مجال
التميز
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تميز دراسي وبحثي + جائزة تفوقية
+ موهبة إبداعية
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البحوث المنشورة
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البحث (1):
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عنوان البحث:
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Prognostic
implications of left ventricular strain by speckle-tracking echocardiography
in population-based studies: a systematic review protocol of the published
literature
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رابط إلى البحث:
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Click here
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تاريخ النشر:
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16 July
2018
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موجز عن البحث:
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Introduction: Left ventricular (LV) strain by speckle tracking
echocardiography (STE) is a comparatively new prognostic marker.
Meta-analyses relating LV strain by STE to outcomes have been conducted in
selected patient-based populations with established or suspected
cardiovascular (CV) diseases. However, the evidence related to
population-based studies of community-dwelling individuals is uncertain. The
aim of this study is to provide a comprehensive systematic review and
analysis of the current available literature regarding LV strain by STE as a
predictor of adverse outcomes in population-based studies.
Methods
and analyses:
Thesaurus and text-word searching will be used to search two online databases
(MEDLINE and EMBASE) and additional sources will be
identified from citation metrics and reference lists’ search. Dual search
results’ screening, data extraction, and quality assessment will be
performed. Cohort studies of community/population-based samples who have had
STE and followed up longitudinally for mortal and morbid events, and
published in English and peer reviewed journals will be included. Primary
outcome will be all-cause mortality whereas secondary outcomes will be
composite cardiac and CV end points. Risk of bias will be assessed using
Newcastle-Ottawa Quality Assessment Scale of cohort studies that will be
modified as appropriate. Any arising discrepancies will be discussed and
resolved through consensus.
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البحث (2):
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عنوان البحث:
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Left atrial function in heart failure with mid-range
ejection fraction differs from that of heart failure with preserved ejection
fraction: a 2D speckle-tracking echocardiographic study
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رابط إلى البحث:
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Click
here
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تاريخ النشر:
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04 December
2018
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موجز عن البحث:
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Aims: Heart failure (HF) with mid-range ejection
fraction (HFmrEF) shares similar diagnostic criteria to HF with preserved
ejection fraction (HFpEF). Whether left atrial (LA) function differs between
HFmrEF and HFpEF is unknown. We,
therefore, used 2D-speckle-tracking echocardiography
(2D-STE) to assess LA phasic function in patients with
HFpEF and HFmrEF.
Methods
and results:
Consecutive outpatients diagnosed with HF according to current European
recommendations were prospectively enrolled. There were 110 HFpEF and 61
HFmrEF patients with sinus rhythm, and 37 controls matched by age. LA phasic
function was analysed using 2D-STE. Peak-atrial longitudinal strain (PALS),
peak-atrial contraction strain (PACS), and PALS-PACS were measured reflecting
LA reservoir, pump, and conduit function, respectively. Among HF groups, most
of left ventricular (LV) diastolic function measures, and LA volume were
similar. Both HF groups had abnormal LA phasic function compared with
controls. HFmrEF patients had worse LA phasic function than HFpEF patients
even among patients with LA enlargement. Among patients with normal LA size,
LA reservoir, and pump function remained worse in HFmrEF. Differences in LA
phasic function between HF groups remained significant after adjustment for
confounders. Global PALS and PACS were inversely correlated with brain
natriuretic peptide, LA volume, E/A, E/e0, pulmonary artery systolic
pressure, and diastolic dysfunction grade in both HF groups.
Conclusion: LA phasic function was worse in HFmrEF patients
compared with those with HFpEF regardless of LA size, and independent of
potential confounders. These differences could be attributed to intrinsic LA
myocardial dysfunction perhaps in relation to altered LV function.
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البحث (3):
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عنوان البحث:
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Prognostic
implications of left ventricular strain by speckle-tracking echocardiography
in the general population: a meta-analysis
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رابط إلى البحث:
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Click
here
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تاريخ النشر:
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24 July
2019
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موجز عن البحث:
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Purpose: Left ventricular (LV) mechanics by speckle-tracking
echocardiography (STE) is prognostic in patients with cardiovascular
diseases, but evidence related to community-dwelling individuals is
uncertain. We therefore performed a systematic review and meta-analysis of
STE as a predictor of adverse outcomes in the general population.
