Publications
394 results found
Tang HS, Kwan CT, He J, et al., 2023, Prognostic Utility of Cardiac MRI Myocardial Strain Parameters in Patients With Ischemic and Nonischemic Dilated Cardiomyopathy: A Multicenter Study., AJR Am J Roentgenol, Vol: 220, Pages: 524-538
BACKGROUND. Prior small single-center studies have yielded conflicting results regarding the prognostic significance of myocardial strain parameters derived from feature tracking (FT) on cardiac MRI in patients with dilated cardiomyopathy (DCM). OBJECTIVE. The purpose of this study was to evaluate the prognostic utility of FT parameters on cardiac MRI in patients with ischemic and nonischemic DCM and to determine the optimal strain parameter for outcome prediction. METHODS. This retrospective study included 471 patients (median age, 61 years; 365 men, 106 women) with ischemic (n = 233) or nonischemic (n = 238) DCM and left ventricular (LV) ejection fraction (EF) less than 50% who underwent cardiac MRI at any of four centers from January 2011 to December 2019. Cardiac MRI parameters were determined by manual contouring. In addition, software-based FT was used to calculate six myocardial strain parameters (LV and right ventricular [RV] global radial strain, global circumferential strain, and global longitudinal strain [GLS]). Late gadolinium enhancement (LGE) was also evaluated. Patients were assessed for a composite outcome of all-cause mortality and/or heart-failure hospitalization. Cox regression models were used to determine associations between strain parameters and the composite outcome. RESULTS. Mean LV EF was 27.5% and mean LV GLS was -6.9%. The median follow-up period was 1328 days. The composite outcome occurred in 220 patients (125 deaths, 95 heart-failure hospitalizations). All six myocardial strain parameters were significant independent predictors of the composite outcome (hazard ratio [HR] = 0.92-1.16; all p < .05). In multivariable models that included age, corrected LV and RV end-diastolic volume, LV and RV EF, and presence of LGE, the only strain parameter that was a significant independent predictor of the composite outcome was LV GLS (HR = 1.13, p = .006); LV EF and presence of LGE were not independent predictors of the composite outcome in the
Mohiaddin R, Hatipoglu S, 2023, Diagnosis of cardiac sarcoidosis in patients presenting with cardiac arrest or life-threatening arrhythmias, Heart, Pages: 1-8, ISSN: 1355-6037
Objective Cardiac sarcoidosis (CS) may present with cardiac arrest or life-threatening arrhythmias. There are limited data on this subgroup of patients with CS. Advanced imaging including cardiovascular magnetic resonance (CMR) and cardiac 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) are used for diagnosis. This study aimed to describe advanced imaging patterns suggestive of CS among patients presenting with cardiac arrest or life-threatening arrhythmias.Methods An imaging database of a CS referral centre (Royal Brompton Hospital, London) was screened for patients presenting with cardiac arrest or life-threatening arrhythmias and having imaging features of suspected CS. Patients diagnosed with definite or probable/possible CS were included.Results Study population included 60 patients (median age 49 years) with male predominance (76.7%). The left ventricle was usually non-dilated with mildly reduced ejection fraction (53.4±14.8%). CMR studies showed extensive late gadolinium enhancement (LGE) with 5 (4–8) myocardial segments per patient affected; the right ventricular (RV) side of the septum (28/45) and basal anteroseptum (28/45) were most frequently involved. Myocardial inflammation by FDG-PET was detected in 45 out of 58 patients vs 11 out of 33 patients with oedema imaging available on CMR. When PET was treated as reference to detect myocardial inflammation, CMR oedema imaging was 33.3% sensitive and 77% specific.Conclusions In patients with CS presenting with cardiac arrest or life-threatening arrhythmias, LGE was located in areas where the cardiac conduction system travels (basal anteroseptal wall and RV side of the septum). While CMR was the imaging technique that raised possibility of cardiac scarring, oedema imaging had low sensitivity to detect myocardial inflammation compared with FDG-PET.
