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1. A Randomized, double-blind, dose ranging clinical trial of intravenous FDY-5301 in acute STEMI patients undergoing primary PCI

Author

Adlam, David, Zarebinski, Maciej, Uren, Neal G., Ptaszynski, Pawel, Oldroyd, Keith G., Munir, Shahzad, Zaman, Azfar, Contractor, Hussain, Kiss, Róbert Gábor, Édes, István, Szachniewicz, Joanna, Nagy, Gergely Gyorgy, Garcia, Mario J., Tomcsanyi, János, Irving, John, Sharp, Andrew S.P., Musialek, Piotr, Lupkovics, Géza, Shirodaria, Cheerag, Selvanayagam, Joseph B., Quinn, Pauline, Ng, Leong, Roth, Mark, Insko, Michael A., Haber, Ben, Hill, Stephen, Siegel, Lori, Tulloch, Simon, and Channon, Keith M.

Published
2022
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2. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial

Author

Joshi, Nikhil V, Vesey, Alex T, Williams, Michelle C, Shah, Anoop S V, Calvert, Patrick A, Craighead, Felicity H M, Yeoh, Su Ern, Wallace, William, Salter, Donald, Fletcher, Alison M, van Beek, Edwin J R, Flapan, Andrew D, Uren, Neal G, Behan, Miles W H, Cruden, Nicholas L M, Mills, Nicholas L, Fox, Keith A A, Rudd, James H F, Dweck, Marc R, and Newby, David E

Published
2014
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3. Effect of Transcatheter Aortic Valve Implantation vs Surgical Aortic Valve Replacement on All-Cause Mortality in Patients With Aortic Stenosis: A Randomized Clinical Trial

Author

Toff, William D., Hildick-Smith, David, Kovac, Jan, Mullen, Michael J., Wendler, Olaf, Mansouri, Anita, Rombach, Ines, Abrams, Keith R., Conroy, Simon P., Flather, Marcus D., Gray, Alastair M., MacCarthy, Philip, Monaghan, Mark J., Prendergast, Bernard, Ray, Simon, Young, Christopher P., Crossman, David C., Cleland, John G. F., de Belder, Mark A., Ludman, Peter F., Jones, Stephen, Densem, Cameron G., Tsui, Steven, Kuduvalli, Manoj, Mills, Joseph D., Banning, Adrian P., Sayeed, Rana, Hasan, Ragheb, Fraser, Douglas G. W., Trivedi, Uday, Davies, Simon W., Duncan, Alison, Curzen, Nick, Ohri, Sunil K., Malkin, Christopher J., Kaul, Pankaj, Muir, Douglas F., Owens, W. Andrew, Uren, Neal G., Pessotto, Renzo, Kennon, Simon, Awad, Wael I., Khogali, Saib S., Matuszewski, Maciej, Edwards, Richard J., Ramesh, Bandigowdanapalya C., Dalby, Miles, Raja, Shahzad G., Mariscalco, Giovanni, Lloyd, Clinton, Cox, Ian D., Redwood, Simon R., Gunning, Mark G., and Ridley, Paul D.

Subjects
Aged, 80 and over, Heart Valve Prosthesis Implantation, Male, Aortic Valve Insufficiency, General Medicine, Aortic Valve Stenosis, Transcatheter Aortic Valve Replacement, Treatment Outcome, Risk Factors, Aortic Valve, Heart Valve Prosthesis, Humans, Female, Aged, Original Investigation
Abstract

IMPORTANCE: Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement and is the treatment of choice for patients at high operative risk. The role of TAVI in patients at lower risk is unclear. OBJECTIVE: To determine whether TAVI is noninferior to surgery in patients at moderately increased operative risk. DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial conducted at 34 UK centers, 913 patients aged 70 years or older with severe, symptomatic aortic stenosis and moderately increased operative risk due to age or comorbidity were enrolled between April 2014 and April 2018 and followed up through April 2019. INTERVENTIONS: TAVI using any valve with a CE mark (indicating conformity of the valve with all legal and safety requirements for sale throughout the European Economic Area) and any access route (n = 458) or surgical aortic valve replacement (surgery; n = 455). MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality at 1 year. The primary hypothesis was that TAVI was noninferior to surgery, with a noninferiority margin of 5% for the upper limit of the 1-sided 97.5% CI for the absolute between-group difference in mortality. There were 36 secondary outcomes (30 reported herein), including duration of hospital stay, major bleeding events, vascular complications, conduction disturbance requiring pacemaker implantation, and aortic regurgitation. RESULTS: Among 913 patients randomized (median age, 81 years [IQR, 78 to 84 years]; 424 [46%] were female; median Society of Thoracic Surgeons mortality risk score, 2.6% [IQR, 2.0% to 3.4%]), 912 (99.9%) completed follow-up and were included in the noninferiority analysis. At 1 year, there were 21 deaths (4.6%) in the TAVI group and 30 deaths (6.6%) in the surgery group, with an adjusted absolute risk difference of −2.0% (1-sided 97.5% CI, −∞ to 1.2%; P

