Recognition of heart murmur based on machine learning and visual based analysis of phonocardiography, Kotb, H., Elmahdy, H.N., Mostafa F. E. Z., and.Refaey M. A. , Advances in Intelligent Systems and Computing,, (2019)
The machine learned stethoscope provides accurate operator independent diagnosis of chest disease , Kotb, MA, Elmahdy H. N., Mostafa F. E. Z., Draz I. H., and Basanti C. W. S. , Medical Devices: Evidence and Research, (2020)
The overlooked left ventricle in persistent pulmonary hypertension of the newborn, Abdelmassih, A. F., Al. Zahraa Hassan F., El-Gammal A., Tawfik M., and Nabil D. , Journal of Maternal-Fetal and Neonatal Medicine,, (2021)
Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography, Elshamaa, MF, Mostafa FA, Sad I. A. E. S., Badr A. M., and Abd Elrahim Y. A. E. M. , Clinical Medicine Insights: Cardiology,, (2020)
Modified Senning procedure for the correction of the transposition of the great arteries: Mid-term results, Moustafa, Fatma Alzahraa, Khalil Mohamed Abdel-Raouf, Saied Dalia A., AbdElAziz Osama, and Moustafa Kefaya D. , Journal of the Egyptian Society of Cardio-Thoracic Surgery, Volume 25, Issue 3, p.252 - 258, (2017) Abstract

Congenital heart disease, Transposition, Survival analysis",
abstract = "Background
Many patients with Transposition of the great arteries (TGA) who underwent Senning procedure are in follow-up and approaching adulthood. This study aimed to assess the mid-term outcome after Senning procedure to disclose and manage subsequent complications.
Methods
Twenty five d-TGA patients, who underwent Modified Senning Procedure were enrolled in the study. Investigations done included 12- leads ECG and 24 h Holter monitoring for detection of cardiac arrhythmias. Two dimensional Echocardiography and 2-D Doppler ultrasound were done to evaluate the right ventricular function and detect any postoperative complications.
Results
The median age was 6.3 years (mean: 7.25 ± 3.2, range 4–16 years). The median follow-up duration was 5.5 years (mean: 6.04 ± 3.2, range: 1.5–14.6 years). There were no mortalities and no need for reoperations. All patients had good right ventricular function and baffle leaks were present in 12% of the cases. Significant tricuspid regurgitation was encountered in 36% of the patients. Ninety six percent of the patients maintained sinus rhythm. Tachyarrhythmias were present in 3 patients (12%) and one patient (4%) had complete heart block and required pacemaker insertion. Eighty eight percent of the patients were in NYHA class I-II and the event-free survival rate was 100%, 67.8% and 28.6% at 1, 5, and 10 years respectively.
Conclusions
Despite that data from our study revealed satisfactory outcome as regards mortality and functional status of d-TGA children, further studies are warranted to assess the long term outcome of these patients and for further assessment of their right ventricular function.

Prediction of Pulmonary Regurge and Right Ventricular Function in Asymptomatic Repaired Tetralogy of Fallot Patients in Developing Countries: A Comparison to Cardiac Magnetic Resonance Imaging, Agha, Hala, Aly Doaa Mahgoub, Moustafa Fatma Alzahraa, Kharabish Ahmed, Kamal Yasser Hussein, Hussein Gehan H., Lamiaa ElZambely, El-Kiky Hassan, El-Raouf Mohamed Abd, and Rahman Mohamed Youssef Abd El , Journal of Clinical & Experimental Cardiology, Volume 5, Issue 5, p.1-7, (2014) Abstract

Objective: To assess the value of conventional echocardiographic measurements for quantification of pulmonary regurge and right ventricular function in comparison to Cardiac Magnetic Resonance Imaging (CMR) after surgical repair of Tetralogy Of Fallot (TOF).

Methods: Twenty five asymptomatic children after TOF repair (9.2 ± 4 years) were compared to twenty five age matched healthy children. Echocardiographic quantification of pulmonary regurge was assessed by (1) pulmonary regurge jet width/pulmonary artery diameter, (2) pulmonary pressure half time, (3) pulmonary regurge index; pulmonary regurge duration to diastole duration, (4) no flow time; diastole duration - pulmonary regurge duration and (5) diastole/systole velocity time integral ratio. Measurements derived from conventional echocardiography were compared to pulmonary regurgitant fraction, right ventricular volumes and ejection fraction by CMR.

Results: On CMR, the pulmonary regurgitant fraction was 28.64 ± 10.2%. By conventional echocardiography, pulmonary regurge index and no flow time were found to offer the best prediction for severity of pulmonary regurge. Pulmonary regurge index of <0.8 has sensitivity of 86.36% and specificity of 100% (AUC=0.924) and no flow time of >64 msec has sensitivity of 81% and specificity of 100% (AUC=0.894) in identifying significant pulmonary regurge. Compared to controls, patients after TOF repair showed significantly lower right ventricle myocardial velocities, higher E/ E‘ ratio and prolonged MPI. Among the TOF patients, right ventricular MPI showed significant negative correlation (r=-0.402; P=0.008) with tricuspid valve annulus peak systolic velocity (S‘) and significant positive correlation (r= 0. 413; P=0.04) with right ventricle stroke volume by CMR.

