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Christopher J Boos

Christopher J Boos
University Hospital Dorset, Poole

MBBS MD Dip IMC FRCP PhD

About

207
Publications
29,534
Reads
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4,674
Citations
Introduction
Dr Christopher Boos is a Consultant Cardiologist at Poole Hospital NHS Foundation Trust, where he is the Cardiac Research Lead. He is a visiting Professor at Leeds Beckett University and a visiting Fellow at Bournemouth University. He is involved in a wide variety of collaborative research projects focused on Cardiovascular risk and high altitude Medicine.
Additional affiliations
May 2009 - present
Bournemouth University
Position
  • Visting fellow
September 2008 - present
Poole Hospital NHS Foundation Trust
Position
  • Consultant Cardiologist
January 2005 - March 2007
University of Birmingham
Position
  • Researcher

Publications

Publications (207)
Article
Full-text available
Introduction High-altitude (HA) exposure affects heart rate variability (HRV) and has been inconsistently linked to acute mountain sickness (AMS). The influence of increasing HA exposure on ultra-short HRV and its relationship to gold standard HRV measures at HA has not been examined. Methods This was a prospective observational study of adults ag...
Article
Full-text available
Background Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients’ clinical phenotypes and analyse the differential clinical course. Methods We performed a hierarchical cluster analysis based on Ward’s Method and Squared Euclidea...
Article
Purpose This study investigated the effect of carbohydrate supplementation on substrate oxidation during exercise in hypoxia after pre-exercise breakfast consumption and omission. Methods Eleven men walked in normobaric hypoxia (FiO2 ~11.7%) for 90-min at 50% of hypoxic V[Combining Dot Above]O2max. Participants were supplemented with a carbohydr...
Article
Introduction: Low energy availability (EA) may impede adaptation to exercise, suppressing reproductive function and bone turnover. Exercise energy expenditure (EEE) measurements lack definition and consistency. This study aimed to compare EA measured from moderate and vigorous physical activity from accelerometry (EEEmpva) with EA from total physi...
Article
Full-text available
Introduction The Afghanistan war (2003–2014) was a unique period in military medicine. Many service personnel survived injuries of a severity that would have been fatal at any other time in history; the long-term health outcomes of such injuries are unknown. The A rme D Ser V ices Tr A uma and Rehabilitatio N Out C om E (ADVANCE) study aims to dete...
Article
Backgroud Diastolic dysfunction (DD) is reported to affect up to 35% of the adult general population. The consequence of progressive DD is heart failure with preserved ejection fraction (HFpEF). Coronary microvascular dysfunction (CMD) has been suggested as one of the pathologic mechanisms leading to HFpEF. We investigated whether there was an asso...
Article
Full-text available
Introduction: There is evidence that intermittent hypoxic exposure (IHE) may improve high altitude (HA) performance. In this study, the effects of short-term IHE through voluntary apnea training on HA-related symptoms, including acute mountain sickness (AMS), were examined for the first time. Methods: Forty healthy adults were randomized to a self...
Article
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Article
Full-text available
Background and objectives: Cardiovascular disease (CVD) is a leading cause of death among military veterans with several reports suggesting a link between combat and related traumatic injury (TI) to an increased CVD risk. The aim of this paper is to conduct a widespread systematic review and meta-analysis of the relationship between military comba...
Article
Full-text available
Purpose The purpose of experiment one was to determine the appetite, acylated ghrelin and energy intake response to breakfast consumption and omission in hypoxia and normoxia. Experiment two aimed to determine the appetite, acylated ghrelin and energy intake response to carbohydrate supplementation after both breakfast consumption and omission in h...
Article
Purpose: This study compared the co-ingestion of glucose and fructose on exogenous and endogenous substrate oxidation during prolonged exercise at terrestrial high altitude (HA) versus sea level, in women. Method: Five women completed two bouts of cycling at the same relative workload (55% Wmax) for 120 minutes on acute exposure to HA (3375m) an...
Article
Military personnel with Post-Traumatic Stress Disorder (PTSD) can experience high levels of mental and physical health comorbidity, potentially indicating a high level of functional impairment that can impact on both military readiness and later ill-health. There is strong evidence to implicate PTSD as a contributory factor to Cardiovascular Diseas...
