133 results found
Dawes TJW, Corden B, Cotter S, et al., 2016, Moderate Physical Activity in Healthy Adults is Associated with Cardiac Remodeling, Circulation-Cardiovascular Imaging, Vol: 9, ISSN: 1942-0080
Background—Cardiac mass and volumes are often elevated in athletes, but it is not known whether moderate physical activity is also associated with cardiac dilatation and hypertrophy in a healthy adult population.Methods and Results—In total, 1096 adults (54% female, median age 39 years) without cardiovascular disease or cardiomyopathy-associated genetic variants underwent cardiac magnetic resonance imaging to determine biventricular volumes and function. Physical activity was assessed using a validated activity questionnaire. The relationship between cardiac parameters and activity was assessed using multiple linear regression adjusting for age, sex, race, and systolic blood pressure. Logistic regression was performed to determine the effect of activity on the likelihood of subjects having cardiac dilatation or hypertrophy according to standard cardiac magnetic resonance normal ranges. Increasing physical activity was associated with greater left ventricular (LV) mass (β=0.23; P<0.0001) and elevated LV and right ventricular volumes (LV: β=0.26, P<0.0001; right ventricular: β=0.26, P<0.0001). Physical activity had a larger effect on cardiac parameters than systolic blood pressure (0.06≤β≤0.21) and a similar effect to age (−0.20≤β≤−0.31). Increasing physical activity was a risk factor for meeting imaging criteria for LV hypertrophy (adjusted odds ratio 2.1; P<0.0001), LV dilatation (adjusted odds ratio 2.2; P<0.0001), and right ventricular dilatation (adjusted odds ratio 2.2; P<0.0001).Conclusions—Exercise-related cardiac remodeling is not confined to athletes, and there is a risk of overdiagnosing cardiac dilatation or hypertrophy in a proportion of active, healthy adults.
O'Regan DP, 2016, Stiff Arteries, Stiff Ventricles: Correlation or Causality in Heart Failure?, Circulation: Cardiovascular Imaging, Vol: 9, ISSN: 1941-9651
de Marvao A, Cook SA, O'Regan DP, 2016, Precursors of Hypertensive Heart Phenotype Develop in Healthy Adults: An Alternative Explanation Reply, JACC-Cardiovascular Imaging, Vol: 9, Pages: 763-764, ISSN: 1936-878X
Jaijee S, Quinlan M, Tokarczuk P, et al., 2016, DETERIORATION OF RIGHT VENTRICULAR FUNCTION ON EXERCISE DETECTED BY EXERCISE CARDIAC MAGNETIC RESONANCE IMAGING IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION, Annual Conference of the British-Cardiovascular-Society (BCS) on Prediction and Prevention, Publisher: BMJ PUBLISHING GROUP, Pages: A88-A89, ISSN: 1355-6037
Corden B, de Marvao A, Dawes T, et al., 2016, Relationship between body composition and left ventricular geometry using three dimensional cardiovascular magnetic resonance, Journal of Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1532-429X
BackgroundAlthough obesity is associated with alterations in left ventricular (LV) mass and volume which are of prognostic significance, widely differing patterns of remodelling have been attributed to adiposity. Our aim was to define the relationship between body composition and LV geometry using three-dimensional cardiovascular magnetic resonance.MethodsIn an observational study 1530 volunteers (55 % female, mean age 41.3 years) without known cardiovascular disease underwent investigation including breath-hold high spatial resolution 3D cines. Atlas-based segmentation and co-registration was used to create a statistical model of wall thickness (WT) and relative wall thickness (RWT) throughout the LV. The relationship between bio-impedence body composition and LV geometry was assessed using 3D regression models adjusted for age, systolic blood pressure (BP), gender, race and height, with correction to control the false discovery rate.ResultsLV mass was positively associated with fat mass in women but not in men (LV mass: women β = 0.11, p < 0.0001; men β = −0.01, p = 0.82). The 3D models revealed that in males fat mass was strongly associated with a concentric increase in relative wall thickness (RWT) throughout most of the LV (β = 0.37, significant area = 96 %) and a reduced mid-ventricular cavity (β = −0.22, significant area = 91 %). In women the regional concentric hypertrophic association was weaker, and the basal lateral wall showed an inverse relationship between RWT and fat mass (β = −0.11, significant area = 4.8 %).ConclusionsIn an adult population without known cardiovascular disease increasing body fat is predominately associated with asymmetric concentric hypertrophy independent of systolic BP, with women demonstrating greater cavity dilatation than men. Conventional mass
Harden SP, Bull RK, Bury RW, et al., 2016, The safe practice of CT coronary angiography in adult patients in UK imaging departments, Clinical Radiology, Vol: 71, Pages: 722-728, ISSN: 1365-229X
Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014.
