Publications by authors named "Ouali Sana"
Little is known about the effects of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on atherosclerosis. We aimed to determine if a 90-day intake of Dapagliflozin could improve atherosclerosis biomarkers (namely endothelial function assessed by flow-mediated dilatation [FMD] and carotid intima-media thickness [CIMT]) in diabetic and non-diabetic acute coronary syndrome (ACS) patients when initiated in the early in-hospital phase. ATH-SGLT2i was a prospective, single-center, observational trial that included 113 SGLT2i naive patients who were admitted for ACS and who were prescribed Dapagliflozin at a fixed dose of 10 mg during their hospital stay for either type 2 diabetes or for heart failure.
View Article and Find Full Text PDFBackground: 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.
During the month of Ramadan, over one billion Muslims observe a water and food fast from sunrise to sunset. The practice of this religious duty causes marked changes in eating and sleeping habits. With the increasing incidence of cardiovascular (CV) risk factors, the number of patients with CV pathologies who wish to fast is increasing worldwide, and in Tunisia, which is ranked as a high CV risk country.
View Article and Find Full Text PDFBackground: 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.
Aim: To determine the prevalence of carotid atheroma in hypertensive patients and assess the levels of cardiovascular risk.
Methods: This is a prospective study that took place in the outpatient department of the National Cardiology Center of Nouakchott over a period of 6 months (October 2019 to March 2020). Patients with hypertension without complications were included.
Introduction: New-onset AF atrial fibrillation (NOAF) frequently complicates acute coronary syndromes (ACS) leading to adverse outcomes in the short and long term. The prevalence of NOAF in patients hospitalized for ACS is variably reported and ranges between 2 and 37%. Several predictor factors have been implicated in the literature but remain a subject of controversy.
View Article and Find Full Text PDFBackground: 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.
Article Synopsis
- The prevalence of heart failure (HF) is increasing in Tunisia, largely due to an aging population and rising rates of coronary artery disease and hypertension, yet there's limited data on patient demographics and care quality.
- The study aims to create the National Tunisian Registry of Heart Failure (NATURE-HF) by analyzing and following 1700 patients over a year, with assessments at 1, 3, and 12 months.
- Results will include tracking cardiovascular and overall mortality, hospital readmissions, and various clinical evaluations and treatment outcomes to gain insights into the management of HF in Tunisia.
Background: This study investigated the association of angiotensin-converting enzyme (ACE I/D) and aldosterone synthase (CYP11B2-344C/T) gene polymorphisms in the renin-angiotensin-aldosterone system (RAAS) with atrial fibrillation (AF) in the Tunisian population.
Materials And Methods: The study population included 120 patients with AF and 123 age-matched controls. Genotyping of the I/D polymorphism in the ACE gene and the -344C/T polymorphism in the CYP11B2 gene was performed by polymerase chain reaction (PCR) and PCR-RFLP methods, respectively.
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.
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
Article Synopsis
- OSAS is highly prevalent in patients with non-valvular atrial fibrillation (NVAF), with a detection rate of 90% among those studied.
- The study determined that OSAS severity was categorized as mild in 32%, moderate in 27%, and severe in 31% of NVAF patients.
- Independent predictors for OSAS included being over 61 years old, having AF for more than 2 years, and snoring.
Introduction: The quality of the training of medical students is one of the guarantors of the proper functioning of our health system. Gamification is an innovative educational pedagogical method that stimulates the pleasure of learning and encourages learner motivation.
Aim: To evaluate the subjective and external motivations and academic self-efficacy of DCEM1 students by playing with TD sessions designed to learn the systematic interpretation of rhythm disorders on surface ECGs using playing cards.
Patients with ferromagnetic cardiac devices, particularly cardiac implantable electronic devices (CIED) such as pacemakers or implantable cardioverter defibrillators, are often inappropriately deprived of magnetic resonance imaging (MRI) for safety reasons. This consensus document is written by a multidisciplinary working group involving rhythmologists, interventional cardiologists, echocardiographists and radiologists. Its objective is to establish good practice recommendations to optimize the management of patients with cardiac devices requiring MRI examination, while ensuring their safety and facilitating their access to MRI.
