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High sensitivity C-Reactive Protein in Chronic heart failure: Patient Characteristics, Phenotypes and mode of death (2019)
Journal Article
Pellicori, P., Zhang, J., Cuthbert, J., Urbinati, A., Shah, P., Kazmi, S., …Cleland, J. (in press). High sensitivity C-Reactive Protein in Chronic heart failure: Patient Characteristics, Phenotypes and mode of death. Cardiovascular research, https://doi.org/10.1093/cvr/cvz198

Aims: Plasma concentrations of high sensitivity C-reactive protein (hsCRP) are often raised in chronic heart failure (CHF) and might indicate inflammatory processes that could be a therapeutic target. We aimed to study the associations between hsCRP,... Read More

Oral modified release morphine for breathlessness in chronic heart failure: a randomised placebo-controlled trial (2019)
Journal Article
Johnson, M., Cockayne, S., Currow, D., Bell, K., Hicks, K., Fairhurst, C., …Clark, A. (in press). Oral modified release morphine for breathlessness in chronic heart failure: a randomised placebo-controlled trial. ESC Heart Failure,

ABSTRACT Aims: Morphine is shown to relieve chronic breathless in chronic obstructive pulmonary disease. There are no definitive data in people with heart failure. We aimed to determine the effectiveness and cost-effectiveness of 12 weeks’ morphine... Read More

Clinical and prognostic association of total atrial and conduction time in patients with heart failure: a report from Studies Investigating Co-morbidities Aggravating Heart Failure (2019)
Journal Article
Nuzzi, V., Pellicori, P., Nikolaidou, T., Kallvikbacka-Bennett, A., Torromeo, C., Barilla, F., …Clark, A. (2019). Clinical and prognostic association of total atrial and conduction time in patients with heart failure: a report from Studies Investigating Co-morbidities Aggravating Heart Failure. European journal of heart failure, 20(7), 442–449. https://doi.org/10.2459/JCM.0000000000000802

Background The total atrial conduction time can be measured as the time from the onset of the P wave on the ECG to the peak of the A wave recorded at the mitral annulus using tissue Doppler imaging (A′; P-A′TDI); when prolonged, it might predict inci... Read More

Characteristics and outcome of acute heart failure patients according to the severity of peripheral oedema (2019)
Journal Article
Shoaib, A., Mamas, M. A., Ahmad, Q. S., McDonagh, T. M., Hardman, S. M., Rashid, M., …Cleland, J. G. F. (2019). Characteristics and outcome of acute heart failure patients according to the severity of peripheral oedema. International journal of cardiology, 285, 40-46. https://doi.org/10.1016/j.ijcard.2019.03.020

Background Most trials of patients hospitalized for heart failure focus on breathlessness (alveolar pulmonary oedema) but worsening peripheral oedema is also an important presentation. We investigated the relationship between the severity of periphe... Read More

Prevalence, pattern and clinical relevance of ultrasound indices of congestion in outpatients with heart failure (2019)
Journal Article
Pellicori, P., Shah, P., Cuthbert, J., Urbinati, A., Zhang, J., Kallvikbacka-Bennett, A., …Cleland, J. G. F. (2019). Prevalence, pattern and clinical relevance of ultrasound indices of congestion in outpatients with heart failure. European journal of heart failure, 21(7), 904-916. https://doi.org/10.1002/ejhf.1383

Aims Even if treatment controls symptoms, patients with heart failure may still be congested. We aimed at assessing the prevalence and clinical relevance of congestion in outpatients with chronic heart failure. Conclusions Many patients with chr... Read More

Are there patients missing from community heart failure registers? An audit of clinical practice (2018)
Journal Article
Cuthbert, J. J., Gopal, J., Crundall-Goode, A., & Clark, A. L. (2019). Are there patients missing from community heart failure registers? An audit of clinical practice. European Journal of Preventive Cardiology, 26(3), 204748731881083. https://doi.org/10.1177/2047487318810839

Background General practitioners in the UK are financially incentivised, via the Quality Outcomes Framework, to maintain a record of all patients at their practice with heart failure and manage them appropriately. The prevalence of heart failure rec... Read More

Mode of presentation and mortality amongst patients hospitalized with heart failure? A report from the First Euro Heart Failure Survey (2018)
Journal Article
Shoaib, A., Farag, M., Nolan, J., Rigby, A., Patwala, A., Rashid, M., …Cleland, J. G. (2019). Mode of presentation and mortality amongst patients hospitalized with heart failure? A report from the First Euro Heart Failure Survey. Clinical Research in Cardiology, 108(5), 510-519. https://doi.org/10.1007/s00392-018-1380-6