Durighel G, Tokarczuk PF, Karsa A, et al., 2016, Acute myocardial infarction: susceptibility-weighted cardiac MRI for the detection of reperfusion haemorrhage at 1.5 T, CLINICAL RADIOLOGY, Vol: 71, Pages: E150-E156, ISSN: 0009-9260
Dawes T, de Marvao A, Shi W, et al., 2016, Use of artificial intelligence to predict survival in pulmonary hypertension, Spring Meeting on Clinician Scientists in Training, Publisher: ELSEVIER SCIENCE INC, Pages: 35-35, ISSN: 0140-6736
de Marvao A, Meyer H, Dawes T, et al., 2016, Development of integrated high-resolution three-dimensional MRI and computational modelling techniques to identify novel genetic and anthropometric determinants of cardiac form and function, Spring Meeting on Clinician Scientists in Training, Publisher: ELSEVIER SCIENCE INC, Pages: 36-36, ISSN: 0140-6736
Dawes TJW, Gandhi A, de Marvao A, et al., 2016, Pulmonary artery stiffness is independently associated with right ventricular mass and function: a cardiac magnetic resonance study., Radiology, Vol: 280, ISSN: 1527-1315
PurposeTo determine the relationship between pulmonary artery (PA) stiffness and both right ventricular (RV) mass and function with cardiac magnetic resonance (MR) imaging.Materials and MethodsThe study was approved by the local research ethics committee, and all participants gave written informed consent. Cardiac MR imaging was performed at 1.5 T in 156 healthy volunteers (63% women; age range, 19–61 years; mean age, 36.1 years). High-temporal-resolution phase-contrast imaging was performed in the main and right PAs. Pulmonary pulse wave velocity (PWV) was determined by the interval between arterial systolic upslopes. RV function was assessed with feature tracking to derive peak systolic strain and strain rate, as well as peak early-diastolic strain rate. RV volumes, ejection fraction (RVEF), and mass were measured from the cine images. The association of pulmonary PWV with RV function and mass was quantified with univariate linear regression. Interstudy repeatability was assessed with intraclass correlation.ResultsThe repeatability coefficient for pulmonary PWV was 0.96. Increases in pulmonary PWV and RVEF were associated with increases in age (r = 0.32, P < .001 and r = 0.18, P = .025, respectively). After adjusting for age (P = .090), body surface area (P = .073), and sex (P = .005), pulmonary PWV demonstrated an independent positive association with RVEF (r = 0.34, P = .026). Significant associations were also seen with RV mass (r = 0.41, P = .004), RV radial strain (r = 0.38, P = .022), and strain rate (r = 0.35, P = .002), and independent negative associations were seen with radial (r = 0.27, P = .003), longitudinal (r = 0.40, P = .007), and circumferential (r = 0.31, P = .005) peak early-diastolic strain rate with the same covariates.ConclusionPulmonary PWV is reliably assessed with cardiac MR imaging. In subjects with no known cardiovascular disease, increasing PA stiffness is associated with increasing age and is also moderately associated with bo
Marvao AD, Meyer HV, Dawes TJ, et al., 2016, Genome wide association analysis of the heart using high-resolution 3D cardiac MRI identifies new genetic loci underlying cardiac structure and function., Journal of Cardiovascular Magnetic Resonance, Vol: 18, ISSN: 1097-6647
Jaijee S, Quinlan M, Tokarczuk P, et al., 2016, Cardiac Magnetic Resonance Imaging In Healthy Volunteers In Normoxic And Hypoxic Exercise, International Conference of the American-Thoracic-Society (ATS), Publisher: AMER THORACIC SOC, ISSN: 1073-449X
Oktay O, Tarroni G, Bai W, et al., 2016, Respiratory Motion Correction for 2D Cine Cardiac MR Images using Probabilistic Edge Maps, 43rd Computing in Cardiology Conference (CinC), Publisher: IEEE, Pages: 129-132, ISSN: 2325-8861
Alenaini W, O'Regan DP, de Marvao A, et al., 2015, Three dimensional modelling of the effect of arterial pulse wave velocity and body size on left ventricular geometry, Journal of Cardiovascular Magnetic Resonance, Vol: 17
