Publications
517 results found
Dhutia NM, Zolgharni M, Willson K, et al., 2014, Guidance for accurate and consistent tissue Doppler velocity measurement: comparison of echocardiographic methods using a simple vendor-independent method for local validation, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 15, Pages: 817-827, ISSN: 2047-2404
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- Citations: 13
Sohaib SMA, Jones S, Kyriacou A, et al., 2014, EVIDENCE THAT HAEMODYNAMIC RESPONSE TO VV DELAY OPTIMISATION OF CRT DEVICES MAY BE SIMPLY A FUNCTION OF THE METHOD OF PROGRAMMING AV DELAY, HEART, Vol: 100, Pages: A21-A22, ISSN: 1355-6037
Ghosh AK, Hardy RJ, Francis DP, et al., 2014, IS IT TIME FOR A NEW LOOK AT THE "WATCH AND WAIT" APPROACH - MID-LIFE ANTIHYPERTENSIVE TREATMENT MAY NOT NORMALIZE LEFT VENTRICULAR MASS IN SPITE OF CONTROLLED BLOOD PRESSURE, 35th Annual Scientific Meeting of the High-Blood-Pressure-Research-Council-of-Australia (HBPRCA) / 39th Annual Scientific Meeting of the Australian-Atherosclerosis-Society (AAS), Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E149-E149, ISSN: 0194-911X
Ghosh AK, Hardy RJ, Francis DP, et al., 2014, Impaired diastolic function in the elderly - could high systolic blood pressures and a faster rise in systolic blood pressures in mid-life be the cause?, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 16, Pages: 183-183, ISSN: 1388-9842
Park CM, Tillin T, March K, et al., 2014, Hyperglycemia Has a Greater Impact on Left Ventricle Function in South Asians Than in Europeans, Diabetes Care, Vol: 37, Pages: 1124-1131, ISSN: 1935-5548
OBJECTIVE Diabetes is associated with left ventricular (LV) diastolic and systolic dysfunction. South Asians may be at particular risk of developing LV dysfunction owing to a high prevalence of diabetes. We investigated the role of diabetes and hyperglycemia in LV dysfunction in a community-based cohort of older South Asians and white Europeans.RESEARCH DESIGN AND METHODS Conventional and Doppler echocardiography was performed in 999 participants (542 Europeans and 457 South Asians aged 58–86 years) in a population-based study. Anthropometry, fasting bloods, coronary artery calcification scoring, blood pressure, and renal function were measured.RESULTS Diabetes and hyperglycemia across the spectrum of HbA1c had a greater adverse effect on LV function in South Asians than Europeans (N-terminal-probrain natriuretic peptide β ± SE 0.09 ± 0.04, P = 0.01, vs. −0.04 ± 0.05, P = 0.4, P for HbA1c/ethnicity interaction 0.02), diastolic function (E/e′ 0.69 ± 0.12, P < 0.0001, vs. 0.09 ± 0.2, P = 0.6, P for interaction 0.005), and systolic function (s′ −0.11 ± 0.06, P = 0.04, vs. 0.14 ± 0.09, P = 0.1, P for interaction 0.2). Multivariable adjustment for hypertension, microvascular disease, LV mass, coronary disease, and dyslipidemia only partially accounted for the ethnic differences. Adverse LV function in diabetic South Asians could not be accounted for by poorer glycemic control or longer diabetes duration.CONCLUSIONS Diabetes and hyperglycemia have a greater adverse effect on LV function in South Asians than Europeans, incompletely explained by adverse risk factors. South Asians may require earlier and more aggressive treatment of their cardiometabolic risk factors to reduce risks of LV dysfunction.