Published
2022

4. Supplement to: Efficacy of a device to narrow the coronary sinus in refractory angina.

Author

Verheye, Stefan, Joliœur, Marc E., Behan, Miles W, Pettersson, Thomas, Sainsbury, Paul, Hill, Jonathan, Vrolix, Mathias, Agostoni, Pierfrancesco, Engstrom, Thomas, Labinaz, Marino, de Silva, Ranil, Schwartz, Marc, Meyten1, Nathalie, Uren, Neal G, Doucet, Serge, Tanguay, Jean-Francois, Lindsay, Steven, Henry, Timothy D., White, Christopher J., Edelman, Elazer R, and Banai, Shmuel

Published
2015

7. A Randomized, double-blind, dose ranging clinical trial of intravenous FDY-5301 in acute stemi patients undergoing primary PCI

Author

Dhil, David Adlam, primary, Zarebinski, Maciej, additional, Uren, Neal G., additional, Ptaszynski, Pawel, additional, Oldroyd, Keith G., additional, Munir, Shahzad, additional, Zaman, Azfar, additional, Contractor, Hussain, additional, Kiss, Róbert Gábor, additional, Édes, István, additional, Szachniewicz, Joanna, additional, Nagy, Gergely Gyorgy, additional, Garcia, Mario J., additional, Tomcsanyi, János, additional, Irving, John, additional, Sharp, Andrew S.P., additional, Musialek, Piotr, additional, Lupkovics, Géza, additional, Shirodaria, Cheerag, additional, Selvanayagam, Joseph B., additional, Quinn, Pauline, additional, Ng, Leong, additional, Roth, Mark, additional, Insko, Michael A., additional, Haber, Ben, additional, Hill, Stephen, additional, Siegel, Lori, additional, Tulloch, Simon, additional, and Channon, Keith M., additional

Published
2021
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8. Native Aortic Valve Disease Progression and Bioprosthetic Valve Degeneration in Patients With Transcatheter Aortic Valve Implantation

Author

Kwiecinski, Jacek, primary, Tzolos, Evangelos, additional, Cartlidge, Timothy R.G., additional, Fletcher, Alexander, additional, Doris, Mhairi K., additional, Bing, Rong, additional, Tarkin, Jason M., additional, Seidman, Michael A., additional, Gulsin, Gaurav S., additional, Cruden, Nicholas L., additional, Barton, Anna K., additional, Uren, Neal G., additional, Williams, Michelle C., additional, van Beek, Edwin J.R., additional, Leipsic, Jonathon, additional, Dey, Damini, additional, Makkar, Raj R., additional, Slomka, Piotr J., additional, Rudd, James H.F., additional, Newby, David E., additional, Sellers, Stephanie L., additional, Berman, Daniel S., additional, and Dweck, Marc R., additional

Published
2021
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11. Efficacy of a Device to Narrow the Coronary Sinus in Refractory Angina

Author

Verheye, Stefan, Jolicœur, Marc E., Behan, Miles W., Pettersson, Thomas, Sainsbury, Paul, Hill, Jonathan, Vrolix, Mathias, Agostoni, Pierfrancesco, Engstrom, Thomas, Labinaz, Marino, de Silva, Ranil, Schwartz, Marc, Meyten, Nathalie, Uren, Neal G., Doucet, Serge, Tanguay, Jean-François, Lindsay, Steven, Henry, Timothy D., White, Christopher J., Edelman, Elazer R., and Banai, Shmuel

Published
2015
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12. Rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction

Author

Gershlick, Anthony H., Banning, Adrian, Baumbach, Andreas, Stephens-Loyd, Amanda, Pitt, Michael, Man Fai Shiu, Hughes, Sarah, Davis, John, Schofield, Peter, Abrams, Keith R., de Belder, Adam, Dawkins, Keith D., Stevens, Suzanne E., Uren, Neal G., Henderson, Robert A., Oldroyd, Keith G., and Wilcox, Robert

Subjects
Heart attack -- Care and treatment, Angioplasty -- Patient outcomes, Thrombolytic therapy -- Usage
Abstract

A multicenter trial in the United Kingdom is conducted for comparing rescue percutaneous coronary intervention (PCI) with repeated thrombolysis. Event-free survival after failed thrombolytic therapy is significantly higher with rescue PCI than with repeated thrombolysis or conservative treatment.

