bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Cardiac Rehabilitation Program on the Quality of Life of Young Adults versus Elderly Egyptians with Ischemic Heart Disease
Authors: omer Rihan Ann Ibrahim , Shabana Adel Mohamed , Khorshid Hazem Mohamed , Zaki Tarek Muneer 
Published: November 2024

Abstract

Background
Exercise-based cardiac rehabilitation is underutilized in patients after myocardial infarction, especially in the elderly population. The ageing biology of this senior population is definitely unique, and they are more likely to experience different consequences for which cardiac rehabilitation can be especially useful.

Objective
To investigate the impact of a 12-week completed cardiac rehabilitation program on the quality of life of two different age groups with recent myocardial infarction.

Methods
This non-randomized prospective cohort study was conducted on 50 patients, divided into two groups; 25 patients for each, group1 included those more than 60 years, group 2 from 18 to 60 years. Both groups underwent cardiac rehabilitation programs during the period of May 2018 to August 2020 at Ain Shams university hospitals. Quality of life assessment was performed via RAND-36 questionnaire, while depression screening was done via PHQ-9 questionnaire.

Results
Both groups showed improvement in the quality of life after completion of the cardiac rehabilitation program. The younger group achieved better improvement in the domains related to physical functioning, general health, role limitation due to physical health, energy/fatigue, and also showed better improvement in depressive symptoms, dyslipidemia and left ventricular Ejection fraction, whereas the senior group showed better improvement regarding role limitation due to emotional problems.

Conclusion
Exercise training in the context of comprehensive CR program improves quality of life in young as well as elderly patients. The young population improved mainly in the domains related to physical health while the elderly group improved regarding emotional domain in the quality of life questionnaires.
Correlation between Myocardial Strain by 2D Speckle Tracking Echocardiography and Severity of Coronary Artery Disease by Coronary Angiography in Chronic Stable Angina
Authors: Anwar Kamel Daniel Nabil , Salam Fahmy Zainab Abdel , Kadis Viola William 
Published: November 2024

Abstract

Background
CAD is a significant cause of mortality and morbidity, Noninvasive imaging techniques are crucial in the diagnosis and risk stratification of patients with suspected stable angina pectoris. However, invasive coronary angiography remains the gold standard for CAD diagnosis. To enhance patient selection for this procedure, myocardial deformation imaging using strain echocardiography provides a simple and noninvasive method to evaluate LV deformation during myocardial ischemia. Strain echocardiography improves the identification of patients who would benefit from invasive coronary angiography.

Objective
To correlate between severity of coronary artery disease using Gensini score and 2D speckle-tracking derived LV global longitudinal strain.

Patients and Methods
The study included 100 patients with symptoms of chronic stable angina. History taking, cardiac examination, full transthoracic echocardiographic study including assessment of left ventricular global longitudinal strain (GLS) using 2D speckle tracking echocardiography and coronary angiography were done for all patients.

Results
The study concluded that a GLS value of -15% was the optimal cut-off for predicting the presence of significant coronary artery lesions, with a sensitivity of 55.81% and specificity of 82.46%. Correlation analysis revealed a positive correlation between GLS and the Gensini score, indicating that as the Gensini score increased (indicating more severe coronary artery disease), the GLS became less negative.

Conclusion
GLS has significant correlation with Gensini score and aids in detection of significant CAD in patients with chronic stable angina. Myocardial strain by 2-D speckle tracking echocardiography together with Gensini score assessment correlates with the angiographic severity evaluated by coronary angiography in patients with stable angina with good sensitivity and specificity thus facilitating prediction of presence of significant CAD. Accordingly, this promises to be an efficient, non-invasive diagnostic tool that may facilitate early intervention for patients with CAD and application of preventive or treatment measures for patients with chronic coronary syndrome.
Effect of Pre-Procedural Statin/Ezetimibe Combination Therapy Versus Statin Monotherapy on Myocardial No-Reflow Following Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Randomized Controlled Clinical Trial
Authors: Ahmed Ghada Atef , Abdallah Mina Magued , Abdelrahman Mohamed Ahmed , Sharaf Eldin Ahmed Abdelrahman 
Published: November 2024

Abstract

Aim and Objectives
The aim of the study was to compare the effectiveness of pre- procedural Statin therapy and Statin/Ezetimibe in reducing the no-reflow phenomenon in patients undergoing primary PCI.

