Publications
487 results found
Bhattacharyya S, Khattar R, Chahal N, et al., 2015, Dynamic Mitral Regurgitation <i>Review of Evidence Base</i>, <i>Assessment and Implications for Clinical Management</i>, CARDIOLOGY IN REVIEW, Vol: 23, Pages: 142-147, ISSN: 1061-5377
- Author Web Link
- Open Access Link
- Cite
- Citations: 6
Gurunathan S, Senior R, 2015, Right ventricular lead perforation complicating late pacemaker infection, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 190, Pages: 47-48, ISSN: 0167-5273
Marwick TH, Gillebert TC, Aurigemma G, et al., 2015, Recommendations on the Use of Echocardiography in Adult Hypertension: A Report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE), JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 28, Pages: 727-754, ISSN: 0894-7317
- Author Web Link
- Cite
- Citations: 340
Yildiz YO, Eckersley RJ, Senior R, et al., 2015, CORRECTION OF NON-LINEAR PROPAGATION ARTIFACT IN CONTRAST-ENHANCED ULTRASOUND IMAGING OF CAROTID ARTERIES: METHODS AND <i>IN VITRO</i> EVALUATION, ULTRASOUND IN MEDICINE AND BIOLOGY, Vol: 41, Pages: 1938-1947, ISSN: 0301-5629
- Author Web Link
- Cite
- Citations: 16
Gujral DM, Shah BN, Chahal NS, et al., 2015, Do traditional risk stratification models for cerebrovascular events apply in irradiated head and neck cancer patients?, QJM, Vol: 109, Pages: 383-389, ISSN: 1460-2725
BACKGROUND: Primary radical radiotherapy (RT) for head and neck cancer (HNC) often results in significant radiation dose to the carotid arteries. AIM: We assessed whether HNC patients are at increased risk of a cerebrovascular event primarily due to RT or other risk factors for atherosclerosis by (i) risk-stratifying patients according to validated QRISK-2 and QSTROKE scores and (ii) comparing the prevalence of carotid artery stenosis (CAS) in irradiated and unirradiated carotid arteries. DESIGN: HNC patients treated with an RT dose >50 Gy to one side of the neck ≥2 years previously were included. METHODS: QRISK-2 (2014) and Q-STROKE (2014) scores were calculated. We compared the prevalence of CAS in segments of the common carotid artery on the irradiated and unirradiated sides of the neck. RESULTS: Fifty patients (median age of 58 years (interquartile range (IQR) 50-62)) were included. The median QRISK-2 score was 10% (IQR 4.4-15%) and the median QSTROKE score was 3.4% (IQR 1.4-5.3%). For both scores, no patient was classified as high risk. Thirty-eight patients (76%) had CAS in one or both arteries. There was a significant difference in the number of irradiated arteries with stenosis (N = 37) compared with unirradiated arteries (N = 16) (P < 0.0001). There were more plaques on the irradiated artery compared with the unirradiated side - 64/87 (73.6%) versus 23/87 (26.4%), respectively (P < 0.001). CONCLUSIONS: Traditional vascular risk factors do not play a role in radiation-induced carotid atherosclerosis. Clinicians should be aware that traditional risk prediction models may under-estimate stroke risk in these patients.
Zacharias K, Ahmadvazir S, Ahmed A, et al., 2015, Relative diagnostic, prognostic and economic value of stress echocardiography versus exercise electrocardiography as initial investigation for the detection of coronary artery disease in patients with new onset suspected angina., International Journal of Cardiology: Heart and Vasculature, Vol: 7, Pages: 124-130, ISSN: 2352-9067
OBJECTIVES: We hypothesised that stress echocardiography (SE), may be superior to exercise ECG (ExECG), for predicting CAD and outcome, and cost-beneficial, when performed as initial investigation in newly suspected angina. METHODS: All patients seen in 2011, with suspected angina, no history of CAD, pre-test likelihood of CAD of > 10% and who underwent SE or ExECG as first line were identified retrospectively. Cost to diagnosis was calculated by adding the cost of all tests, up to and including coronary angiography (CA), on an intention-to-treat basis. Follow-up data on cardiac death and myocardial infarction (MI) were collected, 26 months after the presentation of the last study patient. RESULTS: A total of 456 patients underwent ExECG (224 (49%) negative, 93 (20%) positive, 139 (31%) inconclusive) and 241 underwent SE (200 (83%) negative, 35 (15%) positive, 6 (2%) inconclusive) as first line. In patients subsequently undergoing CA, CAD was present in 46% (37/80) of patients with positive ExECG vs. 72% (23/32) patients with positive SE (p = 0.01). Mean cost to diagnosis was £456 for the ExECG vs. £360 for the SE group (p = 0.002). Over a mean follow-up period of 31 ± 5 months, cardiac events were 2% each in negative SE vs. negative ExECG (p = 0.9). CONCLUSIONS: SE is superior to ExECG for prediction of CAD and is cost-beneficial when used as initial test in patients with no history of CAD presenting with suspected angina.
