Imperial College London

DrMilesDalby

Faculty of MedicineNational Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

miles.dalby

 
 
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Location

 

Guy Scadding BuildingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
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151 results found

Bhattacharyya S, Mittal T, Abayalingam M, Kabir T, Dalby M, Cleland JG, Baltabaeva A, Rahman Haley Set al., 2015, Classification of Aortic Stenosis by Flow and Gradient Patterns Provides Insights into the Pathophysiology of Disease, Angiology, Vol: 67, Pages: 664-669, ISSN: 1940-1574

Different patterns of flow and valve gradients can lead to diagnostic uncertainty about the severity of aortic stenosis (AS). Consecutive patients with severe AS (valve area <1 cm(2)) underwent echocardiography and computed tomography. Patients were classified into 4 groups (high-gradient/normal flow [HGNF], high-gradient/low flow [HGLF], low-gradient/normal flow [LGNF], and low-gradient/low flow [LGLF]). Low flow was defined as stroke volume index <35 mL/m(2) and low gradient as a mean aortic gradient <40 mm Hg. Aortic valve calcification (AVC) was calculated using the Agatston score. Of 181 patients, 56, 30, 46, and 49 had HGNF, HGLF, LGNF and LGLF with median AVC of 2048, 2015, 1366, and 1178 AU/m(2) (P < .0001) and valvuloarterial impedance of 4.5, 6.4, 4.2, and 5.9, respectively (P < .0001). Among those with LGLF, AVC was lower in patients with preserved compared to reduced left ventricular ejection fraction (1018 vs 2550 AU/m(2); P < .0001), but valvuloarterial impedance was similar (P = .33). The LGLF AS with preserved ejection fraction is associated with lower AVC and may identify patients with less severe AS in association with an adaptive ventricular response to high afterload.

Journal article

Tarkin J, Malhotra A, Apps A, Smith R, Di Mario C, Rogers P, Lane R, Kabir T, Mason M, Ilsley C, Whitbread M, Dalby Met al., 2015, Inter-hospital transfer for primary angioplasty: delays are often due to diagnostic uncertainty rather than systems failure and universal time metrics may not be appropriate, EUROINTERVENTION, Vol: 11, Pages: 511-517, ISSN: 1774-024X

Journal article

Geisler T, Booth J, Tavlaki E, Karathanos A, Mueller K, Droppa M, Gawaz M, Yanez-Lopez M, Davidson SJ, Stables RH, Banya W, Zaman A, Flather M, Dalby Met al., 2015, High Platelet Reactivity in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: Randomised Controlled Trial Comparing Prasugrel and Clopidogrel, PLOS One, Vol: 10, ISSN: 1932-6203

BackgroundPrasugrel is more effective than clopidogrel in reducing platelet aggregation in acute coronary syndromes. Data available on prasugrel reloading in clopidogrel treated patients with high residual platelet reactivity (HRPR) i.e. poor responders, is limited.ObjectivesTo determine the effects of prasugrel loading on platelet function in patients on clopidogrel and high platelet reactivity undergoing percutaneous coronary intervention for acute coronary syndrome (ACS).PatientsPatients with ACS on clopidogrel who were scheduled for PCI found to have a platelet reactivity ≥40 AUC with the Multiplate Analyzer, i.e. “poor responders” were randomised to prasugrel (60 mg loading and 10 mg maintenance dose) or clopidogrel (600 mg reloading and 150 mg maintenance dose). The primary outcome measure was proportion of patients with platelet reactivity <40 AUC 4 hours after loading with study medication, and also at one hour (secondary outcome). 44 patients were enrolled and the study was terminated early as clopidogrel use decreased sharply due to introduction of newer P2Y12 inhibitors.ResultsAt 4 hours after study medication 100% of patients treated with prasugrel compared to 91% of those treated with clopidogrel had platelet reactivity <40 AUC (p = 0.49), while at 1 hour the proportions were 95% and 64% respectively (p = 0.02). Mean platelet reactivity at 4 and 1 hours after study medication in prasugrel and clopidogrel groups respectively were 12 versus 22 (p = 0.005) and 19 versus 34 (p = 0.01) respectively.ConclusionsRoutine platelet function testing identifies patients with high residual platelet reactivity (“poor responders”) on clopidogrel. A strategy of prasugrel rather than clopidogrel reloading results in earlier and more sustained suppression of platelet reactivity. Future trials need to identify if this translates into clinical benefit.

