Medical Specialties Commons^™

Artificial Intelligence-Enhanced Ecg For Hypertrophic Cardiomyopathy Diagnosis: A Systematic Review And Meta-Analysis, Fernando (Alonzo) Theja, Louis (Fabio Jonathan) Jusni, Robby Soetedjo, Dimetrio (Alonzo) Theja

Journal of the Saudi Heart Association

Objectives: Diagnosing hypertrophic cardiomyopathy (HCM) can be challenging due to its nonspecific clinical manifestations, variability in electrocardiographic (ECG) patterns, and limited access to echocardiography, the gold standard for diagnosis, often leading to delayed detection. Recent artificial intelligence (AI) advancements have enabled ECG-based algorithms to improve HCM detection. This systematic review and meta-analysis aim to assess the overall diagnostic performance of AI-enhanced ECG in identifying HCM.

Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Articles were retrieved from PubMed, EBSCO, and Proquest. Inclusion criteria encompassed all studies evaluating AI algorithms for the detection of …

Response To The Letter Titled: “Platelet-To-White Blood Cell Ratio As A Prognostic Biomarker For Spontaneous Reperfusion After Primary Percutaneous Coronary Intervention” By Hinpetch Daungsupawong, Gökhan Alıcı, Tayfur Erdoğdu, Arafat Yıldırım, Özge Ö. Abacıoğlu, Ömer Genç, Ceyhun Yücel, Örsan D. Urgun, Abdullah Yıldırım, Şerafettin Demir

Journal of the Saudi Heart Association

No abstract for this article type.

Platelet-To-White Blood Cell Ratio And Prognostic Biomarker For Spontaneous Reperfusion After Primary Percutaneous Coronary Intervention, Hinpetch Daungsupawong, Viroj Wiwanitkit

Journal of the Saudi Heart Association

No abstract for this article type.

Comparison Of Patent Foramen Ovale Closure Vs Medical Therapy For The Prevention Of Recurrent Cryptogenic Stroke: A Systematic Review, Omar Hamodata, Saif , Almuzainy, Rand Yahya, Salam Koniali

Journal of the Saudi Heart Association

Objectives: The optimal management approach for patients with cryptogenic stroke and patent foramen ovale (PFO) remains uncertain. Whether medical therapy—using antiplatelet agents or anticoagulants—or transcatheter device closure offers superior protection against stroke recurrence has been a topic of considerable debate. This systematic review aims to assess and compare the effectiveness of these two treatment strategies, incorporating recent studies to provide updated insights on the most effective approach to preventing recurrent cryptogenic stroke. Methodology: We systematically searched PubMed, Scopus, and Ovid database through December 2024. Eligible studies were randomized controlled clinical trials (RCTs) comparing PFO closure versus medical therapy among patients …

Efficacy And Safety Of Concomitant Surgical Ablation During Mitral Valve Replacement: A Systematic Review, Omar Hamodat, Saif Almuzainy, Rand Yahya, Razan Alzaatreh, Samiullah Haroon, Salam Koniali

Journal of the Saudi Heart Association

Objectives: Atrial fibrillation (AF) is a common comorbidity in patients undergoing mitral valve surgery (MVS), significantly increasing the risk of thromboembolism, heart failure, and mortality. Surgical ablation has recently been given a Class IA recommendation for concomitant MVS, reinforcing its role in restoring sinus rhythm and improving outcomes in this population. However, concerns about procedural complexity, extended operative time, and postoperative risks have limited its widespread adoption. This systematic review aims to synthesize evidence from recent randomized controlled trials to evaluate the safety and efficacy of surgical ablation for AF in patients undergoing MVS, addressing critical gaps in current clinical …

"The Role Of Venous Excess Ultrasound Score In Optimizing Acute Heart Failure Diagnosis And Prognosis, Saoussen Antit, Sarra Romdhane, Imen Mtiri, Lilia Zakhama

Journal of the Saudi Heart Association

Acute heart failure (AHF) is a critical condition with significant morbidity and mortality, necessitating timely and accurate diagnosis for effective management.