Article
The recent Iraq and Afghanistan conflicts represent a unique time in UK battlefield medicine; with more service personnel surviving complex traumas than any previous time. During these recent conflicts, approximately 830 UK service personnel were very seriously or seriously injured, and over 9000 were aero-medially evacuated. Little is known about...
Article
Full-text available
Introduction: There is conflicting data at sea-level to suggest that Paced Breathing (PB) versus Spontaneous Breathing (SB) during short-term Heart Rate Variability (HRV) measurement improves data reliability. Aim: This study sought to examine the effects of SB versus PB on HRV, at High Altitude (HA). Materials and Methods: This was a prospective o...
Article
Full-text available
The relationship between autonomic function and recovery following prolonged arduous exercise in women has not been examined. We undertook an exploratory study that aimed to examine the temporal change in linear and nonlinear measures of heart rate variability (HRV) following prolonged arduous exercise in the form of first all‐female (mean age 32.7...
Article
Full-text available
Introduction Whilst the link between physical factors and risk of high altitude (HA)-related illness and acute mountain sickness (AMS) have been extensively explored, the influence of psychological factors has been less well examined. In this study we aimed to investigate the relationship between ‘anxiety and AMS risk during a progressive ascent to...
Data
Anonymised data file for the study. (CSV)
Article
Full-text available
The binding of high-mobility group box-1 (HMGB-1) to the membrane receptor for advanced glycation end-products (mRAGE) is a key early mediator of non-infectious inflammation and its triggers include ischaemia/hypoxia. The effects of acute hypoxia on soluble RAGE (sRAGE) are unknown. Fourteen healthy adults (50% women; 26.6+/-3.8 years) were assesse...
Article
Full-text available
Background: High altitude (HA) exposure can lead to changes in resting heart rate variability (HRV), which may be linked to acute mountain sickness (AMS) development. Compared with traditional HRV measures, non-linear HRV appears to offer incremental and prognostic data, yet its utility and relationship to AMS have been barely examined at HA. This...
Article
Full-text available
Introduction: Aldosterone decreases at high altitude (HA) but the effect of hypoxia on angiotensin-converting enzyme (ACE), a key step in the renin-angiotensin-aldosterone system, is unclear. Methods: We investigated the effects of exercise and acute normobaric hypoxia (NH, ~11.0% FiO2) on nine participants and six controls undertaking the same...
Article
Full-text available
Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military servi...
Data
Participant AMS occurrence at all altitudes. (DOCX)
Data
SpO2 at different altitudes. (DOCX)
Data
Centre of pressure velocity in the medial-lateral direction at different altitudes. (DOCX)
Data
SRT Scores at different altitudes. (DOCX)
Data
Number of subjects with abnormal and normal results for the Sharpened Romberg Test (SRT) and with or without acute mountain sickness (AMS)†. (DOCX)
Data
Relative error of knee joint position sense at different altitudes. (DOCX)
Data
Absolute error of knee joint position sense at different altitudes. (DOCX)
Data
Variable error of knee joint position sense at different altitudes. (DOCX)
Article
Full-text available
Purpose: Heat adaptation (HA) is critical to performance and health in a hot environment. Transition from short-term heat acclimatisation (STHA) to long-term heat acclimatisation (LTHA) is characterised by decreased autonomic disturbance and increased protection from thermal injury. A standard heat tolerance test (HTT) is recommended for validatin...
Article
Full-text available
Purpose: Circulating acylated ghrelin concentrations are associated with altitude-induced anorexia in laboratory environments, but have never been measured at terrestrial altitude. This study examined time course changes in appetite, energy intake, body composition, and ghrelin constituents during a high-altitude trek. Methods: Twelve participan...
Article
Full-text available
Methods: HRV (5-minute single lead ECG) was measured in 63 healthy adults (41 men and 22 women) aged 18-56 years at sea level (SL) and during a HA trek at 3619m, 4600m and 5140m respectively. The main effects of altitude (SL, 3619, 4600 and 5140m) and sex (men vs women) and their potential interaction were assessed using a Factorial Repeated Measu...
