.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391936","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":"Persistent bradycardia requiring temporary pacing in a young adult with lyme carditis: a case report.","authors":"Mohammad Hazique, Fnu Ekta, Sehneet Grewal, Akshat Banga, Kamran Haleem","doi":"10.1186/s43044-026-00729-4","DOIUrl":"10.1186/s43044-026-00729-4","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease is a common vector-borne infection that can lead to complications such as Lyme carditis (LC), particularly in untreated cases. LC can manifest as conduction abnormalities, including heart block and other arrhythmias, potentially leading to serious cardiac events.</p><p><strong>Case presentation: </strong>We report a case of a 38-year-old male with no prior medical history presenting with recurrent dizziness and bradycardia. The patient exhibited Erythema Migrans and had a history of a recent tick bite, with Lyme serology confirming the diagnosis. Despite intravenous ceftriaxone, the patient experienced persistent bradycardia and intermittent episodes of ventricular tachycardia, necessitating transvenous pacing. His condition stabilized, and he completed a 28-day antibiotic regimen, leading to full recovery.</p><p><strong>Conclusions: </strong>This case highlights the importance of recognizing Lyme carditis in endemic areas and the role of temporary pacing in managing symptomatic bradycardia. Early intervention with antibiotics and appropriate supportive measures can facilitate recovery, prevent progression, and reduce the need for permanent pacing.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391898","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":"Zilebesiran: an RNA interference agent-its need and potential to transform hypertension treatment.","authors":"Sajeet Verma, Akshyaya Pradhan, Prashant Thandi","doi":"10.1186/s43044-026-00724-9","DOIUrl":"10.1186/s43044-026-00724-9","url":null,"abstract":"<p><strong>Background: </strong>Hypertension remains the leading modifiable risk factor for cardiovascular morbidity and mortality worldwide, yet nearly half of patients fail to achieve target blood pressure (BP) despite the availability of multiple antihypertensive agents. Non-adherence, therapeutic inertia, and complex dosing regimens continue to undermine treatment effectiveness. The renin-angiotensin-aldosterone system (RAAS) is central to BP regulation, and long-term blockade of its components reduces cardiovascular risk. However, current therapies require daily adherence. Zilebesiran, a novel RNA interference (RNAi) therapeutic, represents an innovative approach by silencing hepatic angiotensinogen (AGT) synthesis, offering sustained RAAS suppression with infrequent dosing.</p><p><strong>Main text: </strong>Zilebesiran is a GalNAc-conjugated small interfering RNA (siRNA) that targets AGT mRNA in hepatocytes via asialoglycoprotein receptor-mediated delivery. This mechanism leads to durable reductions in circulating AGT and downstream angiotensin II, providing consistent BP lowering for up to 6 months after a single subcutaneous injection. Phase I and II trials demonstrated > 90% AGT suppression and clinically significant reductions in 24-h systolic BP (- 10 to - 27 mmHg), with favorable safety and tolerability. The KARDIA-1 and KARDIA-2 studies confirmed zilebesiran's sustained efficacy as monotherapy and as an adjunct to standard antihypertensive agents, without major renal or electrolyte disturbances.</p><p><strong>Conclusions: </strong>Zilebesiran may redefine therapy in hypertension management through twice-yearly dosing that enhances adherence, ensures sustained BP control, and may reduce cardiovascular risk. Ongoing Phase III trials (ZENITH and KARDIA-3) will clarify its long-term efficacy, safety, and applicability across diverse populations, potentially establishing RNAi therapeutics as a new frontier in chronic hypertension treatment.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328489","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":"Finerenone in mildly reduced or preserved ejection fraction and chronic kidney disease: a narrative review.","authors":"Muhammad Shaheer Bin Faheem, Hafiza Qurat Ul Ain, Aatka Rauf, Qasra Faheem, Own E Mohammad Najmi","doi":"10.1186/s43044-026-00722-x","DOIUrl":"10.1186/s43044-026-00722-x","url":null,"abstract":"<p><p>BACKGROUND: In patients with type 2 diabetes and chronic kidney disease (CKD) heart failure with preserved ejection fraction is associated with considerable morbidity and it has fewer treatment options available. HFpEF, which is characterized by increased cardiovascular risks and poor