Background This study was conducted to assess the relationship between scar burden (extent and severity) and the follow-up left ventricular ejection fraction (LVEF). Methods Patients were referred for viability assessment with late gadolinium enhancement (LGE) on cardiovascular magnetic resonance imaging. To measure the transmural extent of LGE in each segment (scar score), we used a five-point scale system. Baseline ejection fraction (EF) and at follow-up were recorded. LVEF classified as non-severe and severely depressed. Results The study included 178 patients (males: 88.8%; mean age: 57.1±10.02 years; mean baseline LVEF: 28.61±10.39). In patients with severe baseline LVEF, the mean scar percentage was higher than that in patients who had non-severe LVEF (38.8±19.41 vs. 24.61±21.21; p˂0.001). On linear regression analysis, aldosterone antagonist and total scar score significantly predicted follow-up ejection fraction (EF) (B=-7.083, p˂0.001 and B=-3.038, p=0.038, respectively). Left anterior descending artery (LAD) territory viability and baseline EF significantly predicted change in EF in patients with LVEF ≤ 35% (B=5.389, p=0.009 and B=-0.581, p˂0.001, respectively). On binary regression analysis for the prediction of at least 5% improvement in EF in patients with baseline EF ≤ 35%, baseline EF and LAD viability were significant (B=-0.15, p=0.014 and B=1.042 and p=0.054, respectively). Conclusions The extent of myocardial scar and viability of LAD territory are identified as the important and independent parameters for the predictions of improvement in EF even after adjustment for demographics and baseline EF and following the standards of care medication.

Background: Worldwide, breast cancer is the most common cancer affecting women, and a common cause of death-related cancer. Fortunately, evidence suggests that we might be able to help improve the outcome with screening, early diagnosis, and intervention. Objective: The present study investigates the awareness of breast cancer screening and breast cancer risk factors among women in the western province of Saudi Arabia. Method: The present study employed a cross-sectional survey design, with 365 participating females (aged ≥ 18 years) in the western region of Saudi Arabia. Data were collected from December 2019 to January 2020 using a self-administered questionnaire. The questionnaire covered sociodemographic characteristics, breast cancer knowledge, risk factors, family history, and screening, as well as personal medical history. Data were analyzed using descriptive statistics, chi-square tests, the t-test, and one-way ANOVA tests. Result: In general, the majority of the women (98.1%) were aware of breast cancer screening. The most commonly identified risk factor in our study was a family history of breast cancer (75.1%), and women with previous exposure to breast cancer measured significantly higher on the socioeconomic index score (M=0.147, SD-0.95) than did those who had never been screened (M=-0.134, SD=1, p=0.007). The findings denote that the women who had a higher knowledge are of a higher socioeconomic class and educational level than were those who were measured and found to have a lower knowledge. Conclusion: The findings indicate that the level of awareness of breast cancer screening and breast cancer risk factors, including knowledge about mammogram usage, among women of Saudi Arabia is acceptable, being more than a half. However, the results are still sub-optimal and more educational campaigns are needed to improve the knowledge and screening compliance.

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