Cardiology Commons^™

Nanoparticle-Mediated Drug Delivery For The Treatment Of Cardiovascular Diseases, Rajasekharreddy Pala, Vt Anju, Madhu Dyavaiah, Siddhardha Busi, Surya M. Nauli

Pharmacy Faculty Articles and Research

Cardiovascular diseases (CVDs) are one of the foremost causes of high morbidity and mortality globally. Preventive, diagnostic, and treatment measures available for CVDs are not very useful, which demands promising alternative methods. Nanoscience and nanotechnology open a new window in the area of CVDs with an opportunity to achieve effective treatment, better prognosis, and less adverse effects on non-target tissues. The application of nanoparticles and nanocarriers in the area of cardiology has gathered much attention due to the properties such as passive and active targeting to the cardiac tissues, improved target specificity, and sensitivity. It has reported that more than …

Progress In The Seasonal Variations Of Blood Lipids: A Mini-Review., Xiaochun Ma, Haichen Yan, Haizhou Zhang, Mansen Wang, Qunye Zhang, Xiaoming Zhou

Articles, Abstracts, and Reports

The seasonal variations of blood lipids have recently gained increasing interest in this field of lipid metabolism. Elucidating the seasonal patterns of blood lipids is particularly helpful for the prevention and treatment of cardiovascular and cerebrovascular diseases. However, the previous results remain controversial and the underlying mechanisms are still unclear. This mini-review is focused on summarizing the literature relevant to the seasonal variability of blood lipid parameters, as well as on discussing its significance in clinical diagnoses and management decisions.

Regulation Of Myofilament Contractile Function In Human Donor And Failing Hearts, Kerry S. Mcdonald, Laurin M. Hanft, Joel C. Robinett, Maya Guglin, Kenneth S. Campbell

Internal Medicine Faculty Publications

Heart failure (HF) often includes changes in myocardial contractile function. This study addressed the myofibrillar basis for contractile dysfunction in failing human myocardium. Regulation of contractile properties was measured in cardiac myocyte preparations isolated from frozen, left ventricular mid-wall biopsies of donor (n = 7) and failing human hearts (n = 8). Permeabilized cardiac myocyte preparations were attached between a force transducer and a position motor, and both the Ca²⁺ dependence and sarcomere length (SL) dependence of force, rate of force, loaded shortening, and power output were measured at 15 ± 1°C. The myocyte preparation size was …

Cardiac Screening To Mitigate The Risk Of Sudden Cardiac Death In Middle Eastern And African Competitive Athletes. A Systematic Review, Yusuf Hallak, Umberto Battistin, Ahmad Mustafa Al-Masaeed

Journal of the Saudi Heart Association

Objective: The study aims to review the literature regarding abnormalities predisposing to Sudden Cardiac Death (SCD) in young Middle Eastern and African competitive athletes between the years 2009e2019 and aims to assess cardiac pre-participation screening methods.

Methods: A PubMed search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search targeted articles that reported the prevalence of cardiac abnormalities found in Middle Eastern and African athletes, and it also focused on comparing cardiac screening methods for assessment of athletes. Results: our studies fell within the inclusion criteria and were included in the …

The Carpentier-Edwards Classic And Physio Annuloplasty Rings In Repair Of Degenerative Mitral Valve Disease: A Retrospective Study, Abubakari I. Sidiki Md, Alexandr G. Faybushevich Md, Phd, Alexandr N. Lishchuk Md, Phd, Alexandr N. Koltunov Md, Phd, Ekaterina A. Roshchina, Jonas Atulebire Akambase

Journal of the Saudi Heart Association

Objectives. Physio ring (SR) is considered an improved version of the Classic rigid ring (RR). Today, SR is more widely used in mitral valve (MV) repair. We sought to compare the long-term outcomes of repair with RR and SR in degenerative mitral valve disease.

