Yunis Daralammouri - Academia.edu (original) (raw)

Papers by Yunis Daralammouri

Cardiology research and practice, 2024

Case Reports in Medicine, 2012

Hypertrophic cardiomyopathy is the most common genetic disease of the heart. We report a rare cas... more Hypertrophic cardiomyopathy is the most common genetic disease of the heart. We report a rare case of hypertrophic obstructive cardiomyopathy mimicking an acute anterior myocardial infarction associated with sudden cardiac death. The patient presented with acute ST elevation myocardial infarction and significant elevation of cardiac enzymes. Cardiac catheterization showed some atherosclerotic coronary artery disease, without significant stenosis. Echocardiography showed left ventricular hypertrophy with a left ventricular outflow tract obstruction; the pressure gradient at rest was 20 mmHg and became severe with the Valsalva maneuver (100 mmHg). There was no family history of sudden cardiac death. Six days later, the patient suffered a syncope on his way to magnetic resonance imaging. He was successfully resuscitated by ventricular fibrillation.

European Heart Journal, 2012

Palestinian medical and pharmaceutical journal/Palestinian medical & pharmaceutical journal, Mar 1, 2024

Percutaneous coronary intervention in unprotected left main coronary artery Percutaneous coronary... more Percutaneous coronary intervention in unprotected left main coronary artery Percutaneous coronary intervention in unprotected left main coronary artery stenosis patients. A Retrospective Study from Palestine stenosis patients. A Retrospective Study from Palestine

Palestinian Medical and Pharmaceutical Journal, Apr 5, 2020

Palestinian Medical and Pharmaceutical Journal

BMC Cardiovascular Disorders

Background Heart failure (HF) is considered one of the main causes of morbidity and death among c... more Background Heart failure (HF) is considered one of the main causes of morbidity and death among chronic diseases worldwide. Patients have increasingly reported chronic pain in long-standing heart failure as a disturbing symptom. Its unknown etiology and mechanism, in addition to its insidious progressive nature, made both the doctor and the patient not notice it until it affects the quality of life (QoL) and general health status. The primary objective of this study is to find the prevalence of pain in chronic heart failure patients and its impact on their QoL. The secondary objective is to determine the predictors of QoL in HF patients. Methods A multicenter cross-sectional design was used. The European Quality of Life scale five dimensions scale and the Brief Pain Inventory were adopted to evaluate QoL and pain, respectively. The Statistical Package for the Social Sciences version 25 was applied to present the data. The Mann-Whitney U, Kruskal-Wallis, and Cronbach alpha tests were...

Akute hämodynamische Auswirkung der Optimierung des AV-Intervalls mit der Impedanzkardiographie b... more Akute hämodynamische Auswirkung der Optimierung des AV-Intervalls mit der Impedanzkardiographie bei Zweikammerstimulation Abstract: Hintergrund: Eine Optimierung des AV- Intervalls bei Zweikammerstimulation kann zu einer Verbesserung der Hämodynamik führen. Die Beurteilung der Hämodynamik kann mittels invasiver und nichtinvasiver Verfahren erfolgen. Eine mögliche Methode ist die Impedanzkardiographie, bei der kardiale Voluminaänderungen registriert werden. Ziel dieser Arbeit war eine Untersuchung der akuten hämodynamischen Effekte unterschiedlich lang programmierter AV- Intervalle bei 2- Kammerstimulation ermittelt durch Bestimmung des Herzschlagvolumens mit der Impedanzkardiographie. Methoden: Eingeschlossen wurden 42 Patienten, die einen Zweikammer-Schrittmacher bzw. 2-Kammer-ICD implantiert bekommen hatten, aufgenommen und es wurde eine Optimierung des AV- Intervalls mittels Impedanzkardiographie vorgenommen. Die linksventrikulären Pumpfunktion wurde echokardiographisch ermittelt...

