Publications
517 results found
Eastwood SV, Tillin T, Mayet J, et al., 2015, Ethnic differences in cross-sectional associations between impaired glucose regulation, identified by oral glucose tolerance test or HbA1c values, and cardiovascular disease in a cohort of European and South Asian origin, Diabetic Medicine, Vol: 33, Pages: 340-347, ISSN: 0742-3071
AimsWe contrasted impaired glucose regulation (prediabetes) prevalence, defined according to oral glucose tolerance test or HbA1c values, and studied cross-sectional associations between prediabetes and subclinical/clinical cardiovascular disease (CVD) in a cohort of European and South Asian origin.MethodsFor 682 European and 520 South Asian men and women, aged 58–85 years, glycaemic status was determined by oral glucose tolerance test or HbA1c thresholds. Questionnaires, record review, coronary artery calcification scores and cerebral magnetic resonance imaging established clinical plus subclinical coronary heart and cerebrovascular disease.ResultsPrediabetes was more prevalent in South Asian participants when defined by HbA1c rather than by oral glucose tolerance test criteria. Accounting for age, sex, smoking, systolic blood pressure, triglycerides and waist–hip ratio, prediabetes was associated with coronary heart disease and cerebrovascular disease in European participants, most obviously when defined by HbA1c rather than by oral glucose tolerance test [odds ratios for HbA1c-defined prediabetes 1.60 (95% CI 1.07, 2.39) for coronary heart disease and 1.57 (95% CI 1.00, 2.51) for cerebrovascular disease]. By contrast, non-significant associations were present between oral glucose tolerance test-defined prediabetes only and coronary heart disease [odds ratio 1.41 (95% CI 0.84, 2.36)] and HbA1c-defined prediabetes only and cerebrovascular disease [odds ratio 1.39 (95% CI 0.69, 2.78)] in South Asian participants. Prediabetes defined by HbA1c or oral glucose tolerance test criteria was associated with cardiovascular disease (defined as coronary heart and/or cerebrovascular disease) in Europeans [odds ratio 1.95 (95% CI 1.31, 2.91) for HbA1c prediabetes criteria] but not in South Asian participants [odds ratio 1.00 (95% CI 0.62, 2.66); ethnicity interaction P = 0.04].ConclusionsPrediabetes appeared to be less associated with cardiovascular disease in the S
Ahmad Y, Sen S, Shun-Shin M, et al., 2015, Intra-aortic balloon pump therapy does not reduce mortality in acute myocardial infarction, with or without cardiogenic shock: application of a baseline inequality index to account for differential outcomes in randomized and observational studies, 27th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B103-B103, ISSN: 0735-1097
Ahmad Y, Nijjer SS, Cook C, et al., 2015, Patients consider PCI and CABG equal: Derivation of a novel patient-centered, quantitative analysis of Major Adverse Cardiac Events (MACE) and its application to trials comparing PCI to CABG, 27th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B195-B196, ISSN: 0735-1097
Ahmad Y, Sen S, Keene D, et al., 2015, Thrombus aspiration does not reduce mortality in STEMI patients: a meta-analysis of 20,192 patients, with implications for future trial design, 27th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B103-B104, ISSN: 0735-1097
Sen S, Petraco R, Nijjer S, et al., 2015, Can Resting Indices Obviate the Need for Hyperemia and Promote the Routine Use of Physiologically Guided Revascularization?, Interv Cardiol Clin, Vol: 4, Pages: 459-469
This article assesses the data from contemporary human studies to address some of the common assumptions regarding hyperemic and baseline physiology in the context of the baseline pressure-derived index of instant wave-free ratio and the hyperemic index of fractional flow reserve. The article aims to determine if the available evidence supports the continued investigation, development, and use of baseline indices.
