Prof. Samir Rafla, MD, PhD,  - Alexandria University - Emeritus professor of cardiology

Prof. Samir Rafla

MD, PhD,

Alexandria University

Emeritus professor of cardiology

Alexandria, Alexandria | Egypt

Main Specialties: Cardiovascular Disease, Clinical Cardiac Electrophysiology

Additional Specialties: electrophysiology

ORCID logohttps://orcid.org/0000-0001-8688-6532

Prof. Samir Rafla, MD, PhD,  - Alexandria University - Emeritus professor of cardiology

Prof. Samir Rafla

MD, PhD,

Introduction

Name SAMIR MORCOS RAFLA
Born 31 August 1947 Egypt.
Certificates:
- Bachalorious in Medicine and Surgery, grade Very Good with honor, June 1970 Alexandria University
- Diploma in Medicine, June 1974
- Doctoral Degree in Medicine (Cardiology), June 1982, Alex. Univ.
- ECFMG 1983
Positions:
- Resident in Cardiology June 1972 to February 1975
- Assistant Lecturer in Cardiology March 1975 to June 1982
- Lecturer in Cardiology June 1982
- Assistant Professor April 1989
- Professor of Cardiology June, Alexandria Univ. Department of Cardiology, June 1994
- Head of the Cardiology Dept. Alexandria Univ. since 1/8/2004 till 30 August 2007 (three years and one month).
Other positions:
- Vice president (Egyptian Cardiac Rhythm Association ECRA) for two years.
- Fellow American College of Cardiology (FACC)
- Fellow European Society of Cardiology (FESC).
- Fellow Heart Rhythm Society FHRS
- Member EHRA
- Member Egyptian Society of Cardiology.
- Head of the Cardiology Dept. Alexandria Univ. since 1/8/2004 to 30/8/2007
- Member (assessor) National board for promotion of assistant professors in cardiology and critical care for eight years 2004-2012
- Member editorial board (assessor) of the Egyptian Journal of Cardiology, Alexandria J of Medicine, Indian J of cardiology.
Awards and medals:
- Bronze medal of the Bachalorious with honor 1970.
- Silver medal of Award for scientific encouragement of Alexandria Univ. 1994
- Award of the Egyptian Medical Syndicate Feb 2008 for scientific distinction.

Scholarships: Research fellow in Cleveland Clinic Foundation, Ohio, USA for 10 months from Oct 1983 to Aug 1984.
Authorship:
- Differential diagnosis in clinical Medicine, part I, 1996, 1998
- Differential diagnosis in Clinical Medicine, part II 1996
- Recent advances in diagnosis and Management of Cardiac Arrhythmias, 2nd ed. 1998
- Alexandria book of cardiology 2004 (Co-author and co-editor).
- Principles of Cardiology Sept 2008 (single author).

Supervision of thesis: many times
Publications: Has many abstracts and papers accepted in conferences and journals in Europe and USA, Many abstracts in Egypt. Researchgate impact factor 14.61, number of publications 31
Representation outside Egypt: Co Chairman or Lecturer many times in conferences outside Egypt

Email smrafla@yahoo.com
Telephone 0020 (0)1001495577
Home 00203 5451072
Address 172 Omar Lotfy Street Sporting Alexandria Egypt
Publications are uploaded on Researchgate and on Google Scholar
Impact factor on Researchgate 16.7

Primary Affiliation: Alexandria University - Alexandria, Alexandria , Egypt

Specialties:

Additional Specialties:

Research Interests:

Education

Apr 1983
ECFMG
ECFMG
Ameriican Medical Exam, licence
Jun 1972
Alexandria University Faculty of Medicine
Ph.D. Emeritus professor
Cardiology

Experience

Apr 2019
Arrhythmologist
Teaching
Alexandria Cardiology department
Apr 1995
Alexandria Unniversity Eward and silver Medal for scientific encouragement
For publications
Apr 1995
Alexandria Unniversity Eward and silver Medal for scientific encouragement
For publications
Sep 1984
Fellow Cleveland Clinic Foundation OhioElectrophysiology
Research Fellow
Electrophysiology
Jun 1972
Alexandria University Faculty of Medicine
Emeritus professor
Cardiology

Publications

26Publications

9Reads

841Profile Views

24PubMed Central Citations

The Significance of Early Repolarization and Incomplete Right Bundle Block in Athletes

Citation: Rafla S, Younes, G.A.E, Nassar A, Kamal A (2020) The Significance of Early Repolarization and Incomplete Right Bundle Block in Athletes. Int J Sports Exerc Med 6:168. doi.org/10.23937/2469- 5718/1510168

