Publications by authors named "Alun D Hughes"

Consumer-grade wearables provide an opportunity to understand public health trends, develop risk stratification tools and monitor interventions. This review introduces the most common wearable sensors and describes the health parameters that can be measured using them. We highlight research into the validity and accuracy of these measurements and practical considerations for the use of wearable data.

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Background And Aims: Increasing evidence suggests that COVID-19 survivors experience long-term cardiovascular complications possibly through development of vascular damage. The study aimed to investigate whether accelerated vascular ageing occurs after COVID-19 infection, and if so, identify its determinants.

Methods: This prospective, multicentric, cohort study, included 34 centres in 16 countries worldwide, in 4 groups of participants-COVID-19-negative controls (ⅰ) and three groups of individuals with recent (6 ± 3 months) exposure to SARS-CoV-2: not hospitalized (ⅱ), hospitalized in general wards (ⅲ), and hospitalized in intensive care units (ⅳ).

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Background: Sleep and physical activity (PA) are important lifestyle-related behaviors that impact cardiometabolic health. This study investigated the joint associations of daily step count and sleep patterns (regularity and duration) with cardiometabolic biomarkers in adults.

Methods: We conducted a cross-sectional study using pooled data from the Prospective PA, Sitting, and Sleep Consortium, comprising 6 cohorts across Europe and Australia with thigh-worn accelerometry data collected between 2011 and 2021.

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Background: Systolic blood pressure (SBP) amplification is a physiological phenomenon related to the level of pressure difference between the aorta and brachial artery and is associated with cuff blood pressure (BP) measurement inaccuracy. However, knowledge on the invasively measured level of aortic-to-brachial SBP amplification is limited. This study aimed to explore this, as well as anticipated effects on hypertension classification.

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Background: Cardiovascular disease has been associated with an increased dementia risk, but the underlying mechanisms for this heart-brain link are unclear. This study sought to examine associations between aortic and carotid artery structure with cerebrovascular reactivity (CVR), white matter hyperintensities (WMHs), and cognition in later-life.

Methods: One hundred sixty three participants (25.

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Introduction: Aortic pulse wave velocity (PWV) is a prognostic biomarker for cardiovascular disease, which can be measured by dividing the aortic path length by the pulse transit time. However, current MRI techniques require special sequences and time-consuming manual analysis. We aimed to fully automate the process using deep learning to measure PWV from standard sequences, facilitating PWV measurement in routine clinical and research scans.

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Background: Lamin (LMNA) heart disease is a lethal form of dilated cardiomyopathy (DCM).

Objectives: The authors explored its cardiovascular magnetic resonance (CMR) phenotype to discover prognostically useful and subclinical biomarkers.

Methods: This prospective multicenter study recruited 4 groups: LMNA carriers with left ventricular ejection fraction ≥55% (Lamin+EF), LMNA carriers with left ventricular ejection fraction <50% (Lamin-EF), individuals with DCM with wild-type LMNA (DCMwt), and healthy volunteers.

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Background: Women who experience adverse pregnancy outcomes (APOs; gestational hypertension, preeclampsia (PE), gestational diabetes (GD), preterm birth (PTB), small or large for gestational age, miscarriage, multiple miscarriages, stillbirth, and offspring with major congenital anomalies) have increased risk of developing cardiovascular disease (CVD). We aimed to compare cardiometabolic health trajectories across the life course between women with and without APOs.

Methods: We studied 187,186 women with a registered pregnancy in the UK Clinical Practice Research Datalink (CPRD) GOLD linked to Hospital Episode Statistics.

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Background: Left ventricular diastolic function as assessed by tissue Doppler echocardiography predicts cardiovascular event rates at 4 years of follow-up in patients with hypertension. Our aim was to evaluate whether this extends to predicting cardiovascular mortality after 20 years of follow-up.

Methods: Conventional (E) and tissue Doppler (e') echocardiography was performed on hypertensive participants in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) with long-term follow-up ascertained via linkage to the Office of National Statistics.

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Article Synopsis
  • Aircraft noise significantly impacts heart structure and function, particularly in communities near major UK airports.
  • The study included 3,635 participants from the UK Biobank, focusing on those exposed to higher levels of aircraft noise (≥45 dB and ≥50 dB).
  • Findings revealed higher noise exposure correlates with greater left ventricular mass and thickness, leading to increased risks of major adverse cardiac events (MACE), estimated at four times higher for individuals with typical heart changes linked to elevated noise levels.
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Background: Hypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death. Current diagnosis emphasizes the detection of left ventricular hypertrophy (LVH) using a fixed threshold of ≥15-mm maximum wall thickness (MWT). This study proposes a method that considers individual demographics to adjust LVH thresholds as an alternative to a 1-size-fits-all approach.

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Aims: This large population-based study aimed to investigate whether arterial stiffness, assessed oscillometrically, was associated with incident diabetes/prediabetes.

Methods: The study sample comprised 4240 participants from the Vitamin D Assessment (ViDA) Study (mean±SD age = 66 ± 8). Arterial stiffness was assessed from 5 April 2011-6 November 2012 by way of aortic PWV (aPWV) and estimated carotid-femoral PWV (ecfPWV).

