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

Jones DG, Haldar SK, Sharma R, Rahman-Haley SL, Francis DP, McDonagh TA, Mattar W, Underwood R, Hussain W, Markides V, Wong Tet al., 2012, A Randomised Trial to Assess Catheter Ablation versus Rate Control in the Management of Persistent Atrial Fibrillation in Chronic Heart Failure, Scientific Sessions of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 2788-2788, ISSN: 0009-7322

Conference paper

Ghosh AK, Hardy RJ, Francis DP, Chaturvedi N, Pellerin D, Deanfield J, Kuh D, Mayet J, Hughes ADet al., 2012, The Effect of Mid-life Blood Pressure Change and Anti-Hypertensive Treatment on Subsequent Left Ventricular Mass - A Life Course Approach, CIRCULATION, Vol: 126, ISSN: 0009-7322

Journal article

Konstantinou K, Aung N, Norrington K, Jabbour R, Kelshiker M, Turner HK, Barakat MF, Ling HZ, Aggarwal S, Flint J, Mayet J, Francis DP, Thomas M, Woldman S, Okonko DOet al., 2012, Evolving Iron Deficiency Confers Most of the Adversity Associated with a Temporal Rise in Red Cell Distribution Width, is More Ominous than a Falling Hemoglobin, and Blunts Left Ventricular Long Axis Function in Chronic Heart Failure, CIRCULATION, Vol: 126, ISSN: 0009-7322

Journal article

Norrington KD, Turner HK, Barakat MF, Konstantinou K, Kelshikir M, O'Driscoll S, Screeche-Powelll C, Chilcott J, Hayat S, Koa-Wing M, Graspa J, Nihovannopoulos P, Manisty C, Fox K, Connolly S, Chapman N, Sutaria N, Kanagaratnam P, Mayet J, Francis DP, Okonko DOet al., 2012, Prognostic Utility of the Hemoglobin/Hematocrit Equation for Estimating Plasma Volume Changes During Hospitalization for Acute Decompensated Heart Failure, CIRCULATION, Vol: 126, ISSN: 0009-7322

Journal article

Barron AJ, Wensel R, Francis DP, Malik Iet al., 2012, The role for cardiopulmonary exercise testing in patients with atrial septal defects: A review, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 161, Pages: 68-72, ISSN: 0167-5273

Journal article

Kyriacou A, Pabari PA, Francis DP, 2012, Cardiac resynchronization therapy is certainly cardiac therapy, but how much resynchronization and how much atrioventricular delay optimization?, HEART FAILURE REVIEWS, Vol: 17, Pages: 727-736, ISSN: 1382-4147

Journal article

Terranova G, Ferro M, Carpeggiani C, Recchia V, Braga L, Semelka RC, Picano Eet al., 2012, Low Quality and Lack of Clarity of Current Informed Consent Forms in Cardiology: How to Improve Them (vol 5, pg 649, 2012), JACC-CARDIOVASCULAR IMAGING, Vol: 5, Pages: 1190-1190, ISSN: 1936-878X

Journal article

Sen S, Davies JE, Malik IS, Foale RA, Mikhail GW, Hadjiloizou N, Hughes A, Mayet J, Francis DPet al., 2012, Why Does Primary Angioplasty Not Work in Registries? Quantifying the Susceptibility of Real-World Comparative Effectiveness Data to Allocation Bias, CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, Vol: 5, Pages: 759-766, ISSN: 1941-7705

Journal article

Foin N, Sen S, Petraco R, Torii R, Nijjer S, Xu YX, Mehta V, Mayet J, Hughes A, Francis D, Di Mario C, Krams R, Davies Jet al., 2012, Investigation of Fractional Flow Reserve Correlation with Direct Anatomical Parameters Using a Percutaneous Model of Coronary Artery Stenosis, Transcatheter Cardiovascular Therapeutics (TCT) Symposium, Publisher: ELSEVIER SCIENCE INC, Pages: B67-B67, ISSN: 0735-1097

Conference paper

Sen S, Petraco R, Nijjer S, Foin N, Broyd C, Foale R, Malik I, Mikhail G, Francis D, Hughes A, Mayet J, Di Mario C, Escaned J, Davies Jet al., 2012, The Diastolic Wave-Free Period Is The Most Suitable Period In The Cardiac Cycle For The Assessment Of A Coronary Stenosis: Implications For The Accurate Calculation Of The Instantaneous Wave-Free Ratio (iFR), Transcatheter Cardiovascular Therapeutics (TCT) Symposium, Publisher: ELSEVIER SCIENCE INC, Pages: B68-B68, ISSN: 0735-1097

Conference paper

Kyriacou A, Whinnett ZI, Sen S, Pabari PA, Wright I, Cornelussen R, Lefroy D, Davies DW, Peters NS, Kanagaratnam P, Mayet J, Hughes AD, Francis DP, Davies JEet al., 2012, Improvement in Coronary Blood Flow Velocity With Acute Biventricular Pacing Is Predominantly Due to an Increase in a Diastolic Backward-Travelling Decompression (Suction) Wave, CIRCULATION, Vol: 126, Pages: 1334-+, ISSN: 0009-7322