International Journal of Sports and Exercise Medicine

Abstract Background: Sudden death in athletes is a major concern; the predictors remain to be settled. The significance of early repolarization is the subject of this work. Methods: The study included hundred persons engaged in competitive sports for duration not less than 6 months; with training at least 3 days per week and at least two hours per day. All were males. Full history especially questioning for syncope, tachycardias or chest pain was obtained as well as family history of sudden death or coronary disease. ECG was done for all plus echo Doppler in some cases. Early repolarization was accepted present if J point is elevated more than one mm in LII, III, aVF or in chest leads, with or without raised ST > 1 mm. RV conduction disturbance was considered present if there is Rsr’ or bifid R. 54 played isotonic sport while 46 were on isometric sport. Types of sports: 46 isometric (static) (body builders). Isotonic (dynamic) 54 (Bicycling 6, Football 15, Tennis 3, Basketball 16, Volleyball 8, Swimming 4, Boxing 2). Results: Early repolarization was found in 9 and Rsr’ were present in 14 subjects, (5 had both). None was diagnosed as Brugada or RV dysplasia. Echo was done in 15 who showed ECG increased voltage, increase in LV size was found in 5 (Diastolic diameter up to 61 mm). 10 persons were re-examined after months, no abnormal events were found. Follow up by telephone was up to two years. No one reported tachyarrhythmia or syncope neither before recruitment in the study (retrospective) or after follow-up (prospective). Conclusion: Early repolarization and RV conduction disturbance in athletes apparently did not prove to be hazardous. Further studies are needed.

View Article
June 2020

Does Mitral Valve Commissural Calcification Predicts Restenosis at Long-Term Follow-up After Percutaneous Balloon Mitral Valvuloplasty? DOI: 10.26502/fccm.92920099

Cardiology and Cardiovascular Medicine

Abstract Percutaneous balloon mitral valvuloplasty (PBMV) is an effective form of treatment for patients with mitral valve stenosis (MS). The commissural (com.) appearance is a factor that is not assessed by the mitral valve (MV) scores (as the Wilkins score). The aim of this study was to determine whether the presence of calcium in the MV coms. as demonstrated echocardiographically, could predict restenosis at 3 years follow-up after PBMV. 220 consecutive patients with rheumatic MS who underwent successful PBMV by using the Inoue balloon catheter were studied prospectively. Com. calcification (calc.) was present in 70 patients (32%). Com. splitting occurred immediately after PBMV in all the 220 patients studied. Bilateral com. splitting was present more significantly in patients without com. calc. than in patients with com. calc. (P < 0.001). 140 patients presented at 3 years follow-up. Com. calc. was present in 35 patients (25%) while the other 105 patients (75%) had no com. calc. Bilateral com. splitting was present more significantly in patients without com. calc. than in patients with com. calc. (P < 0.001). Severe MR was present in 20 patients (14.3%). It was present more significantly in patients with com. calc. than in patients without com. calc. (P < 0.001). Restenosis occurred in 30 patients (21.4%). Conclusion, patients with com. calc. have a lower incidence of bilateral com. splitting; have a higher incidence of severe MR at one year and at 3 years follow-up after PBMV. Old age, large LAD, high total echo score of the MV, MV score  8, lower MVA before PBMV, low incidence of bilateral com. splitting, low MVA after PBMV and the presence of com. calc. are significant predictors of restenosis at 3 years of follow-up. Com. calc. is a strong predictor of restenosis at 3 years follow-up after PBMV.

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April 2020

ECG interpretation and commentary

Journal of Cardiology and Cardiovascular Medicine

https://doi.org/10.29328/journal.jccm.1001083

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March 2020

Impact Factor 3.500

4 Reads

The pattern of risk-factor profile in Egyptian patients with acute coronary syndrome: phase II of the Egyptian cross-sectional CardioRisk project.

Cardiovasc J Afr 2019 Mar/Apr 23;30(2):87-94. Epub 2019 Jan 16.

Department of Physiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.

Background: Egypt is the most populous country in the Middle East and North Africa and has more than 15% of the cardiovascular deaths in the region, but little is known about the prevalence of traditional risk factors and treatment strategies in acute coronary syndrome (ACS) patients across Egypt.

Methods: From November 2015 to August 2017, data were collected from 1 681 patients with ACS in 30 coronary care centres, covering 11 governorates across Egypt, spanning the Mediterranean coast, Nile Delta and Upper Egypt, with a focus on risk factors and management strategies.