Methods: PRISMA guidelines were followed and MEDLINE and
EMBASE were searched to identify eligible studies. Primary outcome was
all-cause mortality and secondary outcomes were composite cardiac and
cardiovascular end-point. Random effects meta-analysis was performed, and a
modified Newcastle-Ottawa Assessment Scale was used for quality assessment.
Results: Eight papers matched the predefined criteria
(total number of individuals studied=11,744). All publications assessed
global longitudinal strain (GLS) by two-dimensional speckle-tracking echocardiography
(2D-STE), one assessed circumferential, radial and transverse strains, and
one assessed GLS-derived post-systolic shortening. None assessed LV rotational
measures in association with outcomes. Two studies reported associations
between GLS and all-cause mortality and composite cardiovascular end-point.
Six papers reported an association between GLS and composite cardiac end-point,
three of which were from the same study. Four papers were suitable for
meta-analysis. GLS predicted all-cause mortality (pooled minimally adjusted
HR per unit strain (%)=1.07 [95% CI 1.03–1.11], p=0.001), and composite
cardiovascular (pooled maximally adjusted HR=1.18 [1.09–1.28], p<0.0001)
and cardiac (HR=1.08 [1.02–1.14], p=0.006) end-points. GLS also predicted
coronary heart disease (HR=1.15 [1.03–1.29], p=0.017) and heart failure
(HR=1.07 [1.02–1.13], p=0.012). The quality of all studies was good.
Conclusions: This study provides some evidence that STE may
have utility as a measure of cardiac function and risk in the general
population. 2D-STE-basedGLSpredicts total mortality, major adverse cardiac,
and cardiovascular end points in community-dwelling individuals in a limited
number of studies. Despite this, this systematic review also highlights
important knowledge gaps in the current literature and further evidence is
needed regarding the prognostic value of LV mechanics in unselected older
populations.
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المؤتمرات العلمية:
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المؤتمر (1):
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عنوان المؤتمر:
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ESC Congress
2018
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تاريخ الإنعقاد:
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25/08/2018
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مكان الإنعقاد:
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Munich, Germany
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طبيعة المشاركة:
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Poster Presentation
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عنوان المشاركة:
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Left atrial
function in heart failure with midrange ejection fraction differs from that
of heart failure with preserved ejection fraction: a two dimensional speckle
tracking echocardiographic study
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ملخص المشاركة:
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Background: Heart failure (HF) with mid-range ejection fraction (HFmrEF), a
newly defined category by the recent ESC HF guidelines, shares similar
diagnostic criteria with HF with preserved ejection fraction (HFpEF)
including diastolic dysfunction (DD) and structural dysfunction such as left
atrial (LA) enlargement. Whether LA function differs between HFmrEF and HFpEF
is unknown.
Objectives: To compare LA phasic function in HFmrEF and HFpEF patients using
two-dimensional speckle tracking echocardiography (2D-STE).
Methods: Consecutive outpatients from HF clinics fulfilling current
recommendations were enrolled prospectively. All patients underwent
echocardiography including 2D-STE. We included 110 HFpEF and 61 HFmrEF
patients, and 37 healthy controls matched by age. Patients with non-sinus
rhythm, significant valve disease, implantable pacemakers, or suboptimal
image quality were excluded. Taking the onset of QRS complex as a reference
point, peak-atrial longitudinal strain (PALS), peak-atrial contraction strain
(PACS), and PALS-PACS were measured reflecting LA reservoir, pump and conduit
function, respectively. Global PALS and PACS were obtained from 12 LA
segments from the apical four- and two-chamber views. Data are mean [95%
confidence interval].
Results: Among HF groups, conventional echocardiographic measures of left
ventricular (LV) diastolic function (E/A, e’, E/e’, tricuspid regurgitation
velocity and DD grades), and LA volume (39.5±13 ml/m2 in HFmrEF vs.
