898 results found
Lota AS, Halliday BP, Hatipoglu S, et al., 2019, Risk prediction in patients with mild dilated cardiomyopathy by cardiovascular magnetic resonance: integrating assessment of myocardial mechanics with tissue characterisation, Publisher: WILEY, Pages: 406-407, ISSN: 1388-9842
Khalique Z, Ferreira PF, Scott AD, et al., 2019, DIFFUSION TENSOR CARDIOVASCULAR MAGNETIC RESONANCE IN CARDIAC AMYLOIDOSIS, Annual Meeting of the British-Society-of-Cardiovascular-Magnetic-Resonance (BSCMR), Publisher: BMJ PUBLISHING GROUP, Pages: A6-A7, ISSN: 1355-6037
Halliday BP, Pennell DJ, 2019, Prediction and prevention of heart failure in high-risk elderly patients, European Heart Journal, Vol: 40, Pages: 539-541, ISSN: 1522-9645
Liu B, Edwards NC, Pennell D, et al., 2019, The evolving role of cardiac magnetic resonance in primary mitral regurgitation: ready for prime time?, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 20, Pages: 123-130, ISSN: 2047-2404
Gorodezky M, Ferreira P, Nielles-Vallespin S, et al., 2019, High resolution in-vivo DT-CMR using an interleaved variable density spiral STEAM sequence, Magnetic Resonance in Medicine, Vol: 81, Pages: 1580-1594, ISSN: 0740-3194
Purpose: Diffusion tensor cardiovascular magnetic resonance (DT-CMR) has a limited spatial resolution. Thepurpose of this study was to demonstrate high-resolution DT-CMR using a segmented variable density spiralsequence with correction for motion, off-resonance and T2* related blurring.Methods: A single-shot STEAM EPI DT-CMR sequence at 2.8x2.8x8mm3 and 1.8x1.8x8mm3 was compared to asingle shot spiral at 2.8x2.8x8mm3 and an interleaved spiral sequence at 1.8x1.8x8mm3resolution in 10 healthyvolunteers at peak-systole and diastasis. Motion-induced phase was corrected using the densely sampledcentral k-space data of the spirals. STEAM field maps and T2* measures were obtained using a pair ofstimulated echoes each with a double spiral readout, the first used to correct the motion-induced phase of thesecond.Results: The high resolution spiral sequence produced similar DT-CMR results and quality measures to thestandard resolution sequence in both cardiac phases. Residual differences in fractional anisotropy and helixangle gradient between the resolutions could be due to spatial resolution and/or signal to noise ratio. The dataquality increased after both motion-induced phase correction and off-resonance correction and sharpnessincreased after T2* correction. The high resolution EPI sequence failed to provide sufficient data quality forDT-CMR reconstruction.Conclusion: In this study an in-vivo DT-CMR acquisition at 1.8x1.8mm2in-plane resolution was demonstratedusing a segmented spiral STEAM sequence. The motion-induced phase and off-resonance corrections areessential for high resolution spiral DT-CMR. Segmented variable density spiral STEAM was found to be theoptimal method for acquiring high resolution DT-CMR data.
