Imperial College London

ProfessorDudleyPennell

Faculty of MedicineNational Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7351 8810d.pennell

 
 
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Location

 

CMR UnitRoyal BromptonRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

965 results found

Lota A, Hazebroek M, Theotokis P, Wassall R, Salmi S, Halliday B, Tayal U, Verdonschot J, Meena D, Owen R, de Marvao A, Iacob A, Yazdani M, Hammersley D, Jones R, Wage R, Buchan R, Vivian F, Hafouda Y, Noseda M, Gregson J, Mittal T, Wong J, Robertus JL, Baksi AJ, Vassiliou V, Tzoulaki I, Pantazis A, Cleland J, Barton P, Cook S, Pennell D, Cooper L, Garcia-Pavia P, Heymans S, Ware J, Prasad Set al., 2022, Genetic architecture of acute myocarditis and the overlap with inherited cardiomyopathy, Circulation, ISSN: 0009-7322

Background: Acute myocarditis is an inflammatory condition that may herald the onset of dilated (DCM) or arrhythmogenic cardiomyopathy (ACM). We investigated the frequency and clinical consequences of DCM and ACM genetic variants in a population-based cohort of patients with acute myocarditis. Methods: Population-based cohort of 336 consecutive patients with acute myocarditis enrolled in London and Maastricht. All participants underwent targeted DNA-sequencing for well-characterised cardiomyopathy-associated genes with comparison to healthy controls (n=1053) sequenced on the same platform. Case ascertainment in England was assessed against national hospital admission data. The primary outcome was all-cause mortality. Results: Variants that would be considered pathogenic if found in a patient with DCM or ACM were identified in 8% of myocarditis cases compared to <1% of healthy controls (p=0.0097). In the London cohort (n=230; median age 33years; 84% men), patients were representative of national myocarditis admissions (median age 32years; 71% men; 66% case ascertainment), and there was enrichment of rare truncating variants (tv) in ACM-associated genes (3.1% cases vs 0.4% controls; odds ratio 8.2; p=0.001). This was driven predominantly by desmoplakin (DSP)-tv in patients with normal LV ejection fraction and ventricular arrhythmia. In Maastricht (n=106; median age 54years; 61% men), there was enrichment of rare truncating variants in DCM-associated genes, particularly TTN-tv found in 7% (all with LVEF<50%) compared to 1% in controls (OR 3.6; p=0.0116). Across both cohorts over a median of 5.0 years (IQR 3.9-7.8), all-cause mortality was 5.4%. Two thirds of deaths were cardiovascular, due to worsening heart failure (92%) or sudden cardiac death (8%). The 5-year mortality risk was 3.3% in genotype negative patients versus 11.1% for genotype positive patients (Padjusted=0.08). Conclusions: We identified DCM- or ACM-associated genetic variants in 8% of patients wit

Journal article

Azzu A, Antonopoulos AS, Krupickova S, Mohiaddin Z, Almogheer B, Vlachopoulos C, Pantazis A, Pennell DJ, Mohiaddin RHet al., 2022, Myocardial strain analysis by cardiac magnetic resonance 3D feature-tracking identifies subclinical abnormalities in patients with neuromuscular disease and no overt cardiac involvement, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, ISSN: 2047-2404

Journal article

Hatipoglu S, Mohiaddin RH, Gatehouse P, Alpendurada F, Baksi AJ, Izgi C, Prasad SK, Pennell DJ, Krupickova Set al., 2022, Performance of artificial intelligence for biventricular cardiovascular magnetic resonance volumetric analysis in the clinical setting, INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, ISSN: 1569-5794

Journal article

Voges I, Caliebe A, Hinz S, Boroni Grazioli S, Gabbert DD, Daubeney PEF, Uebing AS, Pennell DJ, Krupickova Set al., 2022, Pediatric Cardiac Magnetic Resonance Reference Values for Biventricular Volumes Derived From Different Contouring Techniques, JOURNAL OF MAGNETIC RESONANCE IMAGING, ISSN: 1053-1807

