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2. International Impact of COVID-19 on the Diagnosis of Heart Disease
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Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. 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Premprabha, Tanyaluck, Thientunyakit, Ali, Sellem, Kemal Metin Kir, Haluk, Sayman, Mugisha Julius Sebikali, Zerida, Muyinda, Yaroslav, Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna, Satyr, Batool, Albalooshi, Mohamed Ismail Ahmed Hassan, Jill, Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, 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Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, U Joseph Schoepf, Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T Ahmed Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael, Zgaljardic, Omar, Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando, Mut, Omoa, Djuraev, Gulnora, Rozikhodjaeva, Ha Le Ngoc, Son Hong Mai, Xuan Canh Nguyen, Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Paez, D., Cuocolo, A., Einstein, A, Shaw, L, Hirschfeld, C, Williams, M, Villines, T, Better, N, Vitola, J, Cerci, R, Dorbala, S, Raggi, P, Choi, A, Lu, B, Sinitsyn, V, Sergienko, V, Kudo, T, Norgaard, B, Maurovich-Horvat, P, Campisi, R, Milan, E, Louw, L, Allam, A, Bhatia, M, Malkovskiy, E, Goebel, B, Cohen, Y, Randazzo, M, Narula, J, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Pacella, S, and Erba, P
- Subjects
INCAPS COVID Investigators Group ,Heart disease ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Diagnostic Techniques, Cardiovascular ,coronavirus ,global health ,IAEA ,Disease ,Telehealth ,Cardiorespiratory Medicine and Haematology ,030204 cardiovascular system & hematology ,Cardiovascular ,0302 clinical medicine ,cardiovascular disease ,cardiac testing ,COVID-19 ,diagnostic techniques, cardiovascular ,health care surveys ,heart diseases ,humans ,international agencies ,Pandemic ,Global health ,030212 general & internal medicine ,COVID-19 Heart Disease ,Cause of death ,STATEMENT ,Heart Disease ,International Agencie ,Public Health and Health Services ,Biomedical Imaging ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Heart Diseases ,03 medical and health sciences ,Clinical Research ,medicine ,Humans ,Personal protective equipment ,Heart Disease - Coronary Heart Disease ,business.industry ,International Agencies ,medicine.disease ,the ,coronaviru ,Diagnostic Techniques ,Good Health and Well Being ,Clinical research ,Cardiovascular System & Hematology ,Health Care Survey ,Health Care Surveys ,Emergency medicine ,Global Health ,business - Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.
- Published
- 2021
3. Endothelium-derived intermedin/adrenomedullin-2 protects human ventricular cardiomyocytes from ischaemia-reoxygenation injury predominantly via the AM 1 receptor
- Author
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Liz Donaghy, Mark Harbinson, Stephen McAleer, Malcolm Campbell, David Bell, and Matthew Ferguson
- Subjects
0301 basic medicine ,Small interfering RNA ,Endothelium ,Physiology ,business.industry ,macromolecular substances ,Pharmacology ,Calcitonin gene-related peptide ,Biochemistry ,Adrenomedullin ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Paracrine signalling ,030104 developmental biology ,0302 clinical medicine ,Endocrinology ,medicine.anatomical_structure ,RAMP2 ,cardiovascular system ,Medicine ,cardiovascular diseases ,business ,Autocrine signalling ,Receptor ,030217 neurology & neurosurgery - Abstract
Application of intermedin/adrenomedullin-2 (IMD/AM-2) protects cultured human cardiac vascular cells and fibroblasts from oxidative stress and simulated ischaemia-reoxygenation injury (I-R), predominantly via adrenomedullin AM1 receptor involvement; similar protection had not been investigated previously in human cardiomyocytes (HCM). Expression of IMD, AM and their receptor components was studied in HCM. Receptor subtype involvement in protection by exogenous IMD against injury by simulated I-R was investigated using receptor component-specific siRNAs. Direct protection by endogenous IMD against HCM injury, both as an autocrine factor produced in HCM themselves and as a paracrine factor released from HCMEC co-cultured with HCM, was investigated using peptide-specific siRNA for IMD. IMD, AM and their receptor components (CLR, RAMPs1-3) were expressed in HCM. IMD 1nmol L(-1), applied either throughout ischaemia (3h) and re-oxygenation (1h) or during re-oxygenation (1h) alone, attenuated HCM injury (P