Published
2005

18. Reduced coronary vasodilator function in infarcted and normal myocardium after myocardial infarction

Author

Uren, Neal G., Crake, Tom, Lefroy, David C., De Silva, Ranil, Davies, Graham J., and Maseri, Attilio

Subjects
Heart attack -- Physiological aspects, Blood vessels -- Dilatation, Heart muscle, Vasodilators -- Evaluation
Abstract

After a heart attack, the response of cardiac blood vessels to a dilating drug is abnormal. This abnormal response is not only in the damaged region but also in distant areas served by normal cardiac vessels. Cardiac blood flow was measured with positron-emission tomography (PET) in 13 patients approximately a week after the heart attack and again six months later. Measurements were made before and after administration of a vasodilating drug. Although measurements improved during the intervening period, they were still abnormally low in undamaged areas served by normal blood vessels when compared with control subjects who had single-vessel coronary artery disease (stable angina) but no history of heart attack.

Published
1994

19. Relation between myocardial blood flow and the severity of coronary-artery stenosis

Author

Uren, Neal G., Melin, Jacques A., De Bruyne, Bernard, Wijns, William, Baudhuin, Thierry, and Camici, Paolo G.

Subjects
Arteries -- Stenosis, Blood flow -- Measurement
Abstract

Basal myocardial blood flow appears to remain constant regardless of the degree of arterial stenosis and maximal blood flow starts to decrease once stenosis is measured at more than 40%. Arterial stenosis is narrowing of the arteries. A study of 35 patients with coronary artery disease also showed that the coronary vasodilator reserve, defined as the ratio of maximal to basal coronary blood flow, became exhausted if stenosis was measured at 80% or more. Basal flow and maximal blood flow were measured when the patients were at rest and during maximal vasodilation, and results were compared to a control group whose members did not have coronary artery disease. The basal flow rate was not found to differ among patients and controls, but the total coronary resistance was much higher in the patients during maximal vasodilation. The use of positron emission tomography was found to be an effective, noninvasive way to measure myocardial blood flow and vasodilator flow reserve.

Published
1994

22. Non-invasive assessment of coronary artery bypass graft patency using 16-slice computed tomography angiography

Author

Uren Neal G, Sengupta Anshuman, Lawton Tristan, Houslay Emma S, McKillop Graham, and Newby David E

Subjects
Surgery, RD1-811, Anesthesiology, RD78.3-87.3
Abstract

Abstract Background Invasive coronary angiography is the gold standard means of imaging bypass vessels and carries a small but potentially serious risk of local vascular complications, including myocardial infarction, stroke and death. We evaluated computed tomography as a non-invasive means of assessing graft patency. Methods Fifty patients with previous coronary artery bypass surgery who were listed for diagnostic coronary angiography underwent contrast enhanced computed tomography angiography using a 16-slice computed tomography scanner. Images were retrospectively gated to the electrocardiogram and two dimensional axial, multiplanar and three dimensional reconstructions acquired. Sensitivity, specificity, positive and negative predictive value, accuracy and level of agreement for detection of graft patency by multidetector computed tomography. Results A total of 116 grafts were suitable for analysis. The specificity of CT for the detection of graft patency was 100%, with a sensitivity of 92.8%, positive predictive value 100%, negative predictive value 85.8% and an accuracy of 94.8%. The kappa value of agreement between the two means of measuring graft patency was 0.9. Mean radiation dose was 9.0 ± 7.2 mSv for coronary angiography and 18.5 ± 4 mSv for computed tomography. Pooled analysis of eight studies, incorporating 932 grafts, confirmed a 97% accuracy for the detection of graft patency by multidetector computed tomography. Conclusion Computed tomography is an accurate, rapid and non-invasive method of assessing coronary artery bypass graft patency. However, this was achieved at the expense of an increase in radiation dose.

Published
2007
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24. Primary pulmonary hypertension: the role of endothelial dysfunction and treatment implications

Author

Uren, Neal G. and Oakley, Celia M.

Subjects
Pulmonary hypertension -- Development and progression, Vascular endothelium -- Physiological aspects, Calcium channel blockers -- Dosage and administration, Anticoagulants (Medicine) -- Physiological aspects, Prostacyclin -- Physiological aspects, Nitric oxide -- Physiological aspects, Health
Abstract

The pathogenesis of primary pulmonary hypertension appears to be related to dysfunction of the pulmonary vascular endothelial cells. Current therapy is of limited benefit and includes high-dose calcium channel blockade, oral anticoagulation, intravenous prostacyclin, and inhaled nitric oxide. Newer avenues of investigation include elastase inhibitors, smooth-muscle cell growth inhibitors, and antibodies to hyaluronic-acid-binding protein.