Article
Background: Although calcific aortic valve disease (CAVD) is associated with coronary atherosclerosis, it is not known whether early CAVD is associated with coronary microcirculatory dysfunction (CMD). We sought to investigate the relationship between myocardial blood flow reserve (MBFR) - a measure of CMD, and early CAVD in the absence of obstruc...
Article
Full-text available
PurposeTo investigate whether there is a differential response at rest and following exercise to conditions of genuine high altitude (GHA), normobaric hypoxia (NH), hypobaric hypoxia (HH), and normobaric normoxia (NN). Method Markers of sympathoadrenal and adrenocortical function [plasma normetanephrine (PNORMET), metanephrine (PMET), cortisol], my...
Article
Introduction: The autonomic system and sympathetic activation appears integral in the pathogenesis of acute mountain sickness (AMS) at high altitude (HA), yet a link between heart rate variability (HRV) and AMS has not been convincingly shown. In this study we investigated the utility of the smartphone-derived HRV score to predict and diagnose AMS...
Article
Full-text available
Introduction: High altitude environments lead to a significant physiological challenge and disease processes which can be life threatening; operational effectiveness at high altitude can be severely compromised. The UK military research is investigating ways of mitigating the physiological effects of high altitude. Methods: The British Service Dhau...
Article
Full-text available
Central arterial systolic blood pressure (SBP) and arterial stiffness are known to be better predictors of adverse cardiovascular outcomes than brachial SBP. The effect of progressive high altitude (HA) on these parameters has not been examined. Ninety healthy adults were included. Central BP and the augmentation index (AI) were measured at the lev...
Article
Full-text available
This study compared the effects of coingesting glucose and fructose on exogenous and endogenous substrate oxidation during prolonged exercise at altitude and sea level, in men. Seven male British military personnel completed two bouts of cycling at the same relative workload (55% Wmax) for 120 min on acute exposure to altitude (3375 m) and at sea l...
Article
Background: Regulation of core body temperature (Tc) can cause significant cardiovascular strain, leading to impaired performance, incapacitation and occupational hazard during work in the heat. Where continuous Tc and heart rate (HR) monitoring is not possible (e.g. during firefighting or on military operations), safer working could result from in...
Article
Atrial fibrillation (AF) and heart failure (HF) frequently coexist. AF is identified in approximately one third of patients with HF and is linked to increased morbidity and mortality than from either condition alone. AF is relatively more common in HF with preserved ejection fraction (HFpEF) than with reduced ejection fraction (HFrEF). Nevertheless...
Article
Full-text available
Background: There has been considerable debate as to whether different modalities of simulated hypoxia induce similar cardiac responses. Materials and methods: This was a prospective observational study of 14 healthy subjects aged 22-35 years. Echocardiography was performed at rest and at 15 and 120 minutes following two hours exercise under nor...
Data
Excel file with full data for all four experimental study groups. (XLSX)
Data
SPSS file with information on the three hypoxia groups and their respective echo data. (SAV)
Article
Full-text available
Methods: Fourteen young healthy adult Caucasian subjects were studied at sea-level rest and then after >150-minute exposure to acute normobaric hypoxia (NH) equivalent to 4800 m and again at sea-level rest at 2 hours post-NH exposure. Cardiac function, using transthoracic echocardiography, physiological variables, and Lake Louise Scores for acute...
Article
Heart rate variability (HRV) is a useful index of autonomic function and has been linked to the development of high altitude (HA) related illness. However, its assessment at HA has been undermined by the relative expense and limited portability of traditional HRV devices which have mandated at least a minute heart rate recording. In this study, the...
Article
Full-text available
Introduction: Previous studies have reported a variable burden of cardiac arrhythmias, particularly supraventricular (SVE) and ventricular extrasystoles (VES), during hypoxic exposure. The majority of studies have either used simulated altitude and/or subjects at rest with passive ascent (eg cable car). In this study the burden and type of cardiac...
Article
Methods: Forty-eight trekkers were studied during a progressive trek at 3833, 4450, and 5129 m at rest postascent (exercise), and then again at rest 24 hours later. Twenty of the subjects were also tested at rest pre- and postexercise at sea level (SL) at 6 weeks preascent. We examined plasma levels of the interleukin 6 (IL-6), 17a (IL-17a), and e...