Journal article

Tayal U, Verdonschot JAJ, Hazebroek MR, Howard J, Gregson J, Newsome S, Gulati A, Pua CJ, Halliday BP, Lota AS, Buchan RJ, Whiffin N, Kanapeckaite L, Baruah R, Jarman JWE, O'Regan DP, Barton PJR, Ware JS, Pennell DJ, Adriaans BP, Bekkers SCAM, Donovan J, Frenneaux M, Cooper LT, Januzzi JL, Cleland JGF, Cook SA, Deo RC, Heymans SRB, Prasad SKet al., 2022, Precision phenotyping of dilated cardiomyopathy using multidimensional data., Journal of the American College of Cardiology, Vol: 79, Pages: 2219-2232, ISSN: 0735-1097

BACKGROUND: Dilated cardiomyopathy (DCM) is a final common manifestation of heterogenous etiologies. Adverse outcomes highlight the need for disease stratification beyond ejection fraction. OBJECTIVES: The purpose of this study was to identify novel, reproducible subphenotypes of DCM using multiparametric data for improved patient stratification. METHODS: Longitudinal, observational UK-derivation (n = 426; median age 54 years; 67% men) and Dutch-validation (n = 239; median age 56 years; 64% men) cohorts of DCM patients (enrolled 2009-2016) with clinical, genetic, cardiovascular magnetic resonance, and proteomic assessments. Machine learning with profile regression identified novel disease subtypes. Penalized multinomial logistic regression was used for validation. Nested Cox models compared novel groupings to conventional risk measures. Primary composite outcome was cardiovascular death, heart failure, or arrhythmia events (median follow-up 4 years). RESULTS: In total, 3 novel DCM subtypes were identified: profibrotic metabolic, mild nonfibrotic, and biventricular impairment. Prognosis differed between subtypes in both the derivation (P < 0.0001) and validation cohorts. The novel profibrotic metabolic subtype had more diabetes, universal myocardial fibrosis, preserved right ventricular function, and elevated creatinine. For clinical application, 5 variables were sufficient for classification (left and right ventricular end-systolic volumes, left atrial volume, myocardial fibrosis, and creatinine). Adding the novel DCM subtype improved the C-statistic from 0.60 to 0.76. Interleukin-4 receptor-alpha was identified as a novel prognostic biomarker in derivation (HR: 3.6; 95% CI: 1.9-6.5; P = 0.00002) and validation cohorts (HR: 1.94; 95% CI: 1.3-2.8; P = 0.00005). CONCLUSIONS: Three reproducible, mechanistically distinct DCM subtypes were identified using widely available clinical and biological data, adding prognostic value to trad

Journal article

Tayal U, 2022, Exposure to elevated nitrogen dioxide concentrations and cardiac remodelling in patients with dilated cardiomyopathy, Journal of Cardiac Failure, Vol: 28, Pages: 924-934, ISSN: 1071-9164

Rationale: Empirical evidence suggests a strong link between exposure to air pollution and heart failure incidence, hospitalisations and mortality, but the biological basis of this remains unclear. Objective: To determine the relationship between differential air pollution levels and changes in cardiac structure and function in patients with dilated cardiomyopathy. Methods and Results: We undertook a prospective longitudinal observational cohort study of patients in England with dilated cardiomyopathy (enrollment 2009-2015; n=716, 66% male, 85% Caucasian) and conducted cross sectional analysis at the time of study enrollment. Annual average air pollution exposure estimates for nitrogen dioxide (NO2) and particulate matter with diameter ≤ 2.5µm (PM2.5) at enrolment were assigned to each residential postcode (on average 12 households). The relationship between air pollution and cardiac morphology was assessed using linear regression modelling. Greater ambient exposure to NO2 was associated with higher indexed left ventricular mass (4.3 g/m2 increase per interquartile range (IQR) increase in NO2, 95% CI 1.9 to 7.0 g/m2) and lower left ventricular ejection fraction (-1.5% decrease per IQR increase in NO2, 95% CI -2.7 to -0.2%), independent of age, sex, socio-economic status and clinical covariates. The associations were robust to adjustment for smoking status and geographical clustering by postcode area. The effect of air pollution on left ventricular mass was greatest in women. These effects were specific to NO2 exposure. Conclusion: Exposure to air pollution is associated with raised left ventricular mass and lower left ventricular ejection fraction, with the strongest effect in women. Whilst epidemiological associations between air pollution and heart failure have been established and supported by pre-clinical studies, our findings provide novel empirical evidence of cardiac remodelling and exposure to air pollution with important clinical and public health

