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

714 results found

Giannoni A, Baruah R, Leong T, Rehman MB, Pastormerlo LE, Harrell FE, Coats AJS, Francis DPet al., 2014, Do Optimal Prognostic Thresholds in Continuous Physiological Variables Really Exist? Analysis of Origin of Apparent Thresholds, with Systematic Review for Peak Oxygen Consumption, Ejection Fraction and BNP, PLOS ONE, Vol: 9, ISSN: 1932-6203

Journal article

Unsworth B, Francis DP, Mayet J, 2014, RE: Impact of transcatheter aortic valve implantation or surgical aortic valve replacement on right ventricular function, HEART, Vol: 100, Pages: 180-180, ISSN: 1355-6037

Journal article

Bouri S, Whinnett ZI, Cole GD, Manisty CH, Cleland JG, Francis DPet al., 2014, Definitions of Outcome, Response and Effect in Imaging Research to Avoid Confusion, JACC-CARDIOVASCULAR IMAGING, Vol: 7, Pages: 104-106, ISSN: 1936-878X

Journal article

Tarkin JM, Nijjer S, Sen S, Petraco R, Echavarria-Pinto M, Asress KN, Lockie T, Khawaja MZ, Mayet J, Hughes AD, Malik IS, Mikhail GW, Baker CS, Foale RA, Redwood S, Francis DP, Escaned J, Davies JEet al., 2014, Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment Results of the Adenosine for the Functional Evaluation of Coronary Stenosis Severity (AFFECTS) Study, CELL BIOLOGY INTERNATIONAL, Vol: 38, Pages: 654-661, ISSN: 1065-6995

Journal article

Cole GD, Francis DP, 2014, Research failure can result in lost lives (Retracted article. See vol. 14, 2014), EUROPEAN HEART JOURNAL, Vol: 35, Pages: 135-137, ISSN: 0195-668X

Journal article

Dhutia NM, Zolgharni M, Willson K, Cole G, Nowbar AN, Manisty CH, Francis DPet al., 2014, Calibration of echocardiographic tissue doppler velocity, using simple, universally-applicable methods, Pages: 90400G-90400G

Conference paper

Baruah R, Giannoni A, Willson K, Manisty CH, Mebrate Y, Kyriacou A, Yadav H, Unsworth B, Sutton R, Mayet J, Hughes AD, Francis DPet al., 2014, Novel cardiac pacemaker-based human model of periodic breathing to develop real-time, pre-emptive technology for carbon dioxide stabilisation., Open Heart, Vol: 1, ISSN: 2053-3624

BACKGROUND: Constant flow and concentration CO2 has previously been efficacious in attenuating ventilatory oscillations in periodic breathing (PB) where oscillations in CO2 drive ventilatory oscillations. However, it has the undesirable effect of increasing end-tidal CO2, and ventilation. We tested, in a model of PB, a dynamic CO2 therapy that aims to attenuate pacemaker-induced ventilatory oscillations while minimising CO2 dose. METHODS: First, pacemakers were manipulated in 12 pacemaker recipients, 6 with heart failure (ejection fraction (EF)=23.7±7.3%) and 6 without heart failure, to experimentally induce PB. Second, we applied a real-time algorithm of pre-emptive dynamic exogenous CO2 administration, and tested different timings. RESULTS: We found that cardiac output alternation using pacemakers successfully induced PB. Dynamic CO2 therapy, when delivered coincident with hyperventilation, attenuated 57% of the experimentally induced oscillations in end-tidal CO2: SD/mean 0.06±0.01 untreated versus 0.04±0.01 with treatment (p<0.0001) and 0.02±0.01 in baseline non-modified breathing. This translated to a 56% reduction in induced ventilatory oscillations: SD/mean 0.19±0.09 untreated versus 0.14±0.06 with treatment (p=0.001) and 0.10±0.03 at baseline. Of note, end-tidal CO2 did not significantly rise when dynamic CO2 was applied to the model (4.84±0.47 vs 4.91± 0.45 kPa, p=0.08). Furthermore, mean ventilation was also not significantly increased by dynamic CO2 compared with untreated (7.8±1.2 vs 8.4±1.2 L/min, p=0.17). CONCLUSIONS: Cardiac pacemaker manipulation can be used to induce PB experimentally. In this induced PB, delivering CO2 coincident with hyperventilation, ventilatory oscillations can be substantially attenuated without a significant increase in end-tidal CO2 or ventilation. Dynamic CO2 administration might be developed into a clinical treatment for PB. TRIAL REGISTRATION N

Journal article

Zolgharni M, Dhutia NM, Cole GD, Willson K, Francis DPet al., 2014, Feasibility of using a reliable automated Doppler flow velocity measurements for research and clinical practices, Pages: 90401D-90401D