Methods. In a computerized registry of our institution, 306 patients had MV repair with either RR (139 patients) or SR (167 patients) ring between 2005 and 2015. Fifteen of them had concomitant tricuspid valve repair. Ninety-two (30.1%) had Barlow’s disease and 214 (69.9%) had fibroelastic deficiency. The patients had similar demographic and echocardiographic characteristics. …

Tricuspid Valve Regurgitation After Heart Transplantation: A Single-Center 10-Year Experience, Khaled D. Algarni, Amr A. Arafat, Claudio Pragliola, Yahya S. Alhebaishi, Latifa A. Alfayez, Khaled Alotaibi, Abeer M. Bakhsh, Ahmed A. Amro, Adam I. Adam

Journal of the Saudi Heart Association

Background: Tricuspid valve regurgitation may affect the outcomes after heart transplantation. There is a paucity of data reporting the outcomes of heart transplants in our region. The objectives of this study were to report the occurrence of tricuspid regurgitation after heart transplantation, its course, and its effect on survival.

Methods: From 2009 to 2019, 30 patients had heart transplantation at our cardiac center. Their age was 36.73± 13.5 years, and 25 (83.33%) were males. Indications for transplantation were dilated cardiomyopathy (n= 21; 72.41%), ischemic cardiomyopathy (n= 8; 26.67%) and hypertrophic cardiomyopathy (n=1; 3.45%). Cardiopulmonary bypass time was 157.24± 34.6 minutes, …

The Trans-Septal Approach In Transcatheter Mitral Valve-In-Valve Implantation For Degenerative Bioprosthesis, Mohammed Al Otaiby, Turki A. Al Garni, Abdullah Alkhushail, Abdulrahman Almoghairi, Sondos Samargandy, Monirah Albabtain, Amr A. Arafat, Hussein Alamri

Journal of the Saudi Heart Association

Background: Transcatheter Mitral Valve-in-Valve Implantation (TMViVI) has recently emerged as a novel therapy for degenerated mitral valve bioprosthesis. Re-operative mitral valve surgery is associated with a substantial risk of mortality and morbidity. The objective of this study was to describe the outcomes of transcatheter mitral valve-in-valve implantations in our cardiac center.

Methods: Twenty-two patients underwent the valve-in-valve procedure because of bioprosthesis degeneration from March 2017 to October 2018. Clinical, echocardiographic, procedural details and survival at follow up were assessed.

Results: Eight patients refused re-operative cardiac surgery while others were deemed a high risk for conventional re-operative sternotomy. All patients had …

Aortopulmonary Window: Types, Associated Cardiovascular Anomalies, And Surgical Outcome. Retrospective Analysis Of A Single Center Experience, Mohammed Bin-Moallim, Hussam K. Hamadah, Fahad Alhabshan, Abdullah A. Alghamdi, Mohamed S. Kabbani

Journal of the Saudi Heart Association

Objective: Aortopulmonary window (APW) is a rare congenital heart defect. It occurs as an isolated cardiac lesion or in association with other cardiac anomalies and rarely with abnormal coronary arteries. The spectrum of cardiovascular anomalies associated with APW and overall management and outcome in the current era were reviewed.

Methods: Between 2001 and 2018, all patients diagnosed with APW were included. Based on associated cardiovascular anomalies, those patients were divided into 2 groups: simple APW group and complex APW group (APW with asso- ciated other cardiovascular anomalies). All cases were followed longitudinally. The outcomes are described.

Result: Twenty patients underwent …

Cardiac Catheterisation Interventions In Neonates And Infants Less Than Three Months, Ali A. Alakhfash, Ali Jelly, Abdulrahman Almesned, Abdullah Alqwaiee, Mansour Almutairi, Sherif Salah, Mahmoud Hasan, Mustafa Almuhaya, Abdulhamid Alnajjar, Mohammed Mofeed, Bana Nasser

Journal of the Saudi Heart Association

Introduction: Pediatric cardiac catheterization interventions become an established way of care for selected patients with congenital heart diseases. Cardiac catheterization for neonates and small infants can be challenging. The indications for diagnostic cardiac catheterization have decreased with the advent of advanced non-invasive imaging modalities.

