Publications by authors named "Selma Charfeddine"

Introduction: Post-COVID syndrome (PCS) is characterized by a polymorphism of symptoms with hypothetical pathophysiological mechanisms. Here, we aimed to analyze the profile of inflammatory cytokines in patients with PCS and to study the relationship between this profile, the clinical symptoms as well as the endothelial function in PCS.

Methods: Our analytical study involved all eligible patients (n = 66) with PCS included from April 2021 to December 2021.

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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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Introduction: simulator training in interventional cardiology (ST) is an educational tool that is rapidly spreading worldwide. The purpose of this study was to evaluate the advantages of ST in improving skills of beginners in interventional cardiology procedures, through a short training cycle.

Methods: we conducted a before-and-after quasi-experimental evaluative study in the simulation center of the Faculty of Medicine in Sfax.

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Background: This trial aimed to assess the efficacy of Atorvastatin reloading on the prevention of Contrast-induced nephropathy (CIN) in patients pre-treated with this statin and undergoing coronary catheterization.

Methods: This was a prospective randomized controlled study including patients on chronic atorvastatin therapy. We randomly assigned the population to the Atorvastatin Reloading group (AR group), by reloading patients with 80 mg of atorvastatin one day before and three days after the coronary procedure, and the Non-Reloading group (NR group), including patients who received their usual dose without a reloading dose.

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Background: Radial artery occlusion (RAO) remains the most frequent complication of trans-radial access. Once the radial artery is occluded, its future use as an access site for coronary procedures, or as a conduit for coronary bypass grafting or fistula for hemodialysis, will be precluded. Therefore, we aimed to assess the value of the short-term use of Rivaroxaban to prevent RAO after a trans-radial coronary procedure.

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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.

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Introduction: There are no clear data about the incidence and the prophylactic strategies of arterial and venous thromboembolic events (TE) in COVID-19 ambulatory patients. Thus, we conducted this study to analyze thromboembolic complications in this setting and to assess thromboprophylaxis management and outcomes in the real life.

Patients And Methods: This is an observational study including Covid-19 ambulatory patients.

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Article Synopsis
  • Subvalvular aortic stenosis poses challenges in management due to unpredictable changes and high rates of recurrence after surgery.
  • An observational study at Sfax University Hospital included 28 patients, predominantly male, with an average age of 6.82 years at diagnosis, and many presenting with symptoms and significant gradients on echocardiography.
  • While surgical techniques like subaortic membrane resection showed no postoperative mortality, 25% of patients experienced recurrences, linked to residual gradients, emphasizing the necessity for ongoing monitoring post-surgery.
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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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We review the literature on the safety of fasting in cardiac patients. We examined the changes of blood pressure among hypertensive patients and the incidence of cardiac events during Ramadan in patients with coronary disease and heart failure. We also assess the modifications of INR levels in cardiac patients who take oral anticoagulant.

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Background: Severe valvular heart disease, especially stenosis, is a contraindication for conception according to the World Health Organization. This is still encountered in countries with a high rheumatic fever prevalence. The objective of this study was to determine predictors of maternal cardiac, obstetric and neonatal complications in pregnant women with severe valve disease.

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Article Synopsis
  • - The study focused on elderly patients (aged 80+) with hypertension, aiming to assess their clinical and epidemiological characteristics and identify factors leading to uncontrolled hypertension.
  • - A total of 346 patients were analyzed, revealing that over half had uncontrolled hypertension, with common risk factors including dyslipidemia and diabetes, and a significant portion had a history of coronary artery disease or stroke.
  • - Key findings indicated that factors like male sex, diabetes, and poor adherence to blood pressure medications were significantly associated with uncontrolled hypertension in this age group.
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Cardiac myxomas are the most common primary intracardiac tumors in adults. Although benign from a histopathological point of view, they can be life-threatening for the patient. We present a case of an unusually giant left atrial myxoma causing mitral valve obstruction and pulmonary hypertension successfully treated with surgical resection.

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Introduction: interventional cardiology procedures have become complex and expensive in time with a higher risk of exposure to ionizing radiations. The purpose of our study was to assess radiation protection knowledge and practices among Tunisian cardiologists exposed to X-rays.

Methods: we conducted a descriptive, analytical study in October 2019.

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EP after TEE represents a medico-surgical emergency. Given the high rate of asymptomatic patients with COVID 19, the risk of contamination and the frailty of esophageal tissues, we should check coronavirus infection in every patient before TEE.

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Introduction: high blood pressure (HBP), atrial fibrillation (AF) and ischemic stroke are three public health problems. The purpose of this study was to determine the prevalence of AF and ischemic stroke in hypertensive patients and the factors associated with the occurrence of non-valvular AF in these patients.

Methods: we used data collected in the Department of Cardiology at the University Hospital of Sfax as a part of National Tunisian Registry of Hypertension.

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The HER2 receptor (Human Epidermal Growth Receptor 2) is a transmembrane receptor with tyrosine kinase activity that is over-expressed in 25-30 % of breast carcinomas. Its activation is associated with an exaggeration of cell proliferation with an increase in repair capacity resulting in increased radioresistance. On cardiac tissues, HER2 receptor activation plays a cardio-protective role.

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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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Intramyocardial dissecting hematoma (IDH) is a rare complication of myocardial infarction (MI). It can affect the left ventricular free wall, the right ventricle, or the interventricular septum. We report a case of a 58-year-old man with an IDH following an acute anterior wall myocardial infarction detected by echocardiography and confirmed by Cardiac magnetic resonance (CMR).

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The distal radial approach (DRA) is suggested to have benefits over the conventional radial approach (CRA) in terms of local complications and comfort of both patient and operator. Therefore, we aimed to compare the feasibility and safety of DRA and CRA in a real life population. We conducted a prospective, observational multicentric trial, including all patients undergoing coronary procedures in September 2019.

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Background: Valvular heart diseases occur frequently in Tunisia, but no precise statistics are available.

Aim: To analyse the characteristics of patients with abnormal valvular structure and function, and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in a single cardiovascular centre in Tunisia.

Methods: This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology department between January 2010 and December 2013.

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