Cardiology Commons^™

Reply To The Letter-To-Editor On Article "Evaluation Of Left Ventricular Function In Coronary Artery Ectasia: The Added Value Of 2d Speckle-Tracking Echocardiography", Osama Elshaer

Journal of the Saudi Heart Association

No abstract provided.

Impella 5.5 Versus Heartmate 3 In Left Ventricular Unloading, Hannah Frederick, Douglas Tran, Erik Sorenson, H. Todd Massey, Albert Hicks, Manjula Ananthram, Bartley P. Griffith, Aakash Shah

The VAD Journal

The Impella 5.5 (Abiomed) is increasingly used as a bridge to durable left ventricular assist device (LVAD) implantation in advanced heart failure, yet most studies focus on survival and transition success rather than left ventricular (LV) unloading or valvular effects. This study addresses this gap by comparing Impella 5.5 and HeartMate 3 (HM3, Abbott) in terms of unloading and cardiac support at similar flow rates. We conducted a retrospective study of nine patients who received Impella 5.5 before HM3 implantation. The primary outcome was the degree of LV unloading, as assessed by changes in left ventricular end-diastolic diameter (LVEDD). There …

Safety And Feasibility During Early Implementation Of Robotic-Assisted Percutaneous Coronary Intervention, Dung Thuong Ho, Manh Cuong Nguyen, Tran Tran Nguyen, Long Tran, Huy Nguyen, Dil Mai, Tuong Mien Ngo, Duc Chinh Nguyen, Chi Cuong Tran, Khiem D. Ngo

School of Medicine Publications

Background: Robotic-assisted Percutaneous Coronary Intervention (R-PCI) is an advanced technique offering potential advantages for both patients and interventional cardiology practices. In 2023, Can Tho S.I.S General Hospital implemented its first robotic system for PCI procedures. This study aimed to evaluate the safety and clinical outcomes during the early learning curve of R-PCI.

Methods: This prospective study included all patients undergoing R-PCI with the CorPath GRX Vascular Robotic System at Can Tho S.I.S General Hospital from April to September 2023. Baseline patient characteristics, procedural details, and six-month follow-up data were collected. Primary outcomes included Clinical Success, defined as < 30% residual diameter stenosis in the target vessel without major adverse cardiovascular events (MACE) during hospitalization (e.g., death, myocardial infarction, target-vessel revascularization, stroke), and robotic success, defined as achieving clinical success with partial manual support or no manual support.

Results: Thirty-one patients …

Plasma Ca125 Levels As A Predictor Of Major Adverse Cardiac Events In Patients With Acute Coronary Syndrome: A Six-Month Follow-Up Study, Nazlı Dilek Çolak, Turgut Karabağ, Onuralp Çalışkan, Songül Tezcan

Journal of the Saudi Heart Association

Objectives: Carbohydrate antigen 125 (CA125) is associated with different cardiovascular conditions. This study aimed to determine CA125 levels in patients with acute coronary syndrome (ACS) and the potential relationship between major adverse cardiac events (MACE) in the short-term following.

Methods: This prospective cohort study was conducted in a coronary care unit between May and November 2022. Plasma CA125 levels were measured only once upon hospital admission. Patients were followed for six months. All-cause mortality, recurrent acute coronary syndrome, requirement for revascularization, decompensated heart failure, cardiogenic pulmonary edema, atrial fibrillation, and stroke were recorded as MACE.

Results: A total of 127 …

“From Compression To Closure: Efficacy And Safety Of Vascular Closure Devices (Vcd) Versus Manual Compression: A Comparative Analysis Of Hemostatic Strategies Of Obtura, Angioseal, And Proglide Vcd“, Praveen Shukla, Kumar Himanshu, Ali Mohammed, Mukesh Jitendra Jha, Santosh Kumar Sinha, Puneet Aggarwal, Mohammad Mahmodullah Razi, Mohit Sachan, Awadhesh Kumar Sharma, Umeshwar Pandey, Neeraj Prakash, Rakesh Kumar Verma

Journal of the Saudi Heart Association

Objective: Use of vascular closure devices (VCDs) for femoral artery puncture site hemostasis has increased but their safety and efficacy have remained unclear. This study was designed to compare safety and efficacy of Obtura, Angioseal, and Proglide VCD to manual compression (MC) and also between for femoral artery haemostasis.