Journal article

Rathod KS, Jones DA, Iqbal MB, Dalby M, Wragg Aet al., 2015, Intra-aortic balloon pump use is not associated with reduced mortality in patients with cardiogenic coronary intervention, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 74-75, ISSN: 0195-668X

Conference paper

Gershlick AH, Khan JN, Kelly DJ, Greenwood JP, Sasikaran T, Curzen N, Blackman DJ, Dalby M, Fairbrother KL, Banya W, Wang D, Flather M, Hetherington SL, Kelion AD, Talwar S, Gunning M, Hall R, Swanton H, McCann GPet al., 2015, REPLY: Complete Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI Is It Really What We Should Be Doing?, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 66, Pages: 332-333, ISSN: 0735-1097

Journal article

Iqbal MB, Khamis R, Ilsley C, Mikhail G, Crake T, Firoozi S, Kalra S, Knight C, Archbold A, Lim P, Mathur A, Meier P, Rakhit RD, Redwood S, Whitbread M, Bromage D, Rathod K, Jones DA, Wragg A, Dalby M, MacCarthy P, Malik ISet al., 2015, Time-Trend Analyses of Bleeding and Mortality After Primary Percutaneous Coronary Intervention During Out of Working Hours Versus In-Working Hours An Observational Study of 11 466 Patients, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 8, ISSN: 1941-7640

Journal article

Jones DA, Rathod KS, Gallagher S, Jain AK, Kalra SS, Lim P, Crake T, Ozkor M, Rakhit R, Knight CJ, Iqbal MB, Dalby MC, Malik IS, Whitbread M, Mathur A, Redwood S, MacCarthy PA, Weerackody R, Wragg Aet al., 2015, Manual Thrombus Aspiration Is Not Associated With Reduced Mortality in Patients Treated With Primary Percutaneous Coronary Intervention An Observational Study of 10,929 Patients With ST-Segment Elevation Myocardial Infarction From the London Heart Attack Group, JACC-Cardiovascular Interventions, Vol: 8, Pages: 575-584, ISSN: 1936-8798

Journal article

Taggart DP, Ben Gal Y, Lees B, Patel N, Webb C, Rehman SM, Desouza A, Yadav R, De Robertis F, Dalby M, Banning A, Channon KM, Di Mario C, Orion Eet al., 2015, A randomized trial of external stenting for saphenous vein grafts in coronary artery bypass grafting, Annals of Thoracic Surgery, Vol: 99, Pages: 2039-2045, ISSN: 0003-4975

BackgroundExternal stents inhibit saphenous vein graft (SVG) intimal hyperplasia in animal studies. We investigated whether external stenting inhibits SVG diffuse intimal hyperplasia 1 year after coronary artery bypass graft surgery.MethodsThirty patients with multivessel disease undergoing coronary artery bypass graft surgery were enrolled. In addition to an internal mammary artery graft, each patient received one external stent to a single SVG randomly allocated to either the right or left coronary territories; and one or more nonstented SVG served as the control. Graft patency was confirmed at the end of surgery in all patients. The primary endpoint was SVG intimal hyperplasia (mean area) assessed by intravascular ultrasonography at 1 year. Secondary endpoints were SVG failure, ectasia (>50% initial diameter), and overall uniformity as judged by Fitzgibbon classification.ResultsOne-year follow-up angiography was completed in 29 patients (96.6%). All internal mammary artery grafts were patent. Overall SVG failure rates did not differ significantly between the two groups (30% stented versus 28.2% nonstented SVG, p = 0.55). The SVG mean intimal hyperplasia area, assessed in 43 SVGs, was significantly reduced in the stented group (4.37 ± 1.40 mm2) versus nonstented group (5.12 ± 1.35 mm2, p = 0.04). In addition, stented SVGs demonstrated marginally significant improvement in lumen uniformity (p = 0.08) and less ectasia (6.7% versus 28.2%, p = 0.05). There was some evidence that ligation of side branches with metallic clips increased SVG failure in the stented group.ConclusionsExternal stenting has the potential to improve SVG lumen uniformity and reduce diffuse intimal hyperplasia 1 year after coronary artery bypass graft surgery.