outcomes, continues to be a therapeutic challenge, particularly in older persons. MAIN BODY: A non-steroidal mineralocorticoid receptor antagonist (MRA), finerenone has excellent therapeutic potential in patients with HFpEF and CKD, notably those with diabetes type 2. Research indicate that Finerenone preferentially targets mineralocorticoid receptors associated with inflammation and fibrosis and that it also has an advantage over commonly used steroidal MRAs (e.g., spironolactone), which carry significant risks such as hyperkalemia, gynecomastia, and renal impairment. There are two phase 3 clinical trials namely FIDELIO-DKD and FIGARO-DKD demonstrating how effectively finerenone works in preventing the progression of renal damage and cardiovascular events in type 2 diabetic patients and in patients with CKD. In addition, the FINEARTS-HF study shows that hospitalizations for heart failure were reduced with use of finerenone and also the overall decline in individuals with HFpEF across all ages, particularly the older populations. Finally, Finerenone is found to be more appropriate for patients with complex medical histories because its safety profile shows fewer side effects compared to the traditional steroidal MRAs, as it has lower risks for electrolyte imbalances and renal function deterioration. CONCLUSION: This article addresses the safety, efficacy, mechanism of action, and various trials conducted on Finerenone and how it gained importance as an effective substitute in the management of HFpEF and CKD, decreasing morbidity and mortality risks while limiting adverse effects. </p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328478","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":"Artificial intelligence in heart failure.","authors":"Xueqin Li, Yu Liu, Xianya Zhang, Na Yang, Tong Xu, Xinwu Cui, Gongquan Chen","doi":"10.1186/s43044-026-00723-w","DOIUrl":"10.1186/s43044-026-00723-w","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) affects millions of individuals worldwide and shows an increasing trend, constituting a serious public health issue. Considerable attention has been paid to the screening, diagnosis, risk prediction, treatment, and prognosis of HF. Although many guidelines for the management of HF have been proposed in recent years, the efficacy of evidence-based treatments seems to vary among patients. Therefore, the era of \"one-size-fits-all\" approaches is drawing to a close, and the concepts of precision medicine and individualized medicine are gradually taking root. Artificial intelligence (AI) is an emerging discipline in the rapidly growing field of computer science. It has now become deeply involved in all aspects of cardiovascular disease research, with particular relevance to HF, though its translation into clinical practice is yet to be fully realized. Although the use of AI in cardiovascular disease (CVD) and HF patient care, as well as cardiac resynchronization therapy (CRT), has been extensively discussed, a discussion from the standpoint of all aspects of HF clinical process is lacking.</p><p><strong>Main body: </strong>This review provides a comprehensive overview of the use of AI in HF in specific scenarios, including patient diagnosis, subtyping, prognostic assessment, pre- and post-treatment evaluation, and telecare. It also presents the prospects and challenges for the development of AI in the field of HF, with the expectation that a mature AI diagnosis and treatment system adapted to clinical practice will be developed in the future through in-depth research and validation.</p><p><strong>Conclusions: </strong>This review summarizes the application of AI in various links of HF management from diagnosis to telecare, and analyzes its current application limitations, existing challenges and future research directions, aiming to provide a reference for the subsequent clinical transformation and research optimization of AI in the HF field.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328565","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":"Feasibility, outcomes and follow-up analysis of transcatheter closure of outlet ventricular septal defect with various devices from North-Eastern India: a single centre observational study.","authors":"Saurabhi Das, Shantanu Jain, Nayem Raja, Narendra Sharma","doi":"10.1186/s43044-026-00719-6","DOIUrl":"10.1186/s43044-026-00719-6","url":null,"abstract":"<p><strong>Background: </strong>Outlet septum ventricular septal defects (VSDs) are notably more prevalent in North-Eastern India and often associated with aortic valve prolapse, leading to a need for surgical intervention. While surgical methods remain the conventional approach, there is an opportunity to explore the effectiveness of transcatheter closure techniques.