Results: Women constituted 25% of the patients. Premature ACS was common, with 43% of men aged less than 55 years, and 67% of women under 65 years. Most men had ST-elevation myocardial infarction (STEMI) (49%), while a larger percentage of women had unstable angina and non-ST-elevation myocardial infarction (NSTEMI) (32% each; p < 0.001). Central obesity was present in 80% of men and 89% of women, with 32% of men and women having atherogenic dyslipidaemia. Current smoking was reported by 62% of men and by 72% of men under 55 years. A larger proportion of women had type 2 diabetes (53 vs 34% of men), hypertension (69 vs 49%), dyslipidaemia, and obesity (71 vs 41%) (p < 0.001 for all). There were no gender differences in most diagnostic and therapeutic procedures, but among STEMI patients, 51% of men underwent primary percutaneous coronary intervention compared to 46% of women (p = 0.064).

Conclusions: Central obesity and smoking are extremely prevalent in Egypt, contributing to an increased burden of premature ACS, which warrants tailored prevention strategies. The recognised tendency worldwide to treat men more aggressively was less pronounced than expected.

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http://dx.doi.org/10.5830/CVJA-2018-074DOI Listing
February 2020
9 Reads
2 Citations
2.000 Impact Factor

Localization of the occluded vessel in acute myocardial infarction

Journal of Cardiology and Cardiovascular Medicine

https://doi.org/10.29328/journal.jccm.1001082

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February 2020

Impact Factor 3.500

3 Reads

The prognostic significance of QRS duration in patients with ST segment elevation myocardial infarction receiving thrombolytic therapy

Samir Rafla (2019) The Prognostic Significance of QRS Duration in Patients with ST-Segment Elevation Myocardial Infarction Receiving Thrombolytic Therapy. J Cardio Vasc Med 5: 1-15.

Journal of Cardiology and Vascular Medicine

The prognostic significance of QRS duration in patients with ST segment elevation myocardial infarction receiving thrombolytic therapySamir Rafla, MD, PhD; Tarek Elbadawy, MD, PhDSamir Rafla: MD, PhD, FACC, FESC, FHRS, member EHRA. Emeritus professor of cardiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt. 01001495577 smrafla@yahoo.comTarek Elbadawy: MD, PhD, Emeritus professor of cardiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt. 01288594234  tarekelbadawy7@gmail.comAbstractProlongation of the QRS duration has been shown to be associated with adverse outcomes post-myocardial infarction (MI). The relation to thrombolytic therapy was not widely studied before. The study included 30 patients with ST-segment elevation myocardial infarction who were given thrombolytic therapy. Results: ST segment deviation score (STD score) ranged from 5 to 23 with a mean of 14. ECG one hour after thrombolysis showed: Number of patients with successful thrombolytic therapy was sixteen (53.3%). ECG one day after thrombolysis showed: ST segment deviation score ranged from 0 to 10. QRS minimum duration ranged from 84 to 117 msec with a mean of 100. QRS maximum duration ranged from 85 to 118 msec with a mean of 102 msec. ECG measurements were repeated after thrombolytic therapy by one hour, 1 day, 2 days and on discharge. The 30 patients included in this study were divided into three groups according to the QRS maximum duration. The relation between QRS max before thrombolysis and the incidence of successful thrombolysis: Number of patients with successful thrombolytic therapy was not different in relation to QRS duration. QRS duration was compared with complications. Comparison between the success of the thrombolysis and the change of the QRS max before thrombolysis and before discharge showed that the shortening of the QRS duration in patients with successful thrombolysis was significant. Conclusion: improvement of QRS duration is a marker of successful thrombolysis.  The incidence of complications (arrhythmias, heart failure, shock, pulmonary edema, mortality) increases with the increase of the QRS duration. Key Words: Fibrinolytic therapy; QRS duration; Reperfusion; ST Segment Elevation Myocardial Infarction. Introduction:

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May 2019

Impact Factor 3.400

5 Reads

Follow-up of Atrial Septal Defect Closure after Percutaneous Balloon Mitral Valvotomy by Transesphageal Echocardiography

Rafl a S, Bishay T. Long-Term Follow-Up of Atrial Septal Defect Closure after Percutaneous Balloon Mitral Valvuloplasty by Transesphageal Echocardiography. Int J Cardiovasc Dis Diagn. 2019;4(1): 001-006.

