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Article ; Online: Peripartum Cardiogenic Shock and Mechanical Circulatory Support.

Botti, Giulia / Thirunavukarasu, Sharmaine / Ziviello, Francesca / Chieffo, Alaide

Interventional cardiology (London, England)

2023 Volume 18, Page(s) e28

Abstract: Despite remarkable improvements in the past two decades, the annual cardiovascular mortality rate has remained higher for women than for men. Pregnant women represent an underinvestigated population in clinical research, and the mechanisms of long-term ... ...

Abstract	Despite remarkable improvements in the past two decades, the annual cardiovascular mortality rate has remained higher for women than for men. Pregnant women represent an underinvestigated population in clinical research, and the mechanisms of long-term cardiovascular complications in women with obstetric complications remain to be elucidated. Regarding advanced heart failure during pregnancy, interventional approaches are effective but still underutilised. Percutaneous mechanical circulatory support is a valuable option for peripartum cardiogenic shock, although its use during pregnancy is still limited. Survival rates have improved in recent years, but further emphasis on the importance of early recognition and initiation of heart failure treatment in this patient group is warranted. The aims of this review are to summarise the current literature on the implementation of mechanical circulatory support in cardiogenic shock during pregnancy and delivery and to understand the role of percutaneous ventricular assist devices in the management of such conditions.
Language	English
Publishing date	2023-11-29
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2813989-6
ISSN	1756-1485 ; 1756-1485
ISSN (online)	1756-1485
ISSN	1756-1485
DOI	10.15420/icr.2020.09
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Article ; Online: A case report of refractory angina in a patient with diabetes and apical hypertrophic cardiomyopathy.

Jex, Nicholas / Chowdhary, Amrit / Thirunavukarasu, Sharmaine / Levelt, Eylem

European heart journal. Case reports

2022 Volume 6, Issue 8, Page(s) ytac347

Abstract: Background: Using serial imaging over time, this case reviews the natural history of co-morbid Type two diabetes (T2D) and apical hypertrophic cardiomyopathy (HCM) and assesses the potential combined impact on myocardial structure and perfusion.: Case ...

Abstract	Background: Using serial imaging over time, this case reviews the natural history of co-morbid Type two diabetes (T2D) and apical hypertrophic cardiomyopathy (HCM) and assesses the potential combined impact on myocardial structure and perfusion. Case summary: A 59-year-old patient with concomitant T2D and an apical phenotype of HCM was seen over a 11-year period with a significant burden of anginal chest pain. Chest pain was refractory to anti-anginal medical therapy and persisted at on-going follow-up. Multi-modality imaging demonstrated significant deterioration in coronary microvascular function and increased myocardial scar burden despite unobstructed epicardial coronary arteries. Discussion: Comorbidity with T2D and apical HCM resulted in a significant increase in myocardial fibrosis and deterioration in coronary microvascular function.
Language	English
Publishing date	2022-08-16
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytac347
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Article ; Online: Global microvascular ischaemia following Takotsubo cardiomyopathy with left ventricular function recovery.

Chowdhary, Amrit / Thirunavukarasu, Sharmaine / Jex, Nick / Levelt, Eylem

European heart journal. Case reports

2021 Volume 5, Issue 3, Page(s) ytab093

Language	English
Publishing date	2021-03-10
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytab093
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Article ; Online: Multiple Etiologies to Myocardial Injury in COVID-19.

Gorecka, Miroslawa / Thirunavukarasu, Sharmaine / Levelt, Eylem / Greenwood, John P

JACC. Case reports

2021 Volume 3, Issue 6, Page(s) 971–972

Abstract: In patients with acute myocardial injury secondary to coronavirus disease-2019 (COVID-19), cardiovascular magnetic resonance imaging can identify the underlying pathology. We highlight a case of acute myocardial injury secondary to COVID-19, which ... ...

Abstract	In patients with acute myocardial injury secondary to coronavirus disease-2019 (COVID-19), cardiovascular magnetic resonance imaging can identify the underlying pathology. We highlight a case of acute myocardial injury secondary to COVID-19, which demonstrated both epicardial vessel thrombosis and the recently described phenomenon of microvascular thrombosis. (
Language	English
Publishing date	2021-06-16
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2021.05.003
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Article ; Online: Progressive myocardial dysfunction following COVID-19.

