Publications
1335 results found
Martinez-Perez ME, Parker KH, Witt N, et al., 2020, Automatic artery/vein classification in colour retinal images, 12th International Conference on Machine Vision (ICMV), Publisher: SPIE-INT SOC OPTICAL ENGINEERING, ISSN: 0277-786X
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- Citations: 2
Farmaki A-E, Garfield V, Eastwood SV, et al., 2019, Type 2 diabetes risks and determinants in 2<sup>nd</sup> generation migrants and mixed ethnicity people of South Asian and African Caribbean descent in the UK
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Type 2 diabetes mellitus (T2DM) risk is markedly higher in UK South Asians (SA) and African Caribbeans (AC) compared to Europeans. Explanations for this excess are unclear. We therefore compared risks and determinants of T2DM in first- and second-generation (born in the UK) migrants, and in those of mixed ethnicity populations.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Data from the UK Biobank, a large population-based cohort of volunteers aged 40-69, were used. T2DM was assigned using self-report and glycated haemoglobin. Ethnicity was self-assigned. Using logistic regression and mediation analysis, we compared T2DM between first- and second-generation migrants, and between mixed European/South Asians (MixESA), or mixed European/African Caribbeans (MixEAC) with both Europeans and SA or AC respectively.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>T2DM prevalence was three to five times higher in SA and AC compared with Europeans [OR (95%CI): 4·80(3·60,6·40) and 3·30(2·70,4·10) respectively]. T2DM was 20-30% lower in second versus first generation SA and AC migrants [0·78(0·60,1·01) and 0·71(0·57,0·87) respectively]. T2DM in mixed populations was lower than comparator ethnic minority groups [MixESA versus SA 0·29(0·21,0·39), MixEAC versus AC 0·48(0·37,0·62)] and higher than Europeans, in MixESA 1·55(1·11, 2·17), and in MixEAC 2·06 (1·53, 2·78). Improved adiposity patterns in second generation migrants made an important contribution to risk reduction. Greater socioeconomic deprivation accounted for 17% and 42% of the excess risk of T2DM in MixESA and MixEAC comp
Kettunen J, Holmes MV, Allara E, et al., 2019, Lipoprotein signatures of cholesteryl ester transfer protein and HMG-CoA reductase inhibition, PLoS Biology, Vol: 17, Pages: 1-19, ISSN: 1544-9173
Cholesteryl ester transfer protein (CETP) inhibition reduces vascular event risk, but confusion surrounds its effects on low-density lipoprotein (LDL) cholesterol. Here, we clarify associations of genetic inhibition of CETP on detailed lipoprotein measures and compare those to genetic inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). We used an allele associated with lower CETP expression (rs247617) to mimic CETP inhibition and an allele associated with lower HMGCR expression (rs12916) to mimic the well-known effects of statins for comparison. The study consists of 65,427 participants of European ancestries with detailed lipoprotein subclass profiling from nuclear magnetic resonance spectroscopy. Genetic associations were scaled to 10% reduction in relative risk of coronary heart disease (CHD). We also examined observational associations of the lipoprotein subclass measures with risk of incident CHD in 3 population-based cohorts totalling 616 incident cases and 13,564 controls during 8-year follow-up. Genetic inhibition of CETP and HMGCR resulted in near-identical associations with LDL cholesterol concentration estimated by the Friedewald equation. Inhibition of HMGCR had relatively consistent associations on lower cholesterol concentrations across all apolipoprotein B-containing lipoproteins. In contrast, the associations of the inhibition of CETP were stronger on lower remnant and very-low-density lipoprotein (VLDL) cholesterol, but there were no associations on cholesterol concentrations in LDL defined by particle size (diameter 18–26 nm) (−0.02 SD LDL defined by particle size; 95% CI: −0.10 to 0.05 for CETP versus −0.24 SD, 95% CI −0.30 to −0.18 for HMGCR). Inhibition of CETP was strongly associated with lower proportion of triglycerides in all high-density lipoprotein (HDL) particles. In observational analyses, a higher triglyceride composition within HDL subclasses was associated with higher risk of CHD
Eastwood S, Chaturvedi N, Sattar N, et al., 2019, Impact of Kidney Function on Cardiovascular Risk and Mortality: A Comparison of South Asian and European Cohorts, AMERICAN JOURNAL OF NEPHROLOGY, Vol: 50, Pages: 425-433, ISSN: 0250-8095
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- Citations: 8
Torlasco C, D'Silva A, Bhuva A, et al., 2019, Age-related differences in cardiovascular plasticity induced by physical training, 80th SIC National Congress, Publisher: OXFORD UNIV PRESS, Pages: J194-J195, ISSN: 1520-765X
Chiesa ST, Masi S, Shipley MJ, et al., 2019, Accelerated Aortic Stiffening Relative to Carotid Stiffness is Associated With Cognitive Decline: The Whitehall II Study, Scientific Sessions of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322