Baksi AJ, Davies JE, Hadjiloizou N, et al., 2015, Attenuation of reflected waves in man during retrograde propagation from femoral artery to proximal aorta, International Journal of Cardiology, Vol: 202, Pages: 441-445, ISSN: 1874-1754
BackgroundWave reflection may be an important influence on blood pressure, but the extent to which reflections undergo attenuation during retrograde propagation has not been studied. We quantified retrograde transmission of a reflected wave created by occlusion of the left femoral artery in man.Methods20 subjects (age 31–83 years; 14 male) underwent invasive measurement of pressure and flow velocity with a sensor-tipped intra-arterial wire at multiple locations distal to the proximal aorta before, during and following occlusion of the left femoral artery by thigh cuff inflation. A numerical model of the circulation was also used to predict reflected wave transmission. Wave reflection was measured as the ratio of backward to forward wave energy (WRI) and the ratio of peak backward to forward pressure (Pb/Pf).ResultsCuff inflation caused a marked reflection which was largest at 5–10 cm from the cuff (change (Δ) in WRI = 0.50 (95% CI 0.38, 0.62); p < 0.001, ΔPb/Pf = 0.23 (0.18–0.29); p < 0.001). The magnitude of the cuff-induced reflection decreased progressively at more proximal locations and was barely discernible at sites > 40 cm from the cuff including in the proximal aorta. Numerical modelling gave similar predictions to those observed experimentally.ConclusionsReflections due to femoral artery occlusion are markedly attenuated by the time they reach the proximal aorta. This is due to impedance mismatches of bifurcations traversed in the backward direction. This degree of attenuation is inconsistent with the idea of a large discrete reflected wave arising from the lower limb and propagating back into the aorta.
Ahmad Y, Nijjer S, Cook CM, et al., 2015, A new method of applying randomised control study data to the individual patient: A novel quantitative patient-centred approach to interpreting composite end points, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 195, Pages: 216-224, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 18
Thompson DM, Hughes A, Stanton A, et al., 2015, Long-term anti-hypertensive treatment with amlodipine/perindopril results in lower carotid IMT at 3.5 years than with atenolol/bendroflumethiazide, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 1142-1143, ISSN: 0195-668X
Raphael CE, Finegold JA, Barron AJ, et al., 2015, The effect of duration of follow-up and presence of competing risk on lifespan-gain from implantable cardioverter defibrillator therapy: who benefits the most?, European Heart Journal, Vol: 36, Pages: 1676-1688, ISSN: 0195-668X
BackgroundIn at-risk patients with left ventricular dysfunction, implantable cardioverter defibrillators (ICDs) prolong life. Implantable cardioverter defibrillators are increasingly implanted for primary prevention and therefore into lower risk patients. Trial data have demonstrated the benefit of these devices but does not provide an estimate of potential lifespan-gain over longer time periods, e.g. a patient's lifespan.MethodsUsing data from landmark ICD trials, lifespan-gain was plotted against baseline annual mortality in the individual trials. Lifespan-gain was then extrapolated to a time-horizon of >20 years while adjusting for increasing ‘competing’ risk from ageing and non-sudden cardiac death (pump failure).ResultsAt 3 years, directly observed lifespan-gain was strongly dependent on baseline event rate (r = 0.94, P < 0.001). However, projecting beyond the duration of the trial, lifespan-gain increases rapidly and non-linearly with time. At 3 years, it averages 1.7 months, but by 10 years up to 9-fold more. Lifespan-gain over time horizons >20 years were greatest in lower risk patients (∼5 life-years for 5% baseline mortality, ∼2 life-years for 15% baseline mortality). Increased competing risks significantly reduce lifespan-gain from ICD implantation.ConclusionWhile high-risk patients may show the greatest short-term gain, the dramatic growth of lifespan-gain over time means that it is the lower risk patients, e.g. primary prevention ICD implantation, who gain the most life-years over their lifetime. Benefit is underestimated when only trial data are assessed as trials can only maintain randomization over limited periods. Lifespan-gain may be further increased through advances in ICD device programming.
