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Helal AM, Mashali MH, Elmahrouk AF, Galal MO, Jamjoom AA, Kouatli AA. Right ventricle to pulmonary artery conduit: a comparison of long-term graft-related events between bovine jugular vein conduit, aortic homograft, and porcine-valved conduits. Cardiovasc Diagn Ther 2024; 14:109-117. [PMID: 38434570 PMCID: PMC10904299 DOI: 10.21037/cdt-23-364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/04/2023] [Indexed: 03/05/2024]
Abstract
Background The optimal conduit for right ventricle to pulmonary artery (RV-PA) reconstruction does not exist. Reinterventions are common due to conduit stenosis and endocarditis. Tailoring conduit choice according to patients' characteristics could improve the outcomes. The study aimed to compare graft-related events (infective endocarditis, transcatheter pulmonary valve replacement (PVR), transcatheter conduit dilatation, surgical conduit replacement, and transcatheter pulmonary branch intervention for RV-PA reconstruction using bovine jugular vein, aortic homograft, and porcine-valved conduits. Methods In a retrospective cohort study, 155 patients with 193 procedures that were done in King Faisal Specialist Hospital and Research Center-Jeddah (KFSHRC JED) for implanting RV-PA conduits from 1999 to 2021 were included. The patients were grouped according to the type of conduit into 3 groups; Group 1 (n=153) received bovine jugular vein (BJVs) grafts, Group 2 (n=29) received aortic homografts, Group 3 (n=11) received porcine-valved conduits. Factors associated with graft-related events were evaluated using stepwise Cox regression analysis. Results Patients with BJVs were significantly younger than those with porcine-valved conduits 3 (P=0.009). The weight of BJVs patients was significantly lower than homografts (P=0.002) and porcine-valved conduits patients 3 (P<0.001). The conduit size was as expected significantly lower in BJVs patients than patients who received porcine-valved conduits (P<0.001) and patients who received aortic homografts (P<0.001). There was no difference between Group 2 and 3 (P=0.084). Operative mortality occurred in 13 patients: 12 (7.84%) with BJV conduit and 1 (9.09%) with porcine valved conduit (P=0.351). Male gender [odds ratio (OR): 10.04; 95% confidence interval (CI): 1.28-78.86; P=0.028] and smaller conduit size (OR: 0.78; 95% CI: 0.61-0.99; P=0.048) were associated with increased operative mortality. Freedom from graft-related events at 5 and 10 years was 67% and 52% in BJVs patients, 74% and 36% in patients who received aortic homografts, and 53% in patients who received porcine-valved conduits. Factors associated with increased graft-related events were male gender (HR: 1.58; 95% CI: 1.004-2.50, P=0.048) and younger age (HR: 0.995; 95% CI: 0.991-0.999, P=0.041). Conclusions RV-PA reconstruction was associated with low mortality, unrelated to the conduit type. Reinterventions for graft-related events were common. The durability and graft-related events might be comparable among BJV grafts, aortic homografts, and porcine-valved conduits. Factors associated with increased graft-related events in this study were male gender and younger age.
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Affiliation(s)
- Abdelmonem M. Helal
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
| | - Mohamed H. Mashali
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
| | - Ahmed F. Elmahrouk
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt
| | - Mohammed O. Galal
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed A. Jamjoom
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Amjad A. Kouatli
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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Abdelmohsen GA, Gabel HA, Al-Ata JA, Bahaidarah SA, Alkhushi NA, Abdelsalam MH, Bekheet SB, Elakaby AR, Zaher ZF, Maghrabi KA, Mashali MH, Dohain AM. Percutaneous closure of postoperative residual ventricular septal defects, including dehiscence of surgical patches. Cardiovasc Diagn Ther 2023; 13:710-727. [PMID: 37675084 PMCID: PMC10478022 DOI: 10.21037/cdt-22-624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/31/2023] [Indexed: 09/08/2023]
Abstract
Background Percutaneous closure of residual ventricular septal defects (VSDs) after congenital heart surgery may provide a safer and more efficient alternative to redo surgery. This study aimed to evaluate the outcome of transcatheter closure of residual postoperative VSD. Methods This multicenter retrospective cohort study was conducted at the tertiary care institutions of King Faisal Specialist Hospital and King Abdulaziz University Hospital, Saudi Arabia, from March 2012 to March 2022. All patients who underwent transcatheter closure of postoperative residual VSD were included. As catheter closure of VSD related to surgical patches is challenging, patients were divided into two groups. Group 1 comprised patients with VSD related to the surgical patches, while Group 2 included residual muscular VSD. Various occluders and approaches were utilized based