Published
1993

25. Initial experience of a large, self‐expanding, and fully recapturable transcatheter aortic valve: The UK & Ireland Implanters’ registry

Author

Dowling, Cameron, primary, Firoozi, Sami, additional, Doyle, Niamh, additional, Blackman, Daniel J., additional, Malkin, Christopher J., additional, Cunnington, Michael S., additional, Saraf, Smriti, additional, Buch, Mamta H., additional, Levy, Richard, additional, Chowdhary, Saqib, additional, Spence, Mark S., additional, Manoharan, Ganesh, additional, Owens, Colum G., additional, Brennan, Paul F., additional, Roberts, David, additional, More, Ranjit, additional, Wiper, Andrew, additional, Abdelaziz, Hesham K., additional, Mylotte, Darren, additional, Neylon, Antoinette, additional, Martin, Niamh, additional, Mercanti, Federico, additional, Dorman, Stephen, additional, Panoulas, Vasileios, additional, Dalby, Miles, additional, Kashyap, Mavin N., additional, Kabir, Tito, additional, Kovac, Jan, additional, Kontoprias, Kosmas, additional, Malik, Iqbal S., additional, Ghada, Mikhail W., additional, Sen, Sayan, additional, Ruparelia, Neil, additional, Demir, Ozan M., additional, Frame, Angela, additional, Uren, Neal G., additional, Anderson, Richard, additional, Rajathurai, Thirumaran, additional, Tapp, Luke, additional, Deegan, Lauren, additional, Grech, Ever, additional, Hall, Ian, additional, Neville, Melanie, additional, Rampat, Rajiv, additional, Hildick‐Smith, David, additional, Mullen, Michael, additional, Kennon, Simon, additional, Chandrala, Pavan, additional, Doshi, Sagar, additional, and Brecker, Stephen J., additional

Published
2018
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29. The treatment of primary pulmonary hypertension

Author

Uren, Neal G. and Oakley, Celia M.

Subjects
Pulmonary hypertension -- Development and progression, Pulmonary circulation -- Abnormalities, Health
Abstract

Hypertension of the pulmonary (lung) blood vessels affects large and small arteries and, less often, large and small veins. The high pressure within affected vessels has been associated with constriction of the vessel wall. In the past, primary pulmonary hypertension was classed as being due to thrombosis (clot formation) or vasculitis (blood vessel inflammation). The latter condition was thought to have an autoimmune basis, and to be characterized by the proliferation of fibrous material and the presence of autoantibodies (antibodies inappropriately produced against the body's own molecules). Accordingly, vascular damage might be caused by thickening of arterial walls (by fibrous material), rather than by the constriction of muscle fibers in arterial walls. This classification had no scientific basis, and a recent study described both thrombotic and plexiform (with a network of fibrous tissue) lesions in affected patients. Anticoagulants, which decrease thrombosis, are associated with clinical improvement of this condition. Responses to vasodilators (which relax vessel walls) are generally poor, perhaps, because vessel wall thickening, rather than vasoconstriction, is the problem, or because most patients with primary pulmonary hypertension are seen in advanced stages of disease. Vasodilators often affect systemic vessels (but not pulmonary vessels), and may cause adverse changes in cardiac output and contractility. Survival varies from months to 40 years, reflecting the severity of the condition. The prognosis of pulmonary hypertension is most strongly related to the function of the right ventricle (which pumps blood to the lungs). Echocardiography is useful in assessing heart function in affected patients. In cases of right ventricular failure, heart and lung transplantation provides the only hope of long-term survival with good quality of life. Improvements in transplant management and lung surveillance have improved three-year survival to 65 percent. Patients who are young and have no other disease are most likely to benefit. Further understanding of the physiology of arteries, endothelial cells (which line vessels), and hormones (which regulate them) are needed to develop more successful treatments for primary pulmonary hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

30. Efficacy of a Device to Narrow the Coronary Sinus in Refractory Angina

Author

Institute for Medical Engineering and Science, Edelman, Elazer R., Verheye, Stefan, Jolicœur, E. Marc, Behan, Miles W., Pettersson, Thomas, Sainsbury, Paul, Hill, Jonathan, Vrolix, Mathias, Agostoni, Pierfrancesco, Engstrom, Thomas, Labinaz, Marino, de Silva, Ranil, Schwartz, Marc, Meyten, Nathalie, Uren, Neal G., Doucet, Serge, Tanguay, Jean-François, Lindsay, Steven, Henry, Timothy D., White, Christopher J., Banai, Shmuel, Institute for Medical Engineering and Science, Edelman, Elazer R., Verheye, Stefan, Jolicœur, E. Marc, Behan, Miles W., Pettersson, Thomas, Sainsbury, Paul, Hill, Jonathan, Vrolix, Mathias, Agostoni, Pierfrancesco, Engstrom, Thomas, Labinaz, Marino, de Silva, Ranil, Schwartz, Marc, Meyten, Nathalie, Uren, Neal G., Doucet, Serge, Tanguay, Jean-François, Lindsay, Steven, Henry, Timothy D., White, Christopher J., and Banai, Shmuel

