A5074324263- Cardiac Imaging and Diagnostics
- Cardiovascular Function and Risk Factors
- Cardiovascular and exercise physiology
- Ultrasound in Clinical Applications
- Cardiovascular and Diving-Related Complications
- Advanced MRI Techniques and Applications
- Cardiac Valve Diseases and Treatments
- Hemodynamic Monitoring and Therapy
- Birth, Development, and Health
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiovascular Health and Disease Prevention
- Ultrasound and Hyperthermia Applications
- Cardiovascular Effects of Exercise
- Acute Myocardial Infarction Research
- Coronary Interventions and Diagnostics
- Congenital Heart Disease Studies
- Cardiac Structural Anomalies and Repair
- Heart Rate Variability and Autonomic Control
- Sports Performance and Training
- COVID-19 Clinical Research Studies
- Primary Care and Health Outcomes
- Healthcare cost, quality, practices
- Blood Pressure and Hypertension Studies
- Cardiovascular Disease and Adiposity
- COVID-19 and healthcare impacts
University of Oxford
2020-2025
King's College London
2019-2025
John Radcliffe Hospital
2020-2024
King's College - North Carolina
2024
The purpose of this study was to establish whether an artificially intelligent (AI) system can be developed automate stress echocardiography analysis and support clinician interpretation.Coronary artery disease is the leading global cause mortality morbidity remains one most commonly used diagnostic imaging tests.An automated image processing pipeline extract novel geometric kinematic features from echocardiograms collected as part a large, United Kingdom-based prospective, multicenter,...
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...
BackgroundExercise is advised for young adults with elevated blood pressure, but no trials have investigated efficacy at this age. We aimed to determine whether aerobic exercise, self-monitoring and motivational coaching lowers pressure in group.MethodsThe study was a single-centre, open, two-arm, parallel superiority randomized clinical trial open community-based recruitment of physically-inactive 18–35 year old awake 24 h 115/75mmHg-159/99 mmHg BMI<35 kg/m2. The took place the...
Abstract Background/Introduction EVAREST is a large-scale prospective, multicenter, observational study evaluating the use and accuracy of stress echocardiography (SE) in patients recruited from 31 NHS hospitals. Purpose Sub-study analysis to assess whether SE practice outcome varies with age patients. Methods Patients were sequentially on attendance at clinic between March 2015 2020. Differences characteristics outcomes compared two groups separated by median population into Younger Older...
Abstract Background/Introduction Recent guidelines and randomised controlled trials have proposed less frequent use of invasive strategies for patients with stable chest pain, demonstrated the non-inferiority an initial medical management strategy. However, impact these updates on clinical practice in United Kingdom has not been previously reported. Purpose We aimed to identify if recent literature changed being referred stress echocardiography assess inducible ischaemia a real-world,...
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...
Abstract Aims To evaluate whether left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), automatically calculated by artificial intelligence (AI), increases the diagnostic performance of stress echocardiography (SE) for coronary artery disease (CAD) detection. Methods results SEs from 512 participants who underwent a clinically indicated SE (with or without contrast) evaluation CAD seven hospitals in UK US were studied. Visual wall motion scoring (WMS) was performed...
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...
Transvalvular pressure drops are assessed using Doppler echocardiography for the diagnosis of heart valve disease. However, this method is highly user-dependent and may overestimate transvalvular by up to 54%. This work aimed assess velocity fields derived from blood speckle imaging (BSI), as a potential alternative Doppler. METHODS: A silicone 3D-printed aortic model, segmented healthy CT scan, was placed within tube. CardioFlow 5000MR flow pump used circulate mimicking fluid create eight...
Premature birth is an independent predictor of long-term cardiovascular risk. Individuals affected are reported to have a lower rate [Formula: see text]o
The aim of this study was to assess the changes determined by increased cadence on skeletal muscle oxygenation during cycling at an exercise intensity equal ventilatory threshold (Tvent).Nine healthy, active individuals with different levels experience exercised a power output Tvent, pedaling cadences 40, 50, 60, 70, 80 and 90 rpm, each for 4 min. Cadences were tested in randomized counterbalanced sequence. Cardiopulmonary metabolic responses studied using ECG heart rate, gas calorimetry...
