Publications by authors named "Fehri W"

Background: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease of undetermined etiology. Cardiac involvement is common in SLE and constitutes one of the main causes of mortality. More recently, new ultrasound imaging techniques, such as transthoracic ultrasound (TTE) with strain evaluation, have appeared and seem promising for the detection of cardiac involvement.

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Background: In Tunisia, the number of cardiac implantable electronic devices (CIEDs) is increasing, owing to the increase in patient life expectancy and expanding indications. Despite their life-saving potential and a significant reduction in population morbidity and mortality, their increased numbers have been associated with the development of multiple early and late complications related to vascular access, pockets, leads, or patient characteristics.

Objective: The study aims to identify the rate, type, and predictors of complications occurring within the first year after CIED implantation.

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Research Problem: Hypertension is a multifactorial disease that affects approximately one third of the Tunisian adult population. It is a major risk factor for stroke and cardiovascular disease. Environmental and psychosocial factors play an important role in hypertension onset and control.

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Aims: Access to echocardiography is a significant barrier to heart failure (HF) care in many low- and middle-income countries. In this study, we hypothesized that an artificial intelligence (AI)-enhanced point-of-care ultrasound (POCUS) device could enable the detection of cardiac dysfunction by nurses in Tunisia.

Methods And Results: This CUMIN study was a prospective feasibility pilot assessing the diagnostic accuracy of home-based AI-POCUS for HF conducted by novice nurses compared with conventional clinic-based transthoracic echocardiography (TTE).

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Introduction: The conventional radial approach (CRA), the gold standard approach for percutaneous coronary interventions (PCI), is associated with the risk of radial artery occlusion (RAO). The distal radial approach (DRA) is an effective alternative with fewer complications.

Aim: To evaluate the efficacy in terms of puncture success and safety by RAO rate of the DRA in elective PCI in Tunisian patients.

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Introduction: Simulation-based education (SE) in interventional cardiology improves knowledge acquisition and mastery of procedures including the conventional radial access (CRA).

Aim: To evaluate the contribution of SE in CRA compared with theoretical learning alone.

Methods: This is a prospective randomized controlled study including cardiology residents and patients with normal radial pulses.

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Background: Children with sickle cell anemia (SCA) are at an increased risk of cardiovascular complications. The aim of this study was to assess the role of speckle tracking echocardiography in detecting subclinical myocardial damage in children with SCA.

Methods: A cross-sectional case-control study was conducted at the echocardiography laboratory of the military hospital of Tunis between July and December 2018.

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Background: Retained foreign bodies are dreadful events associated with invasive procedures. Their occurrence implicate physical complications as well as serious professional and medico-legal consequences. Cases of retained surgical items, in the pericardial space, following cardiothoracic surgery are rare and their management is delicate as the risks of their removal must be thoroughly weighed against the complications of leaving them inside the chest.

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Background: This study was designed to evaluate the care of hypertensive patients in daily clinical practice in public and private centers in all Tunisian regions.

Objective: This study will provide us an overview of hypertension (HTN) management in Tunisia and the degree of adherence of practitioners to international recommendations.

Methods: This is a national observational cross-sectional multicenter study that will include patients older than 18 years with HTN for a duration of 4 weeks, managed in the public sector from primary and secondary care centers as well as patients managed in the private sector.

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Article Synopsis
  • The study aims to compare the safety and effectiveness of the newly proposed distal radial approach for vascular access in percutaneous coronary interventions against the conventional radial approach, particularly in North African patients.
  • It will be a non-inferiority, randomized controlled trial involving 250 patients, focusing on key outcomes such as success rates and radial artery occlusion risks, with a follow-up period of 30 days.
  • The trial is set to run for four months starting February 2022 and emphasizes ethical considerations while seeking to enhance clinical practices based on the findings.
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Background: Coronary artery diseases remain the leading cause of death in the world. The management of this condition has improved remarkably in the recent years owing to the development of new technical tools and multicentric registries.

Objective: The aim of this study is to investigate the in-hospital and 1-year clinical outcomes of patients treated with percutaneous coronary intervention (PCI) in Tunisia.

