Publications
487 results found
Reynolds HR, Shaw LJ, Min JK, et al., 2020, Association of Sex With Severity of Coronary Artery Disease, Ischemia, and Symptom Burden in Patients With Moderate or Severe Ischemia Secondary Analysis of the ISCHEMIA Randomized Clinical Trial, JAMA CARDIOLOGY, Vol: 5, Pages: 773-786, ISSN: 2380-6583
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- Citations: 83
Mushemi-Blake S, Surkova E, Hatipoglu S, et al., 2020, Severe regurgitation of a double-orifice left atrioventricular valve in a patient with repaired atrioventricular septal defect: added value of 3D echocardiography, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 21, Pages: 814-814, ISSN: 2047-2404
Nam MCY, Meneses AL, Byrne CD, et al., 2020, An Experimental Series Investigating the Effects of Hyperinsulinemic Euglycemia on Myocardial Blood Flow Reserve in Healthy Individuals and on Myocardial Perfusion Defect Size following ST-Segment Elevation Myocardial Infarction, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 33, Pages: 868-+, ISSN: 0894-7317
Gurunathan S, Shanmuganathan M, hampson R, et al., 2020, The role of adjuvant carotid ultrasound in women undergoing stress echocardiography for the assessment of suspected coronary artery disease, Open Heart, Vol: 7, ISSN: 2053-3624
Objective Due to the low prevalence of obstructive coronary artery disease (CAD) in women, stress testing has a relatively low predictive value for this. Additionally, conventional cardiovascular risk scores underestimate risk in women. This study sought to evaluate the role of atherosclerosis assessment using carotid ultrasound (CU) in women attending for stress echocardiography (SE).Methods This was a prospective study in which consecutive women with recent-onset suspected angina, who were referred for clinically indicated SE, underwent CU.Results 415 women (mean age 61±10 years, 29% diabetes mellitus, mean body mass index 28) attending for SE underwent CU. 47 women (11%) had inducible wall motion abnormalities, and carotid disease (CD) was present in 46% (carotid plaque in 41%, carotid intima-media thickness >75th percentile in 15%). Women with CD were older (65 vs 58 years, p<0.001), and more likely to have diabetes (41% vs 21%, p=0.001), hypertension (67% vs 36%, p<0.01) and a higher pretest probability of CAD (59% vs 41%, p<0.001). 40% of women classified as low Framingham risk were found to have evidence of CD.The positive predictive value of SE for flow-limiting CAD was 51%, but with the presence of carotid plaque, this was 71% (p<0.01). Carotid plaque (p=0.004) and ischaemia (p=0.01) were the only independent predictors of >70% angiographic stenosis. In women with ischaemia on SE and no carotid plaque, the negative predictive value for flow-limiting disease was 88%.During a follow-up of 1058±234 days, there were 15 events (defined as all-cause mortality, non-fatal myocardial infarction, heart failure admissions and late coronary revascularisation). Age (HR 1.07 (1.00–1.15), p=0.04), carotid plaque burden (HR 1.65 (1.36–2.00), p<0.001) and ischaemic burden (HR 1.41 (1.18–1.68), p<0.001) were associated with outcome. There was a stepwise increase in events/year from 0.3% when there were no ischaemia and
Ahmadvazir S, Pradhan J, Khattar RS, et al., 2020, Long-Term Prognostic Value of Simultaneous Assessment of Atherosclerosis and Ischemia in Patients with Suspected Angina: Implications for Routine Use of Carotid Ultrasound during Stress Echocardiography, Congress of the European-Society-of-Cardiology (ESC) / World Congress of Cardiology, Publisher: MOSBY-ELSEVIER, Pages: 559-569, ISSN: 0894-7317
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- Citations: 4
