bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of right ventricular function in patients presenting with inferior ST segment elevation myocardial infarction and right ventricular infarction undergoing primary percutaneous intervention by different echocardiographic modalities in correlation with angiographic findings
Authors: Lotfy Ahmed , Eldesoky Ahmed I , Thabet . Sameh S 
Published: October 2021

Abstract

Background
Patients with inferior wall myocardial infarction who have right ventricular (RV) involvement appear to have a worse prognosis than those without RV involvement; infarcted RV tissue fails to offer a sufficient preload which is essential for adequate LV performance. Thus, assessment of RV function is an important step in dealing with patients presenting with inferior wall myocardial infarction that will help in adopting a proper management plan.

Objective
To assess the correlation between RV function and angiographic findings in patients presenting with inferior wall myocardial infarction associated with RV infarction undergoing primary percutaneous coronary intervention.

Patients and Methods
Study included 60 patients who presented to Ain shams university hospitals by inferior wall ST segment elevation myocardial infarction associated with RV infarction during the period from February 2019 to August 2019.All patients were subjected to history taking, clinical examination, ECG recording then primary percutaneous coronary intervention. Echocardiographic assessment was done to all patients within 48 hours of admission.

Results
Study included 60 patients, 43 males (71.7%) and 17 females (28.3%), with mean age of 56.73 ± 9.94 years. Commonest Infarction related Artery (IRA) associated with impaired RV function was proximal RCA (p-value: 0.003). In 23 patients (38.3%) heavy thrombus burden was found while in the other 37 patients (61.7%) there was no evidence of heavy thrombus burden. Regarding post procedural TIMI flow grade: 1 patient (1.7%) had final TIMI I flow, 9 patients (15.0%) had final TIMI II flow and 50 patients (83.3%) had final TIMI III flow. There was statistically significant relationship between RV function assessed through measuring RV free wall strain and both of thrombus burden and final TIMI flow grade. Abnormal RV function was more commonly associated with heavy thrombus burden (p-value:0.023) and less than TIMI III flow after angioplasty (p-value:0.011).RV free wall systolic strain assessment had highest accuracy (75%) in detection of proximal RCA occlusion compared to other parameters including TAPSE, S’ and FAC.

Conclusion
Impaired RV function in patients presenting with RV infarction can be predicted by different angiographic findings. Proximal RCA total occlusion being commonest IRA associated with impaired RV function. Also, presence of heavy thrombus burden and less than TIMI III flow after angioplasty are associated with increased risk of impaired RV function. RV free wall strain measured by 2D-speckle tracking echocardiography has highest accuracy in detection of proximal RCA occlusion compared to other echocardiographic indices including TAPSE, S’ and FAC.
Intravascular ultrasound guidance to minimize the use of contrast in percutaneous coronary interventions in diabetic patients with chronic stable angina
Authors: Marey Mohamed Abdelfattah , Mohamed Hisham Ammar , Moneim Rezq Ahmed Abdol , Elias Ramy Raymond 
Published: October 2021

Abstract

Objective
To evaluate the impact of Intravascular ultrasound guidance on the final volume of contrast agent utilized in diabetic patients undergoing PCI for chronic stable angina.

Background
To date, few approaches have been described to reduce the final dose of contrast agent in percutaneous coronary interventions (PCI). We hypothesized that intravascular ultrasound (IVUS) might serve as an adjuctive imaging tool in many steps during PCI, thereby reducing the use of iodine contrast.

Methods
A total of 100 Diabeic Egyptian patients were selected to angiography-guided PCI or IVUSguided PCI from June 2019 to January 2020 .The study type was case control and non consecutive . Both groups were treated according to a pre-defined meticulous procedural strategy. A written informed consent was taken from all patients.The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 6 months.

Results
The median total volume of contrast was 111.65 ml (interquartile range [IQR] 170.40 ± 52.91ml , range from 100 ml to 300 ml) in angiography-guided group vs. 56.99 ml (IQR 94.70 ± 19.28ml , range from 70 ml to 180 ml) in IVUS-guided group (p &lt; 0.001).similary, the median total volume of contrast was 111.65 ml (interquartile range [IQR] 170.40 ± 52.91ml , range from 100 ml to 300 ml) in angiographyguided group vs. 56.99 ml (IQR 94.70 ± 19.28ml , range from 70 ml to 180 ml) in IVUS-guided group (p &lt; 0.001).In-hospital and 6 month outcomes were not different between patients randomized to angiography-guided and IVUS-guided PCI according to : Death, Acute myocardial infarction, Unplanned revascularization, Stent thrombosis.