International Journal of Cardiovascular Diseases & Diagnosis

ABSTRACT

Percutaneous Balloon Mitral Valvuloplasty (PBMV) involves atrial septostomy during the procedure. One of the consequences of

transseptal puncture is the creation of an Atrial Septal Defect (ASD). Transesophageal Echocardiography (TEE) can detect Left to Right

(L-R) shunts too small to be detected by other methods. The aim of this study was to evaluate the 3 years follow-up of ASD closure

after PBMV by TEE. 200 consecutive patients with rheumatic Mitral Stenosis (MS) who underwent successful PBMV by using the Inoue

balloon catheter were studied prospectively. ASD with small L-R atrial shunting occurred in all the patients (100%) immediately after

PBMV. Total study 200 patients. All the ASDs were small in size (≤ 5 mm). The puncture site (ASD site) occurred in the fossa ovalis

(Fo.Ov) in 120 patients (60%), while it occurred outside the Fo.Ov (either in the superior limbus or in the inferior limbus of the Interatrial

Septum (IAS)) in the other 80 patients (40%). 180 patients presented at 6 month follow-up. ASD was closed in 117 patients (65%), while

it was persisted in 63 patients (35%). 95 patients presented at 3 years follow-up. ASD was closed in 76 patients (80%) (Group I), while it

was persisted in 19 patients (20%) (Group II). All the 74 patients who had ASD immediately after PBMV in the Fo.Ov, presented with ASD

closure at 3 years follow-up. Only 2 patients who had ASD immediately after PBMV outside the Fo.Ov, presented with ASD closure at 3

years follow-up. All the 19 patients who presented at 3 years follow-up with ASD persistence had ASD immediately after PBMV outside

the Fo.Ov (14 in the superior limbus and 5 in the inferior limbus). No patient presented at 3 years follow-up with ASD persistence, had

ASD immediately after PBMV in the Fo.Ov Large LAD, high total Echocardiographic (echo) score of the Mitral Valve (MV), thick Fo.Ov,

thick superior limbus, thick inferior limbus and ASD site immediately after PBMV outside the Fo.Ov were signifi cant predictors of ASD

persistence at 3 years follow-up.

In conclusion, ASD with L-R atrial shunting occurs in all the patients after PBMV by using the Inoue balloon catheter. ASD after PBMV

persists in 20% of the patients at 3 years follow-up. Predictors of ASD persistence at 3 years follow-up are: large LAD, high total echo

score of the MV, thick Fo.Ov, thick superior limbus, thick inferior limbus and ASD site immediately after PBMV outside the Fo.Ov. ASD

closes at 3 years follow-up in all the patients who had ASD in the Fo.Ov immediately after PBMV. All the patients with ASD persistence

at 3 years follow-up had ASD outside the Fo.Ov after PBMV. It is recommended that operators doing transseptal puncture during PBMV

by using the Inoue balloon catheter should aim to do it in the Fo.Ov.

View Article
April 2019

1 Citation

Impact Factor 1.540

4 Reads

Study of the diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure

Samir Rafla, Ali Aboelhoda, Rania Swied, et al. Study of the diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. Merit Research Journal of Medicine and Medical Sciences (ISSN: 2354-323X) Vol. 7(3) pp. 112-118, March, 2019

Merit Research Journal of Medicine and Medical Sciences

research

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March 2019

1 Citation

Impact Factor 1.235

5 Reads

THE DANGER OF DUAL ANTIPLATELET THERAPY IN A PATIENT WITH ACUTE EFFUSIVE CONSTRICTIVE PERICARDITIS WHO WAS SUBJECTED TO STENTING.

Int. J. Adv. Res. 5(12), 1069-1072

International Journal of Advanced Research

Background: Patients admitted with chest pain and

electrocardiographic (ECG) changes have more than one possibility.

Wrong diagnosis and management can lead to complications up to

death.

Case presentation: A 55 year male presented with severe chest pain.

ECG revealed raised ST segment in inferior leads. The PR segment

depression of pericarditis was overlooked. The patient was admitted,

received loading doses of dual antiplatelet (DAP) (ASA 300 mg &

Clopidogrel 300 mg) plus heparin.

Clinical findings: Exam: B.P.: 110/70, T. 37 ˚C. Normal jugular

venous pulse (JVP). Heart: Normal. Echo revealed no regional wall

motion abnormalities and no pericardial effusion. CKMB = -ve,

Troponin Zero.

Diagnostic assessments: Coronary angio

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February 2019

1 Citation

6 Reads

Copeptin as Early Marker of Acute Non-ST Elevation Myocardial Infarction in Patients Suspected with Acute Coronary Syndrome

Citation: Samir Rafla, et al. “Copeptin as Early Marker of Acute Non-ST Elevation Myocardial Infarction in Patients Suspected with Acute Coronary Syndrome”. EC Cardiology 6.1 (2018).