Senior R, Khattar RS, 2020, Assessment of Aortic Stenosis Time to Go With the Flow, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 75, Pages: 1770-1771, ISSN: 0735-1097
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- Citations: 3
Maron DJ, Hochman JS, Reynolds HR, et al., 2020, Initial invasive or conservative strategy for stable coronary disease., New England Journal of Medicine, Vol: 382, Pages: 1395-1407, ISSN: 0028-4793
BACKGROUND: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median o
Reynolds HR, Shaw LJ, Chaitman B, et al., 2020, SEX DIFFERENCES IN STRESS TEST AND CCTA FINDINGS AND SYMPTOMS IN THE RANDOMIZED ISCHEMIA TRIAL, Conference of American-College-of-Cardiology (ACC) / World Congress of Cardiology (WCC), Publisher: ELSEVIER SCIENCE INC, ISSN: 0735-1097
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- Citations: 1
Felker GM, McMurray J, Cleland J, et al., 2020, HEMODYNAMIC EFFECTS OF NITROXYL DONOR BMS-986231 COMPARED TO NITROGLYCERIN OR PLACEBO IN PATIENTS WITH CHRONIC HEART FAILURE-A RANDOMIZED DOUBLE-BLIND CROSSOVER TRIAL, Conference of American-College-of-Cardiology (ACC) / World Congress of Cardiology (WCC), Publisher: ELSEVIER SCIENCE INC, Pages: 850-850, ISSN: 0735-1097
Senior R, Reynolds H, Min J, et al., 2020, PREDICTION OF LEFT MAIN DISEASE USING CLINICAL AND STRESS TEST PARAMETERS, Conference of American-College-of-Cardiology (ACC) / World Congress of Cardiology (WCC), Publisher: ELSEVIER SCIENCE INC, Pages: 52-52, ISSN: 0735-1097
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- Citations: 2
Fusco F, Shimada E, Scognamiglio G, et al., 2020, Restrictive ventricular septal defect resulting in systemic outflow obstruction in adults with Fontan circulation: challenging diagnosis of a serious and potentially fatal complication, JOURNAL OF CARDIOVASCULAR MEDICINE, Vol: 21, Pages: 276-279, ISSN: 1558-2027
Dewey M, Siebes M, Kachelrieß M, et al., 2020, Clinical quantitative cardiac imaging for the assessment of myocardial ischaemia, Nature Reviews Cardiology, Vol: 17, Pages: 427-450, ISSN: 1759-5002
Cardiac imaging has a pivotal role in the prevention, diagnosis and treatment of ischaemic heart disease. SPECT is most commonly used for clinical myocardial perfusion imaging, whereas PET is the clinical reference standard for the quantification of myocardial perfusion. MRI does not involve exposure to ionizing radiation, similar to echocardiography, which can be performed at the bedside. CT perfusion imaging is not frequently used but CT offers coronary angiography data, and invasive catheter-based methods can measure coronary flow and pressure. Technical improvements to the quantification of pathophysiological parameters of myocardial ischaemia can be achieved. Clinical consensus recommendations on the appropriateness of each technique were derived following a European quantitative cardiac imaging meeting and using a real-time Delphi process. SPECT using new detectors allows the quantification of myocardial blood flow and is now also suited to patients with a high BMI. PET is well suited to patients with multivessel disease to confirm or exclude balanced ischaemia. MRI allows the evaluation of patients with complex disease who would benefit from imaging of function and fibrosis in addition to perfusion. Echocardiography remains the preferred technique for assessing ischaemia in bedside situations, whereas CT has the greatest value for combined quantification of stenosis and characterization of atherosclerosis in relation to myocardial ischaemia. In patients with a high probability of needing invasive treatment, invasive coronary flow and pressure measurement is well suited to guide treatment decisions. In this Consensus Statement, we summarize the strengths and weaknesses as well as the future technological potential of each imaging modality.
