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Research Article | DOI: https://doi.org/10.31579/2641-0419/542
1Faculty of medicine and biomedical sciences, University of Yaoundé I, Yaoundé, Cameroon.
2Department of internal medicine, Garoua general hospital, Garoua, Cameroon.
3Department of internal medicine, Yaoundé university teaching hospital, Yaoundé, Cameroon.
4Department of internal medicine, Yaoundé general hospital, Yaoundé, Cameroon.
*Corresponding Author: Hamadou Ba, Faculty of medicine and biomedical sciences, University of Yaoundé I, Cameroon.
Citation: Hamadou Ba, Chris-Nadège NG, Oummoul K. Dewa, Owona Ngabede Amalia, Danwe Dieudonné, et al, (2025), Echocardiographic Assessment and Prognostic Role of Right Ventricular Function in Chronic Heart Failure Patients in Cameroon, J Clinical Cardiology and Cardiovascular Interventions, 8(17); DOI:10.31579/2641-0419/542
Copyright: © 2025, Hamadou Ba. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 09 December 2025 | Accepted: 22 December 2025 | Published: 26 December 2025
Keywords: chronic heart failure; right ventricular function; echocardiography; prognosis
Aim: this study aimed to assess right ventricular (RV) function by echocardiography in chronic heart failure (CHF) patients, and its prognostic role.
Materials and methods: we conducted a 1-year longitudinal study. Participants were aged ≥21 years, with stable CHF. RV systolic and diastolic functions were assessed with bidimensional, time-motion, and Döppler modes. 6-months outcomes evaluated were all-cause death, or heart failure (HF) hospitalization.
Results: we included 82 patients with a median age of 63 years. The median left ventricular ejection fraction was 36 %. RV systolic dysfunction was observed in 64.6% of patients, while 52.4% had RV diastolic dysfunction. The 6-months mortality rate was 13.4%, and 54.9% had at least 1 HF hospitalization. RV systolic dysfunction was only significantly associated to HF hospitalizations (OR = 2.75 (1.04 – 7.28); p = 0.039).
Conclusion: RV systolic dysfunction is frequent and increases the risk of hospitalization in Cameroonian CHF patients
Chronic heart failure (CHF) is a major public health problem worldwide with an increasing prevalence [1,2]. In 2017, the estimated number of people living with CHF in the world was 64 million [3]. Despite significant improvements in the management and prevention of CHF over the past decades, its related mortality rate remains high. In a community-based study in the United States, Tsao et al reported a mortality rate of 67% for both heart failure with and without reduced ejection fraction during a follow-up period of 20 years [4]. Chronic left heart failure is a complex clinical syndrome which often leads, during its evolution, to right ventricular (RV) dysfunction, resulting from post-capillary pulmonary hypertension thus increasing afterload [5]. However, in most CHF studies, the left heart function is always assessed, while the RV function is often overlooked, although it plays an important role. Recent studies have shown that RV function was a significant predictive factor of mortality related to CHF [6–9]. Consequently, right ventricular function assessment should be an integral part of the management of CHF patients. The right ventricle has a complex anatomy and function, compared to the left ventricle, and thus is better assessed by cardiac magnetic resonance imaging, which is considered as the gold standard method, and sometimes right heart catheterization [10]. However, these tools are not readily available nor accessible in low-and-middle income countries such as Cameroon. We therefore rely on echocardiographic assessment of the right ventricle which is challenging because of the above-mentioned complex morphology, not allowing a good geometric modelization. Nevertheless, a multiparametric echocardiographic approach may help for a better characterization of the global function of the right ventricle [9,10]. This study aimed to assess right ventricular function using echocardiography and to determine its prognostic role in CHF patients in the Yaoundé and Garoua general hospitals.
Study design and setting
We conducted a longitudinal study during 12 months, spanning from August 2023 to July 2024, in the cardiology units of the Yaoundé and Garoua general hospitals, two reference hospitals in Cameroon.