Conference paper

Finegold JA, Raphael CE, Levy WC, Whinnett Z, Francis DPet al., 2013, Quantification of survival gain from cardiac resynchronization therapy: nonlinear growth with time, and greater gain in low-risk patients, make raw trial data an underestimate of real-world behavior., J Am Coll Cardiol, Vol: 62, Pages: 2406-2413

OBJECTIVES: The goal of this study was to examine the impact of calculation-window duration on lifespan gain (as observed in trials) and on who gains most. BACKGROUND: The landmark trials of biventricular pacing (cardiac resynchronization therapy [CRT]) typically ran for <1 device battery life, and they may therefore underestimate lifespan benefit over longer durations. METHODS: We conducted a meta-analysis of biventricular pacing trials to calculate lifespan gained: first, within the duration of randomized controlled trial data up to 2 years; second, over a 5-year typical battery life; and third, over >1 battery life. Importantly, we applied the Gompertz method for age-related increase in mortality from non-CRT-preventable causes. RESULTS: Five landmark trials (COMPANION [Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure], CARE-HF (CArdiac REsynchronization-Heart Failure), MADIT-CRT [Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy], REVERSE [Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction], RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure)) provided data for 2 years (6,561 patients), with an average hazard ratio of 0.71. Lifespan gained across all trials increased nonlinearly with time from 0.1 month at 1 year, to 0.5 month at 2 years, and a projected 6.5 months at 5 years (65 times more than at 1 year). After multiple devices, it reached 14 months, involving on average 1.6 devices (i.e., 8.8 months per device implanted). Moreover, while over a short window (e.g., 2 years), lower-mortality patients may gain less than higher-mortality patients (1.4 vs. 2.3 months), their positions reverse by 15 years (16.0 vs. 13.7 months). CONCLUSIONS: Lifespan gain from biventricular pacing rises nonlinearly with time. Early on, higher-risk patients exhibit more gain, but later, lower-risk patients exhibit more gain. Quantifying ga

Journal article

Sohaib SMA, Whinnett ZI, Ellenbogen KA, Stellbrink C, Quinn TA, Bogaard MD, Bordachar P, van Gelder BM, van Geldorp IE, Linde C, Meine M, Prinzen FW, Turcott RG, Spotnitz HM, Wichterle D, Francis DPet al., 2013, Cardiac resynchronisation therapy optimisation strategies: Systematic classification, detailed analysis, minimum standards and a roadmap for development and testing, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 170, Pages: 118-131, ISSN: 0167-5273

Journal article

Schlaich MP, Schmieder RE, Bakris G, Blankestijn PJ, Boehm M, Campese VM, Francis DP, Grassi G, Hering D, Katholi R, Kjeldsen S, Krum H, Mahfoud F, Mancia G, Messerli FH, Narkiewicz K, Parati G, Rocha-Singh KJ, Ruilope LM, Rump LC, Sica DA, Sobotka PA, Tsioufis C, Vonend O, Weber MA, Williams B, Zeller T, Esler MDet al., 2013, International Expert Consensus Statement Percutaneous Transluminal Renal Denervation for the Treatment of Resistant Hypertension, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 62, Pages: 2031-2045, ISSN: 0735-1097

Journal article

Jamil-Copley S, Linton N, Koa-Wing M, Kojodjojo P, Lim PB, Malcolme-Lawes L, Whinnett Z, Wright I, Davies W, Peters N, Francis DP, Kanagaratnam Pet al., 2013, Application of Ripple Mapping with an Electroanatomic Mapping System for Diagnosis of Atrial Tachycardias, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 24, Pages: 1361-1369, ISSN: 1045-3873

Journal article

Tarkin JM, Nijjer S, Sen S, Petraco R, Echavarria-Pinto M, Asress KN, Lockie T, Khawaja MZ, Mayet J, Hughes AD, Malik IS, Mikhail GW, Baker CS, Foale RA, Redwood S, Francis DP, Escaned J, Davies JEet al., 2013, Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment Results of the Adenosine for the Functional Evaluation of Coronary Stenosis Severity (AFFECTS) Study, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 6, Pages: 654-661, ISSN: 1941-7640

Journal article

Sohaib SMA, Chen Z, Whinnett ZI, Bouri S, Dickstein K, Linde C, Hayes DL, Manisty CH, Francis DPet al., 2013, Meta-analysis of symptomatic response attributable to the pacing component of cardiac resynchronization therapy, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 15, Pages: 1419-1428, ISSN: 1388-9842

Journal article

Kousera CA, Nijjer SS, Torii R, Petraco R, Sen S, Foin N, Broyd C, Hughes AD, Xu YX, Francis DP, Davies JEet al., 2013, Patient-specific Coronary Stenoses Can Be Modeled Using a Combination of Optical Coherence Tomography and Flow Velocities to Accurately Predict Hyperaemic Pressure Gradients, 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B186-B186, ISSN: 0735-1097

