Girish Viswanathan

Girish Viswanathan
University Hospitals Plymouth NHS Trust · Department of Cardiology

MBBS, MD, MRCP, PhD

About

52
Publications
5,363
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
512
Citations
Additional affiliations
November 2014 - present
National Health Service Plymouth UK
Position
  • Consultant Interventional Cardiologist
April 2012 - October 2014
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
Position
  • Fellow in Interventional Cardiology
June 2008 - present
Newcastle University
Position
  • Research Associate

Publications

Publications (52)
Preprint
Platelet dependent thrombogenicity is higher in type 2 diabetes mellitus (T2DM) but there is no data on association between thrombus and mortality or vascular inflammation. We studied 80 patients who received guideline based therapy (40 T2DM) after NSTE-ACS. Platelet dependent thrombus was assessed using the validated ex vivo Badimon Chamber and al...
Article
Full-text available
Background The prevalence of culture negative infective endocarditis (IEC) is reported as 2–7% though this figure may be as high as 70% in developing countries.1 This higher rate will, at least in part, be due to reduced diagnostic facilities though some data suggests higher rates even when appropriate cultures were taken. The frequency is signific...
Article
Full-text available
Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with...
Article
Assessment of intermediate coronary lesions with diameter stenosis of 40% to 70% severity is being a challenge for cardiologist to identify potentially ischemic stenosis for revascularization and nonculprit stenosis which can be deferred from stenting. An invasive coronary angiography and intravascular ultrasound provide anatomic information of ste...
Conference Paper
Full-text available
AIMS Outcomes of PCI are poor in those with stent malapposition. It is unknown if prolonged duration of balloon inflation during PCI will result in better stent apposition and thereby reduce future adverse events. METHODS AND RESULTS We studied 40 patients with de-novo coronary lesions and stable angina pectoris in our randomised blinded controlled...
Article
The purpose of this study is to investigate the effect of various degrees of percentage stenosis on hemodynamic parameters during the hyperemic flow condition. 3D patient-specific coronary artery models were generated based on the CT scan data using MIMICS-18. Numerical simulation was performed for normal and stenosed coronary artery models of 70,...
Article
The effect of coronary arterial wall curvature on noninvasive assessment of stenosis severity was studied by examining the fractional flow reserve (FFR), pressure drop coefficient (CDP) and lesion flow coefficient (LFC) under different angles of curvature of the arterial wall models. Computational simulation of hyperemic blood flow in curved arteri...
Article
Theoretical impact of left coronary bifurcation angulation (BA) variations and percentage of flow distribution variations (FDV) in coronary artery branches (CAB) on anatomic assessment of bifurcated lesions, is investigated by considering fractional flow reserve (FFR) as a standard diagnostic parameter. According to Medina classification, computati...
Article
This study aims to investigate the influence of artery wall curvature on the anatomical assessment of stenosis severity and to identify a region of misinterpretation in the assessment of per cent area stenosis (AS) for functionally significant stenosis using fractional flow reserve (FFR) as standard. Five artery models of different per cent AS seve...
Article
Percutaneous coronary intervention (PCI) in patients with lesions of large calibre coronary arteries (≥5 mm) and saphenous venous grafts (≥5 mm) can be challenging. There are no separate guidelines available to treat these vessels with PCI. Standard coronary stents of 4 mm diameter are used to treat these lesions conventionally but carry the risk o...
Article
Full-text available
Introduction Despite optimal secondary prevention therapy following non-ST elevation acute coronary syndrome (NSTE-ACS), recurrent thrombotic events are more frequent in patients with type 2 diabetes mellitus (T2DM). Materials and Methods This exploratory study was aimed to evaluate quantitative and qualitative aspects of thrombus. In 28 patients...
Article
Functional assessment of a coronary artery stenosis severity is generally assessed by fractional flow reserve (FFR), which is calculated from pressure measurements across the stenosis. The purpose of this study is to investigate the effect of porous media of the stenosed arterial wall on this diagnostic parameter. To understand the role of porous m...
Article
Full-text available
Context: Higher serum TSH levels, both within the reference range and in those with subclinical hypothyroidism (SCH), have been associated with increased risk of atherosclerosis and cardiovascular (CV) events in a number of cross-sectional and longitudinal studies. Objective: Our objective was to evaluate blood thrombogenicity in patients post-n...
Article
Platelets play a central role in atherothrombotic events. We investigated the effect of a novel platelet-lowering agent, rafigrelide, on thrombus formation and characteristics. In this phase 1, open-label, non-randomised, single-sequence, crossover study, healthy male volunteers received rafigrelide for 14 days (Period 1). Following a ≥6-week washo...
Article