Patients and Methods
The study was carried out on 200 patients (age 55.86 ± 11.32) presenting to Ain Shams university hospitals with ST-segment elevation Myocardial Infarction and received the standard of care management which is Primary PCI. The patients were assessed regarding the demographic data, risk factors, symptoms including characterization of chest pain, physical examination, 12 lead ECG, labs, Coronary angiography to identify the coronary anatomy, culprit vessel, TIMI flow score and MBG.

Results
Our study compared 100 patients who received high intensity Statin/Ezetimibe combination before primary PCI and 100 patients who received high intensity statin only. Among the case group, 72% were smokers, 33% were diabetic and 24% were hypertensive, 94% presented with killip 1, 5 with killip 2, 1% with killip 3, 70% were anterior STEMI, 2% Lateral, 18% inferior and 10% posterior. Among the control group 75% were smokers, 18% were diabetic and 24% were hypertensive, 95 % presented with killip 1, 3% with killip 2, 2% with killip 3, 49% were anterior STEMI, 6% Lateral, 34% inferior and 11% posterior. The study revealed that there was no statistically significant difference between the two groups, group A (case group) and group B (control group) regarding the occurrence of no reflow, 7 no reflow patients in group A versus 8 in group B, with a P-value of 0.788. There was no significant difference between the two groups in the tissue perfusion post primary PCI as being assessed by TIMI flow classification and myocardial blush grade.

Conclusion
Statin/Ezetimibe combination did not result in a significant reduction in the incidence of no-reflow in STEMI patients in comparison to Statins alone. Although the occurrence of MACE was less in the case group, the exact effect on in-hospital MACE could not be detected due to the small number of total MACE in the study. Larger additional randomized studies are needed to establish the effect of preprocedural high-dose Statin/Ezetimibe combination therapy on angiographic results in patients who undergo primary PCI.
Role of Speckle Tracking in Detection and Short Term Follow Up of Right Ventricular Systolic Dysfunction in Patients with Acute Inferior STEMI
Authors: Aboellil Hassan Samieh , Sallam Walid Mohammed , Arab Tamer Abo , Aboul Soud Mona Ibrahim 
Published: November 2024

Abstract

Background
The right ventricle (RV) is a thin-walled chamber characterized by functioning under low oxygen demands and pressure. RV is perfused throughout the cardiac cycle in both systole and diastole. These factors make RV less susceptible to infarction compared to the left ventricle. Successful primary PCI in patients with RV infarction has shown to regain the RV systolic function and is associated with better in-hospital morbidity and mortality. Speckle tracking derived strain provides accurate assessment of the RV global and segmental myocardial function.

Objective
To assess RV systolic function in inferior STEMI using 2D echocardiography speckle tracking derived longitudinal strain early after primary PCI and follow up 3 months later.

Methods
This prospective cohort study was conducted at Ain Shams University Hospitals. 50 patients underwent successful (PCI) after inferior STEMI. Another 50 healthy individuals were examined “to obtain reference values for RV FWS”.

Results
RV function parameters showed good prognosis 3 months after primary PCI: TAPSE (39 patients “78%” showed improvement Vs 11 “22%” that had no change), also Fractional area change (FAC) (42 patients “84 %” improved Vs 8 non improved patients “16%”) finally Free wall strain showed the better improvement (44 patients “88 %” improved).