Gorecka, Miroslawa Maria / Thirunavukarasu, Sharmaine / Levelt, Eylem / Greenwood, John P

BMJ case reports

2021 Volume 14, Issue 11

MeSH term(s)	COVID-19 ; Cardiomyopathies ; Humans ; SARS-CoV-2 ; Ventricular Function, Left
Language	English
Publishing date	2021-11-11
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-246291
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Article ; Online: Intravascular lithotripsy to treat an underexpanded coronary stent: 4-Month angiographic and OCT follow-up.

Alawami, Mohammed / Thirunavukarasu, Sharmaine / Ahmed, Javed / El-Omar, Magdi

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2020 Volume 96, Issue 6, Page(s) 1251–1257

Abstract: We report the case of a 79-year-old man with stable angina who underwent percutaneous coronary intervention to a severe and calcified left circumflex lesion. Despite extensive preparation of the lesion with high-pressure balloon predilatation and ... ...

Abstract	We report the case of a 79-year-old man with stable angina who underwent percutaneous coronary intervention to a severe and calcified left circumflex lesion. Despite extensive preparation of the lesion with high-pressure balloon predilatation and rotablation, the implanted stent was grossly underexpanded and failed to respond to high-pressure balloon postdilatation. The patient was readmitted 6 weeks later for intravascular lithotripsy that resulted in excellent stent expansion. Coronary angiography with optical coherence tomography 4 months later revealed sustained acute lumen gain with no evidence of stent recoil or in-stent restenosis.
MeSH term(s)	Aged ; Angioplasty, Balloon, Coronary/adverse effects ; Angioplasty, Balloon, Coronary/instrumentation ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/therapy ; Coronary Vessels/diagnostic imaging ; Humans ; Lithotripsy ; Male ; Predictive Value of Tests ; Severity of Illness Index ; Stents ; Time Factors ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Calcification/diagnostic imaging ; Vascular Calcification/therapy
Language	English
Publishing date	2020-01-20
Publishing country	United States
Document type	Case Reports
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/ccd.28738
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Zs.A 1226: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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Jg. 1995 - 2021: Lesesall (1.OG)
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Article ; Online: A 30-Year-Old Man With Primary Cardiac Angiosarcoma.

Jex, Nicholas / Farley, Jonathan / Thirunavukarasu, Sharmaine / Chowdhary, Amrit / Sengupta, Anshuman / Greenwood, John / Schlosshan, Dominik / Plein, Sven / Levelt, Eylem

JACC. Case reports

2021 Volume 3, Issue 6, Page(s) 944–949

Abstract: A previously fit and well 30-year-old man presented with palpitations, fever, and pleuritic chest pain. Multimodality imaging and histopathology confirmed the diagnosis of primary cardiac angiosarcoma. We present the details of the presentation, ... ...

Abstract	A previously fit and well 30-year-old man presented with palpitations, fever, and pleuritic chest pain. Multimodality imaging and histopathology confirmed the diagnosis of primary cardiac angiosarcoma. We present the details of the presentation, diagnostic process using multimodality imaging, and clinical management. (
Language	English
Publishing date	2021-05-12
Publishing country	Netherlands
Document type	Case Reports
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2021.03.009
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Article ; Online: Rationale and design of the randomised controlled cross-over trial: Cardiovascular effects of empaglifozin in diabetes mellitus.

Thirunavukarasu, Sharmaine / Brown, Louise Ae / Chowdhary, Amrit / Jex, Nicholas / Swoboda, Peter / Greenwood, John P / Plein, Sven / Levelt, Eylem

Diabetes & vascular disease research

2021 Volume 18, Issue 3, Page(s) 14791641211021585

Abstract: Background: Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular (CV) disease. In patients with T2D and established CV disease, selective inhibitors of sodium-glucose cotransporter 2 (SGLT2) have been shown to decrease CV and all- ...