Methods:This was prospective, randomized controlled study where patients were randomly assigned on 1:1:1:1 basis. Primary endpoints were time to hemostasis (TTH) and ambulation time (AT) while secondary endpoints were deployment success, device related adverse events and technical success rate. ANOVA and Tukey HSD was conducted to draw significant difference between …

Cancer Treatment Induced Skeletal Muscle Loss As A Predictor Of Late Cardiotoxicity In Aya: A Pilot Study, Savannah V. Rauschendorfer, Efstratios Koutroumpakis, Behrang Amini, Juhee Song, Michelle Hildebrandt, Anita Deswal Md Mph, J. Andrew Livingston, Michael Roth, Eugenie S. Kleinerman Md

Cancer Survivorship Research Retreat

No abstract provided.

Racing Against Time: Simultaneous Anterior And Inferior St-Elevation Myocardial Infarction Managed With The Nano-Crush Bifurcation Stenting Technique, Selim Süleyman Sert, Fatih Aksoy

Journal of the Saudi Heart Association

We present a rare case of simultaneous anterior and inferior ST-elevation myocardial infarction caused by the acute occlusion of both the right coronary artery and the left anterior descending artery. The culprit LAD lesion involved a true bifurcation, which was successfully treated using the nano-crush stenting technique, achieving complete reperfusion. This case highlights the feasibility of complex bifurcation intervention in a hemodynamically unstable patient with double-vessel STEMI. It underscores the importance of rapid diagnosis, aggressive revascularization, and appropriate stenting strategy in managing multivessel acute myocardial infarction.

Six-Year Outcomes After Transcatheter Vs Surgical Aortic Valve Replacement In Low-Risk Patients With Aortic Stenosis., John K Forrest, Steven J Yakubov, G Michael Deeb, Michael J Reardon

Heart and Vascular Articles

BACKGROUND: The Evolut Low Risk trial enrolled patients with severe aortic stenosis at low surgical risk. Annual follow-up is planned for 10 years, evaluating the composite of all-cause mortality or disabling stroke and key secondary endpoints.

OBJECTIVES: Our prespecified objective was to report the 6-year clinical outcomes of transcatheter aortic valve replacement (TAVR) vs surgery from the Evolut Low Risk trial. Given an increase in reintervention rates at 6 years, we performed additional analyses in available 7-year data.

METHODS: Low-risk patients with severe symptomatic aortic stenosis were randomized to TAVR or surgery from 2016-2019. Prespecified analyses at 6 years included …

Postdilation Of Evolut Transcatheter Heart Valves: Insights From Bench Testing., Ole De Backer, Ryan Stublaski, Hatem Tadros, Arif Khokhar, Gintautas Bieliauskas, Steven J Yakubov, Michael Deeb, Kendra J Grubb, John K Forrest, Michael J Reardon

Heart and Vascular Articles

No abstract provided.

Ruptured Sinus Of Valsalva Aneurysm In A Patient With Mixed Connective Tissue Disease: Case Report, Kenzo Adhi Wiranata, Pramadya Vardhani Mustafiza, Enrico Ananda Budiono

Journal of the Saudi Heart Association

Sinus of Valsalva aneurysm is a rare cardiac anomaly, affecting approximately 0.09% of the population. Its rupture represents a life-threatening event that can rapidly lead to heart failure. We report a 32-year-old woman with mixed connective tissue disease presenting with right-sided heart failure. Echocardiography demonstrated a ruptured right coronary cusp sinus of valsalva aneurysm into the right ventricle with moderate aortic regurgitation. Surgical repair was successfully performed, and histopathology supported an autoimmune-mediated etiology. To our knowledge, this is the first reported case of ruptured sinus of valsalva aneurysm occurring in a patient with autoimmune mixed connective tissue disease.

