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ELFaramawy, A., W. ElAroussy, G. Youssef, D. El Remisy, H. El Deeb, A. Abdelaal, and M. Ibrahim, " PREVALENCE OF CARDIOVASCULAR RISK FACTORS AMONG HYPERTENSIVE EGYPTIANS, DATA FROM THE EGYPTIAN SPECIALIZED HYPERTENSION CLINICS", Journal of Hypertension, vol. 37, pp. e168, 2019. prevalence_of_cardiovascular_risk_factors_among.475.pdf
Rezk, H., G. Youssef, K. Said, I. Mandour, and M. A. Hamid, "Abdominal Congestion as a Predictor of Worsening Renal Function in Patients With Acute Decompensated Heart Failure.", Journal of the Saudi Heart Association, vol. 36, issue 1, pp. 60-69, 2024. Abstract

BACKGROUND: Worsening renal function is a frequent finding in patients with acute decompensated heart failure (ADHF) and is a powerful independent prognostic factor for adverse outcomes. The link between abdominal congestion and worsening renal function in such patients is not yet fully addressed.

OBJECTIVE: To evaluate the role of abdominal congestion in the early prediction of worsening renal function in hospitalized patients with acute decompensated heart failure.

METHODS: This was a prospective study that enrolled 100 patients with a diagnosis of ADHF and received intravenous diuretic therapy. Intra-abdominal pressure (IAP), splenic Doppler impedance indices and serum prouroguanylin were measured on admission, 24 h after admission and on discharge. Patients were then divided into 2 groups: those who developed WRF (WRF group), and those who did not (non-WRF group). Worsening renal function was defined as an increase in serum creatinine level ≥0.3 mg/dL above baseline admission value. Intrabdominal pressure was measured transvesically using standard Foley catheter. Splenic Doppler impedance indices (resistivity and pulsatility indices) were measured using splenic Doppler ultrasound.

RESULTS: Among recruited patients (age: 54.73 ± 13.1 years, 72% are male), there was a significant decline in IAP (6.67 mmHg vs 8.36 mmHg, p = 0.001) and significant rise in splenic resistivity index (0.69 vs 0.67, p = 0.002) before discharge compared to admission values. The median level of serum prouroguanylin before discharge showed significant decline compared to admission level (29.2 vs 34.6 ng/l, p = 0.006). WRF developed in 37 (37%) patients. Independent predictors of WRF during hospitalization were high splenic arterial resistivity index 24 h after admission, high intra-abdominal pressure (≥8 mmHg) 24 h after admission, and low LVEF on admission.

CONCLUSION: In ADHF patients receiving diuretic therapy, transvesical measurement of intra-abdominal pressure and splenic resistivity index by splenic Doppler early after admission can help to identify patients at increased risk of WRF near discharge.

Youssef, G., "Aortic valve diseases in pregnancy", E-Journal of Cardiology Practice, vol. Vol. 18, issue N° 19, 2020. avd_during_pregnancy.pdf
Youssef, G., Z. Saad, W. Ammar, and Yasser Sharaf, "Assessment of left ventricular regional wall motion abnormalities using regional time-volume curves obtained by real time three-dimensional echocardiography", The Egyptian heart journal, vol. 70, issue 3, pp. 189-194, 2018. 3d_assessment_of_swma.pdf
El Fol, A., W. Ammar, Yasser Sharaf, and G. Youssef, "The central arterial stiffness parameters in decompensated versus compensated states of heart failure: a paired comparative cohort study.", The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, vol. 74, issue 1, pp. 2, 2022. Abstract

BACKGROUND: Arterial stiffness is strongly linked to the pathogenesis of heart failure and the development of acute decompensation in patients with stable chronic heart failure. This study aimed to compare arterial stiffness indices in patients with heart failure with reduced ejection fraction (HFrEF) during the acute decompensated state, and three months later after hospital discharge during the compensated state.

RESULTS: One hundred patients with acute decompensated HFrEF (NYHA class III and IV) and left ventricular ejection fraction ≤ 35% were included in the study. During the initial and follow-up visits, all patients underwent full medical history taking, clinical examination, transthoracic echocardiography, and non-invasive pulse wave analysis by the Mobil-O-Graph 24-h device for measurement of arterial stiffness. The mean age was 51.6 ± 6.1 years and 80% of the participants were males. There was a significant reduction of the central arterial stiffness indices in patients with HFrEF during the compensated state compared to the decompensated state. During the decompensated state, patients presented with NYHA FC IV (n = 64) showed higher AI (24.5 ± 10.0 vs. 16.8 ± 8.6, p < 0.001) and pulse wave velocity (9.2 ± 1.3 vs. 8.5 ± 1.2, p = 0.021) than patients with NYHA FC III, and despite the relatively smaller number of females, they showed higher stiffness indices than males.

CONCLUSIONS: Central arterial stiffness indices in patients with HFrEF were significantly lower in the compensated state than in the decompensated state. Patients with NYHA FC IV and female patients showed higher stiffness indices in their decompensated state of heart failure.