Jaijee SK, Ariff B, Howard L, et al., 2015, Left main bronchus compression due to main pulmonary artery dilatation in pulmonary hypertension: two case reports, Pulmonary Circulation, Vol: 5, Pages: 723-725, ISSN: 2045-8940
Pulmonary arterial dilatation associated with pulmonary hypertension may result in significant compression of local structures. Left main coronary artery and left recurrent laryngeal nerve compression have been described. Tracheobronchial compression from pulmonary arterial dilatation is rare in adults, and there are no reports in the literature of its occurrence in idiopathic pulmonary arterial hypertension. Compression in infants with congenital heart disease has been well described. We report 2 cases of tracheobronchial compression: first, an adult patient with idiopathic pulmonary arterial hypertension who presents with symptomatic left main bronchus compression, and second, an adult patient with Eisenmenger ventricular septal defect and right-sided aortic arch, with progressive intermedius and right middle lobe bronchi compression in association with enlarged pulmonary arteries.
de Marvao A, Dawes TJW, Shi W, et al., 2015, Precursors of the hypertensive heart phenotype develop in normotensive adults: a high resolution 3D MRI study, JACC: Cardiovascular Imaging, Vol: 8, Pages: 1260-1269, ISSN: 1936-878X
ObjectivesThis study used high-resolution 3-dimensional cardiac magnetic resonance to define the anatomical and functional left ventricular (LV) properties associated with increasing systolic blood pressure (SBP) in a drug-naïve cohort.BackgroundLV hypertrophy and remodeling occur in response to hemodynamic stress but little is known about how these phenotypic changes are initiated in the general population.MethodsIn this study, 1,258 volunteers (54% women, mean age 40.6 ± 12.8 years) without self-reported cardiovascular disease underwent 3-dimensional cardiac magnetic resonance combined with computational modeling. The relationship between SBP and wall thickness (WT), relative WT, end-systolic wall stress (WS), and fractional wall thickening were analyzed using 3-dimensional regression models adjusted for body surface area, sex, race, age, and multiple testing. Significantly associated points in the LV model (p < 0.05) were identified and the relationship with SBP reported as mean β coefficients.ResultsThere was a continuous relationship between SBP and asymmetric concentric hypertrophic adaptation of the septum and anterior wall that was associated with normalization of wall stress. In the lateral wall an increase in wall stress with rising SBP was not balanced by a commensurate hypertrophic relationship. In normotensives, SBP was positively associated with WT (β = 0.09) and relative WT (β = 0.07) in the septal and anterior walls, and this regional hypertrophic relationship was progressively stronger among pre-hypertensives (β = 0.10) and hypertensives (β = 0.30).ConclusionsThese findings show that the precursors of the hypertensive heart phenotype can be traced to healthy normotensive adults and that an independent and continuous relationship exists between adverse LV remodeling and SBP in a low-risk population. These adaptations show distinct regional variations with concentric hypertrophy of the septum and eccentric hyper
Cheng Z, Kidher E, Jarral OA, et al., 2015, Assessment of hemodynamic conditions in the aorta following root replacement with composite valve-conduit graft, Annals of Biomedical Engineering, Vol: 44, Pages: 1392-1404, ISSN: 0090-6964