Cole GD, Dhutia NM, Shun-Shin MJ, et al., 2015, Defining the real-world reproducibility of visual grading and visual estimation of left ventricular ejection fraction: impact of image quality, experience and accreditation., International Journal of Cardiovascular Imaging, Vol: 31, Pages: 1303-1314, ISSN: 1569-5794
Left ventricular function can be evaluated by qualitative grading and by eyeball estimation of ejection fraction (EF). We sought to define the reproducibility of these techniques, and how they are affected by image quality, experience and accreditation. Twenty apical four-chamber echocardiographic cine loops (Online Resource 1–20) of varying image quality and left ventricular function were anonymized and presented to 35 operators. Operators were asked to provide (1) a one-phrase grading of global systolic function (2) an “eyeball” EF estimate and (3) an image quality rating on a 0–100 visual analogue scale. Each observer viewed every loop twice unknowingly, a total of 1400 viewings. When grading LV function into five categories, an operator’s chance of agreement with another operator was 50 % and with themself on blinded re-presentation was 68 %. Blinded eyeball LVEF re-estimates by the same operator had standard deviation (SD) of difference of 7.6 EF units, with the SD across operators averaging 8.3 EF units. Image quality, defined as the average of all operators’ assessments, correlated with EF estimate variability (r = −0.616, p < 0.01) and visual grading agreement (r = 0.58, p < 0.01). However, operators’ own single quality assessments were not a useful forewarning of their estimate being an outlier, partly because individual quality assessments had poor within-operator reproducibility (SD of difference 17.8). Reproducibility of visual grading of LV function and LVEF estimation is dependent on image quality, but individuals cannot themselves identify when poor image quality is disrupting their LV function estimate. Clinicians should not assume that patients changing in grade or in visually estimated EF have had a genuine clinical change.
Brown CE, McCarthy NS, Hughes AD, et al., 2015, Urinary proteomic biomarkers to predict cardiovascular events, Proteomics Clinical Applications, Vol: 9, Pages: 610-617, ISSN: 1862-8354
PurposeWe have previously demonstrated associations between the urinary proteome profile and coronary artery disease (CAD) in cross-sectional studies. Here, we evaluate the potential of a urinary proteomic panel as a predictor of CAD in the hypertensive atherosclerotic cardiovascular disease (HACVD) substudy population of the Anglo-Scandinavian Cardiac Outcomes Trial study.Experimental designThirty-seven cases with primary CAD endpoint were matched for sex and age to controls who had not reached a CAD endpoint during the study. Spot urine samples were analyzed using CE coupled to Micro-TOF MS. A previously developed 238-marker CE-MS model for diagnosis of CAD (CAD238) was assessed for its predictive potential.ResultsSixty urine samples (32 cases; 28 controls; 88% male, mean age 64 ± 5 years) were analyzed. There was a trend toward healthier values in controls for the CAD model classifier (–0.432 ± 0.326 versus –0.587 ± 0.297, p = 0.170), and the CAD model showed statistical significance on Kaplan–Meier survival analysis p = 0.021. We found 190 individual markers out of 1501 urinary peptides that separated cases and controls (AUC >0.6). Of these, 25 peptides were also components of CAD238.Conclusion and clinical relevanceA urinary proteome panel originally developed in a cross-sectional study predicts CAD endpoints independent of age and sex in a well-controlled prospective study.