Participants and sampling
We included patients aged 21 years or more, with chronic stable left heat failure, irrespective of the left ventricular ejection fraction. We excluded patient with isolated right heat failure, congenital heart failure, prosthetic heart valve, cardiac pacemaker, pericardial effusion and those with incomplete echocardiographic data.
We performed a non-probabilistic consecutive sampling.
Data collection
We collected data using a predesigned sheet. The data included:
- Sociodemographic characteristics: age, gender, revenue.
- Comorbidities: hypertension, diabetes, dyslipidemia, chronic kidney disease, hyperuricemia, human immunodeficiency syndrome, cancer, pulmonary embolism, anemia, tobacco smoking and alcohol consumption.
- Heart failure stage using the New York Heart Association (NYHA) classification
- harmacologic treatment of CHF and adherence assessed using the Morisky’s questionnaire.
- Blood pressure, heart rate, weight and height.
We used two echocardiographic machines. A General Electric Vivid T9 and a Hitachi Aloka. All the measurements were performed following the 2015 recommendations of the American Society of Echocardiography and the European Association of Cardiovascular Imaging [11].
Left ventricular ejection fraction (LVEF) was measured using the Simpson method. The left ventricular diastolic function was graded using the Appleton classification.
The RV systolic function was assessed using a combination of parameter: two-dimensional fractional area change (2D-FAC), tricuspid annular plane systolic excursion (TAPSE), DTI-derived tricuspid lateral annular systolic velocity (S’) and right ventricular index of myocardial performance (RIMP) or Tei index.
- The 2D-FAC was calculated using the formula: FAC = ((EDA – ESA)/EDA) x 100. It was considered pathological when < 35>
- The TAPSE was measured in the apical 4-chamber view by time-motion mode with the cursor aligned with the lateral tricuspid annulus. It was considered as pathological when < 17mm>
- The DTI-derived tricuspid lateral annular systolic velocity (S’) was measured in the apical 4-chamber view by DTI mode. The cursor was optimally aligned with the lateral tricuspid annulus. It was considered pathological when < 9>
- The RIMP or Tei index was calculated using the formula: RIMP = (IVCT + IVRT)/ET. Measurements were done in the apical 4-chamber view using DTI velocity at the lateral tricuspid annulus. The isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), and ejection time (ET) intervals were measured from the same heartbeat. Value of Tei index > 0.54 were considered as pathological.
RV diastolic function was assessed using the tricuspid E/A and E/E’ ratios.
- Tricuspid E/A ratio: obtained by measuring tricuspid E and A velocities in the apical 4-chamber view by pulse wave Doppler with the cursor placed at the tip of the tricuspid valve leaflets. It was considered as pathological when < 0> 1.2. The E wave deceleration (EDT) time was also measured.
- Tricuspid E/E’ ratio: the E’ wave velocity was obtained in the apical 4-chamber view by DTI mode. The cursor was aligned with the lateral tricuspid annulus. It was considered pathological when > 6
RV diastolic dysfunction stages were classified as follows:
- Altered relaxation: E/A ratio Less-than sign 0.8
- Pseudo-normal pattern: E/A ratio between 0.8 and 1.2, and E/E’ ratio > 6
- Restrictive pattern: E/A ratio > 1.2 and EDT < 120ms>
Furthermore, we made an echocardiographic estimation of pulmonary vascular resistance (PVR) by dividing the tricuspid regurgitation velocity (TRV) by the velocity-time integral in the right ventricular outflow track (RVOT): PVR = TRV/VTI (RVOT). PVR was expressed in Woods units, and considered abnormal when it was > 2 [12].
Follow-up
The participants were followed-up in office consultation on M1, M3 and M6, and by phone calls on M2, M4 and M5.
During office consultations, data collected during were the following:
- Occurrence or aggravation of signs and symptoms of heart failure, and change in vital parameters leading to the modification of heart failure treatment or hospitalization.
- Medication adherence: monitored using 8-item Morisky medication adherence scale. A score of 8 indicated a high adherence, 6 to 7 medium adherence, and Less-than sign 6 low adherence.