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Near-infrared spectroscopy (NIRS) is an optical technique that can be used to non-invasively interrogate haemodynamic changes within skeletal muscle. It can be combined with a short (3-5 min) arterial cuff-occlusion to quantify post-occlusive reactive hyperaemia (PORH). This technique has utility in tracking changes in vascular health in relation to exercise, disease progression or treatment efficacy.

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While the associations of mid-life cardiovascular risk factors with late-life white matter lesions (WMH) and cognitive decline have been established, the role of cerebral haemodynamics is unclear. We investigated the relation of late-life (69-71 years) arterial spin labelling (ASL) MRI-derived cerebral blood flow (CBF) with life-course cardiovascular risk factors (36-71 years) and late-life white matter hyperintensity (WMH) load in 282 cognitively healthy participants (52.8% female).

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Background: Blood pressure (BP)-lowering effects of structured exercise are well-established. Effects of 24-hour movement behaviors captured in free-living settings have received less attention. This cross-sectional study investigated associations between a 24-hour behavior composition comprising 6 parts (sleeping, sedentary behavior, standing, slow walking, fast walking, and combined exercise-like activity [eg, running and cycling]) and systolic BP (SBP) and diastolic BP (DBP).

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Article Synopsis
  • The study addresses the challenge of accurately identifying and measuring aortic aneurysms, which is crucial but often limited by the time-consuming nature of high-resolution 3D CMR sequences used for assessment.
  • Researchers developed a 3D U-Net that can create detailed 3D segmentations of the aorta from standard 2D images with lower resolution, enhancing the efficiency of aortic assessments in clinical and population studies.
  • The results showed that the new U-Net model produced 93% clinically suitable segmentations and achieved a high DICE score of 0.9, matching the accuracy of traditional high-resolution methods, indicating its potential for reliable clinical use.
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  • Exercise capacity is crucial for predicting cardiovascular and overall mortality, and submaximal tests like the 6-minute walk test (6MWT) can enhance patient care with remote monitoring, often using consumer-grade smartwatches.
  • The study involved 16 healthy adults performing various exercise tests while using Garmin and Fitbit smartwatches to measure distance, step counts, and heart rate, comparing their performance against reference measures.
  • Results showed that both smartwatches performed well in measuring heart rate during rest and recovery, but Garmin was more accurate for step counts, and the continuous lap protocol for 6MWT offered better distance agreement than the standard protocol.
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Objective: Hypertension is a recognized risk factor for the development of cognitive impairment and dementia in older adults. Aortic stiffness and altered haemodynamics could promote the transmission of detrimental high pressure pulsatility into the cerebral circulation, potentially damaging brain microvasculature and leading to cognitive impairment. We determined whether reservoir-excess pressure parameters were associated with cognitive function in people with hypertension (HT) and normotension (NT).

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Background: Near-infrared spectroscopy (NIRS) provides a non-invasive, cost-effective method for assessing skeletal muscle oxidative capacity when combined with a short exercise protocol and arterial occlusions. However, the impact of different exercise protocols and reproducibility of the method in non-athletic adults have not previously been assessed.

Methods: Young, non-athletic adults (YA) were invited to perform a short duration, fast frequency contraction (SF) exercise protocol and a long duration slow frequency (LS) contraction protocol, combined with NIRS measurements and arterial occlusions to assess skeletal muscle oxidative capacity.

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Article Synopsis
  • The study aimed to investigate the prevalence of incidental cerebrovascular findings and variations of the circle of Willis (CoW) among a diverse UK tri-ethnic population using high-resolution MRI imaging.
  • A total of 750 participants, including White Europeans, South Asians, and African Caribbeans, were analyzed; incidental findings were found in 11.2% of subjects, with cerebral aneurysms and stenoses being the most common, particularly prevalent in South Asians.
  • Results indicated that the CoW was more complete in women and showed significant ethnic differences, suggesting that ethnicity plays a role in both cerebrovascular abnormalities and the anatomy of the CoW.
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Aims: Parameters derived from reservoir-excess pressure analysis have been demonstrated to predict cardiovascular events. Thus, altered reservoir-excess pressure parameters could have a detrimental effect on highly-perfused organs like the heart. We aimed to cross-sectionally determine whether reservoir-excess pressure parameters were associated with N-terminal pro-brain-type natriuretic peptide (NT-proBNP) in older adults.

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Obese adults are often reported to have smaller brain volumes than their non-obese peers. Whether this represents evidence of accelerations in obesity-driven atrophy or is instead a legacy of developmental differences established earlier in the lifespan remains unclear. This study investigated whether early-life differences in adiposity explain differences in numerous adult brain traits commonly attributed to mid-life obesity.

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Background: Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.

Objectives: To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.

Methods: In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months.

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Purpose: To investigate whether arterial stiffness, assessed oscillometrically, is associated with incident glaucoma in the Vitamin D Assessment (ViDA) Study cohort, aged 50 to 84 years.

Design: Prospective, population-based cohort study.

Methods: Arterial stiffness was assessed in 4,713 participants without known glaucoma (mean ± SD age = 66 ± 8 years) from 5 April 2011 to 6 November 2012 by way of aortic PWV (aPWV), estimated carotid-femoral PWV (ePWV) and aortic PP (aPP).

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