Journal article

Puricelli F, Voges I, Gatehouse P, Rigby M, Izgi C, Pennell DJ, Krupickova Set al., 2022, Performance of Cardiac MRI in Pediatric and Adult Patients with Fontan Circulation., Radiol Cardiothorac Imaging, Vol: 4

Cardiac MRI has become a widely accepted standard for anatomic and functional assessment of complex Fontan physiology, because it is noninvasive and suitable for comprehensive follow-up evaluation after Fontan completion. The use of cardiac MRI in pediatric and adult patients after completion of the Fontan procedure are described, and a practical and experience-based cardiac MRI protocol for evaluating these patients is provided. The current approach and study protocol in use at the authors' institution are presented, which address technical considerations concerning sequences, planning, and optimal image acquisition in patients with Fontan circulation. Additionally, for each sequence, the information that can be obtained and guidance on how to integrate it into clinical decision-making is discussed. Keywords: Pediatrics, MRI, MRI Functional Imaging, Heart, Congenital © RSNA, 2022.

Journal article

Voges I, Caliebe A, Hinz S, Grazioli SB, Gabbert DD, Wegner P, Uebing AS, Daubeney PEF, Pennell DJ, Krupickova Set al., 2022, Reference Values for Pediatric Atrial Volumes Assessed by Steady-State Free-Precession Magnetic Resonance Imaging Using Monoplane and Biplane Area-Length Methods, JOURNAL OF MAGNETIC RESONANCE IMAGING, ISSN: 1053-1807

Journal article

Hundley WG, Bluemke DA, Bogaert J, Flamm SD, Fontana M, Friedrich MG, Grosse-Wortmann L, Karamitsos TD, Kramer CM, Kwong RY, McConnell M, Nagel E, Neubauer S, Nijveldt R, Pennell DJ, Petersen SE, Raman S, van Rossum Aet al., 2022, Society for Cardiovascular Magnetic Resonance (SCMR) guidelines for reporting cardiovascular magnetic resonance examinations, JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE, Vol: 24, ISSN: 1097-6647

Journal article

Ferreira PF, Banerjee A, Scott AD, Khalique Z, Yang G, Rajakulasingam R, Dwornik M, De Silva R, Pennell DJ, Firmin DN, Nielles-Vallespin Set al., 2022, Accelerating Cardiac Diffusion Tensor Imaging With a U-Net Based Model: Toward Single Breath-Hold, JOURNAL OF MAGNETIC RESONANCE IMAGING, ISSN: 1053-1807

Journal article

Petersen SE, Friedrich MG, Leiner T, Elias MD, Ferreira VM, Fenski M, Flamm SD, Fogel M, Garg R, Halushka MK, Hays AG, Kawel-Boehm N, Kramer CM, Nagel E, Ntusi NAB, Ostenfeld E, Pennell DJ, Raisi-Estabragh Z, Reeder SB, Rochitte CE, Starekova J, Suchá D, Tao Q, Schulz-Menger J, Bluemke DAet al., 2022, Cardiovascular Magnetic Resonance for Patients With COVID-19., JACC Cardiovasc Imaging, Vol: 15, Pages: 685-699