Krupickova S, Voges I, Mohiaddin R, et al., 2023, Short-term outcome of late gadolinium changes detected on cardiovascular magnetic resonance imaging following coronavirus disease 2019 Pfizer/BioNTech vaccine-related myocarditis in adolescents, PEDIATRIC RADIOLOGY, ISSN: 0301-0449
Androulakis E, Azzu A, Papagkikas P, et al., 2022, Spontaneous coronary artery dissection: current evidence from cardiac magnetic resonance and angiography screening, Publisher: OXFORD UNIV PRESS, Pages: 298-298, ISSN: 0195-668X
Nazir MS, Okafor J, Murphy T, et al., 2022, LVEF MEASURED WITH SAME DAY ECHOCARDIOGRAPHY AND CMR IN PATIENTS WITH SUSPECTED CARDIOTOXICITY, BSCI/BSCCT Annual Meeting, Publisher: BMJ PUBLISHING GROUP, Pages: A11-A11, ISSN: 1355-6037
Fong LCW, Lee NHC, Poon JWL, et al., 2022, Prognostic value of cardiac magnetic resonance derived global longitudinal strain analysis in patients with ischaemic and non-ischaemic dilated cardiomyopathy: a systematic review and meta-analysis, INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol: 38, Pages: 2707-2721, ISSN: 1569-5794
Antonopoulos AS, Azzu A, Mohiaddin RH, 2022, Myocardial fibrosis pattern in dilated cardiomyopathy: not every rounded thing is an orange!, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 23, Pages: E474-E475, ISSN: 2047-2404
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- Citations: 1
Azzu A, Antonopoulos AS, Krupickova S, et al., 2022, Myocardial strain analysis by cardiac magnetic resonance 3D feature-tracking identifies subclinical abnormalities in patients with neuromuscular disease and no overt cardiac involvement, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, ISSN: 2047-2404
Hatipoglu S, Mohiaddin RH, Gatehouse P, et al., 2022, Performance of artificial intelligence for biventricular cardiovascular magnetic resonance volumetric analysis in the clinical setting, INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol: 38, Pages: 2413-2424, ISSN: 1569-5794
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- Citations: 1
Androulakis E, Mohiaddin R, Bratis K, 2022, Magnetic resonance coronary angiography in the era of multimodality imaging, CLINICAL RADIOLOGY, Vol: 77, Pages: E89-E99, ISSN: 0009-9260
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- Citations: 1
Androulakis E, Azzu A, Papagkikas P, et al., 2022, Spontaneous Coronary Artery Dissection: Insights From Cardiac Magnetic Resonance and Extracoronary Arterial Screening, CIRCULATION, Vol: 145, Pages: 555-557, ISSN: 0009-7322
Arzanauskaite M, Cookson S, Mohiaddin RH, 2022, Long-standing Cannonball Metastases in Myxoid Chondrosarcoma: Multimodality Appearances of the Radiological Sign, ARCHIVOS DE BRONCONEUMOLOGIA, Vol: 58, Pages: 171-171, ISSN: 0300-2896
Jun C, Zhang H, Mohiaddin R, et al., 2022, Adaptive hierarchical dual consistency for semi-supervised left atrium segmentation on cross-domain data, IEEE Transactions on Medical Imaging, Vol: 41, Pages: 420-433, ISSN: 0278-0062
Semi-supervised learning provides great significance in left atrium (LA) segmentation model learning with insufficient labelled data. Generalising semi supervised learning to cross-domain data is of high importance to further improve model robustness. However, the widely existing distribution difference and sample mismatch between different data domains hinder the generalisation of semi-supervised learning. In this study, we alleviate these problems by proposing an Adaptive Hier10 archical Dual Consistency (AHDC) for the semi-supervised LA segmentation on cross-domain data. The AHDC mainlyconsists of a Bidirectional Adversarial Inference module (BAI) and a Hierarchical Dual Consistency learning module (HDC). The BAI overcomes the difference of distributions and the sample mismatch between two different domains. It mainly learns two mapping networks adversarially to obtain two matched domains through mutual adaptation. The HDC investigates a hierarchical dual learning paradigm for cross-domain semi-supervised segmentation based on the obtained matched domains. It mainly builds two dual modelling networks for mining the complementary information in both intra-domain and inter-domain. For the intra domain learning, a consistency constraint is applied to the dual-modelling targets to exploit the complementary modelling information. For the inter-domain learning, a consistency constraint is applied to the LAs modelled by two dual modelling networks to exploit the complementary knowl28 edge among different data domains. We demonstrated the performance of our proposed AHDC on four 3D late gadolinium enhancement cardiac MR (LGE-CMR) datasets fromdifferent centres and a 3D CT dataset. Compared to otherstate-of-the-art methods, our proposed AHDC achievedhigher segmentation accuracy, which indicated its capability in the cross-domain semi-supervised LA segmentation.
