A5067106740- Cardiac Valve Diseases and Treatments
- Cardiac Imaging and Diagnostics
- Cardiovascular Disease and Adiposity
- Aortic Disease and Treatment Approaches
- Cardiac Structural Anomalies and Repair
- Cardiac and Coronary Surgery Techniques
- Mechanical Circulatory Support Devices
- Transplantation: Methods and Outcomes
- Cardiovascular Function and Risk Factors
- Adipokines, Inflammation, and Metabolic Diseases
- Advanced MRI Techniques and Applications
- Infective Endocarditis Diagnosis and Management
- Coronary Interventions and Diagnostics
- Coronary Artery Anomalies
- Adipose Tissue and Metabolism
- Cardiovascular, Neuropeptides, and Oxidative Stress Research
- Cardiac, Anesthesia and Surgical Outcomes
- Congenital Heart Disease Studies
- Pharmacological Effects and Assays
- Organ Transplantation Techniques and Outcomes
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Cardiac Ischemia and Reperfusion
- Kawasaki Disease and Coronary Complications
- Cardiovascular and exercise physiology
- Cardiomyopathy and Myosin Studies
University of York
2025
Harefield Hospital
2004-2024
Guy's and St Thomas' NHS Foundation Trust
2021-2024
Royal Brompton & Harefield NHS Foundation Trust
2006-2023
John Radcliffe Hospital
2013-2023
University of Oxford
2013-2021
Royal Brompton Hospital
1995-2021
Imperial College London
1997-2021
Oxford University Hospitals NHS Trust
2012-2020
Norfolk and Norwich University Hospitals NHS Foundation Trust
2018-2020
Early detection of vascular inflammation would allow deployment targeted strategies for the prevention or treatment multiple disease states. Because is not detectable with commonly used imaging modalities, we hypothesized that phenotypic changes in perivascular adipose tissue (PVAT) induced by could be quantified using a new computerized tomography (CT) angiography methodology. We show inflamed human vessels release cytokines prevent lipid accumulation PVAT-derived preadipocytes vitro, ex...
Background— Takotsubo cardiomyopathy is an acute heart failure syndrome characterized by myocardial hypocontractility from the mid left ventricle to apex. It precipitated extreme stress and can be triggered intravenous catecholamine administration, particularly epinephrine. Despite its grave presentation, rapidly reversible, with generally good prognosis. We hypothesized that this represents switching of epinephrine signaling through pleiotropic β 2 -adrenergic receptor (β AR) canonical...
Background— Adiponectin is an adipokine with potentially important roles in human cardiovascular disease states. We studied the role of adiponectin cross-talk between adipose tissue and vascular redox state patients atherosclerosis. Methods Results— The study included 677 undergoing coronary artery bypass graft surgery. Endothelial function was evaluated by flow-mediated dilation brachial vivo vasomotor studies saphenous vein segments ex vivo. Vascular superoxide (O 2 − ) endothelial nitric...
Oxidative stress plays a critical role in the vascular complications of type 2 diabetes. We examined effect diabetes on NADPH oxidase human vessels and explored mechanisms this interaction. Segments internal mammary arteries (IMAs) with their perivascular adipose tissue (PVAT) thoracic were obtained from 386 patients undergoing coronary bypass surgery (127 diabetes). Type was strongly correlated hypoadiponectinemia increased oxidase–derived superoxide anions (O2˙−). The genetic variability...
Adiponectin has anti-inflammatory effects in experimental models, but its role the regulation of myocardial redox state humans is unknown. Although adiponectin released from epicardial adipose tissue (EpAT), it unclear whether exerts any paracrine on human myocardium.To explore cross talk between EpAT-derived and heart.EpAT atrial myocardium were obtained 306 patients undergoing coronary artery bypass grafting. Functional genetic polymorphisms that increase ADIPOQ expression (encoding...
To explore the role of systemic inflammation in regulation adiponectin levels patients with ischemic heart disease.In a cross-sectional study 575 subjects, serum was compared between healthy coronary artery disease no/mild/severe failure (HF), and nonischemic HF. Adiponectin expression release from femoral, subcutaneous thoracic adipose tissue determined 258 additional bypass grafting. Responsiveness various human depots to interleukin-6, tumor necrosis factor-α, brain natriuretic peptide...
Rationale: Aberrant airway smooth muscle cell (ASMC) function and overexpression of transforming growth factor (TGF)-β, which modulates ASMC proliferative inflammatory induces oxidant release, are features asthma. Nuclear E2-related 2 (Nrf2) activates antioxidant genes conferring protection against oxidative stress.Objectives: To determine the role Nrf2 in ASMCs its modulation by TGF-β, compare activity from subjects with severe nonsevere asthma healthy subjects.Methods: were cultured...