on the patient's weight and the VSD type, size, and proximity to the cardiac valves. Demographic, echocardiographic, catheterization, and outcome data were collected and analyzed using descriptive and comparative statistics. Results Thirty-three patients underwent 37 VSD catheter closure procedures. Twenty-two procedures were done to close residual VSD related to the surgical patch, while fifteen were done for additional muscular VSD. The median age of the patients was 3.3 years, and the interquartile range (IQR) ranged between 9 months and 7 years. The median weight was 13.1 kilograms, with an IQR of 5.1 to 16.8 kilograms. The median pulmonary to systemic flow ratio (QP/QS) was 1.6 with an IQR of 1.5 to 2.44; the median systolic pulmonary pressure was 46 mmHg with an IQR of 32 to 54 mmHg. The median procedure duration was 120 minutes, with an IQR of 90 to 160 minutes. Patients in Group 1 were older and had a lower mean pulmonary pressure than Group 2 (P=0.02, P=0.007, respectively). Of the 37 procedures, 35 (94.6%) were done successfully, while two patients had redo surgery due to failed procedures (one had device embolization). Ten successful catheterizations were performed for infants weighing ≤5 kilograms. The functional heart failure class improved significantly after the closure of the residual VSD. There were three documented mortalities, none related to the procedure. No significant difference between patient groups regarding hospital stay or survival (P=0.660, P=0.791, respectively). Conclusions After congenital heart surgery, transcatheter closure of residual VSD may be a safe and effective alternative to surgical closure. It can be applied to various residual VSD using a variety of occluders with satisfactory results. Moreover, using specific approaches can close residual VSD, even in small infants.
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Affiliation(s)
- Gaser A. Abdelmohsen
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Hala A. Gabel
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Jameel A. Al-Ata
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Saud A. Bahaidarah
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Naif A. Alkhushi
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohamed H. Abdelsalam
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Cardiology Department, Benha University, Benha, Egypt
| | - Samia B. Bekheet
- Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
- Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed R. Elakaby
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Department, Al-Azhar University, Cairo, Egypt
| | - Zaher F. Zaher
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Khadijah A. Maghrabi
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mohamed H. Mashali
- Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
- Pediatric Cardiology Division, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed M. Dohain
- Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Pediatric Cardiology Division, Department of Pediatrics, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
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Helal AM, Baho HA, Elmahrouk AF, Mashali MH. PR and QRS interval changes after transcatheter pulmonary valve replacement in children. Egypt Heart J 2023; 75:66. [PMID: 37486586 PMCID: PMC10366049 DOI: 10.1186/s43044-023-00394-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/20/2023] [Indexed: 07/25/2023] Open
Abstract
BACKGROUND Changes in PR intervals after transcatheter pulmonary valve replacement (TCPVR) have not been thoroughly evaluated in children. This study evaluated the changes in PR and QRS intervals six months after TCPVR in children with congenital heart disease. RESULTS This study included 41 patients who underwent TCPVR from 2010 to 2022. ECG of patients was reviewed before and six months after TCPVR, and the PR and QRS intervals were reported. Right ventricular systolic pressure (RVSP) was retrieved indirectly from echocardiography and compared pre- and 6-months after TPVR. The median age was 13 years (25th-75th percentiles: 11-16), and 61% were males. The preoperative diagnosis was tetralogy of Fallot (n = 29, 71%), transposition of great vessels (n = 4, 10%), common arterial trunk (n = 3, 7%), pulmonary valve stenosis (n = 3, 7%) and pulmonary atresia (n = 2, 5%). The Melody valve was used in 30 patients, and Edwards Sapien was used in 11 patients. RVSP was significantly reduced six months after the procedure (pre-RVSP 40 (30-55) mmHg vs. post-RVSP 25 (20-35) mmHg; P < 0.001). The PR interval was 142 (132-174) msec before TPVR and 146 (132-168) msec post-TCPVR (P = 0.442). Post-TPVR PR was positively related to the pre-PR (β: 0.79 (0.66-0.93), P < 0.001) and inversely related to the right ventricular outflow tract size (- 1.48 (- 2.76 to - 0.21), P = 0.023). The pre-TPVR QRS was 130 (102-146) msec, and the post-TPVR QRS was 136 (106-144) msec (P = 0.668). CONCLUSIONS In children undergoing TCPVR, the PR and QRS intervals did not change significantly during a 6-month follow-up.