Abstract

Background: Many patients with coronary artery disease who are not candidates for revascularization have refractory angina despite standard medical therapy. The balloon-expandable, stainless steel, hourglass-shaped, coronary-sinus reducing device creates a focal narrowing and increases pressure in the coronary sinus, thus redistributing blood into ischemic myocardium. Methods: We randomly assigned 104 patients with Canadian Cardiovascular Society (CCS) class III or IV angina (on a scale from I to IV, with higher classes indicating greater limitations on physical activity owing to angina) and myocardial ischemia, who were not candidates for revascularization, to implantation of the device (treatment group) or to a sham procedure (control group). The primary end point was the proportion of patients with an improvement of at least two CCS angina classes at 6 months. Results: A total of 35% of the patients in the treatment group (18 of 52 patients), as compared with 15% of those in the control group (8 of 52), had an improvement of at least two CCS angina classes at 6 months (P=0.02). The device was also associated with improvement of at least one CCS angina class in 71% of the patients in the treatment group (37 of 52 patients), as compared with 42% of those in the control group (22 of 52) (P=0.003). Quality of life as assessed with the use of the Seattle Angina Questionnaire was significantly improved in the treatment group, as compared with the control group (improvement on a 100-point scale, 17.6 vs. 7.6 points; P=0.03). There were no significant between-group differences in improvement in exercise time or in the mean change in the wall-motion index as assessed by means of dobutamine echocardiography. At 6 months, 1 patient in the treatment group had had a myocardial infarction; in the control group, 1 patient had died and 3 had had a myocardial infarction. Conclusions: In this small clinical trial, implantation of the coronary-sinus reducing device was associated w, Neovasc, Inc. (COSIRA ClinicalTrials.gov number, NCT01205893)

Published
2016

32. Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial:study protocol for randomized controlled trial

Author

Newby, David E, Williams, Michelle C, Flappan, Andrew D, Forbes, John F, Hargreaves, Allister D, Leslie, Stephen J, Lewis, Stephanie, McKillop, Graham, McLean, Scott, Reid, John, Spratt, James C, Uren, Neal G, van Beek, Edwin J, Boon, Nicholas A, Clark, Liz, Craig, Peter, Flather, Marcus D, McCormack, Chiara, Roditi, Giles, Timmis, Adam D, Krishan, Ashma, Donaldson, Gillian, Fotheringham, Marlene, Hall, Fiona J, Neary, Paul, Cram, Louisa, Perkins, Sarah, Taylor, Fiona, Eteiba, Hany, Rae, Alan P, Robb, Kate, Barrie, Dawn, Bissett, Kim, Dawson, Adelle, Dundas, Scot, Fogarty, Yvonne, Ramkumar, Prasad G, Houston, Graeme J, Letham, Deborah, O'Neill, Linda, Pringle, Stuart, Ritchie, Valerie, Sudarshan, Thiru, Weir-McCall, Jonathan, Cormack, Alistair, Findlay, Iain N, Hood, Stuart, Murphy, Clare, Peat, Eileen, Allen, Barbara, Bertram, Danielle, Brian, David, Cowan, Amy, Cruden, Nicholas L, Dweck, Marc R, Flint, Laura, Fyfe, Samantha, Harding, Collette, Macgillivray, Tom J, Maclachlan, David S, Macleod, Margaret, Misadraee, Saeed, Morrison, Avril, Mills, Nicholas L, Phillips, Alyson, Queripel, Laura J, Weir, Nicholas W, Bett, Fiona, Divers, Frances, Fairley, Katie, Jacob, Ashok J, Keegan, Edith, White, Tricia, Gemmil, John, Henry, Margo, McGowan, James, Dinnel, Lorraine, Francis, Marc C, Sandeman, Dennis, Yerramasu, Ajay, Berry, Colin, Boylan, Heather, Brown, Ammani, Duffy, Karen, Frood, Alison, Johnstone, Janet, Langhan, Kirsten, Macduff, Ross, Macleod, Martin, McGlynn, Deborah, McMillan, Nigel, Murdoch, Laura, Noble, Colin, Paterson, Victoria, Steedman, Tracey, Tzemos, Nikolaos, Baird, Andrew, and Minns, Fiona C