Conclusions
Thoughtful and extensive utilization of IVUS as the primary imaging tool to guide PCI is safe, and markedly reduces the volume of iodine contrast, compared to angiography alone guidance.
Myocardial bridge analysis by multidetector computed tomography and its association with coronary atherosclerosis
Authors: Mousa Mohamed Ismail Ahmed Abd El Ati , Mohamed Yasser Gomaa , Onsy Ahmed Mohamed 
Published: October 2021

Abstract

Background
Myocardial Bridging an inborn coronary abnormality, is defined as a segment of a major epicardial coronary artery, the tunneled artery, that goes intramurally through the myocardium beneath the muscle bridge.

Objective
To evaluate noninvasively the presence and distribution of atherosclerotic plaques in relation to myocardial bridge coronary segments and to determine the prevalence of myocardial bridges and their location and morphology by using MDCT.

Patients and Methods
The study population consisted of 55 patients presented with chest pain, referred for MDCT coronary angiography and found to have myocardial bridge at during the period from April 2018 and August 2019. 23 patients was found having Myocardial Bridge and coronary artery atherosclerotic plaques included in Group (A), 29 persons found having Myocardial Bridge without CAD included in Group (B). All patients were subjected to detailed history taking, clinical evaluation, ECG analysis and MSCT coronary angiography.

Results
In the present study, patients with atherosclerotic plaque (group A) (n = 29), mean age was 52.41 ± 10.55 years ranged from 35.0 to 73.0 years, 41.4% were males, while in Myocardial bridge without atherosclerotic lesion group (group B) (n = 26), mean age was 51.65 ± 7.58 ranged from 38.0 to 65.0 years., 30.8% were males.

Conclusion
Our study showed that diabetes mellitus and dyslipidemia are a significant risk factor for developing atherosclerotic plaque in the segment proximal to myocardial bridge. Myocardial bridge were usually located over the Mid segment of the left anterior descending coronary artery
Comparative Study between 3D Echocardiography Right Ventricular -Volumes and Functions- and Invasive RV Quantification in children with valvular pulmonary stenosis pre and post balloon Dilation
Authors: Hafez M , Kamel H , Abdelrazik Y , Attia H 
Published: October 2021

Abstract

Aim and objectives
The aim of this study was To correlate between 3D echocardiographic assessment of RV volumes and functions with invasive RV quantification by angiography in children with mainly valvular pulmonary stenosis undergoing balloon pulmonary valvuloplasty pre & post balloon dilation, to evaluate the immediate impact of relieving obstruction on RV volumes.

Patients and Methods
The study included 25 patients in the pediatric age group (up to 18 years old) with Pulmonary valve stenosis referred to our congenital and structural heart disease unit cardiology department in Ain shams university hospital for balloon pulmonary valvuloplasty. All patients were subjected to history taking, clinical examination and ECG recording. Then echocardiographic assessment by 2D and 3D was done to all patients pre and post BPV. All patients were subjected to have pre and post RV angiography for assessment of RV volumes and functions angiographically.

Results
The study included 25 patients,65% of patients were males and 44% were females, mean of age was 22.79 with range from 2 to 144 months There was statistically significant increase in 3D Echo RV quantification post BPV in comparison to 3D Echo RV quantification pre BPV with RV/EDV(p-value:0.001), RV/ESV(p-value:0.034), RV/SV(p-value:0.002), FAC %(p-value:0.014), TAPSE(p-value:0.001). Also,there was statistically significant increase in angiographic RV quantification post BPV in comparison to angiographic RV quantification pre BPV with EDV(p-value:&lt;0.001), ESV(p-value:&lt;0.001), SV(pvalue:&lt;0.001) and EF %(p-value:&lt;0.001).