Whinnett ZI, Sohaib SMA, Jones S, et al., 2014, British randomised controlled trial of AV and VV optimization ("BRAVO") study: rationale, design, and endpoints, BMC CARDIOVASCULAR DISORDERS, Vol: 14, ISSN: 1471-2261
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- Citations: 4
Nijjer SS, van de Hoef T, da Cunha RP, et al., 2014, RESTING CORONARY BLOOD FLOW VELOCITY IS CONSTANT ACROSS ALL STENOSIS SEVERITIES: IMPLICATIONS FOR TANDEM LESION AND PULLBACK ASSESSMENT, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A1610-A1610, ISSN: 0735-1097
da Cunha RP, van de Hoef T, Nijjer S, et al., 2014, PROGNOSTIC INSIGHTS INTO THE UTILISATION OF INSTANTANEOUS WAVE-FREE RATIO (IFR) TO GUIDE CORONARY REVASCULARISATION: RESULTS OF THE JUSTIFY-CFR STUDY, A COMPARISON OF PRESSURE-ONLY INDICES AGAINST CORONARY FLOW RESERVE, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A1507-A1507, ISSN: 0735-1097
Barron A, Dhutia N, Mayet J, et al., 2014, Response to editorial 'Reproducibility of cardiopulmonary exercise test variables: getting into an additional strength of the test', EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, Vol: 21, Pages: 454-455, ISSN: 2047-4873
Jones S, Shun-Shin MJ, Cole GD, et al., 2014, Applicability of the iterative technique for cardiac resynchronization therapy optimization: full-disclosure, 50-sequential-patient dataset of transmitral Doppler traces, with implications for future research design and guidelines, EUROPACE, Vol: 16, Pages: 541-550, ISSN: 1099-5129
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- Citations: 12
Barron A, Dhutia N, Mayet J, et al., 2014, Test-retest repeatability of cardiopulmonary exercise test variables in patients with cardiac or respiratory disease, EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, Vol: 21, Pages: 445-453, ISSN: 2047-4873
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- Citations: 34
Tillin T, Hughes AD, Whincup P, et al., 2014, QRISK2 validation by ethnic group reply, HEART, Vol: 100, Pages: 437-437, ISSN: 1355-6037
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- Citations: 4
Bouri S, Shun-Shin MJ, Cole GD, et al., 2014, Meta-analysis of secure randomised controlled trials of beta-blockade to prevent perioperative death in non-cardiac surgery, Heart, Vol: 100, Pages: 456-464, ISSN: 1355-6037
Background Current European and American guidelines recommend the perioperative initiation of a course of β-blockers in those at risk of cardiac events undergoing high- or intermediate-risk surgery or vascular surgery. The Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography (DECREASE) family of trials, the bedrock of evidence for this, are no longer secure. We therefore conducted a meta-analysis of randomised controlled trials of β-blockade on perioperative mortality, non-fatal myocardial infarction, stroke and hypotension in non-cardiac surgery using the secure data.Methods The randomised controlled trials of initiation of β-blockers before non-cardiac surgery were examined. Primary outcome was all-cause mortality at 30 days or at discharge. The DECREASE trials were separately analysed.Results Nine secure trials totalling 10 529 patients, 291 of whom died, met the criteria. Initiation of a course of β-blockers before surgery caused a 27% risk increase in 30-day all-cause mortality (p=0.04). The DECREASE family of studies substantially contradict the meta-analysis of the secure trials on the effect of mortality (p=0.05 for divergence). In the secure trials, β-blockade reduced non-fatal myocardial infarction (RR 0.73, p=0.001) but increased stroke (RR 1.73, p=0.05) and hypotension (RR 1.51, p<0.00001). These results were dominated by one large trial.Conclusions Guideline bodies should retract their recommendations based on fictitious data without further delay. This should not be blocked by dispute over allocation of blame. The well-conducted trials indicate a statistically significant 27% increase in mortality from the initiation of perioperative β-blockade that guidelines currently recommend. Any remaining enthusiasts might best channel their energy into a further randomised trial which should be designed carefully and conducted honestly.