COVID-19 is associated with myocardial injury caused by ischemia, inflammation, or myocarditis. Cardiovascular magnetic resonance (CMR) is the noninvasive reference standard for cardiac function, structure, and tissue composition. CMR is a potentially valuable diagnostic tool in patients with COVID-19 presenting with myocardial injury and evidence of cardiac dysfunction. Although COVID-19-related myocarditis is likely infrequent, COVID-19-related cardiovascular histopathology findings have been reported in up to 48% of patients, raising the concern for long-term myocardial injury. Studies to date report CMR abnormalities in 26% to 60% of hospitalized patients who have recovered from COVID-19, including functional impairment, myocardial tissue abnormalities, late gadolinium enhancement, or pericardial abnormalities. In athletes post-COVID-19, CMR has detected myocarditis-like abnormalities. In children, multisystem inflammatory syndrome may occur 2 to 6 weeks after infection; associated myocarditis and coronary artery aneurysms are evaluable by CMR. At this time, our understanding of COVID-19-related cardiovascular involvement is incomplete, and multiple studies are planned to evaluate patients with COVID-19 using CMR. In this review, we summarize existing studies of CMR for patients with COVID-19 and present ongoing research. We also provide recommendations for clinical use of CMR for patients with acute symptoms or who are recovering from COVID-19.

Journal article

Tayal U, gregson J, Buchan R, Whiffin N, Halliday B, Lota A, Roberts A, Baksi A, Voges I, Jarman J, Baruah R, Frenneaux M, Cleland J, Barton P, Pennell D, Ware J, Cook S, Prasad Set al., 2022, Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy, Heart, Vol: 108, Pages: 619-625, ISSN: 1355-6037

Objective The effect of moderate excess alcohol consumption is widely debated and has not been well defined in dilated cardiomyopathy (DCM). There is need for a greater evidence base to help advise patients. We sought to evaluate the effect of moderate excess alcohol consumption on cardiovascular structure, function and outcomes in DCM. Methods Prospective longitudinal observational cohort study. Patients with DCM (n=604) were evaluated for a history of moderate excess alcohol consumption (UK government guidelines; >14 units/week for women, >21 units/week for men) at cohort enrollment, had cardiovascular magnetic resonance and were followed up for the composite endpoint of cardiovascular death, heart failure and arrhythmic events. Patients meeting criteria for alcoholic cardiomyopathy were not recruited. ResultsDCM patients with a history of moderate excess alcohol consumption (n=98, 16%) had lower biventricular function and increased chamber dilatation of the left ventricle, right ventricle and left atrium, as well as increased left ventricular hypertrophy compared to patients without moderate alcohol consumption. They were more likely to be male (alcohol excess group– n =92, 94% vs n =306, 61%, p=<0.001). After adjustment for biological sex, moderate excess alcohol was not associated with adverse cardiac structure. There was no difference in mid-wall myocardial fibrosis between groups. Prior moderate excess alcohol consumption did not affect prognosis (HR 1.29, 0.73 to 2.26, p=0.38) during median follow up of 3.9 years. ConclusionDilated cardiomyopathy patients with moderate excess alcohol consumption have adverse cardiac structure and function at presentation but this is largely due to biological sex. Alcohol may contribute to sex-specific phenotypic differences in DCM. These findings help to inform lifestyle discussions for patients with dilated cardiomyopathy.

Journal article

Halliday B, Owen R, Gregson J, Vazir A, Wassall R, Khalique Z, Lota A, Tayal U, Hammersley D, Jones R, Pennell D, Cowie M, Cleland J, Prasad Set al., 2022, Changes in clinical and imaging variables during withdrawal of heart failure therapy in recovered dilated cardiomyopathy, ESC Heart Failure, Vol: 9, ISSN: 2055-5822

