Early Impact of Severe Acute Respiratory Syndrome Coronavirus 2 on Pediatric Clinical Research: A Pan-European and Canadian Snapshot in Time Olivier L. Mantha, Florence Flamein, Mark A. Turner, Ricardo M. Fernandes, Régis Hankard, Ruth Ladenstein, Andrea Mikolasek, Daphné Christiaens, Eva Degraeuwe, Johan Vande Walle, Lieve Nuytinck, Elise Mok, Jonathon L. Maguire, Thierry Lacaze-Masmonteil, Pavla Pokorna, Pernille Skovby, Heli Rajasaar, Jaana Kallio, Pirkko Lepola, Christele Gras-Le Guen, Frédéric Gottrand, Florentia Kaguelidou, Hugues Chevassus, Isabelle Pin, Jérémie Rouger-Gaudichon, Maya Patel, Eva Neumann, Matthias Schwab, Elias Losifidis, Emmanuel Roilides, Máiréad Murray, Federica La Neve, Francesca Rocchi, Sigrun Margrethe Hjelle, Thomas Halvorsen, Marek Migdał, Aleksander Wiśniewski, Inês Zimbarra Cabrita, Rita Carilho Torrão, Tiago Martins, Cristina Serén Trasorras, Federico Martinón-Torres, Anders Rane, Estelle Naumburg, Klara M. Posfay-Barbe, Manuel Diezi, Paolo Paioni, Fenna Mahler, Saskia N. de Wildt, Tesa Van der Geest, Karen Wilding Journal of Pediatrics, 2021
Coronary artery disease imaging Dialogues in Cardiovascular Medicine, 2016
Echocardiographic and Hemodynamic Predictors of Survival in Precapillary Pulmonary Hypertension Julia Grapsa, Maria Carmo Pereira Nunes, Timothy C. Tan, Ines Zimbarra Cabrita, Taryn Coulter, Benjamin C.F. Smith, David Dawson, J. Simon R. Gibbs, Petros Nihoyannopoulos Circulation Cardiovascular Imaging, 2015 Background— In this study, we looked at the prognostic value of echocardiographic and hemodynamic measures in a large cohort of patients with precapillary pulmonary hypertension before and after initiation of treatment. Methods and Results— Data were collected prospectively in a cohort of consecutive patients with precapillary pulmonary hypertension referred between 2002 and 2011. A range of clinical and echocardiographic variables were collected and stored on a database to assess predictors of survival. Invasive hemodynamic data including pulmonary artery pressure, pulmonary vascular resistance, capillary wedge pressure, and cardiac index were also obtained at baseline in all patients. Outcome was defined as mortality because of cardiovascular-related death. The study cohort comprised 777 patients (514 women) with precapillary pulmonary hypertension. A total of 195 (25%) died. In multivariable analysis, moderate or severe tricuspid regurgitation (hazard ratio [HR], 26.537; 95% confidence interval, 11.536–61.044; P <0.001), right ventricular myocardial performance index (HR, 3.421; 95% confidence interval, 1.777–6.584; P <0.001), and the presence of pericardial effusion (HR, 1.38; 95% confidence interval, 1.023–1.862; P =0.035) were independent predictors of mortality. High pulmonary vascular resistance and right atrial pressure by invasive hemodynamic measurements were independent predictors of mortality (HR, 1.084; 95% confidence interval, 1.041–1.130, and 1.079, respectively; 95% confidence interval, 1.049–1.111; P <0.001 for both), whereas patients with a higher cardiac index had better survival overall (HR, 0.384; 95% confidence interval, 0.307–0.481; P <0.001). Conclusions— Right ventricular dysfunction, moderate–severe tricuspid regurgitation, low cardiac index, and raised right atrial pressure were associated with poor survival for both pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertensive disease patients. The severity of tricuspid regurgitation, myocardial performance index, presence of pericardial effusion, pulmonary vascular resistance, cardiac index, and right atrial pressure may be used to stratify risk of death.