- Published
- 2016
4. Plasma levels of intermedin (adrenomedullin-2) in healthy human volunteers and patients with heart failure
- Author
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Katie Megaw, Mark Harbinson, Brian J. Gordon, Anita Lavery, Michael Owen Kinney, and David Bell
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Physiology ,Peptide Hormones ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Renal function ,030204 cardiovascular system & hematology ,Calcitonin gene-related peptide ,Peptide hormone ,Biochemistry ,Body Mass Index ,Cardiac Resynchronization Therapy ,Young Adult ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Endocrinology ,Internal medicine ,Humans ,Medicine ,Aged ,Heart Failure ,Ejection fraction ,business.industry ,Radioimmunoassay ,Middle Aged ,medicine.disease ,Adrenomedullin ,030104 developmental biology ,Case-Control Studies ,Heart failure ,Female ,business ,Biomarkers - Abstract
Intermedin/adrenomedullin-2 (IMD) is a member of the adrenomedullin/CGRP peptide family. Less is known about the distribution of IMD than for other family members within the mammalian cardiovascular system, particularly in humans. The aim was to evaluate plasma IMD levels in healthy subjects and patients with chronic heart failure. IMD and its precursor fragments, preproIMD(25-56) and preproIMD(57-92), were measured by radioimmunoassay in 75 healthy subjects and levels of IMD were also compared to those of adrenomedullin (AM) and mid-region proadrenomedullin(45-92) (MRproAM(45-92)) in 19 patients with systolic heart failure (LVEF
- Published
- 2016
5. P347 A survey of cardiovascular disease in UK cystic fibrosis centres
- Author
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David J. Grieve, José A. Bengoechea, Damian G. Downey, Tim M. Curtis, and Mark Harbinson
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Disease ,medicine.disease ,business ,Cystic fibrosis - Published
- 2019
6. Intermedin and calcitonin gene-related peptide fail to shine in acute coronary syndrome
- Author
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K.W. Morrice, C P Agnew, David Bell, and Mark Harbinson
- Subjects
Acute coronary syndrome ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,intermedin ,Calcitonin gene-related peptide ,Chest pain ,calcitonin gene-related peptide ,Gastroenterology ,Intermedin ,high sensitivity troponin ,Physiology (medical) ,Internal medicine ,Medicine ,business.industry ,Pain onset ,High Sensitivity Troponin T ,medicine.disease ,Endocrinology ,Calcitonin ,High sensitivity troponin ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
AimsTo measure levels of intermedin and calcitonin gene-related peptide (CGRP) in acute coronary syndrome (ACS) and to determine if they are elevated.Methods and results81 patients admitted with suspected ACS were enrolled into the study. 50 were confirmed ACS by ACC (2000) guidelines and 31 were in a control group as non-cardiac chest pain. Intermedin was non-significantly elevated 6.14 pg/ml vs 4.84 pg/ml < 8 h in the ACS group; sensitivity 68%, specificity 63% on presenting sample. Intermedin was significantly elevated in those patients who had an initially negative troponin T (< 0.03 ng/ml) on presentation, 6.67 pg/ml vs 4.84 pg/ml, p = 0.03.CGRP was significantly elevated in ACS patients, 8–< 16 h after pain onset, 8.67 pg/ml vs 7.08 pg/ml, p = 0.036. However, it didn't aid diagnosis in initially negative troponin patients; sensitivity 61%, specificity 60% on presenting sample. Both intermedin and CGRP were elevated in STEMI patients on a first sample, but only intermedin was significantly elevated; 7.03 pg/ml vs 4.84 pg/ml, p = 0.02 and 8.87 pg/ml vs 7.03 pg/ml p = 0.093, respectively.High sensitivity troponin T was significant elevated in the ACS group at < 8 h (414.9 vs 17.22, p = 0.006) and at 8–< 16 h (3325.27 vs 21.54, p = 0.02).ConclusionsBoth intermedin and CGRP are detectable in human patients. Levels show a trend to elevation in ACS, with CGRP being significantly raised > 8 h after pain onset. The degree of elevation will have limited clinical applicability.