Musella F, Azzu A, Antonopoulos AS, et al., 2022, Comprehensive mitral valve prolapse assessment by cardiovascular MRI, CLINICAL RADIOLOGY, Vol: 77, Pages: E120-E129, ISSN: 0009-9260
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- Citations: 1
Mohiaddin RH, 2022, WSS for Predicting BAV Aortopathy Growth Good as Gold or a Sheer Wall Street Speculation? COMMENT, JACC-CARDIOVASCULAR IMAGING, Vol: 15, Pages: 43-45, ISSN: 1936-878X
Chen J, Yang G, Khan H, et al., 2022, JAS-GAN: generative adversarial network based joint atrium and scar segmentations on unbalanced atrial targets, IEEE Journal of Biomedical and Health Informatics, Vol: 26, Pages: 103-114, ISSN: 2168-2194
Automated and accurate segmentation of the left atrium (LA) and atrial scars from late gadolinium-enhanced cardiac magnetic resonance (LGE CMR) images are in high demand for quantifying atrial scars. The previous quantification of atrial scars relies on a two-phase segmentation for LA and atrial scars due to their large volume difference (unbalanced atrial targets). In this paper, we propose an inter-cascade generative adversarial network, namely JAS-GAN, to segment the unbalanced atrial targets from LGE CMR images automatically and accurately in an end-to-end way. Firstly, JAS-GAN investigates an adaptive attention cascade to automatically correlate the segmentation tasks of the unbalanced atrial targets. The adaptive attention cascade mainly models the inclusion relationship of the two unbalanced atrial targets, where the estimated LA acts as the attention map to adaptively focus on the small atrial scars roughly. Then, an adversarial regularization is applied to the segmentation tasks of the unbalanced atrial targets for making a consistent optimization. It mainly forces the estimated joint distribution of LA and atrial scars to match the real ones. We evaluated the performance of our JAS-GAN on a 3D LGE CMR dataset with 192 scans. Compared with state-of-the-art methods, our proposed approach yielded better segmentation performance (Average Dice Similarity Coefficient (DSC) values of 0.946 and 0.821 for LA and atrial scars, respectively), which indicated the effectiveness of our proposed approach for segmenting unbalanced atrial targets.