Adipose-secreted WNT5A triggers vascular disease in obesity, activating smooth muscle cell migration by an NADPH oxidase–dependent mechanism.
Left ventricular (LV) hypertrophy in aortic stenosis (AS) is characterized by reduced myocardial perfusion reserve due to coronary microvascular dysfunction. However, whether this hypoperfusion leads tissue deoxygenation unknown. We aimed assess oxygenation severe AS without obstructive artery disease, and investigate its association with energetics function. Twenty-eight patients isolated 15 controls underwent cardiovascular magnetic resonance (CMR) for assessment of (myocardial index-MPRI)...
Aortic stenosis (AS) leads to left ventricular (LV) hypertrophy and dysfunction. We hypothesized that cardiac steatosis is involved in the pathophysiology also assessed whether it reversible after aortic valve replacement.Thirty-nine patients with severe AS (symptomatic=25, asymptomatic=14) normal LV ejection fraction no significant coronary artery disease 20 age- sex-matched healthy controls underwent 1H-magnetic resonance spectroscopy imaging for determination of (myocardial triglyceride...
Perfusion cardiovascular magnetic resonance (CMR) performed with inadequate adenosine stress leads to false-negative results and suboptimal clinical management. The recently proposed marker of adequate stress, the "splenic switch-off" sign, detects splenic blood flow attenuation during perfusion (spleen appears dark), but can only be assessed after gadolinium first-pass, when it is too late optimize response. Reduction in volume expected shorten native T1, which may predict switch-off...
Experimental evidence suggests that telomere length (TL) is shortened by oxidative DNA damage, reflecting biological aging. We explore the value of blood (BTL) and vascular TL (VTL) as biomarkers systemic/vascular stress in humans test clinical predictive BTL acute myocardial infarction (AMI).In a prospective cohort 290 patients surviving recent AMI, measured on admission was strong predictor all-cause [hazard ratio (HR) [95% confidence interval (CI)]: 3.21 [1.46-7.06], P = 0.004]...
Several pharmacological agents have been shown to produce 'physiological' or 'pathological' hypertrophy based on their functional characteristics. The aim of this study was examine the features cardiac induced by selective beta 2-adrenergic agonist, clenbuterol.Cardiac in 7-week-old Sprague-Dawley rats daily injections clenbuterol for 3 weeks. Thyroxine and isoproterenol were also used serve as positive controls physiological pathological hypertrophy, respectively. Left ventricular function...
Background Appropriate cardiac hypertrophy (CH) is necessary in several clinical settings, such as pulmonary artery banding the two-stage arterial switch operation for transposition of great arteries. Pressure-overload CH, however, produces ventricular dysfunction due to structural and molecular changes. The β 2 -adrenergic receptor agonist clenbuterol has been shown induce CH without adverse effects rat heart. This study was performed determine its on left (LV) function, structure, gene...
Heart failure is the usual cause of death in patients with amyloid cardiomyopathy. The commonest form hereditary cardiac amyloidosis associated Val122Ile variant transthyretin (TTR), which carried by 3-4% African American population. Here, we report outcome first transplantation a patient TTR V122I. A 59-year-old Caribbean man presented biventricular failure. Other than previous bilateral carpel tunnel syndrome, he had been well and no evidence extracardiac amyloidosis. An endomyocardial...
Background— Cardiac surgery with cardiopulmonary bypass is associated mechanical manipulation of the ascending aorta that occasionally leads to type A aortic dissection (AAD). Methods and Results— One hundred three patients surgical repair for AAD following nonaortic cardiac were identified. With use logistic regression modeling, coronary artery (CABG), either isolated or combined another procedure in initial operation, was significantly higher operative mortality comparison non-CABG...
Feedback of clinical outcome data to clinicians can promote and enhance patient safety. Surgeon-specific mortality (SSMD) have been released the public for a number specialties. This implies that one individual is culpable all deaths. Debate continues about SSMD because risk-averse behaviour. In USA, improved measures derived from phase care analysis (POCMA) failure rescue (FTR) are replacing SSMD, but they not tested in Europe.Using POCMA FTR analysis, we studied hospital deaths 1558...
Background Skeletal muscle assistance of the circulation for patients in end-stage heart failure requires electrical training latissimus dorsi flap to produce fatigue resistance. This process transformation and development postmobilization atrophy results a profound loss peak power generated. The β 2 -adrenoceptor agonist clenbuterol was used investigate its potential selectively induce skeletal hypertrophy, particularly (LDM), independent adverse effects on cardiac muscle. Methods Results...