Journal article

Davies JE, Alastruey J, Francis DP, Hadjiloizou N, Whinnett ZI, Manisty CH, Aguado-Sierra J, Willson K, Foale RA, Malik IS, Hughes AD, Parker KH, Mayet Jet al., 2012, Attenuation of Wave Reflection by Wave Entrapment Creates a "Horizon Effect" in the Human Aorta, HYPERTENSION, Vol: 60, Pages: 778-+, ISSN: 0194-911X

Journal article

Sohaib SMA, Chen ZC, Whinnett Z, Francis DP, Manisty Cet al., 2012, Systematic review of genuine symptomatic response to cardiac resynchronization therapy: acknowledging the contribution of spontaneous response, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 995-995, ISSN: 0195-668X

Conference paper

Zaman N, Barron AJ, Cole GD, Wensel R, Okonko DO, Francis DPet al., 2012, Systematic review of the proportion of heart failure patients reporting side effects of beta-blockers in whom the medication is genuinely causative: ethical implications for informed consent, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 804-804, ISSN: 0195-668X

Conference paper

Kyriacou A, Pabari PA, Whinnett ZI, Arri S, Willson K, Baruah R, Stegemann B, Mayet J, Kanagaratnam P, Hughes AD, Francis DPet al., 2012, Fully Automatable, Reproducible, Noninvasive Simple Plethysmographic Optimization: Proof of Concept and Potential for Implantability, PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol: 35, Pages: 948-960, ISSN: 0147-8389

Journal article

Jarman JW, Wong T, Kojodojojo P, Sophr H, Davies JE, Roughton M, Francis DP, Kanagaratnam P, Markides V, Davies DW, Peters NSet al., 2012, Spatiotemporal behavior of high dominant frequency during paroxysmal and persistent atrial fibrillation in the human left atrium., Circ Arrhythm Electrophysiol., Vol: 4, Pages: 650-658

BACKGROUNDSites of high dominant frequency (DF(peak)) are thought to indicate the location of drivers of atrial fibrillation (AF), but characterization of their spatiotemporal distribution and stability, critical to their relevance as targets for catheter ablation, requires simultaneous global mapping of the left atrium.METHODS AND RESULTS:Noncontact electrograms recorded simultaneously from 256 left atrial sites during spontaneous AF were analyzed. After subtraction of the ventricular component, fast Fourier transform identified the DF at each site. Focal areas of DF(peak) were defined as those having a DF >20% above all neighboring sites. Twenty-four patients with spontaneous AF (11 paroxysmal and 13 persistent) were studied. In paroxysmal AF, sites of DF(peak) (mean DF, 11.6±2.9 Hz) were observed in 100% of patients (present during 65% of the mapping period). In contrast, DF(peak) was detected in only 31% of patients with persistent AF (P<0.001) and for only 5% of the mapping period (P<0.001). In both groups, locations of DF(peak) varied widely in both consecutive and separated segments of AF (κ coefficient range, -0.07-0.22). Activation sequences around sites of DF(peak) did not demonstrate centrifugal activation that would be expected from focal drivers.CONCLUSIONS:Focal areas of high DF are more frequent in paroxysmal than persistent AF, are spatiotemporally unstable, are not the source of centrifugal activation, and are not, therefore, indicative of fixed drivers of AF. In the absence of spatiotemporal stability, the success of ablation at sites of DF(peak) cannot be explained by elimination of fixed drivers.

Journal article

Shun-Shin M, Francis DP, 2012, Why Are Some Studies of Cardiovascular Markers Unreliable? The Role of Measurement Variability and What an Aspiring Clinician Scientist Can Do Before It Is Too Late, PROGRESS IN CARDIOVASCULAR DISEASES, Vol: 55, Pages: 14-24, ISSN: 0033-0620

Journal article

Sobotka PA, Krum H, Boehm M, Francis DP, Schlaich MPet al., 2012, The Role of Renal Denervation in the Treatment of Heart Failure, CURRENT CARDIOLOGY REPORTS, Vol: 14, Pages: 285-292, ISSN: 1523-3782

Journal article

Finegold JA, Manisty CH, Cecaro F, Sutaria N, Mayet J, Francis DPet al., 2012, Choosing between velocity-time-integral ratio and peak velocity ratio for calculation of the dimensionless index (or aortic valve area) in serial follow-up of aortic stenosis, International Journal of Cardiology

