Imperial College London

ProfessorRoxySenior

Faculty of MedicineNational Heart & Lung Institute

Professor of Clinical Cardiology
 
 
 
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Contact

 

+44 (0)20 7351 8635r.senior

 
 
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Location

 

Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

461 results found

Hochman JS, Anthopolos R, Reynolds HR, Bangalore S, Xu Y, O'Brien SM, Mavromichalis S, Chang M, Contreras A, Rosenberg Y, Kirby R, Bhargava B, Senior R, Banfield A, Goodman SG, Lopes RD, Pracon R, López-Sendón J, Maggioni AP, Newman JD, Berger JS, Sidhu MS, White HD, Troxel AB, Harrington RA, Boden WE, Stone GW, Mark DB, Spertus JA, Maron DJ, ISCHEMIA-EXTEND Research Groupet al., 2022, Survival After Invasive or Conservative Management of Stable Coronary Disease., Circulation

Background: The ISCHEMIA trial compared an initial invasive versus an initial conservative management strategy for patients with chronic coronary disease and moderate or severe ischemia, with no major difference in most outcomes over a median of 3.2 years. Extended follow-up for mortality is ongoing. Methods: ISCHEMIA participants were randomized to an initial invasive strategy (INV) added to guideline-directed medical therapy or a conservative strategy (CON). Patients with moderate or severe ischemia, ejection fraction ≥35%, and no recent acute coronary syndromes were included. Those with an unacceptable level of angina were excluded. Extended follow-up for vital status is being conducted by sites or through central death index search. Data obtained through December 2021 are included in this interim report. We analyzed all-cause, cardiovascular, and non-cardiovascular mortality by randomized strategy, using nonparametric cumulative incidence estimators, Cox regression models and Bayesian methods. Undetermined deaths were classified as cardiovascular as pre-specified in the trial protocol. Results: Baseline characteristics for 5179 original ISCHEMIA trial participants included median age 65 years, 23 % women, 16% Hispanic, 4% Black, 42% diabetes, and median EF 0.60. A total of 557 deaths accrued over a median follow-up of 5.7 years, with 268 of these added in the extended follow-up phase. This included a total of 343 cardiovascular deaths, 192 non-cardiovascular deaths and 22 unclassified deaths. All-cause mortality was not different between randomized treatment groups (7-year rate 12.7% in INV, 13.4% in CON; adjusted hazard ratio (HR)=1.00, 95% CI: 0.85-1.18). There was a lower 7-year rate cardiovascular mortality (6.4% vs. 8.6%, adjusted HR=0.78, 95% CI: 0.63-0.96) with an initial invasive strategy but a higher 7-year rate of non-cardiovascular mortality (5.6% vs. 4.4%, adjusted HR=1.44, 95% CI: 1.08-1.91) compared with the conservative strategy. No heterogenei

Journal article

Tang HS, Kwan CT, He J, Ng PP, Hai SHJ, Kwok FYJ, Sze HF, So MH, Lo HY, Fong HTA, Wan EYF, Lee C-H, Yu EYT, Lai YTA, Lee CYJ, Leung ST, Chan HL, Tse HF, Pennell DJ, Mohiaddin RH, Senior R, Yan A, Yiu K-H, Ng M-Yet al., 2022, Prognostic Utility of Cardiac MRI Myocardial Strain Parameters in Patients With Ischemic and Nonischemic Dilated Cardiomyopathy: A Multicenter Study., AJR Am J Roentgenol

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: 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) <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, global circumferential, 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 performed to determine associations between strain parameters and the composite outcome. Results: Mean LV EF was 27.5%, and mean LV GLS was -6.9%. 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 right ventricular (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 models (p>.05). A LV GLS threshold of

Journal article

Reynolds HR, Diaz A, Cyr DD, Shaw LJ, Mancini GBJ, Leipsic J, Budoff MJ, Min JK, Hague CJ, Berman DS, Chaitman BR, Picard MH, Hayes SW, Scherrer-Crosbie M, Kwong RY, Lopes RD, Senior R, Dwivedi SK, Miller TD, Chow BJW, de Silva R, Stone GW, Boden WE, Bangalore S, O'Brien SM, Hochman JS, Maron DJ, ISCHEMIA Research Groupet al., 2022, Ischemia With Nonobstructive Coronary Arteries: Insights From the ISCHEMIA Trial., JACC Cardiovasc Imaging