During phone calls, we asked the participants if they had symptoms of heart failure, and encouraged them to have good medication adherence.
Participants who did not present for office consultations, and who were unreachable on phone were considered as lost to follow-up.
Prognostic criteria were all-cause mortality, and hospitalization for heart failure.
We performed statistical analysis using Statistical Package for Social Sciences software version 23.0. We used the Chi-square test for the comparison of proportions. The Fisher exact test was used where appropriate. The Mann Whitney test was used for the comparison of medians, logistic regression for multivariate analysis. We analyzed factors associated to RV systolic and diastolic dysfunction. The first step consisted of the univariate analysis including the following variables: gender, age, heart failure duration, left ventricular ejection fraction, left ventricular diastolic dysfunction, pulmonary artery systolic pressure, pulmonary vascular resistance, basal RV diameter, and medication adherence. The second step was a logistic regression of all variables with significant p-values in univariate analysis. Data of participants lost to follow-up were not included in mortality analysis. We also did not include in the analysis of hospitalization the data of participants who had never been hospitalized before their lost to follow-up. A p-value Less-than sign 0.05 was considered as statistically significant.
This study was conducted in accordance to with the declaration of Helsinki. We obtained an ethical clearance N°1007/UY1/FMSB/VDRC/DAASR/SCD from the institutional ethical review board of the faculty of medicine and biomedical sciences of the university of Yaoundé I.
We included 82 patients (48.8% women) in the study. The median age was 63 [52 – 71] years. The baseline characteristics of the study population are presented in table I. Hypertension was the most frequent comorbidity. Hypertensive and ischemic cardiopathies as well as dilated cardiomyopathy were the most frequent etiologies of CHF. Most participants were classified NYHA II. Two third of the participants had heart failure with reduced ejection fraction (HFrEF). All classes of guideline-directed medical therapy were used in various proportions, and medication adherence was high in two third of participants.
| Variables | Categories | Number (N=82) | Percentage (%) |
| Gender | Male | 42 | 51.2 |
| Female | 40 | 48.8 | |
| Left heart failure etiologies | Hypertensive cardiopathy | 43 | 52.4 |
| Ischemic cardiopathy | 21 | 25.6 | |
| Dilated cardiomyopathy | 10 | 12.2 | |
| Valvular heart disease | 5 | 6.1 | |
| PPCM | 3 | 3.7 | |
| NYHA stage | II | 50 | 61.0 |
| III | 26 | 31.7 | |
| IV | 6 | 7.3 | |
| LVEF | < 40> | 53 | 64.6 |
| ≥ 40 | 29 | 35.4 | |
| Medications | Diuretic | 74 | 89.0 |
| Betablocker | 69 | 83.1 | |
| ACEi/ARB | 60 | 73.2 | |
| MRA | 42 | 50.6 | |
| SGLT2i | 23 | 27.7 | |
| Sacubitril-valsartan | 14 | 16.9 | |
| Medication adherence | High | 52 | 64.4 |
| Medium | 19 | 23.2 | |
| Low | 11 | 13.4 | |
| Comorbidities | Hypertension | 61 | 74.4 |
| Low physical activity | 48 | 58.5 | |
| Alcohol consumption | 20 | 24.4 | |
| Diabetes | 15 | 18.3 | |
| Obesity | 14 | 17.1 | |
| Dyslipidemia | 11 | 13.4 | |
| Tobacco smooking | 10 | 12.2 | |
| Chronic kidney disease | 8 | 9.8 |
Table I: Baseline characteristics of the study population
PPCM: peripartum cardiomyopathy NYHA: New York Heart Association LVEF: left ventricular ejection fraction ACEI: angiotensin converting enzyme inhibitor ARB: angiotensin receptor blocker MRA: mineralocorticoid receptor antagonist SGLT2I: sodium/glucose cotransporter 2 inhibitor
In table II we reported the findings of morphologic, and functional echocardiographic assessment of the right ventricle. There was no significant difference between men and women. Abnormalities of at least one parameter of RV systolic function were present in 53 participants (64.6%). The Tei index was the most frequently altered parameter followed successively by the 2D-FAC, the TAPSE and the DTI-derived tricuspid lateral annular systolic velocity (Figure 1). RV diastolic dysfunction was present in 43 participants (52.4%) with abnormal relaxation in most cases (Figure 2).