Abstract	Background: Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular (CV) disease. In patients with T2D and established CV disease, selective inhibitors of sodium-glucose cotransporter 2 (SGLT2) have been shown to decrease CV and all-cause mortality, and heart failure (HF) admissions. Utilising CV magnetic resonance imaging (CMR) and continuous glucose monitoring (CGM) by FreeStyle Libre Pro Sensor, we aim to explore the mechanisms of action which give Empagliflozin, an SGLT2 inhibitor, its beneficial CV effects and compare these to the effects of dipeptidyl peptidase-4 inhibitor Sitagliptin. Methods: This is a single centre, open-label, cross-over trial conducted at the Leeds Teaching Hospitals NHS Trust. Participants are randomised for the order of treatment and receive 3 months therapy with Empagliflozin, and 3 months therapy with Sitagliptin sequentially. Twenty-eight eligible T2D patients with established ischaemic heart disease will be recruited. Patients undergo serial CMR scans on three visits. Discussion: The primary outcome measure is the myocardial perfusion reserve in remote myocardium. We hypothesise that Empaglifozin treatment is associated with improvements in myocardial blood flow and reductions in myocardial interstitial fibrosis, independent of CGM measured glycemic control in patients with T2D and established CV disease. Trial registration: This study has full research ethics committee approval (REC: 18/YH/0190) and data collection is anticipated to finish in December 2021. This study was retrospectively registered at https://doi.org/10.1186/ISRCTN82391603 and monitored by the University of Leeds. The study results will be submitted for publication within 6 months of completion.
MeSH term(s)	Benzhydryl Compounds/adverse effects ; Benzhydryl Compounds/therapeutic use ; Coronary Circulation/drug effects ; Cross-Over Studies ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Dipeptidyl-Peptidase IV Inhibitors/adverse effects ; Dipeptidyl-Peptidase IV Inhibitors/therapeutic use ; England ; Fibrosis ; Glucosides/adverse effects ; Glucosides/therapeutic use ; Glycemic Control/adverse effects ; Humans ; Myocardial Ischemia/diagnostic imaging ; Myocardial Ischemia/drug therapy ; Myocardial Ischemia/physiopathology ; Myocardium/pathology ; Randomized Controlled Trials as Topic ; Sitagliptin Phosphate/adverse effects ; Sitagliptin Phosphate/therapeutic use ; Sodium-Glucose Transporter 2 Inhibitors/adverse effects ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Time Factors ; Treatment Outcome
Chemical Substances	Benzhydryl Compounds ; Dipeptidyl-Peptidase IV Inhibitors ; Glucosides ; Sodium-Glucose Transporter 2 Inhibitors ; empagliflozin (HDC1R2M35U) ; Sitagliptin Phosphate (TS63EW8X6F)
Language	English
Publishing date	2021-06-25
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2250793-0
ISSN	1752-8984 ; 1479-1641
ISSN (online)	1752-8984
ISSN	1479-1641
DOI	10.1177/14791641211021585
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Zs.A 6378: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: 4D Flow Cardiac MR in Primary Mitral Regurgitation.

Journal of magnetic resonance imaging : JMRI

2024

Abstract: Background: Four-dimensional-flow cardiac MR (4DF-MR) offers advantages in primary mitral regurgitation. The relationship between 4DF-MR-derived mitral regurgitant volume (MR-Rvol) and the post-operative left ventricular (LV) reverse remodeling has not ... ...