Conclusion
3DE RV volumes and function shows good correlation and agreement with invasive RV quantification by angiography in children with valvular pulmonary stenosis undergoing balloon pulmonary valvuloplasty.
Serum Leptin In Ischemic Heart Disease Patients With And Without Significant Diastolic Dysfunction In Lean And Obese Patients; Cross Sectional Study
Authors: Hamed Ola Mohamed Saad , Tamara Ahmed Fathy , Arab Tamer Abu , Zahran Mohamed 
Published: October 2021

Abstract

Background
Cardiovascular diseases represent the leading cause of mortality worldwide. Ischemic heart disease is one of the main causes of diastolic heart failure and its presence predicts a poor prognosis in ischemic heart patients. Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as overweight and obesity. Leptin –also known as satiety hormone- helps in inhibiting hunger and regulate energy balance (1).

Objective
to correlate leptin level with ischemic heart disease with or without diastolic dysfunction by comparing it in lean and obese patients.

Material and Methods
from June 2019 to November 2019, 140 ischemic patients documented with CA, MSCT or history of PCI AND 35 Control subjects were enrolled from both Ain Shams University, Cardiology department wards and outpatient clinic and Misr University for science and technology, cardiology department wards and outpatient clinic. All participants subjected to history, clinical examination, Duke CAD index to estimate the severity of ischemia, calculation of their BMI, blood sampling for measuring their serum leptin level and echocardiography for detecting the diastolic function. Patients were divided into four groups according to their BMI and Diastolic function in addition to the control group. Groups were demonstrated as follow Group A lean ischemic patients without significant diastolic dysfunction, Group B lean ischemic patients with diastolic dysfunction (II-IV), Group C obese ischemic patients without significant diastolic dysfunction, Group D obese ischemic patients with diastolic dysfunction(II-IV), Group E is a control group lean non ischemic without diastolic dysfunction .

Results
There were significant positive correlations between serum leptin and Duke score in all ischemic groups (n = 140) (p &lt; 0.001). Serum leptin abnormality was significantly more frequent in diastolic dysfunction groups (n = 70) than in non-dysfunction groups (N = 70) (Group B 25.7%, group D 28.6% vs group A 5.7% group C 8.6%, also was lowest in control group (n = 35) 0.0%. serum leptin was significantly positive correlated with ischemia as in group A17.8±2.1ng/mL group B 23.4±11.1ng/mL group C 55.4±10.9 ng/mL group D 65.2±10.8 ng/mL vs control group E 13.1±2.7 ng/mL.

Conclusion
leptin is an independent risk factor for coronary heart disease. Also elevated plasma leptin levels are associated with impaired left ventricular diastolic function in patients with CAD independently of obesity and other confounding variables.
Role of Colchicine in Prevention of Contrast Induced Nephropathy in Patient Undergoing Primary Percutaneous Coronary Intervention
Authors: Elhodhod Omar M , Farouk Mohamed M , Khorshed Walid A Hazem M , Hammady . El 
Published: October 2021

Abstract

Background
Contrast-induced nephropathy (CIN) is a frequent complication after intravascular contrast media administration. The incidence of CIN in STEMI patients undergoing primary PCI is around 19.8%. The pathophysiologic basis of CIN includes an oxidative stress and inflammatory process, and colchicine has been used as an anti-inflammatory and anti-oxidant agent to improve cardiovascular outcomes, hence the aim of the current study is to demonstrate the effect of colchicine on CIN in patients undergoing primary PCI.

Patients and methods
100 STEMI patients planned for primary PCI were enrolled in this study. They were randomized into two groups of fifty patients: A control group receiving standard guideline based medical treatment alone and a study group receiving same treatment in addition to colchicine. CIN was defined based on serum creatinine that was measured repeatedly over 3 days, with absolute rise of 0.5mg/dl or relative rise of 25% or more from baseline signifying CIN.

Results
There was a trend towards lower CIN incidence, although not statistically significant, in patients receiving colchicine, in whom CIN incidence was 8%, in comparison to incidence of 20 in those receiving standard guideline-based therapy alone % (χ2 = 2.99 & p = 0.083) with relative risk reduction of 60%. The reduction of CIN incidence was found to be statistically significant in diabetic subgroup, with CIN incidence of 32% in those receiving standard guideline-based therapy alone, in comparison to incidence of 7% in those receiving colchicine with p = 0.033. Multiple regression analysis including colchicine as a covariable concluded that colchicine use was the most important CIN risk lowering factor in the current study (β = -0.223 and p = 0.039).