38.8±12.7 ml/m2 in HFpEF) were similar. Both HF groups had abnormal LA phasic
function compared to controls (all p≤0.001). Overall, HFmrEF patients had
worse LA phasic function than HFpEF patients (global PALS 20.6% [19.1, 22.2]
vs. 26.2% [24.9, 27.5], p<0.001; global PACS 9.8% [8.6, 10.9] vs. 13.1%
[12.1, 14.1], p<0.001; and global PALS–PACS 10.7% [9.4, 12.0] vs. 13.0%
[12.3, 13.8], p=0.003). Among patients with LA enlargement, LA phasic
function remained lower in HFmrEF (Figure 1.A). Even among patients with
normal LA size, LA reservoir and pump function were worse in HFmrEF (Figure
1.B). Differences in LA reservoir, pump and conduit function between HF
groups remained significant after adjustment for confounders including age,
sex, heart rate, systolic blood pressure, body mass index, LV end-diastolic
volume index, LV mass index, LA volume, E/A, deceleration time, E/e’,
diabetes mellitus, hypertension and previous ischemic heart disease (β [95%
CI]; -5.6 [-7.5, -3.7], -3.1 [-4.5, -1.7], and -2.5 [-3.9, -1.0], respectively;
all p≤0.001). Global PALS and PACS were inversely correlated with brain
natriuretic peptide levels, LA volume, E/A, E/e’, pulmonary artery systolic
pressure, and DD grade in both HF groups (all p<0.05).
Conclusions: LA phasic function was worse in HFmrEF patients compared to
those with HFpEF regardless of LA size, and independent of potential
confounders. These differences may be explained by intrinsic LA structural
abnormalities in addition to altered LV function.
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المؤتمر (2):
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عنوان المؤتمر:
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Early
Career Physiologists’ Symposium
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تاريخ الإنعقاد:
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13
September 2018
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مكان
الإنعقاد:
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London, UK
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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The
Impact of Intentional Distortion of Image Quality on Left Ventricular
Deformation Indices by Three-dimensional Speckle-Tracking Echocardiography
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ملخص المشاركة:
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Background:
Three-dimensional speckle-tracking echocardiography (3D-STE) is a novel
technique that provides a comprehensive quantification of regional and global
left ventricular (LV) myocardial deformation. It is increasingly used in
clinical practice. 3D-STE is believed to be influenced by image quality,
although quantitative evidence on this is limited. Purpose: To assess the impact of intentionally distorted image
quality on LV deformation indices measured by 3D-STE.
Methods: 18
healthy volunteers (age 28 ± 6 years, 55.5% men) underwent three-dimensional
echocardiography (3DE). Participants with poor images were excluded. One optimal
and one intentionally impaired 3DE full-volume datasets of the LV were
obtained and analysed per participant. Quality was impaired by including
images with echo drop out, shadow artefacts, or poor visualization of the
endocardium. Both acquisitions were free of stitching artefacts and the frame
rate was maintained similar. Obtained 3D-STE parameters were LV volumetric,
and global and averaged segmental LV deformation measures. The acquisition
protocol was repeated on the same day to assess the test-retest
repeatability. Mixed linear modelling was used to estimate the extent of bias
and the intraclass correlation coefficient (ICC) was used as a measure of
reliability.
Results:
Sub-optimal image quality resulted in a systematic bias in all global and averaged
segmental LV strain measures and LV rotational measures (Table 1). LV
ejection fraction and most of LV volumes by 3D-STE were also consistently
underestimated. Reproducibility was fair to good for all global and averaged
segmental LV strain measures (ICC 0.47 – 0.72) and poor for twist and torsion
(ICC 0.39 and 0.33 respectively). LV volumes and ejection fraction showed
excellent reproducibility irrespective of image quality (ICC 0.78 – 0.92).
Reproducibility was improved for all measures when restricting the analysis
to undistorted quality images [i.e. good image quality] (Table 1).
Conclusions:
Sub-optimal image quality adversely affects the reproducibility of 3D-STE
derived measures and introduces a moderate systematic bias (<10%). Image
quality should be assessed and accounted for in 3DSTE studies.
