A5055552347- Cardiac Imaging and Diagnostics
- Advanced MRI Techniques and Applications
- Cardiovascular Function and Risk Factors
- Cardiomyopathy and Myosin Studies
- Cardiovascular Disease and Adiposity
- Lysosomal Storage Disorders Research
- Advanced X-ray and CT Imaging
- Coronary Interventions and Diagnostics
- Cardiac Arrhythmias and Treatments
- Ultrasound in Clinical Applications
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Pericarditis and Cardiac Tamponade
- Cardiac electrophysiology and arrhythmias
- Congenital Heart Disease Studies
- Trypanosoma species research and implications
- Pulmonary Hypertension Research and Treatments
- Cardiovascular Effects of Exercise
- Atomic and Subatomic Physics Research
- Cardiovascular and exercise physiology
- Cardiac tumors and thrombi
- Metabolism, Diabetes, and Cancer
- Infective Endocarditis Diagnosis and Management
- Parathyroid Disorders and Treatments
- Heart Failure Treatment and Management
- Cardiovascular Health and Disease Prevention
Harefield Hospital
2023-2024
University College London
2017-2024
St George’s University Hospitals NHS Foundation Trust
2015-2024
St Bartholomew's Hospital
2017-2024
Royal Victoria Hospital
2024
University of Ulster
2024
King's College Hospital NHS Foundation Trust
2021-2024
British Heart Foundation
2017-2024
St George's Hospital
2024
King's College - North Carolina
2024
Background: Myocardial perfusion reflects the macro- and microvascular coronary circulation. Recent quantitation developments using cardiovascular magnetic resonance (CMR) permit automated measurement clinically. We explored prognostic significance of stress myocardial blood flow (MBF) reserve (MPR, ratio to rest MBF). Methods: A two center study patients with both suspected known artery disease referred clinically for assessment. Image analysis was performed automatically a novel artificial...
Background: Automated analysis of cardiac structure and function using machine learning (ML) has great potential, but is currently hindered by poor generalizability. Comparison traditionally against clinicians as a reference, ignoring inherent human inter- intraobserver error, ensuring that ML cannot demonstrate superiority. Measuring precision (scan:rescan reproducibility) addresses this. We compared humans multicenter, multi-disease, scan:rescan cardiovascular magnetic resonance data set....
Left ventricular maximum wall thickness (MWT) is central to diagnosis and risk stratification of hypertrophic cardiomyopathy, but human measurement prone variability. We developed an automated machine learning algorithm for MWT compared precision (reproducibility) with that 11 international experts, using a dataset patients cardiomyopathy.60 adult including those carrying cardiomyopathy gene mutations, were recruited at three institutes in the UK from August, 2018, September, 2019: Barts...
Cardiac involvement is the main driver of clinical outcomes in systemic amyloidosis and preliminary studies support hypothesis that myocardial ischaemia contributes to cellular damage. The aims this study were assess presence mechanisms using cardiovascular magnetic resonance (CMR) with multiparametric mapping histopathological assessment.
Non-invasive assessment of myocardial ischaemia is a cornerstone the diagnosis coronary artery disease. Measurement blood flow (MBF) using positron emission tomography (PET) current reference standard for non-invasive quantification ischaemia. Dynamic perfusion cardiovascular magnetic resonance (CMR) offers an alternative to PET and recently developed method with automated inline mapping has shown good correlation MBF values between CMR PET. This study assessed repeatability by in healthy...
Background: Cardiovascular magnetic resonance can demonstrate myocardial processes in Fabry disease (FD), such as low native T1 (sphingolipid storage) and late gadolinium enhancement (LGE, scar). Recently, high T2 (edema) has been observed the basal inferolateral wall along with troponin elevation. We hypothesized that edema myocyte injury would be chronically associated have electrical, mechanical, associations FD. Methods: A prospective international multicenter study was conducted on 186...
Background: Cardiac response to enzyme replacement therapy (ERT) in Fabry disease is typically assessed by measuring left ventricular mass index using echocardiography or cardiovascular magnetic resonance, but neither quantifies myocardial biology. Low native T1 represents sphingolipid accumulation; late gadolinium enhancement with high T2 and troponin elevation reflects inflammation. We evaluated the effect of ERT on storage, inflammation, hypertrophy. Methods: Twenty patients starting (60%...
Abstract Aims Cardiac involvement in Fabry disease (FD) occurs prior to left ventricular hypertrophy (LVH) and is characterized by low myocardial native T1 with sphingolipid storage reflected cardiovascular magnetic resonance (CMR) electrocardiogram (ECG) changes. We hypothesize that a pre-storage phenotype might occur even earlier, lowering. Methods results FD patients age-, sex-, heart rate-matched healthy controls underwent same-day ECG advanced analysis multiparametric CMR [cines, global...
