Publications
337 results found
Charalampopoulos AC, Tzoulaki I, Howard LS, et al., 2013, Can echocardiography discriminate between pulmonary arterial hypertension and pulmonary hypertension related to left heart disease in patients with cardiovascular risk factors?, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 48-49, ISSN: 0195-668X
Grapsa J, Cabrita IZ, Karamasis G, et al., 2013, Right ventricular longitudinal strain in idiopathic pulmonary arterial hypertension: association with 3D echocardiographic and CMR volumetry and clinical deterioration: a follow up study, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 206-206, ISSN: 0195-668X
Cabrita IZ, Mohammed A, Layton M, et al., 2013, The association between tricuspid regurgitation velocity and 5-year survival in a North West London population of patients with sickle cell disease in the United Kingdom, BRITISH JOURNAL OF HAEMATOLOGY, Vol: 162, Pages: 400-408, ISSN: 0007-1048
- Author Web Link
- Cite
- Citations: 24
Charalampopoulos AC, Tzoulaki I, Howard LS, et al., 2013, Cardiovascular risk factors are associated with a reduced response to drug therapies in pulmonary arterial hypertension, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 42-42, ISSN: 0195-668X
Zhao L, Ashek A, Wang L, et al., 2013, Heterogeneity in lung 18FDG uptake in PAH: potential of dynamic 18FDG-PET with kinetic analysis as a bridging biomarker for pulmonary remodeling targeted treatments, Circulation
Shrikrishna D, Howard L, Coker RK, 2013, Authors' response to: How should we best determine the need for in-flight oxygen in patients with pulmonary arterial hypertension, THORAX, Vol: 68, Pages: 680-681, ISSN: 0040-6376
Grapsa J, Cabrita IZ, Durighel G, et al., 2013, Right heart failure and clinical deterioration: the study of idiopathic pulmonary arterial hypertensive patients, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 12, Pages: S280-S280, ISSN: 1388-9842
Howard LS, Hughes RJ, 2013, NICE guideline: management of venous thromboembolic diseases and role of thrombophilia testing, THORAX, Vol: 68, Pages: 391-393, ISSN: 0040-6376
- Author Web Link
- Cite
- Citations: 36
Grapsa J, Cabrita IZ, Durighel G, et al., 2013, IMAGING PREDICTORS OF CLINICAL DETERIORATION IN IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION: PROSPECTIVE TWO-YEAR STUDY WITH 2D AND 3D ECHOCARDIOGRAPHY AND CMR, 62nd Annual Scientific Session of the American-College-of-Cardiology, Publisher: ELSEVIER SCIENCE INC, Pages: E1229-E1229, ISSN: 0735-1097
- Author Web Link
- Cite
- Citations: 1
Rhodes CJ, Wharton J, Boon RA, et al., 2013, Reduced microRNA-150 is associated with poor survival in pulmonary arterial hypertension., American Journal of Respiratory and Critical Care Medicine, Vol: 187, Pages: 294-302
MicroRNAs (miRNAs or miRs) are implicated in the pathogenesis of various cardiovascular diseases, including pulmonary arterial hypertension (PAH).
Howard LSGE, Watson GMJ, Wharton J, et al., 2013, Supplementation of iron in pulmonary hypertension: Rationale and design of a phase II clinical trial in idiopathic pulmonary arterial hypertension, Pulmonary Circulation, Vol: 3, Pages: 100-107, ISSN: 2045-8940
Our aim is to assess the safety and potential clinical benefit of intravenous iron (Ferinject) infusion in iron deficient patients with idiopathic pulmonary arterial hypertension (IPAH). Iron deficiency in the absence of anemia (1) is common in patients with IPAH; (2) is associated with inappropriately raised levels of hepcidin, the key regulator of iron homeostasis; and (3) correlates with disease severity and worse clinical outcomes. Oral iron absorption may be impeded by reduced absorption due to elevated hepcidin levels. The safety and benefits of parenteral iron replacement in IPAH are unknown. Supplementation of Iron in Pulmonary Hypertension (SIPHON) is a Phase II, multicenter, double-blind, randomized, placebo-controlled, crossover clinical trial of iron in IPAH. At least 60 patients will be randomized to intravenous ferric carboxymaltose (Ferinject) or saline placebo with a crossover point after 12 weeks of treatment. The primary outcome will be the change in resting pulmonary vascular resistance from baseline at 12 weeks, measured by cardiac catheterization. Secondary measures include resting and exercise hemodynamics and exercise performance from serial bicycle incremental and endurance cardiopulmonary exercise tests. Other secondary measurements include serum iron indices, 6-Minute Walk Distance, WHO functional class, quality of life score, N-terminal pro-brain natriuretic peptide (NT-proBNP), and cardiac anatomy and function from cardiac magnetic resonance. We propose that intravenous iron replacement will improve hemodynamics and clinical outcomes in IPAH. If the data supports a potentially useful therapeutic effect and suggest this drug is safe, the study will be used to power a Phase III study to address efficacy.
