Publications by authors named "Rodwell L"

Article Synopsis
  • The study investigates the impact of non-culprit (NC) lesions in patients with NSTEMI compared to those with STEMI, focusing on high-risk plaque features and their influence on clinical outcomes.
  • Among 438 patients, both NSTEMI and STEMI groups showed similar prevalence of high-risk plaques, but NSTEMI patients had a higher rate of major adverse cardiovascular events (MACE) after two years.
  • The findings suggest that the presence of high-risk plaques in NC lesions is critical for dictating future cardiovascular events, indicating the need for further research on effective revascularization strategies in NSTEMI patients.
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Brief exposure of monocytes to atherogenic molecules, such as oxidized lipoproteins, triggers a persistent pro-inflammatory phenotype, named trained immunity. In mice, transient high-fat diet leads to trained immunity, which aggravates atherogenesis. We hypothesized that a single high-fat challenge in humans induces trained immunity.

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Background: Paravalvular regurgitation (PVR) is a common complication after transcatheter aortic valve replacement, posing an increased risk of heart failure and mortality. Accurate intraprocedural quantification of PVR is challenging. Both hemodynamic indices and videodensitometry can be used for intraprocedural assessment of PVR.

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Article Synopsis
  • Recurrent events after myocardial infarction (MI) often arise from non-flow limiting lesions, which may differ between sexes, prompting this study to investigate these potential differences among MI patients.
  • The study examined 420 patients, finding that female patients had longer NC lesions and smaller lumen areas and diameters, as well as thinner fibrous caps compared to male patients.
  • Despite females exhibiting more high-risk plaque characteristics, both genders experienced similar rates of major cardiovascular events at two years, suggesting the need for further research on long-term outcomes related to these differences.
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Recent landmark trials showed that colchicine provides a substantial benefit in reducing major cardiovascular events in patients with coronary artery disease. Yet, its exact mechanism of action is still poorly understood. This study aimed to unravel the effect of colchicine on monocyte and neutrophil phenotype and function.

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Background: Papillary muscle-delayed hyperenhancement (papHE) at cardiac magnetic resonance indicates fibrotic or infiltrative processes. Contrary to myocardial HE, the prevalence and prognostic implications of papHE in patients with nonischemic dilated cardiomyopathy are unclear.

Objectives: The purpose of this study was to determine the prevalence of papHE and describe its association with adverse clinical outcomes.

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Aims: Recently, novel post-processing tools have become available that measure intraventricular pressure gradients (IVPGs) on routinely obtained long-axis cine cardiac magnetic resonance (CMR) images. IVPGs provide a comprehensive overview of both systolic and diastolic left ventricular (LV) functions. Whether IVPGs are associated with clinical outcome after ST-elevation myocardial infarction (STEMI) is currently unknown.

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Background: It has been suggested that coronary microvascular function decreases with age, irrespective of the presence of epicardial atherosclerosis.

Aims: Our aim is to quantitatively investigate the effects of age on microvascular function in patients with normal coronary arteries.

Methods: In 314 patients with angina with no obstructive coronary artery disease (ANOCA), microcirculatory function was tested using the continuous thermodilution method.

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Background: During transcatheter aortic valve implantation (TAVI), secondary access is required for angiographic guidance and temporary pacing. The most commonly used secondary access sites are the femoral artery (angiographic guidance) and the femoral vein (temporary pacing). An upper extremity approach using the radial artery and an upper arm vein instead of the lower extremity approach using the femoral artery and femoral vein may reduce clinically relevant secondary access site-related bleeding complications, but robust evidence is lacking.

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Background: Accurate risk stratification identifying patients with hypertension at risk of future cardiovascular disease in primary care would be desirable.

Aim: To investigate the association between elevated brain natriuretic peptide (BNP), left ventricular hypertrophy (LVH) on an electrocardiogram (ECG), and LVH on an echocardiogram and the development of cardiovascular events (CVEs), especially heart failure and all-cause mortality (ACM), in a primary care population with hypertension without symptoms of heart failure.

Design And Setting: A prospective cohort study in five Dutch general practices between 2010-2012 and 2020.

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The femoral vein is commonly used as a pacemaker access site during transcatheter aortic valve replacement (TAVR). Using an upper arm vein as an alternative access site potentially causes fewer bleeding complications and shorter time to mobilization. We aimed to assess the safety and efficacy of an upper arm vein as a temporary pacemaker access site during TAVR.

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Aims: To compare the novel 2D multi-velocity encoding (venc) and 4D flow acquisitions with the standard 2D flow acquisition for the assessment of paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR) using cardiac magnetic resonance (CMR)-derived regurgitant fraction (RF).