Aims: To profile the changes in non-invasive clinical, biochemical and imaging markers during withdrawal of therapy in patients with recovered dilated cardiomyopathy, providing insights into the pathophysiology of relapse.Methods: Clinical, biochemical and imaging data from patients during phased withdrawal of therapy in the randomised or single-arm cross-over phases of TRED-HF were profiled. Clinical variables were measured at each study visit and imaging variables were measured at baseline, 16 weeks and 6 months. Results: Amongst the 49 patients (35% women, mean age 53.6 years [standard deviation 11.6]) who withdrew therapy, 20 relapsed. Increases in mean heart rate (7.6 beats per minute [95% CIs 4.5,10.7]), systolic blood pressure (6.6mmHg [95% CI 2.7,10.5]) and diastolic blood pressure (5.8mmHg [95% CI 3.1,8.5]) were observed within 4-8 weeks of starting to withdraw therapy. A rise in mean LV mass (5.1g/m2 [95%CI 2.8,7.3]) and LV end-diastolic volume (3.9ml/m2 [95% CI 1.1,6.7]) and a reduction in mean LV ejection fraction (-4.2 [95% CI -6.6, -1.8]) were seen by 16 weeks, the earliest imaging follow-up. Plasma NT-pro-BNP fell immediately after withdrawing beta-blockers and only tended to increase 6 months after beginning therapy withdrawal (mean change in log NT-pro-BNP at 6 months: 0.2, 95% CI -0.1,0.4). Conclusion: Changes in plasma NT-pro-BNP are a late feature of relapse, often months after a reduction in LV function. A rise in heart rate and blood pressure are observed soon after withdrawing therapy in recovered dilated cardiomyopathy, typically accompanied or closely followed by early changes in LV structure and function.

Journal article

Kouranos V, Khattar RS, Ahmed R, Azzu A, Okafor J, Shi R, Baksi AJ, Wechalekar K, Cowie MR, Pennell DJ, Wells AU, Sharma Ret al., 2022, MODE OF PRESENTATION, PROGNOSIS AND PREDICTORS OF OUTCOME IN A CONTEMPORARY CARDIAC SARCOIDOSIS POPULATION, Publisher: ELSEVIER SCIENCE INC, Pages: 553-553, ISSN: 0735-1097

Conference paper

Nakou E, De Garate E, Liang K, Williams M, Pennell DJ, Bucciarelli-Ducci Cet al., 2022, Imaging Findings of COVID-19-Related Cardiovascular Complications., Card Electrophysiol Clin, Vol: 14, Pages: 79-93

Other than respiratory disease, patients with coronavirus disease 2019 (COVID-19) commonly have cardiovascular manifestations, which are recognized as significant risk factors for increased mortality. COVID-19 patients may present with a wide spectrum of clinical presentations ranging from asymptomatic heart disease detected incidentally by cardiac investigations (troponin, BNP, and imaging) to cardiogenic shock and sudden cardiac death. In this broad clinical course, advanced imaging plays an important role in the diagnosis of different patterns of myocardial injury, risk stratification of COVID-19 patients, and in detecting potential cardiac side effects of the current treatments and vaccines against the severe acute respiratory syndrome.

Journal article

Androulakis E, Azzu A, Papagkikas P, Antonopoulos A, Al-Hussaini A, Pennell D, Mohiaddin Ret al., 2022, Spontaneous Coronary Artery Dissection: Insights From Cardiac Magnetic Resonance and Extracoronary Arterial Screening, CIRCULATION, Vol: 145, Pages: 555-557, ISSN: 0009-7322

Journal article

Dwornik M, Khalique Z, Rajakulasingam R, Scott A, Azzu A, Ferreira PF, Nielles-Vallespin S, Pennell DJet al., 2022, Cardiovascular Magnetic Resonance in Cardiomyopathy, International Journal of Cardiodiabetes

Journal article

Ghonim S, Gatzoulis M, Ernst S, Li W, Moon J, Smith G, Heng EL, Keegan J, Ho SY, McCarthy KP, Shore D, Uebing A, Kempny A, Alpendurada F, Dimopoulos K, Pennell DJ, Babu-Narayan Set al., 2022, Predicting survival in repaired tetralogy of Fallot- a lesion specific and personalised approach, JACC: Cardiovascular Imaging, Vol: 15, Pages: 257-268, ISSN: 1876-7591