Strain balance of papillary muscles as a prerequisite for successful mitral valve repair in patients with mitral valve prolapse due to fibroelastic deficiency J. Grapsa, I. Zimbarra Cabrita, G. Jakaj, E. Ntalarizou, A. Serapheim, O. M. Demir, B. Smith, D. Dawson, A. Momin, P. P. Punjabi, C. E. Anagnostopoulos, P. Nihoyannopoulos European Heart Journal Cardiovascular Imaging, 2015 AIMS The aim of this study was to assess the papillary muscle strain as a contributor to recurrent mitral regurgitation (MR) after mitral valve repair for fibroelastic deficiency. METHODS AND RESULTS Sixty-four patients with isolated posterior mitral valve prolapse and severe MR referred for surgery were prospectively recruited between 2008 and 2012. Two- and three-dimensional echocardiography and speckle tracking were performed in all patients. The longitudinal strain of the anterolateral (AL) and posteromedial (PM) papillary muscles was individually calculated as well as the global longitudinal strain of both papillary muscles was measured before and after mitral repair and normalized to left ventricle end-diastolic volume. Eight patients (12.5%) had at least moderate MR 6 months after mitral repair. The longitudinal strain of the AL (preop -4.94 ± 2.2 vs. postop -3.28 ± 1.3, P < 0.001) and the PM papillary muscles (preop -12.64 ± 5.3 vs. postop -4.12 ± 6.77, P < 0.001) as well as the global strain of both papillary muscles (preop -7.59 ± 3.48 vs. postop -1.07 ± 6, P < 0.001) were all reduced after surgical repair. The longitudinal strain of the PM papillary muscle was the strongest predictor of recurrent MR (when less than or equal to -14.78). The global preoperative papillary muscle strain was also a determinant of recurrent MR when the global strain was greater than -9.05% (area under the curve: 0.895, sensitivity: 100%, and specificity: 76.8%). CONCLUSIONS Patients with isolated posterior mitral leaflet prolapse are less likely having any residual MR post repair when the global papillary muscle strain of both papillary muscles is close or equal to zero. Strain of the papillary muscles may be an important determinant in predicting residual MR in patients who undergo mitral valve repair.
Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection fraction Susana Gonçalves, Nuno Cortez-Dias, Ana Nunes, Adriana Belo, Inês Zimbarra Cabrita, Catarina Sousa, Fausto J. Pinto Revista Portuguesa De Cardiologia, 2014 O espectro da cardiopatia hipertensiva é diverso podendo ir até à disfunção ventricular esquerda. O desenvolvimento de metodologias ecocardiográficas que permitam melhorar o estadiamento da cardiopatia hipertensiva e identificar precocemente hipertensos em risco de evolução desfavorável poderá ser clinicamente relevante. Identificar o compromisso subclínico da função ventricular esquerda em indivíduos hipertensos com fração de ejeção preservada (> 55%), utilizando parâmetros globais da deformação miocárdica (speckle tracking). Foram estudados dois grupos de indivíduos: normotensos (N = 20; 59 + 7 anos; 55% homens) e hipertensos (N = 229; 62 + 12 anos; 57% homens), tendo sido avaliados vários parâmetros clínicos e ecocardiográficos de função ventricular esquerda (convencionais e parâmetros globais da deformação miocárdica longitudinal e circunferencial). Foram determinados os cut-offs da normalidade a partir do grupo de normotensos e aplicados ao grupo de hipertensos, para se detetar disfunção ventricular esquerda subclínica. Foram utilizados os testes t de Student, Mann-Whitney e do Qui-Quadrado. O grupo de hipertensos apresentou na sua maioria hipertensão arterial do tipo I (53,7%), pressão arterial controlada (64,9%) e alteração estrutural do ventrículo esquerdo em 54,8% dos indivíduos. Não se detetaram diferenças significativas entre os grupos nos parâmetros globais de deformação longitudinal ou circunferencial. Após aplicação dos cut-offs da normalidade nos hipertensos, foram identificados 35 indivíduos (15,3%) com disfunção ventricular esquerda subclínica. A avaliação da deformação miocárdica permitiu identificar o compromisso sistólico subclínico da função ventricular esquerda num grupo de hipertensos com fração de ejeção preservada. A relevância clínica destes achados deverá ser confirmada por estudos de follow–up prolongado. Introduction The spectrum of hypertensive heart disease is wide, and can include left ventricular dysfunction. The development of echocardiographic parameters to improve patient stratification and to identify early adverse changes could be clinically useful. Aim To identify subclinical left ventricular dysfunction in hypertensive subjects with preserved ejection fraction (>55%), identified by global parameters of myocardial strain on speckle tracking imaging. Methods This was a comparative observational study of two groups of individuals: normotensive (n=20, age 59±7 years, 55% male) and hypertensive (n=229, age 62±12 years, 57% male). Left ventricular function was assessed by various conventional clinical and echocardiographic parameters and global longitudinal and circumferential myocardial strain. Cut-off values to detect subclinical left ventricular dysfunction were established and applied in the hypertensive group. The Student's t test, Mann-Whitney test and chi-square test were used for the comparative statistical analysis. Results Most hypertensive subjects (53.7%) had grade I hypertension; blood pressure was controlled in 64.9%, and 54.8% showed left ventricular structural changes. Comparison between the normotensive and hypertensive groups showed no significant differences in parameters of global longitudinal or circumferential systolic strain. Application of the cut-offs to the hypertensive group identified 35 individuals (15.3%) as having subclinical left ventricular systolic dysfunction as assessed by global longitudinal myocardial strain parameters. Conclusions In this group of hypertensive patients, global myocardial strain parameters identified a group of individuals with subclinical left ventricular systolic dysfunction despite preserved ejection fraction. The clinical relevance of these findings needs to be assessed in long-term follow-up studies.
