Background: The no-reflow phenomenon is critical and, if not reversed, causes a high rate of morbidity and mortality. It was demonstrated that the no-reflow phenomenon after Primary percutaneous coronary intervention (pPCI) is a strong predictor of mortality after the acute event in patients with STEMI. The aim of this study was to investigate the impact of visible thrombus aspiration (VTA) material on no reflow and its relation to hospital mortality and early outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Methods: This prospective observational study conducted on 100 patients admitted with acute STEMI and treated with primary PCI within 24 hours of presentation. Patients were divided into two groups: Group VTA (n=58):  who had visible thrombus aspiration material (VTA) (defined as collected visible aspiration material, including atherothrombotic debris or thrombus) & Group non VTA (n=42):  who had non-VTA (defined as no visible aspiration material and only blood). Results: There was significant statistical difference between group VTA & Group non VTA as regard No reflow after aspiration(15.5%vs 45.5%, P =0.001), In hospital mortality (0% vs 9.5% ,P = 0.016), LVEF at hospital (47.90 ± 5.38 vs 42.36 ± 5.95, P =0.001) and LVEF after 1 month (51.90 ± 4.36 vs 48.83 ± 4.53, P =0.001). However, there was no significant statistical difference between both groups as regard baseline TIMI flow, syntax score, in-hospital MACE, length of hospital stays. Conclusions: Our study resulted in aspiration of macro visible thrombus materials led to lower rates of no reflow after aspiration and better short-term clinical outcomes and prognosis than those patients with non-visible thrombus aspiration materials with ST-elevation myocardial infarction treated with pPCI.

Background: Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia found in clinical practice. The assessed frequency of AF in adults is between 2% and 4%, with greater incidence and frequency rates in developed nations [1,2]. AF prevalence increases with advancing age, and with some cardiac and non-cardiac disorders, also it may exist in the absence of any conditions [2]. We aimed to determine case characteristics, practice patterns, management strategies and outcomes of atrial fibrillation in the delta area of Egypt. Methods: This registry-based cross-sectional study included 1000 atrial fibrillation patients (with any AF patterns) who were allowed to enter ER in cardiac centers and hospitals in middle Delta of Egypt from April 2020 to March 2021. Results: 267 patients (26.7%) were unstable. Heart failure, hypertension, and coronary disease were still prevalent comorbidities in our AF dataset, where hypertension accounts for over 50% of all AF cases. Rheumatic valvular heart disorder was a major underlying disease for the development of AF, still about 25.5% by echocardiography. Lone AF still high 20.6%. CHA2DS2VASc score ≥2 is 83.5%. A high proportion of cases were treated with pharmaceuticals for rate control nearly 52.7% of the cases and nearly 30.3% of the cases were given pharmacological medications for the cardioversion to the sinus rhythm and a small proportion of the cases were given electrical cardioversion nearly 7%. Conclusions: Coronary disease, hypertension, and heart failure were still usual comorbidities in AF. Rheumatic valvular heart disease is still about 25.5% of the total registry. Amiodarone is the most prevalent antiarrhythmic medications (AAD) used. lone AF still high 20.6%. minimal use of novel oral anticoagulant (OAC).

Objectives The aim of this study is assessment of persistent functional tricuspid regurgitation in patients with atrial septal defect before and after successful device closure and its relationship to tricuspid valve remodeling. Methods The current study was conducted on 60 patients referred to Tanta University Hospital Cardiology Department with the provisional diagnosis of atrial septal defect secundum type for transcatheter closure from December 2017 to December 2019. All patients were subjected to history taking, clinical examination, 12 lead electrocardiography, plain chest X-ray, full two dimension transthoracic echocardiography (for assessment of tricuspid regurgitation severity) before and at 3, 6 months after transcatheter closure. Results Tricuspid regurgitation was decreased significantly after atrial septal defect closure due to remodeling in the right side. Age, estimated systolic pulmonary artery pressure, right atrium end systolic area, right ventricular end diastolic area, tricuspid valve tenting area and height, tricuspid septal leaflet angle and tricuspid annular diameter were predictors of persistent tricuspid regurgitation after 3 and 6 months of closure. Only estimated systolic pulmonary artery pressure, tricuspid septal leaflet angle and tricuspid annular diameter were independent predictors of persistent tricuspid regurgitation after 3, and 6 months of closure. Conclusion Tricuspid regurgitation significantly improved after transcatheter atrial septal defect closure despite its significance at baseline due to remodeling in right side and tricuspid valve.

Background: Acute coronary syndrome (ACS) is a main reason of morbidity and mortality in patients with coronary heart disease (CHD) in developed nations. It’s one of three coronary artery diseases (CAS): ST-segment elevation myocardial infarction (STEMI), or unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI). The production of sensitive indicators of myocardial necrosis (for example, troponins) is considered a suggestive indication of myocardial cell necrosis and so meets the criteria of myocardial infarction. The goal of the registry is to assess patient features, practice pattern and outcome of ACS in this region using a registry design. Methods: This prospective and observational registry was carried out on 1000 Patients with ACS (whatever its type) in the period of six months in cardiac centres in the region of middle delta of Egypt. The survey took place in (Tanta, Mahalla, Mansoura, Shebin-Elkom, Damanhor, Kafr-Elsheikh, Banha and Cairo). Results: There was an insignificant difference in the primary etiology of ACS between both sexes. Women got less ACE inhibitors, mineralocorticoid receptor antagonists, beta-blockers, antiplatelets, statins, and nitrates, but received more digoxin, amiodarone, anticoagulants, and calcium channel blockers. There was an insignificant association in in-hospital and 1 year mortality between female and male, respectively. Conclusions: Smoking and hypertension are significant risk factors among patients raising an alarming sign for primary and secondary inhibition for CAD. The delay in seeking medical help is related to unawareness of the public on what to do raising important questions about EMS role and public health education.

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