Rizk, H. H., A. A. Elamragy, G. S. Youssef, M. S. Meshaal, A. Samir, A. E. sharkawy, K. Said, H. H. Kassem, M. G. ElAnany, A. A. El-Kholy, et al., "Clinical features and outcomes of infective endocarditis in Egypt: an 11-year experience at a tertiary care facility.", The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, vol. 71, issue 1, pp. 17, 2019. Abstract

BACKGROUND: Few data are available on the characteristics of infective endocarditis (IE) cases in Egypt. The aim of this work is to describe the characteristics and outcomes of IE patients and evaluate the temporal changes in IE diagnostic and therapeutic aspects over 11 years.

RESULTS: The IE registry included 398 patients referred to the Endocarditis Unit of a tertiary care facility with the diagnosis of possible or definite IE. Patients were recruited over two periods; period 1 (n = 237, 59.5%) from February 2005 to December 2011 and period 2 (n = 161, 40.5%) from January 2012 to September 2016. An electronic database was constructed to include information on patients' clinical and microbiological characteristics as well as complications and mortality. The median age was 30 years and rheumatic valvular heart disease was the commonest underlying cardiac disease (34.7%). Healthcare-associated IE affected 185 patients (46.5%) and 275 patients (69.1%) had negative blood cultures. The most common complications were heart failure (n = 148, 37.2%), peripheral embolization (n = 133, 33.4%), and severe sepsis (n = 100, 25.1%). In-hospital mortality occurred in 108 patients (27.1%). Period 2 was characterized by a higher prevalence of injection drug use-associated IE (15.5% vs. 7.2%, p = 0.008), a higher staphylococcal IE (50.0% vs. 35.7%, p = 0.038), lower complications (31.1% vs. 45.1%, p = 0.005), and a lower in-hospital mortality (19.9% vs. 32.1%, p = 0.007).

CONCLUSION: This Egyptian registry showed high rates of culture-negative IE, complications, and in-hospital mortality in a largely young population of patients. Improvements were noted in the rates of complications and mortality in the second half of the reporting period.

Youssef, G., A. El Fol, W. Ammar, and Y Sharaf, "Comparing the central arterial stiffness indices in the decompensated and compensated states of heart failure: a cohort study", European Heart Journal, vol. 42, issue 1, 2021. ehab724.2886.pdf
Marzouk, D., H. El Deeb, Y. Baghdady, and G. Youssef, "Correlation between central aortic stiffness indices and cardiac mechanics in hypertensive patients: new insights from speckle tracking echocardiography imaging", European heart journal , vol. 43, issue Supplement 2, 2022.
Shalaby, A., A. A. Ibrahim, H. Elghobary, and G. Youssef, "Detection of Micro RNA-499 In Acute Myocardial Infarction, Significance Of A New Marker.", Research Journal of Pharmaceutical, Biological and Chemical Sciences, vol. 8, issue 1, pp. 1480-1485, 2017. detection_of_mir_499_in_acute__myocardial_infarction_significance_of_a_new_marker_1.pdf
Taha, H. S., G. Youssef, R. M. Omar, A. M. Kamal El Din, A. A. Shams El Din, and M. S. Meshaal, "Efficacy and speed of conversion of recent onset atrial fibrillation using oral propafenone versus parenteral amiodarone: A randomized controlled comparative study.", Indian heart journal, 2022. Abstract

BACKGROUND: Atrial fibrillation is the most commonly encountered arrhythmia. Several antiarrhythmic agents are effective in restoring and maintaining sinus rhythm.

AIM OF THE WORK: To compare the efficacy and rapidity of conversion of recent onset atrial fibrillation using oral propafenone versus intravenous infusion of amiodarone.

METHODS: The study included 200 patients with recent onset atrial fibrillation. Patients were equally divided into 2 groups; group A where intravenous infusion amiodarone was given and group B where oral propafenone was administrated. The effectiveness and the time needed for conversion of atrial fibrillation to sinus rhythm were compared in both groups.

RESULTS: The success of conversion of atrial fibrillation to sinus rhythm was 83% in group A and 85% in group B, p-value = 0.699. The time elapsed from drug administration till conversion of atrial fibrillation was 9.07 ± 5.04 hours in group A versus 3.9 ± 1.54 hours in group B, p-value = 0.001. In both groups, patients who showed failed conversion had a significantly larger left atrial diameter and a significantly higher high sensitivity C-reactive protein (hsCRP) level.

CONCLUSION: Oral propafenone was faster than parenteral amiodarone in the conversion of recent onset atrial fibrillation to sinus rhythm. Patients with failed conversion had a bigger left atrial diameter and a higher hsCRP when compared to patients with successful conversion.