Halliday BP, Wassall R, Lota A, et al., 2019, Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial, The Lancet, Vol: 393, Pages: 61-73, ISSN: 0140-6736
BackgroundPatients with dilated cardiomyopathy whose symptoms and cardiac function have recovered often ask whether their medications can be stopped. The safety of withdrawing treatment in this situation is unknown.MethodsWe did an open-label, pilot, randomised trial to examine the effect of phased withdrawal of heart failure medications in patients with previous dilated cardiomyopathy who were now asymptomatic, whose left ventricular ejection fraction (LVEF) had improved from less than 40% to 50% or greater, whose left ventricular end-diastolic volume (LVEDV) had normalised, and who had an N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) concentration less than 250 ng/L. Patients were recruited from a network of hospitals in the UK, assessed at one centre (Royal Brompton and Harefield NHS Foundation Trust, London, UK), and randomly assigned (1:1) to phased withdrawal or continuation of treatment. After 6 months, patients in the continued treatment group had treatment withdrawn by the same method. The primary endpoint was a relapse of dilated cardiomyopathy within 6 months, defined by a reduction in LVEF of more than 10% and to less than 50%, an increase in LVEDV by more than 10% and to higher than the normal range, a two-fold rise in NT-pro-BNP concentration and to more than 400 ng/L, or clinical evidence of heart failure, at which point treatments were re-established. The primary analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02859311.FindingsBetween April 21, 2016, and Aug 22, 2017, 51 patients were enrolled. 25 were randomly assigned to the treatment withdrawal group and 26 to continue treatment. Over the first 6 months, 11 (44%) patients randomly assigned to treatment withdrawal met the primary endpoint of relapse compared with none of those assigned to continue treatment (Kaplan-Meier estimate of event rate 45·7% [95% CI 28·5–67·2]; p=0·0001). After 6 months, 25 (96%) of 2
Halliday BP, Wassail R, Lota AS, et al., 2019, Brief Comment Video to the Recommended Article of the Month, REVISTA PORTUGUESA DE CARDIOLOGIA, Vol: 38, Pages: 71-71, ISSN: 0870-2551
Halliday BP, Wassall R, Lota A, et al., 2018, Withdrawal of Pharmacological Heart Failure Therapy in Recovered Dilated Cardiomyopathy - A Randomised Controlled Trial (TRED-HF), Scientific Sessions of the American-Heart-Association (AHA) / Resuscitation Science Symposium, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E761-E761, ISSN: 0009-7322
Krupickova S, Li W, Cheang MH, et al., 2018, Ramipril and left ventricular diastolic function in stable patients with pulmonary regurgitation after repair of tetralogy of Fallot, Scientific Sessions of the American-Heart-Association / Resuscitation Science Symposium, Publisher: ELSEVIER IRELAND LTD, Pages: 64-69, ISSN: 0167-5273
Halliday BP, Gulati A, Ali A, et al., 2018, Sex and age-based differences in the natural history and outcome of dilated cardiomyopathy, European Journal of Heart Failure, Vol: 20, Pages: 1392-1400, ISSN: 1388-9842
Aims: To evaluate the relationship between sex, age and outcome in dilated cardiomyopathy (DCM). Methods & Results: We used proportional hazard modelling to examine the association between sex, age and all-cause mortality in consecutive patients with DCM. Overall, 881 patients (290 women, median age 52 years) were followed for a median of 4.9 years. Women were more likely to present with heart failure (64.0% vs 54.5%; p=0.007) and had more severe symptoms (p<0.001) compared to men. Women had smaller left ventricular end-diastolic volume (125ml/m2 vs 135ml/m2, p<0.001), higher left ventricular ejection fraction (40.2% vs 37.9%, p=0.019) and were less likely to have mid-wall late gadolinium enhancement (23.0% vs 38.9%, p<0.0001). During follow-up 149 (16.9%) patients died, including 41 (4.7%) who died suddenly. After adjustment, all-cause mortality (HR 0.61; 95%CI 0.41:0.92; p=0.018) was lower in women, with similar trends for cardiovascular (HR 0.60; 95%CI 0.35-1.05; p=0.07), non-sudden (HR 0.63; 95%CI 0.39-1.02; p=0.06) and sudden death (HR 0.70, 95%CI 0.30:1.63; p=0.41). All-cause mortality (per 10 yrs: HR 1.36, 95%CI 1.20-1.55; p<0.00001) and non-sudden death (per 10 yrs: HR 1.51, 95%CI 1.26 – 1.82; p<0.00001) increased with age. Cumulative incidence curves confirmed favourable outcomes, particularly in women and those <60 years. Increased all-cause mortality in patients >60 years of age was driven by non-sudden death. Conclusion: Women with DCM have better survival compared to men, which may partly be due to less severe left ventricular dysfunction and a smaller scar burden. There is increased mortality driven by non-sudden death in patients >60 years of age that is less marked in women. Outcomes with contemporary treatment were favourable, with a low incidence of sudden death.