Chiesa ST, Charakida M, Rapala A, et al., 2019, Fat Distribution, Inflammatory Biomarkers, and Cardiometabolic Risk in Young Adults: The Avon Longitudinal Study of Parents and Children, Scientific Sessions of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322
Charakida M, Georgiopoulos G, Dangardt F, et al., 2019, Response to 'Does smoking or alcohol cause early vascular damage in teenage years?', EUROPEAN HEART JOURNAL, Vol: 40, Pages: 3497-3497, ISSN: 0195-668X
Gu B, Piebalgs A, Huang Y, et al., 2019, Computational simulations of thrombolysis in acute stroke: Effect of clot size and location on recanalisation, Medical Engineering & Physics, Vol: 73, Pages: 9-17, ISSN: 1350-4533
Acute ischaemic stroke can be treated by intravenous thrombolysis whereby tissue plasminogen activator (tPA) is infused to dissolve clots that block blood supply to the brain. In this study, we aim to examine the influence of clot location and size on lysis pattern and recanalisation by using a recently developed computational modelling framework for thrombolysis under physiological flow conditions. An image-based patient-specific model is reconstructed which consists of the internal carotid bifurcation with the A1 segment of anterior cerebral arteries and M1 segment of middle cerebral arteries, and the M1 bifurcation containing the M2 segments. By varying the clot size and location, 7 scenarios are simulated mimicking thrombolysis of M1 and M2 occlusions. Our results show that initial breakthrough always occurs along the inner curvature of the occluded cerebral artery, due to prolonged tPA residence time in the recirculation zone. For a given occlusion site, lysis completion time appears to increase almost quadratically with the initial clot volume; whereas for a given clot volume, the simulated M2 occlusions take up to 30% longer for complete lysis compared to the corresponding M1 occlusions.
Tillin T, Tuson C, Sowa B, et al., 2019, Yoga and Cardiovascular Health Trial (YACHT): a UK-based randomised mechanistic study of a yoga intervention plus usual care versus usual care alone following an acute coronary event, BMJ OPEN, Vol: 9, ISSN: 2044-6055
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- Citations: 11
Jones S, James SN, Tillin T, et al., 2019, Association between depressive symptoms and perceived exertion during exercise: observational population-based cohort study of European, Indian Asian, and African-Caribbean older adults, LANCET, Vol: 394, Pages: 62-62, ISSN: 0140-6736
Al Saikhan L, Park C, Hughes AD, 2019, Reproducibility of Left Ventricular Dyssynchrony Indices by Three-Dimensional Speckle-Tracking Echocardiography: The Impact of Sub-optimal Image Quality, FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol: 6, ISSN: 2297-055X
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- Citations: 4
Parker RMA, Leckie G, Goldstein H, et al., 2019, Joint modelling of individual trajectories, within-individual variability and a later outcome: systolic blood pressure through childhood and left ventricular mass in early adulthood
<jats:title>ABSTRACT</jats:title><jats:p>Within-individual variability of repeatedly-measured exposures may predict later outcomes: e.g. blood pressure (BP) variability (BPV) is an independent cardiovascular risk factor above and beyond mean BP. Since two-stage methods, known to introduce bias, are typically used to investigate such associations, we introduce a joint modelling approach, examining associations of both mean BP and BPV across childhood to left ventricular mass (indexed to height; LVMI) in early adulthood with data from the UK’s Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Using multilevel models, we allow BPV to vary between individuals (a “random effect”) as well as to depend on covariates (allowing for heteroscedasticity). We further distinguish within-clinic variability (“measurement error”) from visit-to-visit BPV. BPV was predicted to be greater at older ages, at higher bodyweights, and in females, and was positively correlated with mean BP. BPV had a positive association with LVMI (10% increase in SD(BP) was predicted to increase LVMI by mean = 0.42% (95% credible interval: −0.47%, 1.38%)), but this association became negative (mean = −1.56%, 95% credible interval: −5.01%, 0.44%)) once the effect of mean BP on LVMI was adjusted for. This joint modelling approach offers a flexible method of relating repeatedly-measured exposures to later outcomes.</jats:p>
Bhuva AN, Bai W, Lau C, et al., 2019, A multicenter, scan-rescan, human and machine learning CMR study to test generalizability and precision in imaging biomarker analysis, Circulation: Cardiovascular Imaging, Vol: 12, Pages: 1-11, ISSN: 1941-9651