This paper presents the analysis of detailed hemodynamics in the aortas of four patients following replacement with a composite bio-prosthetic valve-conduit. Magnetic resonance image-based computational models were set up for each patient with boundary conditions comprising subject-specific three-dimensional inflow velocity profiles at the aortic root and central pressure waveform at the model outlet. Two normal subjects were also included for comparison. The purpose of the study was to investigate the effects of the valve-conduit on flow in the proximal and distal aorta. The results suggested that following the composite valve-conduit implantation, the vortical flow structure and hemodynamic parameters in the aorta were altered, with slightly reduced helical flow index, elevated wall shear stress and higher non-uniformity in wall shear compared to normal aortas. Inter-individual analysis revealed different hemodynamic conditions among the patients depending on the conduit configuration in the ascending aorta, which is a key factor in determining post-operative aortic flow. Introducing a natural curvature in the conduit to create a smooth transition between the conduit and native aorta may help prevent the occurrence of retrograde and recirculating flow in the aortic arch, which is particularly important when a large portion or the entire ascending aorta needs to be replaced.
Bai W, Shi W, de Marvao A, et al., 2015, A bi-ventricular cardiac atlas built from 1000+ high resolution MR images of healthy subjects and an analysis of shape and motion, Medical Image Analysis, Vol: 26, Pages: 133-145, ISSN: 1361-8423
Atlases encode valuable anatomical and functional information from a population. In this work, a bi-ventricular cardiac atlas was built from a unique data set, which consists of high resolution cardiac MR images of 1000+ normal subjects. Based on the atlas, statistical methods were used to study the variation of cardiac shapes and the distribution of cardiac motion across the spatio-temporal domain. We have shown how statistical parametric mapping (SPM) can be combined with a general linear model to study the impact of gender and age on regional myocardial wall thickness. Finally, we have also investigated the influence of the population size on atlas construction and atlas-based analysis. The high resolution atlas, the statistical models and the SPM method will benefit more studies on cardiac anatomy and function analysis in the future.
De Marvao A, Dawes T, Shi W, et al., 2015, Rising systolic blood pressure leads to a continuous progression towards hypertensive heart disease: a prospective population study, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 191-191, ISSN: 0195-668X
Dawes T, De Marvao A, Shi W, et al., 2015, Prognostic value of right heart adaptation to pulmonary arterial hypertension: a prospective cohort study, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 708-709, ISSN: 0195-668X
Buyandelger B, Mansfield C, Kostin S, et al., 2015, ZBTB17 (MIZ1) Is Important for the Cardiac Stress Response and a Novel Candidate Gene for Cardiomyopathy and Heart Failure., Circulation. Cardiovascular Genetics, Vol: 8, Pages: 643-652, ISSN: 1942-3268
BACKGROUND: -Mutations in sarcomeric and cytoskeletal proteins are a major cause of hereditary cardiomyopathies, but our knowledge remains incomplete as to how the genetic defects execute their effects. METHODS AND RESULTS: -We used cysteine and glycine-rich protein 3 (CSRP3), a known cardiomyopathy gene, in a yeast two-hybrid screen and identified zinc finger and BTB domain containing protein 17 (ZBTB17) as a novel interacting partner. ZBTB17 is a transcription factor that contains the peak association signal (rs10927875) at the replicated 1p36 cardiomyopathy locus. ZBTB17 expression protected cardiac myocytes from apoptosis in vitro and in a mouse model with cardiac myocyte-specific deletion of Zbtb17, which develops cardiomyopathy and fibrosis after biomechanical stress. ZBTB17 also regulated cardiac myocyte hypertrophy in vitro and in vivo in a calcineurin-dependent manner. CONCLUSIONS: -We revealed new functions for ZBTB17 in the heart, a transcription factor which may play a role as a novel cardiomyopathy gene.