Methods And Results: In this prospective study, patients underwent CMR 1 month after TAVR for the assessment of PVR, for which 2D multi-venc and 4D flow were used, in addition to standard 2D flow. Scatterplots and Bland-Altman plots were used to assess correlation and visualize agreement between techniques.

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Background And Aims: The healthcare burden of acute chest pain is enormous. In the randomized ARTICA trial, we showed that pre-hospital identification of low-risk patients and rule-out of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) with point-of-care (POC) troponin measurement reduces 30-day healthcare costs with low major adverse cardiac events (MACE) incidence. Here we present the final 1-year results of the ARTICA trial.

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Background: Traditional risk stratification modestly predicts adverse cardiovascular events in patients with coronary artery disease (CAD). Our aim was to investigate the association between monocyte subsets numbers and function, and the first major adverse cardiovascular event (MACE) in patients with symptomatic stable CAD and angiographically documented coronary atherosclerosis.

Methods: Patients with stable CAD were screened for inclusion.

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Aims: Systemic sclerosis (SSc) is characterized by vasculopathy, inflammation, and fibrosis, and carries one of the worst prognoses if patients also develop pulmonary arterial hypertension (PAH). Although PAH is a known prognosticator, patients with SSc-PAH demonstrate disproportionately high mortality, presumably due to cardiac involvement. In this cross-sectional study, the relationship between cardiac involvement revealed by cardiovascular magnetic resonance (CMR) and systemic microvascular disease severity measured with nailfold capillaromicroscopy (NCM) in patients with SSc-PAH is evaluated and compared with patients with idiopathic PAH (IPAH).

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Objective: Prehospital rule-out of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in low-risk patient with a point-of-care troponin measurement reduces healthcare costs with similar safety to standard transfer to the hospital. Risk stratification is performed identical for men and women, despite important differences in clinical presentation, risk factors and age between men and women with NSTE-ACS. Our aim was to compare safety and healthcare costs between men and women in prehospital identified low-risk patients with suspected NSTE-ACS.

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Ideally, causal research questions will be answered with randomized trials, but this is not always feasible for practical, ethical, or methodological reasons. To obtain a reliable answer to causal questions with observational data, target trial emulation has been introduced, in which an observational study is designed, conducted, and analyzed emulating the target trial. After phrasing a causal question, this framework first addresses seven components of the target trial protocol: eligibility criteria, treatment strategies, assignment procedures, follow-up period, outcome of interest, causal contrast of interest, and statistical analysis plan.

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Aims/hypothesis: Hypomagnesaemia has been associated with insulin resistance and an increased risk of type 2 diabetes. Whether magnesium supplementation improves insulin sensitivity in people with type 2 diabetes and a low serum magnesium level is unknown.

Methods: Using a randomised, double-blind (both participants and investigators were blinded to the participants' treatment sequences), placebo-controlled, crossover study design, we compared the effect of oral magnesium supplementation (15 mmol/day) for 6 weeks with that of matched placebo in individuals with insulin-treated type 2 diabetes (age ≥18 years, BMI 18-40 kg/m, HbA <100 mmol/mol [11.

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Article Synopsis
  • Patients who undergo FFR-guided revascularization after a myocardial infarction still face high rates of repeat major cardiovascular events, often due to nonculprit lesions identified as high-risk by optical coherence tomography (OCT).
  • The study, called PECTUS-obs, evaluates how OCT can help detect high-risk plaques in nonculprit lesions, which were defined by specific characteristics such as lipid content and plaque stability.
  • Out of 438 enrolled patients, 34% had at least one high-risk plaque, and 15.4% of those with high-risk plaques experienced recurrent major adverse cardiovascular events within a two-year period.
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Cardiac surgery, including surgical aortic valve repair (SAVR) and coronary artery bypass grafting (CABG), are associated with ischemia-reperfusion (I/R) injury. Single bouts of exercise, including handgrip exercise, may protect against I/R injury. This study explored ) the feasibility of daily handgrip exercise in the week before SAVR and/or CABG and ) its impact on cardiac I/R injury, measured as postoperative cardiac troponin-T (cTnT) release.

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Background Coronary flow reserve (CFR) and microvascular resistance reserve (MRR) are physiological parameters to assess coronary microvascular dysfunction. CFR and MRR can be assessed using bolus or continuous thermodilution, and the correlation between these methods has not been clarified. Furthermore, their association with angina and quality of life is unknown.

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Aims: Heyde syndrome is the co-occurrence of aortic stenosis, acquired von Willebrand syndrome, and gastrointestinal bleeding. Aortic valve replacement has been demonstrated to resolve all three associated disorders. A systematic review and meta-analysis were performed to obtain best estimates of the effect of aortic valve replacement on acquired von Willebrand syndrome and gastrointestinal bleeding.

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