The Venous Excess Ultrasound (VExUS) score has emerged as a non-invasive diagnostic tool, aimed at evaluating venous congestion through ultrasound. This scoring system integrates assessments of the inferior vena cava, hepatic veins, portal veins, and renal venous flow to quantify congestion severity. By providing a real-time assessment of venous pressure, the VExUS score has shown potential in optimizing early diagnosis of AHF and predicting outcomes and overall prognosis.

Recent studies suggest that incorporating the VExUS score into clinical practice …

Predictors Of Outcomes In Pediatric Pulmonary Arterial Hypertension, Aditya Doni Pradana

Journal of the Saudi Heart Association

There is no abstract for this article type.

A Saudi Heart Association Position Statement On The Use Of Doacs In Patients With Arterial And Venous Thrombosis, Waleed Alhabeeb, Adel Tash, Ahmed Aljedai, Ayman Morsy, Feras Khaliel, Iman Alhazmi, Mohammed Alsheef, Mohammed Arafah, Owayed Alshammeri, Saeed Alahmari

Journal of the Saudi Heart Association

Background: Direct oral anticoagulants (DOACs) have emerged as non-inferior and effective alternatives to traditional anticoagulants in managing thromboembolic risks associated with various cardiovascular conditions. This position statement by the Saudi Heart Association (SHA) aims to provide guidance on the use of DOACs in the context of cardiovascular disease, particularly patients with arterial and venous thrombosis.

Methods: A multidisciplinary panel of experts reviewed current evidence and international guidelines on DOACs, considering the local healthcare context in Saudi Arabia. The statement addresses the initiation, maintenance, interruption, and re-initiation of DOAC therapy across different patient populations.

Results: DOACs are effective alternatives to traditional …

Perceptions Of Cardiac Surgeons Regarding The Integration Of Artificial Intelligence In Cardiac Surgery, Nada Alguizzani, Fareed Khouqeer, Rasha Alorini, Imtenan Oberi

Journal of the Saudi Heart Association

Background: After the surge of artificial intelligence in late 2022, researchers started exploring the idea of using artificial intelligence in the medical field. Considering the endless possibilities of artificial intelligence, there is still some hesitation toward its use in the medical field. This study aims to explore the attitudes of cardiac surgeons toward involving artificial intelligence in diagnosing cardiac conditions and planning cardiac operations.

Methodology: This study surveyed cardiac surgeons on AI integration in their field using a cross-sectional design and purposive sampling. Data were collected via a structured questionnaire and analyzed in IBM SPSS 29.0.

Results: Our study included …

Exercise And Hypertrophic Cardiomyopathy: Risks, Benefits, And Safety - A Systematic Review And Meta-Analysis, Arif Albulushi, Qasim Al Abri, Ahmed Tawfek, Ahmed Reza Bagheri, Said Al-Hinai

Journal of the Saudi Heart Association

Hypertrophic cardiomyopathy (HCM) is often associated with conservative exercise recommendations due to the risk of sudden cardiac death (SCD). However, emerging evidence suggests that tailored exercise programs may provide significant benefits to HCM patients. This systematic review and meta-analysis evaluated the impact of different types and intensities of exercise on clinical outcomes and quality of life in HCM patients, assessed the role of exercise in preventing disease progression and arrhythmias, and determined the safety and efficacy of structured exercise programs tailored to individual risk profiles.

A comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and relevant cardiology journals. …

Ischemia And Anatomy In The New 2024 European Guidelines For Chronic Coronary Syndromes: Update And Comparison Of Recommendations, Christian Adrián Caroli

Journal of the Saudi Heart Association

The new 2024 European guideline on chronic coronary syndromes is a pivotal document for clinical practice, updating the evidence and indications after five years, incorporating insights from the paradigm-shifting ISCHEMIA trial. This article explores the evolving role of functional and anatomical testing in assessing coronary artery disease, highlighting the introduction of a new risk probability score based on clinical and risk factors. Additionally, it provides a detailed comparison between these European recommendations and those from the most influential American guidelines, emphasizing key differences in the approach to risk stratification and diagnostic strategies. This comprehensive analysis provides valuable insights for optimizing …