Journal article

Mittal TK, Reichmuth L, Chana H, Baltabaeva A, Rahman-Haley S, Dalby M, Long Qet al., 2015, Discrepancy in the severity of aortic valve stenosis between Echocardiography and CT cardiac angiography and evaluation of potential mechanism using computational flow dynamics., Annual Scientific Meeting of Society of Cardiovascular Computed Tomography

Conference paper

Khan JN, Greenwood JP, Nazir SA, Dalby M, Curzen N, Hetherington S, Kelly DJ, Blackman D, Ring A, Peebles C, Wong J, Flather M, Swanton H, Gershlick AH, McCann GPet al., 2015, THE RANDOMISED COMPLETE VS. LESION ONLY PRIMARY PCI TRIAL - CARDIOVASCULAR MRI SUBSTUDY (CvLPRIT-CMR), HEART, Vol: 101, Pages: A10-A11, ISSN: 1355-6037

Journal article

Gershlick AH, Khan JN, Kelly DJ, Greenwood JP, Sasikaran T, Curzen N, Blackman DJ, Dalby M, Fairbrother KL, Banya W, Wang D, Flather M, Hetherington SL, Kelion AD, Talwar S, Gunning M, Hall R, Swanton H, McCann GPet al., 2015, Randomized Trial of Complete Versus Lesion-Only Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI and Multivessel Disease, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 65, Pages: 963-972, ISSN: 0735-1097

Journal article

Iqbal B, Al-Hussaini A, Ilsley C, Archbold A, Crake T, Firoozi S, Kalra S, Knight C, Lim P, Mathur A, Malik I, Meier P, Rakhit R, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy P, Dalby Met al., 2015, INTRA-AORTIC BALLOON PUMP USE IS NOT ASSOCIATED WITH IMPROVED LONG-TERM SURVIVAL IN PATIENTS WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION AND CARDIOGENIC SHOCK UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION, Scientific Session of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: A181-A181, ISSN: 0735-1097

Conference paper

Khan JN, Greenwood JP, Nazir SA, Dalby M, Curzen N, Hetherington S, Kelly DJ, Blackman D, Peebles C, Wong J, Swanton H, Flather M, Hall R, Gershlick AH, McCann GPet al., 2015, THE COMPLETE VERSUS LESION ONLY PRIMARY PCI TRIAL-CARDIOVASCULAR MRI SUBSTUDY (CVLPRIT-CMR), Scientific Session of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: A17-A17, ISSN: 0735-1097

Conference paper

Khan JN, Greenwood JP, Nazir SA, Dalby M, Curzen N, Hetherington S, Kelly D, Blackman DJ, Peebles C, Wong J, Flather M, Gershlick A, McCann GPet al., 2015, Predictive value of segmental extent of late gadolinium enhancement and peak circumferential systolic strain in predicting improvement and normalisation of dysfunctional segments post STEMI, Journal of Cardiovascular Magnetic Resonance, Vol: 17, Pages: O11-O11, ISSN: 1097-6647

Journal article

Ali OF, Schultz C, Jabbour A, Rubens M, Mittal T, Mohiaddin R, Davies S, Di Mario C, Van der Boon R, Ahmad AS, Amrani M, Moat N, De Jaegere PPT, Dalby Met al., 2015, Predictors of paravalvular aortic regurgitation following self-expanding Medtronic CoreValve implantation: The role of annulus size, degree of calcification, and balloon size during pre-implantation valvuloplasty and implant depth, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 179, Pages: 539-545, ISSN: 0167-5273

Journal article

Iqbal MB, Ilsley C, Kabir T, Smith R, Lane R, Mason M, Clifford P, Crake T, Firoozi S, Kalra S, Knight C, Lim P, Malik IS, Mathur A, Meier P, Rakhit RD, Redwood S, Whitbread M, Bromage D, Rathod K, MacCarthy P, Dalby Met al., 2014, Culprit Vessel Versus Multivessel Intervention at the Time of Primary Percutaneous Coronary Intervention in Patients With ST-Segment-Elevation Myocardial Infarction and Multivessel Disease Real-World Analysis of 3984 Patients in London, CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, Vol: 7, Pages: 936-943, ISSN: 1941-7705