© 2018, The Author(s). Background: Heart failure is heterogeneous in aetiology, pathophysiology, and presentation. Despite this diversity, clinical trials of patients hospitalized for HF deal with this problem as a single entity, which may be one rea... Read More

Warm water immersion in patients with chronic heart failure: a pilot study: Shah immerse: HF (2018)
Journal Article
Shah, P., Pellicori, P., Kallvikbacka-Bennett, A., Zhang, J., Pan, D., & Clark, A. L. (2019). Warm water immersion in patients with chronic heart failure: a pilot study: Shah immerse: HF. Clinical Research in Cardiology, 108(5), 468–476. https://doi.org/10.1007/s00392-018-1376-2

Background Patients with chronic conditions, such as heart failure, swim regularly and most rehabilitation exercises are conducted in warm hydrotherapy pools. However, little is known about the acute effects of warm water immersion (WWI) on cardiac... Read More

The impact of heart failure and chronic obstructive pulmonary disease on mortality in patients presenting with breathlessness (2018)
Journal Article
Cuthbert, J. J., Kearsley, J. W., Kazmi, S., Kallvikbakka-Bennett, A., Weston, J., Davis, J., …Clark, A. L. (2019). The impact of heart failure and chronic obstructive pulmonary disease on mortality in patients presenting with breathlessness. Clinical Research in Cardiology, 108(2), 185–193. https://doi.org/10.1007/s00392-018-1342-z

© 2018, The Author(s). Background: Differentiating heart failure from chronic obstructive pulmonary disease (COPD) in a patient presenting with breathlessness is difficult but may have implications for outcome. We investigated the prognostic impact o... Read More

Mortality after admission for heart failure in the UK compared with Japan (2018)
Journal Article
Nagai, T., Sundaram, V., Rothnie, K., Quint, J. K., Shoaib, A., Shiraishi, Y., …Cleland, J. G. (2018). Mortality after admission for heart failure in the UK compared with Japan. Open heart, 5(2), e000811. https://doi.org/10.1136/openhrt-2018-000811

Objective Mortality amongst patients hospitalised for heart failure (HHF) in Western and Asian countries may differ, but this has not been investigated using individual patient-level data (IPLD). We sought to remedy this through rigorous statistical... Read More

Low serum chloride in patients with chronic heart failure: clinical associations and prognostic significance (2018)
Journal Article
Cuthbert, J. J., Pellicori, P., Rigby, A., Pan, D., Kazmi, S., Shah, P., & Clark, A. L. (2018). Low serum chloride in patients with chronic heart failure: clinical associations and prognostic significance. European journal of heart failure, 20(10), 1426-1435. https://doi.org/10.1002/ejhf.1247

© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology Background: Low serum chloride is common in patients with chronic heart failure (CHF) and is associated with worse outcomes. We investigated the clinical and... Read More

Dynamic risk stratification using serial measurements of plasma concentrations of natriuretic peptides in patients with heart failure (2018)
Journal Article
Zhang, J., Pellicori, P., Pan, D., Dierckx, R., Clark, A. L., & Cleland, J. (2018). Dynamic risk stratification using serial measurements of plasma concentrations of natriuretic peptides in patients with heart failure. International journal of cardiology, 269, 196-200. https://doi.org/10.1016/j.ijcard.2018.06.070

Background Prognostic models for patients with chronic heart failure are generally based on a single assessment but treatment is often given with the intention of changing risk; re- evaluation of risk is an important aspect of care. The prognostic va... Read More

Validation of U.S. mortality prediction models for hospitalized heart failure in the United Kingdom and Japan: Validation of risk models in decompensated heart failure (2018)
Journal Article
Nagai, T., Sundaram, V., Shoaib, A., Shiraishi, Y., Kohsaka, S., Rothnie, K. J., …Cleland, J. G. (2018). Validation of U.S. mortality prediction models for hospitalized heart failure in the United Kingdom and Japan: Validation of risk models in decompensated heart failure. European journal of heart failure, 20(8), 1179-1190. https://doi.org/10.1002/ejhf.1210

Aims: Prognostic models for hospitalised heart failure (HHF) were developed predominantly for patients of European origin in the United States of America; it is unclear whether they perform similarly in other health-care systems or for different ethn... Read More

