Publications by authors named "James Stirrup"

The ferritin-lymphocyte ratio (FLR) is a novel inflammatory biomarker for the assessment of acute COVID-19 patients. However, the prognostic value of FLR for predicting adverse clinical outcomes in COVID-19 remains unclear, which hinders its clinical translation. We characterised the prognostic value of FLR in COVID-19 patients, as compared to established inflammatory markers.

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CRB-65 (onfusion; espiratory rate ≥ 30/min; lood pressure ≤ 90/60 mmHg; age ≥ years) is a risk score for prognosticating patients with COVID-19 pneumonia. However, a significant proportion of COVID-19 patients have normal chest X-rays (CXRs). The influence of CXR abnormalities on the prognostic value of CRB-65 is unknown, limiting its wider applicability.

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Article Synopsis
  • The lymphocyte-CRP ratio (LCR) is a potential biomarker for predicting adverse outcomes in COVID-19 patients, but its effectiveness compared to traditional inflammatory markers is still unclear.
  • In a study of 413 COVID-19 inpatients, LCR showed similar predictive power to CRP for mortality and combined adverse outcomes, while outperforming other markers like lymphocyte and platelet counts.
  • Patients with a low LCR (below 58) had significantly poorer survival rates, indicating LCR's importance, but further research is needed to enhance its clinical application.
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Article Synopsis
  • Assessing the risk of inpatient mortality in COVID-19 patients is crucial for clinical decision-making, focusing on the role of high sensitivity cardiac troponin T (hs-cTnT) as a biomarker indicating worse prognosis.
  • A study conducted on 191 COVID-19 patients found that 65% had elevated hs-cTnT levels, correlating with significantly worse survival rates and increased mortality risk.
  • The findings suggest that hs-cTnT could be particularly useful for ruling out inpatient mortality, which could lead to better management practices and potential early discharge for patients with normal levels.
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Objectives: Coronary and cardiac calcification are frequent incidental findings on non-gated thoracic computed tomography (CT). However, radiologist opinions and practices regarding the reporting of incidental calcification are poorly understood.

Methods: UK radiologists were invited to complete this online survey, organised by the British Society of Cardiovascular Imaging (BSCI).

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Background: Concurrent myopericarditis and myositis can present in patients with pre-existing systemic inflammatory diseases. Here we present a case of myopericarditis and myositis associated with COVID-19, in the absence of respiratory symptoms.

Case Summary: We present a middle-aged female with a history of hypertension and previous myopericarditis.

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Article Synopsis
  • Incidental findings of coronary and cardiac calcification are common in non-gated thoracic CT scans, and it's important to review the heart in these cases.
  • Coronary artery calcification indicates coronary artery disease and is linked to a poorer prognosis; it should be reported using a simple scoring system and include management recommendations for cardiovascular risk factors.
  • Additional findings like aortic valve calcification and other cardiac calcifications should also be noted, but many of these may not have clinical significance.
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The incidence of acute ischaemic stroke in young patients is increasing and identifying the underlying cause is critically important with regards to their optimal management. The true proportion of cardiac causes of stroke in young patients is poorly defined. We aimed to determine the proportion of strokes attributable to cardiac causes in an unselected, consecutive cohort of young patients.

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Aortic dissection is characterised by a tear in the intimal and medial layers of the endovascular aortic wall which propagates distally. Here, we discuss the case of a 35-year-old woman who was 37 weeks pregnant and presented with dizziness and blurred vision. She had a history of a neonatal end-to-end repair of a coarctation of aorta, a known bicuspid aortic valve and a dilated ascending aorta under surveillance.

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Transesophageal echocardiography (TEE) is a powerful imaging tool for the comprehensive assessment of valvular structure and function. TEE may be of added benefit when anatomy is difficult to delineate accurately by transthoracic echocardiography. In this article, we present 2-, 3-dimensional, and color Doppler TEE images from a male patient with aortic stenosis.

