Attila Kardos

Attila Kardos
Milton Keynes University Hospital NHS Foundation Trust · Cardiology

MD, PhD, FRCP, FESC

About

132
Publications
19,579
Reads
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7,052
Citations
Additional affiliations
October 2003 - present
University of Oxford
Position
  • Hon Senior Lecturer
October 2003 - present
Milton Keynes University Hospital NHS Foundation Trust
Position
  • Chair

Publications

Publications (132)
Article
Objectives The purpose of this study was to determine whether plaque burden and characteristics can predict subsequent death or myocardial infarction in patients with acute chest pain. Background In patients with stable chest pain, computed tomography (CT) plaque burden is an independent predictor of future coronary events. Methods In a post hoc...
Article
Aims To evaluate the potential associations between presentation cardiac troponin and the clinical impact of early computed tomography coronary angiography (CTCA) in intermediate-risk patients with suspected acute coronary syndrome. Methods and results In a large multicentre randomized controlled trial of patients with intermediate-risk chest pain...
Article
Funding Acknowledgements Type of funding sources: None. OnBehalf SARS-2-DEFORM Myocardial dysfunction is common and associated with worse outcomes in patients with ARDS, pulmonary embolism or severe sepsis due to pulmonary hypoxic vasoconstriction. Thrombotic events, myocarditis and endothelial dysfunction may contribute to these effects in COVID-...
Article
Background Cardiac computed tomography angiography (CCTA) includes several extra-cardiac structures. A variety of abnormalities may be clinically important and, in some cases, explain the patient's symptoms. The incidence of extra cardiac findings (ECFs) on CCTA examination ranges between 7% and 56%, with the true prevalence likely affected by pati...
Article
Full-text available
Objectives To establish if the use of early computed tomography (CT) coronary angiography improves one year clinical outcomes in patients presenting to the emergency department with acute chest pain and at intermediate risk of acute coronary syndrome and subsequent clinical events. Design Randomised controlled trial. Setting 37 hospitals in the U...
Article
Full-text available
Aims Stress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography. Methods and results Participants un...
Article
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Background Biventricular Takotsubo cardiomyopathy (BTC) is estimated to occur in 25–42% of those with Takotsubo cardiomyopathy (TC). Little is known about which subset of patients are predisposed to having concomitant right ventricular (RV) involvement, or the pattern of recovery in BTC. Case summary We describe a 69-year-old woman who presented w...
Article
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Why? To improve stress echocardiography interpretation standards, we introduced a structured five-day interpretation course in 2017. In order to deliver the course during the world-wide pandemic we transformed the existing boardroom style, workstation based, interactive course into a cloud-based digital entity maintaining the same features. How? O...
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Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by muscle hypertrophy and fibrosis, interfering with force generation and relaxation. Abnormal ventricular (LV) myocardial deformation have been demonstrated in patients with HOCM at rest, but there is lack of data regarding the deformational mechanics in exercise in obstructive HCM....
Article
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Recent clinical trials have revealed that aggressive insulin treatment has a neutral effect on cardiovascular risk in patients with diabetes despite improved glycemic control, which may suggest confounding direct effects of insulin on the human vasculature. We studied 580 patients with coronary atherosclerosis undergoing coronary artery bypass surg...
Article
Aims: Given the inherent inaccuracies stemming from the assumption that the left ventricular outflow tract (LVOT) is circular, this study aimed to improve the accuracy of transthoracic echocardiography (TTE)-based aortic valve area (AVA) calculation using continuity equation (CE) by introducing a correction factor (CF) derived from multidetector c...
Article
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Background 2D stress echocardiography (SE) is based in the visual analysis of wall motion abnormalities and it requires a trained operator. This operator-dependence has promoted the search for a semiautomatic method to reduce SE limitations and improve test accuracy. The aim of this study was to evaluate the value of 3D speckle tracking (3DSTE) in...
Article
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Background Takotsubo cardiomyopathy (TC) usually manifests as transient apical ballooning of the left ventricle and may mimic acute coronary syndrome. Concomitant right ventricle involvement may occur in about a third of the cases. Recurrence had been observed in up to 10% of TC with variable ventricular involvement. Despite this knowledge, there h...
Preprint
BACKGROUND Stress echocardiography (SE) is a well-established diagnostic tool in assessing patients with suspected coronary artery disease (CAD). Cardiovascular risk factors are used in the assessment of the probability of CAD. The link between the outcome of SE and patients’ variables including cardiovascular risk factors, current medication and a...