Subjects
Time Factors, Medicine (miscellaneous), Coronary Disease, Research & Experimental Medicine, Rapid access chest pain clinic, Coronary Angiography, Chest pain, ANGIOGRAPHY, DISEASE, Health Services Accessibility, law.invention, Angina, Study Protocol, Clinical Protocols, Randomized controlled trial, Risk Factors, law, Pharmacology (medical), Prospective Studies, Prospective cohort study, 1102 Cardiorespiratory Medicine and Haematology, Computed tomography, medicine.diagnostic_test, Prognosis, Coronary heart disease, Medicine, Research & Experimental, Research Design, Predictive value of tests, Cardiology Service, Hospital, Radiology, medicine.symptom, Emergency Service, Hospital, Life Sciences & Biomedicine, ACCIDENT, medicine.medical_specialty, Angina Pectoris, Decision Support Techniques, Time-to-Treatment, CORONARY-ARTERY CALCIUM, Predictive Value of Tests, General & Internal Medicine, Multidetector Computed Tomography, medicine, Humans, Science & Technology, business.industry, 1103 Clinical Sciences, Emergency department, medicine.disease, EMERGENCY-DEPARTMENT, CALCIFICATION, Cardiovascular System & Hematology, Scotland, Angiography, Imaging technology, business
Abstract

Background Rapid access chest pain clinics have facilitated the early diagnosis and treatment of patients with coronary heart disease and angina. Despite this important service provision, coronary heart disease continues to be under-diagnosed and many patients are left untreated and at risk. Recent advances in imaging technology have now led to the widespread use of noninvasive computed tomography, which can be used to measure coronary artery calcium scores and perform coronary angiography in one examination. However, this technology has not been robustly evaluated in its application to the clinic. Methods/design The SCOT-HEART study is an open parallel group prospective multicentre randomized controlled trial of 4,138 patients attending the rapid access chest pain clinic for evaluation of suspected cardiac chest pain. Following clinical consultation, participants will be approached and randomized 1:1 to receive standard care or standard care plus ≥64-multidetector computed tomography coronary angiography and coronary calcium score. Randomization will be conducted using a web-based system to ensure allocation concealment and will incorporate minimization. The primary endpoint of the study will be the proportion of patients diagnosed with angina pectoris secondary to coronary heart disease at 6 weeks. Secondary endpoints will include the assessment of subsequent symptoms, diagnosis, investigation and treatment. In addition, long-term health outcomes, safety endpoints, such as radiation dose, and health economic endpoints will be assessed. Assuming a clinic rate of 27.0% for the diagnosis of angina pectoris due to coronary heart disease, we will need to recruit 2,069 patients per group to detect an absolute increase of 4.0% in the rate of diagnosis at 80% power and a two-sided P value of 0.05. The SCOT-HEART study is currently recruiting participants and expects to report in 2014. Discussion This is the first study to look at the implementation of computed tomography in the patient care pathway that is outcome focused. This study will have major implications for the management of patients with cardiovascular disease. Trial registration ClinicalTrials.gov Identifier: NCT01149590

Published
2012
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33. Efficacy of a Device to Narrow the Coronary Sinus in Refractory Angina

Author

Cardiologie, Circulatory Health, Verheye, Stefan, Jolicoeur, E. Marc, Behan, Miles W., Pettersson, Thomas, Sainsbury, Paul, Hill, Jonathan, Vrolix, Mathias, Agostoni, Pierfrancesco, Engstrom, Thomas, Labinaz, Marino, de Silva, Ranil, Schwartz, Marc, Meyten, Nathalie, Uren, Neal G., Doucet, Serge, Tanguay, Jean-Francois, Lindsay, Steven, Henry, Timothy D., White, Christopher J., Edelman, Elazer R., Banai, Shmuel, Cardiologie, Circulatory Health, Verheye, Stefan, Jolicoeur, E. Marc, Behan, Miles W., Pettersson, Thomas, Sainsbury, Paul, Hill, Jonathan, Vrolix, Mathias, Agostoni, Pierfrancesco, Engstrom, Thomas, Labinaz, Marino, de Silva, Ranil, Schwartz, Marc, Meyten, Nathalie, Uren, Neal G., Doucet, Serge, Tanguay, Jean-Francois, Lindsay, Steven, Henry, Timothy D., White, Christopher J., Edelman, Elazer R., and Banai, Shmuel

Published
2015

35. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

Author

Joshi, Nikhil V., primary, Toor, Iqbal, additional, Shah, Anoop S. V., additional, Carruthers, Kathryn, additional, Vesey, Alex T., additional, Alam, Shirjel R., additional, Sills, Andrew, additional, Hoo, Teng Y., additional, Melville, Adam J., additional, Langlands, Sarah P., additional, Jenkins, William S. A., additional, Uren, Neal G., additional, Mills, Nicholas L., additional, Fletcher, Alison M., additional, van Beek, Edwin J. R., additional, Rudd, James H. F., additional, Fox, Keith A. A., additional, Dweck, Marc R., additional, and Newby, David E., additional

Published
2015
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36. Observer variability in the assessment of CT coronary angiography and coronary artery calcium score: substudy of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial

Author

Williams, Michelle C, primary, Golay, Saroj K, additional, Hunter, Amanda, additional, Weir-McCall, Jonathan R, additional, Mlynska, Lucja, additional, Dweck, Marc R, additional, Uren, Neal G, additional, Reid, John H, additional, Lewis, Steff C, additional, Berry, Colin, additional, van Beek, Edwin J R, additional, Roditi, Giles, additional, Newby, David E, additional, and Mirsadraee, Saeed, additional

Published
2015
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37. Transcatheter Aortic Valve Implantation in the United Kingdom

Author

Ludman, Peter F., primary, Moat, Neil, additional, de Belder, Mark A., additional, Blackman, Daniel J., additional, Duncan, Alison, additional, Banya, Winston, additional, MacCarthy, Philip A., additional, Cunningham, David, additional, Wendler, Olaf, additional, Marlee, Damian, additional, Hildick-Smith, David, additional, Young, Christopher P., additional, Kovac, Jan, additional, Uren, Neal G., additional, Spyt, Tomasz, additional, Trivedi, Uday, additional, Howell, Jonathan, additional, and Gray, Huon, additional

Published
2015
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40. Identification and Predictive Value of Interleukin-6 + Interleukin-10 + and Interleukin-6 − Interleukin-10 + Cytokine Patterns in ST-Elevation Acute Myocardial Infarction

Author

Ammirati, Enrico, primary, Cannistraci, Carlo V., additional, Cristell, Nicole A., additional, Vecchio, Viviana, additional, Palini, Alessio G., additional, Tornvall, Per, additional, Paganoni, Anna M., additional, Miendlarzewska, Ewa A., additional, Sangalli, Laura M., additional, Monello, Alberto, additional, Pernow, John, additional, Björnstedt Bennermo, Marie, additional, Marenzi, Giancarlo, additional, Hu, Dayi, additional, Uren, Neal G., additional, Cianflone, Domenico, additional, Ravasi, Timothy, additional, Manfredi, Angelo A., additional, and Maseri, Attilio, additional

Published
2012
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41. Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial: study protocol for randomized controlled trial

Author

Newby, David E, primary, Williams, Michelle C, additional, Flapan, Andrew D, additional, Forbes, John F, additional, Hargreaves, Allister D, additional, Leslie, Stephen J, additional, Lewis, Steff C, additional, McKillop, Graham, additional, McLean, Scott, additional, Reid, John H, additional, Sprat, James C, additional, Uren, Neal G, additional, van Beek, Edwin J, additional, Boon, Nicholas A, additional, Clark, Liz, additional, Craig, Peter, additional, Flather, Marcus D, additional, McCormack, Chiara, additional, Roditi, Giles, additional, Timmis, Adam D, additional, Krishan, Ashma, additional, Donaldson, Gillian, additional, Fotheringham, Marlene, additional, Hall, Fiona J, additional, Neary, Paul, additional, Cram, Louisa, additional, Perkins, Sarah, additional, Taylor, Fiona, additional, Eteiba, Hany, additional, Rae, Alan P, additional, Robb, Kate, additional, Barrie, Dawn, additional, Bissett, Kim, additional, Dawson, Adelle, additional, Dundas, Scot, additional, Fogarty, Yvonne, additional, Ramkumar, Prasad Guntur, additional, Houston, Graeme J, additional, Letham, Deborah, additional, O’Neill, Linda, additional, Pringle, Stuart D, additional, Ritchie, Valerie, additional, Sudarshan, Thiru, additional, Weir-McCall, Jonathan, additional, Cormack, Alistair, additional, Findlay, Iain N, additional, Hood, Stuart, additional, Murphy, Clare, additional, Peat, Eileen, additional, Allen, Barbara, additional, Baird, Andrew, additional, Bertram, Danielle, additional, Brian, David, additional, Cowan, Amy, additional, Cruden, Nicholas L, additional, Dweck, Marc R, additional, Flint, Laura, additional, Fyfe, Samantha, additional, Keanie, Collette, additional, MacGillivray, Tom J, additional, Maclachlan, David S, additional, MacLeod, Margaret, additional, Mirsadraee, Saeed, additional, Morrison, Avril, additional, Mills, Nicholas L, additional, Minns, Fiona C, additional, Phillips, Alyson, additional, Queripel, Laura J, additional, Weir, Nicholas W, additional, Bett, Fiona, additional, Divers, Frances, additional, Fairley, Katie, additional, Jacob, Ashok J, additional, Keegan, Edith, additional, White, Tricia, additional, Gemmill, John, additional, Henry, Margo, additional, McGowan, James, additional, Dinnel, Lorraine, additional, Francis, C Mark, additional, Sandeman, Dennis, additional, Yerramasu, Ajay, additional, Berry, Colin, additional, Boylan, Heather, additional, Brown, Ammani, additional, Duffy, Karen, additional, Frood, Alison, additional, Johnstone, Janet, additional, Lanaghan, Kirsten, additional, MacDuff, Ross, additional, MacLeod, Martin, additional, McGlynn, Deborah, additional, McMillan, Nigel, additional, Murdoch, Laura, additional, Noble, Colin, additional, Paterson, Victoria, additional, Steedman, Tracey, additional, and Tzemos, Nikolaos, additional