Journal article

Cristescu SM, Kiss R, Hekkert STL, Dalby M, Harren FJM, Risby TH, Marczin Net al., 2014, Real-time monitoring of endogenous lipid peroxidation by exhaled ethylene in patients undergoing cardiac surgery, AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY, Vol: 307, Pages: L509-L515, ISSN: 1040-0605

Pulmonary and systemic organ injury produced by oxidative stress including lipid peroxidation is a fundamental tenet of ischemia-reperfusion injury, inflammatory response to cardiac surgery, and cardiopulmonary bypass (CPB) but is not routinely measured in a surgically relevant time frame. To initiate a paradigm shift toward noninvasive and real-time monitoring of endogenous lipid peroxidation, we have explored pulmonary excretion and dynamism of exhaled breath ethylene during cardiac surgery to test the hypothesis that surgical technique and ischemia-reperfusion triggers lipid peroxidation. We have employed laser photoacoustic spectroscopy to measure real-time trace concentrations of ethylene from the patient breath and from the CPB machine. Patients undergoing aortic or mitral valve surgery-requiring CPB (n = 15) or off-pump coronary artery bypass surgery (OPCAB) (n = 7) were studied. Skin and tissue incision by diathermy caused striking (>30-fold) increases in exhaled ethylene resulting in elevated levels until CPB. Gaseous ethylene in the CPB circuit was raised upon the establishment of CPB (>10-fold) and decreased over time. Reperfusion of myocardium and lungs did not appear to enhance ethylene levels significantly. During OPCAB surgery, we have observed increased ethylene in 16 of 30 documented reperfusion events associated with coronary and aortic anastomoses. Therefore, novel real-time monitoring of endogenous lipid peroxidation in the intraoperative setting provides unparalleled detail of endogenous and surgery-triggered production of ethylene. Diathermy and unprotected regional myocardial ischemia and reperfusion are the most significant contributors to increased ethylene.

Journal article

Iqbal MB, Ilsley CD, Mikhail G, Khamis R, Archbold A, Crake T, Firoozi S, Kalra SS, Knight C, Lim P, Mathur A, Meier P, Rakhit R, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy PA, Dalby MC, Malik ISet al., 2014, Comparison Of Outcomes For Primary Percutaneous Coronary Intervention During Out Of Working Hours Versus In Working Hours: An Observational Cohort Study Of 11,461 Patients, 26th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B9-B9, ISSN: 0735-1097

Conference paper

Iqbal MB, Arujuna A, Ilsley C, Archbold A, Crake T, Firoozi S, Kalra S, Knight C, Lim P, Malik IS, Mathur A, Meier P, Rakhit RD, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy P, Dalby Met al., 2014, Radial Versus Femoral Access Is Associated With Reduced Complications and Mortality in Patients With Non-ST-Segment-Elevation Myocardial Infarction An Observational Cohort Study of 10095 Patients, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 7, Pages: 456-+, ISSN: 1941-7640

Journal article

Froehlich GM, Redwood S, Rakhit R, MacCarthy PA, Lim P, Crake T, White SK, Knight CJ, Kustosz C, Knapp G, Dalby MC, Mali IS, Archbold A, Wragg A, Timmis AD, Meier Pet al., 2014, Long-term Survival in Patients Undergoing Percutaneous Interventions With or Without Intracoronary Pressure Wire Guidance or Intracoronary Ultrasonographic Imaging A Large Cohort Study, JAMA INTERNAL MEDICINE, Vol: 174, Pages: 1360-1366, ISSN: 2168-6106

Journal article

Ghimire G, Spiro J, Kharbanda R, Dalby Met al., 2014, ATTENUATED HEAT SHOCK PROTEIN 27 (HSP27) AT THE SITE OF CORONARY OCCLUSION IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFARCTION, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A93-A93, ISSN: 0735-1097

Journal article

Iqbal B, Ilsley C, Kabir T, Smith R, Lane R, Mason M, Archbold A, Crake T, Firoozi S, Kalra S, Knight C, Lim P, Mathur A, Malik I, Meier P, Rakhit R, Redwood S, Whitbread M, Rathod K, Bromage D, Wragg A, MacCarthy P, Dalby Met al., 2014, CULPRIT VESSEL VERSUS MULTIVESSEL INTERVENTION FOR PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION WITHOUT CARDIOGENIC SHOCK: AN OBSERVATIONAL COHORT STUDY OF 9,377 PATIENTS, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A6-A6, ISSN: 0735-1097