Senior R, Shah B, Chahal N, et al., 2015, INCREASED CAROTID PLAQUE NEOVASCULARIZATION, A MARKER OF PLAQUE VULNERABILITY, IS INDEPENDENTLY ASSOCIATED WITH SOUTH ASIAN ETHNICITY: A POSSIBLE MECHANISM UNDERLYING THE GREATER BURDEN OF CARDIOVASCULAR EVENTS IN SOUTH ASIANS VS NORTHERN EUROPEANS, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A74-A74, ISSN: 1355-6037
Senior R, Chahal NS, Drakopoulou M, et al., 2015, RESTING AORTIC VALVE AREA AT NORMAL TRANSAORTIC FLOW RATE BUT NOT AT NORMAL STROKE VOLUME REFLECTS THE TRUE VALVE AREA IN PTS WITH LOW GRADIENT SEVERE AORTIC STENOSIS: IMPLICATIONS FOR OBVIATING THE NEED FOR STRESS ECHOCARDIOGRAPHY IN SUCH PTS, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A55-A55, ISSN: 1355-6037
Echocardiographic Normal Ranges Meta-Analysis of the Left Heart Collaboration, 2015, Ethnic-Specific Normative Reference Values for Echocardiographic LA and LV Size, LV Mass, and Systolic Function: The EchoNoRMAL Study., JACC Cardiovasc Imaging, Vol: 8, Pages: 656-665
OBJECTIVES: This study sought to derive age-, sex-, and ethnic-appropriate adult reference values for left atrial (LA) and left ventricular (LV) dimensions and volumes, LV mass, fractional shortening, and ejection fraction (EF) derived from geographically diverse population studies. BACKGROUND: The current recommended reference values for measurements from echocardiography may not be suitable to the diverse world population to which they are now applied. METHODS: Population-based datasets of echocardiographic measurements from 22,404 adults without clinical cardiovascular or renal disease, hypertension, or diabetes were combined in an individual person data meta-analysis. Quantile regression was used to derive reference values at the 95th percentile (upper reference value [URV]) and fifth percentile (lower reference value [LRV]) of each measurement against age (treated as linear), separately within sex and ethnic groups. RESULTS: The URVs for left ventricular end-diastolic volume (LVEDV), LV end-systolic volume, and LV stroke volume (SV) were highest in Europeans and lowest in South Asians. Important sex and ethnic differences remained after indexation by body surface area or height for these measurements, as well as for the LRV for SV. LVEDV and SV decreased with increasing age for all groups. Importantly, the LRV for EF differed by ethnicity; there was a clear apparent difference between Europeans and Asians. The URVs for LV end-diastolic diameter and LV end-systolic diameter were higher for Europeans than those for East Asian, South Asian, and African people, particularly among men. Similarly, the URVs for LA diameter and volume were highest for Europeans. CONCLUSIONS: Sex- and/or ethnic-appropriate echocardiographic reference values are indicated for many measurements of LA and LV size, LV mass, and EF. Reference values for LV volumes and mass also differ across the age range.
Marwick TH, Gillebert TC, Aurigemma G, et al., 2015, Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE), EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging, Vol: 16, Pages: 577-605, ISSN: 2047-2412
Hypertension remains a major contributor to the global burden of disease. The measurement of blood pressure continues to have pitfalls related to both physiological aspects and acute variation. As the left ventricle (LV) remains one of the main target organs of hypertension, and echocardiographic measures of structure and function carry prognostic information in this setting, the development of a consensus position on the use of echocardiography in this setting is important. Recent developments in the assessment of LV hypertrophy and LV systolic and diastolic function have prompted the preparation of this document. The focus of this work is on the cardiovascular responses to hypertension rather than the diagnosis of secondary hypertension. Sections address the pathophysiology of the cardiac and vascular responses to hypertension, measurement of LV mass, geometry, and function, as well as effects of treatment.
Gurunathan S, Ahmed A, Senior R, 2015, The benefits of revascularization in chronic heart failure., Curr Heart Fail Rep, Vol: 12, Pages: 112-119
Recent efforts have reduced the mortality from coronary artery disease (CAD), with the consequent increase in heart failure with reduced left ventricular function, referred to as ischaemic cardiomyopathy (ICM). As ischemic left ventricular (LV) dysfunction may be partially or completely reversible by revascularization in the presence of viable myocardium, the assessment of myocardial viability is central to the management of ICM. Decades of observational analyses have provided positive evidence for the role of revascularization in hibernating myocardium in improving survival. However, recently the Surgical Treatment for Ischaemic Heart Failure (STICH) trial has challenged this notion, highlighting the noninferiority of optimal medical therapy (OMT) over revascularization and OMT. In this review, we discuss noninvasive imaging modalities to assess myocardial viability and the impact of myocardial viability on revascularization. We critically appraise the STICH trial and suggest an algorithm for viability testing before revascularization in patients with ICM and significant LV dysfunction.