Nijjer S, Sen S, Petraco R, et al., 2015, VIRTUAL PCI WITH IFR-PULLBACK IN COMPLEX CORONARY DISEASE: THE POTENTIAL FOR REDUCING STENT LENGTH, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A60-A60, ISSN: 1355-6037
Nijjer S, Sen S, Davies J, et al., 2015, VIRTUAL-PCI WITH IFR-PULLBACK CAN PLAN CORONARY INTERVENTION IN COMPLEX CORONARY DISEASE WITH A PREDICTION OF FUNCTIONAL GAIN, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A61-A61, ISSN: 1355-6037
Nijjer SS, Petraco R, van de Hoef TP, et al., 2015, Change in Coronary Blood Flow After Percutaneous Coronary Intervention in Relation to Baseline Lesion Physiology Results of the JUSTIFY-PCI Study, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 8, ISSN: 1941-7640
- Author Web Link
- Cite
- Citations: 29
Sharp A, Sohaib A, Willson K, et al., 2015, SIGNAL-TO-NOISE RATIO DURING HAEMODYNAMIC OPTIMISATION OF AV DELAY IS IMPROVED MORE BY ATRIAL PACING THAN BY INCREASING HEART RATE, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A25-A26, ISSN: 1355-6037
Sohaib SM, Kyriacou A, Jones S, et al., 2015, Evidence that conflict regarding size of haemodynamic response to interventricular delay optimization of cardiac resynchronization therapy may arise from differences in how atrioventricular delay is kept constant., Europace, Vol: 17, ISSN: 1532-2092
AIMS: Whether adjusting interventricular (VV) delay changes haemodynamic efficacy of cardiac resynchronization therapy (CRT) is controversial, with conflicting results. This study addresses whether the convention for keeping atrioventricular (AV) delay constant during VV optimization might explain these conflicts. METHOD AND RESULTS: Twenty-two patients in sinus rhythm with existing CRT underwent VV optimization using non-invasive systolic blood pressure. Interventricular optimization was performed with four methods for keeping the AV delay constant: (i) atrium and left ventricle delay kept constant, (ii) atrium and right ventricle delay kept constant, (iii) time to the first-activated ventricle kept constant, and (iv) time to the second-activated ventricle kept constant. In 11 patients this was performed with AV delay of 120 ms, and in 11 at AV optimum. At AV 120 ms, time to the first ventricular lead (left or right) was the overwhelming determinant of haemodynamics (13.75 mmHg at ±80 ms, P < 0.001) with no significant effect of time to second lead (0.47 mmHg, P = 0.50), P < 0.001 for difference. At AV optimum, time to first ventricular lead again had a larger effect (5.03 mmHg, P < 0.001) than time to second (2.92 mmHg, P = 0.001), P = 0.02 for difference. CONCLUSION: Time to first ventricular activation is the overwhelming determinant of circulatory function, regardless of whether this is the left or right ventricular lead. If this is kept constant, the effect of changing time to the second ventricle is small or nil, and is not beneficial. In practice, it may be advisable to leave VV delay at zero. Specifying how AV delay is kept fixed might make future VV delay research more enlightening.
Eriksen A, Tillin T, O'Connor L, et al., 2015, The Impact of Health Behaviours on Incident Cardiovascular Disease in Europeans and South Asians - A Prospective Analysis in the UK SABRE Study, PLOS ONE, Vol: 10, ISSN: 1932-6203
- Author Web Link
- Open Access Link
- Cite
- Citations: 19
Eastwood SV, Tillin T, Mayet J, et al., 2015, The definition of pre-diabetes influences the nature of its association with cardiovascular disease, and differs by ethnicity, DIABETIC MEDICINE, Vol: 32, Pages: 56-56, ISSN: 0742-3071
Nijjer SS, Sen S, Petraco R, et al., 2015, The Instantaneous wave-Free Ratio (iFR) pullback: a novel innovation using baseline physiology to optimise coronary angioplasty in tandem lesions, CARDIOVASCULAR REVASCULARIZATION MEDICINE, Vol: 16, Pages: 167-171, ISSN: 1553-8389
- Author Web Link
- Open Access Link
- Cite
- Citations: 49
Nijjer SS, Sen S, Petraco R, et al., 2014, Pre-Angioplasty Instantaneous Wave-Free Ratio Pullback Provides Virtual Intervention and Predicts Hemodynamic Outcome for Serial Lesions and Diffuse Coronary Artery Disease, JACC-CARDIOVASCULAR INTERVENTIONS, Vol: 7, Pages: 1386-1396, ISSN: 1936-8798
- Author Web Link
- Cite
- Citations: 81
Cole GD, Patel SJ, Zaman N, et al., 2014, "Triple Therapy" of Heart Failure With Angiotensin-Converting Enzyme Inhibitor, Beta-Blocker, and Aldosterone Antagonist May Triple Survival Time Shouldn't We Tell Patients?, JACC-HEART FAILURE, Vol: 2, Pages: 545-548, ISSN: 2213-1779