Introduction Healthcare delivery is being transformed by COVID-19 to reduce transmission risk but continued of routine clinical tests essential. Stress echocardiography one the most widely used cardiac in NHS. We assessed impact first (W1) and second (W2) waves pandemic on ability deliver stress echocardiography. Methods Clinical teams 31 NHS hospitals participating EVAREST study were asked complete a survey structure as well its patients staff July November 2020. Results compared activity...
Abstract Background Stress echocardiography is widely used to detect coronary artery disease, but little evidence on downstream hospital costs in real-world practice available. We examined how stress accuracy and vary across NHS hospitals identified key factors that affect help inform future clinical planning guidelines. Methods Data 7636 patients recruited from 31 within the UK between 2014 2020 as part of EVAREST/BSE-NSTEP study, were used. included all diagnostic tests, procedures,...
Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main source(s): MRC. Background Cardiac catheterisation is the gold standard for assessing cardiac pressures. However, this an invasive and costly procedure. A minimally alternative may be to use subharmonic signal microbubble ultrasound contrast agents estimate pressure using echocardiography (Sub-Harmonic Assisted Pressure Estimation: SHAPE). Purpose The aim work was investigate ability SHAPE...
Abstract Background People born preterm (&lt;37 weeks’ gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation and may explain their increased risk of early heart failure cardiovascular-related mortality. It remains unknown whether lifestyle or pharmacological interventions lead to beneficial left ventricle (LV) right (RV) structural and/or functional changes in preterm-born adults. Purpose To determine adults elevated stage 1 hypertension...
ABSTRACT Background People born preterm (<37 weeks’ gestation) have a potentially adverse cardiac phenotype that progresses with blood pressure elevation. We sought to determine whether preterm-born adults elevated and stage 1 hypertension exhibit similar structural functional remodeling following 16-week aerobic exercise intervention as their term-born peers. Methods conducted an open, parallel, two-arm superiority randomized controlled (1:1) trial in n=203 aged 18-35 years old or...
Abstract Background Stress echocardiography is a widely used, non-invasive imaging modality used to identify prognostically significant coronary artery disease. High levels of accuracy have been reported, however this highly dependent on operator training and image quality. There are currently limited data available the stress echo in every day clinical practice. Purpose The EVAREST study links clinics 30 NHS Hospital Trusts England therefore provides evaluate performance diagnostic...
Cardiac catheterization is the gold standard for assessing cardiac pressures. However, this an invasive and costly procedure. An alternative may be to use subharmonic signal of microbubble ultrasound contrast agents estimate pressure using echocardiography. The aim work was investigate response agent SonoVue (Bracco Spa, Milan, Italy) dynamic pressures in a flow phantom. circulated through silicone tube peristaltic pump. ULtrasound Advanced Open Platform (ULA-OP) used with phased array...
Aortic stenosis is a condition which fatal if left untreated. Novel quantitative imaging techniques better characterise transvalvular pressure drops are being developed but require refinement and validation. A customisable cost-effective workbench valve phantom circuit capable of replicating mechanics pathology was created. The reproducibility relationship differing haemodynamic metrics were assessed from ground truth data alongside compatibility. met the requirements to capture ultrasound...
Abstract Background Point of care imaging devices are promising tools for cardiovascular in low-resource settings. Purpose Our aim was to determine whether hand-held echocardiography scans performed by obstetricians can help identify the cardiac phenotypes pregnant women with heart failure India. Methods In November 2018, eighteen from 10 hospitals across states Assam, Meghalaya and Uttar Pradesh were given 2 days hands-on training image acquisition using Philips Lumify devices....
Abstract Background Stress echocardiography has become established as the most widely applied non-invasive imaging test for diagnosis of coronary artery disease within UK. However, stress been substantially qualitative, rather than quantitative, based on visual wall motion assessment. For first time, we have identified and validated quantitative descriptors cardiac geometry motion, extracted from ultrasound images acquired using contrast agents in an automated way. Purpose To establish...
Abstract Background Transvalvular pressure drops are assessed using Doppler echocardiography for the diagnosis of heart valve disease. However, this method is highly user-dependent and may overestimate transvalvular by up to 54%. This work aimed assess velocity fields derived from blood speckle imaging (BSI), as a potential alternative Doppler. Methods A silicone 3D-printed aortic model, segmented healthy CT scan, was placed within tube. CardioFlow 5000MR flow pump used circulate mimicking...