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Affiliation(s)
- Abdelmonem M Helal
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
| | - Haysam A Baho
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed F Elmahrouk
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, 21499, Jeddah, Saudi Arabia.
- Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt.
| | - Mohamed H Mashali
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
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Yousef AA, Elmahrouk AF, Hamouda TE, Helal AM, Dohain AM, Alama A, Shihata MS, Al-Radi OO, Jamjoom AA, Mashali MH. Factors affecting the outcomes after bidirectional Glenn shunt: two decades of experience from a tertiary referral center. Egypt Heart J 2023; 75:53. [PMID: 37378691 DOI: 10.1186/s43044-023-00381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/25/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Despite the improved management of patients with a single ventricle, the long-term outcomes are not optimal. We reported the outcomes of the bidirectional Glenn procedure (BDG) and factors affecting the length of hospital stay, operative mortality, and Nakata index before Fontan completion. RESULTS This retrospective study included 259 patients who underwent BDG shunt from 2002 to 2020. The primary study outcomes were operative mortality, duration of hospital stay, and Nakata index before Fontan. Mortality occurred in 10 patients after BDG shunt (3.86%). By univariable logistic regression analysis, postoperative mortality after BDG shunt was associated with high preoperative mean pulmonary artery pressure (OR: 1.06 (95% CI 1.01-1.23); P = 0.02). The median duration of hospital stay after BDG shunt was 12 (9-19) days. Multivariable analysis indicated that Norwood palliation before BDG shunt was significantly associated with prolonged hospital stay (β: 0.53 (95% CI 0.12-0.95), P = 0.01). Fontan completion was performed in 144 patients (50.03%), and the pre-Fontan Nataka index was 173 (130.92-225.34) mm2/m2. Norwood palliation (β: - 0.61 (95% CI 62.63-20.18), P = 0.003) and preoperative saturation (β: - 2.38 (95% CI - 4.49-0.26), P = 0.03) were inversely associated with pre-Fontan Nakata index in patients who had Fontan completion. CONCLUSIONS BDG had a low mortality rate. Pulmonary artery pressure, Norwood palliation, cardiopulmonary bypass time, and pre-BDG shunt saturation were key factors associated with post-BDG outcomes in our series.
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Affiliation(s)
- Aly A Yousef
- Division of Pediatric Critical Care, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Pediatrics, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Ahmed F Elmahrouk
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, Jeddah, 21499, Saudi Arabia.
- Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt.
| | - Tamer E Hamouda
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, Jeddah, 21499, Saudi Arabia
- Cardiothoracic Surgery Department, Benha University, Benha, Egypt
| | - Abdelmonem M Helal
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed M Dohain
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
- Pediatric Cardiology Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulhadi Alama
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, Jeddah, 21499, Saudi Arabia
| | - Mohammad S Shihata
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, Jeddah, 21499, Saudi Arabia
| | - Osman O Al-Radi
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, Jeddah, 21499, Saudi Arabia
- Cardiac Surgery Section, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Jamjoom
- Division of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O. Box:40047, Jeddah, 21499, Saudi Arabia
| | - Mohamed H Mashali
- Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt
- Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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Mashali MH, Yousef AA, Elmahrouk AF, Ba-Atiyah W, Rasol MA, Arafa MA, Shihata MS, Jamjoom AA, Hamouda TE. Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience. Cardiothorac Surg 2023. [DOI: 10.1186/s43057-023-00096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Abstract
Background
Reinterventions after tetralogy of Fallot repair (TOF) remains a common clinical problem. The objective of this study was to evaluate types of reintervention after TOF repair and identify the risk factors for reinterventions.
Methods
This retrospective study was conducted from 2010 to 2022 and included 171 patients with complete TOF repair. Patients were grouped according to the occurrence of reintervention into two groups: patients who did not have reintervention (n = 138) and those who required reintervention (n = 33).
Results
Median follow-up was 36 (13–67) months. The first reintervention was required in 33 patients. Freedom from the first reintervention at 1, 3, 5, and 7 years was 91%, 85%, 81%, and 76%, respectively. Surgical reintervention was required in 12 patients and transcatheter intervention in 21 patients. Second reinterventions were required in 11 patients; 4 had surgery, and 7 had a transcatheter intervention. Third reinterventions were performed on two patients; one had surgery, and one had a transcatheter intervention. The most common interventions were performed at the level of pulmonary arteries (n = 17), followed by the pulmonary valve and the right ventricular outflow tract (n = 15). The risk of reintervention was associated with the low weight (HR: 0.65 (95% CI: 0.48–0.88); P = 0.005) and small LPA diameter (HR: 0.36 (95% CI: 0.21–0.60); P < 0.001) at the time of the primary intervention and the nonuse of the transannular patch (HR: 0.27 (95% CI: 0.08–0.85); P = 0.026).