Nijjer S, Petraco R, Sen S, et al., 2014, The change in coronary flow after percutaneous coronary intervention in physiologically defined coronary stenoses, LANCET, Vol: 383, Pages: 76-76, ISSN: 0140-6736
Al-Lamee R, Broyd C, Parker J, et al., 2014, Influence of Gender on Clinical Outcomes Following Transcatheter Aortic Valve Implantation,from the UK Transcatheter Aortic Valve Implantation Registry and the National Institute for Cardiovascular Outcomes Research, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 113, Pages: 522-528, ISSN: 0002-9149
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- Citations: 40
Kyriacou A, Pabari PA, Mayet J, et al., 2014, Cardiac resynchronization therapy and AV optimization increase myocardial oxygen consumption, but increase cardiac function more than proportionally, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 171, Pages: 144-152, ISSN: 0167-5273
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- Citations: 12
Barron AJ, Hughes AD, Sharp A, et al., 2014, Long-Term Antihypertensive Treatment Fails to Improve E/e′ Despite Regression of Left Ventricular Mass An Anglo-Scandinavian Cardiac Outcomes Trial Substudy, HYPERTENSION, Vol: 63, Pages: 252-+, ISSN: 0194-911X
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- Citations: 20
Sen S, Petraco R, Mayet J, et al., 2014, Wave intensity analysis in the human coronary circulation in health and disease., Curr Cardiol Rev, Vol: 10, Pages: 17-23
Coronary artery hemodynamics are very different to that of the systemic arteries; unlike the systemic circulation, in the coronary circulation pressure is generated from both the proximal and distal end of the artery - due to the effect of contraction and relaxation of the myocardium on the microvasculature. As a result, the systemic artery hemodynamic model cannot be used to explain the pressure-flow relationship in the coronaries. Wave intensity analysis is an investigative tool that is able to distinguish simultaneous proximal and distal influences on coronary blood flow and is therefore uniquely suitable for the study of coronary haemodynamics. This review discusses the concept behind wave intensity analysis and evaluates how it has been used to characterise and provide new insights on coronary haemodynamics in health and disease.
Hunter RJ, Berriman TJ, Diab I, et al., 2014, A Randomized Controlled Trial of Catheter Ablation Versus Medical Treatment of Atrial Fibrillation in Heart Failure (The CAMTAF Trial), CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol: 7, Pages: 31-38, ISSN: 1941-3149
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- Citations: 314
Unsworth B, Francis DP, Mayet J, 2014, RE: Impact of transcatheter aortic valve implantation or surgical aortic valve replacement on right ventricular function, HEART, Vol: 100, Pages: 180-180, ISSN: 1355-6037
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- Citations: 1
Tillin T, Hughes AD, Whincup P, et al., 2014, Ethnicity and prediction of cardiovascular disease: performance of QRISK2 and Framingham scores in a UK tri-ethnic prospective cohort study (SABRE-Southall And Brent REvisited), Heart, Vol: 100, Pages: 60-67, ISSN: 1355-6037
Objective To evaluate QRISK2 and Framingham cardiovascular disease (CVD) risk scores in a tri-ethnic UK population.Design Cohort study.Setting West London.Participants Randomly selected from primary care lists. Follow-up data were available for 87% of traced participants, comprising 1866 white Europeans, 1377 South Asians, and 578 African Caribbeans, aged 40–69 years at baseline (1998–1991).Main outcome measures First CVD events: myocardial infarction, coronary revascularisation, angina, transient ischaemic attack or stroke reported by participant, primary care or hospital records or death certificate.Results During follow-up, 387 CVD events occurred in men (14%) and 78 in women (8%). Both scores underestimated risk in European and South Asian women (ratio of predicted to observed risk: European women: QRISK2: 0.73, Framingham: 0.73; South Asian women: QRISK2: 0.52, Framingham: 0.43). In African Caribbeans, Framingham over-predicted in men and women and QRISK2 over-predicted in women. Framingham classified 28% of participants as high risk, predicting 54% of all such events. QRISK2 classified 19% as high risk, predicting 42% of all such events. Both scores performed poorly in identifying high risk African Caribbeans; QRISK2 and Framingham identified as high risk only 10% and 24% of those who experienced events.Conclusions Neither score performed consistently well in all ethnic groups. Further validation of QRISK2 in other multi-ethnic datasets, and better methods for identifying high risk African Caribbeans and South Asian women, are required.