Cardiology Research and Practice, 2021

Background. The standard electrocardiogram (ECG) is commonly performed in the supine posture. It ... more Background. The standard electrocardiogram (ECG) is commonly performed in the supine posture. It may be difficult to report ECG in a supine posture for those who are unable to adopt the supine posture because of certain circumstances such as acute respiratory distress syndrome—patients who are placed in a prone position for long periods to improve oxygenation. Few data are available on the impact of the prone position on the ECG recording with electrodes on the posterior chest. Examining and analyzing the type and extent of changes observed in the prone ECG in healthy adults have become vitally valuable. Methods. A cross-sectional observational study enrolled forty healthy adults (24 males and 16 females) aged between 18 and 40 years. The ECG was performed in two different body positions, supine and prone. Influence of prone position on the heart rate, mean QRS axis, amplitude, morphology, duration, mean T wave axis and polarity, mean P wave axis, PR, and mean QTc duration was evalu...

Journal of Medical Case Reports, 2016

Background: A normal anatomy of coronary arteries is important to have adequate cardiac muscle bl... more Background: A normal anatomy of coronary arteries is important to have adequate cardiac muscle blood supply especially during extraneous physical activities. This case report describes a rare coronary anomaly in which the accessory coronary artery arose from the right coronary artery, reentered the left anterior descending coronary artery, and then ran as a single vessel. Case presentation: We present a case of a coronary anomaly in a 47-year-old white man who presented with atypical angina. Computed tomographic angiography and coronary angiography showed a variant of dual left anterior descending coronary artery not previously described. Our patient's accessory coronary artery arose from his right coronary artery. It took an intramuscular course beneath the right ventricular outflow tract in the interventricular septal area to the anterior interventricular sulcus, giving off septal perforators that reentered his medial left anterior descending coronary artery. Both vessels ran after the anastomosis in the anterior interventricular sulcus as a single vessel. Conclusions: We propose that this anomaly represents a new variant of coronary artery anomaly. This coronary artery anomaly does not cause ischemia. Recognition of this coronary anomaly is important in patients undergoing percutaneous coronary intervention or coronary artery bypass graft operations.

International Heart Journal, 2017

Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to anal... more Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention. We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014. Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63.8%). Non-STEMI accounted for two-thirds of the myocardial infarctions. We found higher prevalences of previous coronary artery disease (CAD) (38%), other atherosclerotic diseases (20.4%), cardiac risk factors such as hypertension (84.3%), diabetes (49.1%), hyperlipidemia (50.9%), heart failure (42.6%), atrial fibrillation (AF) (25.0%), severe aortic stenosis (13.0%), severe mitral regurgitation (3.7%), and implantable devices (25.0%), and co-morbidities such as renal impairment (48.1%), COPD (12.0%), and previous stroke (6.5%). Three-vessel disease was present in 34.6% of the patients. The left anterior descending artery (LAD) was the most affected coronary artery (67.6%). Percutaneous coronary intervention (PCI), mostly with bare metal stents (BMS), was used to manage 54.6% of the patients, and it failed in 4 of the patients. Conservative treatment was used in 39.8% of the patients and 15.7% had no significant CAD. The incidences of vascular complications, such as bleeding (6.5%), bleeding in other organs (6.5%), blood transfusion (6.5%), in-hospital paroxysmal atrial fibrillation (7.4%), in-hospital successful reanimation (2.8%), complete heart block (5.6%), acute renal impairment (23.1%), associated infection (25.9%), cardiogenic shock (14.8%), and death (15.7%) were high. Considering the more extensive risk factors, CAD and co-morbidities, acute presentation and age per se, we believe that the reported higher rates of complications and mortality are still acceptable.

The Journal of Thoracic and Cardiovascular Surgery, 2013

Coronary artery aneurysm (CAA), first described Bougon in 1812, 1 is a localized dilatation excee... more Coronary artery aneurysm (CAA), first described Bougon in 1812, 1 is a localized dilatation exceeding the diameter of adjacent arterial segments by 50%. 2 The uncommon CAAs with diameters larger than 2 cm are considered giant aneurysms. 3,4 We report here the case of a giant CAA detected incidentally in a 67-year-old man and successfully resected.

