Salma Krichène

Hedi Chaker Hospital, Şafāqis, Şafāqis, Tunisia

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Publications (19)16.74 Total impact

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    ABSTRACT: Supraventricular tachycardia in infants are variable. We try to summarize clinical, electrical and treatment particularities of supraventricular arrhythmia in infants. The majority of infants with supraventricular arrhythmia have a good clinical outcome and an excellent prognosis and may not require chronic antiarrhythmic therapy if they had precocious treatment.
    Annales de cardiologie et d'angeiologie 06/2011; 60(3):141-7. · 0.21 Impact Factor
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    ABSTRACT: To study the epidemiologic, clinical, therapeutic and prognostic characteristics of the myocardial infarction (MI) in patients with chronic kidney disease (CKD). To identify the impact of CKD in hospital, mid- and long-term survival after myocardial infarction. To determine the predictive factors of hospital and midterm MACCE in patients with CKD. The study population was 231 patients with a myocardial infarction admitted alive from January 2005 to December 2006. The population was divided into two groups. Group 1: glomerular filtration rate (GFR) ≥60 ml/min: 112 patients; group 2: GFR<60 ml/min: 119 patients. Patients with CKD had more history of stroke and arterial hypertension. They had received less medical therapies and urgent reperfusion. In multivariate analysis, CKD was a predictive factor of hospital (P=0.016), at 6 months (P=0.003), at 1 year (P=0.004) and at 2 years MACCE (P=0,015). The predictive factors of hospital MACCE in group 2 were: use of vasopressors (P=0.001) and primary angioplasty (P=0.043). In patients with CKD, only surgical coronary revascularization was MACCE predictive factor (P=0.03). Baseline renal function is a powerful predictor of short- and long-term events after myocardial infarction. Our results confirm the need to include the renal function in the evaluation of the level of risk among patients admitted with acute myocardial infarction.
    Annales de cardiologie et d'angeiologie 02/2011; 60(3):127-34. · 0.21 Impact Factor
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    Archives of Cardiovascular Diseases - ARCH CARDIOVASC DIS. 01/2011; 104(4):278-279.
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    ABSTRACT: Aims of the studyTo study the epidemiologic, clinical, therapeutic and prognostic characteristics of the myocardial infarction (MI) in patients with chronic kidney disease (CKD). To identify the impact of CKD in hospital, mid- and long-term survival after myocardial infarction. To determine the predictive factors of hospital and midterm MACCE in patients with CKD.
    Annales De Cardiologie Et D Angeiologie - ANN CARDIOL ANGEIOL. 01/2011; 60(3):127-134.
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    ABSTRACT: Supraventricular tachycardia in infants are variable. We try to summarize clinical, electrical and treatment particularities of supraventricular arrhythmia in infants. The majority of infants with supraventricular arrhythmia have a good clinical outcome and an excellent prognosis and may not require chronic antiarrhythmic therapy if they had precocious treatment.
    Annales De Cardiologie Et D Angeiologie - ANN CARDIOL ANGEIOL. 01/2011; 60(3):141-147.
  • Archives of Cardiovascular Diseases Supplements 01/2011; 3(1):47-47.
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    ABSTRACT: The large reduction in restenosis rates with drug-eluting stents (DES), compared with bare-metal stents (BMS), has already been demonstrated. In those studies this gain was not associated with safety concerns such as excess early and late stent thrombosis (ST). We tried to determine predictive factors of drug eluting instent thrombosis in a tertiary center. Our study is retrospective enrolling 619 patients who underwent drug eluting stenting. Thrombosis definition was based on the Academic Research Consortium (ACR 2008), We compared 2 groups T+ (thrombosis) et T-(no thrombosis). The rate of thrombosis was 3,7% (23 patients among 619). This complication occurred at a mean follow-up of 21,43 days. There were one case of acute thrombosis, 21 cases of subacute Thrombosis, one case of late thrombosis. No very late thrombosis was noted. Patients who had thrombosis were older (T+ = 67years old; T− = 63,16 years old), more diabetic (T+ = 65%; T− = 61,5%) but without significant difference. The occurring of stent thrombosis didn’t depend on the site nor on the technic of implantation. There was no correlation between this complication and stent sizes despite that it seems to be more frequent in the case of longer stents (T+ = 24,32; T− = 22,13; p = 0,47) and in the case of small diameter (T+ = 2,82; T− = 2,94; p = 0,36). Predictive factors of stent thrombosis were clopidogrel withdrawal for surgery (T+ = 43,47%; T− = 27,51%; p = 0,09), the early withdrawal of clopidogrel (T+ = 13,99 mois; T− = 9,08 mois; p = 0,02). Stent thrombosis was associated to the increase of major cardiovascular events (T+ = 39,13%; T = 9,7%; p < 0,001) especially myocardial infarction (T+ = 21,7%; T− = 1,67; p < 0,001), the rate of revascularisation (T+ = 13,04; T− = 3,35%; p = 0,01) but there was no significant effect on the mortality (T+ = 8,6%; T− = 3,02%; p = 0,13). Instent thrombosis is a lifethreatening complication occurring in 0 to 3,5% based on randomized studies. It is more frequent in case of drug eluting stenting.
