A5064909881- Cardiac Imaging and Diagnostics
- Cardiac Valve Diseases and Treatments
- Coronary Interventions and Diagnostics
- Cardiovascular Function and Risk Factors
- Cardiomyopathy and Myosin Studies
- Infective Endocarditis Diagnosis and Management
- Angiogenesis and VEGF in Cancer
- Advanced MRI Techniques and Applications
- Ultrasound in Clinical Applications
- Acute Myocardial Infarction Research
- Pericarditis and Cardiac Tamponade
- Cardiovascular Effects of Exercise
- Cardiac electrophysiology and arrhythmias
- Cardiac, Anesthesia and Surgical Outcomes
- Antiplatelet Therapy and Cardiovascular Diseases
- Cardiovascular Disease and Adiposity
- Atrial Fibrillation Management and Outcomes
- Ion channel regulation and function
- Congenital Heart Disease Studies
- Venous Thromboembolism Diagnosis and Management
- COVID-19 and healthcare impacts
- Ultrasound and Hyperthermia Applications
- Cardiac Fibrosis and Remodeling
- Biomarkers in Disease Mechanisms
- Long-Term Effects of COVID-19
Imperial College Healthcare NHS Trust
2012-2024
Hammersmith Hospital
2014-2024
Imperial College London
2008-2023
Changi General Hospital
2022
Royal Brompton Hospital
2015-2021
NIHR Royal Brompton Cardiovascular Biomedical Research Unit
2021
Chelsea and Westminster Hospital NHS Foundation Trust
2021
St Mary's Hospital
2020
St. Mary's Hospital
2020
Royal Brompton & Harefield NHS Foundation Trust
2015
The objective of this study was to examine determinants excess coronary artery disease risk in UK South Asians, more prevalent population than Caucasians, by examining differences factors, vascular function, and endothelial progenitor cells (EPCs).24 Asian 25 Caucasian healthy age-matched nonsmoking men were studied. Vascular function assessed flow-mediated GTN brachial dilatation blood flow responses infusion ACh, SNP, L-NMMA. EPC number measured cytometry (CD34, CD133, KDR positive cells),...
In this study, a systematic analysis was conducted of phasic intracoronary pressure and flow velocity in patients with severe aortic stenosis (AS) coronary artery disease, undergoing transcatheter valve replacement (TAVR), to determine how AS affects: 1) flow; 2) hyperemic 3) the most common clinically used indices severity, instantaneous wave-free ratio fractional reserve. A significant proportion have concomitant disease. The effect on pressure, flow, established invasive clinical severity...
Background: There are no data on how fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) associated with the placebo-controlled efficacy of percutaneous coronary intervention (PCI) in stable single-vessel artery disease. Methods: We report association between prerandomization invasive physiology within ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy Angioplasty Stable Angina), a trial patients who have angina angiographically severe disease...
Dobutamine stress echocardiography is widely used to test for ischemia in patients with stable coronary artery disease. In this analysis, we studied the ability of prerandomization score predict placebo-controlled efficacy percutaneous intervention (PCI) within ORBITA trial (Objective Randomised Blinded Investigation With Optimal Medical Therapy Angioplasty Stable Angina).One hundred eighty-three underwent dobutamine before randomization. The broadly number segments abnormal at peak stress,...
Acute myocardial infarction (AMI) is a common cause of death for which effective treatments are available provided that diagnosis rapid. The current diagnostic gold standards circulating cardiac troponins I and T. However, their slow release delays diagnosis, persistence limits utility in the identification reinfarction. aim was to identify candidate biomarkers AMI. Isolated mouse hearts were perfused with oxygenated protein-free buffer, coronary effluent collected after ischemia or during...
Objectives The clinical impact of SARS-CoV-2 has varied across countries with varying cardiovascular manifestations. We review the cardiac presentations, in-hospital outcomes and development complications in initial cohort positive patients at Imperial College Healthcare National Health Service Trust, UK. Methods retrospectively analysed 498 COVID-19 adult admissions to our institute from 7 March April 2020. Patient data were collected for baseline demographics, comorbidities outcomes,...
Abstract Aims To assess the real world impact of updated clinical guidelines and literature on management patients undergoing stress echocardiography for assessment inducible ischaemia across a national health service. Methods Results A total 13,819 from 32 UK hospitals, referred between 2015-2023, were analysed two phases: phase 1 (2015-2020) 2 (2020-2023). Follow-up data one year was available 4,920 participants through NHS Digital. Patients in younger, presented with higher cardiovascular...
Rapid thrombus recanalization reduces the incidence of post-thrombotic complications. This study aimed to discover whether adenovirus-mediated transfection vascular endothelial growth factor gene (ad.VEGF) enhanced and resolution.In rats, thrombi were directly injected with either ad.VEGF (n=40) or ad.GFP (n=37). Thrombi in SCID mice (n=12) human macrophages transfected ad.GFP. analyzed at 1 14 days. GFP was found mainly vein wall adventitia by 3 days, but predominantly cells within body day...
