A5021504775- Coronary Interventions and Diagnostics
- Cardiac Imaging and Diagnostics
- Acute Myocardial Infarction Research
- Advanced MRI Techniques and Applications
- Cardiovascular Function and Risk Factors
- Peripheral Artery Disease Management
- Acute Kidney Injury Research
- Hormonal Regulation and Hypertension
- Cardiac Ischemia and Reperfusion
- Cardiac Arrest and Resuscitation
- Atrial Fibrillation Management and Outcomes
- Mechanical Circulatory Support Devices
- Diabetic Foot Ulcer Assessment and Management
- Thermal Regulation in Medicine
- Cardiac Arrhythmias and Treatments
- Cardiac tumors and thrombi
- Cardiovascular Effects of Exercise
- Cardiac Structural Anomalies and Repair
- Cardiovascular Disease and Adiposity
- Heart Failure Treatment and Management
- Pain Management and Treatment
- Business Process Modeling and Analysis
- Cerebrovascular and Carotid Artery Diseases
- Photoacoustic and Ultrasonic Imaging
Essex Cardiothoracic Centre
2015-2024
Anglia Ruskin University
2015-2021
Basildon and Thurrock University Hospitals NHS Foundation Trust
2016-2020
The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements predict post-percutaneous coronary intervention (PCI) physiological outcomes, and quantify how often iFR alters PCI strategy in real-world clinical settings. In tandem diffuse disease, offline analysis continuous measurement has previously been demonstrated accurately outcome revascularization. However, online approach (iFR pullback) remains untested. Angiographically intermediate and/or...
Recently, the therapeutic benefits of percutaneous coronary intervention (PCI) have been challenged in patients with stable artery disease (SCD). The authors examined impact PCI on exercise responses circulation, microcirculation, and systemic hemodynamics SCD. A total 21 (mean age 60.3 ± 8.4 years) SCD single-vessel stenosis underwent cardiac catheterization. Pre-PCI, exercised a supine ergometer until rate-limiting angina or exhaustion. Simultaneous trans-stenotic pressure-flow...
Background The aim of this study was to evaluate the functional result chronic total occlusion percutaneous coronary intervention (PCI) measured by fractional flow reserve (FFR) immediately post index procedure and at short-term follow-up. Methods Results This a prospective single-center observational study. Consecutive patients with right artery scheduled for elective PCI were included. FFR measurements performed after successful 4 months Twenty-six completed baseline follow-up...
Mineralocorticoid receptor antagonist (MRA) therapy has been shown to prevent adverse left ventricular (LV) remodeling in ST-segment elevation myocardial infarction (STEMI) patients with heart failure. Whether initiating MRA prior primary percutaneous coronary intervention (PPCI) accrues additional benefit of reducing infarct size and preventing LV is not known. We aimed investigate whether initiated reperfusion reduces (MI) prevents STEMI patients.STEMI presenting within 12 hours a proximal...
Abstract Objective To investigate the immediate and short term impact of right coronary artery (RCA) chronic total occlusion (CTO) percutaneous intervention (PCI) upon collateral donor vessel fractional flow reserve (FFR) instantaneous wave‐free ratio (iFR). Background CTO PCI influences physiology, making indication and/or timing revascularization difficult to determine. Methods In patients with RCA CTO, FFR, iFR, function index (FFR coll ) were measured in LAD LCx pre‐CTO PCI, immediately...
Background Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been performed the improvement of symptoms and quality life in patients with stable angina. The ORBITA study demonstrated role placebo effect contemporary PCI non-CTO syndromes. However, benefit CTO beyond that a not demonstrated. Aims ORBITA-CTO pilot will be double-blind, placebo-controlled randomising who have: (1) accepted by operator PCI; (2) experienced due to CTO; (3) evidence ischaemia; (4)...
ABSTRACT Novel therapies capable of reducing myocardial infarct ( MI ) size when administered prior to reperfusion are required prevent the onset heart failure in ST ‐segment elevation infarction STEMI patients treated by primary percutaneous coronary intervention PPCI ). Experimental animal studies have demonstrated that mineralocorticoid receptor antagonist MRA therapy can reduce size, and prevents adverse left ventricular LV remodeling post‐ with impairment. With these 2 benefits mind, we...