View Article
February 2019

2 Citations

4 Reads

The Feasibility and Efficacy of Ablation of Paroxysmal Atrial Fibrillation Using Different Technologies

Citation. Rafla S, Kamal A, Nawar M, Kautzner J. 2019. The Feasibility and Efficacy of Ablation of Paroxysmal Atrial Fibrillation Using Different Technologies. International Journal of Cardiac Science and Research, Volume 2019, Issue 01

International Journal of Cardiac Science and Research Kosmos Publishers

Abstract

This analysis assesses the efficacy of ablation of paroxysmal atrial fibrillation (PAF). Methods: We studied 150 patients (pts) (86 males and 64 females) having a mean age of 51.3 yrs. (54 > 50, 96 below 50 yrs.), who suffered from symptomatic drug refractory paroxysmal AF. Cardiac MSCT (Multi Slice Computed Tomography) image integration to the 3D electroanatomic LA map was used in 106 pts (70.6%, however all of them underwent intracardiac echo guided imaging during the ablation procedure. 40 pts underwent manual radio frequency (RF) ablation using CARTO, 40 pts underwent ablation using NavX system, 70 pts underwent robotic ablation using Sansui system. Results: 34 patients (22.6%) developed early recurrence of AF after an initial blanking period of 3 months. The incidence of recurrence of AF in males was 13% (11/86), 14% in females (9/64), P= NS. ECG during follow up: Atrial Tachycardia 4, PAF 2, A. flutter 2. Complications: air embolism zero, cardiac tamponade zero, trivial pericardial effusion 1, groin hematoma 5%, pulmonary vein stenosis > 50% zero. There was no difference between males and females in success of ablation or complications. Those below age 50 and above 50 were not different in incidence of maintenance of SR or complications. In all, the mean age was 53.6 years in successful group and 58 years in failure group, with no significant differences between both groups. Conclusions: The success rate for the robotic group was 92.4%. The manually treated group (Carto and NavX) has a success rate of 88.5%.

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January 2019
5 Reads

Validation of Cornell Product as a Method of Assessing Left Ventricular Hypertrophy

Rafla S, Elzawawy T, Elbahy OI, Mohamed AK, Elshourbagy A (2018) Validation of Cornell Product as a Method of Assessing Left Ventricular Hypertrophy. Int J Cardiovasc Res 7:6.

International Journal of Cardiovascular Research

Abstract

Background: LV diastolic dysfunction (DD) and diastolic HF is

a major and widely spreaded health proplem and it’s

associated with higher cardiovascular morbidity and all-cause

mortality, ECG –LVH is studied as an early predictor of LV

diastolic dysfunction.

Methods: diastolic dysfunction is evaluated in 100 patients

with Cornell product (CP) criteria >2440 mm.ms with complete

evaluation of diastolic function via mitral inflow velocities (mitral

E velocity, A velocity and E/A ratio ), tissue Doppler

imaging(septal and lateral annular velocity, E/E’ ratio),

deceleration time, isovolumic relaxation time, left atrial

Enlargement, left ventricular mass index.

Results: Among the 100 patients (59% female and 41%

males ), 14% presented with normal diastolic function, while

86% had diastolic dysfunction with different grades, with

increasing values of CP with more progression of the diastolic

dysfunction severity, in concern to the echocardiographic

parameters there were progressively higher values of LVEDD,

PWD, IVSD, LVMI, E/A ratio, E/E’ ratio and LAVI with

advancement of diastolic dysfunction ; while there were inverse

relation between the diastolic dysfunction severity and (Evelocity,

a-velocity, lateral E’ velocity and DT).

The IVRT shows higher values with mild degree of diastolic

dysfunction then with progression of diastolic dysfunction there

were progressive reduction in IVRT values, while there were no

significant difference in concern of LVESD and septal E’

velocity between normal population and different grades of

diastolic dysfunction.

Conclusions: CP LVH is a strong predictor of presence of

Diastolic dysfunction and with higher degrees of diastolic

dysfunction; the CP LVH was higher indicating good predictor

for the severity of diastolic dysfunction.