Patients and method: Between June 2012 and July 2017 patients less than three months who had cardiac catheterization in two centers were reviewed

Results: During the study period, 174 patients underwent interventional cardiac catheterization,83.3% of them had CHD with two-ventricle circulation and 29 patients (16.7%) had single ventricle pathophysiology. Procedures include diagnostic cath, BAS, balloon pulmonary …

A New Scoring System Detecting The Supraventricular Tachycardia Inducibility And Radiofrequency Ablation With High Specificity In Electrophysiological Study, Savas Ozer, Mustafa Çetin, Ali Gokhan Ozyildiz, Ramazan Gengorü, Oguzhan Ekrem Turan, Meltem Pusuroglu, Bülent Bahçeci, Turan Erdogan

Journal of the Saudi Heart Association

Aim: The relationship between arrhythmia induction and ablation with palpitation characteristics has been demonstrated in electrophysiological study (EPS) patients. However, there is insufficient data on palpitation characteristics and their sensitivity and specificity. We aimed to identify the relationship between scoring composed of palpitation characteristics with the supraventricular tachycardia (SVT) induction and the success rate of the procedure.

Method: A total of 119 patients, diagnosed as paroxysmal supraventricular tachycardia (PSVT) by electrocardiography, rhythm Holter or symptoms, and underwent EPS, were enrolled in the study. A psychiatrist administered the Hospital Anxiety and Depression Score (HADS) questionnaire.

Results: In SVT induced group, palpitation …

Pacemaker Detected Prolonged Atrial High Rate Episodes – Incidence, Predictors And Implications; A Retrospective Observational Study, Pratheesh George Mathen, David Chase

Journal of the Saudi Heart Association

Introduction: Atrial tachyarrhythmias especially atrial fibrillation are the most commonly encountered arrhythmias in clinical practice. Most atrial tachyarrhythmia episodes are subclinical. Cardiac implantable electronic devices with atrial sensing function enable detection of atrial tachyarrhythmias through means of atrial high rate event algorithms. Prolonged atrial high rate episodes(AHRE) above a defined rate and duration threshold represent episodes of atrial fibrillation, atrial flutter, and longer atrial tachycardias that correlate strongly with risk for thromboembolic events.

Objective: 1. To examine the occurrence of prolonged AHRE in dual-chamber pacemaker recipients over the study period. 2. To examine the factors which influence the occurrence of …

Comparison Of The Effects Of Ticagrelor And Clopidogrel On Heart Rate Variability And Heart Rate Turbulence In Patients With Percutaneous Coronary Interventions, Pinar Yagcioglu, Selma Ari, Hasan Ari, Mehmet Melek

Journal of the Saudi Heart Association

Introduction: Clopidogrel and ticagrelor are commonly used, antiplatelet agents. Ticagrelor has an effect of enhancing the plasma level of adenosine that may alter the autonomic function. The aim of this study is to compare the effects of ticagrelor and clopidogrel on heart rate variability (HRV) and heart rate turbulence (HRT).

Methods: Thirty subjects who performed percutaneous coronary intervention (PCI) were included in the randomized, crossover study. These patients were divided into two groups. Clopidogrel or ticagrelor was administered in two different testing sessions (1-month treatment for each session). In group 1, clopidogrel and ticagrelor treatment were used while in group …

Delayed Repair Of Aortic Dissection In Sickle Cell Anaemia As A Combined Cardiac And Vascular Surgical Approach, Massimo Capoccia, Maziar Mireskandari, Nicholas J. Cheshire, Ulrich P. Rosendahl

Journal of the Saudi Heart Association

We discuss a patient who presented with a type B aortic dissection with a retrograde progression in the context of sickle cell anaemia. Given the involvement of the superior mesenteric artery and concern for bowel ischaemia, a delayed approach was considered. Subsequently, a frozen elephant trunk was performed in the hybrid theatre with the back-up of the vascular surgeon for mesenteric protection. A technically demanding procedure followed by a prolonged and challenging postoperative course finally led to a successful outcome. We argue that the case presented is an example of how a close cooperation between professionals can offer additional options …