Epidemiological Characteristics Of Patients With Supraventricular Tachycardias Who Were Inappropriately Diagnosed With Panic Attacks: Experience From A Large Saudi Tertiary Care Center, Ghram Awlia, Ahmed T. Mokhtar, Maha Alsaiari, Nagham Alsolaimani, Waddah Ashram, Naeem Alshoaibi, Alaa Algazzar

Journal of the Saudi Heart Association

Objectives: Supraventricular tachycardia (SVT) is a significant cause of morbidity in patients visiting cardiology clinics with a chief complaint of palpitations and notable signs of distress worldwide. SVTs and panic attacks have overlapping clinical presentations, beginning with rapid palpitations of the heart that start abruptly and can be accompanied by shortness of breath, chest pain or discomfort, and a feeling of lightheadedness. The diagnosis could be straightforward if an ECG is recorded precisely during the attack. The chances of misdiagnosing patients with panic attacks increase because of the self-terminating nature of SVTs. Given the diagnostic dilemma caused by these conditions …

Sex-Based Differences In The Utility And Outcomes Of Left Ventricular Assist Devices, Mirvat Alasnag, Waleed Alhabeeb, Feras Khaliel

Journal of the Saudi Heart Association

The totality of evidence suggests that there remains a significant disparity in the use of left ventricular assist devices (LVADs) and heart transplantation (HT) in women. This disparity persists even after accounting for differences in baseline characteristics, comorbidities, and cardiovascular risk factors between men and women undergoing LVAD implantation as a bridge to HT. Generally, women are less likely to undergo HT, leading to a higher mortality rate in women on the HT waiting list. The differences in risk profiles and device-related complications may account for the sex-related disparities in the assignment of device therapies. These findings warrant an urgent …

How To Avoid Arterial Access During Transcatheter Closure Of Patent Ductus Arteriosus Using Anatomo-Haemodynamic Landmark, Mohit Sachan, Kumar Himanshu, Mukesh Jitendra Jha, Santhosh Kumar Sinha, Mahmodullah Razi, Awadhesh Kumar Sharma, Puneet Aggarwal, Praveen Shukla, Rakesh Verma

Journal of the Saudi Heart Association

Objective- To evaluate the feasibility, safety, and efficacy of transcatheter closure (TCC) of patent ductus arteriosus (PDA) using anatomical-physiological landmark without any arteriography.Method- In this prospective, non-randomized study, all consecutive patients with PDA undergoing transcatheter closure at LPS Institute of Cardiology, Kanpur, India between January 2019 and June 2024 were evaluated. TCC was performed using anatomical and physiological landmark without aortogram, and device was deployed through antegrade route only. Transthoracic echocardiography with colour-Doppler imaging was used to confirm position of the device before final deployment. Primary outcome was procedural and fluoroscopy time, and major complications (access site …

Challenges In Diagnosing And Treating Fungal Endocarditis: A Case Report Of Recurrent Candida Endocarditis In A Hemodialysis Patient, Ghaidaa Almuhammadi, Rawia Alzughaibi, Lamar Amer, Talal Alzahrani

Journal of the Saudi Heart Association

Fungal endocarditis (FE) is a rare yet life-threatening condition, especially in hemodialysis (HD) patients with indwelling long-term catheters. Symptoms often overlap with non-fungal infective endocarditis, making diagnosis difficult. As FE incidence increases, healthcare providers face challenges in diagnosing and managing this severe condition. Early suspicion of FE is crucial for patients with long-term catheters. We reported a 23-year-old male with end-stage renal disease (ESRD) on HD that developed FE affecting the tricuspid valve, requiring valve replacement and anti-fungal medication. Despite these interventions, he had recurrent Candida prosthetic endocarditis(CPE). Currently, he is receiving anti-fungal medication, with plans for a third surgery.