Khalique Z, Ferreira P, Scott A, et al., 2018, Diffusion Tensor Cardiovascular Magnetic Resonance of Microstructural Recovery in Dilated Cardiomyopathy, JACC: Cardiovascular Imaging, Vol: 11, Pages: 1548-1550, ISSN: 1936-878X
Loudon B, Ntatsaki E, Newsome S, et al., 2018, Osteoprotegerin and myocardial fibrosis in patients with aortic stenosis, Scientific Reports, Vol: 8, ISSN: 2045-2322
Left ventricular myocardial fibrosis in patients with aortic stenosis (AS) confers worse prognosis. Plasma osteoprotegerin (OPG), a cytokine from the TNF receptor family, correlates with the degree of valve calcification in AS, reflecting the activity of the tissue RANKL/RANK/OPG (receptor activator of nuclear factor κΒ ligand/RANK/osteoprotegerin) axis, and is associated with poorer outcomes in AS. Its association with myocardial fibrosis is unknown. We hypothesised that OPG levels would reflect the extent of myocardial fibrosis in AS. We included 110 consecutive patients with AS who had undergone late-gadolinium contrast enhanced cardiovascular magnetic resonance (LGE-CMR). Patients were characterised according to pattern of fibrosis (no fibrosis, midwall fibrosis, or chronic myocardial infarction fibrosis). Serum OPG was measured with ELISA and compared between groups defined by valve stenosis severity. Some 36 patients had no fibrosis, 38 had midwall fibrosis, and 36 had chronic infarction. Patients with midwall fibrosis did not have higher levels of OPG compared to those without fibrosis (6.78 vs. 5.25 pmol/L, p = 0.12). There was no difference between those with midwall or chronic myocardial infarction fibrosis (6.78 vs. 6.97 pmol/L, p = 0.27). However, OPG levels in patients with chronic myocardial infarction fibrosis were significantly higher than those without fibrosis (p = 0.005).
Schlemper J, Yang G, Ferreira P, et al., 2018, Stochastic deep compressive sensing for the reconstruction of diffusion tensor cardiac MRI, Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), Vol: 11070 LNCS, Pages: 295-303, ISSN: 0302-9743
© Springer Nature Switzerland AG 2018. Understanding the structure of the heart at the microscopic scale of cardiomyocytes and their aggregates provides new insights into the mechanisms of heart disease and enables the investigation of effective therapeutics. Diffusion Tensor Cardiac Magnetic Resonance (DT-CMR) is a unique non-invasive technique that can resolve the microscopic structure, organisation, and integrity of the myocardium without the need for exogenous contrast agents. However, this technique suffers from relatively low signal-to-noise ratio (SNR) and frequent signal loss due to respiratory and cardiac motion. Current DT-CMR techniques rely on acquiring and averaging multiple signal acquisitions to improve the SNR. Moreover, in order to mitigate the influence of respiratory movement, patients are required to perform many breath holds which results in prolonged acquisition durations (e.g., ~ 30 min using the existing technology). In this study, we propose a novel cascaded Convolutional Neural Networks (CNN) based compressive sensing (CS) technique and explore its applicability to improve DT-CMR acquisitions. Our simulation based studies have achieved high reconstruction fidelity and good agreement between DT-CMR parameters obtained with the proposed reconstruction and fully sampled ground truth. When compared to other state-of-the-art methods, our proposed deep cascaded CNN method and its stochastic variation demonstrated significant improvements. To the best of our knowledge, this is the first study using deep CNN based CS for the DT-CMR reconstruction. In addition, with relatively straightforward modifications to the acquisition scheme, our method can easily be translated into a method for online, at-the-scanner reconstruction enabling the deployment of accelerated DT-CMR in various clinical applications.
