Imperial College London

ProfessorDarrelFrancis

Faculty of MedicineNational Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7594 3381d.francis Website

 
 
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Assistant

 

Miss Juliet Holmes +44 (0)20 7594 5735

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

579 results found

Jabbour R, Ling HZ, Norrington K, Amaral N, Zaman N, Aggarwal S, Aung N, Barron A, Manisty C, Baruah R, Cole GD, Missouris CG, Mayet J, Francis DP, Cheng AS, Thomas M, Woldman S, Okonko DOet al., 2014, Serum albumin changes and multivariate dynamic risk modelling in chronic heart failure, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 176, Pages: 437-443, ISSN: 0167-5273

Journal article

Rosen MR, Myerburg RJ, Francis DP, Cole GD, Marban Eet al., 2014, Translating Stem Cell Research to Cardiac Disease Therapies Pitfalls and Prospects for Improvement, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 64, Pages: 922-937, ISSN: 0735-1097

Journal article

Sau A, Qureshi N, Roney C, Bai W, Kim S, Ng FS, Kanagaratnam P, Peters N, Francis D, Lim PBet al., 2014, The influence of late-gadolinium enhanced cardiac MRI defined scar on left atrial electrophysiological properties in patients with persistent atrial fibrillation, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 780-780, ISSN: 0195-668X

Conference paper

Lau C, Barron A, Mcdonagh S, Screeche-Powell C, Francis DP, Mayet J, Manisty Cet al., 2014, A heart-failure led one-stop diagnostic service for breathlessness: initial experiences and diagnostic yield, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 1008-1008, ISSN: 0195-668X

Conference paper

Jabbour R, Shun-Shin M, Finegold JA, Sohaib SMA, Cook C, Whinnett Z, Manisty C, Francis Det al., 2014, Meta-analysis identifying the source of conflict of differing reports of CRT patients with narrow QRS heart failure, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 167-167, ISSN: 0195-668X

Conference paper

Cole GD, Francis DP, 2014, Perioperative beta blockade: guidelines do not reflect the problems with the evidence from the DECREASE trials, BMJ-BRITISH MEDICAL JOURNAL, Vol: 349, ISSN: 1756-1833

Journal article

Petraco R, van de Hoef TP, Nijjer S, Sen S, van Lavieren MA, Foale RA, Meuwissen M, Broyd C, Echavarria-Pinto M, Foin N, Malik IS, Mikhail GW, Hughes AD, Francis DP, Mayet J, Di Mario C, Escaned J, Piek JJ, Davies JEet al., 2014, Baseline Instantaneous Wave-Free Ratio as a Pressure-Only Estimation of Underlying Coronary Flow Reserve Results of the JUSTIFY-CFR Study (Joined Coronary Pressure and Flow Analysis to Determine Diagnostic Characteristics of Basal and Hyperemic Indices of Functional Lesion Severity-Coronary Flow Reserve), CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 7, Pages: 492-502, ISSN: 1941-7640

Journal article

Kidher E, Harling L, Nihoyannopoulos P, Shenker N, Ashrafian H, Francis DP, Mayet J, Athanasiou Tet al., 2014, High aortic pulse wave velocity is associated with poor quality of life in surgical aortic valve stenosis patients, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 19, Pages: 189-197, ISSN: 1569-9293

Journal article

Dhutia NM, Zolgharni M, Willson K, Cole G, Nowbar AN, Dawson D, Zielke S, Whelan C, Newton J, Mayet J, Manisty CH, Francis DPet al., 2014, Guidance for accurate and consistent tissue Doppler velocity measurement: comparison of echocardiographic methods using a simple vendor-independent method for local validation, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 15, Pages: 817-827, ISSN: 2047-2404

Journal article

Finegold JA, Francis DP, 2014, Application of the Gompertz Method for Evaluating Survival Gains in Patients Receiving Cardiac Resynchronization Therapy Reply, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: 2879-2880, ISSN: 0735-1097

Journal article

Davies JE, Lacy P, Tillin T, Collier D, Cruickshank JK, Francis DP, Malaweera A, Mayet J, Stanton A, Williams B, Parker KH, Thom SAM, Hughes ADet al., 2014, Excess Pressure Integral Predicts Cardiovascular Events Independent of Other Risk Factors in the Conduit Artery Functional Evaluation Substudy of Anglo-Scandinavian Cardiac Outcomes Trial, HYPERTENSION, Vol: 64, Pages: 60-68, ISSN: 0194-911X