The Safety Of Ramadan Fasting In Chronic Heart Failure Patients With Reduced Ejection Fraction, Ahmed Farouk Alaarag, Mahmoud Abd Elkhalek Abou-Omar, Osama Ahmed Amin

Journal of the Saudi Heart Association

Objectives: Even though Islam excludes the sick from Ramadan Fasting (RF), countless Muslims choose to fast throughout this holy month. So, it is of paramount importance to review how RF influences patients with chronic Heart Failure with reduced Ejection Fraction (HFrEF). Our study intended to check the safety of RF in these patients.

Methods: We selected patients under 75 years old with compensated chronic HFrEF. After applying all the exclusion conditions, those who insisted on fasting during the coming Ramadan were enrolled in fasting Group I (90 patients). Those who decided not to fast were listed as control Group …

Effectiveness Of Empagliflozin In Treating Patients With Heart Failure With Preserved Ejection Fraction: A Systematic Review, Sara Abou Al-Saud

Journal of the Saudi Heart Association

Aim

The goal of this systematic review is to determine the effectiveness of empagliflozin in managing patients with heart failure with preserved ejection fraction (HFpEF) as compared with a placebo

Methods

Web of Science, Cochrane, PubMed, and Scopus databases were searched for articles from 2000 to 2023. Reference lists of articles were manually screened. Trials that recruited patients with HFpEF and reported the effects of empagliflozin were included. Endnote X9 software was used for the study screening process.

Results

1029 non-duplicate articles were identified from the literature and 9 were selected for inclusion in this review. The included papers were …

The Usefulness Of 3d Heart Models As A Tool Of Congenital Heart Disease Education: A Narrative Review, Raghad Abdulaziz Alhojailan, Reghd Husain M Alkhalifah, Bana Albani, Majed Wadi

Journal of the Saudi Heart Association

Objectives: The objective of this review is to evaluate the effectiveness of three-dimensional (3D) heart models as teaching tools for congenital heart disease (CHD), addressing the limitations of traditional medical education methods. Methods: A thorough literature review was conducted using PubMed, Google Scholar, Scientific Direct and Scopus databases. Relevant articles were screened and selected based on their discussion of the application of 3D models in CHD education. Results: The comprehensive review of 19 studies revealed that 3D heart models provide students, healthcare professionals, and patients with meaningful experiences that significantly enhance understanding and learning outcomes. These models improve …

Provisional Stenting Of Distal Bifurcation Of Left Main Stem With Angle Equal Or More Than 90° With And Without Final Kissing Balloon: One-Year Outcomes, Ali Mahdi Mohammed Abuajmaa, Khalid Ibrahim Amber

Journal of the Saudi Heart Association

Objective: To identify the outcomes of provisional single stent (PS) strategy without final kissing balloon (FKB) in wide angle (≥90°) distal bifurcation of the left main stem (LMS).

Methods: A pilot study of prospective interventional cohort study was conducted from January 2021 to February 2024. Patients with unprotected LMS - left anterior descending artery with LMS distal bifurcation angle ≥90° were divided into: Group I (Medina class 1,1,0 treated with PS without FKB), Group II (Medina class 1,1,1 treated with PS) which subcategorized into two subgroups; Group IIa (PS with FKB) and Group IIb (PS without FKB). One-year follow-up outcomes …

Pediatric Pulmonary Arterial Hypertension; Is It Possible To Predict Its Outcome?, Hala Mounir Agha, Ranya Hegazy, Ahmed Gamal, Ranya Essam, Antoine Abd Elmessih, Ahmed Behairy, Nagib Dahdah, Ahmed Abdelwahed, Nesrine Sobhy, Noha Ali

Journal of the Saudi Heart Association

Objectives: to assess the outcome of pediatric pulmonary arterial hypertension (PAH) and to identify the predictors of morbidity and mortality of this progressive disease. Patients and methods: This prospective observational cohort study was conducted on consecutive pediatric patients with PAH. Medical history was taken with a grading of the WHO functional class as well as the serum N-terminal pro-BNP (NT pro-BNP), six minutes’ walk test (6MWT), and echocardiography at the initial assessment and at follow-up. Results: The cohort study included 71 patients; 39 patients had idiopathic and heritable PAH, 27 patients had PH secondary to CHD and five patients had …