Ultraslow Thrombolytic Therapy In Stuck Mechanical Aortic Valve, Case Report, And Review Of The Literature, Hesham Abdo Naeim, Osama Amoudi, Amjad Karam, Abeer Mahmood, Ahmed Albagi, Ibraheem Alharbi, Reda Abuelatta

Journal of the Saudi Heart Association

Background: Stuck mechanical heart valves had a debate about the management plan. There is debate regarding the type, dose, and rate of administration of various thrombolytic agents. We report a case with successful thrombolysis using an ultraslow regimen.

Case summary: A 43-year-old female with a history of aortic valve (AV) and mitral valve replacement (bi-leaflet metallic valves), and tricuspid valve repair (MINI band) at 10/2017. Physical examination showed normal metallic first heart sound and weak metallic second heart sound. Laboratory investigations were normal except low INR, hematocrit, and hemoglobin level ( 9gm/L due to iron deficiency anemia). Transthoracic echocardiogram (TTE) …

Chylothorax After Coronary Artery Bypass Surgery. Report Of A Case And Review Of The Literature, Imran Khan, Zahid M. Khan, Abdelbasset El Refy, Ahmad Mahmood El Badry, Tarig Faisal Babiker

Journal of the Saudi Heart Association

Chylothorax after coronary artery bypass grafting is a rare complication and leads to increased mortality and morbidity. Because of the rarity of this complication, its management is debatable. We present the case of a 41 years old male patient who had a left sided chylothorax after coronary artery bypass grafting. The patient was managed conservatively with low fat diet and drainage of the chylothorax. A thorough search of the literature published on the subject was done and treatment strategies employed by various authors were studied. Various treatment options are conservative management with chest tube drainage, octreotide and low-fat diet or …

Removal Of Unusual Multiple Aortic Valve Fibroelastoma Using Right Mini-Thoracotomy, Muhammed Tamim Tamim, Marwan Sadek, Khaled Al-Faraidy, Donya Al-Hassan

Journal of the Saudi Heart Association

Papillary Fibroelastomas are rare, primary cardiac tumors. They are typically diagnosed as an incidental finding but can also present as thrombo-embolic events. We present the case of 78-years- old man who presented to emergency room with a cerebrovascular event (CVE). Transesophageal echocardiography (TEE) revealed e presence of a mass on the aortic valve. Intra-operatively, two masses where found: one was highly mobile attached to left ventricular (LV) side of the left coronary cusp, another small size mass attached to the non-coronary cusp, and there was suspicion of a mass attached to the mitral valve. The two masses were surgically excised …

Myocardial Infarction Caused By An Enclosed Thrombus In A Patent Foramen Ovale, Meriem Boumaaz, Iliyasse Asfalou, Amine Hamami, Maha Raissouni, Zouhair Lakhal, Aatif Benyass

Journal of the Saudi Heart Association

Paradoxical embolism in coronary artery is a rarely diagnosed clinical entity. In the majority of reported cases; the diagnostic of this pathology is « presumptive » based on certain criteria. It can be considered “proven” when the embolus is found lodged in the abnormal communication between the venous and arterial circulation; which is very rare. We herein report a case of myocardial infarction caused by a proven paradoxical coronary embolism through a patent foramen ovale. The authors highlight through this paper the contribution of echocardiography and particularly transesophageal echocardiography, especially if performed soon after presentation, for early diagnosis.