Antonopoulos AS, Boutsikou M, Simantiris S, et al., 2021, Machine learning of native T1 mapping radiomics for classification of hypertrophic cardiomyopathy phenotypes, SCIENTIFIC REPORTS, Vol: 11, ISSN: 2045-2322
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- Citations: 8
Krupickova S, Bautista-Rodriguez C, Hatipoglu S, et al., 2021, Myocardial deformation assessed by CMR in children after multisystem inflammatory syndrome (MIS-C), INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 346, Pages: 105-106, ISSN: 0167-5273
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- Citations: 3
Mahon C, Mohiaddin RH, 2021, Cardiovascular magnetic resonance for selecting anatomically suitable patients for transcatheter aortic valve implantation: should it be rolled out or ruled out?, EUROPEAN HEART JOURNAL-CASE REPORTS, Vol: 5
Antonopoulos AS, Azzu A, Androulakis E, et al., 2021, Eosinophilic heart disease: diagnostic and prognostic assessment by cardiac magnetic resonance, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 22, Pages: 1273-1284, ISSN: 2047-2404
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- Citations: 1
Antonopoulos A, Boutsikou M, Simantiris S, et al., 2021, Myocardial tissue phenotyping by radiomic features of native T1 maps and machine learning enhances disease detection and classification, Publisher: OXFORD UNIV PRESS, Pages: 221-221, ISSN: 0195-668X
Wustmann K, Constantine A, Davies JE, et al., 2021, Prognostic implications of pulmonary wave reflection and reservoir pressure in patients with pulmonary hypertension, International Journal of Cardiology: Congenital Heart Disease, Vol: 5, Pages: 1-8, ISSN: 2666-6685
BackgroundRight ventricular (RV) coupling to the pulmonary circulation influences the response of the RV to the increased afterload caused by pulmonary hypertension (PH), which ultimately determines prognosis. A methodology that accounts for pulsatile flow is required when assessing ventriculo-arterial coupling. We applied wave intensity analysis (WIA) methods to assess the compliance of the main pulmonary artery (PA) in patients with or without PH and compared this to PA distensibility, RV function and clinical outcomes.MethodsHigh-fidelity blood pressure and Doppler flow velocity tracings were obtained simultaneously during cardiac catheterisation for suspected PH. RV volumes, main PA distensibility and ventriculo-arterial coupling (Emax/Ea) were analysed using cardiovascular magnetic resonance.ResultsThe study included 17 PH patients and 6 controls. Wave speed, reservoir and excess pressure were higher in PH patients compared to controls (p < 0.01 for all). Waveforms relating to RV ejection, microvascular wave reflection and late systolic proximal deceleration were higher in PH patients compared to controls (p < 0.01 for all) and related to echocardiographic findings, including PA Doppler notching and shortened acceleration time. Wave speed, reservoir pressure and excess pressure were strongly correlated to main PA distensibility, RV function and Emax/Ea. A higher total pressure integral was associated with an increased risk of death (all-cause mortality).ConclusionThe reservoir-excess pressure model, in combination with conventional clinical imaging, provides valuable information on the pathophysiology of PH that standard haemodynamic parameters do not. Future studies should further investigate the prognostic implications of WIA in PH, and its potential role in clinical practice.
Azzu A, Morosin M, Antonopoulos AS, et al., 2021, Cardiac Decompression by Pericardiectomy for Constrictive Pericarditis: Multimodality Imaging to Identify Patients at Risk for Prolonged Inotropic Support., J Cardiovasc Imaging, Vol: 29, Pages: 361-372
BACKGROUND: Post-pericardiectomy right ventricular (RV) failure has been reported but it remains not well-studied. To investigate imaging parameters that could predict RV function and the outcome of patients post-pericardiectomy. METHODS: We analysed data from a total of 53 CP patients undergoing pericardiectomy. Preoperative, early and at 6 months postoperative echocardiographic (echo) imaging datasets were analysed and correlated with preoperative cardiac magnetic resonance (CMR), cardiac computed tomography scans and histology. The primary endpoint of the study was RV functional status early postoperatively and at 6 months. Secondary endpoint was the need for prolonged inotropic support. RESULTS: A cause of CP was identified in 26 patients (49%). Inotropic support ≥ 48 hours was required in n = 28 (53%) of patients and was correlated with lower preoperative RV areas by echo or RV volumes by CMR (p < 0.05 for all). A pericardial score based on pericardial thickness/calcification and epicardial fat thickness had good diagnostic accuracy to identify patients requiring prolonged use of inotropes (area under the curve, 0.825; 95% confidence interval, 0.674-0.976). Pericardiectomy resulted in RV decompression and impaired RV function early postoperatively (fractional area change: 40.5% ± 8.8% preoperatively vs. 31.4% ± 10.4% early postoperatively vs. 42.5% ± 10.2% at 6 months, p < 0.001). CONCLUSIONS: We show that a smaller RV cavity size and a pericardial scoring system are associated with prolonged inotropic support in CP patients undergoing pericardiectomy. RV systolic impairment post decompression is present in most patients, but it is only transient.
