Publications
487 results found
Vamvakidou A, Jin W, Danylenko O, et al., 2019, Impact of Pre-Intervention Transaortic Flow Rate Versus Stroke Volume Index on Mortality Across the Hemodynamic Spectrum of Severe Aortic Stenosis, JACC-CARDIOVASCULAR IMAGING, Vol: 12, Pages: 205-206, ISSN: 1936-878X
- Author Web Link
- Cite
- Citations: 14
Krupickova S, Li W, Cheang MH, et al., 2018, Ramipril and left ventricular diastolic function in stable patients with pulmonary regurgitation after repair of tetralogy of Fallot, Scientific Sessions of the American-Heart-Association / Resuscitation Science Symposium, Publisher: ELSEVIER IRELAND LTD, Pages: 64-69, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 11
Gurunathan S, Senior R, 2018, Catastrophic stroke in a patient with left ventricular non-compaction, Echo Research and Practice, Vol: 5, Pages: K59-K62, ISSN: 2055-0464
SummaryWe present the case of a 32-year-old man who presented with a remote history of chest pain and was diagnosed with non-compaction cardiomyopathy on echocardiography. On presentation, he was relatively asymptomatic with normal cardiac function. Unfortunately, he presented 1 year later with a catastrophic embolic stroke. LEARNING POINTS: Left ventricular non-compaction (LVNC) is a myocardial disorder characterised by prominent left ventricular (LV) trabeculae, a thin compacted layer and deep intertrabecular recesses.Two-dimensional echocardiography with colour Doppler is the study of choice for diagnosis and follow-up of LVNC. CMR serves an important role where adequate echocardiographic imaging cannot be obtained.LVNC is associated with high rates of mortality and morbidity in adults, including heart failure, thromboembolic events and tachyarrhythmias.
Manivarmane R, Khattar RS, Mirsadraee S, et al., 2018, A slowly growing mass in the left chest wall: additive value of real time myocardial contrast echocardiography, EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging, Vol: 19, Pages: 956-956, ISSN: 2047-2412
Karogiannis N, Vamvakidou A, Gurunathan S, et al., 2018, Long-Term Association of Dipyridamole Stress Myocardial Contrast Echocardiography versus Single-Photon Emission Computed Tomography with Clinical Outcomes in Patients with Known or Suspected Coronary Artery Disease, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 31, Pages: 860-869, ISSN: 0894-7317
- Author Web Link
- Cite
- Citations: 1
Surkova E, Senior R, Li W, 2018, Making complex pathology simple: added value of 3D transthoracic echocardiography in an adult patient with congenitally corrected transposition of great arteries and severe tricuspid regurgitation, EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging, Vol: jey100, ISSN: 2047-2412
Toulemonde MEG, Corbett R, Papadopoulou V, et al., 2018, High frame rate contrast echocardiography –in human demonstration, JACC: Cardiovascular Imaging, Vol: 11, Pages: 923-924, ISSN: 1936-878X
Gurunathan S, Zacharias K, Akhtar M, et al., 2018, Cost-effectiveness of a management strategy based on exercise echocardiography versus exercise electrocardiography in patients presenting with suspected angina during long term follow up: A randomized study, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 259, Pages: 1-7, ISSN: 0167-5273
IntroductionExercise ECG (Ex-ECG) is advocated by guidelines for patients with low - intermediate probability of coronary artery disease (CAD). However, there are no randomized studies comparing Ex-ECG with exercise stress echocardiography (ESE) evaluating long term cost-effectiveness of each management strategy.MethodsAccordingly, 385 patients with no prior CAD and low-intermediate probability of CAD (mean pre-test probability 34%), were randomized to undergo either Ex-ECG (194 patients) or ESE (191 patients). The primary endpoint was clinical effectiveness defined as the positive predictive value (PPV) for the detection of CAD of each test. Cost-effectiveness was derived using the cumulative costs incurred by each diagnostic strategy during a mean of follow up of 3.0 years.ResultsThe PPV of ESE and Ex-ECG were 100% and 64% (p = 0.04) respectively for the detection of CAD. There were fewer clinic (31 vs 59, p < 0.01) and emergency visits (14 vs 30, p = 0.01) and lower number of hospital bed days (8 vs 29, p < 0.01) in the ESE arm, with fewer patients undergoing coronary angiography (13.4% vs 6.3%, p = 0.02). The overall cumulative mean costs per patient were £796 for Ex-ECG and £631 for ESE respectively (p = 0.04) equating to a >20% reduction in cost with an ESE strategy with no difference in the combined end-point of death, myocardial infarction, unplanned revascularization and hospitalization for chest pain between ESE and Ex-ECG (3.2% vs 3.7%, p = 0.38).ConclusionIn patients with low to intermediate pretest probability of CAD and suspected angina, an ESE management strategy is cost-effective when compared with Ex-ECG during long term follow up.