Conclusion: Conventional echocardiography can offer a simple, readily available and accurate tool for quantification of pulmonary regurge and right ventricular function during mid- term follow up after surgical repair of tetralogy of Fallot.

Short-term effects of corticosteroid therapy on cardiac and skeletal muscles in muscular dystrophies., Hussein, Gehan, Mansour Lobna, Ghafar Hadeer Abdel, Mostafa Fatma Alzahraa, and Fawaz Lubna , Journal of investigative medicine : the official publication of the American Federation for Clinical Research, 2014 Aug, Volume 62, Issue 6, p.875-9, (2014) Abstract

BACKGROUND: Duchenne muscular dystrophy (DMD) is the most common muscular dystrophy of childhood. It leads to progressive deterioration in cardiac and skeletal muscles. Corticosteroids are considered an effective therapy.

OBJECTIVE: This study aimed to evaluate the role of short-term prednisone therapy in improving left ventricular (LV) systolic function, LV mass (LVM), and motor power in cases of muscular dystrophies.

PATIENTS AND METHODS: Twenty-five cases of muscular dystrophy including 17 cases of DMD, 3 cases of Becker muscular dystrophies, and 5 cases of female patients with DMD-like phenotype were included in the study. The diagnosis of 12 patients was confirmed by muscle biopsy with immunohistochemistry; the patients were subjected to motor assessment, measurement of creatine kinase level, and echocardiographic examination before and after prednisone therapy. Transthoracic echocardiographic assessment of the LV systolic function (fractional shortening) was done. Myocardial performance index and LVM were calculated. Intermittent dosage of prednisone was administered 5 mg/kg per day on 2 consecutive days weekly for 3 months.

RESULTS: Fractional shortening improved on prednisone therapy (P = 0.009) and LVM increased (P = 0.012); improvement in walking was detected in 77% of the patients, climbing stairs improved in 88.9%, Gower sign improved in 70%, and rising from chair improved in 60%. Prednisone had no effect on the patients with marked motor impairment (on wheelchair). The creatine kinase level was significantly lower after steroid therapy (P = 0.04).

CONCLUSIONS: Three months of intermittent prednisone therapy could improve cardiac and skeletal muscle function in congenital muscular dystrophy.

Regression of a large congenital hepatic arteriovenous malformation., Agha, Hala Mounir, Zakaria Rania, Mostafa Fatma Alzahraa, and Hamza Hala , Texas Heart Institute journal, 2015 Apr, Volume 42, Issue 2, p.184-7, (2015) Abstract

Congenital hepatic arteriovenous malformations are rarely seen in association with persistent neonatal pulmonary hypertension. We report the case of a full-term female newborn who presented with heart failure and respiratory distress soon after birth. Echocardiographic investigation revealed severe persistent pulmonary hypertension and patent ductus arteriosus. Here we report spontaneous regression in size of both the feeder vessel and the vascular bed of the congenital hepatic arteriovenous malformation. We postulate that our conservative use of oral heart failure therapy, in the form of diuretic agents and captopril, decreased the congestion and diameter of the affected vessels.

Forgotten Right Ventricle in Pediatric Dilated Cardiomyopathy., Agha, Hala Mounir, Ibrahim Hossam, Satar Inas Abd El, Rahman Naglae Abd El, Aziz Doaa Abd El, Salah Zeinab, Saeidi Sonia El, Mostafa Fatma, Attia Wael, Abdelrahman Mohamed, et al. , Pediatric cardiology, 2017 Apr, Volume 38, Issue 4, p.819-827, (2017) Abstract

To evaluate the right ventricular (RV) function in relation to that of the left ventricle (LV) in patients with dilated cardiomyopathy (DCM). Echocardiographic examination was done using tissue Doppler imaging (TDI) and two-dimensional speckle tracking echocardiography (2D-STE) for 32 pediatric patients with DCM comparing them to another 32 normal matched controls. The global longitudinal strain (GLS) derived from 2D-STE was used to reflect the LV systolic function. Tricuspid annular plan systolic excursion (TAPSE) and the following RV TDI derived indexes: peak systolic velocity (S'), peak early diastolic velocity E', peak late diastolic velocity A', isovolumic acceleration (IVA) and myocardial performance index (MPI) were measured. RV had significant systolic and diastolic dysfunction; TAPSE, S' velocity, IVA, peak early diastolic velocity (E') and peak early diastolic velocity/peak late diastolic velocity (E'/A') ratio were significantly decreased while MPI was significantly prolonged compared to controls. Moreover, TAPSE, S', IVA, E', E'/A' and RV MPI were significantly correlated to LV GLS. For prediction of LV dysfunction among patients, the area under the receiver operating characteristic curve was 0.98 for RV MPI, 0.906 for RV IVA. For identifying severe LV dysfunction; RV MPI  > 0.29 had 100% sensitivity and 93.7% specificity, while the RV IVA  ≤ 3 had 84.4% sensitivity and 90.6% specificity. In pediatric patients with DCM the RV systolic and diastolic functions are affected beside the LV dysfunction. Non-conventional echocardiographic evaluation of RV function is recommended in among this cohort.