Chahal NS, Drakopoulou M, Gonzalez A, et al., 2015, REST FLOW RATE, NOT STROKE VOLUME, IS ABETTER DISCRIMINATOR OF TRUE VERSUS PSEUDOSEVERE SEVERE AORTIC STENOS'S: IMPLICATIONS FOR STRESS ECHOCARDIOGRAPHY AND FOR THE ROUTINE ASSESSMENT OF AORTIC STENOSIS SEVERITY, Scientific Session of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: A1326-A1326, ISSN: 0735-1097
Donataccio M-P, Li W, Ramasamy M, et al., 2015, Anomalous origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA): A rare presentation in late adulthood, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 182, Pages: 179-180, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 3
de Silva R, Tsujioka H, Gaze D, et al., 2015, Serial Changes in High-Sensitivity Cardiac Troponin, N-terminal Pro-B-Type Natriuretic Peptide, and Heart Fatty Acid Binding Protein during Exercise Echocardiography in Patients with Suspected Angina Pectoris and Normal Resting Left Ventricular Function, CLINICAL CHEMISTRY, Vol: 61, Pages: 554-556, ISSN: 0009-9147
- Author Web Link
- Open Access Link
- Cite
- Citations: 2
Ahmed A, Senior R, 2015, High normal blood pressure: to treat or not to treat?, JOURNAL OF HUMAN HYPERTENSION, Vol: 29, Pages: 7-8, ISSN: 0950-9240
- Author Web Link
- Cite
- Citations: 1
Alhajiri A, Ramadan MM, Senior R, 2014, Left atrial enlargement causing dysphagia and weight loss: A rare contraindication for catheter ablation therapy in a patient with complex atrial arrhythmia, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 177, Pages: E111-E112, ISSN: 0167-5273
- Author Web Link
- Cite
- Citations: 2
Oxborough D, Ghani S, Harkness A, et al., 2014, Impact of methodology and the use of allometric scaling on the echocardiographic assessment of the aortic root and arch: a study by the Research and Audit Sub-Committee of the British Society of Echocardiography, Echo Research and Practice, Vol: 1, Pages: 1-9, ISSN: 2055-0464
The aim of the study is to establish the impact of 2D echocardiographic methods on absolute values for aortic root dimensions and to describe any allometric relationship to body size. We adopted a nationwide cross-sectional prospective multicentre design using images obtained from studies utilising control groups or where specific normality was being assessed. A total of 248 participants were enrolled with no history of cardiovascular disease, diabetes, hypertension or abnormal findings on echocardiography. Aortic root dimensions were measured at the annulus, the sinus of Valsalva, the sinotubular junction, the proximal ascending aorta and the aortic arch using the inner edge and leading edge methods in both diastole and systole by 2D echocardiography. All dimensions were scaled allometrically to body surface area (BSA), height and pulmonary artery diameter. For all parameters with the exception of the aortic annulus, dimensions were significantly larger in systole (P<0.05). All aortic root and arch measurements were significantly larger when measured using the leading edge method compared with the inner edge method (P<0.05). Allometric scaling provided a b exponent of BSA(0.6) in order to achieve size independence. Similarly, ratio scaling to height in subjects under the age of 40 years also produced size independence. In conclusion, the largest aortic dimensions occur in systole while using the leading edge method. Reproducibility of measurement, however, is better when assessing aortic dimensions in diastole. There is an allometric relationship to BSA and, therefore, allometric scaling in the order of BSA(0.6) provides a size-independent index that is not influenced by the age or gender.