Journal article

Ghosh AK, Francis DP, Chaturvedi N, Kuh D, Mayet J, Hughes AD, Hardy RJet al., 2014, Cardiovascular Risk Factors from Early Life Predict Future Adult Cardiac Structural and Functional Abnormalities: A Systematic Review of the Published Literature., J Cardiol Ther, Vol: 2, Pages: 78-87, ISSN: 2311-052X

BACKGROUND: Clinical practice evaluates cardiovascular risk based on current risk factor (RF) levels [Blood pressure (BP), body mass index (BMI) and glycaemic control] largely disregarding previous risk-factor history over the totality of the life course. RFs are related to contemporaneous echocardiographic measures of cardiac structure and function which in turn are independently related to cardiovascular morbidity and mortality in cross-sectional studies. However, the effect of lifetime or earlier RF history on future echocardiographic changes has never been systematically examined. METHODS: A systematic review of the published literature identified 24 studies relating either earlier BP, BMI, glycaemic control or a combination to future cardiac structure and/or function. RESULTS: The majority of studies showed that elevated BP and BMI in earlier life and greater cumulative burden of these factors resulted in worse cardiac structure up to 24 years later. Studies examining glycaemic control as RF were few, but poorer glycaemic control in young adults was associated with increased future left ventricular mass. While only 5 papers related RFs to future cardiac function, all RFs were positively associated with worse future diastolic function. CONCLUSIONS: BP, BMI and glycaemic control measures in childhood, adolescence and early adulthood and subsequent longitudinal trajectories of BP and BMI are predictive of future abnormalities in cardiac structure and function. Lifetime RF history should be used to inform clinical practice. Further research is required to enable the identification of any sensitive periods in the life course to enable prevention when it is most likely to be effective.

Journal article

Kidher E, Patel VM, Nihoyannopoulos P, Anderson JR, Chukwuemeka A, Francis DP, Ashrafian H, Athanasiou Tet al., 2014, Aortic stiffness is related to the ischemic brain injury biomarker N-methyl-D-aspartate receptor antibody levels in aortic valve replacement, Neurology Research International, Vol: 2014, ISSN: 2090-1860

Background. Aortic stiffness changes the flow pattern of circulating blood causing microvascular damage to different end-organ tissues, such as brain cells. The relationship between aortic stiffness measured by pulse wave velocity (PWV) and serum ischemic brain injury biomarker N-methyl-D-aspartate receptor antibody (NR2Ab) levels in aortic valve replacement has not been assessed. Methods. Patients undergoing aortic valve replacement (AVR) for aortic stenosis (AS) had their PWV and NR2Ab serum levels measured preoperatively. We analyzed PWV and NR2Ab in two ways: (1) as continuous variables using the actual value and (2) as dichotomous variables (PWV-norm and PWV-high groups) and (NR2Ab-low and NR2Ab-high groups). Results. Fifty-six patients ( years) were included in this study. The NR2Ab level (ng/mL) was significantly higher in the PWV-high group () than in PWV-norm group (; median versus , resp., ). NR2Ab level was positively associated with PWV and negatively associated with male gender. Multiple regression revealed PWV independently related to NR2Ab level, and PWV cut-off was associated with a 7.23 times increase in the likelihood of having high NR2Ab (>1.8 ng/mL). Conclusion. Higher PWV in patients with surgical aortic stenosis is associated with higher levels of the ischemic brain biomarker NR2Ab.

Journal article

Fontana M, Asaria P, Moraldo M, Finegold J, Hassanally K, Manisty CH, Francis DPet al., 2014, Patient-Accessible Tool for Shared Decision Making in Cardiovascular Primary Prevention Balancing Longevity Benefits Against Medication Disutility, CIRCULATION, Vol: 129, Pages: 2539-2546, ISSN: 0009-7322

Journal article

Kidher E, Harling L, Ashrafian H, Naase H, Francis DP, Evans P, Athanasiou Tet al., 2014, Aortic stiffness as a marker of cardiac function and myocardial strain in patients undergoing aortic valve replacement, Journal of Cardiothoracic Surgery, Vol: 9, ISSN: 1749-8090