Francis C, de Marvao A, O'Regan DP, et al., 2015, AORTOPATHY-CAUSING MUTATIONS INCREASE AORTIC STIFFNESS IN HEALTHY INDIVIDUALS, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A99-A99, ISSN: 1355-6037
Roberts AM, Ware JS, Herman DS, et al., 2015, Integrated allelic, transcriptional, and phenomic dissection of the cardiac effects of titin truncations in health and disease., Sci Transl Med, Vol: 7
The recent discovery of heterozygous human mutations that truncate full-length titin (TTN, an abundant structural, sensory, and signaling filament in muscle) as a common cause of end-stage dilated cardiomyopathy (DCM) promises new prospects for improving heart failure management. However, realization of this opportunity has been hindered by the burden of TTN-truncating variants (TTNtv) in the general population and uncertainty about their consequences in health or disease. To elucidate the effects of TTNtv, we coupled TTN gene sequencing with cardiac phenotyping in 5267 individuals across the spectrum of cardiac physiology and integrated these data with RNA and protein analyses of human heart tissues. We report diversity of TTN isoform expression in the heart, define the relative inclusion of TTN exons in different isoforms (using the TTN transcript annotations available at http://cardiodb.org/titin), and demonstrate that these data, coupled with the position of the TTNtv, provide a robust strategy to discriminate pathogenic from benign TTNtv. We show that TTNtv is the most common genetic cause of DCM in ambulant patients in the community, identify clinically important manifestations of TTNtv-positive DCM, and define the penetrance and outcomes of TTNtv in the general population. By integrating genetic, transcriptome, and protein analyses, we provide evidence for a length-dependent mechanism of disease. These data inform diagnostic criteria and management strategies for TTNtv-positive DCM patients and for TTNtv that are identified as incidental findings.
Wang H, Shi W, Bai W, et al., 2015, Prediction of Clinical Information from Cardiac MRI Using Manifold Learning, 8th International Conference on Functional Imaging and Modeling of the Heart(FIMH), Publisher: SPRINGER-VERLAG BERLIN, Pages: 91-98, ISSN: 0302-9743
Bai W, Peressutti D, Oktay O, et al., 2015, Learning a Global Descriptor of Cardiac Motion from a Large Cohort of 1000+Normal Subjects, 8th International Conference on Functional Imaging and Modeling of the Heart(FIMH), Publisher: SPRINGER-VERLAG BERLIN, Pages: 1-9, ISSN: 0302-9743
de Marvao A, Dawes TJ, Shi W, et al., 2015, Adverse changes in left ventricular structure begin at normotensive systolic blood pressures: a high resolution MRI study., Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, Vol: 17, Pages: M11-M11, ISSN: 1097-6647
Kidher E, Cheng Z, Jarral OA, et al., 2014, In-vivo assessment of the morphology and hemodynamic functions of the BioValsalva (TM) composite valve-conduit graft using cardiac magnetic resonance imaging and computational modelling technology, Journal of Cardiothoracic Surgery, Vol: 9, ISSN: 1749-8090
Background: The evaluation of any new cardiac valvular prosthesis should go beyond the classical morbidityand mortality rates and involve hemodynamic assessment. As a proof of concept, the objective of this study wasto characterise for the first time the hemodynamics and the blood flow profiles at the aortic root in patientsimplanted with BioValsalva™ composite valve-conduit using comprehensive MRI and computer technologies.Methods: Four male patients implanted with BioValsalva™ and 2 age-matched normal controls (NC) underwent cardiacmagnetic resonance imaging (MRI). Phase-contrast imaging with velocity-mapping in 3 orthogonal directions wasperformed at the level of the aortic root and descending thoracic aorta. Computational fluid dynamic (CFD) simulationswere performed for all the subjects with patient-specific flow information derived from phase-contrast MR data.Results: The maximum and mean flow rates throughout the cardiac cycle at the aortic root level were very comparablebetween NC and BioValsalva™ patients (541 ± 199 vs. 567 ± 75 ml/s) and (95 ± 46 vs. 96 ± 10 ml/s), respectively.The maximum velocity (cm/s) was higher in patients (314 ± 49 vs. 223 ± 20; P = 0.06) due to relatively smaller effectiveorifice area (EOA), 2.99 ± 0.47 vs. 4.40 ± 0.24 cm2 (P = 0.06), however, the BioValsalva™ EOA was comparable to otherreported prosthesis. The cross-sectional area and maximum diameter at the root were comparable between the twogroups. BioValsalva™ conduit was stiffer than the native aortic wall, compliance (mm2 • mmHg−1 • 10−3) values were(12.6 ± 4.2 vs 25.3 ± 0.4.; P = 0.06). The maximum time-averaged wall shear stress (Pa), at the ascending aorta wasequivalent between the two groups, 17.17 ± 2.7 (NC) vs. 17.33 ± 4.7 (BioValsalva™ ). Flow streamlines at the root andascending aorta were also similar between the two groups apa
de Marvao A, Dawes TJW, Shi W, et al., 2014, Population-based studies of myocardial hypertrophy: high resolution cardiovascular magnetic resonance atlases improve statistical power, Journal of Cardiovascular Magnetic Resonance, Vol: 16, ISSN: 1532-429X
Background: Cardiac phenotypes, such as left ventricular (LV) mass, demonstrate high heritability although mostgenes associated with these complex traits remain unidentified. Genome-wide association studies (GWAS) haverelied on conventional 2D cardiovascular magnetic resonance (CMR) as the gold-standard for phenotyping.However this technique is insensitive to the regional variations in wall thickness which are often associated with leftventricular hypertrophy and require large cohorts to reach significance. Here we test whether automated cardiacphenotyping using high spatial resolution CMR atlases can achieve improved precision for mapping wall thicknessin healthy populations and whether smaller sample sizes are required compared to conventional methods.Methods: LV short-axis cine images were acquired in 138 healthy volunteers using standard 2D imaging and 3Dhigh spatial resolution CMR. A multi-atlas technique was used to segment and co-register each image. Theagreement between methods for end-diastolic volume and mass was made using Bland-Altman analysis in 20subjects. The 3D and 2D segmentations of the LV were compared to manual labeling by the proportion ofconcordant voxels (Dice coefficient) and the distances separating corresponding points. Parametric andnonparametric data were analysed with paired t-tests and Wilcoxon signed-rank test respectively. Voxelwise powercalculations used the interstudy variances of wall thickness.Results: The 3D volumetric measurements showed no bias compared to 2D imaging. The segmented 3D imageswere more accurate than 2D images for defining the epicardium (Dice: 0.95 vs 0.93, P < 0.001; mean error 1.3 mmvs 2.2 mm, P < 0.001) and endocardium (Dice 0.95 vs 0.93, P < 0.001; mean error 1.1 mm vs 2.0 mm, P < 0.001). The3D technique resulted in significant differences in wall thickness assessment at the base, septum and apex of theLV compared to 2D (P < 0.001). Fewer subjects were required for 3D imaging to detect a 1 mm d
Shi W, Lombaert H, Bai W, et al., 2014, Multi-atlas Spectral PatchMatch: Application to Cardiac Image Segmentation, 17th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI), Publisher: SPRINGER INTERNATIONAL PUBLISHING AG, Pages: 348-+, ISSN: 0302-9743
Pabari P, Konstantinou K, Sutaria N, et al., 2014, Comprehensive cardiovascular MRI in hypertension: a UK single centre experience, Journal of Cardiovascular Magnetic Resonance, Vol: 16
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