Article
Full-text available
Background: Stress echocardiography is a well-established diagnostic tool for suspected coronary artery disease (CAD). Cardiovascular risk factors are used in the assessment of the probability of CAD. The link between the outcome of stress echocardiography and patients' variables including risk factors, current medication, and anthropometric varia...
Article
Background “Cardiac electrical biomarker” (CEB) is a numerical index measured by the Vectraplex ECG (vECG) System with Vectraplex AMI software that detects changes in the cardiac electrical fields from dipolar to multipolar vectors during myocardial ischemia. CEB has been validated with ECG traces derived from patients with acute myocardial infarct...
Article
Full-text available
Introduction The National Early Warning Score is used as standard clinical practice in the UK as a track and trigger system to monitor hospitalised patients. Currently, nurses are tasked to take routine vital signs measurements and manually record these on a clinical chart. Wearable devices could provide an easier, reliable, more convenient and cos...
Article
Purpose: Anomalous Origin of Coronary Arteries from Opposite Sinus of Valsalva (ACAOS) is prevalent in 1% of the general and 0.4-0.7% of the imaging population. An Inter-Arterial Course (IAC) is considered to be associated with sudden cardiac death, particularly in young athletes predominantly related to anomalous left coronary artery originating f...
Article
BACKGROUND AND AIMS: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. METHODS: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medic...
Article
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Objectives: SUPPORT-HF 2 tests the hypothesis that home monitoring with information technology-supported specialist management is more effective in optimizing medical therapy than is home monitoring alone for patients with heart failure. Methods and results: The study was designed as a 2-armed partially blinded parallel randomized controlled tri...
Article
Aortic valve area is one of the main criteria used by echocardiography to determine the degree of valvular aortic stenosis, and it is calculated using the continuity equation which assumes that the flow volume of blood is equal at two points, the aortic valve area and the left ventricular outflow tract (LVOT). The main fallacy of this equation is t...
Article
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The carcinoid syndrome is rare but it is associated with carcinoid heart disease in more than a half of the cases. Carcinoid heart disease is typically characterised by morphological and functional modifications of right-sided valves. Its aetiology is probable multifactorial but serotonin appears to play a key role in the development of this valvul...
Poster
Full-text available
he prevalence of extra cardiac findings (ECFs) on cardiac computed tomography angiography (CCTA) has been reported a common occurrence with a range between 7% - 56%, with the true prevalence likely affected by patient selection. The clinical and prognostic significance of incidental ECFs as well as financial implications of follow-up imaging and ca...
Article
Full-text available
The Medtronic ATS Open Pivot mechanical valve has been successfully used in heart valve surgery for more than two decades. We present the case of a patient who, 19 years following a tricuspid valve replacement with an ATS prosthesis as part of a triple valve operation following infective endocarditis, developed severe tricuspid regurgitation due to...
Data
The purpose of the present study was to evaluate the prognostic value of left atrial (LA) mechanics and stiffness in a prospective cohort of 82 asymptomatic patients (31 men, mean age 73±10 years) with severe aortic stenosis (AS) and normal left ventricular ejection fraction. Methods: By the use of 2-dimensional speckle tracking echocardiography, L...
Article
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Purpose: Although delayed-enhancement magnetic resonance imaging (DEMRI) is essential for diagnosis of cardiac sarcoidosis (CS), the test was not available when pacemaker was implamted. Recently, MR-conditional pacemaker has become avilable and we hypothesized that this device would be useful for diagnosis and management of CS. The aim of this stud...
Article
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-Clinical trials in heart failure have focused on the improvement in symptoms or decreases in the risk of death and other cardiovascular events. Little is known about the effect of drugs on the risk of clinical deterioration in surviving patients. -We compared the angiotensin-neprilysin inhibitor LCZ696 (400 mg daily) with the angiotensinconverting...
Article
http://www.scmr.org/caseoftheweek/2014/7060.html#.VCj1uWK9KK0
Article
Full-text available
Background: We compared the angiotensin receptor-neprilysin inhibitor LCZ696 with enalapril in patients who had heart failure with a reduced ejection fraction. In previous studies, enalapril improved survival in such patients. Methods: In this double-blind trial, we randomly assigned 8442 patients with class II, III, or IV heart failure and an e...
Article
Full-text available
Introduction Up to 10% of patients presenting with chest pain and elevated troponin levels demonstrate non-obstructive coronary arteries on angiography, posing a clinical challenge in diagnosis, prognosis and management. The final diagnosis has important implications for the patient, including prescription for treatment and fitness for permissible...