- Published
- 2014
7. The Effect of Multiple Micronutrient Supplementation on Left Ventricular Ejection Fraction in Patients With Chronic Stable Heart Failure
- Author
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Mark Harbinson, Charlotte E. Neville, Nicholas A. McKeag, Jayne V. Woodside, Rebecca L Noad, Ann McGinty, Michelle C. McKinley, Lynn H. Dixon, and Pascal P. McKeown
- Subjects
medicine.medical_specialty ,Ejection fraction ,business.industry ,Placebo-controlled study ,Stroke volume ,medicine.disease ,Placebo ,Brain natriuretic peptide ,Micronutrient ,Surgery ,Heart failure ,Internal medicine ,Cardiology ,Clinical endpoint ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives This study sought to investigate the effect of a multiple micronutrient supplement on left ventricular ejection fraction (LVEF) in patients with heart failure. Background Observational studies suggest that patients with heart failure have reduced intake and lower concentrations of a number of micronutrients. However, there have been very few intervention studies investigating the effect of micronutrient supplementation in patients with heart failure. Methods This was a randomized, double-blind, placebo-controlled, parallel-group study involving 74 patients with chronic stable heart failure that compared multiple micronutrient supplementation taken once daily versus placebo for 12 months. The primary endpoint was LVEF assessed by cardiovascular magnetic resonance imaging or 3-dimensional echocardiography. Secondary endpoints were Minnesota Living With Heart Failure Questionnaire score, 6-min walk test distance, blood concentrations of N-terminal prohormone of brain natriuretic peptide, C-reactive protein, tumor necrosis factor alpha, interleukin-6, interleukin-10, and urinary levels of 8-iso-prostaglandin F2 alpha. Results Blood concentrations of a number of micronutrients increased significantly in the micronutrient supplement group, indicating excellent compliance with the intervention. There was no significant difference in mean LVEF at 12 months between treatment groups after adjusting for baseline (mean difference: 1.6%, 95% confidence interval: −2.6 to 5.8, p = 0.441). There was also no significant difference in any of the secondary endpoints at 12 months between treatment groups. Conclusions This study provides no evidence to support the routine treatment of patients with chronic stable heart failure with a multiple micronutrient supplement. (Micronutrient Supplementation in Patients With Heart Failure [MINT-HF]; NCT01005303 )
- Published
- 2014
8. Lifetime Risk of Cardiovascular Disease: The Next Generation in Risk Prediction
- Author
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Caroline, Bleakley, Auleen, Millar, Paul K, Hamilton, Mark, Harbinson, and Gary Eugene, McVeigh
- Subjects
education.field_of_study ,Framingham Risk Score ,business.industry ,Population ,Disease ,Global Health ,Risk Assessment ,Cardiovascular Diseases ,Risk Factors ,Global health ,Humans ,Medicine ,Lifetime risk ,Morbidity ,Risk factor ,Cardiology and Cardiovascular Medicine ,education ,Risk assessment ,business ,Forecasting ,Subclinical infection ,Demography - Abstract
The Development of Lifetime Risk Prediction Amid mounting concern that younger individuals are inadequately served by short-term risk prediction, the assessment of lifetime risk of a cardiovascular event is gaining credence. The majority of US adults (82%) are at low shortterm risk of a cardiovascular event, with almost all young individuals and women classified as low risk by current algorithms, in part because models such as Framingham weight excessively for age and sex (Table 1). This is misleading, as more than half of all cardiovascular events will occur in those labelled with a low or intermediate 10-year risk score (Fig. 1). To some degree, this apparent paradox may be attributed to the extent of the lowand intermediate-risk population, meaning that by sheer volume these individuals are expected to accrue the majority of events. However, within the low-risk category, there is a substantial variation in lifetime risk, with the emergence of a significant new group of those who are low short-term but high longterm risk. In those younger than 50 years, around half of those in the low short-term risk category fall into this group. The question is, why do some individuals continue to experience a low level of threat of an event for their life duration while others seemingly accumulate risk at a much greater rate? The answer may in part be found in the influence of various risk factors at different stages of life. For instance, absence of any risk factor at the age of 50 years is associated with persistently low lifetime risk compared with those with at least 2 risk factors, who seem to experience a dramatic escalation in risk over the course of their lifetime: 5.2% vs 68.9% in men and 8.2% vs 50.2% in women. What may be underappreciated is the interplay between separate risk factors and the potential for quiet accumulation of subclinical