Massive Hemoptysis And Recurrent Infective Endocarditis In Intravenous Drug User: A Case Report, Mutlaq Almutairi, Yasser Ahmed El-Ghoneimy, Abdulaziz Omar Alghamdi, Hashem Abdulkarim Alkhamis, Ziyad Abdulmohsen Altayyar, Khalid Mohsen Houbani

Journal of the Saudi Heart Association

Intravenous drug use (IDU) poses a high risk of serious complications such as infective endocarditis (IE), which carries high morbidity and mortality rates. Mycotic pulmonary artery aneurysms (MPAA) are rarely associated with right-sided IE, especially in the setting of IDU. It is a potentially fatal complication as it can lead to severe hemorrhage if the aneurysm ruptures. We report the case of a young male with a history of current IDU and tricuspid valve replacement post complicated IE 2 years ago. The patient initially presented with massive hemoptysis and fever. Chest computed tomography (CT) showed a lobulated lesion in the …

Cardiac Surgery Services During The Covid-19 Outbreak: Surgeons’ Thoughts, Ahmed Arifi, Abdullah A. Alghamdi

Journal of the Saudi Heart Association

Cardiac surgeons during this pandemic crisis have a responsibility to ensure that essential elective cardiac operations are provided at their centers to the public, at the same time, they have to face administrative as well as the infection prevention guidelines and restrictions to protect themselves and their patients. Here, we describe the patient and procedures characteristics that we recommend to protect our patients and the healthcare workers.

Microrna-148a Regulates Low-Density Lipoprotein Metabolism By Repressing The (Pro)Renin Receptor, Na Wang, Lishu He, Hui Lin, Lunbo Tan, Yuan Sun, Xiaoying Zhang, A. H. Jan Danser, Hong S. Lu, Yongcheng He, Xifeng Lu

Saha Cardiovascular Research Center Faculty Publications

High plasma LDL cholesterol (LDL-c) concentration is a major risk factor for atherosclerosis. Hepatic LDL receptor (LDLR) regulates LDL metabolism, and thereby plasma LDL-c concentration. Recently, we have identified the (pro)renin receptor [(P)RR] as a novel regulator of LDL metabolism, which regulates LDLR degradation and hence its protein abundance and activity. In silico analysis suggests that the (P)RR is a target of miR-148a. In this study we determined whether miR-148a could regulate LDL metabolism by regulating (P)RR expression in HepG2 and Huh7 cells. We found that miR-148a suppressed (P)RR expression by binding to the 3’-untranslated regions (3’-UTR) of the (P)RR …

Saudi Arabian Society Of Echocardiography Recommendations For Echocardiography Service During Corona Virus Disease 2019 (Covid-19) Outbreak, Sami Ghazal, Fatima Qaddoura, Abdulhalim Kinsara Kinsara, Ahmed Omran, Merna Atiyah, Mustafa Al Refae, Faisal Dalak, Saeed Al Ahmari, Abdullah Al Sehly, Noureldin Sahal, Ahmed Onazi, Rima Bader

Journal of the Saudi Heart Association

We are summarizing the recommendations for the use of Echocardiography in patients during COVID-19 pandemic. The patient risk for COVID-19 should be assessed according to the Saudi CDC guidelines. Echocardiography should only be performed of considered appropriate and will likely alter the clinical decision. In COVID-19 suspected/ confirmed patients, echocardiography study should be performed bedside and in infection control approved area with airborne precaution. Limited focused imaging is recommended to minimize contact time. A dedicated machine for COVID-19 suspected/confirmed cases is recommended. Transesophageal echocardiography is considered an aerosol generating procedure; therefore, an alternative modality should be strongly considered. In COVID-19 …

Challenges And Special Aspects Of Pulmonary Hypertension In Middle- To Low-Income Regions: Jacc State-Of-The-Art Review, Babar Hasan, Georg Hansmann, Werner Budts, Alexandra Heath, Zahra Hoodbhoy, Zhi-Cheng Jing, Martin Koestenberger, Katharina Meinel, Ana Olga Mocumbi, Ganna D. Radchenko

Department of Paediatrics and Child Health

Challenges and special aspects related to the management and prognosis of pulmonary hypertension (PH) in middle- to low-income regions (MLIRs) range from late presentation to comorbidities, lack of resources and expertise, cost, and rare options of lung transplantation. Expert consensus recommendations addressing the specific challenges for prevention and therapy of PH in MLIRs with limited resources have been lacking. To date, 6 MLIR-PH registries containing mostly adult patients with PH exist. Importantly, the global prevalence of PH is much higher in MLIRs compared with high-income regions: group 2 PH (left heart disease), pulmonary arterial hypertension associated with unrepaired congenital heart …