Conclusion
Among the echo Doppler parameters, FAC and. RV speckle tracking derived strain parameters were the most sensitive in assessment of RV function impairment and recovery after inferior STEMI.
Glycated Hemoglobin as a Predictor of No Reflow in Diabetic Patients with ST Segment Elevation Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention
Authors: Mohamed Farag Ibrahim Ahmed , Hashem Ahmed Reda , Elias Ramy Raymond 
Published: November 2024

Abstract

Background
Prognosis after myocardial infarction in patients with diabetes mellitus is worse compared with patients without diabetes mellitus, even in the setting of optimal reperfusion strategy involving primary percutaneous intervention (PCI).

Objective
To detect the correlation between HbA1C and no reflow in diabetic patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Methods
In this comparative cross-sectional study, we examined 62 diabetic patients who experienced an acute STEMI and had undergone PCI at Ain Shams University Hospitals and Nasr City Hospital for Health Insurance in a period of six months starting from February 2023 till August 2023. These patients were divided into two groups. Group 1 consisted of 31 diabetic patients who exhibited normal blood flow following PCI. Group 2 included an equal number of patients (31) who demonstrated no-reflow phenomenon.

Results
A total of 62 participants were included, with 5 females (8.1%) and 57 males (91.9%), ranging in age from 39 to 83 years. The mean age of the participants was 61.1 years. Statistical analysis showed no significant differences in age and gender distribution between the normal flow group and the no-reflow group, with p-values of 0.151 and 0.641, respectively. There was no statistically significant difference between the two groups regarding physical examination except for diastolic blood pressure that was lower in no reflow group. Also, There was no statistically significant difference between the two groups regarding HbA1C level. Mean with 95% confidence interval (CI) of 7.69 (6.86 – 8.52) in normal flow group and 8.05 (7.02 – 9.7) in no reflow group.

Conclusion
In this study of diabetic patients with STEMI undergoing primary PCI, we found no statistically significant correlation between HbA1C levels and the occurrence of the “no reflow” phenomenon., although there was a trend towards higher HbA1C in the no reflow group which may need conducting large-scale studies involving a more diverse population.
Registry of Transcatheter Aortic Valve Implantation (TAVI) for Patients with Severe Aortic Stenosis at Ain Shams University Hospitals
Authors: Yahya Mohamed , Baraka Mahmoud , Kamal Diaa Eldin , Elsayed Ahmed 
Published: November 2024

Abstract

Background
TAVI is now the standard of care for inoperable patients and a valid alternative to surgery for many high-risk patients (5). it has shown non-inferiority to SAVR in patients with intermediate risk for cardiac surgery, Other recent trials have assessed the safety of TAVI in low-risk patients such as the PARTNER 3, Nordic NOTION 2 and the Medtronic TAVR low risk trial.

Aim
The aim of this study was to evaluate the clinical and echocardiographic outcomes in patients undergoing successful TAVI at Ain Shams University Hospitals during six months follow-up after the procedure, according to the Valve Academic Research Consortium-3 (VARC-3). (9)

Methods
This is a retrospective & prospective cohort Study. It was conducted in cardiology department, Ain Shams University Hospitals in the period of November 2022 to May 2023.it included (151) patients who were treated with TAVI in Ain Shams University Hospitals in the period From January 2020 to October 2022 retrospectively and from November 2022 to May 2023 prospectively29 patients were missed during follow up and excluded due to incomplete data and failure of follow up, to end the study with (122) patients, fulfilling the inclusion criteria.

Results
Regarding death as the most objective and unbiased endpoint, our registry reported a 30-day survival rate of (97.5%), and a six-month survival rate of (96.7%). Regarding symptomatology, our registry shows high significant improvement of symptoms with 99 (81.1%) of patients were asymptomatic at follow up, p-value (&lt;0.001), and the majority of patients with NYHA III (73%) & IV (26.2%) at baseline show high significant improvement with majority of patients at NYHA I (91.8%) & II (7.4%) at follow up with p-value (&lt;0.001). Based on echocardiography assessment in our registry, TAVI significantly improved the patient’s hemodynamics. The mean pre- and post-procedural left ventricular ejection fraction were 59.10 ± 14.62 and 62.70 ± 11.75 respectively with p-value (&lt;0.001), also patients with reduced EF% show significant improvement with mean pre- and post-procedural LV EF% 33.44 ± 8.42 and 42.16 ± 8.40 respectively with p-value (&lt;0.001), The mean pre- and post-procedural pressure gradient (MPG) was 50.12 ± 14.00 and 6.13 ± 1.58 respectively with p-value (&lt;0.001), with more than (99%) absence of moderate or severe valvular leak.