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Background: Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control.

Methods: Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study.

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Background: Right ventricular (RV) dysfunction is a strong predictor of poor outcomes of patients with mitral stenosis (MS). The aim of this study was to detect a subclinical right ventricular dysfunction in patients with MS.

Methods: We conducted a prospective study from January 2015 to June 2019 in 104 asymptomatic patients with MS (mean age: 46.

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Research Problem: Drug-eluting balloon (DEB) angioplasty is a well-established treatment modality for in-stent restenosis, however its safety and efficacy in de-novo lesion especially in large vessel remains undetermined. Theoretically, DEB sight to eliminate stent thrombosis and reduce restenosis rates by leaving no metal behind.

Aim: To compare the results of angioplasty of de novo lesions by DEB (SEQUENT PLEASE) versus DES (Promus Premier and Promus Elite) in a Tunisian population.

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Introduction: Systemic hypertension is a major health problem worldwide, it is associated with impaired left atrial (LA) function. Myocardial deformation analysis using speckle-tracking echocardiography has emerged as a promising tool to evaluate atrial deformation and function.

Aim: To evaluate early changes in left atrial longitudinal strain based on speckle tracking echocardiography in patients with hypertension.

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Hydatid disease remains an important public health problem in endemic areas. We report a rare case of intramyocardial hydatid cyst of the right atrium along with a pulmonary hydatid cyst in a 16-year-old girl who was admitted to our hospital because of chest pain with recurrent episodes of fainting. One-stage surgery by median sternotomy under cardiopulmonary bypass was performed with excision of the hydatid cyst in the right atrium followed by the removal of the pulmonary hydatid cyst in the same session.

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Objective: prosthetic valve endocarditis is a rare but a life-threatening complication of brucellosis. It remains a diagnostic challenge. Optimal treatment of prosthetic valve endocarditis is debated.

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Introduction: Gemcitabine is a commonly used antimetabolite that has been effective in a broad spec- trum of tumors so far. The main grade three and four known toxicity of this drug is myelosuppres- sion. Cardiac adverse events have been rarely reported and gemcitabine-induced Atrial-Fibrillation (AF) has been described in only five previous cases so far.

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Congenital analbuminemia (CAA) is a very rare disorder with an estimated prevalence of less than one in one million. This anomaly can be lethal at birth and in early infancy but it's not very symptomatic in adulthood. The clinical signs are edema, lipodystrophy, fatigue… Hypercholesterolemia is the main biological disorder and it predisposes to cardiovascular complications.

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Article Synopsis
  • * The study found a 1-year all-cause mortality rate of 22.8% for acute heart failure (AHF) patients and 10.6% for CHF patients, with various factors like age and diabetes influencing these rates.
  • * Results indicated that AHF has a poor prognosis, while outcomes for CHF patients are improving, highlighting potential variations based on different healthcare systems and patient characteristics.
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Coronary artery aneurysms are uncommon, are usually associated with atherosclerosis, and rarely involve all three major coronary arteries. Data on the optimal choice of acute myocardial infarction (AMI)´s revascularization in the context of polyarteritis nodosa (PAN) is limited to case reports and is still an open question. The present report describes a rare case of a young male patient followed for PAN presenting with acute myocardial infarction (AMI).

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Article Synopsis
  • * The study included 915 patients, primarily middle-aged, where about 22.4% were found to have valvular AF, and only half of the patients with low embolic risk were prescribed oral anticoagulants.
  • * Findings highlighted that the management strategies for AF in Tunisia were inadequate, with concerns over low anticoagulation quality, as evidenced by a 1.64% thromboembolism rate and a notable number of patients not receiving proper antithrom
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Coronary artery disease is an inflammatory disease. Systemic markers of inflammation such as Interleukin-6, Tumor Necrosis Factor alpha and C-reactive protein have previously been shown to be associated with increased risk of cardiovascular events. The aim of the present study is to assess the role of variants in the IL-6 (- 174 G/C), TNFα (- 308 A/G) and CRP (+ 1059G/C) genes as susceptibility markers for CAD in a Tunisian population.

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