Objective: We sought to identifyrepaired tetralogy of Fallot (rTOF) patients at high-risk of death and malignant ventricular arrhythmia (VA). Background: To date there is no robust risk stratification scheme to predict outcomes in adults with rTOF. Methods: Consecutive patients were prospectively recruited for late gadolinium enhancement cardiovascular magnetic resonance (LGE CMR) to define right and left ventricular (RV,LV) fibrosisin addition to proven risk markers. Results: The primary end-point was all-cause mortality. Of the 550 patients, (median age 32 years, 56% male), 27 died (mean follow-up 6.4 (±5.8); total 3512 years). Mortality was independently predicted by RVLGE extent, presence of LVLGE, RV ejection fraction (EF) ≤47%, LVEF ≤55%, B-type natriuretic peptide (BNP) ≥127ng/L, peak exercise oxygen uptake (V02) ≤17ml/kg/min, prior sustained atrial arrhythmia and age ≥50 years. The weighted scores for each of the above independent predictors differentiated a high-risk sub-group patients with a 4.4%, annual risk of mortality (AUC 0.87,P<0.001). The secondary end-point (VA), a composite of life-threatening sustained ventricular tachycardia/resuscitated ventricular fibrillation/sudden cardiac death occurred in 29. Weighted scores that included several predictors of mortality and RV outflow tractakinetic length ≥55mm and RVsystolic pressure ≥47mm Hg identified high-risk patients with a 3.7%, annual risk ofVA (AUC 0.79,P<0.001) RVLGE was heavily weighted in both risk scores due to its strong relative prognostic value. Conclusion: We present ascore integrating multiple appropriately weighted risk factors to identify the sub-group of rTOF patients that are at highannual risk of death who may benefit from targeted therapy.

Journal article

Voges I, Negwer I, Caliebe A, Grazioli SB, Daubeney PEF, Uebing A, Pennell DJ, Krupickova Set al., 2022, Myocardial Deformation in the Pediatric Age Group: Normal Values for Strain and Strain Rate Using 2D Magnetic Resonance Feature Tracking, JOURNAL OF MAGNETIC RESONANCE IMAGING, ISSN: 1053-1807

Journal article

Scott A, Jackson T, Khalique Z, Gorodezky M, Pardoe B, Begum L, Bruno VD, Chowdhury R, Ferreira P, Nielles-Vallespin S, Roehl M, McCarthy K, Sarathchandra P, Rose J, Doorly D, Pennell D, Ascione R, De Silva PER, Firmin Det al., 2022, Development of a CMR compatible large animal isolated heart model for direct comparison of beating and arrested hearts, NMR in Biomedicine, Vol: 35, ISSN: 0952-3480

BackgroundCardiac motion results in image artefacts and quantification errors in many cardiovascular magnetic resonance (CMR) techniques, including microstructural assessment using diffusion tensor cardiovascular magnetic resonance (DT-CMR). Here we develop a CMR compatible isolated perfused porcine heart model that allows comparison of data obtained in beating and arrested states.Methods10 porcine hearts (8/10 for protocol optimisation) were harvested using a donor heart retrieval protocol and transported to the remote CMR facility. Langendorff perfusion in a 3D printed chamber and perfusion circuit re-established contraction. Hearts were imaged using cine, parametric mapping and STEAM DT-CMR at cardiac phases with the minimum and maximum wall thickness. High potassium and lithium perfusates were then used to arrest the heart in a slack and contracted state respectively. Imaging was repeated in both arrested states. After imaging, tissue was removed for subsequent histology in a location matched to the DT-CMR data using fiducial markers.ResultsRegular sustained contraction was successfully established in 6/10 hearts, including the final 5 hearts. Imaging was performed in 4 hearts and one underwent the full protocol including co-localised histology. Image quality was good and there was good agreement between DT-CMR data in equivalent beating and arrested states. Despite the use of autologous blood and dextran within the perfusate, T2, DT-CMR measures and an increase in mass was consistent with development of myocardial edema resulting in failure to achieve a true diastolic-like state. A contiguous stack of 313 5μm histological sections at and a 100μm thick section showing cell morphology on 3D fluorescent confocal microscopy co-localised to DT-CMR data were obtained.ConclusionsA CMR compatible isolated perfused beating heart setup for large animal hearts allows direct comparisons of beating and arrested heart data with subsequent co-localised histology without