Background:Automated analysis of cardiac structure and function using machine learning (ML) has great potential, but is currently hindered by poor generalizability. Comparison is traditionally against clinicians as a reference, ignoring inherent human inter- and intraobserver error, and ensuring that ML cannot demonstrate superiority. Measuring precision (scan:rescan reproducibility) addresses this. We compared precision of ML and humans using a multicenter, multi-disease, scan:rescan cardiovascular magnetic resonance data set.Methods:One hundred ten patients (5 disease categories, 5 institutions, 2 scanner manufacturers, and 2 field strengths) underwent scan:rescan cardiovascular magnetic resonance (96% within one week). After identification of the most precise human technique, left ventricular chamber volumes, mass, and ejection fraction were measured by an expert, a trained junior clinician, and a fully automated convolutional neural network trained on 599 independent multicenter disease cases. Scan:rescan coefficient of variation and 1000 bootstrapped 95% CIs were calculated and compared using mixed linear effects models.Results:Clinicians can be confident in detecting a 9% change in left ventricular ejection fraction, with greater than half of coefficient of variation attributable to intraobserver variation. Expert, trained junior, and automated scan:rescan precision were similar (for left ventricular ejection fraction, coefficient of variation 6.1 [5.2%–7.1%], P=0.2581; 8.3 [5.6%–10.3%], P=0.3653; 8.8 [6.1%–11.1%], P=0.8620). Automated analysis was 186× faster than humans (0.07 versus 13 minutes).Conclusions:Automated ML analysis is faster with similar precision to the most precise human techniques, even when challenged with real-world scan:rescan data. Assessment of multicenter, multi-vendor, multi-field strength scan:rescan data (available at www.thevolumesresource.com) permits a generalizable assessment of ML precision and may facili
Alfarih M, Leu C, Moon J, et al., 2019, Echocardiographic Assessment of Left Ventricular Function in Patients with Aortic Stenosis and the short-term effects after intervention, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 507-507, ISSN: 0195-668X
Michail M, Comella A, McCormick L, et al., 2019, The Immediate Physiological Impact of Transcatheter Aortic Valve Replacement on Central Aortic Pressure in Patients With Severe Aortic Stenosis, 31st Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B137-B137, ISSN: 0735-1097
Sluyter JD, Hughes AD, Camargo CA, et al., 2019, Identification of Distinct Arterial Waveform Clusters and a Longitudinal Evaluation of Their Clinical Usefulness, HYPERTENSION, Vol: 74, Pages: 921-928, ISSN: 0194-911X
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- Citations: 7
Wong BLH, Chaturvedi N, Tillin T, et al., 2019, Association of blood pressure measures with brain structure and function: the Southall and Brent REvisited (SABRE) study, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 3707-3707, ISSN: 0195-668X
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- Citations: 1
Park CM, Taylor H, Jones S, et al., 2019, Adiposity gain from 17 to 25 years has a substantial effect on cardiac structure, independent of haemodynamics, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 3026-3026, ISSN: 0195-668X
Al Saikhan L, Park C, Tillin T, et al., 2019, Comparison of 3D and 2D echocardiography-derived indices of left ventricular function and structure to predict long-term mortality in the general population: Southall And Brent Revisited (SABRE) study, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 1410-1410, ISSN: 0195-668X
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- Citations: 1
Smith LA, Melbourne A, Owen D, et al., 2019, Cortical cerebral blood flow in ageing: effects of haematocrit, sex, ethnicity and diabetes, EUROPEAN RADIOLOGY, Vol: 29, Pages: 5549-5558, ISSN: 0938-7994
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- Citations: 16
Su J, Hughes AD, Simonsen U, et al., 2019, Impact of pulmonary endarterectomy on pulmonary arterial wave propagation and reservoir function., Am J Physiol Heart Circ Physiol, Vol: 317, Pages: H505-H516
High wave speed and large wave reflection in the pulmonary artery have previously been reported in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We assessed the impact of pulmonary endarterectomy (PEA) on pulmonary arterial wave propagation and reservoir function in patients with CTEPH. Right heart catheterization was performed using a combined pressure and Doppler flow sensor-tipped guidewire to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery in eight patients with CTEPH before and 3 mo after PEA. Wave intensity and reservoir-excess pressure analyses were then performed. Following PEA, mean pulmonary arterial pressure (PAPm; ∼49 vs. ∼32 mmHg), pulmonary vascular resistance (PVR; ∼11.1 vs. ∼5.1 Wood units), and wave speed (∼16.5 vs. ∼8.1 m/s), i.e., local arterial stiffness, markedly decreased. The changes in the intensity of the reflected arterial wave and wave reflection index (pre: ∼28%; post: ∼22%) were small, and patients post-PEA with and without residual pulmonary hypertension (i.e., PAPm ≥ 25 mmHg) had similar wave reflection index (∼20 vs. ∼23%). The reservoir and excess pressure decreased post-PEA, and the changes were associated with improved right ventricular afterload, function, and size. In conclusion, although PVR and arterial stiffness decreased substantially following PEA, large wave reflection persisted, even in patients without residual pulmonary hypertension, indicating lack of improvement in vascular impedance mismatch. This may continue to affect the optimal ventriculoarterial interaction, and further studies are warranted to determine whether this contributes to persistent symptoms in some patients.NEW & NOTEWORTHY We performed wave intensity analysis in the pulmonary artery in patients with chronic thromboembolic pulmonary hypertension before and 3 mo after pulmonary endarterectomy. Despite substantial reduction in pulmonary arterial pres