Article
Purpose of review: This review seeks to provide an evidence-based update on the issue of atrial fibrillation and chronic heart failure with an emphasis on anticoagulation and the expanding use of the novel oral anticoagulants (NOACs). Recent findings: There is an increasing appreciation of the important reciprocal relationship between atrial fib...
Article
Full-text available
The British Army screens potential recruits for disease, including cardiovascular disease, at the pre-employment medical assessment in the Army Selection Centres. The epidemiology of cardiovascular disease in the Armed Forces coupled with the high physical demand placed on the cardiovascular system, often in remote locations make screening desirabl...
Article
The pericardium is the thin double-walled sac encapsulating the heart which has a number of important physiological roles including fixing the heart in the mediastinum, protecting it from cross-organ infection (eg, lung) and lubricating cardiac contraction. The pericardium is associated with several disease syndromes that occasionally affect the mi...
Article
Full-text available
Syncope is a relatively common occurrence in military populations. It is defined as a transient loss of consciousness due to global cerebral hypoperfusion, characterised by a rapid onset, short duration and a spontaneous and complete recovery. While the symptom of syncope is easily elicited, discovering the mechanism can be more problematic and may...
Article
Myocarditis, simply defined as inflammation of the heart muscle, is a commonly encountered cardiac disease in primary and secondary care, both in the UK and on Operational deployments. In the UK Armed Forces, myocarditis results in deaths as well as the premature termination of military careers on medical grounds. The aetiology is usually the resul...
Article
Full-text available
Cardiomyopathies are a group of heterogeneous myocardial diseases that are frequently inherited and are a recognised cause of premature sudden cardiac death in young individuals. Incomplete expressions of disease and the overlap with the physiological cardiac manifestations of regular intensive exercise create diagnostic challenges in young athlete...
Article
Full-text available
When the general public look from the outside at the armed services, their impression is often one of earnest young men and women who are the pinnacle of physical fitness and health, and put their lives on the line for their country. There is usually sadness and respect for those killed on active operations, having put themselves in harm's way. The...
Article
Background: Calcific aortic valve disease (CAVD) affects 1 in 4 of the popula- tion >65 years. Subsequent progression to severe aortic valve stenosis has a high morbidity and mortality. The pathophysiology of CAVD is poorly understood. Understanding the processes involved are important if successful non-surgical treatments are to be developed. Both...
Article
Full-text available
Mellor AJ, Woods DR, O'Hara J, Howley M, Watchorn J, Boos C. Rating of perceived exertion and acute mountain sickness during a high-altitude trek. Aviat Space Environ Med 2014; 85:1214-6. There is a widely held belief that strenuous exercise should be avoided on arrival at high altitude (HA) and during acclimatization. Data from chamber studies are...
Article
Full-text available
-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
Full-text available
Background: Classically, biomarkers such as the natriuretic peptides (NPs) BNP/NT-proBNP are associated with the diagnosis of heart failure and hs-cTnT with acute coronary syndromes. NPs are also elevated in pulmonary hypertension. High pulmonary artery systolic pressure (PASP) is a key feature of high altitude pulmonary edema (HAPE), which may be...
Article
Purpose A diuresis is a key part of acclimatisation to high altitude (HA). Arginine vasopressin (AVP) is a hormone involved in salt and water balance and may potentially have a role in the development of altitude illness. ProAVP (copeptin) is more stable than AVP and is assayed by a straightforward, automated method. We investigated the relationsh...
Article
Fluid retention is a recognized feature of acute mountain sickness. However, accurate assessment of hydration, including the quantification of body water, has traditionally relied on expensive and non-portable equipment limiting its utility in the field setting. We compared the assessment of total body water (TBW) and their relationship to total bo...
Article
Background: Chest pain in the context of unobstructed coronary arteries (CA) is a common problem associated with increased adverse cardiovascular events. Studies have suggested microvascular dysfunction to be a cause which may reflect underlying atherosclerotic CA disease. We investigated in patients presenting with chest pain and unobstructed CA:...
Article
Full-text available
It has been consistently shown that heavy exercise leads to cardiac troponin (cTn) release and variable changes in post exercise cardiac function. This relationship has not been explored at increasing or significant high altitude (HA). This study assessed the effects of exercise at progressively increasing HA on high-sensitivity (hs)-cTnT levels an...