Conference paper

Petraco R, van de Hoef TP, Nijjer SS, Sen S, Meuwissen M, Foale RA, Malik IS, Broyd C, Foin N, Mikhail G, van Lavieren MA, Francis DP, Echavarria-Pinto M, Escaned J, Hughes AD, Mayet J, Piek J, Davies JEet al., 2013, Identification of stenoses with high underlying coronary flow reserve from pressure-only measurements using baseline instant wave-free ratio (iFR) and hyperaemic fractional flow reserve (FFR), 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B190-B190, ISSN: 0735-1097

Conference paper

Kousera CA, Nijjer SS, Torii R, Petraco R, Sen S, Foin N, Broyd C, Hughes AD, Xu YX, Francis DP, Davies JEet al., 2013, Optical Coherence Tomography can be combined with angiography to create highly accurate patient-specific models of human coronary anatomy in a rapid automated manner, 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B195-B195, ISSN: 0735-1097

Conference paper

Barron AJ, Zaman N, Cole GD, Wensel R, Okonko DO, Francis DPet al., 2013, Systematic review of genuine versus spurious side-effects of beta-blockers in heart failure using placebo control: Recommendations for patient information, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 3572-3579, ISSN: 0167-5273

Journal article

Petraco R, Escaned J, Sen S, Nijjer S, Francis DP, Davies JEet al., 2013, How high can "accuracy" be for iFR (or IVUS, or SPECT or OCT...) if using fractional flow reserve as the gold standard? RESPONSE, EUROINTERVENTION, Vol: 9, Pages: 770-772, ISSN: 1774-024X

Journal article

Ponikowski P, Jankowska EA, 2013, Hypoglycaemia in diabetic patients: highly undesirable by cardiologists, EUROPEAN HEART JOURNAL, Vol: 34, Pages: 3102-3105, ISSN: 0195-668X

Journal article

Whinnett ZI, Francis DP, 2013, Cardiac Resynchronization Therapy Mechanisms in Atrial Fibrillation, HEART FAILURE CLINICS, Vol: 9, Pages: 475-+, ISSN: 1551-7136

Journal article

Cleland JG, Clark AL, Costanzo P, Francis DPet al., 2013, Diabetes, aliskiren, and heart failure: let's bring ASTRONAUT down to earth, EUROPEAN HEART JOURNAL, Vol: 34, Pages: 3097-3099, ISSN: 0195-668X

Journal article

Finegold JA, Asaria P, Francis DP, 2013, Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 934-945, ISSN: 0167-5273

Journal article

Nowbar AN, Cole GD, Francis DP, 2013, The changing relative contribution of operator salary and hardware costs to echocardiography - A historical perspective, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 1641-1641, ISSN: 0167-5273

Journal article

Raphael CE, Kyriacou A, Jones S, Pabari P, Cole G, Baruah R, Hughes AD, Francis DPet al., 2013, Multinational evaluation of the interpretability of the iterative method of optimisation of AV delay for CRT, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 407-413, ISSN: 0167-5273

Journal article

Wensel R, Francis DP, Meyer FJ, Opitz CF, Bruch L, Halank M, Winkler J, Seyfarth H-J, Glaeser S, Blumberg F, Obst A, Dandel M, Hetzer R, Ewert Ret al., 2013, Incremental prognostic value of cardiopulmonary exercise testing and resting haemodynamics in pulmonary arterial hypertension, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 167, Pages: 1193-1198, ISSN: 0167-5273

Journal article

Kyriacou A, Wa MELK, Pabari PA, Unsworth B, Baruah R, Willson K, Peters NS, Kanagaratnam P, Hughes AD, Mayet J, Whinnett ZI, Francis DPet al., 2013, A systematic approach to designing reliable VV optimization methodology: Assessment of internal validity of echocardiographic, electrocardiographic and haemodynamic optimization of cardiac resynchronization therapy, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 167, Pages: 954-964, ISSN: 0167-5273

Journal article

Broyd CJ, Sen S, Mikhail GW, Francis DP, Mayet J, Davies JEet al., 2013, Myocardial ischemia in aortic stenosis: Insights from arterial pulse-wave dynamics after percutaneous aortic valve replacement, TRENDS IN CARDIOVASCULAR MEDICINE, Vol: 23, Pages: 185-191, ISSN: 1050-1738

Journal article

Tarkin J, Nijjer S, Sen S, Petraco R, Mayet J, Echavarria Pinto M, Redwood S, Francis D, Escaned J, Davies Jet al., 2013, The haemodynamic response to intravenous adenosine and its impact on fractional flow reserve: results of the AFFECTS (Adenosine For the Functional assEssment of Coronary sTenosis Severity) study, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 514-514, ISSN: 0195-668X

Conference paper

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