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Accurate and timely assessment of suspected acute aortic syndrome is crucial in this life-threatening condition. Imaging with CT plays a central role in the diagnosis to allow expedited management. Diagnosis can be made using locally available expertise with optimized scanning parameters, making full use of recent advances in CT technology.

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Improved multi-detector computed tomography (MDCT) temporal and spatial resolution allows for the assessment of coronary artery disease, left ventricular systolic function and resting myocardial perfusion defects with high sensitivity and specificity. Here we present a case using a novel combination technique of cardiac computed tomography scanning with dipyridamole stress for the detection of functionally significant coronary disease, and demonstrate that dipyridamole-induced myocardial ischaemia is both detectable and quantifiable by cardiac MDCT.

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Unlabelled: Little is known about the effect of chronic beta-blockade on adenosine actions. We sought to investigate the effect of oral beta-blockers on the presence, extent, and severity of myocardial perfusion abnormality induced by adenosine in patients with coronary artery disease.

Methods: In this crossover study, 45 male patients with coronary artery disease on beta-blocker therapy with atenolol, bisoprolol, or metoprolol underwent adenosine myocardial perfusion imaging both on and off beta-blockade in a random order on separate days.

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Background: CT coronary angiography (CTA) with 64 slice multi-detector CT (64-MDCT) has assumed an increasing role in clinical practice; however the high radiation dose associated with retrospective ECG-gated CTA has led to suggestions that a low dose prospectively gated strategy may be more appropriate. This study aims to assess the feasibility of this proposed strategy amongst standard referral for CTA in our centre.

Methods: We retrospectively analyzed 200 consecutive clinical CTA studies assessing the number of cardiac phases required to allow full diagnostic visualisation of the coronary tree.

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Introduction Or Background: Many tests are available for the investigation of patients with heart failure. The identification of the underlying aetiology of ventricular dysfunction is crucial as early treatment may limit or even reverse myocardial abnormalities.

Sources Of Data: This article describes cardiac radionuclide imaging techniques and their applications in ischaemic ventricular dysfunction.

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Objectives: To assess intraobserver and interobserver variability in cardiac computed tomographic measurements of global biventricular function, left ventricular (LV) regional wall motion, systolic wall thickening, and first pass perfusion in 3 patient cohorts at very low, low to intermediate, and intermediate to high cardiac risk.

Methods: One hundred thirty-three patients underwent 64-channel cardiac computed tomography. Images were analyzed by 2 experienced, blinded observers.

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Objectives: To assess intraobserver and interobserver variation in computed tomography coronary angiography (CTA) in 3 patient cohorts at very low, low-to-intermediate, and intermediate-to-high likelihood of coronary artery disease (CAD).

Methods: One hundred thirty-three patients underwent 64-channel CTA. Coronary arteries were analyzed by 2 experienced blinded observers and reported as having 0%, 1% to 29%, 30% to 49%, 50% to 69%, 70% to 99%, or 100% stenosis.

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There is currently much debate around the limited positive predictive value (PPV) of CT coronary angiography (CTA). There remain no published studies comparing different thresholds to define significant visual stenoses on CTA compared to the gold standard quantitative coronary angiography (QCA). The spatial resolution for ICA is (0.

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There are currently no published studies of the impact of CT coronary angiography (CTA) on patient management or cost when compared with other established imaging techniques. We assessed the short term investigation and treatment costs of CTA compared with myocardial perfusion scintigraphy (MPS) using real clinical scenarios. Clinical information with either their CTA or MPS results were presented to 20 cardiologists in a random order.

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Introduction: The increasing number of available cardiac imaging techniques has made the investigation of coronary artery disease (CAD) more complex. Appropriate patient referral depends on an understanding of the pre-test likelihood of CAD and the information provided by each test.

Sources Of Data: This article describes myocardial perfusion scintigraphy (MPS) and summarizes evidence for its role in stable CAD and acute coronary syndromes with particular reference to current guidelines.

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