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المؤتمر (3):
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عنوان المؤتمر:
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Europhysiology
2018
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تاريخ الإنعقاد:
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14-16
September 2019
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مكان
الإنعقاد:
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London, UK
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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The Impact
of Intentional Distortion of Image Quality on Left Ventricular Deformation
Indices by Three-dimensional Speckle-Tracking Echocardiography
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ملخص المشاركة:
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Background:
Three-dimensional speckle-tracking echocardiography (3D-STE) is a novel
technique that provides a comprehensive quantification of regional and global
left ventricular (LV) myocardial deformation. It is increasingly used in
clinical practice. 3D-STE is believed to be influenced by image quality,
although quantitative evidence on this is limited. Purpose: To assess the impact of intentionally distorted image
quality on LV deformation indices measured by 3D-STE.
Methods: 18
healthy volunteers (age 28 ± 6 years, 55.5% men) underwent three-dimensional
echocardiography (3DE). Participants with poor images were excluded. One
optimal and one intentionally impaired 3DE full-volume datasets of the LV
were obtained and analysed per participant. Quality was impaired by including
images with echo drop out, shadow artefacts, or poor visualization of the
endocardium. Both acquisitions were free of stitching artefacts and the frame
rate was maintained similar. Obtained 3D-STE parameters were LV volumetric,
and global and averaged segmental LV deformation measures. The acquisition
protocol was repeated on the same day to assess the test-retest
repeatability. Mixed linear modelling was used to estimate the extent of bias
and the intraclass correlation coefficient (ICC) was used as a measure of
reliability.
Results:
Sub-optimal image quality resulted in a systematic bias in all global and
averaged segmental LV strain measures and LV rotational measures (Table 1).
LV ejection fraction and most of LV volumes by 3D-STE were also consistently
underestimated. Reproducibility was fair to good for all global and averaged
segmental LV strain measures (ICC 0.47 – 0.72) and poor for twist and torsion
(ICC 0.39 and 0.33 respectively). LV volumes and ejection fraction showed
excellent reproducibility irrespective of image quality (ICC 0.78 – 0.92).
Reproducibility was improved for all measures when restricting the analysis
to undistorted quality images [i.e. good image quality] (Table 1).
Conclusions:
Sub-optimal image quality adversely affects the reproducibility of 3D-STE
derived measures and introduces a moderate systematic bias (<10%). Image
quality should be assessed and accounted for in 3DSTE studies.
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المؤتمر (4):
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عنوان المؤتمر:
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The
British Society of Echocardiography Annual meeting (BSEcho 2018)
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تاريخ الإنعقاد:
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05-06
October 2018
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مكان
الإنعقاد:
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Liverpool, UK
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Prognostic
implications of left ventricular strain by speckle-tracking echocardiography
in the general population: A systematic review and meta-analysis
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ملخص المشاركة:
|
Background: Left ventricular (LV) strain by speckle-tracking
echocardiography (STE) is prognostic in patients with cardiovascular (CV)
diseases, but evidence related to community-dwelling individuals is
uncertain.
Purpose: To perform a systematic review and meta-analysis
of STE as a predictor of adverse outcomes in population-based studies.
Methods: PRISMA guidelines were followed, MEDLINE and
EMBASE were searched (to February 2018) to identify eligible studies. Primary
outcome was all-cause mortality; secondary outcomes were composite cardiac
and CV end-points. Newcastle-Ottawa assessment scale was used to assess
quality of studies.
Results: A total of eight papers matched the predefined
criteria. All used two-dimensional (2D)-STE: all studies assessed global
longitudinal strain (GLS), one assessed circumferential, radial and
transverse strains, and one assessed GLS derived post-systolic shortening
measures. None of the identified studies assessed LV rotational measures in
association with outcomes. Two studies reported an association between GLS
and all-cause mortality and a composite CV end-point. Six papers reported an
association between GLS and composite cardiac end-points, three of which were
from the same study population. In total, four studies were suitable for
meta-analysis. Random effects meta-analysis revealed that GLS predicted
composite CV end-point (pooled maximally adjusted hazard-ratio (HR) =1.18
(95% confidence-interval 1.09-1.28), p<0.0001, I2 = 0.0%) and
the composite cardiac end-point (HR=1.08 (1.02-1.14), p=0.006, I2
= 25.1%) (Figure.1). GLS also
predicted coronary heart disease [CHD] and heart failure [HF] (HR=1.15
(1.03-1.29), p=0.017, I2 = 57.8%; and HR=1.07 (1.02-1.13),
p=0.012, I2 = 0.0% for CHD and HF respectively) (Figure.1). It was not possible to
pool results for all-cause mortality. The quality of all studies was good.