BACKGROUND: Ischemia with nonobstructive coronary arteries (INOCA) is common clinically, particularly among women, but its prevalence among patients with at least moderate ischemia and the relationship between ischemia severity and non-obstructive atherosclerosis severity are unknown. OBJECTIVES: The authors investigated predictors of INOCA in enrolled, nonrandomized participants in ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), sex differences, and the relationship between ischemia and atherosclerosis in patients with INOCA. METHODS: Core laboratories independently reviewed screening noninvasive stress test results (nuclear imaging, echocardiography, magnetic resonance imaging or nonimaging exercise tolerance testing), and coronary computed tomography angiography (CCTA), blinded to results of the screening test. INOCA was defined as all stenoses <50% on CCTA in a patient with moderate or severe ischemia on stress testing. INOCA patients, who were excluded from randomization, were compared with randomized participants with ≥50% stenosis in ≥1 vessel and moderate or severe ischemia. RESULTS: Among 3,612 participants with core laboratory-confirmed moderate or severe ischemia and interpretable CCTA, 476 (13%) had INOCA. Patients with INOCA were younger, were predominantly female, and had fewer atherosclerosis risk factors. For each stress testing modality, the extent of ischemia tended to be less among patients with INOCA, particularly with nuclear imaging. There was no significant relationship between severity of ischemia and extent or severity of nonobstructive atherosclerosis on CCTA. On multivariable analysis, women female sex was independently associated with INOCA (odds ratio: 4.2 [95% CI: 3.4-5.2]). CONCLUSIONS: Among participants enrolled in ISCHEMIA with core laboratory-confirmed moderate or severe ischemia, the prevalence of INOCA was 13%. Severity of ischemia was not assoc

Journal article

Porter TR, Feinstein SB, Senior R, Mulvagh SL, Nihoyannopoulos P, Strom JB, Mathias W, Gorman B, Rabischoffsky A, Main ML, Appis Aet al., 2022, CEUS cardiac exam protocols International Contrast Ultrasound Society (ICUS) recommendations, ECHO RESEARCH AND PRACTICE, Vol: 9, ISSN: 2055-0464

Journal article

Bangalore S, Spertus JA, Stevens SR, Jones PG, Mancini GBJ, Leipsic J, Reynolds HR, Budoff MJ, Hague CJ, Min JK, Boden WE, O'Brien SM, Harrington RA, Berger JS, Senior R, Peteiro J, Pandit N, Bershtein L, de Belder MA, Szwed H, Doerr R, Monti L, Alfakih K, Hochman JS, Maron DJet al., 2022, Outcomes With Intermediate Left Main Disease: Analysis From the ISCHEMIA Trial, CIRCULATION-CARDIOVASCULAR INTERVENTIONS, Vol: 15, ISSN: 1941-7640

Journal article

Hampson R, Botrous C, Chahal N, Senior Ret al., 2022, Feasibility, efficacy and safety of exercise stress echocardiography during the COVID-19 pandemic, OPEN HEART, Vol: 9, ISSN: 2053-3624

Journal article

Cosyns B, Helfen A, Leong-Poi H, Senior Ret al., 2022, How to perform an ultrasound contrast myocardial perfusion examination?, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 23, Pages: 727-729, ISSN: 2047-2404

Journal article

Senior R, Reynolds HR, Min JK, Berman DS, Picard MH, Chaitman BR, Shaw LJ, Page CB, Govindan SC, Lopez-Sendon J, Peteiro J, Wander GS, Drozdz J, Marin-Neto J, Selvanayagam JB, Newman JD, Thuaire C, Christopher J, Jang JJ, Kwong RY, Bangalore S, Stone GW, Brien SM, Boden WE, Maron DJ, Hochman JSet al., 2022, Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 79, Pages: 651-661, ISSN: 0735-1097

Journal article

Surkova E, Kovacs A, Lakatos BK, Tokodi M, Fabian A, West C, Senior R, Li Wet al., 2021, Contraction patterns of the systemic right ventricle: a three-dimensional echocardiography study, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, ISSN: 2047-2404