BackgroundCardiac function and myocardial strain are affected by cardiac afterload, which is in part due to the stiffness of the aortic wall. In this study, we hypothesize that aortic pulse wave velocity (PWV) as a marker of aortic stiffness correlates with conventional clinical and biochemical markers of cardiac function and perioperative myocardial strain in aortic valve replacement (AVR).MethodsPatients undergoing AVR for aortic stenosis between June 2010 and August 2012 were recruited for inclusion in this study. PWV, NYHA class and left ventricular (LV) function were assessed pre-operatively. PWV was analysed both as a continuous and dichotomous variable according to age-standardized reference values. B-type natriuretic peptide (BNP) was measured pre-operatively, and at 3 h and 18-24 h after cardiopulmonary bypass (CPB). NYHA class, leg edema, and LV function were recorded at follow-up (409 ± 159 days).ResultsFifty-six patients (16 females) with a mean age of 71 ± 8.4 years were included, with 50 (89%) patients completing follow-up. The NYHA class of PWV-norm patients was significantly lower than PWV-high patients both pre- and post-operatively. Multiple logistic regression also highlighted PWV-cut off as an independent predictor of NYHA class pre- and post-operatively (OR 8.3, 95%CI [2.27,33.33] and OR 14.44, 95%CI [1.49,139.31] respectively). No significant relationship was observed between PWV and either LV function or plasma BNP.ConclusionIn patients undergoing AVR for aortic stenosis, PWV is independently related to pre- and post-operative NYHA class but not to LV function or BNP. These findings provisionally support the use of perioperative PWV as a non-invasive marker of clinical functional status, which when used in conjunction with biomarkers of myocardial strain such as BNP, may provide a holistic functional assessment of patients undergoing aortic valve surgery. However, in order for PWV assessment to be tran

Journal article

Nowbar AN, Howard JP, Finegold JA, Asaria P, Francis DPet al., 2014, 2014 Global geographic analysis of mortality from ischaemic heart disease by country, age and income: Statistics from World Health Organisation and United Nations, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 174, Pages: 293-298, ISSN: 0167-5273

Journal article

Finegold J, Cazeau S, Sohaib SMA, Kyriacou A, Manisty C, Ritter P, Bordachar P, Whinnett Z, Francis Det al., 2014, THE EFFECT OF ALTERING AV DELAY ON THE PRE-EJECTION PERIOD IN PATIENTS WITH BIVENTRICULAR PACEMAKERS, HEART, Vol: 100, Pages: A22-A22, ISSN: 1355-6037

Journal article

Kousera CA, Nijjer S, Torii R, Petraco R, Sen S, Foin N, Hughes AD, Francis DPP, Xu XY, Davies JEet al., 2014, Patient-Specific Coronary Stenoses Can Be Modeled Using a Combination of OCT and Flow Velocities to Accurately Predict Hyperemic Pressure Gradients, IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, Vol: 61, Pages: 1902-1913, ISSN: 0018-9294

Journal article

Finegold J, Bordachar P, Kyriacou A, Sohaib SMA, Kanagaratnam P, Ploux S, Lim B, Peters N, Davies DW, Lefroy D, Ritter P, Francis D, Whinnett Zet al., 2014, CORRELATION AND REPRODUCIBILITY OF INVASIVE AND NON-INVASIVE HAEMODYNAMIC PARAMETERS FOR IDENTIFYING OPTIMAL AV DELAY IN CARDIAC RESYNCHRONISATION THERAPY, HEART, Vol: 100, Pages: A22-A23, ISSN: 1355-6037

Journal article

Sohaib SMA, Jones S, Kyriacou A, Manisty C, Mayet J, Kanagaratnam P, Peters N, Hughes A, Whinnett Z, Francis Det al., 2014, EVIDENCE THAT HAEMODYNAMIC RESPONSE TO VV DELAY OPTIMISATION OF CRT DEVICES MAY BE SIMPLY A FUNCTION OF THE METHOD OF PROGRAMMING AV DELAY, HEART, Vol: 100, Pages: A21-A22, ISSN: 1355-6037

Journal article

Sau A, Cole G, Cook C, Shun-Shin M, Francis Det al., 2014, SYSTEMATIC ANALYSIS OF EUROPEAN SOCIETY OF CARDIOLOGY GUIDELINES: WHAT DO WE ACTUALLY BASE OUR PRACTICE ON?, HEART, Vol: 100, Pages: A63-A64, ISSN: 1355-6037

Journal article

Jabbour R, Shun-Shin M, Finegold J, Sohaib A, Cook C, Whinnett Z, Manisty C, Francis Det al., 2014, META-ANALYSIS IDENTIFYING THE SOURCE OF CONFLICT BETWEEN DIFFERENT TRIAL REPORTS ON THE EFFECT OF CRT IN HEART FAILURE WITH NARROW QRS COMPLEXES, HEART, Vol: 100, Pages: A23-A23, ISSN: 1355-6037