Li Y, Ho CP, Toulemonde M, et al., 2018, Fully automatic myocardial segmentation of contrast echocardiography sequence using random forests guided by shape model, IEEE Transactions on Medical Imaging, Vol: 37, Pages: 1081-1091, ISSN: 0278-0062
Myocardial contrast echocardiography (MCE) is animaging technique that assesses left ventricle function and myocardialperfusion for the detection of coronary artery diseases.Automatic MCE perfusion quantification is challenging and requiresaccurate segmentation of the myocardium from noisy andtime-varying images. Random forests (RF) have been successfullyapplied to many medical image segmentation tasks. However, thepixel-wise RF classifier ignores contextual relationships betweenlabel outputs of individual pixels. RF which only utilizes localappearance features is also susceptible to data suffering fromlarge intensity variations. In this paper, we demonstrate howto overcome the above limitations of classic RF by presentinga fully automatic segmentation pipeline for myocardial segmentationin full-cycle 2D MCE data. Specifically, a statisticalshape model is used to provide shape prior information thatguide the RF segmentation in two ways. First, a novel shapemodel (SM) feature is incorporated into the RF frameworkto generate a more accurate RF probability map. Second, theshape model is fitted to the RF probability map to refineand constrain the final segmentation to plausible myocardialshapes. We further improve the performance by introducinga bounding box detection algorithm as a preprocessing stepin the segmentation pipeline. Our approach on 2D image isfurther extended to 2D+t sequences which ensures temporalconsistency in the final sequence segmentations. When evaluatedon clinical MCE datasets, our proposed method achieves notableimprovement in segmentation accuracy and outperforms otherstate-of-the-art methods including the classic RF and its variants,active shape model and image registration.
Vamvakidou A, Jin W, Danylenko O, et al., 2018, FLOW RATE NOT STROKE VOLUME IS A SUPERIOR PROGNOSTIC MARKER OF TRANSORTIC FLOW AND FLOW RESERVE IN PATIENTS WITH LOW-FLOW LOW-GRADIENT AORTIC STENOSIS UNDERGOING LOW-DOSE DOBUTAMINE ECHOCARDIOGRAPHY, 67th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 1458-1458, ISSN: 0735-1097
Shah BN, MacNab A, Lynch J, et al., 2018, Stress echocardiography in contemporary clinical cardiology: practical considerations and accreditation, ECHO RESEARCH AND PRACTICE, Vol: 5, Pages: E1-E6, ISSN: 2055-0464
Stress echocardiography is a widely utilised test in patients with known or suspected coronary artery disease (CAD), valvular heart disease and cardiomyopathies. Its advantages include the ubiquitous availability of echocardiography, lack of ionising radiation, choice of physiological or pharmacological stressors, good diagnostic accuracy and robust supporting evidence base. SE has evolved significantly as a technique over the past three decades and has benefitted considerably from improvements in overall image quality (superior resolution), machine technology (e.g. digital cine-loop acquisition and side-by-side image display) and development of second-generation ultrasound contrast agents that have improved reader confidence and diagnostic accuracy. The purpose of this article is to review the breadth of SE in contemporary clinical cardiology and discuss the recently launched British Society of Echocardiography (BSE) Stress Echocardiography accreditation scheme.
Porter TR, Mulvagh SL, Abdelmoneim SS, et al., 2018, Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 31, Pages: 241-274, ISSN: 0894-7317
- Author Web Link
- Cite
- Citations: 191
Gurunathan S, Ahmed A, Vamvakidou A, et al., 2018, Diagnostic Concordance and Clinical Outcomes in Patients Undergoing Fractional Flow Reserve and Stress Echocardiography for the Assessment of Coronary Stenosis of Intermediate Severity, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 31, Pages: 180-186, ISSN: 0894-7317
BackgroundThe ischemic consequences of coronary artery stenosis can be assessed by invasive fractional flow reserve (FFR) or by noninvasive imaging. We sought to determine (1) the concordance between wall thickening assessment during clinically indicated stress echocardiography (SE) and FFR measurements and (2) the factors associated with hard events in these patients.MethodsTwo hundred twenty-three consecutive patients who underwent SE and invasive FFR measurements in close succession were analyzed retrospectively for diagnostic concordance and clinical outcomes.ResultsAt the vessel level, the sensitivity, specificity, positive predictive value, and negative predictive value of SE for identifying significant disease as assessed by FFR was 68%, 75%, 43%, and 89%, respectively. The greatest discordance was seen in patients with wall thickening abnormalities (WTAs) and negative FFR. During a follow-up of 3.6 ± 2.2 years, there were 23 cardiovascular (CV) events (death and nonfatal myocardial infarction). The number of wall segments with inducible WTAs emerged as the strongest factor associated with CV events (hazard ratio, 1.18 [1.05-1.34]; P = .008). FFR was not associated with outcome. There was a significant increase in event rate in patients with WTA/negative FFR versus no WTA/negative FFR (P = .01), but no significant difference versus WTA/positive FFR (P = .85).ConclusionsIn a patient population with significant CV risk factors, a normal SE had a high negative predictive value for excluding abnormal FFR. WTAs were associated with outcomes regardless of FFR value, suggesting that this is a superior marker of ischemia to FFR.