Tarkin JM, Nijjer S, Sen S, et al., 2014, Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment Results of the Adenosine for the Functional Evaluation of Coronary Stenosis Severity (AFFECTS) Study, CELL BIOLOGY INTERNATIONAL, Vol: 38, Pages: 654-661, ISSN: 1065-6995
Baruah R, Giannoni A, Willson K, et al., 2014, Novel cardiac pacemaker-based human model of periodic breathing to develop real-time, pre-emptive technology for carbon dioxide stabilisation., Open Heart, Vol: 1, ISSN: 2053-3624
BACKGROUND: Constant flow and concentration CO2 has previously been efficacious in attenuating ventilatory oscillations in periodic breathing (PB) where oscillations in CO2 drive ventilatory oscillations. However, it has the undesirable effect of increasing end-tidal CO2, and ventilation. We tested, in a model of PB, a dynamic CO2 therapy that aims to attenuate pacemaker-induced ventilatory oscillations while minimising CO2 dose. METHODS: First, pacemakers were manipulated in 12 pacemaker recipients, 6 with heart failure (ejection fraction (EF)=23.7±7.3%) and 6 without heart failure, to experimentally induce PB. Second, we applied a real-time algorithm of pre-emptive dynamic exogenous CO2 administration, and tested different timings. RESULTS: We found that cardiac output alternation using pacemakers successfully induced PB. Dynamic CO2 therapy, when delivered coincident with hyperventilation, attenuated 57% of the experimentally induced oscillations in end-tidal CO2: SD/mean 0.06±0.01 untreated versus 0.04±0.01 with treatment (p<0.0001) and 0.02±0.01 in baseline non-modified breathing. This translated to a 56% reduction in induced ventilatory oscillations: SD/mean 0.19±0.09 untreated versus 0.14±0.06 with treatment (p=0.001) and 0.10±0.03 at baseline. Of note, end-tidal CO2 did not significantly rise when dynamic CO2 was applied to the model (4.84±0.47 vs 4.91± 0.45 kPa, p=0.08). Furthermore, mean ventilation was also not significantly increased by dynamic CO2 compared with untreated (7.8±1.2 vs 8.4±1.2 L/min, p=0.17). CONCLUSIONS: Cardiac pacemaker manipulation can be used to induce PB experimentally. In this induced PB, delivering CO2 coincident with hyperventilation, ventilatory oscillations can be substantially attenuated without a significant increase in end-tidal CO2 or ventilation. Dynamic CO2 administration might be developed into a clinical treatment for PB. TRIAL REGISTRATION N
Tarkin JM, Nijjer S, Sen S, et al., 2013, Hemodynamic Response to Intravenous Adenosine and Its Effect on Fractional Flow Reserve Assessment Results of the Adenosine for the Functional Evaluation of Coronary Stenosis Severity (AFFECTS) Study, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 6, Pages: 654-661, ISSN: 1941-7640
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- Citations: 47
Kelshiker MA, Mayet J, Unsworth B, et al., 2013, Basal septal hypertrophy., Curr Cardiol Rev, Vol: 9, Pages: 325-330
A significant clinical problem is patients presenting with exercise-limiting dyspnoea, sometimes with associated chest pain, in the absence of detectable left ventricular (LV) systolic dysfunction, coronary artery disease, or lung disease. Often the patients are older, female, and have isolated basal septal hypertrophy (BSH), frequently on a background of mild hypertension. The topic of breathlessness in patients with clinical heart failure, but who have a normal ejection fraction (HFNEF) has attracted significant controversy over the past few years. This review aims to analyse the literature on BSH, identify the possible associations between BSH and HFNEF, and consequently explore possible pathophysiological mechanisms whereby clinical symptoms are experienced.
Petraco R, van de Hoef TP, Nijjer SS, et al., 2013, Identification of stenoses with high underlying coronary flow reserve from pressure-only measurements using baseline instant wave-free ratio (iFR) and hyperaemic fractional flow reserve (FFR), 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B190-B190, ISSN: 0735-1097
Nijjer SS, van de Hoef TP, Petraco R, et al., 2013, Mean Hyperemic Flow is Not Increased Following Adenosine Administration in Physiologically Significant Lesions, 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B188-B188, ISSN: 0735-1097
Brown CE, Mischak H, Abalat A, et al., 2013, Urinary proteomics can be predictive of cardiovascular events, JOURNAL OF HUMAN HYPERTENSION, Vol: 27, Pages: 647-647, ISSN: 0950-9240
Strain WD, Hughes AD, Mayet J, et al., 2013, Attenuated Systemic Microvascular Function in Men with Coronary Artery Disease is Associated with Angina but not Explained by Atherosclerosis, MICROCIRCULATION, Vol: 20, Pages: 670-677, ISSN: 1073-9688
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- Citations: 11
Nijjer SS, Sen S, Petraco R, et al., 2013, Improvement in coronary haemodynamics after percutaneous coronary intervention: assessment using instantaneous wave-free ratio., Heart, Vol: 99, Pages: 1740-1748
To determine whether the instantaneous wave-free ratio (iFR) can detect improvement in stenosis significance after percutaneous coronary intervention (PCI) and compare this with fractional flow reserve (FFR) and whole cycle Pd/Pa.
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