Journal article

Cook C, Cole G, Asaris P, Jabbour R, Francis Det al., 2014, THE ANNUAL GLOBAL ECONOMIC BURDEN OF HEART FAILURE, HEART, Vol: 100, Pages: A28-A29, ISSN: 1355-6037

Journal article

Keene D, Shun-Shin M, Price C, Francis Det al., 2014, 108 The Observational HDL Hypothesis: A Useful Therapeutic Target? a Meta Analysis of 117,411 Patients in Randomised Controlled Trials., Heart, Vol: 100 Suppl 3, Pages: A62-A63

Epidemiological studies have shown HDL to be a prognostic marker. We undertook a meta-analysis to assess the benefit on cardiovascular outcomes for those patients on pharmacological interventions aimed at increasing HDL. Niacin, fibrates and cholesteryl ester transfer protein inhibitors (CETP-I) were identified as agents that raise HDL levels.

Journal article

Kidher E, Harling L, Ashrafian H, Naase H, Chukwuemeka A, Anderson J, Francis DP, Athanasiou Tet al., 2014, Pulse wave velocity and neutrophil gelatinase-associated lipocalin as predictors of acute kidney injury following aortic valve replacement, Journal of Cardiothoracic Surgery, Vol: 9, ISSN: 1749-8090

BackgroundAccurate prediction, early detection and treatment of acute kidney injury (AKI) are essential for improving post-operative outcomes. This study aimed to examine the role of aortic stiffness and neutrophil gelatinase-associated lipocalin (NGAL) as predictors of AKI or need for early medical renal intervention following aortic valve replacement (AVR).MethodsAortic pulse wave velocity and plasma NGAL were measured pre-operatively in recruited patients undergoing AVR for aortic stenosis (AS). Plasma NGAL was also measured at 3 and 18–24 hours after cardiopulmonary bypass (CPB). AKI was defined using RIFLE criteria. Early medical renal intervention included diuretics or dopamine infusion exclusively for renal causes.ResultsFifty-three patients aged 71 ± 9 years were included. Sixteen (30%) developed AKI (AKI-Yes) and 24 patients (45%) received early medical intervention (Intervention-Yes). There was no significant difference in the demographic, clinical or operative characteristics between the two groups for either outcome. PWV did not significantly correlate with AKI (r = 0.12, P = 0.13) or early intervention (r = 0.18, P = 0.18). At 3 h post-CPB, plasma NGAL was a much stronger predictor of both AKI and the need for early medical intervention than conventional markers such as creatinine (AKI: AUC 83%, 95% CI 0.70–0.95 vs. AUC 65%, 95% CI 0.47- 0.82; Medical intervention: AUC 84%, 95% CI 0.72–0.96 vs. AUC 56%, 95% CI 0.38–0.73). Post-CPB (3 hr) plasma NGAL was also significantly associated with AKI (r = 0.68, P < 0.001) at levels above 150 ng/ml; and significantly associated with early intervention (r = 0.64, P < 0.001) above 136 ng/ml. Simple linear regression showed no relationship between PWV and NGAL levels.ConclusionAortic PWV does not correlate significantly with pos

Journal article

Wensel R, Francis DP, 2014, Prognosis in patients with chronic heart failure: it's the way they breathe that matters, HEART, Vol: 100, Pages: 754-755, ISSN: 1355-6037

Journal article

Ingle L, Rigby AS, Sloan R, Carroll S, Goode KM, Cleland JG, Clark ALet al., 2014, Development of a composite model derived from cardiopulmonary exercise tests to predict mortality risk in patients with mild-to-moderate heart failure, HEART, Vol: 100, Pages: 781-786, ISSN: 1355-6037

Journal article

Zolgharni M, Dhutia NM, Cole GD, Bahmanyar MR, Jones S, Sohaib SMA, Tai SB, Willson K, Finegold JA, Francis DPet al., 2014, Automated Aortic Doppler Flow Tracing for Reproducible Research and Clinical Measurements, IEEE TRANSACTIONS ON MEDICAL IMAGING, Vol: 33, Pages: 1071-1082, ISSN: 0278-0062

Journal article

Cook CM, Cole G, Asaria P, Jabbour R, Francis Det al., 2014, The annual global economic burden of heart failure, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 16, Pages: 184-184, ISSN: 1388-9842

Journal article

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