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December 2018
9 Reads

Upgrading patients with pacemakers to resynchronization pacing Predictors of success

Samir Rafla et al, Merit Research Journal of Medicine and Medical Sciences, Vol. 5(10) pp. 472-476, October 2017

Merit Research Journal of Medicine and Medical Sciences

View Article
December 2018
7 Reads

Predictors of Ischaemia and Outcomes in Egyptian Patients with Diabetes Mellitus Referred for Perfusion Imaging

Citation: Rafla S, Abdel-Aaty A, Sadaka MA, Elhoda AAA, Shams AM (2018) Predictors of Ischaemia and Outcomes in Egyptian Patients with Diabetes Mellitus Referred for Perfusion Imaging . J Clin Exp Cardiolog 9: 591. doi:10.4172/2155-9880.1000591

Journal of Clinical and Experimental Cardiology

View Article
March 2018
19 Reads

Robotic Ablation of Atrial Fibrillation Saves Time and Irradiation Dose

Citation: Samir Rafla, Mostafa Nawar, Amr Kamal, Josef Kautzner (2017). Robotic Ablation of Atrial Fibrillation Saves Time and Irradiation Dose

Annals of Clinical Research and Trials

Research article

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December 2017
135 Reads

Effect of Kidney Dysfunction on Results of Revascularization of Multivessel Coronary Disease

Merit Research Journal of Medicine and Medical Sciences (ISSN: 2354-323X) Vol. 5(11) pp. 538-542, November, 2017

Merit Research Journal of Medicine and Medical Sciences

Kidney dysfunction is a risk factor for interventional procedures in coronary

artery disease. We analyzed this point. We studied 120 patients who had

objective and angiographic evidence of myocardial ischemia and significant

coronary artery disease (lesion > 70%) in two or more vessels. Forty

patients underwent Percutaneous Coronary Intervention (PCI) of the

significant lesions beside optimal medical therapy (PCI group II), 40 received

optimal medical therapy alone (medical-therapy group III) and 40 were

subjected to CABG (Group I). The choice between PCI and CABG was based

on the Syntax score. The 40 pts on medical therapy alone either refused

surgery (18), or were not suitable for surgery (12) or the lesions were not

severe as assessed by FFR (7) or failed stenting (3). The primary outcome

was death from any cause and nonfatal myocardial infarction during a

follow-up period of 1 year. There was no significant difference between the

three groups as regards incidence of diabetes, hypertension, dyslipidemia

or age. Renal dysfunction (creatinine >2) was present in 18 pts (10+4+4). The

highest was 2.28 mg/dl. Results comparing pts with creatinine >2 (18 pts)

with those with creatinine < 2 (102 pts): Death 0 vs 4 (NS), non fatal MI 3 vs 8

(NS), heart failure 0 vs 10 (NS), recurrence of chest pain 3 vs 7 (NS).

Conclusion: In 120 patients with multivessel disease treated by CABG or PCI

or medical therapy, the presence of creatinine >2 and < 2.3 did not affect the

results or prognosis or incidence of complications.

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November 2017
5 Reads

Smoking is a more dangerous risk factor than metabolic syndrome in Egyptian patients with acute myocardial infarction

Merit Research Journal of Medicine and Medical Sciences (ISSN: 2354-323X) Vol. 5(9) pp. 427-431, September, 2017

Merit Research Journal of Medicine and Medical Sciences

The aim of the manuscript is to assess the incidence of each risk factor in

our community as a predictor of acute myocardial infarction. Fifty patients

(Pts) admitted to the main university hospital with acute MI were studied.

Inclusion criteria were: pts diagnosed as acute ST segment elevation

myocardial infarction (STEMI) based on typical retrosternal chest pain

associated with typical electrocardiographic changes of STEMI, with at least

one cardiac enzyme assay result above twice the limit of normal. Incident

cases of acute STEMI presenting within 24h of symptoms onset were

eligible. Metabolic Syndrome (MS) components were defined as detailed in

the ATP III report: 1) waist circumference >102 cm in men and >88 cm in

women, 2) fasting triglycerides ≥150 mg/dl. 3) HDL cholesterol <40 mg/dl in

men and <50 mg/dl in women, 4) BP ≥130/85 mmHg, and 5) fasting - glucose

≥ 110 mg/dl. Participants with at least three of these components were

determined to have the MS. MS was present in 27 pts (54%) The incidence of

different risk factors in the 50 pts: Family history of any point (before age

60) as coronary disease, sudden death, diabetes, Ht was present in 36 pts

(72%), smoking 38 pts (76%). 60 % had diabetes. Comparing to incidence in

Egypt: Diabetes in infarcted patients was 5 (6) times more. Smoking was

twice more, metabolic s. was twice more; HT was twice more (48%). We

highlight the danger of diabetes and smoking as the most significant

predictors of MI in Egyptians.