Conclusions
The risk of reintervention is high after tetralogy of Fallot repair. In our experience, the smaller the left pulmonary artery and weight at the repair time increased the risk of reintervention. Using a transannular patch in our series was associated with a lower risk of reintervention.
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Elkoumi MA, Abdellatif SH, Mohamed FY, Sherif AH, Elashkar SSA, Saleh RM, Boraey NF, Abdelaal NM, Akeel NE, Elhewala AA, Mosbah AA, Zakaria MT, Soliman MM, Salah A, Sedky YM, Sobieh AA, Mashali MH, Waked NM, Elshreif AM, Hafez SF, Hashem MIA, Shehab MM, Soliman AA, Emam AA, Ahmed AAA, Fahim MS, Elshehawy NA, Abdel-Aziz MM, Abdou AM, El-Shehawy AA, Youssef MAA, Fahmy DS, Malek MM, Osman SF, Ibrahim MAM, Alanwar MI, Zeidan NMS. Ficolin-1 gene (FCN1) -144 C/A polymorphism is associated with adverse outcome of severe pneumonia in the under-five Egyptian children: A multicenter study. Pediatr Pulmonol 2020; 55:1175-1183. [PMID: 32142211 DOI: 10.1002/ppul.24719] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 02/22/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Pneumonia is the foremost cause of child death worldwide. M-ficolin is encoded by the FCN1 gene and represents a novel link between innate and adaptive immunity. OBJECTIVES To investigate the FCN1 -144 C/A (rs10117466) polymorphism as a potential marker for pneumonia severity and adverse outcome namely complications or mortality in the under-five Egyptian children. METHODS This was a prospective multicenter study that included 620 children hospitalized with World Health Organization-defined severe pneumonia and 620 matched healthy control children. Polymorphism rs10117466 of the FCN1 gene promoter was analyzed by PCR-SSP, while serum M-ficolin levels were assessed by ELISA. RESULTS The FCN1 A/A genotype and A allele at the -144 position were more frequently observed in patients compared to the control children (43.4% vs 27.6%; odds ratio [OR]: 1.62; [95% confidence interval {CI}: 1.18-2.2]; for the A/A genotype) and (60.8% vs 52.5%; OR: 1.4; [95% CI: 1.19-1.65]; for the A allele); P < .01. The FCN1 -144 A/A homozygous patients had significantly higher serum M-ficolin concentrations (mean: 1844 ± 396 ng/mL) compared with those carrying the C/C or C/A genotype (mean: 857 ± 278 and 1073 ± 323 ng/mL, respectively; P = .002). FCN1 -144 A/A genotype was an independent risk factor for adverse outcomes in children with severe pneumonia (adjusted OR = 4.85, [95% CI: 2.96-10.25]; P = .01). CONCLUSION The FCN1 A/A genotype at the -144 position was associated with high M-ficolin serum levels and possibly contributes to enhanced inflammatory response resulting in the adverse outcome of pneumonia in the under-five Egyptian children.
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Affiliation(s)
- Mohamed A Elkoumi
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sawsan H Abdellatif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Faisal Y Mohamed
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Ahmed H Sherif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shaimaa S A Elashkar
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rabab M Saleh
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Naglaa F Boraey
- Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - NourEldin M Abdelaal
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Nagwa E Akeel
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Elhewala
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amira A Mosbah
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mervat T Zakaria
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohammed M Soliman
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed Salah
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Yasser M Sedky
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Alaa A Sobieh
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohamed H Mashali
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nevin M Waked
- Department of Pediatrics, Faculty of Medicine, October 6 University, Cairo, Egypt
| | - Anas M Elshreif
- Department of Pediatrics, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Sahbaa F Hafez
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mustafa I A Hashem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed M Shehab
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Attia A Soliman
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Emam
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Mohamed S Fahim
- Department of Anathesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Naglaa A Elshehawy
- Department of Anathesia, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Marwa M Abdel-Aziz
- Department of Anathesia, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Adel M Abdou
- Department of Clinical pathology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Ahmed A El-Shehawy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Manal A A Youssef
- Department of Rheumatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dalia S Fahmy
- Department of Rheumatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mai M Malek
- Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sherif F Osman