    Archives of Cardiovascular Diseases Supplements 01/2011; 3(1):7-7.
  • Archives of Cardiovascular Diseases Supplements 01/2011; 3(1):51-52.
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    ABSTRACT: Introduction Several clinical trials have validated the effectiveness of drug eluting stents (DES) and its benefit comparing to bare-metal stent for restenosis rate reduction after angioplasty. But the major disadvantage of DES is thrombosis. The aim of this study is to describe clinical and angiographic outcomes of DES implantation in Sfax Cardiology Departments (public and private centers). Patients and methods Our study is retrospective including 619 patients undergoing percutaneous angioplasty by 769 eluding stents during the period between juillet 2003 and June 2009. Results The mean age was 63,25 years and most patients were men (80,7%). The majority of patients (61, 6%) were diabetic. Most patients (46, 3%) had multivessel disease. Coronary lesion sites were located mainly on the left descending coronary artery at 71, 4%. The mean diameter stent was 2, 93 ± 0,37 mm, and the mean length was 26,95 ± 6,91 mm. Coronary lesion was in the most time long (in 43,1%). We used Taxus stents in 81,4% of cases. The stenting was direct in 72,1% of procedures, and after dilatation in 22 procedures%. A post inflation was achieved in 11,3% of procedures. The mean of pression inflation was 14, 29 mmhg. The angiographic success was noted in 100%. The mean follow-up was 18, 26 months. Acute instent thrombosis occurred in 3,7% (23 patients/619 patients). One case of acute thrombosis, 21 cases of subacute thrombosis, one case of late thrombosis, no case of verylate thrombosis was noted. On the Follow up, an angiographic control was performed in 8,3% des cas (49 patients). A restenosis in stent was noted in 16% and new lesions were noted in 3,6% of cases. MACE rate was 10,2% with 2,5% of mortality. Conclusion The high price of drug eluting stents relative to bare stents has been an obstacle to widespread utilization of drug eluting stents in our tertiary region. These latter are more interesting for diabetic persons and complex lesions but they are limited by the risk of acute and late thrombosis.
    Archives of Cardiovascular Diseases Supplements 01/2011; 3(1):11.
  • Archives of Cardiovascular Diseases Supplements 01/2010; 2(1):58-58.
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    ABSTRACT: Introduction The multivalvular endocarditis is rare, frequently involving two valves, and is associated with bad prognosis. Objective To compare clinical, microbiological and in hospital prognostic of multivalvular infective endocarditis with single valve infective endocarditis. Methods and patients This is a retrospective study; included 225 patients admitted between 2001 and 2005 for management of infective endocarditis. Subsequently, our population was divided into two groups: Group 1: multivalvular patients (29 patients), Group 2: monovalvular patients (196 patients). Results Group1's patients were younger. Most of patients of two groups had underlying heart disease, essentially rheumatic heart disease. In group1, there is more mitral insufficiency, more aortic insufficiency (p=0.002), but less aortic stenosis. Groups’ 1 patients have more mechanical valves prosthesis (p=0,004). The germ most frequently involved was the staphylococcus in case of multivalvular disease (46.7% vs 37.3%) and streptococcus in case of monovalvular disease (26.7% vs 38.2%), but without a significant difference in the both cases. The localization of vegetations in multi valvular IE were: mitro aortic in 25 cases. In the TTE, there are more vegetations in group 1 : (p=0,048). Vegetations with size between 10 and 15 mm are more frequent in the group 1(p=0,019). Valvular perforations are more frequent (p=0,070). Evolution to valvular abscess (p=0,414), and acute pericardial effusion (p=0,051) was more frequent in group 1. During their hospital period, urgent surgical indication was more frequent in the group 1(62, 1% vs. 51, 3%; p=0,279), with more frequent hemodynamic indication (72, 2% vs. 47%; p=0,049). Hospital mortality is higher in the group 1 (21, 4% vs. 17, 2%; p=0,586), but without a statistical significance. Conclusion Mutivalvular endocarditis has specific characteristics: Staphylococcus is the more incriminated germ. It is associated to more complications, and necessitates more urgent surgery because of acute left heart failure.
    Archives of Cardiovascular Diseases Supplements 01/2010; 2(1):28-28.
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    ABSTRACT: Cardiac involvement in echinococcosis remains a singular finding, possibly associated with confusing symptomatology. We report the original case of a 17 year-old young woman, referred to our cardiology department for repeated exertion syncopes, and ultimately, proven through echocardiography, serologies and magnetic resonance imaging to have a massive hydatid cyst developing inside the left ventricular cavity towards the outflow tract. The cyst has been surgically completely removed with excellent results.