Michail M, Dehbi H-M, Nerlekar N, et al., 2019, Application of the DILEMMA score to improve lesion selection for invasive physiological assessment, CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol: 94, Pages: E96-E103, ISSN: 1522-1946
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- Citations: 8
Viljanen A, Soinio M, Cheung CY-L, et al., 2019, Effects of bariatric surgery on retinal microvascular architecture in obese patients, INTERNATIONAL JOURNAL OF OBESITY, Vol: 43, Pages: 1675-1680, ISSN: 0307-0565
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- Citations: 10
Eastwood SV, Tillin T, Hughes AD, et al., 2019, Ethnic differences in CVD for UK South Asians and Europeans with diabetes, and their explanations: SABRE study 1988-2015, 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S63-S63, ISSN: 0012-186X
Park C, Howe L, Rapala A, et al., 2019, The association between obesity and arterial stiffness from adolescence through to emerging adulthood and the confounding role of blood pressure, Publisher: NATURE PUBLISHING GROUP, Pages: 23-24, ISSN: 0950-9240
Alfarih M, Syrris P, Arbustini E, et al., 2019, Familial cardiomyopathy caused by a novel heterozygous mutation in the gene LMNA (c.1434dupG): a cardiac MRI-augmented segregation study., Acta Myol, Vol: 38, Pages: 159-162
In a five-generation family carrying a novel frameshift LMNA variant (c.1434dupG, p.Leu479AlafsX72), imaging-augmented segregation analysis supports its association with lamin heart disease. Affected members exhibit conduction abnormalities, supraventricular and ventricular arrythmias, dilated cardiomyopathy with non-infarct pattern midwall septal fibrosis, heart failure and thromboembolic complications.
Tillin T, Park C, Jones S, et al., 2019, Ethnicity and diabetes in older age in association with left ventricular function and structure in a UK population-based cohort (SABRE: Southall and Brent REvisited), 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S99-S99, ISSN: 0012-186X
Jones S, Tillin T, Williams S, et al., 2019, Skeletal muscle oxidative capacity is poorer in the presence of type 2 diabetes in older adults of European, but not South Asian or African Caribbean origin, 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S299-S299, ISSN: 0012-186X
Whinnett Z, Sohaib SMA, Mason M, et al., 2019, Multicenter randomized controlled crossover trial comparing hemodynamic optimization against echocardiographic optimization of AV and VV delay of Cardiac Resynchronization Therapy: The BRAVO Trial, JACC: Cardiovascular Imaging, Vol: 12, Pages: 1407-1416, ISSN: 1936-878X
ObjectivesBRAVO (British Randomized Controlled Trial of AV and VV Optimization) is a multicenter, randomized, crossover, noninferiority trial comparing echocardiographic optimization of atrioventricular (AV) and interventricular delay with a noninvasive blood pressure method.BackgroundCardiac resynchronization therapy including AV delay optimization confers clinical benefit, but the optimization requires time and expertise to perform.MethodsThis study randomized patients to echocardiographic optimization or hemodynamic optimization using multiple-replicate beat-by-beat noninvasive blood pressure at baseline; after 6 months, participants were crossed over to the other optimization arm of the trial. The primary outcome was exercise capacity, quantified as peak exercise oxygen uptake. Secondary outcome measures were echocardiographic left ventricular (LV) remodeling, quality-of-life scores, and N-terminal pro–B-type natriuretic peptide.ResultsA total of 401 patients were enrolled, the median age was 69 years, 78% of patients were men, and the New York Heart Association functional class was II in 84% and III in 16%. The primary endpoint, peak oxygen uptake, met the criterion for noninferiority (pnoninferiority = 0.0001), with no significant difference between the hemodynamically optimized arm and echocardiographically optimized arm of the trial (mean difference 0.1 ml/kg/min). Secondary endpoints for noninferiority were also met for symptoms (mean difference in Minnesota score 1; pnoninferiority = 0.002) and hormonal changes (mean change in N-terminal pro–B-type natriuretic peptide -10 pg/ml; pnoninferiority = 0.002). There was no significant difference in LV size (mean change in LV systolic dimension 1 mm; pnoninferiority < 0.001; LV diastolic dimension 0 mm; pnoninferiority <0.001). In 30% of patients the AV delay identified as optimal was more than 20 ms from the nominal setting of 120 ms.ConclusionsOptimization of cardiac resynchronization therapy
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