Published
2012
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42. High-Sensitivity C-Reactive Protein Is Within Normal Levels at the Very Onset of First ST-Segment Elevation Acute Myocardial Infarction in 41% of Cases

Author

Cristell, Nicole, primary, Cianflone, Domenico, additional, Durante, Alessandro, additional, Ammirati, Enrico, additional, Vanuzzo, Diego, additional, Banfi, Michela, additional, Calori, Giliola, additional, Latib, Azeem, additional, Crea, Filippo, additional, Marenzi, Giancarlo, additional, De Metrio, Monica, additional, Moretti, Luciano, additional, Li, Hui, additional, Uren, Neal G., additional, Hu, Dayi, additional, and Maseri, Attilio, additional

Published
2011
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45. Myopericarditis in Churg-Strauss Syndrome

Author

Uren, Neal G. and Hammond, Peter J.

Subjects
hemic and lymphatic diseases, cardiovascular diseases, Case Reports
Abstract

Churg-Strauss syndrome is a disseminated vasculitis with multisystem involvement, characterized by necrotizing arteritis, eosinophilic infiltration, and extravascular granuloma formation. In as many as 60% of all cases, the heart may be affected. We describe a 30-year-old man in whom pericarditis was followed by the development of a large pericardial effusion, with evidence of impaired right and left ventricular function. The patient had a 5-year history of asthma. Early therapy with high-dose prednisolone and azathioprine led to resolution of the pericardial effusion and prevented a further reduction in biventricular function. (Texas Heart Institute Journal 1991;18:127-31)

Published
1991

49. Relation between myocardial blood flow and the severity of coronary-artery stenosis

Author

UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (SLuc) Service de médecine nucléaire, Uren, Neal G., Melin, Jacques, De Bruyne, Bernard, Wijns, William, Baudhuin, Thierry, Camici, Paolo G., UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (SLuc) Service de médecine nucléaire, Uren, Neal G., Melin, Jacques, De Bruyne, Bernard, Wijns, William, Baudhuin, Thierry, and Camici, Paolo G.

Abstract

Background. We assessed the relation between the severity of stenosis in a coronary artery and the degree of impairment of myocardial blood flow. Studies in laboratory animals have shown that as the degree of coronary-artery stenosis increases, the maximal coronary flow measured after maximal vasodilatation progressively decreases, with a concomitant decrease in basal flow. However, this relation has not been carefully documented in humans through measurement of myocardial blood flow. Methods, We studied 35 patients with single-vessel coronary artery disease and normal left ventricular function and 21 age-matched controls. Regional myocardial blood flow in the area supplied by the stenosed artery was measured by positron-emission tomography with oxygen-15-labeled water while the subject was at rest (basal flow) and during hyperemia induced by the intravenous administration of the vasodilator adenosine (140 mu g per kilogram of body weight per minute) or dipyridamole (0.56 mg per kilogram). Results. The mean (+/-SD) basal myocardial blood flow was 1.14+/-0.42 ml per minute per gram of tissue in the patients and 1.13+/-0.26 ml per minute per gram in the controls; during hyperemia, myocardial flow was 2.10+/-1.16 and 3.37+/-1.25 ml per minute per gram (P<0.001), respectively. Basal flow was unchanged regardless of the severity of stenosis, expressed as a percentage of the diameter of the affected vessel (range of degrees of stenosis, 17 to 87 percent). In contrast, flow during hyperemia correlated inversely and significantly with the degree of stenosis and correlated directly with the minimal luminal diameter. The coronary vasodilator reserve (defined as the ratio of flow during hyperemia to flow at base line) began to decline when the deg ree of stenosis was about 40 percent and approached unity when stenosis was 80 percent or greater. Conclusions. In humans, basal myocardial blood flow remains constant regardless of the severity of coronary-artery stenosis. However

Published
1994

50. Diffuse reduction of myocardial beta-adrenoceptors in hypertrophic cardiomyopathy: A study with positron emission tomography

Author

Lefroy, David C., primary, de Silva, Ranil, additional, Choudhury, Lubna, additional, Uren, Neal G., additional, Crake, Tom, additional, Rhodes, Christopher G., additional, Lammertsma, Adriaan A., additional, Boyd, Heather, additional, Patsalos, Philip N., additional, Nihoyannopoulos, Petros, additional, Oakley, Celia M., additional, Jones, Terry, additional, and Camici, Paolo G., additional

Published
1993
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