International Journal of Cardiology, 2008

Rarely, hypertrophic cardiomyopathy can be associated with ST elevation on electrocardiogram. We ... more Rarely, hypertrophic cardiomyopathy can be associated with ST elevation on electrocardiogram. We report a rare case of anterior hypertrophic cardiomyopathy mimicking an acute myocardial infarction where the diagnosis of myocardial hypertrophy was made by cardiac magnetic resonance. The method was able to identify the myocardial hypertrophy located in basal segments of anterior wall respect to echocardiography.

The American Journal of Cardiology, 2006

Many clinical studies have evaluated the inflammatory response (mainly interleukin [IL]-6 and C-r... more Many clinical studies have evaluated the inflammatory response (mainly interleukin [IL]-6 and C-reactive protein [CRP]) after percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). The aim of this study was to verify the source of possible elevation of IL-6 and CRP after PCI using coronary sinus sampling. We studied 87 subjects who underwent coronary angiography for diagnostic, therapeutic, or follow-up purposes. Blood samples were taken by the PCI team during the catheterization study from the coronary sinus. We measured coronary IL-6 levels by sandwich enzyme-linked immunosorbent assay, and high-sensitivity CRP levels were measured by latex immunonephelometry. The subjects were then classified according to their coronary angiographic findings into non-CAD (no evidence of significant organic CAD), mild CAD (1 vessel narrowed), and severe CAD (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=2 vessels narrowed) groups. PCI (including stent deployment) was performed in 16 patients with CAD. The mean coronary IL-6 value was higher in the severe than in the mild CAD group (3.67 +/- 2.48 vs 2.3 +/- 1.15 pg/ml, p = 0.027). The mean coronary IL-6 value was higher in the subjects who underwent PCI than in those who did not (2.9 +/- 1.23 vs 1.87 +/- 0.9 pg/ml, p = 0.037), and the same was found regarding CRP (1.244 +/- 0.72 vs 0.498 +/- 0.51 mg/L, p = 0.032). The coronary IL-6 values correlated positively with the coronary CRP values (r = 0.374, p = 0.017). In conclusion, the increase in coronary IL-6 and CRP levels after PCI in patients with CAD might be attributed to their release from the coronary atheroma secondary to the direct mechanical effect applied on the atheroma itself by balloon inflation and stent deployment.

Journal of Interventional Cardiology

Background. In our clinical practice, conventional radial access has been employed routinely for ... more Background. In our clinical practice, conventional radial access has been employed routinely for coronary procedures. The distal radial artery (DRA) access site has recently emerged as a novel technique in cardiac procedures. Objectives. This study compares distal radial access to standard forearm radial access (FRA) in terms of feasibility, outcomes, and complications. Method. This prospective, randomized trial was conducted at a single center. The patients were chosen from An-Najah National University Hospital’s catheterization laboratory between December 2019 and November 2020. A total of 209 patients were randomized into two groups: DRA group (n = 104) and FRA group (n = 105). Results. Access was successful in 98% of patients in both the groups. The DRA group had a longer puncture duration and a higher number of attempts (duration: 56.6 ± 61.1 s DRA vs. 20.0 ± 18.4 s FRA, p < 0.001 , attempts: 1.9 ± 1.3 DRA vs. 1.2 ± 0.60 FRA, p < 0.001 ). Puncture-associated pain was grea...

BMC Nephrology, 2022

Background Right ventricular (RV) function is an important prognostic predictor for end-stage ren... more Background Right ventricular (RV) function is an important prognostic predictor for end-stage renal disease (ESRD) patients. Non-invasive evaluation of RV function by simple electrocardiogram (ECG) is not yet evident. The purpose of this article was to investigate the presence and association of pathological right ventricular changes in synthesized ECG with cardiac hospitalization and mortality. Methods A prospective cohort study of 137 ESRD patients (mean age: 56 years) were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. Synthesized ECG was done right before the hemodialysis (HD) session. The pathological right ventricular changes were recorded for each patient. The relationship between pathological RV changes and mortality, cardiac and non-cardiac hospitalization was assessed through a 6-months follow-up period. Results Right ventricular Q wave was found in 2.2% of patients, while right ventricular ST elevation was found in 0.7% o...