Objective International guidelines recommend the use of dual antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI). The recommended duration DAPT varies between guidelines. In this two-part study, we (1) performed a structured survey 45 TAVI centres from around world to determine if there is consensus among clinicians regarding TAVI; and then (2) systematic review all suitable studies (randomised controlled trials (RCTs) registries) aspirin monotherapy can be used...
Abstract Aims Stress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy reported in expert hands but dependent on operator training and image quality. The EVAREST study provides UK-wide data evaluate real-world performance of stress echocardiography. Methods results Participants undergoing for CAD were recruited from 31 hospitals. followed up through health records which underwent adjudication. Cardiac outcome was defined as anatomically or...
Background: Artificial intelligence (AI) for echocardiography requires training and validation to standards expected of humans. We developed an online platform established the Unity Collaborative build a dataset expertise from 17 hospitals training, validation, standardization such techniques. Methods: The consisted 2056 individual frames drawn at random 1265 parasternal long-axis video-loops patients undergoing clinical in 2015 2016. Nine experts labeled these images using our platform....
Patients with severe aortic stenosis (AS) often have coronary artery disease. Both the valve and disease influence blood flow to myocardium its ability respond stress; leading exertional symptoms. In this study, we aim quantify effect of AS on microcirculation determine if is influenced by any concomitant We then compare stenoses microcirculation.Group 1: 55 patients intermediate treated transcatheter implantation (TAVI) were included. Group 2: 85 no percutaneous intervention Coronary...
Heart failure (HF) in hypertrophic cardiomyopathy (HCM) is associated with high morbidity and mortality. Predictors of HF, particular the role myocardial fibrosis microvascular ischemia remain unclear. We assessed predictive value cardiovascular magnetic resonance (CMR) for development HF HCM an observational cohort study.
Transcatheter aortic valve replacement (TAVR) is the treatment of choice for patients with severe stenosis who are at a moderate or higher surgical risk. Stroke recognised and serious complication TAVR, it important to identify stroke This study aims discover if calcium score calculated from pre-TAVR computed tomography associated acute in TAVR patients.
Background— Rapid loss of collateral support has been reported after percutaneous coronary intervention (PCI), leaving the myocardium susceptible to subsequent infarction. However, well-developed collaterals have found in normal hearts, suggesting that exist even absence an ischemic stimulus. We assessed plasticity and determinants supply PCI. Methods Results— Collateral flow index (CFI) was calculated 60 patients as (P w −P v )/(P a ) by measurement aortic ), central venous wedge pressures....
Abstract Aims Stress echocardiography is widely used to assess patients with chest pain. The clinical value of a positive or negative test result inform on likely longer-term outcomes when applied in real-world practice across healthcare system has not been previously reported. Methods and results Five thousand five hundred three recruited 32 UK NHS hospitals between 2018 2022, participating the EVAREST/BSE-NSTEP prospective cohort study, data medical up 2023 available from England were...
Objective Transcatheter aortic valve replacement (TAVR) has been established as an alternative therapy for patients with severe stenosis who are unfit the surgical replacements. Pre and periprocedural imaging TAVR procedure is key to procedural success. Currently transesophageal echocardiography (TOE), including real-time three-dimensional (RT-3D) TOE, used peri-interventional monitoring guidance TAVR. We describe our initial experience intracardiac (RT-3DICE), technology use in procedure....
Background: Physiological assessment with pressure wire pullback can characterize coronary artery disease (CAD) a focal or diffuse pattern. However, the clinical relevance of this distinction is unknown. We use data from ORBITA trial (Objective Randomised Blinded Investigation With Optimal Medical Therapy Angioplasty in Stable Angina) to test if pattern CAD predicts placebo-controlled efficacy percutaneous intervention (PCI) on stress echocardiography ischemia and symptom end points....
The mechanism of flecainide-induced unexpected death remains uncertain. Phase-2 ventricular arrhythmias occur during infarct evolution. We examined whether flecainide (0.74 and 1.48 microM, representing the peak unbound plasma total blood concentrations, respectively, at 'therapeutic' dosage) has proarrhythmic activity on phase-2 arrhythmia susceptibility To achieve this, we used Langendorff-perfused rat heart preparation (n=8 per group) in which baseline is low. Left main coronary occlusion...
Accessory mitral valve tissue (AMVT) is a rare anomaly that can be detected in the first decade. It associated with other congenital cardiac abnormalities, such as ventricular septal defect. When adulthood, it usually an incidental finding on echocardiography. Symptomatic individuals present breathlessness, syncope, and features of distal embolization. Cardiac surgery indicated those significant left outflow tract obstruction.A 45-year-old man without any medical history was referred due to...