Article
Introduction The Celt ACD® (Kimal, Middlesex, U.K.) is a novel stainless steel vascular closure device (VCD). We conducted a prospective, non-randomised study to assess time to hemostasis, patient discomfort and vascular complications when using the Celt ACD® compared with both manual compression and Angio-Seal™ VIP (St Jude Medical, Minnesota, USA...
Article
Full-text available
Background Acute myocarditis can be diagnosed on cardiovascular magnetic resonance (CMR) using multiple techniques, including late gadolinium enhancement (LGE) imaging, which requires contrast administration. Native T1-mapping is significantly more sensitive than LGE and conventional T2-weighted (T2W) imaging in detecting myocarditis. The aims of t...
Article
We report a case of endovascular snare retrieval of a new stainless steel vascular closure device (Celt ACD(®) , Kimal, Middlesex, UK) from the common femoral artery, following device failure after diagnostic coronary angiography. The stainless steel composition of the device aided successful fluoroscopic localization and removal. © 2013 Wiley Peri...
Article
Full-text available
We sought to test the diagnostic performance of native T1 mapping in acute myocarditis compared with cardiac magnetic resonance (CMR) techniques such as dark-blood T2-weighted (T2W)-CMR, bright-blood T2W-CMR, and late gadolinium enhancement (LGE) imaging. The diagnosis of acute myocarditis on CMR often requires multiple techniques, including T2W, e...
Article
Background The accurate diagnosis of acute myocarditis on cardiovascular MRI (CMR) often requires multiple modalities, including T2-weighted (T2W), early and late gadolinium imaging. Novel CMR techniques are now available, including bright-blood T2W-CMR, and T1-mapping which is also sensitive to changes in free water content. We hypothesised that t...
Article
Introduction Patients presenting with chest pain, raised troponin but non-obstructive coronary arteries pose a clinical challenge in diagnosis, prognosis and management. We hypothesised that early cardiovascular magnetic resonance (CMR) imaging can provide a diagnosis and comprehensive characterisation for acute myocardial injury of indeterminate a...
Article
Full-text available
AIMS: Although the focus of therapeutic intervention has been on neurohormonal pathways thought to be harmful in heart failure (HF), such as the renin-angiotensin-aldosterone system (RAAS), potentially beneficial counter-regulatory systems are also active in HF. These promote vasodilatation and natriuresis, inhibit abnormal growth, suppress the RAA...
Article
Background The diagnosis of acute myocarditis can be challenging. Cardiovascular magnetic resonance imaging (CMR) can be a useful tool in this setting but often requires multiple modalities for tissue characterisation, including T2-weighted (T2w), early and late gadolinium imaging. Cardiac T1-mapping is a novel technique that is, quantitative and i...
Article
Full-text available
Summary Non-contrast T1-mapping using ShMOLLI can serve as a novel CMR diagnostic criterion in patients presenting with suspected acute myocarditis. Background The accurate diagnosis of acute myocarditis on cardiovascular magnetic resonance imaging (CMR) often requires multiple modalities, including T2-weighted (T2w), early and late gadolinium imag...
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Full-text available
BACKGROUND: Mineralocorticoid antagonists improve survival among patients with chronic, severe systolic heart failure and heart failure after myocardial infarction. We evaluated the effects of eplerenone in patients with chronic systolic heart failure and mild symptoms. METHODS: In this randomized, double-blind trial, we randomly assigned 2737 pati...
Article
Background The goal of the study was to establish the usefulness of a new device, the Actograph, to differentiate the causes of ischemia detected in ambulatory Holter monitoring. Twenty-five patients (7 women, 18 men) with angiographically proven coronary artery disease and stable effort angina were evaluated.Methods Patients had their physical mot...
Article
The purpose of this study was to investigate the phenomenon of left ventricular (LV) dysfunction after ultraendurance exercise. Subclinical LV dysfunction in response to endurance exercise up to 24 h duration has been described, but its mechanism remains elusive. We tested 86 athletes before and after the Adrenalin Rush Adventure Race using echocar...
Article
Full-text available
To verify whether a deficiency in the cardiac sarcoplasmic reticulum pump SERCA2a causes cardiac dysfunction in humans. Cardiac performance was measured in a serendipitous human model of primary SERCA2a deficiency, Darier's disease, an autosomal dominant skin disorder caused by mutations inactivating one copy of the ATP2A2 gene, which encodes SERCA...
Article
Full-text available
A 53 year old woman with Churg-Strauss syndrome and a history of asthma, pulmonary hyper-eosinophilia, and epileptic seizures was admitted to hospital with atypical chest pains. Her ECG showed generalised T wave inversions accompanied by TnI rise up to 7.8 μmol/l and hyper-eosinophilia (white blood …
Article
Despite the accepted utility of delayed-enhancement MRI in identifying irreversible myocardial injury, no study has yet assessed its role as a viability tool exclusively in the setting of coronary artery bypass surgery (CABG), and no study has repeated delayed-enhancement MRI late after revascularization. In a clinical trial in which patients under...