- Author Web Link
- Cite
- Citations: 13
Ghosh AK, Hardy RJ, Francis DP, et al., 2014, Midlife blood pressure change and left ventricular mass and remodelling in older age in the 1946 British birth cohort study, European Heart Journal, Vol: 35, Pages: 3287-3295, ISSN: 1522-9645
Jabbour R, Ling HZ, Norrington K, et al., 2014, Serum albumin changes and multivariate dynamic risk modelling in chronic heart failure, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 176, Pages: 437-443, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 15
Lau C, Barron A, Mcdonagh S, et al., 2014, A heart-failure led one-stop diagnostic service for breathlessness: initial experiences and diagnostic yield, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 1008-1008, ISSN: 0195-668X
Nijjer SS, Sen S, Petraco R, et al., 2014, Combining pressure wire pullback with the instantaneous wave-free ratio permits measurement of the physiological lesion length of stenoses, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 811-811, ISSN: 0195-668X
Eastwood SV, Tillin T, Wright A, et al., 2014, Thigh Fat and Muscle each Contribute to Excess Cardiometabolic Risk in South Asians, Independent of Visceral Adipose Tissue, OBESITY, Vol: 22, Pages: 2071-2079, ISSN: 1930-7381
- Author Web Link
- Cite
- Citations: 41
Petraco R, van de Hoef TP, Nijjer S, et al., 2014, Baseline Instantaneous Wave-Free Ratio as a Pressure-Only Estimation of Underlying Coronary Flow Reserve Results of the JUSTIFY-CFR Study (Joined Coronary Pressure and Flow Analysis to Determine Diagnostic Characteristics of Basal and Hyperemic Indices of Functional Lesion Severity-Coronary Flow Reserve), CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 7, Pages: 492-502, ISSN: 1941-7640
- Author Web Link
- Cite
- Citations: 122
Kidher E, Harling L, Nihoyannopoulos P, et al., 2014, High aortic pulse wave velocity is associated with poor quality of life in surgical aortic valve stenosis patients, INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol: 19, Pages: 189-197, ISSN: 1569-9293
- Author Web Link
- Cite
- Citations: 15
Ghosh AK, Francis DP, Chaturvedi N, et al., 2014, Cardiovascular Risk Factors from Early Life Predict Future Adult Cardiac Structural and Functional Abnormalities: A Systematic Review of the Published Literature., J Cardiol Ther, Vol: 2, Pages: 78-87, ISSN: 2311-052X
BACKGROUND: Clinical practice evaluates cardiovascular risk based on current risk factor (RF) levels [Blood pressure (BP), body mass index (BMI) and glycaemic control] largely disregarding previous risk-factor history over the totality of the life course. RFs are related to contemporaneous echocardiographic measures of cardiac structure and function which in turn are independently related to cardiovascular morbidity and mortality in cross-sectional studies. However, the effect of lifetime or earlier RF history on future echocardiographic changes has never been systematically examined. METHODS: A systematic review of the published literature identified 24 studies relating either earlier BP, BMI, glycaemic control or a combination to future cardiac structure and/or function. RESULTS: The majority of studies showed that elevated BP and BMI in earlier life and greater cumulative burden of these factors resulted in worse cardiac structure up to 24 years later. Studies examining glycaemic control as RF were few, but poorer glycaemic control in young adults was associated with increased future left ventricular mass. While only 5 papers related RFs to future cardiac function, all RFs were positively associated with worse future diastolic function. CONCLUSIONS: BP, BMI and glycaemic control measures in childhood, adolescence and early adulthood and subsequent longitudinal trajectories of BP and BMI are predictive of future abnormalities in cardiac structure and function. Lifetime RF history should be used to inform clinical practice. Further research is required to enable the identification of any sensitive periods in the life course to enable prevention when it is most likely to be effective.
Davies JE, Lacy P, Tillin T, et al., 2014, Excess Pressure Integral Predicts Cardiovascular Events Independent of Other Risk Factors in the Conduit Artery Functional Evaluation Substudy of Anglo-Scandinavian Cardiac Outcomes Trial, HYPERTENSION, Vol: 64, Pages: 60-68, ISSN: 0194-911X
- Author Web Link
- Cite
- Citations: 73
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.