Howard L, Grocott MP, Naeije R, et al., 2012, Cardiopulmonary exercise testing., Pulmonary Medicine, Vol: 2012, ISSN: 2090-1844
Tsang HH, Leiper J, Lao KH, et al., 2012, The Role of ADMA Metabolism in the Regulation of Human Pulmonary Endothelial Cell Function, CIRCULATION, Vol: 126, ISSN: 0009-7322
Ling Y, Johnson MK, Kiely DG, et al., 2012, Changing Demographics, Epidemiology, and Survival of Incident Pulmonary Arterial Hypertension Results from the Pulmonary Hypertension Registry of the United Kingdom and Ireland, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 186, Pages: 790-796, ISSN: 1073-449X
- Author Web Link
- Cite
- Citations: 399
Ruiter G, Voskuyl A, Lanser I, et al., 2012, Iron deficiency in patients with systemic sclerosis-associated pulmonary arterial hypertension, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Howard LS, Grapsa J, Dawson D, et al., 2012, Echocardiographic assessment of pulmonary hypertension: standard operating procedure., Eur Respir Rev, Vol: 21, Pages: 239-248
Patients with suspected pulmonary hypertension (PH) should be evaluated using a multimodality approach to ensure that they receive a correct diagnosis. The series of investigations required includes clinical evaluation, noninvasive imaging techniques and right heart catheterisation (considered to be the "gold standard" for the diagnosis of PH). Current guidelines recommend that a detailed echocardiographic assessment is performed in all patients with suspected PH. In this review we summarise a protocol adopted by the National Pulmonary Hypertension Centres of UK and Ireland and approved by the British Society of Echocardiography for the evaluation of these patients. The views and measurements described are recommended for diagnosis, assisting in prognosis and providing a noninvasive means of following disease progression or response to therapy.
Ling Y, Johnson M, Kiely D, et al., 2012, 'Idiopathic' pulmonary arterial hypertension with preserved lung function but co-existing parenchymal abnormalities: Response to treatment and survival, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Grapsa J, Howard LSGE, North BV, et al., 2012, Survival in pre-capillary pulmonary hypertension: does echocardiography make the difference?, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 868-868, ISSN: 0195-668X
Grapsa J, Cabrita IZ, Dawson D, et al., 2012, Right ventricular remodeling in idiopathic pulmonary arterial hypertension with three-dimensional echocardiography and cardiac magnetic resonance. follow up within 2 years, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 867-868, ISSN: 0195-668X
Grapsa J, Gibbs JSR, Cabrita IZ, et al., 2012, The association of clinical outcome with right atrial and ventricular remodelling in patients with pulmonary arterial hypertension: study with real-time three-dimensional echocardiography, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 13, Pages: 666-672, ISSN: 2047-2404
- Author Web Link
- Cite
- Citations: 75
Abdul-Salam VB, Zhao L, Howard L, et al., 2012, Chloride intracellular channel protein 4 in pulmonary endothelial angiogenesis, 6th European Meeting on Vascular Biology and Medicine (EMVBM), Publisher: ELSEVIER SCIENCE INC, Pages: 361-361, ISSN: 1537-1891
- Author Web Link
- Cite
- Citations: 1
Howard LS, Crosby A, Vaughan P, et al., 2012, Distinct responses to hypoxia in subpopulations of distal pulmonary artery cells contribute to pulmonary vascular remodeling in emphysema., Pulmonary Circulation, Vol: 2, Pages: 241-249, ISSN: 2045-8940
We have shown previously that hypoxia inhibits the growth of distal human pulmonary artery smooth muscle cells (PASMC) isolated under standard normoxic conditions (PASMC(norm)). By contrast, a subpopulation of PASMC, isolated through survival selection under hypoxia was found to proliferate in response to hypoxia (PASMC(hyp)). We sought to investigate the role of hypoxia-inducible factor (HIF) in these differential responses and to assess the relationship between HIF, proliferation, apoptosis, and pulmonary vascular remodeling in emphysema. PASMC were derived from lobar resections for lung cancer. Hypoxia induced apoptosis in PASMC(norm) (as assessed by TUNEL) and mRNA expression of Bax and Bcl-2, and induced proliferation in PASMC(hyp) (as assessed by (3)H-thymidine incorporation). Both observations were mimicked by dimethyloxallyl glycine, a prolyl-hydroxylase inhibitor used to stabilize HIF under normoxia. Pulmonary vascular remodeling was graded in lung samples taken from patients undergoing lung volume reduction surgery for severe heterogenous emphysema. Carbonic anhydrase IX expression in the medial compartment was used as a surrogate of medial hypoxia and HIF stabilization and increased with increasing vascular remodeling. In addition, a mixture of proliferation, assessed by proliferating-cell nuclear antigen, and apoptosis, assessed by active caspase 3 staining, were both higher in more severely remodeled vessels. Hypoxia drives apoptosis and proliferation via HIF in distinct subpopulations of distal PASMC. These differential responses may be important in the pulmonary vascular remodeling seen in emphysema and further support the key role of HIF in hypoxic pulmonary hypertension.