Conclusions: 2D-STE
based GLS predicts major adverse cardiac and CV end-points in
community-dwelling individuals in a limited number of studies. Further
studies relating different myocardial deformation indices using 2D- and
3D-STE to adverse outcomes are needed in this population.
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المؤتمر (5):
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عنوان المؤتمر:
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The British
Society of Echocardiography Annual meeting (BSEcho 2018)
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تاريخ الإنعقاد:
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05-06
October 2018
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مكان
الإنعقاد:
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Liverpool, UK
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Quantifying
the effect of image quality on three-dimensional speckle tracking
echocardiography
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ملخص المشاركة:
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Background: Three-dimensional
speckle-tracking echocardiography (3D-STE) is believed to be influenced by
image quality, although quantitative evidence on this is limited. A previous evaluation indicated that
sub-optimal image quality introduces a systematic bias in 3D-STE derived left
ventricular (LV) deformation indices1, 2. Therefore, we aimed to quantify
the extent of bias in proportion to impairment in image quality.
Methods: This was a prospective experimental study. 18
healthy participants (age 31 ± 6 years, 83.3 % men) with good
echocardiographic windows underwent 3D echocardiography (3DE). To impair the
quality of the 3DE images of the LV in a reproducible and graded manner, a
sheet of ultrasound-attenuating material, neoprene rubber, of three different
thicknesses (2, 3 and 4 mm) was used to mimic mild, moderate and severe
impairment in image quality respectively. 4 gated LV 3DE full-volume
data-sets (including the optimal quality reference) were acquired per
participant. All acquisitions were
free of stitching artefacts and similar frame rates were maintained
throughout. LV volumetric, and global and segmental LV deformation indices
were measured. Mixed linear modelling was used to estimate the extent of
bias.
Results:
There was a
systematic bias in all global and segmental LV strains, and LV rotational
indices. The extent of this systematic underestimation was in proportion to
the impairment in image quality of the 3D images (i.e. the poorer the image
quality the larger the bias) (Table 1).
Volumetric measures, including LV ejection fraction and LV systolic
dyssynchrony index, were also increasingly underestimated relative to the
grade of impairment in image quality (Table
1).
Conclusions: The systematic bias introduced by sub-optimal
image quality on 3D-STE derived LV deformation
indices is in proportion to and directly linked to the grade of
impairment in image quality. Image quality should be assessed and accounted
for in 3D-STE studies.
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المؤتمر (6):
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عنوان المؤتمر:
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EuroEcho-Imaging
2018
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تاريخ الإنعقاد:
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05-08
December 2018
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مكان
الإنعقاد:
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Milan,
Italy
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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The
Impact of Intentional Distortion of Image Quality on Left Ventricular
Deformation Indices by Three-dimensional Speckle-Tracking Echocardiography
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ملخص المشاركة:
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Background:
Three dimensional speckle tracking echocardiography (3DSTE) measures left
ventricular (LV) myocardial deformation. It is increasingly used in clinical
practice. 3DSTE is believed to be influenced by image quality, although
quantitative evidence on this is limited.
Purpose: To
assess the impact of intentionally distorted image quality on LV deformation
indices measured by 3DSTE.
Methods: 18
healthy volunteers (age 28 ± 6 years, 55.5% men) underwent threedimensional
echocardiography (3DE). Participants with poor images were excluded. One
optimal and one intentionally impaired 3DE fullvolume datasets of the LV
were obtained and analysed per participant. Quality was impaired by including
images with echo drop out, shadow artefacts, or poor visualization of the
endocardium. Both acquisitions were free of stitching artefacts and the frame
rate was maintained similar. Obtained 3DSTE parameters were LV volumetric,
and global and averaged segmental LV deformation measures. The acquisition
protocol was repeated on the same day to assess the testretest
repeatability. Mixed linear modelling was used to estimate the extent of bias
and the intraclass correlation coefficient (ICC) was used as a measure of
reliability.