Redo Minimally Invasive Right Atrial Mass Removal After Surgical Atrial Septal Defect Closure, Chirag Doshi, Pratyaksha Rana, Vidur Bansal, Megha M Sheth, Dinesh Patel

Journal of the Saudi Heart Association

Atrial septal defects are among the most prevalent congenital anomalies necessitating surgical intervention. Thrombus formation is a recognized complication that is typically characterized by an embolic event following patch-based repair. However, thromboembolic complications following primary repair of atrial septal defects are exceedingly uncommon.

Minimally invasive surgery is a suitable alternative to redo sternotomy. We present a 46-year-old man who was diagnosed with a right atrial mass eight years following the patch repair of an atrial septal defect and underwent a successful minimally invasive redo surgery.

Zilebesiran And Hypertension: A Systematic Review And Meta-Analysis, Mohamed Lemine, Saif Almuzainy, Rayan Aljubeh, Ahmad Alilo

Journal of the Saudi Heart Association

Abstract: Objectives: Zilebesiran is an investigational RNA interference therapeutic designed to lower blood pressure by targeting the hepatic production of angiotensinogen, the most upstream precursor of the renin–angiotensin–aldosterone system. This approach aims to offer long-lasting blood pressure control with potentially fewer doses compared to traditional antihypertensive medications. The objective of this systematic review and meta-analysis was to assess the antihypertensive efficacy of zilebesiran in patients with hypertension. Methods: We conducted a search across PubMed, Cochrane Library, Ovid, EBSCO, up until July 2024. The eligible studies included randomized controlled trials that examined Zilebesiran versus placebo in hypertensive patients. These studies …

Platelet-To-White Blood Cell Ratio (Pwr) : A Novel Prognostic Biomarker For Spontaneous Reperfusion After Primary Percutaneous Coronary Intervention., Gökhan Alıcı, Tayfur Erdoğdu, Arafat Yıldırım, Özge Özcan Abacıoğlu, Ömer Genç, Ceyhun Yücel, Örsan Deniz Urgun, Abdullah Yıldırım, Şerafettin Demir

Journal of the Saudi Heart Association

Background: Spontaneous reperfusion (SR) occurring before primary percutaneous coronary intervention (PPCI) can offer additional clinical benefits to patients with ST-segment elevation myocardial infarction (STEMI). The Platelet-to-White Blood Cell Ratio (PWR) has been recognized as a prognostic indicator in various diseases. We aimed to explore the relationship between PWR and SR in patients with STEMI undergoing PPCI.

Methods: We conducted a retrospective analysis involving 995 patients diagnosed with STEMI who underwent PPCI in a single-center setting. Demographic, clinical, laboratory, and angiographic data were extracted from the hospital database, and PWR was calculated by dividing serum platelet levels by white blood cell …

A Saudi Heart Association Position Statement On Cardiovascular Diseases And Diabetes Mellitus, Waleed Alhabeeb, Abdelfatah Elasfar, Abdulhalim Kinsara, Ahmed Aljizeeri, Ibrahim Jelaidan, Kamal Alghalayini, Mohammed F. Alkheraiji., Mousa Akbar, Sameh Lawand, Sarah M. Alyousif, Saud Alsifri, Taher Hassan

Journal of the Saudi Heart Association

Background: Cardiovascular disease (CVD) and diabetes mellitus are prominent public health concerns in Saudi Arabia owing to their increasingly high prevalence and burden. Based on this, the Saudi Heart Association (SHA) set out to develop an official position statement on CVD and diabetes mellitus, with a focus on the prevention and management of these conditions and relevant special populations in the context of Saudi Arabia.