Introduction After an acute coronary syndrome, presence of subclinical hypothyroidism (SCH) has been associated with increased risk of further thrombotic events. We aimed to evaluate platelet dependent thrombus (PDT) formation in patients after non-ST elevation acute coronary syndrome (NSTE-ACS) in relation to their thyroid status. Methods We studi...
Article
Full-text available
Primary Sjögren's syndrome (pSS) shares clinical features and pathogenetic mechanisms with systemic lupus erythematosus (SLE). SLE is associated with an increased thromboembolic risk; however, it is unclear whether pSS patients are susceptible to thromboembolic diseases. In this study, we examined ex vivo blood clot formation (clot strength, rates...
Article
Full-text available
Type 2 diabetes mellitus (T2DM) is associated with higher rates of thrombotic complications in patients with coronary artery disease (CAD) despite optimal medical therapy. Thrombus area was measured in T2DM and non-diabetic patients receiving aspirin and clopidogrel 7-10 days after troponin positive Non ST-elevation acute coronary syndrome (NSTE-AC...
Article
Coronary Artery Disease (CAD) is responsible for most of the deaths in patients with cardiovascular diseases. Diagnostic coronary angiography analysis offers an anatomical knowledge of the severity of the stenosis. The functional or physiological significance is more valuable than the anatomical significance of CAD. Clinicians assess the functional...
Article
Full-text available
In patients with type 2 diabetes mellitus (T2DM), non-ST elevation–acute coronary syndrome (NSTE-ACS) occurs frequently secondary to non-obstructive coronary lesions than those without T2DM. Pathophysiological events leading to acute myocardial infarction in these individuals remain largely unknown, and subsequently demonstrate a poorer prognosis t...
Article
Full-text available
Patients with diabetes mellitus presenting with acute coronary syndrome have a higher risk of cardiovascular complications and recurrent ischemic events when compared to nondiabetic counterparts. Different mechanisms including endothelial dysfunction, platelet hyperactivity, and abnormalities in coagulation and fibrinolysis have been implicated for...
Article
Thrombocytopenia, both at baseline and acquired throughout admission is associated with poor clinical outcomes in patients with coronary artery disease. It is not known whether severe thrombocytopenia in patients receiving glycoprotein IIb/IIIa inhibitors (GPI) carries the same risk as thrombocytopenia from other aetiologies. We identified 50 conse...
Article
Full-text available
Performing coronary angiography in very older patients can prove a challenge due to vessels calcification and torturousity. Manipulation of coronary catheters to engage the artery ostium may result in over twisting and can result in complications ranging from a minor 'kink' to a complex 'knot'. The authors describe a novel method to retrieve the co...
Article
Full-text available
To assess two different dosing strategies of unfractionated heparin (UFH) during elective percutaneous coronary intervention (PCI). The optimal dose of heparin during elective PCI in patients with stable angina is unknown. Existing guidelines are based on limited data. We interrogated data from the PCI database. Patients with stable angina undergoi...
Article
Full-text available
Percutaneous coronary revascularisation [PCR] improves angina and health related quality of life [HRQOL] compared to standard medical therapy. It is unknown whether PCR has the same benefits for patients with a history of CABG. Over a period of 5years, we assessed HRQOL of patients undergoing PCR using Part 1 of the Nottingham Health Profile [NHP]...
Article
Full-text available
Cardiac involvement in systemic amyloidosis carries poor prognosis with a median survival of 5 months.(1) The authors report an unusual presentation of cardiac amyloidosis in the form of predominant mitral regurgitation. The patient responded very well to medical therapy with subsequent improvement of mitral valve dysfunction. The authors would lik...
Article
4452 Introduction Glycoprotein IIb/IIIa inhibitors (GPI) improve outcomes in patients following percutaneous coronary intervention (PCI) and troponin positive acute coronary syndrome. However, GPI's can result in severe but transient thrombocytopenia (platelet count <50×109 cells/l). Guidelines on management of this complication are lacking. Minim...
Article
Adjunctive use of glycoprotein IIb/IIIa inhibitors (GPI) is associated with favorable outcomes following percutaneous coronary intervention (PCI). Guidelines for use of GPI have been published by various national societies including National Institute of Clinical Excellence (NICE), United Kingdom. The latter has not been updated since publication....
Article
Full-text available
Although myocardial infarction (MI) mainly occurs in patients older than 45, young men or women can suffer MI. Fortunately, its incidence is not common in patients younger than 45 years. However, the disease carries a significant morbidity, psychological effects, and financial constraints for the person and the family when it occurs at a young age....

Network

Cited By

Projects

Projects (2)
Project
To analyse the various physical and geometrical parameters under the influence of different percentage of stenosis and to address the issues related to misdiagnosis due to the present available methods.