Ibrahim, M. M., W. El-Aroussy, H. Riz, H. Kandil, A. Farrag, K. Said, G. Youssef, A. Abdelwahab, O. Awwad, O. Elkhashab, et al., "The Egyptian Hypertension Society EGYPTIAN HYPERTENSION GUIDELINES", Egyptian Heart Journal, vol. 66, pp. 79-132, 2014. egyptian_htn_guidelines_publication.pdf
Yehia, H., G. Youssef, M. Gamil, M. Elsaeed, and K. H. A. L. E. D. SADEK, "Electrocardiographic substrates of arrhythmias in patients with end-stage and chronic kidney diseases: a case-control study", The Egyptian Heart Journal, vol. 75, issue 1, pp. 13, 2023.
Tebi, I. E., E. Baligh, H. Gamal, Z. Ashour, G. Youssef, A. Shehata, and M. Mokhtar, "Familial history of hypertension as a predictor of increased arterial stiffness", European Heart Journal, vol. 34, issue Suppl_1, 2013.
Youssef, G., I. Tebi, D. Osama, A. Shehahta, E. Baligh, Z. Ashour, and H. Gamal, "Familial history of hypertension as a predictor of increased arterial stiffness in normotensive offspring", Egyptian Heart Journal, vol. 69, pp. 37-44, 2017.
Youssef, G., "Hypertension in pregnancy", E-Journal of Cardiology Practice, vol. 17, issue N° 22, 2019.
Youssef, G., M. Hosny, W. Ramadan, and E. Baligh, "Incidence of maternal and fetal complications in pregnant with mechanical prosthetic cardiac valves: a cohort study", European Heart Journal, vol. 42, issue 1, 2021. ehab724.2886.pdf
Youssef, G., N. T. Allam, W. Gaber, A. Afifi, and D. Hesham, "Increased arterial stiffness in rheumatoid arthritis and Its relation to disease activity: A cross sectional study", Egyptian Heart Journal, vol. 70, issue 1, pp. 35-40, 2018. arterial_stiffness_in_rheumatoid_arthritis.pdf
Youssef, G., L. Sulaiman, D. Hesham, and M. A. Hamid, "The integrated role of NT-pro BNP and STE-GLS for the early detection of chemotherapy-induced cardiotoxicity", European Heart Journal, vol. 41, issue Supplement 2, pp. 1154, 2020. ehaa946.1154.pdf
Youssef, G., B. Zayed, mohammed momtaz, A. Roshdy, and M. Shaaban, "Lung ultrasound and bioimpedance in assessment of volume status of hemodialysis patients", Kasr Al Ainy Medical Journal, vol. 23, issue 1, pp. 18-23, 2017. kamj_35_16r2_paper_1.pdf
Youssef, G. S., "Management of atrial fibrillation during pregnancy", E-journal of Cardiology Practice, vol. 17, issue N° 15, 2019.
Youssef, G., S. Nagy, A. El-gengehe, A. Abdelaal, and M. A. Hamid, "Masked uncontrolled hypertension: Prevalence and predictors", Egyptian Heart Journal, vol. 70, issue 4, pp. 369-373, 2018. much.pdf
Youssef, G., "Mitral stenosis in pregnant patients", E-journal of Cardiology Practice, vol. 16, N° 18, 2018.
Youssef, G., S. Nagy, A. El-gengehe, M. A. Hamid, and A. Abdelaal, "Once versus twice daily antihypertensive medications for the control of nocturnal blood pressure: a comparative study.", The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, vol. 72, issue 1, pp. 9, 2020. Abstract

BACKGROUND: Blood pressure (BP) shows short-term variability within the 24 h, which can only be assessed with 24-h ambulatory blood pressure monitoring (ABPM). It is of utmost importance to control BP throughout the night to reduce incidence of hypertension complications. The purpose of this study is to evaluate the effect of timing and frequency of antihypertensive medications on the average nighttime and 24-h blood pressure control.

RESULTS: The study enrolled 199 hypertensive patients with controlled office blood pressure; 135 (67.8%) patients were on once daily antihypertensive medication (group 1) while 64 (32.2%) patients were on twice daily doses (group 2). The mean office SBP was 128.7 ± 7.8 mmHg in group 1 vs 129.6 ± 6.6 mmHg in group 2, (p = 0.421). ABPM readings for both groups were as follows: mean daytime SBP was 125.4 ± 11.6 mmHg vs 130.1 ± 12.9, p = 0.011; mean nighttime SBP was 117.0 ± 12.4 mmHg vs 123.1 ± 13.9 mmHg, p = 0.002, and mean 24-h SBP was 122.7 ± 10.6 mmHg vs 127.5 ± 12.0, p = 0.005. The prevalence of non-dipping was 68.9% in group 1 vs 70.3% in group 2 patients, p = 0.8 (the mean dipping ratio was 0.93 ± 0.08 in group 1 vs 0.95 ± 0.07 in group 2, p = 0.198). The prevalence of masked hypertension was higher in group 2 (28.1% vs 43.8%, p = 0.029).

CONCLUSION: Taking an extra antihypertensive pill at night did not show a decrease in the nighttime or the average 24H blood pressure in hypertensive patients with controlled office BP. On the contrary, patients who used twice daily antihypertensive medications seem to have higher nighttime and 24-h SBP, although the dipping ratio was comparable in both groups.