The Impact Of Covid-19 Pandemic On The Hospital Management Of Tavi Patients: Tavi Team Thoughts And Recommendation, Mohamed Balgaith, Ahmed Arifi, Dalia Ahmed, A. Mounir Metwally

Journal of the Saudi Heart Association

The COVID-19 Pandemic has put enormous pressure on the healthcare system globally, causing many healthcare organizations all over the world to cancel or stop elective procedures in their cardiac catheterization Labs. This delay in the elective procedures with no doubt has led to a suspension of patient care primarily to those with severe aortic stenosis, which might place them at higher risk for cardiovascular complications like sudden death and heart failure.

Health Care Worker (HCW) faced with the uncertainty of contracting infections while performing procedures in patients with a confirmed diagnosis of COVID-19 or suspected cases. This unprecedented situation is …

Non-Invasive Cardiac Imaging During The Coronavirus Disease 2019 (Covid-19) Pandemic: A Statement From The Cardiac Imaging Working Group Of The Saudi Heart Association, Yasmin Hanfi, Mirvat Alasnag, Halia Alsherhi, Ahmed Alsaileek, Abdulaziz Alghamdi, Abdullah Al Sehly, Adel Sallam, Ahmed Aljizeeri

Journal of the Saudi Heart Association

COVID-19 pandemic has led to major changes in the delivery of medical care around the globe. Many investigations and elective procedures had to be rescheduled to decrease the risk of spreading the infection. Non-invasive cardiac imaging studies are requested to guide appropriate cardiac care in a variety of urgent, semi-urgent, and elective procedures. This position statement of the Cardiac Imaging Working Group of the Saudi Heart Association provides guidance into the protection of healthcare personnel, assessment of the indications of the imaging studies, and highlights consideration before, during, and after the study.

Cumulative Burden Of Financial Hardship From Medical Bills Across The Spectrum Of Diabetes Mellitus And Atherosclerotic Cardiovascular Disease Among Non-Elderly Adults In The United States, Reed Mszar, Gowtham R. Grandhi, Javier Valero-Elizondo, César Caraballo, Rohan Khera, Nihar Desai, Salim S. Virani, Ron Blankstein, Michael J. Blaha, Khurram Nasir

Office of the Provost

Background: Atherosclerotic cardiovascular disease (ASCVD) has a strong association with diabetes mellitus (DM), accounting for approximately two thirds of deaths in this patient population. Many individuals with ASCVD and DM are vulnerable to financial hardship associated with treatment‐related expenses. Therefore, we examined the burden of financial hardship from medical bills across the spectrum of ASCVD status with and without DM.
Methods and Results: Using data from the National Health Interview Survey from 2013 to 2017, we used logistic regression analysis to examine the association of ASCVD and DM status with financial hardship and an inability to pay medical bills from …

Isolated Polymorphic Ventricular Tachycardia: An Unusual Presentation Of Acute Myocarditis, Natalie S. Shwaish

Research Days

No abstract provided.

Simulating A Novel Angioplasty Technique On A 3d Printed Model​, Sarah Studyvin, Bethany Runkel

Research Days

No abstract provided.

Unusual Echocardiographic Findings Of Myocarditis Mimicking An Aortic Run-Off Lesion, Sarah Studyvin, Barbara A. Pahud, Christine Symes

Research Days

No abstract provided.

Heart Rate Recovery Following Exercise Testing In Pediatric Patients With Acyanotic Repaired Congenital Heart Disease, Natalie S. Shwaish

Research Days

No abstract provided.

Atrioventricular Nodal Reentrant Tachycardia In Patients With Complex Congenital Heart Disease And Twin Atrioventricular Nodes., John Papagiannis, Christopher Mathis, Lindsey Malloy-Walton, Svjetlana Tisma-Dupanovic

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.