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September 2017
9 Reads

Analysis of Bleeding Complications in Acute Coronary Syndrome: Comparison of Effect of Tirofiban in Diabetic and Non-Diabetic Patients

Citation: Rafla S, Zaki AM, Loutfi MI, Elsharkawy EM, Frishah HL (2018) Analysis of Bleeding Complications in Acute Coronary Syndrome: Comparison of Effect of Tirofiban in Diabetic and Non-Diabetic Patients. J Clin Exp Cardiolog 9: 598. doi:10.4172/2155-9880.1000598

Journal of Clinical and Experimental Cardiology

View Article
July 2017
107 Reads

Correlation between the incidence and severity of Aortic Valve Calcific Stenosis and Carotid Atherosclerosis

Samir Rafla, et al. Correlation between the incidence and severity of Aortic Valve Calcific Stenosis and Carotid Atherosclerosis. Biolife j 2017; 5(4):538-543

Biolife

ABSTRACT Background: Aortic valvular calcification (AVC) and carotid arterial disease (CaAD) have a high prevalence in elderly patients (pts). Aim of the work: To study the severity and relation of carotid plaques and coronary atherosclerotic lesions (CAD) in pts with calcific aortic sclerosis/stenosis. Methods: The study included 70 patients, 50 who had Aortic valve calcification (AVC) or stenosis, which was detected in TTE (systolic gradient more than 10 mmHg). The 20 other patients had Aortic valve thickening only or mild calcification (systolic gradient less than 10 mmHg). Risk factors were recorded. Results: Compared with pts with aortic valve thickening only, AVC was associated with significantly higher incidence of carotid plaques. . In the presence of aortic valve calcification/stenosis, there was 86% (43/50) incidence of carotid plaques or stenosis (0.002) and 75% incidence of coronary heart disease or LV hypertrophy p=0.037. IMT was abnormal in 80% and 40% in the two groups (P=0.01). Those with as systolic gradient > 35 mmHg (total 15), 12 patients, had carotid stenosis > 30% in (80%). Those with less AS (55 patients) had carotid stenosis > 30% in 2 only; p=0.0001. Conclusions: We found that aortic valve calcific stenosis with systolic gradient above 35 mmHg is associated with incidence of carotid stenosis in most patients (80%). This is new parameter to our knowledge. Thus carotid study is recommended in this level of stenosis. Key words: Carotid plaques, aortic calcific stenosis, intima media thickness, coronary

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May 2017
7 Reads

Clinical Significance of Inferior Vena Cava Index in Monitoring Patients in Acute Exacerbation of Chronic Heart Failure

SUZY FAWZI et al, Med. J. Cairo Univ., Vol. 84, No. 3, December: 377-385, 2016

Med. J. Cairo Univ

View Article
October 2016

3 Citations

Impact Factor 1.500

6 Reads

Detection of Intrapulmonary Shunts in Schistosomal Cor Pulmonale*

Chest

Detection of Intrapulmonary

Shunts in Schistosomal Cor

Pulmonale*

Samir M. Rajla, M.D., FC.C.P.; a111l Salah Sourow; M.D.

Two patients with schistosoma! cor pulmonale and central

cyanosis were studied by contrast-enhanced echocardiography,

using indocyanine green injection. Intrapulmonary

shunts were detected by this method. To our knowledge,

this is the first report that proves the presence of intrapulmonary

shunts in schistosoma) cor pulmonale detected by

contrast-enhanced echocardiography.

(Chest 1993; 104:1280-81)

CE =contrast enhanced

T he picture of schistosoma! cor pulmonale is a composite

one. In 1957, Zaki' described the various vascular shunts

in this disease. namely, (a) bronchopulmonary, (h) pulmonary

arteriovenous. (c) portopulmonary, and (d) intrasplenic. In

1964, Zaki et al' reported this type of pulmonary artery-

*From the Department of Medicine. Cardiolo!-,'}", and Chest Units,

Faculty of Medicine, Alexandria University, Alexandria, E!-,'}·pt.

Presented at the 57th Annual Seientifk Assemhlv, American

College of Chest Physicians, San Francisco, Novemht;r 4-H, 1991.

Fl<:t 'IIE I . Patient A (top): lndocyanine green injt•eled intravenously

and appearing in the right atrium and right \"t'ntricle. B (bottom):

Dye appeared in the left atrium and left ventricle after five cycles

denoting presence of intrapulmonary shunts. Cycles are counted

from video tape record.

