Publications by authors named "T Kotecha"
Metformin is an antihyperglycemic used to treat type 2 diabetes mellitus (T2DM). Patients with T2DM are at increased risk of cardiovascular disease. We explored the association between metformin use and cardiovascular magnetic resonance (CMR) derived stress myocardial blood flow (MBF), myocardial perfusion reserve (MPR) and major adverse cardiovascular events (MACE; all cause death, MI, stroke, heart failure hospitalisation and coronary revascularisation) in patients with T2DM.
View Article and Find Full Text PDFFractional Flow Reserve and Instantaneous Wave-Free Ratio as Predictors of the Placebo-Controlled Response to Percutaneous Coronary Intervention in Stable Coronary Artery Disease.
Circulation
January 2025
Article Synopsis
- The ORBITA-2 trial examined the effectiveness of percutaneous coronary intervention (PCI) in relieving stable angina in patients with coronary artery disease (CAD) compared to a placebo.
- Participants reported daily angina episodes and underwent tests to measure fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) before being randomized to receive either PCI or a placebo.
- Results indicated that lower FFR and iFR values were associated with significantly greater improvement in angina symptoms following PCI, suggesting these measurements can help predict the benefits of the intervention.
Aims: Cardiac amyloidosis (CA) is characterized by deposition of amyloid fibrils within the extracellular space, causing disarray of the myocardial structure and capillary architecture. This study aims to characterize the prevalence of microvascular obstruction (MVO) in patients with CA and to assess the association between MVO and prognosis.
Methods And Results: The study population comprised 800 patients, of which 400 had light-chain CA (AL-CA) and 400 had transthyretin CA (ATTR-CA).
Article Synopsis
- Cardiac amyloid infiltration significantly impacts survival in systemic light-chain (AL) amyloidosis, with guidelines suggesting early therapy changes for patients not responding well, regardless of cardiac amyloid severity.
- The study aimed to compare serum biomarkers, echocardiography, and cardiovascular magnetic resonance (CMR) with extracellular volume (ECV) mapping in understanding cardiac amyloid and its prognostic value.
- Findings revealed that ECV is a strong independent predictor of mortality, showing different relationships between the depth of hematological response and survival based on specific ECV thresholds over 1- and 6-month periods.
Article Synopsis
- Systemic sclerosis complicated by pulmonary arterial hypertension (SSc-PAH) presents significant risks, and this study aimed to evaluate if exercise-based cardiac assessments could predict patient outcomes better than traditional resting measures.
- Fifty intermediate-risk SSc-PAH patients underwent cardio MRI during exercise, finding that most had normal resting cardiac metrics but that peak exercise indicators, specifically RV indexed end-systolic volume (ESVi), were key for predicting survival.
- The study concluded that exercise CMR could help identify patients at higher risk of mortality, enhancing risk assessment practices even when resting tests appear normal.