Imperial College London

ProfessorMichaelPolkey

Faculty of MedicineNational Heart & Lung Institute

Professor of Respiratory Medicine
 
 
 
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Contact

 

+44 (0)20 7351 8029m.polkey

 
 
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Location

 

Respiratory MuscRoyal BromptonRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

655 results found

Ramsay M, Mandal S, Suh E-S, Steier J, Douiri A, Murphy PB, Polkey M, Simonds A, Hart Net al., 2015, Parasternal electromyography to determine the relationship between patient-ventilator asynchrony and nocturnal gas exchange during home mechanical ventilation set-up, THORAX, Vol: 70, Pages: 946-952, ISSN: 0040-6376

Journal article

Boutou AK, Zoumot Z, Nair A, Davey C, Hansell DM, Jamurtas A, Polkey MI, Hopkinson NSet al., 2015, The Impact of Homogeneous Versus Heterogeneous Emphysema on Dynamic Hyperinflation in Patients With Severe COPD Assessed for Lung Volume Reduction, COPD: Journal of Chronic Obstructive Pulmonary Disease, Vol: 12, Pages: 598-605, ISSN: 1541-2555

Dynamic hyperinflation (DH) is a pathophysiologic hallmark of Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to investigate the impact of emphysema distribution on DH during a maximal cardiopulmonary exercise test (CPET) in patients with severe COPD. This was a retrospective analysis of prospectively collected data among severe COPD patients who underwent thoracic high-resolution computed tomography, full lung function measurements and maximal CPET with inspiratory manouvers as assessment for a lung volume reduction procedure. ΔIC was calculated by subtracting the end-exercise inspiratory capacity (eIC) from resting IC (rIC) and expressed as a percentage of rIC (ΔIC %). Emphysema quantification was conducted at 3 predefined levels using the syngo PULMO-CT (Siemens AG); a difference >25% between best and worse slice was defined as heterogeneous emphysema. Fifty patients with heterogeneous (62.7% male; 60.9 ± 7.5 years old; FEV1% = 32.4 ± 11.4) and 14 with homogeneous emphysema (61.5% male; 62.5 ± 5.9 years old; FEV1% = 28.1 ± 10.3) fulfilled the enrolment criteria. The groups were matched for all baseline variables. ΔIC% was significantly higher in homogeneous emphysema (39.8% ± 9.8% vs.31.2% ± 13%, p = 0.031), while no other CPET parameter differed between the groups. Upper lobe predominance of emphysema correlated positively with peak oxygen pulse, peak oxygen uptake and peak respiratory rate, and negatively with ΔIC%. Homogeneous emphysema is associated with more DH during maximum exercise in COPD patients.

Journal article

Garfield B, Crosby A, Pieran Y, Jen L, Shao D, Parfitt L, Harries C, Morrell N, Polkey M, Kemp P, Wort SJet al., 2015, The role of growth and differentiation factor 15 (GDF-15) in the development of skeletal muscle wasting in pulmonary arterial hypertension (PAH), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Kon S, Jones S, Canavan J, Nolan C, Haselden B, Polkey M, Cullinan P, Man Wet al., 2015, Sit-to-stand ability in patients hospitalised for acute exacerbation of COPD: Clinical characteristics and short-term outcomes, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Jones SE, Canavan JL, Nolan CM, Kon SSC, Maddocks M, Polkey MI, Man WDCet al., 2015, Sit to stand performance and physical activity levels in COPD, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Carrington D, Jones S, Canavan J, Nolan C, Kon S, Polkey M, Man Wet al., 2015, Responsiveness of the short physical performance battery (SPPB) in severely dyspnoeic patients with COPD, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Demeyer H, Louvaris Z, Frei A, De Jong C, Loeckx M, Buesching G, Buttery S, Spruyt M, Tanner R, Rubio N, Gimeno-Santos E, Hopkinson N, Rabinovich R, Polkey M, Garcia-Aymerich J, Vogiatzis I, Troosters Tet al., 2015, Tele-coaching to promote physical activity in patients with COPD: Evaluation by patients, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Canavan JL, Jones SE, Nolan CM, Kon SSC, Maddocks M, Clark AL, Chowdhury F, Polkey MI, Hopkinson NS, Man WD-Cet al., 2015, Multi-frequency bioelectric impedance ratio and physical performance in stable COPD:, European Respiratory Society Conference, Pages: PA4598-PA4598, ISSN: 0903-1936