- Department of Radiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas
| | - Mohamed A M Ibrahim
- Department of Clinical pathology, Faculty of Medicine, Sohag University, Egypt
| | - Mohamed I Alanwar
- Department of Cardiothoracic surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nancy M S Zeidan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
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Elkoumi MA, Emam AA, Allah MAN, Sherif AH, Abdelaal NM, Mosabah A, Zakaria MT, Soliman MM, Salah A, Sedky YM, Mashali MH, Elashkar SSA, Hafez SFM, Hashem MIA, Elshreif AM, Youssef M, Fahmy DS, Sallam MM, Nawara AM, Elgohary EA, Ahmed AA, Fahim MS, Fawzi MM, Abdou AM, Morsi SS, Abo-Alella DA, Malek MM, Anany HG, Sobeih AA, Elbasyouni HAA, El-Deeb FM. Association of ficolin-2 gene polymorphisms and susceptibility to systemic lupus erythematosus in Egyptian children and adolescents: a multicenter study. Lupus 2019; 28:995-1002. [PMID: 31184250 DOI: 10.1177/0961203319856089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pediatric-onset SLE (pSLE) is a multisystem autoimmune disease. Recently, the ficolin-2 (FCN2) gene has emerged as a potential candidate gene for susceptibility to SLE. OBJECTIVES The objective of this study was to evaluate the association of the FCN2 gene polymorphisms at positions -986 (G/A), -602 (G/A), -4 (A/G) and SNP C/T (rs3124954) located in intron 1, with susceptibility to pSLE in Egyptian children and adolescents. METHODS This was a multicenter study of 280 patients diagnosed with pSLE, and 280 well-matched healthy controls. The FCN2 promoter polymorphisms at -986 G/A (rs3124952), -602 G/A (rs3124953), -4 A/G (rs17514136) and SNP C/T (rs3124954) located in intron 1 were genotyped by polymerase chain reaction, while serum ficolin-2 levels were assessed using enzyme-linked immunosorbent assay. RESULTS The frequencies of the FCN2 GG genotype and G allele at -986 and -602 positions were significantly more represented in patients with pSLE than in controls (p < 0.001). Conversely, the FCN2 AA genotype and A allele at position -4 were more common in patients than in controls (p < 0.001). Moreover, patients carrying the FCN2 GG genotype in -986 position were more likely to develop lupus nephritis (odds ratio: 2.6 (95% confidence interval: 1.4-4.78); p = 0.006). The FCN2 AA genotype at position -4 was also identified as a possible risk factor for lupus nephritis (odds ratio: 3.12 (95% confidence interval: 1.25-7.84); p = 0.024). CONCLUSION The FCN2 promoter polymorphisms may contribute to susceptibility to pSLE in Egyptian children and adolescents. Moreover, the FCN2 GG genotype at position -986 and AA genotype at position -4 were associated with low serum ficolin-2 levels and may constitute risk factors for lupus nephritis in pSLE.
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Affiliation(s)
- M A Elkoumi
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | - A A Emam
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | - M A N Allah
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | | | - N M Abdelaal
- 2 Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Egypt
| | - Aaa Mosabah
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - M T Zakaria
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - M M Soliman
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - A Salah
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - Y M Sedky
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - M H Mashali
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - S S A Elashkar
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | - S F M Hafez
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | - M I A Hashem
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | - A M Elshreif
- 4 Department of Pediatrics, Al Azhar Faculty of Medicine, Cairo, Egypt
| | - Maa Youssef
- 5 Department of Rheumatology, Faculty of Medicine, Zagazig University, Egypt
| | - D S Fahmy
- 5 Department of Rheumatology, Faculty of Medicine, Zagazig University, Egypt
| | - M M Sallam
- 6 Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
| | - A M Nawara
- 6 Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
| | - E A Elgohary
- 6 Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
| | - A A Ahmed
- 7 Department of Anesthesia, Faculty of Medicine, Zagazig University, Egypt
| | - M S Fahim
- 8 Department of Anesthesia, Faculty of Medicine, Ain-Shams University, Egypt
| | - M M Fawzi
- 9 Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt
| | - A M Abdou
- 10 Department of Clinical Pathology, Al Azhar Faculty of Medicine, Cairo, Egypt
| | - S S Morsi
- 11 Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Egypt
| | - D A Abo-Alella
- 11 Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Egypt
| | - M M Malek
- 11 Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Egypt
| | - H G Anany
- 1 Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
| | - A A Sobeih
- 3 Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt
| | - H A A Elbasyouni
- 12 Department of Internal Medicine, Faculty of Medicine, Menoufia University, Egypt
| | - F M El-Deeb
- 13 Department of Dermatology, Faculty of Medicine, Zagazig University, Egypt
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