Conclusions
Our registry shows favourable short-term clinical outcomes in unselected TAVI patients, The study found that TAVi candidates in Egypt were younger, had a lower risk for cardiac surgery, and had lower rates of post-procedural complications and mortality than other international all-comer registries, denoting the procedure as safe and beneficial especially by accumulating experience and technical advances in devices and not only add years to patients life by reducing all-cause mortality but also add life to their years by improving quality of life.
Effect of Blood Pressure Control on Left Atrium Functions as Assessed by 2D Echocardiography in Newly Diagnosed Patients with Systemic Hypertension
Authors: Ahmed Elsawye Mostafa Mohamed , Alaa Aly Azza Omran , Ali Moussa Mohamed Khaled , Aly Khaled , El-Salam Zainab Abd 
Published: November 2024

Abstract

Aim and Objectives
The aim of the study is to study the effect of adequate blood pressure control on left atrial functions measured by 2D echocardiography in newly diagnosed patients with systemic hypertension.

Patients and Methods
The study was carried out on 50 Patients with recently diagnosed systemic arterial hypertension and uncontrolled on medications presenting to Ain Shams university hospitals. The patients were assessed regarding the demographic data, risk factors, general examination, local examination, ECG, echocardiography and laboratory measures. Then follow up done after 6 months of proper control of blood pressure (BP) according to JNC 10 in the form of ECG and Echocardiograph

Results
In our study the results showed PALS (peak atrial longitudinal strain) showed increase with change of the mean from 35.04 ± 4.33 to 38.92 ± 5.52with P-value below 0.001. PACS (peak atrial contraction strain)showed increase with change of the mean from 17.38 ± 4.67 to 20.46 ± 4.39 with P-value below 0.001. Mitral peak early (E) and septal and lateral mitral annular velocities and their average (e`) E/e' showed decrease with change of the mean from 8.8 ± 0.93 to 7.8 ± 1.16 with P-value below 0.001. LASI(left atrium stiffness index) showed decrease with change of the mean from 0.24 ± 0.04 to 0.2 ± 0.03with P-value below 0.001.

Conclusion
Our study demonstrated that speckle tracking imaging could be used to detect subtle impairment of LA (left atrium) function in patients with hypertension. proper control of blood pressure in hypertensive patients lead to improvement in PALS, PACS, E/e' and LASI. The clinical usefulness of LA function by STE (speckle tracking echocardiography) in hypertensive patients merits further investigations to better precision of the role of the LA study in the prediction of atrial fibrillation, and the risk of heart failure with preserved ejection fraction.
Registry of Management of Collaterals Post Cavo-Pulmonary Anastomosis and Its Impact on Patients with Single Ventricle Physiology Presented to Ain Shams University
Authors: El-deen Hasan Nehad El-sayed Nour , Samir ElShahed Ghada , Esmail Yasmin Abd El-Razek 
Published: November 2024

Abstract

Background
the bidirectional Glenn shunt is still an essential step in physiologically single ventricle heart repair; as it offers excellent palliation, BDG shunt increases pulmonary blood flow, allows pulmonary arteries growth and improves arterial oxygen saturation. It also enables ventricular volume unloading, associated with a reduction in ventricular end-diastolic volume and ventricular hypertrophy, thus improves survival and quality of life.

Aim of the Work
to register all patients post cavopulmonary anastomosis who developed collateral channels (including venovenous, aortopulmonary collaterals or collaterals to pulmonary veins) and the different methods of management followed and the impact of this management on patients with single ventricle physiology.

