A5037219789- Coronary Interventions and Diagnostics
- Cardiac Imaging and Diagnostics
- Acute Myocardial Infarction Research
- Cardiac Arrest and Resuscitation
- Cardiovascular Function and Risk Factors
- Venous Thromboembolism Diagnosis and Management
- Atrial Fibrillation Management and Outcomes
- Cardiac, Anesthesia and Surgical Outcomes
- Mechanical Circulatory Support Devices
- Cardiac Arrhythmias and Treatments
- Advanced MRI Techniques and Applications
- Antiplatelet Therapy and Cardiovascular Diseases
- Intensive Care Unit Cognitive Disorders
- Peripheral Artery Disease Management
- Respiratory Support and Mechanisms
- Heart Failure Treatment and Management
- Cardiac Structural Anomalies and Repair
- Cardiac Valve Diseases and Treatments
- Traumatic Brain Injury and Neurovascular Disturbances
- Pain Management and Treatment
- Thermal Regulation in Medicine
- Acute Kidney Injury Research
- Takotsubo Cardiomyopathy and Associated Phenomena
- Trauma and Emergency Care Studies
- Hospital Admissions and Outcomes
Essex Cardiothoracic Centre
2016-2025
Anglia Ruskin University
2016-2025
Basildon Hospital
2023-2024
Basildon and Thurrock University Hospitals NHS Foundation Trust
2013-2019
Broomfield Hospital
2004-2007
Addenbrooke's Hospital
1996-2000
University of Cambridge
1996-2000
Hammersmith Hospital
1993-1997
University of Nottingham
1992
Percutaneous coronary intervention (PCI) is frequently performed to reduce the symptoms of stable angina. Whether PCI relieves angina more than a placebo procedure in patients who are not receiving antianginal medication remains unknown. We conducted double-blind, randomized, placebo-controlled trial with Patients stopped all medications and underwent 2-week symptom assessment phase before randomization. were then randomly assigned 1:1 ratio undergo or followed for 12 weeks. The primary end...
Background: Microvascular angina is associated with dysregulation of the endothelin system and impairments in myocardial blood flow, exercise capacity, health-related quality life. The G allele noncoding single nucleotide polymorphism RS9349379 enhances expression endothelin-1 gene ( EDN1 ) human vascular cells, potentially increasing circulating concentrations Endothelin-1 (ET-1). Whether zibotentan, an oral ET-A receptor selective antagonist, efficacious safe for treatment microvascular...
A randomized trial evaluating the coronary sinus reducer for relieving angina by potentially improving myocardial blood flow in patients with no other treatment options, as assessed cardiac MRI and patient symptoms.
Abstract Background Anaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) the treatment of choice; however, recommended dose route administration epinephrine used in anaphylaxis different from that cardiac arrest. Objective To investigate how junior doctors would administer case anaphylactic shock an adult patient. Methods Junior medical staff two district general hospitals were assessed with short questionnaire. Results...
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...
We sought to compare the efficiency of novel EuroCTO (CASTLE) score with commonly used Multicentre CTO Registry in Japan (J-CTO) predicting procedural success percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs).We evaluated 660 consecutive PCIs (mean age 66±11 years, 84% male). The mean J-CTO and scores were 1.86±1.2 1.74±1.2, respectively. Antegrade wire escalation, antegrade dissection re-entry retrograde approach 82%, 14% 37% cases, Receiver operating...
Recombinant adenoviral vectors are being used increasingly for gene transfer studies in mammalian cells and therapy protocols humans. High titers often required successful transduction of vascular smooth muscle (VSMCs), defined as uptake detectable expression the foreign gene, but relative contributions efficiency viral control transcription poorly understood. To explore extent to which a lack may be due inefficient successfully transferred we have replication-deficient adenovirus expressing...
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...
The aim of this study was to investigate whether algorithmic interpretation (AI) instantaneous wave-free ratio (iFR) pressure-wire pull back data would be noninferior expert human interpretation.
Trials demonstrate significant clinical benefit in patients receiving therapeutic hypothermia (TH) after cardiac arrest. However, incidence of mortality and morbidity remains high this patient group. Rapid targeted brain induction, together with prompt correction the underlying cause may improve outcomes these patients. This study investigates efficacy Rhinochill, an intranasal cooling device over Blanketrol, a surface inducing TH arrest within catheter laboratory.70 were randomized to...
Background: To assess whether hydrostatic pressure gradients caused by coronary height differences in supine versus prone positioning during invasive physiological stenosis assessment affect resting and hyperaemic pressure-based indices or flow. Methods: Twenty-three stenoses were assessed twenty-one patients with stable artery disease. All had a of at least 50% visually defined on previous angiography. Pd/Pa, iFR, FFR, flow velocity (APV) measured using Doppler recorded across the same...
Abstract Objectives This study aimed to assess the impact of stent optimization by NC‐balloon postdilatation (PD) during primary‐PCI for STEMI with use coronary physiology and intracoronary imaging. Methods was a prospective observational ( ClinicalTrials.gov :NCT02788396). Optical coherence tomography (OCT) physiological measurements were performed immediately before after PD operators blinded all measurements. The index microcirculatory resistance (IMR), flow reserve (CFR) fractional (FFR)...
Objectives: Use of intracoronary imaging (ICI) in cases stent thrombosis (ST) is recommended and tailored treatment appears reasonable. Nevertheless, data supporting such a strategy are lacking. The aim this study was to evaluate the clinical impact ICI management ST. Methods: unadjusted population consecutive patients with definite ST presenting single tertiary cardiac centre undergoing percutaneous coronary intervention (PCI). presumed major mechanism assigned according real-time...
Background: The Placebo-controlled Trial of Percutaneous Coronary Intervention for the Relief Stable Angina (ORBITA-2) provided evidence role percutaneous coronary intervention (PCI) angina relief in stable artery disease (CAD). Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are often used to guide PCI, however their ability predict placebo-controlled improvement is unknown. Methods: Participants with angina, ischemia, CAD were enrolled antianginal medications stopped....
Abstract Objectives We sought to evaluate mortality predictors and the role of new‐generation drug‐eluting stents (NG‐DES) in stent thrombosis (ST) management. Background No data are available regarding outcome patients with ST after interventional management that includes exclusively NG‐DES. Methods Patients definite DES or BMS who underwent urgent/emergent angiography between 2015 2018 at our institution were considered for study. After excluding achieved TIMI‐flow<2 intervention...
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...