Journal article

Tänzer M, Ferreira P, Scott A, Khalique Z, Dwornik M, Pennell D, Yang G, Rueckert D, Nielles-Vallespin Set al., 2022, Faster Diffusion Cardiac MRI with Deep Learning-Based Breath Hold Reduction, Pages: 101-115, ISSN: 0302-9743

Journal article

Westwood MA, Pennell DJ, 2021, Reducing mortality by myocardial T2*cardiovascular magnetic resonance at national level, EUROPEAN HEART JOURNAL, Vol: 43, Pages: 2493-2495, ISSN: 0195-668X

Journal article

Krupickova S, Bautista-Rodriguez C, Hatipoglu S, Kang H, Fraisse A, Di Salvo G, Piccinelli E, Rowlinson G, Lane M, Bermejo IA, Moscatelli S, Wage R, Mohiaddin R, Pennell DJ, Voges Iet al., 2021, Myocardial deformation assessed by CMR in children after multisystem inflammatory syndrome (MIS-C), INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 346, Pages: 105-106, ISSN: 0167-5273

Journal article

Lota AS, Tsao A, Owen R, Halliday BP, Auger D, Vassiliou VS, Tayal U, Almogheer B, Vilches S, Al-Balah A, Patel A, Mouy F, Buchan R, Newsome S, Gregson J, Ware JS, Cook SA, Cleland JGF, Pennell DJ, Prasad SKet al., 2021, Prognostic significance of non-ischaemic patterns of myocardial fibrosis in patients with normal left ventricular volumes and ejection fraction – the FINALIZE study, JACC: Cardiovascular Imaging, Vol: 14, Pages: 2353-2365, ISSN: 1876-7591

Background: Non-ischaemic patterns of late gadolinium enhancement (LGE) with normal left ventricular volumes and ejection fraction are increasingly detected on cardiovascular magnetic resonance (CMR) but their prognostic significance, and consequently management, is uncertain. Objectives: To investigate the prognostic significance of LGE in patients without coronary artery disease and with normal range LV volumes and ejection fraction. Methods: Patients with mid-wall/subepicardial LGE and normal LV volumes, wall thickness and ejection fraction on CMR were enrolled and compared to a control group without LGE.57 The primary outcome was actual or aborted sudden cardiac death (SCD). Results: Of 748 patients enrolled, 401 had LGE and 347 did not. Median age was 50 years (IQR 38-61), LV ejection fraction 66% (IQR 62-70) and 287 (38%) were women. Scan indications included chest pain (40%), palpitation (33%) and breathlessness (13%). Nopatient experienced SCD and only one LGE+ patient (0.13%) had an aborted SCD in the 11th follow-up year. Over a median of 4.3years, thirty patients (4.0%) died. All-cause mortality was similar for LGE+/- patients (3.7% vs 4.3%; p=0.71) and was associated with age (H 2.04 per 10-years; 95%CI 1.46-2.79; p<0.001). Twenty-one LGE+ and 4 LGE- patients had an unplanned CV hospitalisation (HR 7.22; 95%CI 4.26-21.17; p<0.0001). Conclusion: There was a low SCD risk during long-term follow-up in patients with LGE but otherwise normal LV volumes and ejection fraction. Mortality was driven by age and not LGE presence, location or extent, although the latter was associated with greater CV hospitalisation for suspected myocarditis and symptomatic ventricular tachycardia.