Patients and Methods
our registry included 56 patients who underwent bidirectional Glenn procedure referred for follow up in Ain Shams university hospital from March 2022 till February 2023.

Results
Our patients underwent bidirectional Glenn shunt at a median age of 2.08 (1-3) years which is considered a relatively old age compared to registries conducted in developed countries but similar to others studies that have been made in developing countries like Pakistan, India and Iran. In our study, we evaluated veno-venous and aorto-pulmonary collaterals in patients with bidirectional Glenn shunt. We studied prevalence and predictors of their development. We also studied different lines of management, the effect and complications of this management. Among the 56 patients included in our registry 41 patients (73.2%) had veno-venous collaterals and 37 patients (66.1%) had aorto-pulmonary collaterals. In our registry, we showed that transcatheter occlusion of collaterals is an effective and safe line of management of veno-venous and aorto-pulmonary collaterals, 7 patients underwent transcatheter closure of collterals, one of them underwent successful closure of aorto-pulmonary collaterals while the other 6 patients underwent veno-venous collaterals closure. In our registry, there was a statistically highly significant increase in SO2 (%) after trans-catheter closure of veno-venous collaterals (82.83 ± 9.87 Vs 69.83 ± 10.91) with p-value = 0.008.

Conclusion
the need for larger registries of post bidirectional Glenn shunt and post Fontan patients in our country is mandatory to cover different aspects of follow up and management of these patients that will give us more knowledge and experience that will result in improvement in the public health services for those selected population and will help us provide them a better quality of life and improve associated cardiac morbidity and mortality.
The Correlation between Serum Level of NT-Pro Brain Natriuretic Peptide and Hemodynamically Significant Ventricular Septal Defects
Authors: Robel El-abd Tawadrous Peter , Roushdy Alaa Mahmoud , Nossier Heba Mohamed 
Published: November 2024

Abstract

Background
Ventricular septal defect (VSD) is the most common congenital heart disease accounting for 40% of all congenital heart diseases. An isolated VSD accounts for more than 20% of all congenital heart diseases.

Aim of the Work
We aimed in this study to correlate the serum level of NT Pro-BNP with different 2D and 3D variables and the hemodynamic significance of ventricular septal defects including LV volumes, dimensions, functions and left to right shunt quantification (Qp/Qs) measured by 2D echocardiogram.

Patients and Methods
Our study included 60 patients in the pediatric age group (up to18 years old) who were referred for elective echocardiogram in the congenital and structural heart disease unit cardiology department in Ain Shams University hospital. Patients with VSD were divided into three equal subgroups according to shunt quantification (Qp/Qs): group (1) included patients with (Qp/Qs &lt;1.5), group (2) included patients with (Qp/Qs&gt;1.5-2) and group (3) included patients with (Qp/Qs &gt;2).

Results
There was a highly significant positive correlation between Pro-BNP level and echocardiographic shunt quantification by QP_QS (p &lt; 0.001). And there was a highly significant positive correlation between Pro-BNP and echocardiographic VSD Size (r = 0.8) & Mean. PAP (0.8). A highly significant positive correlation between Pro-BNP and indexed LVEDV and indexed LVESV by 2D and 3D echocardiography was also noticed. Also there was a highly significant negative correlation between Pro- BNP and EF by m mode and a significant negative correlation with LV EF by Simpsons method and LV EF by 3D echocardiography. In our study with ROC curve analysis a cut-off point of discriminating patients with QP/QS &lt;1.5 from those &gt;1.5 was 98 pg/ml that had the highest balanced sensitivity and specificity to predict significant shunt with sensitivity = 97.5 % and specificity = 90 %.

Conclusion
Pro-BNP level correlates with the amount of left to right shunt (Qp/Qs ratio) in children with VSD. Therefore, pro-BNP can be used as a screening tool for evaluating hemodynamic load in these patients.