Bibliography of one hundred key papers Dialogues in Cardiovascular Medicine, 2013
Prevention through imaging: Current knowledge and perspectives Dialogues in Cardiovascular Medicine, 2013
The association between tricuspid regurgitation velocity and 5-year survival in a North West London population of patients with sickle cell disease in the United Kingdom Inês Zimbarra Cabrita, Abubakar Mohammed, Mark Layton, Sara Ghorashian, Annette Gilmore, Gavin Cho, Jo Howard, Kofi A. Anie, Lynda Desforges, Paul Bassett, Julia Grapsa, Luke Howard, Gaia Mahalingam, David Dawson, Fausto J. Pinto, Petros Nihoyannopoulos, Sally C. Davies, J. Simon R. Gibbs British Journal of Haematology, 2013 SummaryRaised tricuspid regurgitant velocity (TRV) occurs in approximately 30% of adults with sickle cell disease (SCD), and has been shown to be an independent risk factor for death. TRV was assessed in 164 SCD patients who were subsequently followed up for survival. Raised pulmonary pressures were defined as a TRV jet ≥2·5 m/s on echocardiography. Elevated TRV was present in 29·1% of patients and it was associated with increased age and left atrial diameter. There were 15 deaths (9·1%) over a median of 68·1 months follow up; seven patients had increased TRV, and eight patients had a TRV<2·5 m/s. Higher TRV values were associated with a greater than 4‐fold increased risk of death (Hazard Ratio: 4·48, 99% confidence interval 1·01‐19·8), although we found a lower overall mortality rate than has been reported in previous studies. TRV was not an independent risk factor for death. We have confirmed the association between raised TRV and mortality in a UK SCD population whose disease severity appears to be less than that reported in previous studies. Further prospective studies are needed to more clearly characterize which patient factors modify survival in SCD patients with raised TRV.
Mitral valve repair results in better right ventricular remodelling than valve replacement for degenerative mitral regurgitation: A three- dimensional echocardiographic study Hellenic Journal of Cardiology, 2012
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Early impact of severe acute respiratory syndrome Coronavirus 2 on pediatric clinical research: A Pan-European and Canadian snapshot in time OL Mantha, F Flamein, MA Turner, RM Fernandes, R Hankard, ... The Journal of pediatrics 239, 67-73. e3 , 2021 2021 Citations: 2
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Echocardiographic and hemodynamic predictors of survival in precapillary pulmonary hypertension: seven-year follow-up J Grapsa, MC Pereira Nunes, TC Tan, IZ Cabrita, T Coulter, BCF Smith, ... Circulation: Cardiovascular Imaging 8 (6), e002107 , 2015 2015 Citations: 94
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Strain balance of papillary muscles as a prerequisite for successful mitral valve repair in patients with mitral valve prolapse due to fibroelastic deficiency J Grapsa, I Zimbarra Cabrita, G Jakaj, E Ntalarizou, A Serapheim, ... European Heart Journal-Cardiovascular Imaging 16 (1), 53-61 , 2015 2015 Citations: 5
The heart in Sickle Cell Disease: role of non invasive cardiac imaging by advanced echocardiography and cardiac magnetic resonance assessment of myocardial function IZ Cabrita Imperial College London , 2014 2014
Cardiac imaging in pulmonary embolism: Assessment of right ventricular dysfunction by tissue Doppler IZ Cabrita Revista Portuguesa de Cardiologia (English Edition) 33 (10), 597-598 , 2014 2014
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Tricuspid regurgitation is the most important prognostic marker of survival in pulmonary arterial hypertension: P966 JJ Grapsa, IZ Cabrita, D Dawson, P Nihoyannopoulos European Journal of Heart Failure 16, 196 , 2014 2014
Imagiologia cardiaca no tromboembolismo pulmonar: avaliacao da disfuncao ventricular direita por Doppler tecidular I Zimbarra Cabrita REVISTA PORTUGUESA DE CARDIOLOGIA 33 (10), 597-598 , 2014 2014
Left ventricular systolic dysfunction detected by speckle tracking in hypertensive patients with preserved ejection fraction S Gonçalves, N Cortez-Dias, A Nunes, A Belo, IZ Cabrita, C Sousa, ... Revista Portuguesa de Cardiologia (English Edition) 33 (1), 27-37 , 2014 2014 Citations: 37