Nel K, Nam MCY, Anstey C, et al., 2017, Myocardial blood flow reserve is impaired in patients with aortic valve calcification and unobstructed epicardial coronary arteries, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 248, Pages: 427-432, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 3
Senior R, Becher H, Monaghan M, et al., 2017, Clinical practice of contrast echocardiography: recommendation by the European Association of Cardiovascular Imaging (EACVI) 2017, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 18, Pages: 1205-+, ISSN: 2047-2404
- Author Web Link
- Cite
- Citations: 123
Gurunathan S, Senior R, 2017, Stress Echocardiography in Stable Coronary Artery Disease, Current Cardiology Reports, Vol: 19, ISSN: 1523-3782
Purpose of ReviewStress echocardiography (SE) is a well-established technique for the diagnosis and risk stratification of patients with known or suspected coronary artery disease (CAD). This review article summarizes the status of SE in CAD, including testing protocols, clinical efficacy and current use of newer technologies: myocardial perfusion, strain imaging, three-dimensional echocardiography and adjunctive carotid ultrasonography.Recent FindingsRecent major findings in SE include the clinical value of myocardial perfusion imaging in multicentre studies, as well as when added to left ventricular (LV) wall motion assessment in clinical service. Additionally, SE has been shown to be more cost-effective than exercise ECG in patients with low-intermediate pre-test probability of CAD. Adjunctive atherosclerosis imaging by carotid ultrasonography (CU) to ischaemia testing by SE provides synergistic prognostic value, equivalent to hybrid imaging by PET-CT.SummaryDespite the development of newer and more expensive imaging modalities, SE remains the cornerstone for the assessment of CAD and has excellent clinical efficacy, is safe and is cost-effective.
Eikelboom JW, Connolly SJ, Bosch J, et al., 2017, Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 377, Pages: 1319-1330, ISSN: 0028-4793
- Author Web Link
- Cite
- Citations: 1321
Steffel J, Ruff CT, Hamershock RA, et al., 2017, First experience with edoxaban and atrial fibrillation ablation - Insights from the ENGAGE AF-TIMI 48 trial, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 244, Pages: 192-195, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 14
Pires N, Li W, Senior R, et al., 2017, Incidental finding of a double orifice mitral valve in an elderly patient: value of 3D imaging., Echo Research and Practice, Vol: 4, Pages: K21-K24, ISSN: 2055-0464
A rare isolated double orifice mitral valve (DOMV) was diagnosed in a 77-year-old male patient, being assessed for surgical repair of the ascending aorta. This is a rare congenital abnormality, usually discovered as an incidental finding during investigation of other congenital heart defects. This case shows that a detailed assessment of all cardiac structures is necessary, not only in young patients, but also in the elderly population, to minimise the under-diagnosis of such rare anomalies. The use of 3D transthoracic echocardiography (TTE) has an increasingly significant role in establishing the diagnosis and extending the morphological and functional understanding of the anomaly. LEARNING POINTS: Thoroughly assessing all cardiac structures, in accordance with the minimum dataset guidelines for transthoracic echocardiography, ensures not only a comprehensive assessment of the primary indication for the scan, but also improves the detection of concomitant and otherwise unknown lesions. Despite falling under the category of congenital heart defects, several rare anomalies such as DOMV can be present in elderly patients, and the adult echocardiographer should have appropriate knowledge and awareness for detecting these conditions. 3D TTE provides a comprehensive assessment of the morphology of DOMV, over and above the information obtained by 2D imaging.