Puntmann VO, Valbuena S, Hinojar R, et al., 2018, Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus for CMR imaging endpoints in clinical research: Part i - Analytical validation and clinical qualification, Journal of Cardiovascular Magnetic Resonance, Vol: 20, ISSN: 1097-6647
Cardiovascular disease remains a leading cause of morbidity and mortality globally. Changing natural history of the disease due to improved care of acute conditions and ageing population necessitates new strategies to tackle conditions which have more chronic and indolent course. These include an increased deployment of safe screening methods, life-long surveillance, and monitoring of both disease activity and tailored-treatment, by way of increasingly personalized medical care. Cardiovascular magnetic resonance (CMR) is a non-invasive, ionising radiation-free method, which can support a significant number of clinically relevant measurements and offers new opportunities to advance the state of art of diagnosis, prognosis and treatment. The objective of the SCMR Clinical Trial Taskforce was to summarizes the evidence to emphasize where currently CMR-guided clinical care can indeed translate into meaningful use and efficient deployment of resources results in meaningful and efficient use. The objective of the present initiative was to provide an appraisal of evidence on analytical validation, including the accuracy and precision, and clinical qualification of parameters in disease context, clarifying the strengths and weaknesses of the state of art, as well as the gaps in the current evidence This paper is complementary to the existing position papers on standardized acquisition and post-processing ensuring robustness and transferability for widespread use. Themed imaging-endpoint guidance on trial design to support drug-discovery or change in clinical practice (part II), will be presented in a follow-up paper in due course. As CMR continues to undergo rapid development, regular updates of the present recommendations are foreseen.
Gulati A, Japp AG, Raza S, et al., 2018, Absence of myocardial fibrosis predicts favorable long-term survival in new-onset heart failure a cardiovascular magnetic resonance study, Circulation: Cardiovascular Imaging, Vol: 11, ISSN: 1941-9651
Background:Myocardial fibrosis, identified by late gadolinium enhancement cardiovascular magnetic resonance, predicts outcomes in chronic heart failure (HF). Its prognostic significance in new-onset HF and reduced left ventricular ejection fraction (LVEF) is unclear. We investigated whether the pattern and extent of fibrosis predict survival in new-onset HF and reduced LVEF of initially uncertain pathogenesis.Methods and Results:Of 120 consecutive patients with new-onset (<6 months) HF and reduced LVEF, 31 (26%) had infarct fibrosis, 25 (21%) had midwall fibrosis, and 64 (53%) had no fibrosis. During median follow-up of 8.9 years, 33 (28%) patients died. Patients with infarct fibrosis (hazard ratios [HR], 3.32; 95% CI, 1.46–7.58; P=0.004) or midwall fibrosis (HR, 2.99; 95% CI, 1.24–7.19; P=0.014) were more likely to die compared with those without fibrosis. On multivariable analysis, the pattern and extent of fibrosis were both associated with all-cause mortality (by fibrosis pattern: infarct: HR, 2.60; 95% CI, 1.08–6.27; P=0.033; midwall: HR, 2.64; 95% CI, 1.08–6.47; P=0.034; by fibrosis extent per 1%: HR, 1.07; 95% CI, 1.03–1.12; P<0.001). Fibrosis pattern also predicted composites of cardiovascular mortality or aborted sudden cardiac death (infarct: HR, 3.45; 95% CI, 1.20–9.90; P=0.022; midwall: HR, 6.59; 95% CI, 2.26–19.22; P<0.001), and all-cause mortality, HF hospitalization, or aborted sudden cardiac death (infarct: HR, 2.69; 95% CI, 1.26–5.76; P=0.011; midwall fibrosis: HR, 2.97; 95% CI, 1.37–6.45; P=0.006). Addition of fibrosis pattern to LVEF improved risk prediction for all-cause mortality (LVEF versus LVEF+fibrosis C statistic: 0.66 versus 0.71; P=0.033). Importantly, the absence of fibrosis heralded a favorable prognosis with an 85% survival rate over the duration of follow-up.Conclusions:The pattern and extent of myocardial fibrosis predict adverse outcomes in new-onset HF and reduced LVEF.