Journal article

Lota AS, Meena D, Halliday B, Tayal U, Iacob A, Hammersley D, Jones R, Dehghan A, Tzoulaki I, Ware JS, Cleland J, Pennell DJ, Prasad SKet al., 2021, Impact of Covid-19 on Acute Myocarditis Hospital Admissions in the National Health Service of England, Uk (2019-2020), Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Halliday BP, Owen R, Gregson J, Vazir A, Lota AS, Khalique Z, Cowie MR, Pennell D, Cleland J, Prasad SKet al., 2021, Longitudinal Changes in Clinical and Imaging Variables During Withdrawal of Heart Failure Therapy in Patients with Recovered Dilated Cardiomyopathy: An Analysis from TRED-HF, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Lota AS, Hazebroek M, Theotokis P, Wassall R, Salmi S, Halliday B, Tayal U, Verdonschot J, Meena D, de Marvao A, Iacob A, Hammersley D, Jones R, Wage R, Buchan R, Yazdani M, Noseda M, Mittal T, Wong J, Robertus JL, Baksi J, Vassiliou V, Tzoulaki Iet al., 2021, Genetic Overlap of Acute Myocarditis and Inherited Cardiomyopathy, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Tayal U, Owen R, Buchan R, Halliday B, Lota AS, Jarman J, Baruah R, Ware JS, Barton PJ, Cleland J, Frenneaux M, Pennell DJ, Gregson J, Prasad SKet al., 2021, Biological Sex as a Modifier of the Natural History of Dilated Cardiomyopathy, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Hatipoglu S, Gatehouse P, Krupickova S, Banya W, Daubeney P, Almogheer B, Izgi C, Weale P, Hayes C, Firmin D, Pennell DJet al., 2021, Reliability of pediatric ventricular function analysis by short-axis "single-cycle-stack-advance" single-shot compressed-sensing cines in minimal breath-hold time, EUROPEAN RADIOLOGY, Vol: 32, Pages: 2581-2593, ISSN: 0938-7994

Journal article

Vassiliou V, Pavlou M, Malley T, Halliday B, Tsampasian V, Raphael C, Tse G, Vieira M, Auger D, Everett R, Chin C, Alpendurada F, Pepper J, Pennell D, Newby D, Jabbour A, Dweck M, Prasad Set al., 2021, A novel cardiovascular magnetic resonance risk score for predicting mortality following surgical aortic valve replacement, Scientific Reports, Vol: 11, ISSN: 2045-2322

The increasing prevalence of patients with aortic stenosis worldwide highlights a clinical need for improved and accurate prediction of clinical outcomes following surgery. We investigated patient demographic and cardiovascular magnetic resonance (CMR) characteristics to formulate a dedicated risk score estimating long-term survival following surgery. We recruited consecutive patients undergoing CMR with gadolinium administration prior to surgical aortic valve replacement from 2003 to 2016 in two UK centres. The outcome was overall mortality. A total of 250 patients were included (68 ± 12 years, male 185 (60%), with pre-operative mean aortic valve area 0.93 ± 0.32cm2, LVEF 62 ± 17%) and followed for 6.0 ± 3.3 years. Sixty-one deaths occurred, with 10-year mortality of 23.6%. Multivariable analysis showed that increasing age (HR 1.04, P = 0.005), use of antiplatelet therapy (HR 0.54, P = 0.027), presence of infarction or midwall late gadolinium enhancement (HR 1.52 and HR 2.14 respectively, combined P = 0.12), higher indexed left ventricular stroke volume (HR 0.98, P = 0.043) and higher left atrial ejection fraction (HR 0.98, P = 0.083) associated with mortality and developed a risk score with good discrimination. This is the first dedicated risk prediction score for patients with aortic stenosis undergoing surgical aortic valve replacement providing an individualised estimate for overall mortality. This model can help clinicians individualising medical and surgical care.

Journal article

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