Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia.

Background: HER2-targeting therapies may increase the risk of decreased left ventricular ejection fraction (LVEF), potentially leading to heart failure. The growing number of breast cancer survivors due to HER2-targeted treatments necessitates long-term cardiotoxicity management.

Method: This retrospective study included HER2-positive breast cancer patients aged 18 or older who received at least 1 dose of HER2-targeting treatment between 2016 and 2020.

A Saudi Heart Association Position Statement on Obesity and Cardiovascular Disease.

Objectives: The obesity pandemic is a major public health concern in Saudi Arabia, with significant impact on cardiovascular disease (CVD). This position statement aims to provide an overview of available evidence as well as the recommendations of the Saudi Heart Association on the management of obesity associated with CVD.

Methods: Under the auspices of the Saudi Heart Association, a multidisciplinary expert panel comprised of cardiologists and endocrinologists discussed available evidence and provided recommendations on the management of obesity in CVD.

Flash'O real-world evidence programme - Attitude and practices toward the use of omega-3 FA by physicians from Middle East Countries.

The Flash'O project was designed to provide insights into the current use of prescription omega-3 and their perceived benefits by physicians in real-world clinical practice, in Russia, Saudi Arabia, Thailand, and Gulf countries, and to determine the adherence of physicians to dyslipidemia management guidelines. The present study focuses on Flash'O's process and results in Middle East countries. A total of 338 physicians and specialists completed the online questionnaire.

The Prevention and Cardiac Rehabilitation Group of the Saudi Heart Association Recommendations Regarding Establishing a Cardiac Rehabilitation Service.

Cardiac rehabilitation (CR) is a cornerstone in the secondary prevention of cardiovascular disease (CVD). Comprehensive cardiac rehabilitation has obtained the highest class of recommendation and the level of evidence for the treatment of patients with ST-segment elevation myocardial infarction, after myocardial revascularization, with chronic coronary syndromes, and in patients with heart failure (HF). Comprehensive cardiac rehabilitation should be implemented as soon as possible, be multi-phasic, and adjusted to the individual needs of the patient.

Echocardiographic Imaging in Transcatheter Structural Intervention: An AAE Review Paper.

Transcatheter structural heart intervention (TSHI) has gained popularity over the past decade as a means of cardiac intervention in patients with prohibitive surgical risks. Following the exponential rise in cases and devices developed over the period, there has been increased focus on developing the role of "structural imagers" amongst cardiologists. This review, as part of a growing initiative to develop the field of interventional echocardiography, aims to highlight the role of echocardiography in myriad TSHIs available within Asia.

The Gulf Achievement of Cholesterol Targets in Out-Patients Study (GULF ACTION): Design, Rationale, and Preliminary Results.

Aim: To assess the current dyslipidemia management in the Arabian Gulf region by describing the demographics, study design, and preliminary results of out-patients who achieved low-density lipoprotein cholesterol (LDL-C) goals at the time of the survey.

Background: The Arabian Gulf population is at high risk for atherosclerotic cardiovascular disease at younger ages. There is no up-to-date study regarding dyslipidemia management in this region, especially given the recent guideline-recommended LDL-C targets.

Right-sided infective endocarditis and pulmonary embolism: a multicenter study.

The incidence of right-sided infective endocarditis (RSIE) is steadily increasing and it has been reported to be associated with high risk of embolic events (EE). Aim of our study was to identify the clinical characteristics of patients with RSIE complicated by PE. Indeed, the identification of patients at high risk of significant PE who will benefit from a more aggressive therapeutic strategy may improve the prognosis.

Identification of Novel and Known LDLR Variants Triggering Severe Familial Hypercholesterolemia in Saudi Families.

Background: Familial hypercholesterolemia (FH) is a common illness mainly caused by variants occurring in the low-density lipoprotein receptor (LDLR) gene. FH is a leading cause of coronary artery disease.

Objective: This study aims to determine genetic defect(s) in homozygous and heterozygous FH index patients and their first-degree blood relatives and understand the genotype-phenotype correlation.

Loss of engagement in controlling chronic anticoagulation therapy during Covid-19 stringency measures. A single center experience of disproportioned increase of stuck mechanical valves.

Stuck valve is a very rare and severe complication that occurs in mechanical valve replacement patients with ineffective anticoagulation. However, with COVID-19 restriction measures, it became challenging to regularly assess INR to make sure it falls within the target therapeutic range to prevent this complication. We present a series of 10 patients who either underwent transthoracic echocardiography for a suspected stuck valve or were seen at the outpatient valve clinic with the residual consequences of a stuck valve during the COVID-19 restriction measures in our institute.

Complications of White-coat Hypertension Compared to a Normotensive and Hypertensive Population.

Background: Accumulating evidence demonstrates that white-coat hypertension (WCH) are associated with several risks and complications. In this study, we aimed to investigate the adverse effects of WCH compared with hypertensive and normotensive patients.

Methods: A retrospective cohort study was conducted over five years.

Familial Hypercholesterolemia in the Arabian Gulf Region: Clinical results of the Gulf FH Registry.

Background And Aims: Familial hypercholesterolemia (FH) is a common autosomal dominant disorder that can result in premature atherosclerotic cardiovascular disease (ASCVD). Limited data are available worldwide about the prevalence and management of FH. Here, we aimed to estimate the prevalence and management of patients with FH in five Arabian Gulf countries (Saudi Arabia, Oman, United Arab Emirates, Kuwait, and Bahrain).

The Myth of Myocardial Infarction With Normal Coronary Angiography.