Is cardiorespiratory fitness related to cardiometabolic health and all-cause mortality risk in patients with coronary heart disease? A CARE CR study (2018)
Journal Article
Nichols, S., Taylor, C., Page, R., Kallvikbacka-Bennett, A., Nation, F., Goodman, T., …Ingle, L. (2018). Is cardiorespiratory fitness related to cardiometabolic health and all-cause mortality risk in patients with coronary heart disease? A CARE CR study. Sports Medicine - Open, 4(1), https://doi.org/10.1186/s40798-018-0138-z

Background: Higher cardiorespiratory fitness (CRF) is associated with lower morbidity and mortality in patients with coronary heart disease (CHD). The mechanisms for this are not fully understood. A more favourable cardiometabolic risk factor profi... Read More

Effect of increased inspired oxygen on exercise performance in patients with heart failure and normal ejection fraction (2018)
Journal Article
Shah, P., Pellicori, P., Rimmer, S., Rigby, A. S., & Clark, A. L. (2018). Effect of increased inspired oxygen on exercise performance in patients with heart failure and normal ejection fraction. International journal of cardiology, 268, 166-169. https://doi.org/10.1016/j.ijcard.2018.05.029

Introduction: We investigated whether increased concentrations of inspired oxygen (FiO2) affects exercise tolerance in patients with heart failure and normal ejection fraction (HeFNEF). Methods: 46 patients (mean age 75 years (63% male) and median NT... Read More

Outcome of hospitalised heart failure in Japan and the United Kingdom stratified by plasma N-terminal pro-B-type natriuretic peptide (2018)
Journal Article
Shiraishi, Y., Nagai, T., Kohsaka, S., Goda, A., Nagatomo, Y., Mizuno, A., …Cleland, J. G. (2018). Outcome of hospitalised heart failure in Japan and the United Kingdom stratified by plasma N-terminal pro-B-type natriuretic peptide. Clinical Research in Cardiology, 107(12), 1103-1110. https://doi.org/10.1007/s00392-018-1283-6

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Background: Mortality subsequent to a hospitalisation for heart failure is reported to be much lower in Japan than in the United Kingdom (UK). This could reflect differences in disease se... Read More

Prevalence and Prognostic Significance of Malnutrition Using 3 Scoring Systems Among Outpatients With Heart Failure: A Comparison With Body Mass Index (2018)
Journal Article
Sze, S., Pellicori, P., Kazmi, S., Rigby, A., Cleland, J. G., Wong, K., & Clark, A. L. (2018). Prevalence and Prognostic Significance of Malnutrition Using 3 Scoring Systems Among Outpatients With Heart Failure: A Comparison With Body Mass Index. JACC: Heart Failure, 6(6), 476-486. https://doi.org/10.1016/j.jchf.2018.02.018

Objectives The authors sought to report the prevalence, clinical associations, and prognostic consequences of malnutrition in outpatients with heart failure (HF). Background Malnutrition may be common in HF and associated with adverse outcomes, but... Read More

Cardiogoniometry compared to fractional flow reserve at identifying physiologically significant coronary stenosis: The Cardioflow Study (2018)
Journal Article
Brown, O. I., Clark, A. L., Chelliah, R., Davison, B. J., Mather, A. N., Cunnington, M. S., …Hoye, A. (2018). Cardiogoniometry compared to fractional flow reserve at identifying physiologically significant coronary stenosis: The Cardioflow Study. Cardiovascular Engineering and Technology, 9(3), 439-446. https://doi.org/10.1007/s13239-018-0354-1

Cardiogoniometry (CGM) is method of 3-dimensional electrocardiographic assessment which has been shown to identify patients with angiographically defined, stable coronary artery disease (CAD). However, angiographic evidence of CAD, does not always co... Read More

Effect of beta-adrenergic blockade on weight changes in patients with chronic heart failure (2018)
Journal Article
Sze, S., Pellicori, P., Kamzi, S., Anton, A., & Clark, A. L. (2018). Effect of beta-adrenergic blockade on weight changes in patients with chronic heart failure. International journal of cardiology, 264, 104-112. https://doi.org/10.1016/j.ijcard.2018.03.089

Abstract: Background: Weight loss is common in patients with chronic heart failure (CHF) and is associated with adverse outcome. Activation of the sympathetic nervous system has been implicated in weight loss, wasting and cachexia. However, the effe... Read More