Journal article

Yakupoglu HY, Saeed S, Senior R, Baksi AJ, Lyon AR, Khattar RSet al., 2021, Reversible exercise-induced left ventricular dysfunction in symptomatic patients with previous Takotsubo syndrome: insights from stress echocardiography, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 1405-1412, ISSN: 2047-2404

Conference paper

Vamvakidou A, Danylenko O, Pradhan J, Kelshiker M, Jones T, Whiteside D, Sethi A, Senior Ret al., 2021, Relative clinical value of coronary computed tomography and stress echocardiography-guided management of stable chest pain patients: a propensity-matched analysis, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 22, Pages: 1473-1481, ISSN: 2047-2404

Journal article

Zhou X, Toulemonde M, Zhou X, Hansen-Shearer J, Senior R, Tang M-Xet al., 2021, Volumetric Flow Estimation in a Coronary Artery Phantom Using High-Frame-Rate Contrast-Enhanced Ultrasound, Speckle Decorrelation, and Doppler Flow Direction Detection, IEEE TRANSACTIONS ON ULTRASONICS FERROELECTRICS AND FREQUENCY CONTROL, Vol: 68, Pages: 3299-3308, ISSN: 0885-3010

Journal article

Vamvakidou A, Annabi M-S, Pibarot P, Plonska-Gosciniak E, Almeida AG, Guzzetti E, Dahou A, Burwash IG, Koschutnik M, Bartko PE, Bergler-Klein J, Mascherbauer J, Orwat S, Baumgartner H, Cavalcante J, Pinto F, Kukulski T, Kasprzak JD, Clavel M-A, Flachskampf FA, Senior Ret al., 2021, Clinical Value of Stress Transaortic Flow Rate During Dobutamine Echocardiography in Reduced Left Ventricular Ejection Fraction, Low-Gradient Aortic Stenosis: A Multicenter Study, CIRCULATION-CARDIOVASCULAR IMAGING, Vol: 14, ISSN: 1941-9651

Journal article

Jenkins S, Alabed S, Swift A, Marques G, Ryding A, Sawh C, Wardley J, Shah BN, Swoboda P, Senior R, Nijveldt R, Vassiliou VS, Garg Pet al., 2021, Diagnostic accuracy of handheld cardiac ultrasound device for assessment of left ventricular structure and function: systematic review and meta-analysis, HEART, Vol: 107, Pages: 1826-1834, ISSN: 1355-6037

Journal article

Bioh G, Botrous C, Howard E, Patel A, Hampson R, Senior Ret al., 2021, Prevalence of cardiac pathology and relation to mortality in a multiethnic population hospitalised with COVID-19, OPEN HEART, Vol: 8, ISSN: 2053-3624

Journal article

Newman JD, Anthopolos R, Mancini GBJ, Bangalore S, Reynolds HR, Kunichoff DF, Senior R, Peteiro J, Bhargava B, Garg P, Escobedo J, Doerr R, Mazurek T, Gonzalez-Juanatey J, Gajos G, Briguori C, Cheng H, Vertes A, Mahajan S, Guzman LA, Keltai M, Maggioni AP, Stone GW, Berger JS, Rosenberg YD, Boden WE, Chaitman BR, Fleg JL, Hochman JS, Maron DJet al., 2021, Outcomes of Participants With Diabetes in the ISCHEMIA Trials, CIRCULATION, Vol: 144, Pages: 1380-1395, ISSN: 0009-7322

Journal article

Senior R, Khattar R, 2021, Stress echocardiography: the quest for risk stratification beyond myocardial ischaemia, EUROPEAN HEART JOURNAL, Vol: 42, Pages: 3879-3881, ISSN: 0195-668X

Journal article

Seitler S, Al-Sakini N, Lacerna A, Flick C, West C, Senior R, Gatzoulis MA, Li Wet al., 2021, Long term outcomes for adults with complete atrioventricular septal defects, Publisher: OXFORD UNIV PRESS, Pages: 1874-1874, ISSN: 0195-668X

Conference paper

Shah BN, Senior R, 2021, Discordant moderate aortic stenosis: is it clinically important?, OPEN HEART, Vol: 8, ISSN: 2053-3624