| Variables | Men | Women | p |
| RV basal diameter | 40 [31 – 47] | 35 [30 – 45] | 0.348 |
| Proximal RVOT in PSLA | 32 [29 – 40] | 32 [30 – 37] | 0.662 |
| Proximal RVOT in PSSA | 34 [28 – 37] | 33 [27 – 37] | 0.670 |
| Distal RVOT in PSSA | 26 [22 – 28] | 24 [21 – 26] | 0.373 |
| PA diameter | 24 [20 – 28] | 24 [20 – 26] | 0.659 |
| Basal RV thickness | 4 [4 – 5] | 4 [3 – 4] | 0.067 |
| RV/LV ratio | 0,76 [0,62 – 0,98] | 0,77 [0,63 – 0,92] | 0.898 |
| RA surface | 19 [16 – 25] | 19 [17 – 23] | 0.686 |
| TAPSE | 18 [13 – 21] | 17 [13 – 22] | 0.762 |
| S’ | 11,0 [8,0 – 12,9] | 10,0 [8,3 – 13,0] | 0.907 |
| 2D-FAC | 32 [21 – 43] | 34 [21 – 46] | 0.534 |
| Tei index | 59 [45 – 73] | 59 [46 – 79] | 0.926 |
| E/A ratio | 0,89 [0,69 – 1,20] | 1,07 [0,73 – 1,36] | 0.269 |
| E/Ea ratio | 5 [4 – 7] | 5 [3 – 6] | 0.722 |
| EDT | 160 [116 – 216] | 188 [119 – 276] | 0.252 |
Table II: parameters of right ventricular morphologic and functional assessment
Figure 2: Proportions of abnormal right ventricular systolic function parameters
Figure 2: Proportion patterns of right ventricular diastolic function
At six months follow-up, half number of participants had presented at least one hospitalization for congestive heart failure. The triggers of depensation were infections (41.0%), poor adherence to treatment (37.0%), anemia (11.0%), and arrythmia (4.1%). The trigger of decompensation was unidentified in 6.9% of participants. The mortality rate was 13.4%. RV systolic dysfunction was significantly associated with hospitalizations for heart failure but not to all-cause mortality (Table III). There was no significant association between RV diastolic dysfunction and neither hospitalizations for heart failure nor all-cause mortality. RV systolic dysfunction was independently associated with LVEF Less-than sign 40 Percent sign (Table IV).
| All-cause mortality | Hospitalizations | |||
| No (n=62) | Yes (n=11) | No (n=30) | Yes (n=45) | |
RV systolic dysfunction Yes No |
38 (61.3) 24 (38.7) |
8 (72.7) 3 (27.3) |
15 (50.0) 15 (50.0) |
33 (73.3) 12 (26.7) |
| OR (95% CI) | 1.68 (0.41 – 6.98) | 2.75 (1.04 – 7.28) | ||
| p | 0.736 | 0.039* | ||
RV diastolic dysfunction Yes No |
36 (58.1) 26 (41.9) |
4 (36.4) 7 (63.6) |
17 (56.7) 13 (43.3) |
23 (53.5) 20 (46.5) |
| OR (95% CI) | 0.41 (0.11 – 1.56) | 0.88 (0.34 – 2.25) | ||
| p | 0.207 | 0.788 | ||
Table III: Assessment of the association between prognostic factors and right ventricular dysfunction
RV: right ventricular OR: odds ratio CI: confidence interval *significant
| All-cause mortality | Hospitalizations | |||
| No (n=62) | Yes (n=11) | No (n=30) | Yes (n=45) | |
RV systolic dysfunction Yes No |
38 (61.3) 24 (38.7) |
8 (72.7) 3 (27.3) |
15 (50.0) 15 (50.0) |
33 (73.3) 12 (26.7) |
| OR (95% CI) | 1.68 (0.41 – 6.98) | 2.75 (1.04 – 7.28) | ||
| p | 0.736 | 0.039* | ||
RV diastolic dysfunction Yes No |
36 (58.1) 26 (41.9) |
4 (36.4) 7 (63.6) |
17 (56.7) 13 (43.3) |
23 (53.5) 20 (46.5) |
| OR (95% CI) | 0.41 (0.11 – 1.56) | 0.88 (0.34 – 2.25) | ||
| p | 0.207 | 0.788 | ||
Table IV: Multivariate analysis of factors associated with right ventricular systolic dysfunction
RV: right ventricular OR: odds ratio CI: confidence interval LVEF: left ventricular ejection faction PASP: pulmonary artery systolic pressure