</p><p><strong>Objective and methodology: </strong>This study aimed to assess the effectiveness and follow-up of transcatheter closure for outlet and outlet muscular type VSDs using three distinct devices: Amplatzer ADO II, KONAR MF VSD Occluder, and Cocoon VSD Occluder. This Descriptive study with follow-up observation up to 1 year was conducted at Health City Hospital in Guwahati, India, from March 2023 to November 2025, involving 21 patients who met the criteria for inclusion.</p><p><strong>Results: </strong>Among the 21 patients, transcatheter closure was successfully achieved in 16 individuals, resulting in a success rate of 76.2%. The mean diameter of the VSDs was 3.8 mm, with 66.6% of the cases showing pre-existing aortic valve prolapse. Closure attempts were unsuccessful in five patients, who subsequently received surgical intervention. In the successful cases, the Amplatzer ADO II was implanted in 7 patients (43.7%), the KONAR MFO in 8 patients (50%), and the Cocoon VSD occluder in 1 patient (6.3%). Seven patients exhibited mild intra-device residual shunts, and 37.5% (6/16) experienced a transient increase in aortic regurgitation (AR) after 24 hours post-procedure. Importantly, follow-up after one year showed static or non-progression of pre-existing AR, with worsening of AR (moderate severity) observed only in one patient, and the majority of residual shunts resolved. No major complications like outflow obstruction or device embolization were reported in the present study.</p><p><strong>Conclusion: </strong>The results indicate that transcatheter closure of outlet and outlet muscular type VSDs is a promising option for selected patients, yielding positive short- to mid-term outcomes. Further long-term follow-up will enhance our understanding of the procedure's safety and efficacy, paving the way for broader application of this technique in clinical practice.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313354","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":"Safety and efficacy of triple combination therapy in hypertension and dyslipidemia: a systematic review and meta-analysis of randomized controlled trials.","authors":"Ahmed Yasser Shaban, Ahmed Hassan, Sherif Eltawansy, Malak A Hassan, Mariam Tarek Desouki, Nourhan Ahmed, Salem Badr, Akram Y Elgendy, Mahmoud Nassar, Diaa Hakim","doi":"10.1186/s43044-026-00720-z","DOIUrl":"10.1186/s43044-026-00720-z","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) and dyslipidemia are major risk factors for cardiovascular diseases. Recently, researchers have investigated the potential benefits of combining multiple medications in one bill to improve their metabolic and cardiovascular efficacy.</p><p><strong>Objectives: </strong>We investigated a treatment approach that combines two antihypertensive medications with one statin. We aim to assess the safety and effectiveness of a triple therapy regimen consisting of angiotensin receptor blockers (ARBs) combined with amlodipine/rosuvastatin. We compared this triple therapy to dual therapy involving either ARBs/amlodipine or ARBs/rosuvastatin in patients with HTN and dyslipidemia.</p><p><strong>Methods: </strong>We conducted systematic search in the following databases: Medline, Web of Science, Scopus, and Cochrane Library until August 2024. The main outcomes assessed were the variations in mean systolic blood pressure (mSBP), mean diastolic blood pressure (mDBP), and the percentage changes in LDL cholesterol (LDL-C) and HDL cholesterol (HDL-C) following an eight-week treatment period.</p><p><strong>Results: </strong>Our analysis included seven randomized controlled trials (RCTs) which enrolled 1074 patients. Triple therapy revealed a significant reduction in mSBP (mean difference (MD): -4.06, 95% C.I. [-7.97: -0.15], p-value = 0.04), mDBP (MD: -5.45, 95% C.I. [-7.96: -2.93], p-value = < 0.0001), and LDL-C (MD: -50.10, 95% C.I. [-55.55: -44.64], p-value = < 0.001) compared to ARBs/amlodipine. Triple therapy significantly decreased mSBP (MD: -12.28, 95% C.I. [- 16.68: -7.88], p-value = < 0.001) and mDBP levels (MD: -6.48, 95% C.I. [-10.95: -2.01], p-value = 0.005) compared with ARBs plus rosuvastatin. There was no significant difference in secondary outcomes, including total adverse events, cerebrovascular adverse events, and adverse drug reactions.