Conclusion
There was a trend towards lower incidence of CIN in patients undergoing primary PCI receiving colchicine, although not statistically significant. However, this trend became significant when studied in diabetic subgroup.
Assessment of Longitudinal Left Ventricular Function in Patients with Coronary Artery Ectasia by 2D Speckle Tracking Echocardiography
Authors: sayed Radwa Gad EL , Abdelmonaem Mustafa , William Viola , Adel Walaa 
Published: October 2021

Abstract

Background
Coronary artery ectasia (CAE) is one of the uncommon cardiovascular disorders. CAE is one of the known risk factors for acute coronary syndrome, its incidence ranges from 1.5%-5% of patients undergoing coronary angiography, with predominance in males. Coronary artery ectasia (CAE) is defined as dilatation of an arterial segment to a diameter at least 1.5 times that of an adjacent normal artery and involves at least one third of the affected artery (1)(1). The exact pathogenesis of CAE is not well established; however, Coronary atherosclerosis is detected in more than 50% of the patients.

Objective
To evaluate global left ventricle longitudinal strain by 2D speckle tracking echocardiography in patients with coronary artery ectasia and without significant (&gt;50%) coronary artery stenosis.

Patients and Methods
This study carried on sixty patients referred to cath lab of Ain Shams university hospital for elective coronary angiography during period between January 2018 and Augest 2019. The patients were divided in to two groups (Group A) included thirty patients with ectasia in one or more of the coronary arteries without any significant coronary artery stenosis and (Group B) included thirty patients with normal coronary angiographic findings serving as control group.

Results
The present study showed a statistically significant decrease in EF comparing CAE group to control group .As regards other echocardiography parameters, there was a highly significant difference of LVEDD, LVEDD index, LVESD,, LVESD index, LV mass, LV mass index, LA volume and LA volume index between the two groups. Global peak longitudinal strain showed highly significant difference between two groups as its mean value was significantly lower in the CAE group.

Conclusion
In our study, we have concluded that global peak longitudinal strain was significantly impaired in patients with coronary artery ectasia without significant coronary artery lesion denoting subclinical LV systolic dysfunction .LV diastolic dysfunction was more prevalent in coronary artery ectasia patients compared to control subjects.
Diagnostic Utility of Red Blood Cell Indices-Derived Formulas in Discriminating Beta-Thalassemia Trait from Iron Deficiency Anemia
Authors: Shoukry Maggie Ibrahim , Osman Amany Ahmed , Eissa Deena Samir 
Published: October 2021

Abstract

Background
The two most frequently encountered microcytic hypochromic anemias are iron deficiency anemia (IDA) and β-thalassemia trait (β-TT) which need relatively expensive laboratory tests to be differentiated.

Objectives
This study aims at evaluating the diagnostic utility of different discrimination formulas derived from red blood cell indices from complete blood count in the differentiation of β-TT from IDA.

Subjects and Methods
This study was conducted on 140 subjects; 40 healthy individuals and 100 patients (60 IDA and 40 β-TT) recruited from outpatient clinics of Ain Shams University Hospitals. They were 45 males and 95 females (M: F 1:2.1), their ages ranged from 19 to 63 years. Patients were subjected to measurement of CBC, iron profile, Hb electrophoresis and HPLC and calculation of RBC indices- derived formulas.

Results
Comparative studies of different formulas among the studied group shows that England and Fraser (E & F), MDHL, MCHD, MCI and Zaghloul 2 can significantly differentiate between β-TT patients and IDA patients (P was 0.009, 0.008, 0, 0.001 and 0.050 respectively). Evaluation of diagnostic performance (efficacy) of the studied RBCs formulas showed that Zaghloul 2 is the best index in discriminating β-TT from IDA at cut off 66.61 with specificity (97.5%), sensitivity (76.7%) and diagnostic efficacy (85%). This was followed by MCI at cut off 22.73 with specificity (57.5%), sensitivity (85.0%) and diagnostic efficacy (74. %). Then they are followed by MDHL at cut off 1.487 with specificity (50.0%), sensitivity (86.7%) and diagnostic efficacy (72.0), then England and Fraser with cut off 8.9 with specificity (50.0%), sensitivity (80.0%) and diagnostic efficacy (68.0%), and lastly MCHD with cut off 0.296 with specificity (72.5%), sensitivity (61.7%) and diagnostic efficacy (66.0%). Values above these cut off levels indicate β-TT whereas values below these levels indicate IDA except for E&F formula where &lt;8.9 cut off indicate β-TT and &gt;8.9 indicate IDA.