Background: Diffuse large B cell lymphoma (DLBCL) is the most common histologic subtype of non-Ho... more Background: Diffuse large B cell lymphoma (DLBCL) is the most common histologic subtype of non-Hodgkin lymphoma. Secondary involvement of the heart is seen late in advanced cases and it is uncommon for DLBCL to present as a cardiac mass.Case Presentation: A 26-year-old female patient presented with progressive shortness of breath, facial swelling, and lower limb swelling. Echocardiography showed a large right atrial mass that was obstructing the tricuspid valve. Computed topography (CT) scan confirmed the findings and a large mediastinal mass with a filling defect in the right atrium occluding the distal Superior Vena Cava was identified. Histopathology showed DLBCL. She received 6 cycles R-CHOP chemotherapy (rituximab, cyclophosphamide, epirubicin, vincristine, and prednisone) with good response and complete resolution of the mass.Conclusions: DLBCL can present with atypical, uncommon sites as the first presentation, such as the heart. Early diagnosis and appropriate management is ...

BMC Cardiovascular Disorders, 2016

Background: Impedance cardiography (IC) is a noninvasive modality that utilizes changes in impeda... more Background: Impedance cardiography (IC) is a noninvasive modality that utilizes changes in impedance across the thorax to assess hemodynamic parameters, including stroke volume (SV). This study compared aortic valve area (AVA) as assessed by a hybrid approach of transthoracic echocardiography (TTE) and impedance cardiography (IC) to AVA determined at cardiac catheterization using the Gorlin equation. Methods: A total of 30 patients with moderate to severe aortic stenosis underwent AVA measurement using two different approaches: using the continuity equation (CE) in a hybrid method combining IC and TTE (AVA = stroke by volume impedance cardiography/trans-aortic-VTI) and using the Gorlin equation. Patient age ranged from 37 to 82 years (mean 48); there were 21 men and 9 women. Twenty-five patients were in sinus rhythm, and five had atrial fibrillation. Results: There was no statistically significant difference for the mean AVA between the two methods (0.7 ± 0.24 cm 2 using the Gorlin equation versus 0.7 ± 0.23 cm 2 using the hybrid approach, p = 0.17; r = 0.76, p < 0.001). The mean difference was 0.004 cm 2 , and the limits of agreement were −0.33 to 0.37. Conclusion: The hybrid method using impedance cardiography and TTE is a reasonable, clinically applicable approach to evaluate AVA and has significant correlation to invasive measurement using the Gorlin equation.

Indian pacing and electrophysiology journal

Phrenic nerve stimulation (PNS) and high pacing thresholds (HPT) hinder biventricular stimulation... more Phrenic nerve stimulation (PNS) and high pacing thresholds (HPT) hinder biventricular stimulation in patients (pts) undergoing cardiac resynchronization therapy (CRT). A new quadripolar left ventricular (LV) lead (Quartet 1458Q, St. Jude Medical) with increased number of pacing configuration, might overcome this problem. All consecutive pts in whom a standard bipolar lead intraoperatively resulted in PNS and/or HPT (≥4.00V/1mV), received, during the same implant, a quadripolar LV lead. Aim of the study was to evaluate acute and short term outcome. 26 pts [24 (92%) male, mean age 74±6 years)] with PNS (22 pts; 85%) and HPT (4 pts; 15%) were included. Permanent right ventricular pacing was the reason for broad QRS complex in 4 (15%) pts, whereas all other pts had a left bundle branch block. Severely symptomatic (NYHA Class ≥3) heart failure with reduced ejection fraction (EF 31±9%) was mostly caused by ischemic heart disease (14 pts; 54%). Idiopathic dilated cardiomyopathy and valvula...