- Published
- 2013
9. Pre-hospital body surface potential mapping improves early diagnosis of acute coronary artery occlusion in patients with ventricular fibrillation and cardiac arrest
- Author
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A.A.J. Adgey, Peter J Scott, Michael J Daly, Mark Harbinson, Chris D. Nugent, and Dewar D. Finlay
- Subjects
Male ,Emergency Medical Services ,medicine.medical_specialty ,Resuscitation ,Emergency Nursing ,Coronary Angiography ,Sensitivity and Specificity ,Electrocardiography ,Risk Factors ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Body Surface Potential Mapping ,medicine.disease ,Early Diagnosis ,medicine.anatomical_structure ,Coronary Occlusion ,Coronary occlusion ,Area Under Curve ,Ventricular Fibrillation ,Emergency ,Angiography ,Ventricular fibrillation ,Emergency Medicine ,Cardiology ,Coronary care unit ,Female ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,TIMI ,Artery - Abstract
Aims: To determine whether 80-lead body surface potential mapping (BSPM) improves detection of acute coronary artery occlusion in patients presenting with out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) and who survived to reach hospital. Methods and results: Of 645 consecutive patients with OHCA who were attended by the mobile coronary care unit, VF was the initial rhythm in 168 patients. Eighty patients survived initial resuscitation, 59 of these having had BSPM and 12-lead ECG post-return of spontaneous circulation (ROSC) and in 35 patients (age 69±13 yrs; 60% male) coronary angiography performed within 24. h post-ROSC. Of these, 26 (74%) patients had an acutely occluded coronary artery (TIMI flow grade [TFG] 0/1) at angiography. Twelve-lead ECG criteria showed ST-segment elevation (STE) myocardial infarction (STEMI) using Minnesota 9-2 criteria - sensitivity 19%, specificity 100%; ST-segment depression (STD) =0.05. mV in =2 contiguous leads - sensitivity 23%, specificity 89%; and, combination of STEMI or STD criteria - sensitivity 46%, specificity 100%. BSPM STE occurred in 23 (66%) patients. For the diagnosis of TFG 0/1 in a main coronary artery, BSPM STE had sensitivity 88% and specificity 100% (c-statistic 0.94), with STE occurring most commonly in either the posterior, right ventricular or high right anterior territories. Conclusion: Among OHCA patients presenting with VF and who survived resuscitation to reach hospital, post-resuscitation BSPM STE identifies acute coronary occlusion with sensitivity 88% and specificity 100% (c-statistic 0.94). © 2012 Elsevier Ireland Ltd.
- Published
- 2013
10. The effects of potassium-ATP channel modulation on ventricular fibrillation and defibrillation in the pig heart
- Author
-
Mark Harbinson, A.A.Jennifer Adgey, and J.Desmond Allen
- Subjects
Agonist ,Cromakalim ,Potassium Channels ,Swine ,medicine.drug_class ,Defibrillation ,Vasodilator Agents ,medicine.medical_treatment ,Blood Pressure ,QT interval ,Glibenclamide ,Defibrillation threshold ,Heart Rate ,Glyburide ,medicine ,Animals ,Hypoglycemic Agents ,Analysis of Variance ,Fourier Analysis ,business.industry ,Antagonist ,Heart ,medicine.disease ,Electrophysiology ,Blood pressure ,Anesthesia ,Ventricular Fibrillation ,Ventricular fibrillation ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Drugs acting on the cardiac ATP-sensitive potassium (K-ATP) channels may modulate responses to ischaemia and arrhythmogenesis. We investigated the effects of K-ATP channel modulation on frequency patterns of ventricular fibrillation (VF) and on defibrillation threshold (DFT).Each group of 24 pigs randomly received intravenous levcromakalim (LKM) 40 microgram/kg (K-ATP agonist), glibenclamide (Glib) 20 mg/kg (K-ATP antagonist), saline or vehicle. Firstly, QTc interval was measured before and after drug. VF was then induced by endocardial stimulation and its power spectra and dominant frequencies over 15 min determined by fast Fourier transformation. Secondly, transthoracic DFT was determined (step-up/step-down protocol) before and after each drug. LKM reduced QTc interval (e.g., lead II, 354-321 ms, P0.05) and increased the dominant VF frequency between 6 and 8 min (9.5+/-0.5 Hz at 6.5 min compared with 7.2+/-0.6 Hz (saline), 7.4+/-0.8 Hz (vehicle), 6.8+/-0.5 Hz (Glib), P=0.03). LKM reduced (to 57.2+/-2.1 mmHg) and Glib increased (to 107.8+/-6.1) mean arterial BP compared with saline (80.3+/-5.6) and vehicle (87. 6+/-7.1; P0.01). There was no significant difference in defibrillation threshold energy, current or voltage, after any drug.Activation of K-ATP channels reduced blood pressure and QTc interval. The lack of major effect on VF dominant frequency and DFT of either LKM or Glib suggests that prior administration of similar drugs to patients should not prejudice outcome from VF cardiac arrest.