Anthracyclines And The Heart: A Double-Edged Sword With Therapeutic Hopes, Tariq Majed Alotaibi, Ahmad Mohammad Samman, Abdullah Abdulaziz Al Ghamdi,, Fisal Salah Alkhamis, Faisal Abdulaziz Alnuwaiser, Abdulrhman Bin Abdullah Alabdulgader, Ahmed Hamad Al Jazirri

Journal of the Saudi Heart Association

Background: Anthracyclines, notably doxorubicin, are potent cytotoxic agents that substantially improved outcomes across numerous malignancies. However, their use is restricted by their cardiotoxicity, a dose-dependent adverse effect that manifests acutely, during treatment, or years post-therapy. It encompasses a spectrum of phenotypes including asymptomatic ventricular dysfunction, heart failure, arrhythmias, and cardiomyopathy, contributing to considerable morbidity and mortality as cancer survival rates improve. Objective: This narrative review summarises current insights into anthracycline-induced cardiotoxicity pathophysiology and evaluates pharmacologic strategies for its prevention and management. Methods: A comprehensive literature search was conducted through August 2025, prioritizing randomised controlled trials, meta-analyses, observational studies, and guideline …

Unilateral Pulmonary Edema Following Minimally Invasive Valve Surgery Via Right Thoracotomy: A Word Of Caution, Arifi Aa, Ahmed Munir Metwaly, Fayez F. Al Mutairi, Bandar Zamzami, Islam Shalaby

Journal of the Saudi Heart Association

We report the first case of unilateral pulmonary edema (UPE) in our series of 150 patients undergoing minimally invasive mitral and tricuspid valve surgery via right thoracotomy. A 30-year-old female with rheumatic heart disease developed UPE requiring temporary extracorporeal membrane oxygenation (ECMO) support postoperatively. The patient recovered uneventfully and was discharged on postoperative day 15. This case underscores the importance of recognizing and mitigating UPE in minimally invasive cardiac surgery (MICS).

What Did We Learn About Vads In 2024-2025?, Maya Guglin

The VAD Journal

This is our 11th annual literature review on left ventricular assist devices (LVADs). Our previous reports were well received by readers.^1-10 In prior years, we also included other forms of mechanical circulatory support (MCS); however, this year, we present a separate review focused exclusively on temporary MCS.

In this article, we summarize the most interesting, from our standpoint, publications from 2024 and 2025, with some inclusion of late 2023 studies that were initially released online before print. For the first time, we provide an independent review on short-term MSC devices, including the intra-aortic balloon pump, Impella (Abiomed), and extracorporeal …

Cardiac Implantable Electronic Device Infections In Saudi Arabia: Incidence, Timing, Causative Organisms, And Outcomes – A Multicenter Study, Saad Albogami, Wael Alqarawi, Ahmed Alfagih, Hiatham Alenzi, Mohammad Alshehri, Mossab Aljuaid, Saeed Alqahtani, Norah Alswaidan, Mohammad Alharbi, Norah Alkaltham, Lama Alasmri, Rghd Sadkh, Muna Albashari, Nour Alhouda, Imad Tleyjeh

Journal of the Saudi Heart Association

Background: Cardiac implantable electronic devices (CIEDs) substantially improve outcomes in cardiac patients, but device-related infection can negate these benefits. Data on the epidemiology of CIED infections in Saudi Arabia are limited. Methods: We performed a multicenter retrospective cohort study of consecutive patients receiving CIEDs (pacemakers [PPM], implantable cardioverter-defibrillators [ICD], and cardiac resynchronization devices [CRT]) at three tertiary hospitals in Riyadh, Saudi Arabia, from January 2017 through December 2021. Patients were followed for at least one year post-implantation. Data collected included patient demographics, device type (new implant, replacement, revision), infection timing and microbiology, management (device extraction vs conservative treatment), and outcomes. …

Commentary On “Ultrasound Evaluation Of Left Ventricular Function In Coronary Artery Ectasia: The Added Value Of 2d Speckle-Tracking Echocardiography”, Eman Aslam, Maryam Amjad

Journal of the Saudi Heart Association

No abstract provided.

Two Faces Of Mitral Stenosis: Uncovering Structural And Hemodynamic Signatures Of Rheumatic And Mitral Annular Calcification-Induced Disease, Mohammad S. Hashemi, Peter Abdelmaseeh, Atif Nehvi, Gregg S. Pressman, Arash Kheradvar

Einstein Health Papers

BACKGROUND: Mitral annular calcification (MAC) is common and associated with increased cardiovascular risk and, when severe, mitral stenosis (MS). MAC-related MS differs anatomically and hemodynamically from rheumatic MS (RMS), challenging standard diagnostic methods. This study compares structural and flow characteristics, including  kinetic energy losses, across MAC-related MS, RMS, and normal mitral valves, and evaluates the applicability of conventional diagnostic metrics in MAC.