Pennell DJ, Khalique Z, Ferreira PF, et al., 2018, Deranged myocyte microstructure in situs inversus totalis demonstrated by diffusion tensor cardiovascular magnetic resonance, JACC: Cardiovascular Imaging, Vol: 11, Pages: 1360-1362, ISSN: 1936-878X
Gorodezky M, Scott AD, Ferreira PF, et al., 2018, Diffusion tensor cardiovascular magnetic resonance with a spiral trajectory: An in vivo comparison of echo planar and spiral stimulated echo sequences, Magnetic Resonance in Medicine, Vol: 80, Pages: 648-654, ISSN: 0740-3194
PURPOSE: Diffusion tensor cardiovascular MR (DT-CMR) using stimulated echo acquisition mode (STEAM) with echo-planar-imaging (EPI) readouts is a low signal-to-noise-ratio (SNR) technique and therefore typically has a low spatial resolution. Spiral trajectories are more efficient than EPI, and could increase the SNR. The purpose of this study was to compare the performance of a novel STEAM spiral DT-CMR sequence with an equivalent established EPI technique. METHODS: A STEAM DT-CMR sequence was implemented with a spiral readout and a reduced field of view. An in vivo comparison of DT-CMR parameters and data quality between EPI and spiral was performed in 11 healthy volunteers imaged in peak systole and diastasis at 3 T. The SNR was compared in a phantom and in vivo. RESULTS: There was a greater than 49% increase in the SNR in vivo and in the phantom measurements (in vivo septum, systole: SNREPI = 8.0 ± 2.2, SNRspiral = 12.0 ± 2.7; diastasis: SNREPI = 8.1 ± 1.6, SNRspiral = 12.0 ± 3.7). There were no significant differences in helix angle gradient (HAG) (systole: HAGEPI = -0.79 ± 0.07 °/%; HAGspiral = -0.74 ± 0.16 °/%; P = 0.11; diastasis: HAGEPI = -0.63 ± 0.05 °/%; HAGspiral = -0.56 ± 0.14 °/%; P = 0.20), mean diffusivity (MD) in systole (MDEPI = 0.99 ± 0.06 × 10-3 mm2 /s, MDspiral = 1.00 ± 0.09 × 10-3 mm2 /s, P = 0.23) and secondary eigenvector angulation (E2A) (systole: E2AEPI = 61 ± 10 °; E2Aspiral = 63 ± 10 °; P&thi
Khan TZ, Gorog DA, Arachchillage D, et al., 2018, Impact of lipoprotein apheresis on thrombotic parameters in patients with refractory angina and raised lipoprotein(a), European-Society-of-Cardiology Congress, Publisher: OXFORD UNIV PRESS, Pages: 1305-1306, ISSN: 0195-668X
Khan TZ, Haskard D, Caga-Anan M, et al., 2018, OXIDISED LDL AND ANTI-OXIDISED LDL ANTIBODIES ARE REDUCED BY LIPOPROTEIN APHERESIS IN A RANDOMISED CONTROLLED TRIAL ON PATIENTS WITH REFRACTORY ANGINA AND ELEVATED LIPOPROTEIN(A), 86th Congress of the European-Atherosclerosis-Society (EAS), Publisher: ELSEVIER IRELAND LTD, Pages: E31-E32, ISSN: 0021-9150
Manning WJ, Pennell DJ, 2018, Cardiovascular Magnetic Resonance A Companion to Braunwald's Heart Disease, Publisher: Churchill Livingstone, ISBN: 9780323415613
Complemented by: Braunwald's heart disease / edited by Douglas P. Zipes, Peter Libby, Robert O. Bonow, Douglas L. Mann, and Gordon F. Tomaselli. 11th ed. 2018.