Fractional flow reserve (FFR) has been shown to improve outcomes when used guide percutaneous coronary intervention (PCI). There have two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with value ≤0.75 predict positive ischaemia test. It then in the DEFER study that vessel ≥0.75 associated safe deferral PCI. During validation phase, ‘grey zone’ values between 0.76 and 0.80 demonstrated, where test may still occur, but...
Contrast-induced acute kidney injury (CI-AKI) is a recognised complication during primary PCI that affects short and long term prognosis. The aim of this study was to assess the impact point-of-care (POC) pre-PPCI creatinine eGFR testing in STEMI patients.160 patients (STATCREAT group) with pre-procedure POC Cr were compared 294 consecutive retrospective (control group). Patients further divided into subjects or without pre-existing CKD.The incidence CI-AKI whole population 14.5% not...
Patients presenting with ST elevation myocardial infarction (STEMI) are routinely treated percutaneous coronary intervention to restore blood flow in the occluded artery reduce infarct size (IS). However, there is evidence suggest that restoration of can cause further damage myocardium through reperfusion injury (RI). Recent research this area has focused on minimizing caused by RI. Therapeutic hypothermia (TH) been shown be beneficial animal models occlusion reducing IS RI if instituted...
The assessment of coronary microvascular dysfunction (CMD) using invasive methods is a field growing interest, however the preferred method remains debated. Bolus and continuous thermodilution are commonly used methods, but weak agreement has been observed in patients with angina non-obstructive arteries (ANOCA). This study examined their revascularized acute syndromes (ACS) chronic (CCS) patients.
Physiological stenosis assessment is recommended to guide percutaneous coronary intervention (PCI) in patients with stable angina.To determine the association between all commonly used indices of physiological severity and angina-limited exercise time angina.This cohort study included data (without follow-up) collected over 1 year from 2 cardiac hospitals. Selected angina physiologically severe single-vessel artery disease presenting for clinically driven elective PCI were...
Fractional flow reserve (FFR) assessment of remote arteries, in the context a bystander chronic total occlusion (CTO), can lead to false positive results. Adenosine stress cardiovascular magnetic resonance (CMR) evaluates perfusion defects across entire myocardium and may therefore be reliable tool work-up lesions CTO patients. The IMPACT-CTO study investigated donor artery invasive physiology before, immediately post, at 4 months following right coronary (RCA) percutaneous intervention...
Fractional flow reserve (FFR) has been shown to improve outcomes when used guide percutaneous coronary intervention (PCI). There have two proposed cut-off points for FFR. The first was derived by comparing FFR against a series of non-invasive tests, with value ≤0.75 predict positive ischaemia test. It then in the DEFER study that vessel ≥0.75 associated safe deferral PCI. During validation phase, ‘grey zone’ values between 0.76 and 0.80 demonstrated, where test may still occur, but...
Background Left ventricular (LV) thrombus formation remains a wellrecognized complication following acute ST-segment elevation myocardial infarction (STEMI) in the primary percutaneous coronary intervention (PPCI) era, with potential devastating consequences such as embolic stroke. Echocardiography-based assessment of anterior STEMI patients, within first 3 months presentation, has reported an incidence LV thrombi ranging from 8 to 15%. CMR not only provides higher resolution anatomical...
<h3>Background</h3> Primary PCI is the gold standard treatment for acute STEMI, but reperfusion injury limits its beneficial effect on infarct size (IS). In experimental studies, therapeutic hypothermia (HT) consistently reduces IS caused by injury, translation into clinical practice remains a challenge. The purpose of our study (part COOL AMI EU study) was to assess feasibility integrating pre-reperfusion HT using an intravascular temperature management system (Thermogard XP, ZOLL, USA)...
<h3>Background</h3> There is strong evidence of FFR guided treatment in multi-vessel disease. The presence a concomitant CTO may influence the measurement donor vessel as suggested previous studies and reports. This has an important implication on clinical decision making for complete revascularisation patients with chronic total occlusion. We sought to investigate collateral regression after successful recanalisation pressure-derived indices. <h3>Methods</h3> study participants were angina...
Coronary morphology and functional assessment (3) 479 evaluate acute chronic effects of transradial coronary intervention on the radial artery.There are significant injuries intimal thickening RA after TRI, mainly in proximal segment.Further study should impact these when TRI RAs subsequently used as conduits, long-term graft patency clinical outcomes bypass surgery.