Journal article

Reynolds HR, Picard MH, Spertus JA, Peteiro J, Lopez Sendon JL, Senior R, El-Hajjar MC, Celutkiene J, Shapiro MD, Pellikka PA, Kunichoff DF, Anthopolos R, Alfakih K, Abdul-Nour K, Khouri M, Bershtein L, De Belder M, Poh KK, Beltrame JF, Min JK, Fleg JL, Li Y, Maron DJ, Hochman JSet al., 2021, Natural History of Patients With Ischemia and No Obstructive Coronary Artery Disease The CIAO-ISCHEMIA Study, CIRCULATION, Vol: 144, Pages: 1008-1023, ISSN: 0009-7322

Journal article

Agostini D, Ananthasubramaniam K, Chandna H, Friberg L, Hudnut A, Koren M, Miyamoto MI, Senior R, Shah M, Travin MI, vom Dahl J, Chen K, Levy WCet al., 2021, Prognostic usefulness of planar I-123-MIBG scintigraphic images of myocardial sympathetic innervation in congestive heart failure: Follow-Up data from ADMIRE-HF, JOURNAL OF NUCLEAR CARDIOLOGY, Vol: 28, Pages: 1490-1503, ISSN: 1071-3581

Journal article

Chahal NS, Senior R, 2021, Severe Patient-Prosthesis Mismatch Compelling Entity or an Epiphenomenon of Low Flow?, CIRCULATION-CARDIOVASCULAR IMAGING, Vol: 14, ISSN: 1941-9651

Journal article

Lindner JR, Belcik T, Main ML, Montanaro A, Mulvagh SL, Olson J, Olyaei A, Porter TR, Senior Ret al., 2021, Expert Consensus Statement from the American Society of Echocardiography on Hypersensitivity Reactions to Ultrasound Enhancing Agents in Patients with Allergy to Polyethylene Glycol, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 34, Pages: 707-708, ISSN: 0894-7317

Journal article

Senior R, Lindner JR, Edvardsen T, Cosyns Bet al., 2021, Ultrasound contrast agent hypersensitivity in patients allergic to polyethylene glycol: position statement by the European Association of Cardiovascular Imaging, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 22, Pages: 959-960, ISSN: 2047-2404

Journal article

Woodward W, Dockerill C, McCourt A, Upton R, O'Driscoll J, Balkhausen K, Chandrasekaran B, Firoozan S, Kardos A, Wong K, Woodward G, Sarwar R, Sabharwal N, Benedetto E, Spagou N, Sharma R, Augustine D, Tsiachristas A, Senior R, Leeson P, Boardman H, D'Arcy J, Abraheem A, Banypersad S, Boos C, Bulugahapitiya S, Butts J, Coles D, Easaw J, Hamdan H, Jamil-Copley S, Kanaganayagam G, Mwambingu T, Pantazis A, Papachristidis A, Rajani R, Rasheed MA, Razvi NA, Rekhraj S, Ripley DP, Rose K, Scheuermann-Freestone M, Schofield R, Sultan Aet al., 2021, Real-world performance and accuracy of stress echocardiography: the EVAREST observational multi-centre study, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 23, Pages: 689-698, ISSN: 2047-2404

Journal article

Khattar RS, Senior R, 2021, Stress Echocardiography and Carotid Ultrasound: Combined Use for the Assessment of Coronary Artery Disease?, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 34, Pages: 625-628, ISSN: 0894-7317

Journal article

Radhakrishnan A, Pickup L, Price A, Law J, Fabritz L, Senior R, Richard P, Ferro C, Townend Jet al., 2021, MYOCARDIAL FIBROSIS IS ASSOCIATED WITH REDUCED CORONARY FLOW VELOCITY RESERVE IN END-STAGE RENAL DISEASE, Publisher: BMJ PUBLISHING GROUP, Pages: A123-A125, ISSN: 1355-6037

Conference paper

Radhakrishnan A, Pickup LC, Price AM, Law JP, McGee KC, Fabritz L, Senior R, Steeds RP, Ferro CJ, Townend JNet al., 2021, Coronary microvascular dysfunction is associated with degree of anaemia in end-stage renal disease, BMC CARDIOVASCULAR DISORDERS, Vol: 21, ISSN: 1471-2261

Journal article

Saeed S, Vamvakidou A, Zidros S, Papasozomenos G, Lysne V, Khattar RS, Senior Ret al., 2021, Sex differences in transaortic flow rate and association with all-cause mortality in patients with severe aortic stenosis, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 22, Pages: 977-982, ISSN: 2047-2404

Journal article

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