Publications by authors named "Nay Aung"

Heart failure (HF) has limited therapeutic options. In this study, we differentiated the pathophysiological underpinnings of the HF subtypes-HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF)-and uncovered subtype-specific therapeutic strategies. We investigated the causal roles of the human proteome and transcriptome using Mendelian randomization on more than 420,000 participants from the Million Veteran Program (27,799 HFrEF and 27,579 HFpEF cases).

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Background: The impact of early-stage chronic kidney disease (CKD) on cardiovascular outcomes, particularly when albuminuria is present, remains unclear. This study examined the associations between early CKD (stages 1 and 2) with and without albuminuria and the incidence of major adverse cardiovascular events (MACEs), heart failure (HF) and all-cause mortality.

Methods: A cohort of 456 015 participants from the UK Biobank was categorised by CKD stage using serum creatinine to calculate estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (≥3 mg/mmol) to define albuminuria.

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Background: Statistical shape atlases have been used in large-cohort studies to investigate relationships between heart shape and risk factors. The generalisability of these relationships between cohorts is unknown. The aims of this study were to compare left ventricular (LV) shapes in patients with differing cardiovascular risk factor profiles from two cohorts and to investigate whether LV shape scores generated with respect to a reference cohort can be directly used to study shape differences in another cohort.

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Aims: In light of recent advances in imaging techniques, molecular understanding and therapeutic options in hypertrophic cardiomyopathy (HCM), we performed a systematic review of current guidelines for the diagnosis and management of HCM in order to identify consensus and discrepant areas in the clinical practice guidelines.

Methods And Results: We systematically reviewed the English language guidelines and recommendations for the management of HCM in adults. MEDLINE and EMBASE databases were searched for guidelines published in the last 10 years.

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Aims: The importance of early life factors in determining health in later adulthood is increasingly recognized. This study evaluated the association of adverse childhood experiences (ACEs) with cardiovascular magnetic resonance (CMR) phenotypes.

Methods And Results: UK Biobank participants who had completed CMR and the self-reported questionnaire on traumatic childhood experiences were included.

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With a prevalence of 2-3% in the general population, mitral valve prolapse (MVP) is the most common valvular heart disease. The clinical course is benign in the majority of patients, although severe mitral regurgitation, heart failure, and sudden cardiac death affect a non-negligible subset of patients. Imaging of MVP was confined to echocardiography until a few years ago when it became apparent that cardiovascular magnetic resonance (CMR) could offer comparative advantages for detecting and quantifying mitral valve abnormalities alongside tissue myocardial characterization.

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Background: Deterioration of the cardiac conduction system is an important manifestation of cardiac ageing. Cellular ageing is accompanied by telomere shortening and telomere length (TL) is often regarded as a marker of biological ageing, potentially adding information regarding conduction disease over and above chronological age. We therefore sought to evaluate the association between leucocyte telomere length (LTL) on two related, but distinct aspects of the cardiac conduction system: ECG measures of conduction (PR interval and QRS duration) and incident pacemaker implantation in a large population-based cohort.

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Objective: Cardiovascular magnetic resonance (CMR) is increasingly used in the diagnosis of myocarditis, with myocardial injury and systolic dysfunction playing key roles in the prognosis of this clinical setting. The clinical determinants of myocardial injury and systolic impairment in acute myocarditis are poorly defined. The aim of the current study is to assess the association of laboratory markers, late gadolinium enhancement (LGE) and left ventricular ejection fraction (LVEF) in patients with acute myocarditis.

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Article Synopsis
  • Flow-mediated dilation (FMD) is a noninvasive technique used to assess vascular endothelial function, which reflects the body's vascular health and responses to inflammation.
  • * FMD is typically performed using ultrasound on the brachial artery, making it more accessible compared to invasive procedures like optical coherence tomography and intravascular ultrasound.
  • * Although endothelial examination via FMD isn't currently recommended for cardiovascular prevention due to inconsistent standard values, it shows promise in predicting cardiovascular outcomes in future research.
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  • This study investigates heart shape variation beyond just mass and volume, using data from 45,683 UK Biobank participants to create a heart shape atlas via cardiovascular magnetic resonance images.
  • Researchers found 43 significant genetic loci associated with heart shape, including 14 that were previously unknown, showing a link between heart shape and cardiometabolic diseases.
  • Specifically, two shapes tied to more spherical ventricles were linked to a higher risk of atrial fibrillation, contributing new insights into the genetic foundations of heart shape and its impact on health.
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  • Clinicians lack data science training, which is essential in today's data-driven healthcare environment, prompting the need for structured education in this area.
  • A 1-day course was conducted with 20 participants, mostly cardiology trainees, combining lectures and hands-on coding exercises in R; feedback showed improved confidence in data analysis skills.
  • Results indicate that such short courses can significantly boost clinicians' abilities and awareness in data science, suggesting a pathway for integrating these skills into medical education.
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Aims: Automated algorithms are regularly used to analyse cardiac magnetic resonance (CMR) images. Validating data output reliability from this method is crucial for enabling widespread adoption. We outline a visual quality control (VQC) process for image analysis using automated batch processing.