Results:
Suboptimal image quality resulted in a systematic bias in all global and
averaged segmental LV strain measures and LV rotational measures (Table 1).
LV ejection fraction and most of LV volumes by 3DSTE were also consistently
underestimated. Reproducibility was fair to good for all global and averaged
segmental LV strain measures (ICC 0.47 – 0.72) and poor for twist and torsion
(ICC 0.39 and 0.33 respectively) when good and suboptimal images were
analysed together. LV volumes and ejection fraction showed excellent
reproducibility irrespective of image quality (ICC 0.78 – 0.92).
Reproducibility was improved for all measures when restricting the analysis
to undistorted image quality [i.e. good quality images] (Table 1).
Conclusions:
Suboptimal image quality adversely affects the reproducibility of 3DSTE
derived LV deformation indices and introduces a moderate systematic bias
(<10%). Image quality should be assessed and accounted for in 3DSTE
studies.
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المؤتمر (7):
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عنوان المؤتمر:
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EuroEcho-Imaging
2018
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تاريخ الإنعقاد:
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05-08
December 2018
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مكان
الإنعقاد:
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Milan,
Italy
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Reliability
of left ventricular dyssynchrony indices by three-dimensional speckle
tracking echocardiography: the impact of intentional impairment of image
quality
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ملخص المشاركة:
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Background:
Three dimensional echocardiography (3DE) derived left ventricular (LV)
systolic dyssynchrony index (SDI) has been proposed as a reliable measure to
assess LV mechanical dyssynchrony (MD) and help guide cardiac
resynchronization thereby. Recently, 3D speckle tracking echocardiography
(3DSTE) has emerged as a novel method in the evaluation of LVMD. 3DSTE is
influenced by image quality, but little is known about the impact of this on
3DSTE derived LV dyssynchrony indices.
Purpose: To
assess the impact of intentionally impaired image quality on 3DSTE derived LV
dyssynchrony indices.
Methods: 3DE
was perfumed using a EPIQ7 equipped with X51 xMATRIX cardiac probe in 18
healthy volunteers (age 28 ± 6 years, 55.5% men) with good echocardiographic
windows. Two gated 3DE full volume data sets of the LV were obtained. One of
these was acquired with optimal quality, the other with intentionally
impaired image quality. Quality was impaired by including images with echo
drop out, shadow artefacts, or poor visualization of the endocardium. Both
acquisitions were free of stitching artefacts and the frame rate was
maintained similar. Measures (normalized to cardiac cycle length) were:
volume based SDI (defined as the
standard
deviation of time to minimum segmental volumes over 16LV segments), strain
based systolic dyssynchrony indices (calculated as the standard deviation of
time to peak segmental strain over 16 LV segments) and volume and strain
derived dispersion indices. The acquisition protocol was repeated on the same
day to assess the test retest repeatability. The intraclass correlation
coefficient was used as a measure of reliability under optimal and suboptimal
conditions and evidence of bias was evaluated by mixed linear modelling.
Results:
There was no evidence of systematic bias in any 3DSTE derived LV dyssynchrony
indices (Table1). Reliability ranged between poor and fair to good when good
and suboptimal quality images were analysed together (Table 1).
Reproducibility was improved for most indices when restricting the analysis
to good quality images (Table 1), nevertheless only volume, circumferential
strain (CS) and principal tangential strain (PTS) derived indices achieved
fair to good reliability, whereas longitudinal and radial based indices
remained poor. CS and PTS based SDIs correlated well with volume based SDI
(r=0.70, p<0.0001 for PTSSDI; and r=0.66, p<0.0001 for CSSDI).
Conclusions:
Suboptimal image quality strongly compromised the reliability of 3DSTE
derived LV dyssynchrony indices, but did not introduce systematic bias. Even
with good quality images only indices based on CS, PTS or volume showed
acceptable reliability.