Bioh G, Senior R, 2020, Stress Echocardiography in the Era of Fractional Flow Reserve, CURRENT CARDIOVASCULAR IMAGING REPORTS, Vol: 13, ISSN: 1941-9066
Newman JD, Alexander KP, Gu X, et al., 2019, Baseline Predictors of Low-Density Lipoprotein Cholesterol and Systolic Blood Pressure Goal Attainment After 1 Year in the ISCHEMIA Trial, CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, Vol: 12, ISSN: 1941-7705
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- Citations: 18
Saeed S, Vamvakidou A, Seifert R, et al., 2019, The impact of aortic valve replacement on survival in patients with normal flow low gradient severe aortic stenosis: a propensity-matched comparison, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 20, Pages: 1094-1101, ISSN: 2047-2404
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- Citations: 26
Vamvakidou A, Jin W, Danylenko O, et al., 2019, Low transvalvular flow rate predicts mortality in patients with low-gradient aortic stenosis following aortic valve intervention, JACC: Cardiovascular Imaging, Vol: 12, Pages: 1715-1724, ISSN: 1936-878X
OBJECTIVES: This study aimed to assess the value of low transvalvular flow rate (FR) for the prediction of mortality compared with low stroke volume index (SVi) in patients with low-gradient (mean gradient: <40 mm Hg), low aortic valve area (<1 cm2) aortic stenosis (AS) following aortic valve intervention. BACKGROUND: Transaortic FR defined as stroke volume/left ventricular ejection time is also a marker of flow; however, no data exist comparing the relative prognostic value of these 2 transvalvular flow markers in patients with low-gradient AS who had undergone valve intervention. METHODS: We retrospectively followed prospectively assessed consecutive patients with low-gradient, low aortic valve area AS who underwent aortic valve intervention between 2010 and 2014 for all-cause mortality. RESULTS: Of the 218 patients with mean age 75 ± 12 years, 102 (46.8%) had low stroke volume index (SVi) (<35 ml/m2), 95 (43.6%) had low FR (<200 ml/s), and 58 (26.6%) had low left ventricular ejection fraction <50%. The concordance between FR and SVi was 78.8% (p < 0.005). Over a median follow-up of 46.8 ± 21 months, 52 (23.9%) deaths occurred. Patients with low FR had significantly worse outcome compared with those with normal FR (p < 0.005). In patients with low SVi, a low FR conferred a worse outcome than a normal FR (p = 0.005), but FR status did not discriminate outcome in patients with normal SVi. By contrast, SVi did not discriminate survival either in patients with normal or low FR. Low FR was an independent predictor of mortality (p = 0.013) after adjusting for age, clinical prognostic factors, European System for Cardiac Operative Risk Evaluation II, dimensionless velocity index, left ventricular mass index, left ventricular ejection fraction, heart rate, time, type of aortic valve intervention, and SVi (p = 0.59). CONCLUSIONS: In patients with low-gradient, low valve area aortic stenosis undergoi
Pradhan J, Senior R, 2019, Assessment of myocardial viability by myocardial contrast echocardiography: current perspectives, CURRENT OPINION IN CARDIOLOGY, Vol: 34, Pages: 495-501, ISSN: 0268-4705
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- Citations: 5
Chong A, Senior R, Wahi S, 2019, Contemporary Imaging of Aortic Stenosis, HEART LUNG AND CIRCULATION, Vol: 28, Pages: 1310-1319, ISSN: 1443-9506
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- Citations: 3
Venneri L, Khattar RS, Senior R, 2019, Assessment of Complex Multi-Valve Disease and Prosthetic Valves, HEART LUNG AND CIRCULATION, Vol: 28, Pages: 1436-1446, ISSN: 1443-9506
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- Citations: 11
Gurunathan S, Senior R, 2019, Reply to 'Management of noncompaction requires optimisation', ECHO RESEARCH AND PRACTICE, Vol: 6, Pages: L3-L4, ISSN: 2055-0464
Castro-Verdes M, Surkova E, Rigby M, et al., 2019, Successful double valve-in-valve percutaneous implantation in a patient with Ebstein's anomaly, EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 20, Pages: 1074-1074, ISSN: 2047-2404
Khattar RS, Senior R, 2019, Stress echocardiography in the assessment of native valve disease, HEART, Vol: 105, Pages: 1034-1043, ISSN: 1355-6037
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- Citations: 3
