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Articles by C Edwards
Total Records ( 2 ) for C Edwards
  J Rawlins , F Carre , G Kervio , M Papadakis , N Chandra , C Edwards , G.P Whyte and S. Sharma

Background— Ethnicity is an important determinant of cardiovascular adaptation in athletes. Studies in black male athletes reveal a higher prevalence of electric repolarization and left ventricular hypertrophy than observed in white males; these frequently overlap with those observed in cardiomyopathy and have important implications in the preparticipation cardiac screening era. There are no reports on cardiac adaptation in highly trained black females, who comprise an increasing population of elite competitors.

Methods and Results— Between 2004 and 2009, 240 nationally ranked black female athletes (mean age 21±4.6 years old) underwent 12-lead ECG and 2-dimensional echocardiography. The results were compared with 200 white female athletes of similar age and size participating in similar sports. Black athletes demonstrated greater left ventricular wall thickness (9.2±1.2 versus 8.6±1.2 mm, P<0.001) and left ventricular mass (187.2±42 versus 172.3±42 g, P=0.008) than white athletes. Eight black athletes (3%) exhibited a left ventricular wall thickness >11 mm (12 to 13 mm) compared with none of the white athletes. All athletes revealed normal indices of systolic and diastolic function. Black athletes exhibited a higher prevalence of T-wave inversions (14% versus 2%, P<0.001) and ST-segment elevation (11% versus 1%, P<0.001) than white athletes. Deep T-wave inversions (–0.2 mV) were observed only in black athletes and were confined to the anterior leads (V1 through V3).

Conclusions— Systematic physical exercise in black female athletes is associated with greater left ventricular hypertrophy and higher prevalence of repolarization changes than in white female athletes of similar age and size participating in identical sporting disciplines. However, a maximal left ventricular wall thickness >13 mm or deep T-wave inversions in the inferior and lateral leads are rare and warrant further investigation.

  C. S Yee , V Farewell , D. A Isenberg , B Griffiths , L. S Teh , I. N Bruce , Y Ahmad , A Rahman , A Prabu , M Akil , N McHugh , C Edwards , D D`Cruz , M. A Khamashta , P Maddison and C. Gordon

Objective. To determine if the BILAG-2004 index is sensitive to change for assessment of SLE disease activity.

Methods. This was a prospective multi-centre longitudinal study of SLE patients. At every assessment, data were collected on disease activity (BILAG-2004 index) and treatment. Analyses were performed using overall BILAG-2004 index score (as determined by the highest score achieved by any of the individual systems) and all the systems scores. Sensitivity to change was assessed by determining the relationship between change in disease activity and change in therapy between two consecutive visits. Statistical analyses were performed using multinomial logistic regression.

Results. There were 1761 assessments from 347 SLE patients that contributed 1414 observations for analysis. An increase in therapy between visits occurred in 22.7% observations, while 37.3% had a decrease in therapy and in 40.0% therapy was unchanged. Increase in overall BILAG-2004 index score was associated with increase in therapy and inversely associated with decrease in therapy. Decrease in overall BILAG-2004 index score was associated with decrease in therapy and was inversely associated with increase in therapy. Changes in overall BILAG-2004 index score were differentially related to change in therapy, with greater change in score having greater predictive power. Increase in the scores of most systems was independently associated with an increase in treatment and there was no significant association between decreases in the score of any system with an increase in therapy.

Conclusions. The BILAG-2004 index is sensitive to change and is suitable for use in longitudinal studies of SLE.

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