Methods: A multidisciplinary panel of experts met under the auspices of the SHA in a series of meetings to review and discuss available evidence on the prevention and management of comorbid CVD and diabetes mellitus. …

Assessment Of Coronary Collaterals Among Patients With St-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention And Its Impact On In-Hospital And 30-Day Mortality: A Prospective Observational Study, Zafar Iqbal, Muhammad Naeem Mengal, Tariq Ashraf, Bashir Ahmed Salongi, Rajesh Kumar, Khalid Iqbal Bhatti, Bilal Ahmed, Abdul Samad Achakzai, Tahir Saghir

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the distribution of coronary collaterals (CC) as per the Rentrop Collateral Score (RCS) among patients with ST-segment elevation myocardial infarction (STEMI) and its impact on in-hospital and 30-day mortality after primary percutaneous coronary intervention (PCI).

Methods: In this study, a selected sample of consecutive STEMI patients was assessed for the development of CC as per the RCS classification. An RCS grade of 2 or 3 was taken as the presence of CC with either partial or complete filling of the infarct-related artery (IRA). Patients were followed during the hospital stay and up to 30 …

Perspectives Of Policymakers On Barriers To And Enablers Of The Uptake Of Cardiac Rehabilitation In Saudi Arabia: A Qualitative Study, Ahmed Mohammed Almoghairi, Jane O’Brien, Jed Duff

Journal of the Saudi Heart Association

• Objectives: This study aimed to identify the barriers to and enablers of secondary prevention care and cardiac rehabilitation (CR) utilization by patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) from the perspective of policymakers.
• Methods: A qualitative study involving an interpretive descriptive design was conducted through recorded semi-structured interviews with key decision-makers in cardiology care in Saudi Arabia. The analysis was guided by the updated Consolidated Framework for Implementation Research (CFIR), which informed the resulting themes.
• Results: Interviews were conducted with nine key decision-makers: four directors of major cardiac centers, four heads of cardiac rehabilitation units, and …

Reply To Author Regarding The Letter “Postoperative Atrial Fibrillation After Cardiac Surgery”, Yasuhiko Imashuku, Susumu Hiraoka, Motoi Inoue, Takayoshi Mizuno, Misuzu Oyagi, Hirotoshi Kitagawa

Journal of the Saudi Heart Association

No abstract for this article type.

Postoperative Atrial Fibrillation After Cardiac Surgery, Mesut Engin, Abdulkerim Özkan, Abdurrahman Demirel

Journal of the Saudi Heart Association

No abstract for this article type.

Caffeine And Arrhythmias: A Critical Analysis Of Cardiovascular Responses And Arrhythmia Susceptibility, Adel Khalifa Sultan Hamad

Journal of the Saudi Heart Association

Caffeine is a frequently consumed stimulant in different foods and beverages: coffee, tea, chocolate, sodas, and energy drinks. While its effects on the cardiovascular system have been extensively studied, there remains controversy surrounding its potential risks, particularly in patients with heart disease. This review provides a complete overview of caffeine's pharmacological properties, sources, and cardiovascular effects, particularly emphasizing its arrhythmogenic potential. The proarrhythmic potential of caffeine, particularly on atrial fibrillation and ventricular arrhythmias, is conducted. It explains the mechanism of action, including adenosine receptor antagonism, phosphodiesterase inhibition, calcium mobilization, and catecholamine release of caffeine. Epidemiological evidence and mechanistic insights are …

Comparative Efficacy And Safety Of Transcatheter Versus Mitral-Valve Surgery In Elderly Patients With Mitral Regurgitation: A Systematic Review And Meta-Analysis, Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Sami Alsalem

Journal of the Saudi Heart Association

Objectives: Mitral valve surgery is the reference treatment for severe symptomatic mitral regurgitation (MR). Percutaneous mitral valve interventions, such as the MitraClip procedure, offer an alternative, particularly for high-risk patients. The aim of this systematic review and meta-analysis was to analyze the safety and effectiveness of transcatheter mitral valve repair (TMVR) compared to surgical mitral valve repair or replacement (SMVR) in elderly patients with mitral regurgitation. Methods: We searched PubMed, Scopus, Ovid, EBSCO, and ProQuest through July 2024. Eligible studies were randomized controlled trials and observational comparative studies of TMVR versus SMVR for patients with MR, reporting outcomes such as …