It remains unclear which echocardiographic measure is most suitable for serial measurement in real-world aortic stenosis (AS) follow-up. We determine whether the dimensionless index (DI) between aortic valve and left ventricular outflow tract velocities is measured more consistently using velocity-time-integral (VTI) or peak velocities (V(peak)) in real life.METHODS:Serial echocardiograms acquired within 6months in subjects with AS were analysed with blinding, to compare the variability over time of DI calculated using V(peak), with that of DI calculated using VTI.RESULTS:Paired echocardiograms, acquired on average 72days apart, were analysed from 70 patients with a range of severities of AS (59% severe). DI, calculated using either V(peak) or VTI, did not significantly change over this short time. Coefficient of variation was significantly better when DI was calculated using V(peak) than VTI (12.6 versus 25.4%, p<0.0001). The variabilities of mean and peak trans-aortic valve 4v(2) and left ventricular outflow tract VTI were no better: 26.9%, 19.1% and 22.1% respectively.CONCLUSIONS:Serially-followed variables require minimal noise to maximise detection of genuine change. For AS surveillance, calculating DI - or effective orifice area - from the ratio of V(peak) rather than VTIs would reduce 95% confidence intervals from ±51% to a still-disappointing ±25%. Guidelines recommend noisy surveillance measures, causing conscientious echocardiographers to 'peek' at previous values, and impairing clinicians' faith in echocardiographically-observed changes when making clinical decisions. For us in echocardiography to improve our ability to contribute to AS follow-up requires us to first acknowledge and discuss this honestly.

Journal article

Sohaib SMA, Chen Z, Whinnett Z, Francis DP, Manisty Cet al., 2012, UNBIASED ASSESSMENT OF SYMPTOMATIC "RESPONSE RATE" TO CARDIAC RESYNCHRONISATION THERAPY BY SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS (REVERSE, MIRACLE, MIRACLE ICD, MIRACLE ICD II, CARE-HF, COMPANION, CONTAK-CD, AND MUSTIC), Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A4-A4, ISSN: 1355-6037

Conference paper

Kyriacou A, Whinnett ZI, Sen S, Pabari P, Davies DW, Peters NS, Kanagaratnam P, Mayet J, Hughes AD, Francis DP, Davies JEet al., 2012, IMPROVEMENT IN CORONARY BLOOD FLOW WITH ACUTE BIVENTRICULAR PACING IS PREDOMINANTLY DUE TO AN INCREASE IN A DIASTOLIC BACKWARD-TRAVELLING DECOMPRESSION (SUCTION) WAVE, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A7-A8, ISSN: 1355-6037

Conference paper

Sen S, Escaned J, Malik I, Mikhail G, Foale R, Mila R, Tarkin J, Petraco R, Broyd C, Jabbour R, Sethi A, Baker C, Bellamy M, Al-Bustami M, Hackett D, Khan M, Lefroy D, Parker K, Hughes A, Francis D, Di Mario C, Mayet J, Davies Jet al., 2012, DEVELOPMENT AND VALIDATION OF A NOVEL PRESSURE-ONLY INTRA-CORONARY INDEX OF CORONARY STENOSIS SEVERITY, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A13-A13, ISSN: 1355-6037

Conference paper

Pabari PA, Moraldo M, Hughes AD, Mayet J, Kyriacou A, Francis DP, Manisty CHet al., 2012, VALIDATING MARKERS OF MECHANICAL DYSSYNCHRONY BY EXPERIMENTAL MANIPULATION OF INTERVENTRICULAR TIMINGS: WHAT IS NEEDED TO MAKE THEM A REASONABLE PROSPECT FOR CARDIAC RESYNCHRONISATION THERAPY SELECTION?, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A5-A5, ISSN: 1355-6037

Conference paper

Jabbour RJ, Husain S, Zaman N, Aung N, Ling HZ, Baruah R, Cole G, Manisty C, Barron A, Mayet J, Francis D, Thomas M, Woldman S, Okonko DOet al., 2012, MULTICENTRE VALIDATION OF THE ADVERSE PROGNOSTIC IMPLICATIONS OF DECLINING SERUM ALBUMIN LEVELS IN CHRONIC HEART FAILURE, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A9-A9, ISSN: 1355-6037

Conference paper

Davies JE, Sen S, Broyd C, Hadjiloizou N, Baksi J, Francis DP, Parker KH, Hughes AD, Foale RA, Chukwuemeka A, Casula R, Malik IS, Mikhail GW, Mayet Jet al., 2012, Response to Letter Regarding Article, "Arterial Pulse Wave Dynamics After Percutaneous Aortic Valve Replacement: Fall in Coronary Diastolic Suction With Increasing Heart Rate as a Basis for Angina Symptoms in Aortic Stenosis", CIRCULATION, Vol: 125, Pages: E613-E613, ISSN: 0009-7322

Journal article

Jabbour RJ, Shah J, Mayet J, Francis Det al., 2012, UNCOVERING THE MECHANISM OF THE PARADOXICAL ASSOCIATION BETWEEN CARDIAC DYSSYNCHRONY AND BETTER SURVIVAL IN HEART FAILURE, 61st Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: E998-E998, ISSN: 0735-1097

Conference paper

Dhutia NM, Cole GD, Willson K, Rueckert D, Parker KH, Hughes AD, Francis DPet al., 2012, A new automated system to identify a consistent sampling position to make tissue Doppler and transmitral Doppler measurements of E, E ' and E/E ', INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 155, Pages: 394-399, ISSN: 0167-5273

Journal article

Moraldo M, Del Franco A, Pugliese NR, Pabari PA, Francis DPet al., 2012, Avoiding bias in measuring "hemisphere radius" in echocardiographic mitral regurgitation quantification: Mona Lisa PISA, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 155, Pages: 318-320, ISSN: 0167-5273

Journal article

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