</p><p><strong>Conclusion: </strong>Triple therapy has greater effectiveness in decreasing blood pressure in hypertensive patients with dyslipidemia compared to treatments involving ARBs combined with amlodipine or ARBs with rosuvastatin. Additionally, Triple therapy significantly improved lipid profiles compared to the ARB/amlodipine group. Our study lays the groundwork for developing a single-pill, triple-combination therapy. Further RCTs are necessary to confirm our findings.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204086","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":"Adherence to European Society of Cardiology guidelines at discharge after Acute Coronary Syndrome: a two-center data from Georgia.","authors":"David Gogoberidze","doi":"10.1186/s43044-026-00721-y","DOIUrl":"10.1186/s43044-026-00721-y","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to investigate the adherence to ESC guidelines in patients discharged after ACS in Georgia.</p><p><strong>Patients and methods: </strong>A prospective observational study was performed in 2 cardiac hospitals in Tbilisi from March 2021 till June 2022. A total of 428 consecutive patients with confirmed diagnosis of Acute Coronary Syndrome at discharge were evaluated. The primary outcome was defined as adherence to Guideline Directed Medical Therapy (GDMT) at discharge post-Acute Coronary Syndrome.</p><p><strong>Results: </strong>Complete guideline adherence for the combination of 5 medication classes was 74.5%, and additionally in 15.2% contraindications or intolerance were well documented, so the complete guideline adherence was very high - 89.7%. The guideline adherence for individual drug class differed from 98.9% for ACE inhibitors/ARB and acetylsalicylic acid to 92.9% for P2Y12 receptor inhibitor.</p><p><strong>Conclusion: </strong>Adherence to GDMT according to the data received from 2 hospitals is promising, but efforts to further improve guideline adherence must be targeted toward patient groups who receive the worse treatment at discharge, e.g. NSTEMI patients and only medical treatment sub-group.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204093","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":"Mitral valve prosthesis endocarditis unveiling metastatic colorectal cancer as the primary infection source: a case study.","authors":"Abdellah Boucetta, Obeida Saleh, Badr Abdallani, Meryem Haboub, Abdenasser Drighil","doi":"10.1186/s43044-026-00718-7","DOIUrl":"10.1186/s43044-026-00718-7","url":null,"abstract":"<p><strong>Background: </strong>This case report is significant due to its illustration of how infectious endocarditis on a prosthetic mitral valve revealed an underlying metastatic colorectal cancer. Although uncommon, associations between cardiac infection and advanced malignancy, particularly with malignancy serving as the source of infection, have been documented in the literature, making this case clinically significant and complex.</p><p><strong>Case presentation: </strong>A 54-year-old postmenopausal woman with insulin-dependent diabetes and poorly managed hypertension, who had previously undergone mitral valve replacement with a mechanical prosthesis and tricuspid valve repair for rheumatic mitral stenosis, was admitted for atrial fibrillation with rapid ventricular response. On admission, she presented with normochromic normocytic anaemia (7.7 g/dL), elevated inflammatory markers (CRP 250 mg/L), and leukocytosis (14,000/µL, neutrophils 10,000/µL). Transthoracic and transesophageal echocardiography identified vegetation on the mitral prosthesis with elevated gradients. Blood cultures were positive for Escherichia coli. A thoraco-abdominopelvic CT scan revealed a rectal tumor, confirmed by FDG-PET, with features consistent with metastatic colorectal cancer, considered the entry point for the infectious endocarditis. Tumor markers including ACE, CA 19 - 9, and CA 72 - 4 were elevated. The patient was treated with dual antibiotic therapy and showed initial clinical improvement but later died due to ventricular tachycardia.</p><p><strong>Conclusions: </strong>This case highlights the importance of considering atypical sources, such as metastatic cancer, in unresolved cases of endocarditis. It underscores the need for comprehensive diagnostic assessment, including oncologic evaluation, in patients with prosthetic valve endocarditis caused by atypical pathogens like E. coli. It also stresses the importance of multidisciplinary collaboration between cardiology and oncology teams. This case report is significant due to its illustration of how infectious endocarditis on a prosthetic mitral valve revealed an underlying metastatic colorectal cancer (CRC).</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"78 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109028","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}