Myocardial infarction with no obstructive atherosclerosis is an increasingly recognized presentation of acute coronary syndrome (ACS). The disease has all the clinical features of an ACS, but the only exception is that the coronary angiogram indicates non-obstructive coronary artery disease. Although different pathophysiological mechanisms have been postulated, no definitive mechanism has been identified.

Transverse sinus mass misinterpreted as the source of cardiac emboli.

Due to the proximity of the transvers sinus (TS) to the left atrial appendage (LAA) and pulmonary veins (PV), a mass in the TS can be misinterpreted as a LAA or PV thrombus, and considered as a source of emboli in a patient with stroke or transient ischemic attack. The incorrect identification of a mass as a LAA thrombus would initiate unnecessary anticoagulation therapy or potentially, an evaluation for the excision of the mass if there is a concern about dislodgement. We are presenting a case illustrating this confusion and review the literature for similar cases.

Peripheral Neuropathy as a Risk Factor for Developing Cardiovascular Disease in Diabetic Patients.

Background Type 2 diabetes mellitus (DM) is prevalent in developing countries and is associated with many comorbidities, including diabetic peripheral neuropathy (DPN) and cardiovascular disease (CVD). In this study, we assessed and evaluated the association between DPN and CVD. Methods The study is a cross-sectional study that included DM patients who are attending DM primary care clinics.

Diagnostic Comparability and Interchangeability Between Daytime Ambulatory Blood Pressure Monitoring and 24-Hour Ambulatory Blood Pressure Monitoring in Detecting Masked Hypertension.

Background The primary aim of this study was to evaluate the level of diagnostic overlap between daytime ambulatory blood pressure (BP) monitoring (DT-ABPM) and 24-hour ambulatory BP monitoring (24-h ABPM) in detecting masked hypertension (MH). Methods This is a prospective study that was performed in a sample of 196 soldiers aged between 21 and 50 years (without a history of hypertension) undergoing ABPM testing. The diagnosis of MH based on DT-ABPM defined as (office blood pressure (OBP) <140/90 and DT-ABPM ≥135/85) was compared with the 24-h ABPM defined as (OBP <140/90 mm Hg and 24-h ABPM ≥130/80 mm Hg).

The Primary Management Strategies for ST-Elevation Myocardial Infarction Patients in Saudi Arabia: A Sub-Study of the Saudi Acute Myocardial Infarction Registry.

Background and objective Not all patients with ST-elevation myocardial infarction (STEMI) in Saudi Arabia are managed with a primary percutaneous coronary intervention (PPCI). We analyzed the management strategies for STEMI patients in the Saudi Acute Myocardial Infarction Registry (STARS). The strategies include PPCI, revascularization with thrombolytic therapy, and conservative management.

Saudi Arabian Society of Echocardiography Recommendations for Echocardiography Service During Corona Virus Disease 2019 (COVID-19) Outbreak.

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.

The Echocardiography Society of Saudi Heart Association Recommendation on Quality and Laboratory Accreditation Guideline and Standards.

Objective: To create the Saudi Arabian Society of Echocardiography Accreditation Commission Guidelines and Standards.

Method: A review of available the North American and European accreditation guidelines was conducted and a model, locally appropriate for Saudi echocardiography laboratories and applicable in the current settings, was developed.

Results: The document specifies the organizational setting as well as the following categories of personnel: medical director, technical director, medical staff, and technical staff.

A New Variant Mutation in Gene in Case of Trichohepatoenteric Syndrome.

Trichohepatoenteric syndrome is an autosomal recessive genetic disease with an estimated prevalence of 1:100,000. The mutation of the disease is placed either in or genes. The onset of presentation is variable, but symptoms usually start with intractable diarrhea associated with woolly hair abnormality, immune dysfunction, and sometimes hepatic abnormality.

Abnormal mitral flow, what is the cause?

Diastolic mitral regurgitation is a unique Doppler finding that can be missed if special attention is not paid to it. There are a few causes of such abnormal flow, ranging from a conduction abnormality to abnormal valvular and left ventricle function. Failure to recognize it might lead to unnecessary investigations and delay the primary diagnosis.

Transient ST Segment Elevation in a Patient with COVID-19 and a Normal Transthoracic Echocardiogram.

Unlabelled: The effect of COVID-19 on the cardiovascular system still needs to be clarified. Patients can develop a spectrum of cardiac diseases, from mild myocarditis to acute coronary syndrome with an impaired systolic fraction. We describe an interesting case of transient ST segment elevation in a COVID-19 patient admitted to ICU for severe respiratory distress syndrome.

Contrast transesophageal three dimensional echocardiographic imaging for patent foramen ovale: a needful role?

We report a case of a 55-year-old male admitted for cardiogenic embolic ischemic stroke work up. A transesophageal (TE) echocardiography (E) with contrast study to rule out patent foramen ovale (PFO) was performed; two-dimensional (2D) analysis did not detect any bubbles passage during Valsalva manoeuvre in the standard 2D cross sectional planes; further real time three-dimensional (3D) TEE imaging revealed passage of bubbles in the left atrium (LA) by both real-time 3DTEE imaging and by the 2D unconventional cross-sectional planes allowed by 3DTEE imaging. Even though 2DTEE is considered to be the gold standard modality for diagnosing PFO, it has some limitations.

The validity of a daytime ambulatory blood pressure to diagnose masked hypertension.

Masked hypertension (MH) is traditionally diagnosed with 24-hour ambulatory blood pressure monitoring (24-ABPM). This is relatively costly and could cause discomfort during the night. We studied the validity of daytime ABP (DT-ABPM) in young National Guard soldiers and determined the prevalence in comparison to the standard 24-ABPM.