Haldar S, Khan HR, Boyalla V, et al., 2021, Thoracoscopic surgical ablation versus catheter ablation as first-line treatment for long-standing persistent atrial fibrillation: the CASA-AF RCT, Efficacy and Mechanism Evaluation, Vol: 8, Pages: 1-122, ISSN: 2050-4365
<jats:sec id="abs1-1"> <jats:title>Background</jats:title> <jats:p>Standalone thoracoscopic surgical ablation may be more effective than catheter ablation in patients with long-standing persistent atrial fibrillation.</jats:p> </jats:sec> <jats:sec id="abs1-2"> <jats:title>Objectives</jats:title> <jats:p>To determine whether or not surgical ablation is clinically superior to catheter ablation as the first-line treatment strategy in long-standing persistent atrial fibrillation.</jats:p> </jats:sec> <jats:sec id="abs1-3"> <jats:title>Design</jats:title> <jats:p>This was a prospective, multicentre, randomised control trial.</jats:p> </jats:sec> <jats:sec id="abs1-4"> <jats:title>Setting</jats:title> <jats:p>Four NHS tertiary centres in England.</jats:p> </jats:sec> <jats:sec id="abs1-5"> <jats:title>Participants</jats:title> <jats:p>Adults with long-standing persistent atrial fibrillation, who had European Heart Rhythm Association symptom scores > 2 and who were naive to previous catheter ablation or thoracic/cardiac surgery.</jats:p> </jats:sec> <jats:sec id="abs1-6"> <jats:title>Interventions</jats:title> <jats:p>Minimally invasive thoracoscopic surgical ablation and conventional catheter ablation (control intervention).</jats:p> </jats:sec> <jats:sec id="abs1-7"> <jats:title>Mai
Bermejo IA, Bautista-Rodriguez C, Fraisse A, et al., 2021, Short-Term Sequelae of Multisystem Inflammatory Syndrome in Children Assessed by CMR (vol 14, pg 1666, 2021), JACC-CARDIOVASCULAR IMAGING, Vol: 14, Pages: 1885-1885, ISSN: 1936-878X
Almogheer B, Antonopoulos AS, Azzu A, et al., 2021, Diagnostic and Prognostic Value of Cardiovascular Magnetic Resonance in Neuromuscular Cardiomyopathies, PEDIATRIC CARDIOLOGY, Vol: 43, Pages: 27-38, ISSN: 0172-0643
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- Citations: 1
Bermejo IA, Bautista-Rodriguez C, Fraisse A, et al., 2021, Short-Term sequelae of Multisystem Inflammatory Syndrome in Children Assessed by CMR, JACC-CARDIOVASCULAR IMAGING, Vol: 14, Pages: 1666-1667, ISSN: 1936-878X
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- Citations: 14
Hatipoglu S, Almogheer B, Mahon C, et al., 2021, Clinical Significance of Partial Anomalous Pulmonary Venous Connections (Isolated and Atrial Septal Defect Associated) Determined by Cardiovascular Magnetic Resonance, CIRCULATION-CARDIOVASCULAR IMAGING, Vol: 14, ISSN: 1941-9651
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- Citations: 3
Almogheer B, Antonopoulos A, Papagkikas P, et al., 2021, The Big Mitral Annulus Calcification (MAC) - Tissue Characterization and Assessment of Haemodynamic Impact Using Cardiac Magnetic Resonance -, CIRCULATION JOURNAL, Vol: 85, Pages: 315-315, ISSN: 1346-9843
Sardari A, Tabarsi P, Borhany H, et al., 2021, Myocarditis detected after COVID-19 recovery, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 22, Pages: 131-132, ISSN: 2047-2404
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- Citations: 21
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