Raphael CE, Cooper R, Mitchell F, et al., 2018, PERFUSION ABNORMALITIES IN HYPERTROPHIC CARDIOMYOPATHY: MECHANISMS AND PROGNOSTIC IMPORTANCE, Annual Conference of the British-Cardiovascular-Society on High Performing Teams, Publisher: BMJ PUBLISHING GROUP, Pages: A112-A113, ISSN: 1355-6037
Khalique Z, Ferreira PF, Scott AD, et al., 2018, ASSESSMENT OF THE MICROSTRUCTURE IN RECOVERED DILATED CARDIOMYOPATHY WITH DIFFUSION TENSOR CARDIOVASCULAR MAGNETIC RESONANCE, Joint Meeting of the British-Society-of-Cardiovascular-Imaging/British-Society-of-Cardiovascular-CT, British-Society-of-Cardiovascular-Magnetic-Resonance and British-Nuclear-Cardiac-Society on British Cardiovascular Imaging, Publisher: BMJ PUBLISHING GROUP, Pages: A6-A7, ISSN: 1355-6037
Bhuva AN, Lascelles K, Patel K, et al., 2018, MRI-CONDITIONALITY HAS NO IMPACT ON PACEMAKER AND DEFIBRILLATOR LEAD PARAMETER CHANGES WITH MRI AT 1.5 T, Joint Meeting of the British-Society-of-Cardiovascular-Imaging/British-Society-of-Cardiovascular-CT, British-Society-of-Cardiovascular-Magnetic-Resonance and British-Nuclear-Cardiac-Society on British Cardiovascular Imaging, Publisher: BMJ PUBLISHING GROUP, Pages: A14-A14, ISSN: 1355-6037
Halliday BP, Baksi AJ, Izgi C, et al., 2018, Improving risk stratification for sudden cardiac death in dilated cardiomyopathy using late gadolinium enhancement cardiovascular magnetic resonance, Heart Failure 2018, Publisher: WILEY, Pages: 184-184, ISSN: 1388-9842
Halliday BP, Wassall R, Khalique Z, et al., 2018, Comprehensive phenoptyping of patients with dilated cardiomyopathy and recovered ejection fraction, Heart Failure 2018, Publisher: WILEY, Pages: 185-185, ISSN: 1388-9842
Lota A, Fazal S, Wassall R, et al., 2018, NATIONAL TRENDS IN THE EPIDEMIOLOGY OF HOSPITAL ADMISSIONS FOR ACUTE MYOCARDITIS: INSIGHTS FROM THE UK NATIONAL HEALTH SERVICE, 67th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 875-875, ISSN: 0735-1097
Lota A, Tsao A, Al-Balah A, et al., 2018, PROGNOSTIC SIGNIFICANCE OF NON-ISCHAEMIC MYOCARDIAL FIBROSIS IN PATIENTS WITH NORMAL LV SIZE AND FUNCTION: A LARGE CMR REGISTRY STUDY, 67th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 436-436, ISSN: 0735-1097
Halliday B, Gulati A, Ali A, et al., 2018, SEX DIFFERENCES IN THE NATURAL HISTORY AND OUTCOME OF DILATED CARDIOMYOPATHY, 67th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 704-704, ISSN: 0735-1097
Halliday B, Baksi A, Gulati A, et al., 2018, DEFINING THE RELATIONSHIP BETWEEN THE EXTENT OF MID-WALL LATE GADOLINIUM ENHANCEMENT AND ADVERSE HEART FAILURE EVENTS IN PATIENTS WITH DILATED CARDIOMYOPATHY, 67th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 1473-1473, ISSN: 0735-1097
Gati S, Sharma S, Pennell D, 2018, The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Highly Trained Athletes, JACC-CARDIOVASCULAR IMAGING, Vol: 11, Pages: 247-259, ISSN: 1936-878X
Exercise-associated benefits on the cardiovascular systems are well established. Although exercise-associated sudden cardiac death is rare, most deaths in young athletes are due to hereditary or congenital cardiac diseases. Athletic adaptation itself is associated with several structural changes that overlap those observed in individuals with cardiomyopathies, often leading to dilemmas for the clinician regarding life-changing decisions including advice against competitive sports participation. Cardiac magnetic resonance plays an increasingly important role in helping to establish an accurate diagnosis in these individuals. This review highlights the role of cardiac magnetic resonance in differentiating physiological adaptation in athletes from pathology.
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