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Myocarditis is a cardiovascular disease characterised by inflammation of the heart muscle which can lead to heart failure. There is heterogeneity in the mode of presentation, underlying aetiologies, and clinical outcome with impact on a wide range of age groups which lead to diagnostic challenges. Cardiovascular magnetic resonance (CMR) is the preferred imaging modality in the diagnostic work-up of those with acute myocarditis.

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Background: Periodontal disease is the sixth most common disease worldwide and may be a contributory risk factor for cardiovascular disease (CVD).

Objectives: This study utilizes noninvasive cardiac imaging and longitudinal and genetic data to characterize the association between periodontal disease and both cardiovascular magnetic resonance (CMR) imaging biomarkers of remodeling and incident coronary artery disease (CAD).

Methods: From the UK Biobank, 481,915 individuals were included, 91,022 (18.

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Article Synopsis
  • * Conducted with data from the UK Biobank, which included extensive genetic, electrocardiogram, and imaging data from nearly 470,000 participants, the study found that 0.1% carried likely pathogenic TTR variants.
  • * Results showed a significant difference in variant prevalence based on ancestry, with a 0.02% prevalence in individuals of European ancestry versus 4.3% in those of African ancestry, highlighting the need for more targeted research and awareness.
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The management of acute myocarditis (AM) is addressed in multiple clinical guidelines. We systematically reviewed current guidelines developed by national and international medical organizations on the management of AM to aid clinical practice. Publications in MEDLINE, EMBASE and Cochrane were identified between 1 January 2013 and 12 April 2024.

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  • Cardiovascular magnetic resonance (CMR) imaging can estimate pulmonary capillary wedge pressure (PCWP) non-invasively, but its prognostic significance at the population level remains unexplored.
  • The study analyzed data from over 39,000 participants to examine how typical cardiovascular risk factors relate to raised CMR-modelled PCWP and its association with heart failure and major adverse cardiovascular events.
  • Results indicated that increased CMR-modelled PCWP was significantly linked with a higher risk of heart failure and major cardiovascular events, suggesting its potential importance in cardiovascular risk assessment.
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Background: Myocardial strain using cardiac magnetic resonance (CMR) is a sensitive marker for predicting adverse outcomes in many cardiac disease states, but the prognostic value in the general population has not been studied conclusively.

Objectives: The goal of this study was to assess the independent prognostic value of CMR feature tracking (FT)-derived LV global longitudinal (GLS), circumferential (GCS), and radial strain (GRS) metrics in predicting adverse outcomes (heart failure, myocardial infarction, stroke, and death).

Methods: Participants from the UK Biobank population imaging study were included.

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  • There are many guidelines for diagnosing and treating heart failure with preserved ejection fraction (HFpEF), which is a type of heart problem in adults.
  • Researchers reviewed important guides from big health organizations to help doctors make better choices for treating HFpEF.
  • While most guides agree on some treatments and definitions, they don’t always agree on the details like how often to check patients or how to screen people who might have HFpEF.
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Aims: Identifying the imaging method that best predicts all-cause mortality, cardiovascular adverse events, and heart failure risk is crucial for tailoring optimal management. Potential prognostic markers include left ventricular (LV) myocardial mass, ejection fraction, myocardial strain, stroke work, contraction fraction, pressure-strain product, and a new measurement called global longitudinal active strain density (GLASED). This study sought to compare the utility of 23 potential LV prognostic markers of structure and contractile function in a community-based cohort.

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Aims: Heart failure (HF) with preserved ejection fraction disproportionately affects women. There are no validated sex-specific tools for HF diagnosis despite widely reported differences in cardiac structure. This study investigates whether sex, as assigned at birth, influences cardiac magnetic resonance (CMR) assessment of left ventricular filling pressure (LVFP), a hallmark of HF agnostic to ejection fraction.

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