Mohamed Ayman Saleh

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Impact of exercise training on myocardial contractile functions assessed by cardiac magnetic resonance in post-myocardial infarction patients

The Egyptian Heart Journal (2022)

Ahmed Elshazly Rana Lateef Hasan Mohamed Ayman Saleh Ahmed S. Ibrahim Hazem Khorshid

Improvement of functional capacity and mortality reduction in post-MI patients were found to be associated with regular exercise training. The cardiac magnetic resonance (CMR) is considered the most accurate non-invasive modality in quantitative assessment of left ventricular (LV) volumes and systolic functions. Our main objective was to investigate the impact of exercise training on LV systolic functions in patients post anterior MI using CMR. 32 patients on recommended medical treatment 4 week after having a successful primary PCI for an anterior MI were recruited, between May 2018 and May 2019. They were divided into two groups, training group (TG): 16 assigned to a 12 week exercise training program and control group (CG): 16 who received medical treatment without participating in the exercise training program. Treadmill exercise using modified Bruce protocol was done to TG before and after the training program in order to record the resting and maximum HR, metabolic equivalent (MET), and calculate HR reserve. CMR was performed for all patients 4 weeks after PCI and was repeated after completion of the study period to calculate ejection fraction (EF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and wall motion score index (WMSI).100% were males. 6 patients from CG dropped during follow-up, no statistically significant difference between the two groups regarding age, BMI, smoking status, hypertension, diabetes mellitus and dyslipidemia. Using the CMR, the TG showed significant improvement in EF (36.6 ± 14.2% to 43.1 ± 12.4%; P < 0.001) and WMSI (2.03 ± 0.57 to 1.7 ± 0.49; P < 0.001), without statistically significant change in LV volumes. Regarding CG no significant changes in EF, WMSI, LV volumes were found. There was significant improvement in EF and WMSI change before and after study in TG vs. CG [6.5 (2.3-9.0) vs. - 2.0 (- 6.8 to 1.3), P value < 0.001] and [- 0.3 (- 0.5 to 0.1) vs. 0.1 (- 0.1 to - 0.5), P value 0.001] respectively.12 weeks of exercise training program in post-MI patients have a favorable impact on LV global and regional systolic functions without adversely affecting LV remodeling (as assessed by CMR).

Bruce protocol

Dyslipidemia

10.1186/s43044-022-00288-4

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Citations (3)

Correlation between endothelial dysfunction and occurrence of no-reflow in patients undergoing post-thrombolysis early invasive percutaneous intervention for ST-elevation myocardial infarction

The Egyptian Heart Journal (2022)

Mohamed Abdel Wahab Elbendary Mohamed Ayman Saleh Sameh Sabet Islam Bastawy

Abstract Background Endothelial dysfunction and no-reflow share microcirculatory obstruction as a common pathophysiological mechanism. This study evaluated the relationship between systemic peripheral endothelial dysfunction assessed by flow-mediated dilatation (FMD) of the brachial artery and no-reflow in patients with ST-segment elevation myocardial infarction (STEMI) who received successful fibrinolysis. Results This study included 150 patients managed by the percutaneous coronary intervention (PCI) after successful fibrinolysis. Patients were divided according to coronary angiographic success into normal flow versus no-reflow groups. According to FMD measured through brachial artery ultrasound, patients were divided based on their endothelial function into endothelial dysfunction versus normal endothelial function. No-reflow occurred in 44 patients (29.3%). No-reflow patients had longer pain to door time (6.52 ± 1.82 vs 5.19 ± 1.85 h), more Killip class II (36.4% vs 16%, p = 0.006), and lower FMD (7.26 ± 1.92 vs 8.23 ± 2.76%, p = 0.036). Also, they showed more endothelial dysfunction; however, this difference was statistically nonsignificant (97.7% vs 87.7%, p = 0.055). One hundred and thirty-six patients (90.7%) had endothelial dysfunction. They were older (57.51 ± 5.92 vs 50.86 ± 4.55 years, p value ≤ 0.001), more smokers (41.2% vs 14.3%, p = 0.04). Patients with normal endothelial function had a more myocardial blush grade (MBG) 3 (78.6% vs 26.5%, p value = 0.001) in comparison with more MBG 2 in those with endothelial dysfunction (41.9% vs 14.3%, p value = 0.001). Endothelial dysfunction patients had nonsignificant more no-reflow (31.6% vs 7.1%, p -value: 0.06). There was a significant weak positive correlation between thrombolysis in myocardial infarction (TIMI) flow and FMD ( r = 0.174, p = 0.033) and a significant moderate positive correlation between MBG and FMD ( r = 0.366, p < 0.001). Patients with TIMI I flow had significantly lower FMD compared with patients with TIMI II and TIMI III flow post-PCI. FMD ≤ 6% could predict post-procedural TIMI I flow. Conclusions In STEMI patients who underwent PCI within 24 h after successful fibrinolysis, those who had no-reflow showed worse peripheral systemic endothelial function as they had lower brachial artery FMD. Also, FMD showed a significant positive correlation with the post-procedural angiographic flow (TIMI flow and MBG). FMD ≤ 6% could predict TIMI I flow.

