94 results match your criteria: "Royal Brompton Hospital and Imperial College London[Affiliation]"

Objective: Oral, low-dose and ultra-low-dose continuous combined 17β-estradiol (E) plus dydrogesterone (D) reduce vasomotor symptoms (VMS) in postmenopausal women.

Methods: Two phase 3, double-blind studies were included. In the European study, postmenopausal women were randomized 2:1:2 to receive E0.

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Article Synopsis
  • The study evaluated the safety and tolerability of ultra-low dose estradiol and dydrogesterone among postmenopausal women using data from three clinical trials.
  • A total of 1027 participants were analyzed, revealing that the rates of treatment-emergent adverse events (TEAEs) were comparable between the treatment (E0.5/D2.5 mg) and placebo groups.
  • While the treatment group saw a higher incidence of breast pain and uterine hemorrhage, the overall conclusion was that the ultra-low dose combination was well tolerated without significant increases in adverse events compared to placebo.
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Tetralogy of Fallot Across the Lifespan: A Focus on the Right Ventricle.

CJC Pediatr Congenit Heart Dis

December 2023

Toronto ACHD Program, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.

Article Synopsis
  • - Tetralogy of Fallot is a congenital heart defect that can lead to long-term complications like progressive right ventricular (RV) failure due to issues like pulmonic regurgitation, even after surgical correction.
  • - The cellular causes of RV failure involve microvascular and mitochondrial problems, which often result in exercise intolerance that can be measured through cardiopulmonary exercise testing to help predict outcomes.
  • - Management of RV failure includes using diuretics to balance fluid levels and, in cases of severe heart failure, employing inotropes or mechanical support while monitoring any remaining heart issues that could affect treatment effectiveness.
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Purpose: The efficacy and safety of ultrasound enhancing agent (UEA) was unknown in the COVID-19 hospitalized patients. We set out to establish the utility of UEA and its safety profile.

Methods: A retrospective observational study of prospectively assessed hospitalized patients referred for transthoracic echocardiography (TTE) for suspected cardiac pathology due to COVID-19.

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Background: Mucociliary clearance is dysfunctional in people with primary ciliary dyskinesia, resulting in the accumulation of dehydrated mucus in the airways that is difficult to clear. We undertook a study to assess the benefit on lung function of treatment with a nebulised epithelial sodium channel (ENaC) blocker, idrevloride, with or without hypertonic saline, in people with primary ciliary dyskinesia.

Methods: The CLEAN-PCD trial was a phase 2, randomised, double-blind, placebo-controlled crossover trial conducted at 32 tertiary adult and paediatric care centres and university hospitals in Canada, Denmark, Germany, Italy, the Netherlands, Poland, the UK, and the USA.

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The function of a cell is defined by its intrinsic characteristics and its niche: the tissue microenvironment in which it dwells. Here we combine single-cell and spatial transcriptomics data to discover cellular niches within eight regions of the human heart. We map cells to microanatomical locations and integrate knowledge-based and unsupervised structural annotations.

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Background: The dorsal striatum, a nucleus in the basal ganglia, plays a key role in the execution of cognitive functions in the human brain. Recent studies have focused on how the dorsal striatum participates in a single cognitive function, whereas the specific roles of the caudate and putamen in performing multiple cognitive functions remain unclear. In this paper we conducted a meta-analysis of the relevant neuroimaging literature to understand the roles of subregions of the dorsal striatum in performing different functions.

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Global Circumferential and Radial Strain Among Patients With Immune Checkpoint Inhibitor Myocarditis.

JACC Cardiovasc Imaging

November 2022

Cardiovascular Imaging Research Center (CIRC), Division of Cardiology and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Article Synopsis
  • The study investigates the impact of immune checkpoint inhibitor (ICI) myocarditis on global circumferential strain (GCS) and global radial strain (GRS), which are measures of heart function, comparing 75 ICI myocarditis patients to 50 controls without myocarditis.
  • Pre-treatment GCS and GRS were similar in both groups, but those with myocarditis had significantly lower GCS and GRS during treatment.
  • Lower GCS and GRS correlated with a higher risk of cardiovascular events, indicating their potential as better indicators of heart health compared to traditional markers like cardiac troponin T and left ventricular ejection fraction.
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Advances in treatment, common cardiovascular (CV) risk factors and the ageing of the population have led to an increasing number of cancer patients presenting with acute CV diseases. These events may be related to cancer itself or cancer treatment. Acute cardiac care specialists must be aware of these acute CV complications and be able to manage them.

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The coronavirus 2019 (COVID-19) infection pandemic has affected the care of patients with heart failure (HF). Several consensus documents describe the appropriate diagnostic algorithm and treatment approach for patients with HF and associated COVID-19 infection. However, few questions about the mechanisms by which COVID can exacerbate HF in patients with high-risk (Stage B) or symptomatic HF (Stage C) remain unanswered.

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Background: Understanding the pulmonary impact of changes in early life nutritional status over time in a paediatric CF population may help inform how to use nutritional assessment to guide clinical care. National registry data provides an opportunity to study patterns of weight gain over time at the level of the individual, and thus to gain detailed understanding of the relationship between early weight trajectories and later lung function in children with Cystic Fibrosis (CF).