Shah BN, Gujral DM, Chahal NS, et al., 2014, Plaque neovascularization is increased in human carotid atherosclerosis related to prior neck radiotherapy: a contrast enhanced ultrasound study, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 634-634, ISSN: 0195-668X
Shah BN, Zacharias K, Pabla JS, et al., 2014, Contemporary stress echocardiography demonstrates excellent feasibility and diagnostic accuracy in patients with significant obesity: the Stress Ultrasonography in Morbid Obesity (SUMO) study, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 113-113, ISSN: 0195-668X
Zacharias K, Shah B, Pabla J, et al., 2014, Exercise echo has superior cost efficacy compared to exercise ECG for the diagnosis of coronary artery disease in patients with new suspected angina: a randomised prospective study, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 117-118, ISSN: 0195-668X
Ahmadvazir S, Zacharias K, Shah BN, et al., 2014, Role of simultaneous carotid ultrasound in patients undergoing stress echocardiography for assessment of chest pain with no previous history of coronary artery disease, AMERICAN HEART JOURNAL, Vol: 168, Pages: 229-236, ISSN: 0002-8703
- Author Web Link
- Cite
- Citations: 9
Marwick TH, Gillebert TC, Aurigemma G, et al., 2014, Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE), TURK KARDIYOLOJI DERNEGI ARSIVI-ARCHIVES OF THE TURKISH SOCIETY OF CARDIOLOGY, Vol: 44, Pages: 23-51, ISSN: 1016-5169
Gonzalez-Gonzalez AM, Drakopoulou M, Bhattacharyya S, et al., 2014, THE INCREMENTAL PROGNOSTIC VALUE OF MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY IN CLINICAL PRACTICE: FOLLOW-UP RESULTS FROM THE IMPACT OF MYOCARDIAL PERFUSION ASSESSMENT IN CLINICAL TESTS OF STRESS ECHOCARDIOGRAPHY (IMPACT-SE) STUDY, HEART, Vol: 100, Pages: A84-A84, ISSN: 1355-6037
Shaw LJ, Berman DS, Picard MH, et al., 2014, Comparative Definitions for Moderate-Severe Ischemia in Stress Nuclear, Echocardiography, and Magnetic Resonance Imaging, JACC-CARDIOVASCULAR IMAGING, Vol: 7, Pages: 593-604, ISSN: 1936-878X
- Author Web Link
- Cite
- Citations: 139
Shah B, Pabla JS, Zacharias K, et al., 2014, STRESS ECHOCARDIOGRAPHY DEMONSTRATES EXCELLENT FEASIBILITY, SAFETY AND DIAGNOSTIC ACCURACY IN PATIENTS WITH SIGNIFICANT OBESITY: FIRST RESULTS FROM THE STRESS ULTRASONOGRAPHY IN MORBID OBESITY (SUMO) STUDY, HEART, Vol: 100, Pages: A85-A85, ISSN: 1355-6037
- Author Web Link
- Cite
- Citations: 1
Senior R, Gujral DM, Chahal NS, et al., 2014, CAROTID INTRAPLAQUE NEOVASCULARIZATION IS INCREASED IN PATIENTS WITH PRIOR IPSILATERAL NECK IRRADIATION - A CONTRAST ENHANCED ULTRASOUND STUDY, HEART, Vol: 100, Pages: A84-A84, ISSN: 1355-6037
- Author Web Link
- Cite
- Citations: 1
Shah BN, Chahal NS, Bhattacharyya S, et al., 2014, The Feasibility and Clinical Utility of Myocardial Contrast Echocardiography in Clinical Practice: Results from the Incorporation of Myocardial Perfusion Assessment into Clinical Testing with Stress Echocardiography Study, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 27, Pages: 520-530, ISSN: 0894-7317
- Author Web Link
- Cite
- Citations: 23
Cheung W, Gujral DM, Shah BNA, et al., 2014, Attenuation correction and normalisation for quantification of contrast enhancement in ultrasound Images of carotid arteries, Ultrasound in Medicine and Biology, Vol: 41, Pages: 1876-1883, ISSN: 0301-5629
An automated attenuation correction and normalisation algorithm was developed to improve the quantification of contrast enhancement in ultrasound images of carotid arteries. The algorithm first corrects attenuation artefact and normalises intensity within the contrast agent-filled lumen and then extends the correction and normalisation to regions beyond the lumen. The algorithm was first validated on phantoms consisting of contrast agent-filled vessels embedded in tissue-mimicking materials of known attenuation. It was subsequently applied to invivo contrast-enhanced ultrasound (CEUS) images of human carotid arteries. Both invitro and invivo results indicated significant reduction in the shadowing artefact and improved homogeneity within the carotid lumens after the correction. The error in quantification of microbubble contrast enhancement caused by attenuation on phantoms was reduced from 55% to 5% on average. In conclusion, the proposed method exhibited great potential in reducing attenuation artefact and improving quantification in contrast-enhanced ultrasound of carotid arteries.
Shah BN, Gonzalez-Gonzalez AM, Drakopoulou M, et al., 2014, SIMULTANEOUS MYOCARDIAL PERFUSION ASSESSMENT DURING MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY PROVIDES INCREMENTAL PROGNOSTIC VALUE BEYOND WALL MOTION ANALYSIS WHEN INCORPORATED INTO A REAL-WORLD CLINICAL STRESS ECHOCARDIOGRAPHY SERVICE, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A1239-A1239, ISSN: 0735-1097
Bhattacharyya S, Kamperidis V, Chahal N, et al., 2014, Clinical and prognostic value of stress echocardiography appropriateness criteria for evaluation of coronary artery disease in a tertiary referral centre, HEART, Vol: 100, Pages: 370-374, ISSN: 1355-6037
- Author Web Link
- Cite
- Citations: 17
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.