Conference paper

Boutou AK, Polkey MI, Hopkinson NS, 2015, Non-anaemic iron deficiency in COPD: A potential therapeutic target?, Respirology, Vol: 20, Pages: 1004-1005, ISSN: 1440-1843

Journal article

Kon SSC, Jones SE, Schofield SJ, Banya W, Dickson MJ, Canavan JL, Nolan CM, Haselden BM, Polkey MI, Cullinan P, Man WD-Cet al., 2015, Gait speed and readmission following hospitalisation for acute exacerbations of COPD: a prospective study, Thorax, Vol: 70, Pages: 1131-1137, ISSN: 1468-3296

Journal article

Canavan JL, Maddocks M, Nolan CM, Jones SE, Kon SSC, Clark AL, Polkey MI, Man WD-Cet al., 2015, Functionally relevant cut point for isometric quadriceps muscle strength in chronic respiratory disease, American Journal of Respiratory and Critical Care Medicine, Vol: 192, Pages: 395-397, ISSN: 1535-4970

Journal article

Murphy PB, Arbane G, Ramsay M, Suh E-S, Mandal S, Jayaram D, Leaver S, Polkey MI, Hart Net al., 2015, Safety and efficacy of auto-titrating noninvasive ventilation in COPD and obstructive sleep apnoea overlap syndrome, EUROPEAN RESPIRATORY JOURNAL, Vol: 46, Pages: 548-551, ISSN: 0903-1936

Journal article

Canavan JL, Kaliaraju D, Nolan CM, Clark AL, Jones SE, Kon SS, Polkey MI, Man WD-Cet al., 2015, Does pulmonary rehabilitation reduce peripheral blood pressure in patients with chronic obstructive pulmonary disease?, Chronic Respiratory Disease, Vol: 12, Pages: 256-263, ISSN: 1479-9731

Pulmonary rehabilitation (PR) can improve aerobic exercise capacity, health-related quality of life and dyspnoea in patients with chronic obstructive pulmonary disease (COPD). Recent studies have suggested that exercise training may improve blood pressure and arterial stiffness, albeit in small highly selected cohorts. The aim of the study was to establish whether supervised outpatient or unsupervised home PR can reduce peripheral blood pressure. Resting blood pressure was measured in 418 patients with COPD before and after outpatient PR, supervised by a hospital-based team (HOSP). Seventy-four patients with COPD undergoing an unsupervised home-based programme acted as a comparator group (HOME). Despite significant improvements in mean (95% confidence interval) exercise capacity in the HOSP group (56 (50–60) m, p < 0.001) and HOME group (30 (17–42) m, p < 0.001) systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) did not change in either the HOSP (SBP: p = 0.47; DBP: p = 0.06; MAP: p = 0.38) or HOME group (SBP: p = 0.67; DBP: p = 0.38; MAP: p = 0.76). Planned subgroup analysis of HOSP patients with known hypertension and/or cardiovascular disease showed no impact of PR upon blood pressure. PR is unlikely to reduce blood pressure, and by implication, makes a mechanism of action in which arterial stiffness is reduced, less likely.

Journal article

Zoumot Z, LoMauro A, Aliverti A, Nelson C, Ward S, Jordan S, Polkey MI, Shah PL, Hopkinson NSet al., 2015, Lung Volume Reduction in Emphysema Improves Chest Wall Asynchrony, Chest, Vol: 148, Pages: 185-195, ISSN: 1931-3543