Conclusion
Zaghloul 2 formula showed the highest efficacy in the differentiation of β-TT from IDA (85%) followed by MCI (74%) and MDHL (72%) then England and Fraser (68%) and lastly MCHD (66%). They can be used for screening in big population, being simple and inexpensive, and then followed by the usual confirmatory tests. Their real use comes in rural areas and primary care facilities where only red blood cell indices are handy. They can be calculated and the cases can be referred to secondary health care to take the confirmatory tests for diagnosis.
The Association between Silent Mating Type Information Regulator 2 Homolog 1 (SIRT1) Gene Polymorphism and Systemic Lupus Erythromatosis (SLE)
Authors: Megid Abeer Ibrahim Abdel , Kamal El-Din Manal Mohsen M , Morshedy Nashwa Aly , Kabiel Walaa Ahmed Yousry , Ismail Sarah Abdel Mohsen 
Published: October 2021

ABSTRACT

Background
Systemic lupus erythematosus (SLE) is a chronic severe multisystem autoimmune disease that affects multiple organs being characterized by heterogeneous manifestations that may affect the skin, joint, heart, brain, kidney, hematopoietic and central nervous systems. It is characterized by autoantibody production for a variety of self-antigens, but it is specifically associated with anti-double stranded DNA (anti-dsDNA), and immune complex deposition. The Silent Mating Type Information Regulator 2 Homolog 1 (SIRT1) is a NAD-dependent deacetylase enzyme that plays an important role in regulating a variety of cellular processes, such as energy metabolism, cell-cycle progression, apoptosis, aging, immune system regulation and inflammation.

Aim of the Work
The aim of the present study is to investigate the association of SIRT1 rs3758391 gene polymorphism with SLE and to study its impact on disease progression to lupus nephritis.

Subjects and Methods
This is a case control study conducted at Ain Shams University Hospital, with a total of 50 participants including 34 patients diagnosed with SLE in addition to 16 age and sex matched individuals serving as a healthy control group.

Results
The results revealed no significant difference between the SLE patients and the controls as regards CC, CT and TT genotypes, yet there was a statistical significant difference between both groups as regards the C and T alleles.

Conclusion
The present study highlights that SIRT1 gene rs3753891 does not seem to influence lupus nephritis susceptibility and disease activity as indicated by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scoring. However, T allele may be a risk factor for lupus susceptibility.
Split face comparative study of microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars
Authors: Sallam Mohamed Abd Elnaeem , El Zawahry Khaled , Ali Mustafa Abdul Rahman Muhammed 
Published: October 2021

Abstract

Background
Acne scars, is a challenge for dermatologists, despite having multiple treatment modalities like microneedling, dermabrasion, Fractional CO2 Laser, dermal fillers, etc. However, monotherapy has been hardly satisfactory because of the polymorphism seen with the scars.

Objective
Comparison between microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars.

Patients and methods
This study was carried out in department of dermatology, venereology and andrology, in Kobry El-Kobba Military complex during the period (from September 2018 to July 2020 ) on 20 patients of both sexes aged from 20 to 60 years old presenting with Goodman and Baron Grade II, III, IV acne scars .

Results
The study revealed a statistically significant difference (p = 0.017) between Goodman and Baron scar grades on the right side of the face before and after treatment indicating that microneedling with platelet rich plasma was effective in improving acne scars. Also, there is a statistically significant difference (p = 0.010) between Goodman and Baron scar grades on the left side of the face before and after treatment, indicating that fractional CO2 laser with platelet rich plasma was effective in improving acne scars.

Conclusion and recommendation
Further controlled and randomized studies are needed to validate our findings in a larger cohort of patients and longer follow up.
Also, number of sessions might be more than 3 sessions.