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المؤتمر (8):
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عنوان المؤتمر:
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British Cardiovascular Society Annual
Conference (BSC 2019)
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تاريخ الإنعقاد:
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03–05 June
2019
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مكان
الإنعقاد:
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Manchester, UK
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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3D ECHOCARDIOGRAPHYDERIVED INDICES OF LEFT VENTRICULAR
FUNCTION AND STRUCTURE PREDICT LONGTERM MOR
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ملخص المشاركة:
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Background: Three-dimensional echocardiography (3DE)-derived
indices of left ventricular (LV) structure and function predict mortality in
various patient groups, although studies are limited. However, whether these
indices equally predict mortality in the general population is unknown.
Further, whether known sex-differences in cardiac structure and function
modify the relationship between these indices and subsequent death is
uncertain.
Purpose: We therefore sought to examine the associations
between 3DE-derived LV ejection fraction (LVEF), volumes and remodelling, and
all-cause mortality in a general population and to investigate whether this
relationship is modified by sex.
Methods: A total of 910 individuals (age, 69.7±6.2 years;
77.7%% male) from the SABRE study, the UK-largest tri-ethnic community
cohort, underwent a heath examination including comprehensive transthoracic
echocardiography. Full volume 3D LV datasets acquired over 4 sub-volumes were
obtained using a matrix-array transducer, and were analysed offline using
Qlab advanced, v7.0. The association between 3D-derived LVEF, body surface
area indexed end-diastolic volume (iEDV) and end-systolic volume (iESV), and
LV remodelling index (LVRI, the ratio of LV mass and EDV) and risk of
all-cause mortality were determined using Cox proportional hazards models.
Results: Over a median follow-up of 8 years, 120
participants (13.1%) died. Overall, lower 3D LVEF, and higher 3D iEDV and
iESV were associated with increased risk of all-cause mortality (table 1a
1b). However, sex modified the associations between volume indices and LVRI
with all-cause mortality; hence we present sex-specific results in table 1.
After multivariable adjustment for age, ethnicity, systolic blood pressure,
antihypertensive medications, cholesterol: HDL ratio, diabetes, body mass
index, smoking and history of coronary heart disease, per SD change, decrease
in LVRI and LVEF, and increase in volumes were independently associated with
increased risk of mortality in men (figure 1, table 1a 1b). However,
associations between volume indices, LVRI and, to a lesser extent, LVEF, and
mortality were reversed in women (figure 1, table 1a 1b): fully adjusted
hazard ratios (95% CI): EDV: men:1.22(1.0, 1.4), women: 0.55(0.28, 1.1), ESV:
men: 1,31(1.10, 1.60), women: 0.59(0.34, 1.0), LVRI: men: 0.79(0.65, 0.98),
women: 1.40(0.88, 2.2), LVEF: men: 0.81(0.67, 0.97), women: 1.31(0.69, 2.5).
Although numbers of women are small, effect sizes indicated that lower
volumes and higher LVRI were associated with higher risk of all-cause
mortality in women.
Conclusion: In the general population, 3DE-derived LVEF,
volumes and remodelling predict the long-term risk of all-mortality, independent
of clinical confounders and cardiovascular risk factors strongly in men.
However the direction of association for volumes and remodelling measures is
reversed in women suggesting that sex-differences in cardiac structure and
function seem to be associated differently with the risk of all-cause
mortality.
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المؤتمر (9):
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عنوان المؤتمر:
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European
Society of Cardiology Congress (ESC 2019)
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تاريخ الإنعقاد:
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31 August –
04 September 2019
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مكان
الإنعقاد:
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Paris – France
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Comparison
of 3D and 2D echocardiography-derived indices of left ventricular function
and structure to predict long-term mortality in the general population:
Southall And Brent Revisited (SABRE) study
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ملخص المشاركة:
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Background:Threedimensional
echocardiography (3DE) may have advantages over twodimensional
echocardiography (2DE) for the assessment of left ventricular (LV) function
and structure. However, studies comparing 3DE and 2DEderived indices in
relation to mortality are limited, particularly in the general population.
Purpose: We
examined associations between 2DE and 3DEderived LV ejection fractions
(LVEF) and volumes for allcause mortality in a populationbased sample.