BACKGROUND: Lung volume reduction (LVR) techniques improve lung function in selectedpatients with emphysema, but the impact of LVR procedures on the asynchronous movementof diff erent chest wall compartments, which is a feature of emphysema, is not known.METHODS: We used optoelectronic plethysmography to assess the eff ect of surgical and bronchoscopicLVR on chest wall asynchrony. Twenty-six patients were assessed before and 3 monthsaft er LVR (surgical [n 5 9] or bronchoscopic [n 5 7]) or a sham/unsuccessful bronchoscopictreatment (control subjects, n 5 10). Chest wall volumes were divided into six compartments(left and right of each of pulmonary ribcage [Vrc,p], abdominal ribcage [Vrc,a], and abdomen[Vab]) and phase shift angles ( u ) calculated for the asynchrony between Vrc,p and Vrc,a ( u RC),and between Vrc,a and Vab ( u DIA).RESULTS: Participants had an FEV 1 of 34.6 18% predicted and a residual volume of 217.846.0% predicted with significant chest wall asynchrony during quiet breathing at baseline( u RC, 31.3° 38.4°; and u DIA, 2 38.7° 36.3°). Between-group diff erence in the change in u RCand u DIA during quiet breathing following treatment was 44.3° (95% CI, 2 78 to 2 10.6;P 5 .003) and 34.5° (95% CI, 1.4 to 67.5; P 5 .007) toward 0° (representing perfect synchrony),respectively, favoring the LVR group. Changes in u RC and u DIA were statistically signifi canton the treated but not the untreated sides.CONCLUSIONS: Successful LVR signifi cantly reduces chest wall asynchrony in patients withemphysema. CHES

Journal article

Haji GS, Polkey MI, Hull JH, 2015, Dynamic laryngeal narrowing in COPD may have effects on the trachea, THORAX, Vol: 70, Pages: 692-692, ISSN: 0040-6376

Journal article

Davey C, Zoumot Z, Jordan S, McNulty WH, Carr DH, Hind MD, Hansell DM, Rubens MB, Banya W, Polkey MI, Shah PL, Hopkinson NSet al., 2015, Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial, Lancet, Vol: 386, Pages: 1066-1073, ISSN: 1474-547X

BackgroundLung volume reduction surgery improves survival in selected patients with emphysema, and has generated interest in bronchoscopic approaches that might achieve the same effect with less morbidity and mortality. Previous trials with endobronchial valves have yielded modest group benefits because when collateral ventilation is present it prevents lobar atelectasis.MethodsWe did a single-centre, double-blind sham-controlled trial in patients with both heterogeneous emphysema and a target lobe with intact interlobar fissures on CT of the thorax. We enrolled stable outpatients with chronic obstructive pulmonary disease who had a forced expiratory volume in 1 s (FEV1) of less than 50% predicted, significant hyperinflation (total lung capacity >100% and residual volume >150%), a restricted exercise capacity (6 min walking distance <450 m), and substantial breathlessness (MRC dyspnoea score ≥3). Participants were randomised (1:1) by computer-generated sequence to receive either valves placed to achieve unilateral lobar occlusion (bronchoscopic lung volume reduction) or a bronchoscopy with sham valve placement (control). Patients and researchers were masked to treatment allocation. The study was powered to detect a 15% improvement in the primary endpoint, the FEV1 3 months after the procedure. Analysis was on an intention-to-treat basis. The trial is registered at controlled-trials.com, ISRCTN04761234.Findings50 patients (62% male, FEV1 [% predicted] mean 31·7% [SD 10·2]) were enrolled to receive valves (n=25) or sham valve placement (control, n=25) between March 1, 2012, and Sept 30, 2013. In the bronchoscopic lung volume reduction group, FEV1 increased by a median 8·77% (IQR 2·27–35·85) versus 2·88% (0–8·51) in the control group (Mann-Whitney p=0·0326). There were two deaths in the bronchoscopic lung volume reduction group and one control patient was unable to attend for follow-up asse

Journal article

Gimeno-Santos E, Raste Y, Demeyer H, Louvaris Z, de Jong C, Rabinovich RA, Hopkinson NS, Polkey MI, Vogiatzis I, Tabberer M, Dobbels F, Ivanoff N, de Boer WI, van der Molen T, Kulich K, Serra I, BasagaƱa X, Troosters T, Puhan MA, Karlsson N, Garcia-Aymerich J, PROactive consortiumet al., 2015, The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease., European Respiratory Journal, Vol: 46, Pages: 988-1000, ISSN: 1399-3003

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD.Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts.236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled "amount" and "difficulty". After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test-retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity.Daily and clinical visit "PROactive physical activity in COPD" instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients.