Endothelial Dysfunction

Brachial artery

TIMI

No reflow phenomenon

10.1186/s43044-022-00309-2

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The impact of a comprehensive pharmaceutical care intervention in addition to cardiac rehabilitation program on outcomes of post-acute coronary syndrome patients: A pilot study

Patient Education and Counseling (2022)

Eman Casper L. Mohmed El Wakeel Mohamed Ayman Saleh Manal El‐Hamamsy

10.1016/j.pec.2022.06.004

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Citations (2)

CHA2DS2 VASc score and brachial artery flow-mediated dilation as predictors for no-reflow phenomenon in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

The Egyptian Heart Journal (2022)

Mohamed Ismail Rashed Mohamed Ayman Saleh Ehab Mohamed Elfekky Ahmed Elmahmoudy

Following primary percutaneous coronary intervention (PCI), no-reflow is associated with a high rate of long-term unfavorable clinical outcomes. Despite the importance of early no-reflow prediction in cardiovascular medicine, noninvasive assessment is lacking. This study aimed to evaluate the preprocedural CHA2DS2 VASc score and the brachial artery flow-mediated dilation percentage (FMD%) as predictors of the no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI.This study included 150 patients who presented with acute STEMI, underwent primary PCI, and were divided into two groups according to the flow result, reflow group and a no-reflow group. The CHA2DS2 VASc score was calculated and evaluation of endothelial function by measuring the brachial artery FDM% was done for each patient before the procedure. There were 39 (26%) patients in the no-reflow group and 111 (74%) in the reflow group. The no-reflow patients were older and had significantly higher body mass index (BMI), higher frequency of diabetes mellitus, hypertension, history of heart failure, dyslipidemia, Killip class IV on admission, thrombus grade V, multiple affected vessels, conventional stenting, and multiple stents placement, longer ischemic times, higher CHA2DS VASc score, and lower brachial artery FMD% (p-values of < 0.05 for all). Moreover, there was a significant negative correlation between CHA2DS VAS score and preprocedural FMD%, with the higher the score indicating lower FMD among cases (p-value = 0.000).Preprocedural CHA2DS2 VASc score and the brachial artery FMD can be used as predictors for the no-reflow phenomenon in patients with STEMI, undergoing primary PCI.

No reflow phenomenon

Brachial artery

Killip class

10.1186/s43044-022-00249-x

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Citations (4)

Towards Efficient Energy Usage at Ain Shams University Campus

Journal of Sustainability Perspectives (2023)

Walid El‐Khattam A. E. Elsabagh Ghada Farouk Hassan Mohamed Ayman Saleh Mahmoud El‐Meteini

In the light of global energy transition to renewable resources and energy efficiency usage, Ain Shams University (ASU) developed an ambitious plan to transform its campus into Green Campus. From an energy perspective, energy consumption data were continuously collected and audited to calculate the university campus carbon footprint. An energy usage strategy was established to tackle various pillars such as electrifying the campuses’ transportation system, improving energy efficiency usage, generating Renewable Energy (RE) for self-consumption, etc. Extensive research has been initiated on electric vehicles, wind and solar Photovoltaic (PV) energy generation with students’ activities/competitions. Thus, electric cars and buses were manufactured at the Faculty of Engineering (FoE) for elderly people and staff movement in ASU campus. Solar PV lighting poles with batteries were installed in the main campus. A small-scale Wind Turbine (WT) is manufactured and installed at the FoE and a pilot solar PV system is installed as well. Currently, an energy efficiency project is under implementation in various buildings/faculties and a parking lot that targets energy efficiency and solar PV energy generation. An energy efficiency measure is under implementation through replacing lamps with LED lamps, installing motion sensors, setting up a control center for monitoring and operation that is supported by Artificial Intelligence decision making algorithms. Rooftop solar PV energy systems are under design with smart meters. The project is targeting energy saving and bill reduction by at least 30% and as a result a reduction of carbon footprint will be achieved following the COP27 recommendations.

Carbon Footprint

10.14710/jsp.2023.21646

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A Comparison between Both Mineralocorticoid Receptor Antagonist Agents (Eplerenone and Spironolactone) in Prognosis of Heart Failure with Reduced Ejection Fraction (HFrEF)

The Egyptian Journal of Hospital Medicine (2019)

Mohamed Ayman Saleh Ramadan Ghaleb Mohammed Ayman Ibrahim Mena Mekhail Solhy

Background: heart is the target organ for Aldosterone, spironolactone and eplerenone (mineralocorticoid receptor antagonists) inhibits the aldosterone extraction through the heart in patients with congestive heart failure (CHF).Objective: to evaluate prognostic impact of both MRA (spironolactone and eplerenone) on heart failure and compare between both agents in incidence of side effect (gynecomastia and hyperkalemia).Patients and Methods: the study was conducted from March 2016 to September 2016 at Aswan University hospital.Our study population consisted of 100 adult patients, who were proved to have heart failure symptoms, with reduced ejection fraction heart failure divided in two groups.Group A contains 50 patients on spironolactone in addition to other anti-failure treatments according to ESC guidelines.Group B is 50 patients on eplerenone in addition to other anti-failure treatments according to ESC guidelines.Results: follow up had been done after one month for patient clinical status and serum potassium level and development of gynecomastia.Another Follow up was done after 3 months for BNP level, gynecomastia, NYHA classification and body weight.Conclusion: MRA are important line of treatment in HF patients, eplerenone and spironolactone are both have good result in improving BNP level and improving NYHA classifications and patients weight loss.

Eplerenone

Gynecomastia

10.21608/ejhm.2019.38654

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Citations (2)

Prognostic Value of Microvascular Obstruction Following Primary Revascularization in Egyptian STEMI Cohort: CMR Study

Cardiovascular revascularization medicine (2022)

Michael Gergis Ramadan Ghalib Amr Shaaban Hanafy Wesam Elmozy Ahmad Samir

10.1016/j.carrev.2022.06.157

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