- Published
- 2000
11. IMPROVING THE DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION BY DERIVING EPICARDIAL POTENTIALS FROM THE BODY SURFACE POTENTIAL MAP USING INVERSE ELECTROCARDIOGRAPHY AND AN INDIVIDUALIZED TORSO MODEL
- Author
-
Raymond Bond, Peter Scott, Daniel Guldenring, Michael J Daly, Jennifer Adgey, Aaron McCann, Dewar D. Finlay, and Mark Harbinson
- Subjects
medicine.medical_specialty ,First medical contact ,business.industry ,Torso ,Chest pain ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Troponin complex ,Internal medicine ,medicine ,Cardiology ,cardiovascular diseases ,Inverse electrocardiography ,Myocardial infarction ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Right anterior - Abstract
Epicardial potentials (EP) derived from the body surface potential map (BSPM) improve acute myocardial infarction (AMI) diagnosis. In this study, we compared EP derived from the 80-lead BSPM using a standard thoracic volume conductor model (TVCM) with those derived using a patient-specific torso model (PSTM) based on body mass index (BMI). Patients presenting to ED between August 2009 and August 2011 with acute ischaemic-type chest pain at rest were enrolled. At first medical contact, 12-lead ECG and BSPM were recorded. BMI for each patient was calculated. Cardiac troponin-T (cTnT) was sampled 12h after symptom onset. Patients were excluded from analysis if they had any electrocardiographic confounders to interpretation of the ST-segment. A cardiologist assessed the 12-lead ECG for STEMI by Minnesota criteria and BSPM. BSPM ST-elevation (STE) was ≥0.2mV in anterior, ≥0.1mV in lateral, inferior, RV or high right anterior and ≥0.05mV in posterior territories. To derive EP, the BSPM data were interpolated to yield values at 352-nodes of a Dalhousie torso. Using an inverse solution based on the boundary element method, EP at 98 cardiac nodes positioned within a standard TVCM were derived. The TVCM was then scaled to produce a PSTM, using a model developed from CT in 48 patients of varying BMI, and EP re-calculated. EP ≥0.3mV defined STE. A cardiologist blinded to both the 12-lead ECG and BSPM interpreted the EP map. AMI was defined as cTnT ≥0.1µg/L. Enrolled were 400 patients (age 62 ± 13 yrs; 57% male): 80 patients had exclusion criteria. Of the remaining 320 patients, BMI was 27.8 ± 5.6kg m-2. Of these, 180 (56%) had AMI. Overall, 132 had Minnesota STEMI on ECG (sensitivity 65%, sensitivity 89%) and 160 had BSPM STE (sensitivity 81%, specificity 90%). EP STE occurred in 165 patients using TVCM (sensitivity 88%, specificity 95%, p
- Published
- 2016
12. Correction
- Author
-
Ann McGinty, Pascal P. McKeown, Charlotte E. Neville, Jayne V. Woodside, Mark Harbinson, Nicholas A. McKeag, L. H. Dixon, Rebecca L Noad, and Michelle C. McKinley
- Subjects
medicine.medical_specialty ,Ejection fraction ,business.industry ,Heart failure ,Internal medicine ,Cardiology ,Placebo-controlled study ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Micronutrient - Published
- 2014
13. An individualised torso model further improves the accuracy of epicardial potentials derived from the body surface potential map using inverse electrocardiography in the diagnosis of acute myocardial infarction: a prospective study
- Author
-
Peter J Scott, Michael J Daly, A.A.J. Adgey, Daniel Guldenring, Dewar D. Finlay, and Mark Harbinson
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,medicine ,Physical therapy ,Inverse electrocardiography ,Myocardial infarction ,Torso ,Northern ireland ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Prospective cohort study - Abstract