METHODS: Three-dimensional transesophageal echocardiographic data sets from 70 patients (22 normal mitral valves, 26 RMS valves, 22 MAC valves) were used to obtain linear, area, and volumetric measurements for valve comparison. Representative valves from each group were converted …

Exercise Performance In Ordinary Children And Adolescents: Baseline, Pandemic, And Post-Pandemic, Abby Skiena, Gina D'Aloisio, Ms, Takeshi Tsuda, Md

Alpha Omega Alpha Research Symposium Posters

Background: The COVID-19 pandemic might have created considerable negative impacts on the physical fitness of ordinary adolescents, which may pose a major threat to long-term cardiovascular health.

Methods: Healthy adolescents (ages 11 to 18) who underwent cardiopulmonary exercise testing (CPET) were grouped into baseline (~ 3/2020), pandemic (4/2020 ~12/2022), and post-pandemic (1/2023~ 5/2024) periods. Data are shown as mean ± standard deviation.

Results: Peak oxygen consumption (VO2/kg) and peak work rate (WR/kg) were significantly reduced during pandemic in both sexes and did not improve during post-pandemic in males (Table 1). The decline of peak oxygen pulse (OP/kg) …

Neck Circumference As A Novel Predictor Of Cardiovascular Risk Assessed Using Framingham And Prevent Equations, Stephen Garrova, Roshaan Gilani, Steven Muller, Jean Pierre Charpentier, Brian Fedgchin, Glenn Cooper, Cindy Cheng

Alpha Omega Alpha Research Symposium Posters

Purpose: While body mass index (BMI) and waist circumference (WC) are standard clinical tools for anthropometric cardiovascular risk assessment, they are limited by measurement variability and patient discomfort. Neck circumference (NC) may offer a novel, convenient, and accurate alternative anthropometric measure for assessment of cardiovascular risk.

Methods: Standardized anthropometric measurements (NC, WC, BMI) were obtained by trained medical students from eligible patients (n = 110, 68% female, 75% African American) from primary care and cardiology offices in an IRB-approved cohort study with retrospective chart review. Electronic medical record data extraction via double data entry was used to calculate cardiovascular …

Jefferson Heart Health (Jhh): A Successful Student-Delivered Motivational Interviewing Pilot Program To Lower Cardiovascular Disease (Cvd) Risk, Nicholas Tomasko, Bs, Cindy Cheng, Md, Phd, Rafael Hernandez, Bs, Alessandra Sapon, Bs

Alpha Omega Alpha Research Symposium Posters

Purpose: The Jefferson Heart Health (JHH) program utilizes student health coaching by trained undergraduate and medical students supporting patients to sustain lifestyle changes and subsequently determine: how can we effectively educate patients by improving adherence to lifestyle recommendations? Also, what is the effectiveness of student-delivered health coaching for reducing patient cardiovascular risk? With our unique student-delivered program, we promote cost-effective lifestyle interventions for lowering overall cardiovascular disease (CVD) burden.

Methods: We successfully completed a four-week pilot with consistent patient attendance. Certified student JHH coaches, supervised by the certified obesity-management specialist and principal investigator, met weekly with 23 patients: 82.6% female/17.4% …

Elucidating The Binding Site Of The Arrestin-Biased Agonist Icl1-20, Kesara Wein, Roger Armen, Jeffrey L. Benovic, Charles P. Scott

Alpha Omega Alpha Research Symposium Posters

Background and Purpose: 6.7 million Americans live with congestive heart failure (CHF). In CHF, catecholamines are released into cardiac tissue, bind β-adrenergic receptors (βARs), and activate G-protein signaling cascades, causing ischemia and apoptosis. Accordingly, β-blockers are used to antagonize catecholamine binding to βARs and suppress apoptotic downstream effects. However, β-blockers have dose-limiting hypotension, bradycardia and fail to stimulate the cardioprotective β-arrestin signaling pathway. These limits create opportunities for the development of drugs that selectively stimulate β-arrestin signaling while suppressing cardiotoxic G protein signaling. We have previously reported a biased agonist of the β-arrestin pathway (ICL1-20) that selectively stimulates β-arrestin recruitment …