Journal article

Xiao S-C, He B-T, Steier J, Moxham J, Polkey MI, Luo Y-Met al., 2015, Neural Respiratory Drive and Arousal in Patients with Obstructive Sleep Apnea Hypopnea, SLEEP, Vol: 38, Pages: 941-U250

Journal article

Coello C, Fisk M, Mohan D, Brown A, Murphy P, Wikinson I, Polkey M, Tal-Singer R, Cheriyan J, Gunn Ret al., 2015, Quantitative kinetic modelling of FDG in lung imaging of COPD, Annual Meeting of the Society-of-Nuclear-Medicine-and-Molecular-Imaging, Publisher: SOC NUCLEAR MEDICINE INC, ISSN: 0161-5505

Conference paper

Pearse SS, Sharma R, Wong T, Morrell M, Simonds A, Lane R, Mason M, Polkey M, Cowie M, Vazir Aet al., 2015, Accuracy of a pacemaker-derived algorithm for the diagnosis of sleep disordered breathing in heart failure, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 17, Pages: 297-297, ISSN: 1388-9842

Journal article

Maddocks M, Jones SE, Kon SSC, Canavan JL, Nolan CM, Clark AL, Polkey MI, Man WD-Cet al., 2015, Sarcopenia definitions: where to draw the line? Response to Scarlata et al, Thorax, Vol: 70, Pages: 694-694, ISSN: 1468-3296

Journal article

Davey C, Zoumot Z, Jordan S, Carr DH, Polkey MI, Shah PL, Hopkinson NSet al., 2015, Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (The BeLieVeR-HIFi trial): study design and rationale, Thorax, Vol: 70, Pages: 288-290, ISSN: 0040-6376

Journal article

Boutou AK, Hopkinson NS, Polkey MI, 2015, Anaemia in chronic obstructive pulmonary disease: an insight into its prevalence and pathophysiology, Clinical Science, Vol: 128, Pages: 283-295, ISSN: 1470-8736

Journal article

Jones SE, Maddocks M, Kon SSC, Canavan JL, Nolan CM, Clark AL, Polkey MI, Man WD-Cet al., 2015, Sarcopenia in COPD: prevalence, clinical correlates and response to pulmonary rehabilitation, THORAX, Vol: 70, Pages: 213-218, ISSN: 0040-6376

Journal article

Jolley C, Luo Y, Steier J, Sylvester K, Man W, Rafferty G, Polkey M, Moxham Jet al., 2015, Neural respiratory drive and symptoms that limit exercise in chronic obstructive pulmonary disease, LANCET, Vol: 385, Pages: 51-51, ISSN: 0140-6736

Journal article

Shields GS, Coissi GS, Jimenez-Royo P, Gambarota G, Dimber R, Hopkinson NS, Matthews PM, Brown AP, Polkey MIet al., 2015, BIOENERGETICS AND INTERMUSCULAR FAT IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE-ASSOCIATED QUADRICEPS WEAKNESS, MUSCLE & NERVE, Vol: 51, Pages: 214-221, ISSN: 0148-639X

Journal article

Jolley CJ, Luo YM, Steier J, Rafferty GF, Polkey MI, Moxham Jet al., 2015, Neural respiratory drive and breathlessness in COPD, EUROPEAN RESPIRATORY JOURNAL, Vol: 45, Pages: 355-364, ISSN: 0903-1936

Journal article

Pagliaroli E, Mohan D, Padmanaban V, Palange P, Elkin S, Polkey MIet al., 2015, Elevated QRISK2 score in patients hospitalized for acute exacerbation of COPD versus stable COPD outpatients, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 179, Pages: 312-314, ISSN: 0167-5273

Journal article

Baz M, Haji GS, Menzies-Gow A, Tanner RJ, Hopkinson NS, Polkey MI, Hull JHet al., 2015, Dynamic laryngeal narrowing during exercise: a mechanism for generating intrinsic PEEP in COPD?, Thorax, Vol: 70, Pages: 251-257, ISSN: 0040-6376

Journal article

Maddocks M, Kon SSC, Jones SE, Canavan JL, Nolan CM, Higginson IJ, Gao W, Polkey MI, Man WD-Cet al., 2015, Bioelectrical impedance phase angle relates to function, disease severity and prognosis in stable chronic obstructive pulmonary disease, Clinical Nutrition, Vol: 34, Pages: 1245-1250, ISSN: 1532-1983

Journal article

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