Journal article

Iqbal B, Ilsley C, Kabir T, Smith R, Lane R, Mason M, Al-Hussaini A, Archbold A, Crake T, Firoozi S, Kalra S, Knight C, Lim P, Mathur A, Malik I, Meier P, Rakhit R, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy P, Dalby Met al., 2014, DRUG-ELUTING STENTS VERSUS BARE METAL STENTS IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A152-A152, ISSN: 0735-1097

Journal article

Iqbal MB, Ilsley CD, Mikhail G, Khamis R, Archbold A, Crake T, Firoozi S, Kalra SS, Knight C, Lim P, Mathur A, Meier P, Rakhit R, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy PA, Dalby MC, Malik ISet al., 2014, Acute Myocardial Infarction (TCT-9 to TCT-62), Journal of the American College of Cardiology, Vol: 64

Journal article

Iqbal MB, Arujuna A, Archbold A, Crake T, Firoozi S, Kalra SS, Knight C, Lim P, Malik IS, Mathur A, Meier P, Rakhit R, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy PA, Dalby MCet al., 2013, Superior Outcomes Associated With Radial Versus Femoral Access In Non-ST Elevation Myocardial Infarction: An Observational Cohort Study of 10,095 patients. Results Of The Radial Versus Femoral Access In Mortality Reduction In Non-ST Elevation Myocardial Infarction (REALITY-NSTEMI) Study, 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B14-B14, ISSN: 0735-1097

Conference paper

Iqbal MB, Kabir T, Archbold A, Crake T, Firoozi S, Kalra SS, Knight C, Lim P, Malik IS, Mathur A, Meier P, Rakhit R, Redwood S, Whitbread M, Bromage D, Rathod K, Wragg A, MacCarthy PA, Dalby MCet al., 2013, Effect Of Drug-Eluting Stents Versus Bare-Metal stents On Long-Term Mortality Following Rotational Atherectomy For Complex Calcific Coronary Lesions, 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B63-B63, ISSN: 0735-1097

Conference paper

Iqbal MB, Hadjiloizou N, Kabir T, Archbold A, Crake T, Firoozi S, Kalra SS, Knight C, Lim P, Malik IS, Mathur A, Meier P, Rakhit R, Redwood S, Whitbread M, Rathod K, Bromage D, Wragg A, MacCarthy PA, Dalby MCet al., 2013, Drug-Eluting Stents Are Superior To Bare Metal Stents In Reducing Mortality In Cardiogenic Shock Complicating ST-Elevation Myocardial Infarction, 25th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B79-B79, ISSN: 0735-1097

Conference paper

Dalby M, Whitbread M, 2013, The role of the emergency services in the optimisation of primary angioplasty: experience from London and the Heart Attack Team, EUROINTERVENTION, Vol: 9, Pages: 517-523, ISSN: 1774-024X

Journal article

Apps A, Malhotra A, Tarkin J, Smith R, Kabir T, Lane R, Mason M, Ali O, Rogers P, Banya W, Whitbread M, Ilsley C, Dalby Met al., 2013, High incidence of acute coronary occlusion in patients without protocol positive ST segment elevation referred to an open access primary angioplasty programme, POSTGRADUATE MEDICAL JOURNAL, Vol: 89, Pages: 376-381, ISSN: 0032-5473

Journal article

Modi BN, Jones DA, Rathod KS, Akhtar M, Jain AK, Kalra SS, Crake T, Meier P, Astroulakis Z, Dollery C, Ozkur M, Rakhit R, Knight CJ, Dalby MC, Malik IS, Bunce N, Lim P, Virdi G, Whitbread M, Weerackody R, Mathur A, Redwood S, MacCarthy PA, Wragg Aet al., 2013, MECHANICAL THROMBECTOMY USE IS ASSOCIATED WITH DECREASED MORTALITY IN PATIENTS TREATED WITH PRIMARY PERCUTANEOUS CORONARY INTERVENTION (9935 PATIENTS FROM THE LONDON HEART ATTACK GROUP), Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: BMJ PUBLISHING GROUP, ISSN: 1355-6037

Conference paper

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