Detection of

View Article
December 1993

6 Citations

5 Reads

Detection of Intrapulmonary Shunts in Schistosomal Cor Pulmonale*

Rafla S; Sorour, S. Detection of Intrapulmonary Shunts in Schistosomal Cor Pulmonale (Chest 1993; 104:1280-81)

Chest

Two patients with schistosoma! cor pulmonale and central

cyanosis were studied by contrast-enhanced echocardiography,

using indocyanine green injection. Intrapulmonary

shunts were detected by this method. To our knowledge,

this is the first report that proves the presence of intrapulmonary

shunts in schistosoma) cor pulmonale detected by

contrast-enhanced echocardiography.

(Chest 1993; 104:1280-81)

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May 1993

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How to quit smoking طريقة الاقلاع عن التدخين

Authors:
Samir Rafla

تعرف على  خطوات فعالة لطريقة الاقلاع عن التدخين How to quit smoking طريقة الاقلاع عن التدخين 1- قم بوضع خطة لـ الاقلاع عن التدخين: ويجب ان تضع لنفسك خطة لتساعد نفسك على الإقلاع عن التدخين، حيث يجب ان تحدد لنفسك مواقيت لتدخين السجائر، وعدد محدود لاستهلاكها في اليوم بأكمله.  2- اشغل وقتك ويومك بالمهام عند الاقلاع عن التدخين: ولكي لا تفكر في التدخين عليك ان تبقيه مشغولا بالعديد من المهام خلال يومك، حيث ان من دور هذا الأمر ان يصرف انتباهك عن الرغبة الملحة لتدخين السجائر، لذا عليك باتباع بعض العادات، مثل: ممارسة الرياضة. الخروج من المنزل للنزهة. مضغ العلكة أو الحلوى الصلبة. اجعل يديك مشغولين باستخدام القلم أو المسواك. اشرب الكثير من الماء. الاسترخاء مع التنفس العميق. إذهب إلى السينما. اقض بعض الوقت مع الأصدقاء والعائلة وبالأخص مع الأشخاص الغير مدخنين. إذهب إلى العشاء في مطعمك المفضل، واجلس في الجزء الغير مخصص للمدخنين.  3- تخلص من الأشياء التي تذكرك عند الاقلاع عن التدخين: وهناك بعض الأشياء أو المواقف، أو حتى الاماكن والتي يمكن ان تذكرك بالتدخين،.و فيما يلي بعض النصائح لمساعدتك في الإقلاع عن التدخين والتغلب على بعض مسببات التدخين الشائعة: تخلص من السجائر ، والولاعات ، وطفايات السجائر إذا لم تقم بذلك بالفعل. اقضي بعض الوقت مع أشخاص غير المدخنين. اذهب إلى الأماكن التي لا يسمح فيها بالتدخين. تناول الطعام الصحي، عند الشعور بالرغبة في تناول الطعام، أو الجوع الشديد. قم بتغيير روتينك لتجنب الأشياء التي قد ترتبط بها بالتدخين.  العاده أن تشرب سيجاره مع كوب الشاى أو فنجان القهوه هى عاده سيئه ولا معنى لها. كوب الشاى أو فنجان القهوه هو متعه فى حد ذاته ليس فى حاجه لإضافة "متعه" إضافيه عليه.   4-كن إيجابيا عند الاقلاع عن التدخين: وسوف يساعد ان تكون إيجابيا في الإقلاع عن التدخين، لذا عليك ان تكافئ نفسك إن مر عليك يوما كاملا بدون ان تدخن السجائر، وحتى إن خانتك عزيمتك، عليك ان تستعيد زمام الأمور، وتعود تتبع نفس الوتيرة في الإقلاع عن التدخين مرة أخرى.  5- اطلب المساعدة من الآخرين عند الاقلاع عن التدخين: لا تحتاج إلى الاعتماد على قوة الإرادة وحدها لـ الاقلاع عن التدخين، ولكن عليك ان تخبر عائلتك وأصدقائك عندما تبدأ في الإقلاع عن التدخين، وذلك حتى يتجنبوا التدخين أمامك، أو حتى يوفوا لك جميع السبل التي تساعدك في التغلب على أعراض الإنسحاب الصعبة. هذا الخبر منقول من : صدى البلد      

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November -0001
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A new score of positivity in Thallium studies of ischemic patients

Samir Rafla, Ahmed Gaber, Gehan Magdy, Ahmed Abdelaaty. A New Score of Positivity in Thallium Studies of Ischemic Patients. Cardiology and Cardiovascular Medicine 4 (2020): 045-057.

Cardiol Cardiovasc Med

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November -0001
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