Simone Rivolo

King's College London | KCL · Department of Biomedical Engineering

The branching pattern of the coronary vasculature is a key determinant of its function and plays a crucial role in shaping the pressure and velocity waveforms measured for clinical diagnosis. However, although multiple scaling laws have been proposed to characterize the branching pattern, the implications they have on wave propagation remains unass...

Objective: coronary wave intensity analysis (cWIA) has increasingly been applied in the clinical research setting to distinguish between the proximal and distal mechanical influences on coronary blood flow. Recently, a cWIA-derived clinical index demonstrated prognostic value in predicting functional recovery post-myocardial infarction. Nevertheles...

Background A first-in-human study of simultaneous invasive real-time left ventricular (LV) and coronary haemodynamics in the cardiac catheter lab enabling accurate delineation of the complex cardiac-coronary interaction and influence of antianginal therapy in coronary artery disease (CAD). Method 15 patients completed the protocol (Figure;A&B). Cor...

Background Complex cardiac-coronary interaction has been debated. We developed novel technology (A) and software (B) to analyse real-time simultaneous LV and coronary haemodynamics with delineation of the interdependence during rest, exercise, ischaemia and ISDN in coronary artery disease (CAD). Methods 25 patients. Coronary measurements (pressure-...

Purpose: Complicated skin and soft tissue infections (cSSTI) are associated with high healthcare resource use and costs. The emergency nature of cSSTI hospitalizations requires starting immediate empiric intravenous (IV) antibiotic treatment, making the appropriate choice of initial antibiotic therapy crucial. Patients and methods: The use of ce...

Background/Objective AUGUSTUS trial demonstrated that, for patients with atrial fibrillation (AF) having acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI), an antithrombotic regimen with apixaban and P2Y12 resulted in less bleeding, fewer hospitalizations, and similar ischemic events than regimens including a vita...

Understanding the cardiac-coronary interaction is fundamental to developing treatment strategies for ischemic heart disease. We sought to examine the impact of afterload reduction following isosorbide dinitrate (ISDN) administration on LV properties and coronary hemodynamics to further our understanding of the cardiac-coronary interaction. Novel me...

Coronary artery disease (CAD) can adversely affect left ventricular (LV) performance during exercise by impairment of contractile function in the presence of increasing afterload. By performing invasive measures of LV pressure-volume and coronary pressure and flow during exercise, we sought to accurately measure this with comparison to the control...

Background Adults admitted to hospital with community-acquired pneumonia (CAP) impose significant burden upon limited hospital resources. To achieve early response and possibly early discharge, thus reducing hospital expenditure, the choice of initial antibiotic therapy is pivotal. Methods A cost-consequences model was developed to evaluate ceftaro...

Background Recognizing the important policy issue of the value of cancer therapies, the European Society of Medical Oncology (ESMO) has developed a validated and reproducible tool to standardize the grading of the relative clinical benefit of new therapies: the magnitude of clinical benefit scale (ESMO-MCBS). The final reimbursement decision about...

The effect of intra-aortic balloon counterpulsation (IABC) varies, and it is unknown whether this is due to a heterogeneous coronary physiological response. This study aimed to characterise the coronary and left ventricular (LV) effects of IABC and define responders in terms of their invasive physiology. Twenty-seven patients (LVEF 31 ± 9%) underwe...

Background Exertional angina and the response to nitrates have been recognised for over two centuries. This ischaemic cascade and the mechanistic relief by nitrates has not been extensively studied. The aim was to identify these precise haemodynamic changes. Methods In 31 patients with exertional angina and coronary artery disease, real-time simul...

Abnormal cardiac motion can indicate different forms of disease, which can manifest at different spatial scales in the myocardium. Many studies have sought to characterise particular motion abnormalities associated with specific diseases, and to utilise motion information to improve diagnoses. However, the importance of spatial scale in the analysi...

This paper aims to summarize and map contemporary views on some contentious aspects of arterial hemodynamics that have remained unresolved despite years of research. These were discussed during a workshop entitled Arterial hemodynamics: past, present and future held in London on June 14 and 15, 2016. To do this we formulated a list of potential con...

The British Heart Foundation (BHF) annual image competition, Reflections of Research, provides a glimpse into the cutting-edge research that the BHF funds

Coronary wave intensity analysis (cWIA) is a diagnostic technique based on invasive measurement of coronary pressure and velocity waveforms. The theory of WIA allows the forward- and backward-propagating coronary waves to be separated and attributed to their origin and timing, thus serving as a sensitive and specific cardiac functional indicator. I...

Biomedical research, combining multi-modal image and geometry data, presents unique challenges for data visualization, processing, and quantitative analysis. Medical imaging provides rich information, from anatomical to deformation, but extracting this to a coherent picture across image modalities with preserved quality is not trivial. Addressing t...

Ischemic heart disease that comprises both coronary artery disease and microvascular disease is the single greatest cause of death globally. In this context, enhancing our understanding of the interaction of coronary structure and function is not only fundamental for advancing basic physiology but also crucial for identifying new targets for treati...

The only criteria currently used to inform surgical decision for abdominal aortic aneurysms are maximum diameter (> 5.5 cm)) and rate of growth, even though several studies have identified the need for more specific indicators of risk. Patient-specific biomechanical variables likely to affect rupture risk would be a valuable addition to the science...

To elucidate the mechanisms governing coronary blood flow in health and disease requires an understanding of the structure-function relationship of the coronary system, which exhibits distinct characteristics over multiple scales. Given the complexities arising from the multiscale and distributed nature of the coronary system and myocardial mechani...

Background Coronary Wave Intensity Analysis (cWIA) is a technique capable of separating the effects of proximal arterial haemodynamics from cardiac mechanics. Studies have identified WIA-derived indices that are closely correlated with several disease processes and predictive of functional recovery following myocardial infarction. The cWIA clinical...

Coronary Wave Intensity Analysis (cWIA) is a technique capable of separating the effects of proximal arterial haemodynamics from cardiac mechanics. The cWIA ability to establish a mechanistic link between coronary haemodynamics measurements and the underlying pathophysiology has been widely demonstrated. Moreover, the prognostic value of a cWIA-der...

To study the efficacy of transdermal clonidine in the treatment of severe refractory hyperemesis gravidarum (HG), the most severe illness of pregnancy. The study had a randomised, double -blind, placebo-controlled, cross-over design (RCT). Single tertiary referral hospital after admission of patients. Twelve women of gestational age 6-12 weeks and...

It is often important, for diagnostic purposes, to evaluate quantitatively the motion undergone by a biological structure, starting from a viable tomographic imaging technique, such as Computed Tomography (CT) or Magnetic Resonance (MR). This is often associated with the need of the clinical personnel to perform an evaluation of a risk factor assoc...