Kouranos V, Minz M, Danylenko O, et al., 2017, Echocardiographic parameters in suspected cardiac sarcoidosis patients-the role of speckle tracking strain analysis in the diagnosis of cardiac sarcoidosis, EUROPEAN RESPIRATORY JOURNAL, Vol: 50, ISSN: 0903-1936
Steeds RP, Cowie MR, Rana BS, et al., 2017, Report from the Annual Conference of the British Society of Echocardiography, November 2016, Queen Elizabeth II Conference Centre, London, ECHO RESEARCH AND PRACTICE, Vol: 4, Pages: M1-M16, ISSN: 2055-0464
Venneri L, Danylenko O, Calicchio F, et al., 2017, Cancer and myocardial dysfunction: observations from myocardial strain imaging in a dedicated cardio-oncology clinic, European Society of Cardiology, Publisher: OXFORD UNIV PRESS, Pages: 1292-1293, ISSN: 0195-668X
Bagai A, Alexander KP, Berger JS, et al., 2017, Use of troponin assay 99th percentile as the decision level for myocardial infarction diagnosis, AMERICAN HEART JOURNAL, Vol: 190, Pages: 135-139, ISSN: 0002-8703
- Author Web Link
- Cite
- Citations: 20
Karogiannis N, Pabla J, Gurunathan S, et al., 2017, Long term prognostic value of dipyridamole stress myocardial contrast echocardiography in comparison with single photon emission tomography in patients with known or suspected coronary artery disease, Publisher: OXFORD UNIV PRESS, Pages: 249-250, ISSN: 0195-668X
Kouranos V, Minz MM, Danylenko O, et al., 2017, Diagnostic value of baseline characteristics and echocardiography in patients with suspected cardiac sarcoidosis, Publisher: OXFORD UNIV PRESS, Pages: 1294-1294, ISSN: 0195-668X
Gurunathan S, Ahmed A, Karogiannis N, et al., 2017, Diagnostic concordance and clinical outcomes in patients undergoing fractional flow reserve and stress echocardiography for the assessment of coronary stenosis of intermediate severity, Publisher: OXFORD UNIV PRESS, Pages: 1266-1266, ISSN: 0195-668X
Gurunathan S, Zacharias K, Akhtar M, et al., 2017, A management strategy based on exercise echocardiography is more cost-effective than exercise ecg in patients presenting with suspected angina during long term follow up: a randomised study, Publisher: OXFORD UNIV PRESS, Pages: 1265-1266, ISSN: 0195-668X
Cazzoli I, Larsen SH, Kempny A, et al., 2017, Echocardiographic predictors of outcome in repaired Tetralogy of Fallot patients over 40 years old, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 149-149, ISSN: 0195-668X
Saeed S, Senior R, Chahal NS, et al., 2017, Lower Transaortic Flow Rate Is Associated With Increased Mortality in Aortic Valve Stenosis, JACC-CARDIOVASCULAR IMAGING, Vol: 10, Pages: 912-920, ISSN: 1936-878X
- Author Web Link
- Cite
- Citations: 39
Li Y, Chahal N, Senior R, et al., 2017, Reproducible computer assisted quantification of myocardial perfusion with contrast enhanced ultrasound, Ultrasound in Medicine & Biology, Vol: 43, Pages: 2235-2246, ISSN: 1879-291X
Myocardial perfusion can be quantified by myocardial contrast echocardiography (MCE) and is used for the diagnosis of coronary artery disease (CAD). However, existing MCE quantification software is highly operator dependent and has poor reproducibility and ease of usage. The aim of this study was to develop robust and easy-to-use software that can perform MCE quantification accurately, reproducibly and rapidly. The developed software has the following features: (i) semi-automatic segmentation of the myocardium; (ii) automatic rejection of MCE data with poor image quality; (iii) automatic computation of perfusion parameters such as myocardial blood flow (MBF). MCE sequences of 18 individuals (9 normal, 9 with CAD) undergoing vasodilator stress with dipyridamole were analysed quantitatively using the software. When evaluated against coronary angiography, the software achieved a sensitivity of 71% and a specificity of 91% for hyperemic MBF. With the automatic rejection algorithm, the sensitivity and specificity further improved to 77% and 94%, respectively. For MBF reproducibility, the percentage agreement is 85% (κ = 0.65) for inter-observer variability and 88% (κ = 0.72) for intra-observer variability. The intra-class correlation coefficients are 0.94 (inter-observer) and 0.96 (intra-observer). The time taken to analyse one MCE sequence using the software is about 3 min on a PC. The software has exhibited good diagnostic performance and reproducibility for CAD detection and is rapid and user-friendly.
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.