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OBJECTIVES The purpose of this study was to test the hypothesis that in heart failure with normal ejection fraction (HFNEF) exercise limitation is due to combined systolic and diastolic abnormalities, particularly involving ventricular twist and deformation (strain) leading to reduced ventricular suction, delayed untwisting, and impaired early diastolic(More)
National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which(More)
Type 2 diabetes (T2DM) is growing at a pandemic scale and is associated with a rapid increase in its complications such as cardiovascular diseases (CVD). This problem is even worse in South Asian population with South Asian people having a much higher prevalence of T2DM and CVD, occurring at an earlier age and being associated with premature and high(More)
OBJECTIVES The aim of this study was to determine whether left ventricular (LV) midwall fibrosis, detected by midwall hyperenhancement (MWHE) on late gadolinium enhancement cardiovascular magnetic resonance (CMR) imaging, predicts mortality and morbidity in patients with dilated cardiomyopathy (DCM) undergoing cardiac resynchronization therapy (CRT). (More)
OBJECTIVES Pulmonary arterial hypertension (PAH) is associated with rapid deterioration and poor prognosis in SLE, especially during pregnancy. The prevalence of PAH in SLE in non-tertiary centres is uncertain. This study aims to estimate the point prevalence of PAH and identify risk factors for PAH in a large cohort of SLE patients. METHODS A prospective(More)
OBJECTIVES We sought to evaluate the role of exercise-related changes in left ventricular (LV) relaxation and of LV contractile function and vasculoventricular coupling (VVC) in the pathophysiology of heart failure with preserved ejection fraction (HFpEF) and to assess myocardial energetic status in these patients. BACKGROUND To date, no studies have(More)
OBJECTIVES To evaluate the clinical response to cardiac resynchronisation therapy (CRT) in patients with heart failure and a normal QRS duration (<120 ms). SETTING Single centre. PATIENTS 60 patients with heart failure and a normal QRS duration receiving optimal pharmacological treatment (OPT). INTERVENTIONS Patients were randomly assigned to CRT(More)
PURPOSE The purpose of this paper is to review systematically the available literature relating to the implementation of peer education to promote health and healthy behaviour in prisons. DESIGN/METHODOLOGY/APPROACH The authors undertook a narrative systematic review of Medline, EMBASE, CINAHL, Psychinfo, Web of Science and Cochrane databases. Relevant(More)
PURPOSE Clinical trials are essential to develop and test novel therapies, yet only 2%-3% of women with breast cancer enroll. We sought to describe patient and physician barriers to trial participation and then implemented targeted interventions to increase awareness and interest in trial participation. Also, with increasing patient interest in(More)