View Article and Find Full Text PDFIn patients with cardiac implantable electronic devices CIEDs, including cardiac pacemakers (PM) and implantable cardioverter-defibrillators (ICD), radiotherapy (RT) could compromise CIED function. Managing radiotherapy patients with CIED, has been a great practical and procedural challenge in radiotherapy and requires a structured multidisciplinary approach. A consensus document is presented as a result of a multidisciplinary working group involving cardiac electrophysiologists, Radiation Oncologists and Medical physicists.
View Article and Find Full Text PDFBackground: Silent strokes are damagesof brain not accompanied by symptoms suggestive of stroke. Currentepidemiological trends suggesttheirindependent association with atrial fibrillation (AF). However, this association is not yetwelldefined.
View Article and Find Full Text PDFIntroduction: Ebstein's disease (ED) is a rare and heterogeneous congenital heart disease affecting the tricuspid valve and the right ventricle. Few studies have analyzed the electrocardiographic features of this disease.
Aim: To describe the electrocardiographic features observed in Ebstein's disease.
Article Synopsis
- - Nurses in cardiac intensive care units are crucial for managing cardiac arrests and often participate in hands-on resuscitation efforts.
- - A study evaluated the effectiveness of simulation training on improving the skills of nurses, finding a significant increase in competency scores after training.
- - The training notably enhanced skills in basic life support and manual defibrillation, with the most improvement seen in areas where nurses had less prior experience.
Article Synopsis
- The study investigates the role of strain in diagnosing and predicting outcomes in non-ST elevation myocardial infarction (NSTEMI) patients, focusing on its relationship with disease severity and coronary artery blockages.
- The research included 70 NSTEMI patients, revealing that global longitudinal strain (GLS) effectively predicted reduced left ventricular ejection fraction (LVEF) and indicated severe coronary artery disease (CAD), while territorial longitudinal strain (TLS) accurately identified the responsible artery and potential occlusions.
- Follow-up results showed that GLS improved over time, with factors like initial LVEF and myocardial revascularization contributing to this positive change, highlighting the significance of strain measurements in NSTEMI management.
Article Synopsis
- In the acute phase of STEMI, traditional viability imaging is either not validated or unavailable, prompting an evaluation of strain parameters as predictive tools for post-revascularization myocardial viability.
- A study involving 31 STEMI patients used echocardiograms to measure global longitudinal strain (GLS) and territorial longitudinal strain (TLS) within 24 hours of admission, later correlating these findings with delayed enhancement cardiac magnetic resonance imaging (CMR) performed three months after treatment.
- The results indicated that lower GLS and TLS values were associated with nonviable myocardium, with specific threshold values predicting viability with good sensitivity and specificity, suggesting that these strain measurements could help prioritize coronary interventions in STEMI patients.
Introduction: Atrial septal defects (ASD) constitute the most frequent congenital heart disease in adults and ostium secundum (OS) the most common type. Benefit of its closure in adulthood has long been controversial.
Aim: To evaluate outcomes of OS-ASD closure in adults.
Background: The continuing increase in care, needs and costs in cardiology with the advances in percutaneous coronary intervention (PCI) techniques represent the ideal scenario for considering same-day discharge (SDD) PCI program.
Aim: The primary endpoints were to examine feasibility and safety of SDD-PCI.
Methods: We conducted a comparative observational study of a prospective cohort (April 2017 to September 2017) where patients benefited from SDD-PCI with a retrospective cohort (October 2016 to March 2017) where patients were conventionally managed.
Background: Cardiogenic shock complicating ST elevation myocardial infarction is burdened by a high mortality. There is only limited evidence for the management except for early revascularization and the relative ineffectiveness of intra-aortic balloon pump.
Aim: Our objectives were to evaluate outcome and predictors of early all-cause 30-day mortality in the setting of cardiogenic shock complicating ST elevation myocardial infarction.