    International journal of cardiology 07/2009; 136(1):e21-3. · 7.08 Impact Factor
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    ABSTRACT: Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystemic disease with frequent cardiac involvement that may cause sudden death. This study was performed to determine the various cardiac manifestations in DM1, their frequency and the relevance of cardiac electrophysiological study in this disease. Ten patients with DM1, five men and five women, mean age 44.3+/-7.8 years underwent neurological and cardiac assessments. The most frequent electrocardiographic findings were conduction abnormalities, essentially by intraventricular conduction defects (eight out of ten cases) such as bundle branch or fascicular blocks. Echocardiography showed alterations in systolic left ventricular function in two cases. Invasive electrophysiology testing showed sub-hisien block in three patients, requiring cardiac pacemaker implantation. These three patients had normal duration of PR interval and normal width of QRS complex. We recommend that all patients with DM1 should undergo cardiac investigation to detect subclinical cardiac involvement.
    La Revue de Médecine Interne 04/2009; 30(7):573-7. · 0.90 Impact Factor
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    ABSTRACT: A 45 day old new-born with arrhythmia-induced cardiomyopathy complicated by thrombus formation is presented. Drug treatment produced immediate symptomatic relief and subsequent reversion to normal cardiac function. The thrombus disappeared a few days later.
    International journal of cardiology 02/2009; 146(2):e33-7. · 7.08 Impact Factor
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    ABSTRACT: IntroductionMyotonic dystrophy type 1 (DM1) is an autosomal dominant multisystemic disease with frequent cardiac involvement that may cause sudden death. This study was performed to determine the various cardiac manifestations in DM1, their frequency and the relevance of cardiac electrophysiological study in this disease.
    Revue De Medecine Interne - REV MED INTERNE. 01/2009; 30(7):573-577.
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    ABSTRACT: Left ventricular pseudoaneurysms are an uncommon and frightening complication after mitral valve replacement. We report the case of a 54-year old woman, having undergone a mitral valve replacement with uneventful postoperative course and normal echocardiographic predischarge control, who was readmitted to hospital, only 16 days later, for rapidly progressing dyspnea, and finally echocardiographically diagnosed to have a massive 8-cm long pseudoaneurysm communicating with the left ventricle through a narrow communication. The patient was proposed for emergency surgery but unfortunately died preoperatively.
    Echocardiography 12/2008; 25(10):1124-6. · 1.26 Impact Factor
  • La Tunisie médicale 10/2008; 86(9):849-51.
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    ABSTRACT: Introduction: Patients with chronic heart failure have frequently an impaired renal function which tends to deteriorate during hospital admissions for acute decompensation episodes. Despite the negative prognostic impact of this alteration, its incidence and predictive factors remain partially unclear especially in idiopathic dilated cardiomyopathy (IDCM). Purpose: To determine the prevalence of worsening renal function (WRF) among hospitalized IDCM patients, clinical predictors of WRF, in hospital and mid term outcomes associated with WRF. Methods: 107 consecutive patients (58 males and 49 females) admitted in the cardiology department for a decompensated IDCM during the period between 1/01/1999 and 31/12/2005 were included. WRF was defined as an increase in serum creatinine level of >26.5μmol/l. Results: The mean age was 50±14.7 years with a mean ejection fraction of 29.7±14.7%, a mean serum creatinine at admission of 132 ±65μmol/l and a mean creatinine clearance of 1.08±27.7ml/min. WRF occurred in 15 patients (14% of the cohort). Those patients had a higher admission NYHA class (3.25 vs 2.86; p=0.027), were more frequently in atrial fibrillation (p=0.024), had a higher admission serum creatinine level (141.09 vs 88.66; p=0.09) and a lower creatinine clearance (54.55 ml/min vs 88.86 ml/min; p<0.001).No differences were noted in terms of age, gender or ejection fraction. In comparison to those who did not deteriorate their renal function, patients among whom this deterioration occurred, remained longer in hospital (19.25 days vs 10.32 days; p=0.004), were more likely to be rehospitalized (1.37 vs 0.5; p<0.001) and had a higher NYHA class at discharge (2.25 against 1.96; p=0.023) and after 12 months follow-up (2.5 against 2.05; p=0.038). A trend to a higher in hospital mortality was also registered without reaching significance (p=0.12). Conclusion: WRF seems common among patients admitted for decompensated IDCMconstituting an additional burden. The simple assessment of the patients’ biological and clinical parameters at admission could be used to predict its occurrence; which was associated in our series to a longer in hospital stay, more frequent hospitalizations and worse mid term functional status
    European Journal of Heart Failure Supplements 01/2008; 7:65-65.
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    ABSTRACT: We report a successful ablation of reentrant atrial tachycardia complicating atrial septal defect repair. This tachyarrhythmia was poorly tolerated hemodynamically and difficult to control with antiarrhythmic drug therapy and atrial pacing. Ablation therapy has focused on extending a line of block from the surgical incision to the inferior veno cava. Immediate success was achieved and the patient is free of arrhythmia after 4 months of Follow-up.
    La Tunisie médicale 01/2003; 80(12):790-2.