Abstract	Background: Four-dimensional-flow cardiac MR (4DF-MR) offers advantages in primary mitral regurgitation. The relationship between 4DF-MR-derived mitral regurgitant volume (MR-Rvol) and the post-operative left ventricular (LV) reverse remodeling has not yet been established. Purpose: To ascertain if the 4DF-MR-derived MR-Rvol correlates with the LV reverse remodeling in primary mitral regurgitation. Study type: Prospective, single-center, two arm, interventional vs. nonintervention observational study. Population: Forty-four patients (male N = 30; median age 68 [59-75]) with at least moderate primary mitral regurgitation; either awaiting mitral valve surgery (repair [MVr], replacement [MVR]) or undergoing "watchful waiting" (WW). Field strength/sequence: 5 T/Balanced steady-state free precession (bSSFP) sequence/Phase contrast imaging/Multishot echo-planar imaging pulse sequence (five shots). Assessment: Patients underwent transthoracic echocardiography (TTE), phase-contrast MR (PMRI), 4DF-MR and 6-minute walk test (6MWT) at baseline, and a follow-up PMRI and 6MWT at 6 months. MR-Rvol was quantified by PMRI, 4DF-MR, and TTE by one observer. The pre-operative MR-Rvol was correlated with the post-operative decrease in the LV end-diastolic volume index (LVEDVi). Statistical tests: Included Student t-test/Mann-Whitney test/Fisher's exact test, Bland-Altman plots, linear regression analysis and receiver operating characteristic curves. Statistical significance was defined as P < 0.05. Results: While Bland-Altman plots demonstrated similar bias between all the modalities, the limits of agreement were narrower between 4DF-MR and PMRI (bias 15; limits of agreement -36 mL to 65 mL), than between 4DF-MR and TTE (bias -8; limits of agreement -106 mL to 90 mL) and PMRI and TTE (bias -23; limits of agreement -105 mL to 59 mL). Linear regression analysis demonstrated a significant association between the MR-Rvol and the post-operative decrease in the LVEDVi, when the MR-Rvol was quantified by PMRI and 4DF-MR, but not by TTE (P = 0.73). 4DF-MR demonstrated the best diagnostic performance for reduction in the post-operative LVEDVi with the largest area under the curve (4DF-MR 0.83; vs. PMRI 0.78; and TTE 0.51; P = 0.89). Data conclusion: This study demonstrates the potential clinical utility of 4DF-MR in the assessment of primary mitral regurgitation. Evidence level: 2 TECHNICAL EFFICACY: Stage 5.
Language	English
Publishing date	2024-02-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1146614-5
ISSN	1522-2586 ; 1053-1807
ISSN (online)	1522-2586
ISSN	1053-1807
DOI	10.1002/jmri.29284
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Zs.A 3648: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 236: Show issues

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Article ; Online: Coronary microvascular function and visceral adiposity in patients with normal body weight and type 2 diabetes.

Chowdhary, Amrit / Thirunavukarasu, Sharmaine / Jex, Nicholas / Coles, Lauren / Bowers, Charles / Sengupta, Anshuman / Swoboda, Peter / Witte, Klaus / Cubbon, Richard / Xue, Hui / Kellman, Peter / Greenwood, John / Plein, Sven / Levelt, Eylem

Obesity (Silver Spring, Md.)

2022 Volume 30, Issue 5, Page(s) 1079–1090

Abstract: Objective: This study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight.: Methods: Seventy-five participants (30 patients with type 2 diabetes [T2D] who were overweight [O-T2D], 15 ... ...

Abstract	Objective: This study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight. Methods: Seventy-five participants (30 patients with type 2 diabetes [T2D] who were overweight [O-T2D], 15 patients with T2D who were lean [LnT2D], 15 healthy volunteers who were lean [LnHV], and 15 healthy volunteers who were overweight [O-HV]) without established cardiovascular disease were recruited. Participants underwent magnetic resonance imaging for assessment of subcutaneous, epicardial, and visceral adipose tissue areas, adenosine stress myocardial blood flow (MBF), and cardiac structure and function. Results: Stress MBF was reduced only in the O-T2D group (mean [SD], LnHV = 2.07 [0.47] mL/g/min, O-HV = 2.08 [0.42] mL/g/min, LnT2D = 2.16 [0.36] mL/g/min, O-T2D = 1.60 [0.28] mL/g/min; p ≤ 0.0001). Accumulation of visceral fat was evident in the LnT2D group at similar levels to the O-HV group (LnHV = 127 [53] cm Conclusions: Patients with T2D and normal body weight do not show alterations in global stress MBF, but they do show significant increases in visceral adiposity. Patients with T2D who were overweight and had no prior cardiovascular disease showed an increase in visceral adiposity and significant reductions in stress MBF.
MeSH term(s)	Adiposity ; Cardiovascular Diseases ; Diabetes Mellitus, Type 2/complications ; Humans ; Ideal Body Weight ; Obesity, Abdominal/complications ; Obesity, Abdominal/diagnostic imaging ; Overweight/complications ; Stroke Volume ; Ventricular Function, Left
Language	English
Publishing date	2022-03-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2230457-5
ISSN	1930-739X ; 1071-7323 ; 1930-7381
ISSN (online)	1930-739X
ISSN	1071-7323 ; 1930-7381
DOI	10.1002/oby.23413
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Zs.A 4061: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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