An individualised torso model further improves the accuracy of epicardial potentials derived from the body surface potential map using inverse electrocardiography in the diagnosis of acute myocardial infarction: a prospective study M.J. Daly , D.D. Finlay , D. Guldenring , P.J. Scott , A.A.J. Adgey , M.T. Harbinson c The Heart Centre, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland UK School of Computing and Mathematics and Computer Science Research Institute, University of Ulster, Northern Ireland, UK Centre for Vision and Vascular Sciences, Queen’s University, Whitla Medical Building, Lisburn Road, Belfast, Northern Ireland, UK
- Published
- 2013
14. Pre-hospital body surface potential mapping improves early diagnosis of acute coronary artery occlusion in patients with ventricular fibrillation and cardiac arrest
- Author
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Michael Daly, Dewar Finlay, Peter Scott, Andrew Howe, Chris Nugent, Mark Harbinson, and Jennifer Adgey
- Subjects
Emergency Medicine ,Emergency Nursing ,Cardiology and Cardiovascular Medicine - Published
- 2012
15. CMR versus SPECT for diagnosis of coronary heart disease
- Author
-
Nikant Sabharwal, Richard Underwood, Mark Harbinson, and Andrew Kelion
- Subjects
medicine.medical_specialty ,Myocardial perfusion imaging ,Text mining ,medicine.diagnostic_test ,business.industry ,Internal medicine ,Cardiology ,Medicine ,General Medicine ,Tomography ,business ,Coronary heart disease ,Magnetic resonance angiography - Published
- 2012
16. Spontaneous coronary dissection by coronary stenting
- Author
-
Mark Harbinson, S.W. Webb, S. Baird, and T.G. Trouton
- Subjects
medicine.medical_specialty ,Vascular disease ,Arterial disease ,business.industry ,Coronary stenting ,medicine.disease ,Surgery ,medicine.anatomical_structure ,medicine ,Cardiology and Cardiovascular Medicine ,Complication ,business ,Artery ,Coronary dissection - Published
- 1999
17. ECG changes after direct current cardioversion of atrial fibrillation by the transthoracic and transvenous routes
- Author
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Aaj Adgey, G. W. N. Dalzell, Mark Harbinson, and T. P. Mathew
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Direct current cardioversion ,medicine ,Cardiology ,Atrial fibrillation ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Published
- 1998
18. Transvenous catheter cardioversion with long duration rounded waveforms-initial findings
- Author
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WA Tacker, J Anderson, V.P. Moohan, G. M. Ayers, Aaj Adgey, Mark Harbinson, and David McEneaney
- Subjects
medicine.medical_specialty ,Catheter ,business.industry ,Internal medicine ,medicine.medical_treatment ,Cardiology ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Cardioversion ,Short duration - Published
- 1998
19. The effect of internal atrial cardioversion on cardiac output
- Author
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A.A.J. Adgey, Mark Harbinson, David McEneaney, L.M. Burgess, and V.P. Moohan
- Subjects
medicine.medical_specialty ,Cardiac output ,business.industry ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Atrial cardioversion - Published
- 1998
20. P-96 Ventricular fibrillation and defibrillation after Potassium-ATP channel modulation
- Author
-
JD Allen, Mark Harbinson, and A.A.J. Adgey
- Subjects
medicine.medical_specialty ,business.industry ,Defibrillation ,Potassium ,medicine.medical_treatment ,chemistry.chemical_element ,Emergency Nursing ,medicine.disease ,chemistry ,Internal medicine ,Ventricular fibrillation ,Emergency Medicine ,medicine ,Cardiology ,Channel modulation ,Cardiology and Cardiovascular Medicine ,business - Published
- 1996
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