Methods: A
total of 899 individuals (age, 69.6±6.1 years; 77.5%male) from the SABRE
study, a UKbased triethnic community cohort, underwent a comprehensive
transthoracic echocardiography examination. 2D LVEF and volumes were
calculated, and fullvolume 3D LV datasets acquired over 4 subvolumes were obtained
using a matrixarray transducer and were analysed offline using Qlab
advanced, v7.0. The associations between both 2D and 3Dderived LVEF
(>=55% vs. <55%), body surface area indexed enddiastolic
volume
(iEDV) and endsystolic volume (iESV), and allcause mortality were
determined using Cox proportional hazards models. Survival curves were
constructed using the KaplanMeier method.
Results: Of
the 899 individuals, 118 (13.1%) died over a median followup period of 8
years to 2018. Kaplan Meier survival estimates (Figure 1 illustrates LVEF)
and Cox regression revealed that 2D and 3D LVEF, iEDV and iESV were
associated with increased risk of allcause mortality (LVEF (>=55% vs.
<55%), 3DE: HR=0.53 (0.35, 0.80); 2DE: HR=0.51 (0.34, 0.75), iEDV (per 1SD
increment), 3DE: HR=1.20 (1.0, 1.41); 2DE: HR=1.19 (1.01.41), iESV (per 1SD
increment), 3DE: HR=1.27 (1.1, 1.52), 2DE: HR=1.32 (1.15,
0.1.51)).
However, 3DE associations tended to be stronger in models adjusted for
classical risk factors including age, sex, ethnicity, systolic blood
pressure, cholesterol:HDL ratio, body mass index, antihypertensive
medications, diabetes, and smoking (LVEF (>=55% vs. <55%), 3DE: HR=0.59
(0.39, 0.90); 2DE: HR=0.69 (0.46, 1.0), iEDV (per 1SD increment), 3DE:
HR=1.20 (1.0, 1.41); 2DE: HR=1.10 (0.93 1.31), iESV (per 1SD increment),
3DE: HR=1.27 (1.1, 1.52), 2DE: HR=1.20 (1.04, 0.1.39)).
Conclusions: In
this populationbased study, both 2DE and 3DEderived indices of LV structure
and function were associated with allcause mortality independently of
classical risk factors, with some indication that strengths of association
were greater for 3DEderived indices.
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المؤتمر (10):
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عنوان المؤتمر:
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European
Society of Cardiology Congress (ESC 2019)
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تاريخ الإنعقاد:
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31 August –
04 September 2019
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مكان
الإنعقاد:
|
Paris – France
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طبيعة المشاركة:
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Oral presentation
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عنوان المشاركة:
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Prognostic
implications of left ventricular strain: a systematic review
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الرابط:
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Click
here
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جوائز التكريم :
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الجائزة (1):
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مسمى الجائزة:
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Faculty Of Medicine Dean’s Prize For
Medical Ultrasound (Echocardiography)
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الجهة المانحة:
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Faculty of Medicine
of Imperial College London
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تاريخ الجائزة:
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01/11/2017
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مجال التكريم:
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The Dean’s Prize is
awarded to the top student for each program judged by the Course Lead to be
outstanding. The student will be listed in the graduation programme for the
Graduation Ceremony. In addition, the Prize includes a £200 award.
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الجائزة (2):
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مسمى الجائزة:
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Volunteering
Award
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الجهة المانحة:
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UCL
Student Union – Volunteering Service
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تاريخ الجائزة:
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June 2019
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مجال التكريم:
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Volunteered with Royal Free Charity
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الجائزة (3):
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مسمى الجائزة:
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‘Best of the Best’
Abstract (Imaging) Award
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الجهة المانحة:
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British Cardiovascular Society at the BCS
Annual conference 2019
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تاريخ الجائزة:
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03–05 June
2019
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مجال التكريم:
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Awarded the Best of the Best clinical
abstract Award in the Imaging section during the BCS Annual conference.
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أنشطة ثقافية إبداعية:
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النشاط (1)
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مسمى النشاط:
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Certified
Publons Academy Peer Reviewer
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الجهة المقيمة:
|
Publons Academy
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تاريخ التقييم:
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29/01/2019
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طبيعة النشاط:
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Certified peer reviewer to assess
scientific manuscripts submitted to scientific medical journals for their quality
and science novelty.
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