Steeds RP, Wheeler R, Bhattacharyya S, et al., 2019, Stress echocardiography in coronary artery disease: a practical guideline from the British Society of Echocardiography, ECHO RESEARCH AND PRACTICE, Vol: 6, Pages: G17-G33, ISSN: 2055-0464
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- Citations: 14
Yakupoglu Y, Saeed S, Manivarmane R, et al., 2019, REVERSIBLE EXERCISE-INDUCED LEFT VENTRICULAR DYSFUNCTION IN SYMPTOMATIC PATIENTS WITH PREVIOUS TAKOTSUBO SYNDROME - INSIGHTS FROM EXERCISE ECHOCARDIOGRAPHY, Annual Conference of the British-Cardiovascular-Society (BCS) - Digital Health Revolution, Publisher: BMJ PUBLISHING GROUP, Pages: A2-A3, ISSN: 1355-6037
Senior R, Ahmadvazir S, Pradhan J, et al., 2019, LONG-TERM PROGNOSTIC VALUE OF SIMULTANEOUS ASSESSMENT OF ATHEROSCLEROSIS AND ISCHEMIA IN PATIENTS WITH SUSPECTED ANGINA: IMPLICATIONS FOR ROUTINE USE OF CAROTID ULTRASOUND DURING STRESS ECHOCARDIOGRAPHY, Annual Conference of the British-Cardiovascular-Society (BCS) - Digital Health Revolution, Publisher: BMJ PUBLISHING GROUP, Pages: A1-A2, ISSN: 1355-6037
Senior R, Saeed S, Vamvakidou A, et al., 2019, THE IMPACT OF AORTIC VALVE REPLACEMENT ON SURVIVAL IN PATIENTS WITH NORMAL FLOW LOW GRADIENT SEVERE AORTIC STENOSIS: A PROPENSITY-MATCHED COMPARISON, Annual Conference of the British-Cardiovascular-Society (BCS) - Digital Health Revolution, Publisher: BMJ PUBLISHING GROUP, Pages: A104-A105, ISSN: 1355-6037
Hampson R, Vamvakidou A, Kinsey C, et al., 2019, Clinical effectiveness of a sonographer-led, cardiologist-interpreted stress echocardiography service in the rapid access stable chest pain clinic, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 281, Pages: 107-112, ISSN: 0167-5273
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- Citations: 1
Surkova E, West C, Flick C, et al., 2019, Added value of three-dimensional transthoracic echocardiography in assessment of an adult patient with atrioventricular septal defect, ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, Vol: 36, Pages: 809-812, ISSN: 0742-2822
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- Citations: 1
Hochman JS, Reynolds HR, Bangalore S, et al., 2019, Baseline characteristics and risk profiles of participants in the ISCHEMIA randomized clinical trial, JAMA Cardiology, Vol: 4, Pages: 273-286, ISSN: 2380-6583
Importance It is unknown whether coronary revascularization, when added to optimal medical therapy, improves prognosis in patients with stable ischemic heart disease (SIHD) at increased risk of cardiovascular events owing to moderate or severe ischemia.Objective To describe baseline characteristics of participants enrolled and randomized in the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial and to evaluate whether qualification by stress imaging or nonimaging exercise tolerance test (ETT) influenced risk profiles.Design, Setting, and Participants The ISCHEMIA trial recruited patients with SIHD with moderate or severe ischemia on stress testing. Blinded coronary computed tomography angiography was performed in most participants and reviewed by a core laboratory to exclude left main stenosis of at least 50% or no obstructive coronary artery disease (CAD) (<50% for imaging stress test and <70% for ETT). The study included 341 enrolling sites (320 randomizing) in 38 countries and patients with SIHD and moderate or severe ischemia on stress testing. Data presented were extracted on December 17, 2018.Main Outcomes and Measures Enrolled, excluded, and randomized participants’ baseline characteristics. No clinical outcomes are reported.Results A total of 8518 patients were enrolled, and 5179 were randomized. Common reasons for exclusion were core laboratory determination of insufficient ischemia, unprotected left main stenosis of at least 50%, or no stenosis that met study obstructive CAD criteria on study coronary computed tomography angiography. Randomized participants had a median age of 64 years, with 1168 women (22.6%), 1726 nonwhite participants (33.7%), 748 Hispanic participants (15.5%), 2122 with diabetes (41.0%), and 4643 with a history of angina (89.7%). Among the 3909 participants randomized after stress imaging, core laboratory assessment of ischemia severity (in 3901 participants) w
Senior R, 2019, Paving the way for improving no-reflow phenomenon, International Journal of Cardiology, Vol: 277, Pages: 20-21, ISSN: 0167-5273
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