Methods: Using data from the United Kingdom (UK) and Canadian CF Registries, a mixed effects linear regression model was used to describe children's weight and BMI z-score trajectories from age 1 to 5 years.

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Characterization of Eosinophilic Bronchiectasis: A European Multicohort Study.

Am J Respir Crit Care Med

April 2022

Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom.

Bronchiectasis is classically considered a neutrophilic disorder, but eosinophilic subtypes have recently been described. To use multiple datasets available through the European Multicentre Bronchiectasis Audit and Research Collaboration to characterize eosinophilic bronchiectasis as a clinical entity focusing on the impact of eosinophils on bronchiectasis exacerbations. Patients were included from five countries to examine the relationships between blood eosinophil counts and clinical phenotypes after excluding coexisting asthma.

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Cardiogenic shock (CS) is a complex multifactorial clinical syndrome, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large phenotypic variability in CS, as a result of the diverse aetiologies, pathogenetic mechanisms, haemodynamics, and stages of severity. Although early revascularization remains the most important intervention for CS in settings of acute myocardial infarction, the administration of timely and effective antithrombotic therapy is critical to improving outcomes in these patients.

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Bronchiectasis refers to both a clinical disease and a radiological appearance that has multiple causes and can be associated with a range of conditions. Disease heterogeneity and the absence of standardised definitions have hampered clinical trials of treatments for bronchiectasis and are important challenges in clinical practice. In view of the need for new therapies for non-cystic fibrosis bronchiectasis to reduce the disease burden, we established an international taskforce of experts to develop recommendations and definitions for clinically significant bronchiectasis in adults to facilitate the standardisation of terminology for clinical trials.

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Mitral annular disjunction (MAD) is an abnormal insertion of the hinge line of the posterior mitral leaflet on the atrial wall: the mitral annulus shows a separation or "disjunction" between the leaflet-atrial wall junction and the crest of the left ventricle myocardium. This anomaly is often observed in patients with myxomatous mitral valve prolapse. The anatomical substrate of MAD remains unclear for the following reasons: (1) most studies are focused on the association between MAD and arrhythmias, rather than on pathomorphological aspects of MAD; and (2) the complex anatomic architecture of the posterior mitral annulus is often simply described as the posterior segment of a fibrous ring.

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Device closure for patent foramen ovale in patients with cryptogenic stroke: which patients should get it?

Eur Heart J Suppl

November 2020

LARC (Laboratorio Analisi e Ricerca Clinica) C.so Venezia 10-Turin - Italy and School of Medicine-, Insubria University, Varese, Italy.

Patent foramen ovale (PFO) and cryptogenic stroke (CS) both have a high prevalence. The optimal treatment to reduce stroke recurrence after CS remains controversial. Results from clinical trials, meta-analyses, and position papers, support percutaneous PFO device closure and medical therapy compared to medical therapy alone.

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Electrocardiographic features of immune checkpoint inhibitor associated myocarditis.

J Immunother Cancer

March 2021

Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA

Background: Myocarditis is a highly morbid complication of immune checkpoint inhibitor (ICI) use that remains inadequately characterized. The QRS duration and the QTc interval are standardized electrocardiographic measures that are prolonged in other cardiac conditions; however, there are no data on their utility in ICI myocarditis.

Methods: From an international registry, ECG parameters were compared between 140 myocarditis cases and 179 controls across multiple time points (pre-ICI, on ICI prior to myocarditis, and at the time of myocarditis).

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Clinical characteristics of SARS-CoV-2 infection in children with cystic fibrosis: An international observational study.

J Cyst Fibros

January 2021

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. Electronic address:

Background: The presence of co-morbidities, including underlying respiratory problems, has been identified as a risk factor for severe COVID-19 disease. Information on the clinical course of SARS-CoV-2 infection in children with cystic fibrosis (CF) is limited, yet vital to provide accurate advice for children with CF, their families, caregivers and clinical teams.

Methods: Cases of SARS-CoV-2 infection in children with CF aged less than 18 years were collated by the CF Registry Global Harmonization Group across 13 countries between 1 February and 7 August 2020.

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With the growing SARS-CoV-2 pandemic, we need to better understand its impact in specific patient groups like those with Cystic Fibrosis (CF). We report on 181 people with CF (32 post-transplant) from 19 countries diagnosed with SARS-CoV-2 prior to 13 June 2020. Infection with SARS-CoV-2 appears to exhibit a similar spectrum of outcomes to that seen in the general population, with 11 people admitted to intensive care (7 post-transplant), and 7 deaths (3 post-transplant).

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Serum biomarkers are an important tool in the baseline risk assessment and diagnosis of cardiovascular disease in cancer patients receiving cardiotoxic cancer treatments. Increases in cardiac biomarkers including cardiac troponin and natriuretic peptides can be used to guide initiation of cardioprotective treatments for cancer patients during treatment and to monitor the response to cardioprotective treatments, and they also offer prognostic value. This position statement examines the role of cardiac biomarkers in the management of cancer patients.

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Purpose Of Review: Long-term survival has increased significantly in breast cancer patients, and cardiovascular side effects are surpassing cancer-related mortality. We summarize risk factors, prevention strategies, detection, and management of cardiotoxicity, with focus on left ventricular dysfunction and heart failure, during breast cancer treatment.

Recent Findings: Baseline treatment of cardiovascular risk factors is recommended.

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