This study aimed to determine the prognostic value of RV function assessed by echocardiography in CHF patients in Cameroon, were other work-up such as cardiac magnetic resonance imaging, and biomarkers are not readily available, and most patients unable to afford them in the absence of universal health coverage. Our participants similarity as found by previous authors in Cameroon [13–16]; were relatively young with approximately 10 years difference as compared to CHF patients in high income countries [17,18]. This can be explained by the limited access to health services in Cameroon, which can lead to late management of risk factors, leading to early onset heart failure. Hypertension was the most frequent comorbidity. It is the predominant cardiovascular risk factor in Africa where its prevalence reaches 42% [19]. Hypertension which is asymptomatic at early stages often goes undiagnosed and undertreated in our milieu, leading inexorably to complications such as CHF. This fact can explain why hypertensive cardiopathy most prevalent in our sample, contrasting with the pattern in high income countries where ischemic heart disease is the leading cause of CHF [20]. Heart failure with reduced ejection fraction was more frequent is our study population, and corroborate the data from a large European registry reporting 60% of HFrEF phenotype [21]. Concerning RV systolic dysfunction, the prevalence we obtained is close to those reported by Meluzin et al in Czechia, and Menanga et al in Cameroon [13,22]. They reported respectively 70% and 81.6%. In contrary, Venner et al in France, and Shaker et al in Egypt found lower prevalences, respectively 25% and 48.7% [23,24]. These disparities may be explained by different study populations (only HFrEF patients included in the latter studies), and different definitions of RV systolic dysfunction. RV systolic dysfunction was based on --TAPSE, S’ and 2D-FAC in the study of Shaker et al, while it was only base on TAPSE in the Study of Venner et al. Concerning RV diastolic function, data in the literature is very scarce. However, Sumin et al in the USA also found in 2021 that approximately half of the participants with ischemic heart failure with preserved ejection fraction had RV diastolic dysfunction [25]. The multivariate analysis showed an association between RV systolic dysfunction and LVEF < 40>
This study has some limitations. First as mentioned in the discussion section, our sample size and follow-up period were respectively small and short, thus decreasing the statistical power. Secondly, we were unable to perform RV strain and magnetic resonance imaging because of unavailability for the first modality, and financial constrains for the second.
Chronic heart failure patients frequently present right ventricular dysfunction, particularly those with reduced left ventricular ejection fraction. Right ventricular systolic dysfunction was found to be independently associated with hospitalization for worsening heart failure, but not with all-cause mortality. Right ventricular function assessment should be systematically integrated in the management of heart failure patients.
Hamadou B, Nganou-Gnindjio C-N, Oummoul Koulsoumi D, and Owona Ngabede A: study design. Oummoul Koulsoumi D: data collection. Djantio Noundou H J, Oummoul Koulsoumi D, and Danwe Dieudonné: statistical analysis; Oummoul Koulsoumi D, and Danwe Dieudonné: manuscript drafting. Hamadou B, and Menanga A P: supervision.
The authors declare no conflict of interest.
No funding was received for this study.
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The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