Recently developed in-line automated cardiovascular magnetic resonance (CMR) myocardial perfusion mapping has been shown to be reproducible and comparable with positron emission tomography (PET), can easily integrated into clinical workflows. Bringing quantitative CMR routine care requires knowledge of sex- age-specific normal values in order define thresholds for disease detection. This study aimed establish stress rest blood flow (MBF) healthy volunteers.A total 151 volunteers recruited...
Background: Apical hypertrophic cardiomyopathy (ApHCM) accounts for ≈10% of cases and is characterized by apical hypertrophy, cavity obliteration, tall ECG R waves with ischemic-looking deep T-wave inversion. These may be present even <15 mm hypertrophy (relative ApHCM). Microvascular dysfunction well described in cardiomyopathy. We hypothesized that perfusion defects would common ApHCM. Methods: A 2-center study using cardiovascular magnetic resonance short- long-axis quantitative...
Cardiac MR stress perfusion remains a qualitative technique in clinical practice due to technical and postprocessing challenges. However, automated inline mapping now permits myocardial blood flow (MBF, ml/g/min) quantification on-the-fly without user input.To investigate the diagnostic performance of this novel detecting occlusive coronary artery disease (CAD) patients scheduled undergo angiography.Prospective, observational.Fifty with suspected CAD 24 healthy volunteers.1.5T. SEQUENCE:...
To develop a deep neural network-based computational workflow for inline myocardial perfusion analysis that automatically delineates the myocardium, which improves clinical and offers "one-click" solution.In this retrospective study, consecutive adenosine stress rest scans were acquired from three hospitals between October 1, 2018 February 27, 2019. The training validation set included 1825 series 1034 patients (mean age, 60.6 years ± 14.2 [standard deviation]). independent test 200 105 59.1...
The purpose of this study was to explore the prognostic significance PTT and PBVi using an automated, inline method estimation CMR. Pulmonary transit time (PTT) pulmonary blood volume index (PBVi) (the product cardiac index), are quantitative biomarkers cardiopulmonary status. development cardiovascular magnetic resonance (CMR) perfusion mapping permits their automated derivation, facilitating clinical adoption. In retrospective 2-center patients referred for myocardial assessment CMR,...
To evaluate the impact of a simplified, rapid cardiovascular magnetic resonance (CMR) protocol embedded in care and supported by partner education programme on management cardiomyopathy (CMP) low- middle-income countries (LMICs).Rapid CMR focused particularly CMP was implemented 11 centres, 7 cities, 5 countries, 3 continents linked to training courses for local professionals. Patients were followed up 24 months assess impact. The rate subsequent adoption tracked. Five conferences delivered...
Typical electrocardiogram (ECG) features of apical hypertrophic cardiomyopathy (ApHCM) include tall R waves and deep or giant T-wave inversion in the precordial leads, but these are not always present. The ECG is used as gatekeeper to cardiac imaging for diagnosis. We tested whether explainable advanced (A-ECG) could accurately diagnose ApHCM.
Background Impaired myocardial blood flow (MBF) in the absence of epicardial coronary disease is a feature hypertrophic cardiomyopathy (HCM). Although most evident hypertrophied or scarred segments, reduced MBF can occur apparently normal segments. We hypothesized that impaired and perfusion reserve, quantified using mapping cardiac magnetic resonance, might overt left ventricular hypertrophy (LVH) late gadolinium enhancement, mutation carriers without LVH criteria for HCM...
Objective In patients with hypertrophic cardiomyopathy (HCM), the role of small vessel disease and myocardial perfusion remains incompletely understood data on absolute blood flow (MBF, mL/g/min) are scarce. We measured MBF using cardiovascular magnetic resonance fully quantitative mapping to determine relationship between perfusion, hypertrophy late gadolinium enhancement (LGE) in HCM. Methods 101 HCM unobstructed epicardial coronary arteries 30 controls (with matched risk factors)...
Background: Fabry disease (FD) is an X-linked lysosomal storage resulting in tissue accumulation of sphingolipids. Key myocardial processes that lead to adverse outcomes FD include storage, hypertrophy, inflammation, and fibrosis. These are quantifiable by multiparametric cardiovascular magnetic resonance. Recent developments resonance perfusion mapping allow rapid in-line quantification permitting broader clinical application, including the assessment microvascular dysfunction. We...
Unrecognised coronary artery disease (CAD) may contribute to adverse outcomes in chronic obstructive pulmonary (COPD). Improved identification of at-risk groups could inform better preventative care. We aimed evaluate the burden and relationships radiologically detectable CAD COPD, establish frequency occult disease, examine potential cardiovascular screening methods. Using CT angiogram (CTCA), we prospectively evaluated 50 patients with COPD compared age, sex-matched controls. In those...