Disfunção sistólica ventricular esquerda detetada por speckle tracking em hipertensos com fração de ejeção preservada S Gonçalves, N Cortez-Dias, A Nunes, A Belo, IZ Cabrita, C Sousa, ... Revista Portuguesa de Cardiologia 33 (1), 27-37 , 2014 2014 Citations: 5
Poster session Thursday 12 December-PM: 12/12/2013, 1400–1800Location Poster area EA Khalifa European Heart Journal Cardiovascular Imaging 14 (suppl_2), ii99-ii126 , 2013 2013
Advanced Echocardiographic Comparison of Pulmonary Arterial Hypertension And Pulmonary Hypertension Secondary to Left Heart Disease: 3-Dimensional Speckle Tracking and 3D … J Grapsa, O Demir, TC Tan, IZ Cabrita, S Hamid, D Dawson, R Sharma, ... Circulation 128 (suppl_22), A16727-A16727 , 2013 2013
Precapillary Pulmonary Hypertension and Echocardiographic Determinants of Survival J Grapsa, MC Nunes, TC Tan, IZ Cabrita, B Smith, D Dawson, ... Circulation 128 (suppl_22), A12272-A12272 , 2013 2013
The association between tricuspid regurgitation velocity and 5‐year survival in a N orth W est L ondon population of patients with sickle cell disease in the U nited K ingdom I Zimbarra Cabrita, A Mohammed, M Layton, S Ghorashian, A Gilmore, ... British journal of haematology 162 (3), 400-408 , 2013 2013 Citations: 45
Right ventricular longitudinal strain in idiopathic pulmonary arterial hypertension: association with 3D echocardiographic and CMR volumetry and clinical deterioration: a … J Grapsa, IZ Cabrita, G Karamasis, A Kalogeropoulos, D Dawson, ... European Heart Journal 34 (suppl_1), P1167 , 2013 2013
MOST CITED SCHOLAR PUBLICATIONS
The association of clinical outcome with right atrial and ventricular remodelling in patients with pulmonary arterial hypertension: study with real-time three-dimensional … J Grapsa, JSR Gibbs, IZ Cabrita, GF Watson, H Pavlopoulos, D Dawson, ... European Heart Journal–Cardiovascular Imaging 13 (8), 666-672 , 2012 2012 Citations: 131
Echocardiographic and hemodynamic predictors of survival in precapillary pulmonary hypertension: seven-year follow-up J Grapsa, MC Pereira Nunes, TC Tan, IZ Cabrita, T Coulter, BCF Smith, ... Circulation: Cardiovascular Imaging 8 (6), e002107 , 2015 2015 Citations: 94
Assessment of cardiac valve dysfunction in patients receiving cabergoline treatment for hyperprolactinaemia T Tan, IZ Cabrita, D Hensman, J Grogono, WS Dhillo, KC Baynes, ... Clinical endocrinology 73 (3), 369-374 , 2010 2010 Citations: 75
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Disfunção sistólica ventricular esquerda detetada por speckle tracking em hipertensos com fração de ejeção preservada S Gonçalves, N Cortez-Dias, A Nunes, A Belo, IZ Cabrita, C Sousa, ... Revista Portuguesa de Cardiologia 33 (1), 27-37 , 2014 2014 Citations: 5
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Anomalous insertion of the papillary muscle in a patient with sickle cell disease: a normal variant with no left ventricular outflow obstruction IZ Cabrita, J Grapsa, D Dawson, FJ Pinto, JSR Gibbs, P Nihoyannopoulos Revista Portuguesa de Cardiologia 31 (10), 683-684 , 2012 2012 Citations: 2
Study Coordination and its key role in Clinical Research IZ Cabrita, FP Figueiras, M Nogueira, S Silva, C Gomes, FJ Pinto Lusiadas Scientific Journal 3 (2) , 2022 2022 Citations: 1
Imagiologia cardíaca no tromboembolismo pulmonar: avaliação da disfunção ventricular direita por Doppler tecidular IZ Cabrita Revista Portuguesa de Cardiologia 33 (10), 597-598 , 2014 2014 Citations: 1
Imaging predictors of clinical deterioration in idiopathic pulmonary arterial hypertension: prospective two-year study with 2D and 3D echocardiography and CMR J Grapsa, IZ Cabrita, G Durighel, B Smith, D Dawson, D O'Regan, ... Journal of the American College of Cardiology 61 (10S), E1229-E1229 , 2013 2013 Citations: 1
The SAFEST study: The crucial role of primary health care in the diagnosis and management of atrial fibrillation P Gonçalves Teixeira, D Caldeira, R Baptista, I Zimbarra Cabrita, ... Revista Portuguesa de Cardiologia 43 (2), 91-93 , 2023 2023
Coronary artery disease imaging FJ Pinto, IZ Cabrita, NC Dias Dialogues in Cardiovascular Medicine 21 (4), 249-263 , 2016 2016