Grapsa J, Gibbs JSR, Dawson D, et al., 2012, Morphologic and Functional Remodeling of the Right Ventricle in Pulmonary Hypertension by Real Time Three Dimensional Echocardiography, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 109, Pages: 906-913, ISSN: 0002-9149
- Author Web Link
- Cite
- Citations: 38
Davies R, Howard L, 2012, Pulmonary vascular disease: Pulmonary thromboembolism and pulmonary hypertension, Medicine, Vol: 40, Pages: 214-220, ISSN: 1357-3039
The pulmonary circulation is a high-flow, low-pressure circuit that is highly adapted for efficient gas exchange. Pathological events in the pulmonary circulation either seriously impair ventilation-perfusion matching, resulting in increased dead space, or increase pulmonary vascular resistance, putting extra load on the right ventricle that ultimately leads to right heart failure. This article will explore the pathophysiology, clinical presentation, diagnosis and treatment of two major diseases affecting the pulmonary circulation - namely pulmonary thromboembolism and pulmonary hypertension. © 2012 Elsevier Ltd. All rights reserved.
O'Driscoll BR, Rudenski A, Turkington PM, et al., 2012, An audit of hypoxaemia, hyperoxaemia, hypercapnia and acidosis in blood gas specimens, EUROPEAN RESPIRATORY JOURNAL, Vol: 39, Pages: 219-221, ISSN: 0903-1936
- Author Web Link
- Cite
- Citations: 6
Kane B, Turkington PM, Howard LS, et al., 2011, [Rebound hypoxemia after oxygen therapy in acute exacerbation of chronic obstructive lung disease]., Praxis (Bern 1994), Vol: 100, Pages: 1549-1551, ISSN: 1661-8157
Howard LS, 2011, Prognostic factors in pulmonary arterial hypertension: assessing the course of the disease., Eur Respir Rev, Vol: 20, Pages: 236-242
The practical management of pulmonary arterial hypertension (PAH) requires an accurate assessment of disease severity and prognosis. A number of prognostic indicators are known to be associated with patient outcome, and recent treatment guidelines advocate using such parameters to guide management decisions. Although PAH is characterised by the presence of pulmonary vasculopathy, it is the response of the right ventricle to an increased afterload that is the greatest determinant of a patient's symptoms and survival; thus, measurements that capture right ventricular function provide the best potential to assess PAH severity. One challenge is to understand how the tests we use in everyday clinical practice relate to right heart function in PAH patients, and how current measures can be improved and developed to optimise assessment of disease status and progress. Future research in the field of PAH should focus on how best to assess right heart function, and which measures or combination of measures provide the most relevant information for the individual patient.
Ling Y, Johnson MK, Kiely D, et al., 2011, PREDICTION OF SURVIVAL IN PULMONARY ARTERIAL HYPERTENSION USING SURVIVAL EQUATIONS. RESULTS FROM THE PULMONARY HYPERTENSION REGISTRY OF THE UK AND IRELAND, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A35-A36, ISSN: 0040-6376
- Author Web Link
- Cite
- Citations: 1
Thing JER, Mukherjee B, Murphy K, et al., 2011, EVALUATION OF THE ROLE OF CARDIO-PULMONARY EXERCISE TESTING IN THE DIAGNOSIS OF UNEXPLAINED BREATHLESSNESS, Winter Meeting of the British-Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: A144-A145, ISSN: 0040-6376
- Author Web Link
- Cite
- Citations: 2
Rhodes CJ, Wharton J, Howard L, et al., 2011, Iron deficiency in pulmonary arterial hypertension: a potential therapeutic target, EUROPEAN RESPIRATORY JOURNAL, Vol: 38, Pages: 1453-1460, ISSN: 0903-1936
- Author Web Link
- Cite
- Citations: 75
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.