Full Text Journal Articles by
Author J David Spence

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Shouldn't Patients With Paradoxical Emboli and Thrombophilia Be Given Anticoagulant Agents?

M Reza Azarpazhooh, Chrysi Bogiatzi, J David Spence,

JACC Cardiovasc Interv (JACC. Cardiovascular interventions)
[2021, 14(5):583]

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Treatment of asymptomatic carotid stenosis.

J David Spence,

Lancet Neurol (The Lancet. Neurology)
[2021, 20(3):163-165]

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Deep learning-based measurement of total plaque area in B-mode ultrasound images.

Ran Zhou, Fumin Guo, Reza Azarpazhooh, Samineh Hashemi, Xinyao Cheng, J David Spence, Mingyue Ding, Aaron Fenster,

Measurement of total-plaque-area (TPA) is important for determining long term risk for stroke and monitoring carotid plaque progression. Since delineation of carotid plaques is required, a deep learning method can provide automatic plaque segmentations and TPA measurements; however, it requires large datasets and manual annotations for training with unknown performance ... Read more >>

IEEE J Biomed Health Inform (IEEE journal of biomedical and health informatics)
[2021, PP:]

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It's time to stop the nonsense of withholding lipid lowering therapy on account of age.

J David Spence,

Atherosclerosis (Atherosclerosis)
[2021, :]

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Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment: JACC Focus Seminar.

David J A Jenkins, J David Spence, Edward L Giovannucci, Young-In Kim, Robert G Josse, Reinhold Vieth, Sandhya Sahye-Pudaruth, Melanie Paquette, Darshna Patel, Sonia Blanco Mejia, Effie Viguiliouk, Stephanie K Nishi, Meaghan Kavanagh, Tom Tsirakis, Cyril W C Kendall, Sathish C Pichika, John L Sievenpiper,

This is an update of the previous 2018 systematic review and meta-analysis of vitamin and mineral supplementation on cardiovascular disease outcomes and all-cause mortality. New randomized controlled trials and meta-analyses were identified by searching the Cochrane library, Medline, and Embase, and data were analyzed using random effects models and classified ... Read more >>

J Am Coll Cardiol (Journal of the American College of Cardiology)
[2021, 77(4):423-436]

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Increased Sympathetic Activity and Excess Aldosterone Secretion in Masked Hypertension.

J David Spence,

Hypertension (Hypertension (Dallas, Tex. : 1979))
[2021, 77(2):445-446]

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Stroke Prevention in Older Adults: Recent Advances.

J David Spence, M Reza Azarpazhooh, Susanna C Larsson, Chrysi Bogiatzi, Graeme J Hankey,

The risks of stroke and dementia increase steeply with age, and both are preventable. At present, the best way to preserve cognitive function is to prevent stroke. Therapeutic nihilism based on age is common and unwarranted. We address recent advances in stroke prevention that could contribute greatly to prevention of ... Read more >>

Stroke (Stroke)
[2020, 51(12):3770-3777]

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Reducing the Risk of Stroke in Patients with Impaired Renal Function: Nutritional Issues.

J David Spence,

Patients with renal failure have extremely high cardiovascular risk; in dialysis patients the risk of stroke is increased approximately 10-fold over that in the general population. Reasons include not only a high prevalence of traditional risk factors such as diabetes, hypertension and dyslipidemia, but also the accumulation of toxic substances ... Read more >>

J Stroke Cerebrovasc Dis (Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association)
[2020, :105376]

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Blind spots in the new International Society of Hypertension guidelines: physiologically individualized therapy for resistant hypertension based on renin/aldosterone phenotyping, and amiloride for Liddle phenotype.

J David Spence,

J Hypertens (Journal of hypertension)
[2020, 38(11):2338]

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Management of asymptomatic carotid stenosis.

J David Spence,

Patients with asymptomatic carotid stenosis (ACS) are at very high risk of coronary events, so they should all receive intensive medical therapy. What is often accepted as "best medical therapy" is usually suboptimal. Truly intensive medical therapy includes lifestyle modification, particularly smoking cessation and a Mediterranean diet. All patients with ... Read more >>

Ann Transl Med (Annals of translational medicine)
[2020, 8(19):1262]

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Measurement of carotid plaque burden.

J David Spence,

<h4>Purpose of review</h4>To describe the uses of measurement of carotid plaque burden, as total plaque area (TPA), total plaque volume (TPV), and vessel wall volume (VWV), which includes plaque burden and wall volume.<h4>Recent findings</h4>Measurement of plaque burden is useful for risk stratification, research into the genetics and biology of atherosclerosis, ... Read more >>

Curr Opin Lipidol (Current opinion in lipidology)
[2020, 31(5):291-298]

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Recent advances in preventing recurrent stroke.

J David Spence,

Since a 2017 update, there have been important advances in stroke prevention. These include new evidence about nutrition, antiplatelet therapy, anticoagulation, lipid-lowering therapy, hypertension control, pioglitazone, and carotid endarterectomy and stenting. Evidence regarding toxic metabolites produced by the intestinal microbiome from egg yolk and red meat has important dietary implications, ... Read more >>

F1000Res (F1000Research)
[2020, 9:]

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China Stroke Statistics 2019: a wealth of opportunities for stroke prevention.

J David Spence,

Stroke Vasc Neurol (Stroke and vascular neurology)
[2020, 5(3):240-241]

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Mechanisms of Stroke in COVID-19.

J David Spence, Gabriel R de Freitas, L Creed Pettigrew, Hakan Ay, David S Liebeskind, Carlos S Kase, Oscar H Del Brutto, Graeme J Hankey, Narayanaswamy Venketasubramanian,

Cerebrovasc Dis (Cerebrovascular diseases (Basel, Switzerland))
[2020, 49(4):451-458]

Cited: 6 times

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Intracerebral Hemorrhage in SPARCL: What Was the Relationship to LDL-C?

J David Spence,

J Am Coll Cardiol (Journal of the American College of Cardiology)
[2020, 76(7):885-886]

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Uses of ultrasound in stroke prevention.

J David Spence,

Ultrasound methods are useful in stroke prevention in several ways. Measurement of carotid plaque burden, as either total plaque area (TPA) or total plaque volume (TPV) are strong predictors of cardiovascular risk: much stronger than intima-media thickness, which does not represent true atherosclerosis, but a biologically and genetically distinct phenotype. ... Read more >>

Cardiovasc Diagn Ther (Cardiovascular diagnosis and therapy)
[2020, 10(4):955-964]

Cited: 1 time

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Segmentation of 3D ultrasound carotid vessel wall using U-Net and segmentation average network.

Mingjie Jiang, J David Spence, Bernard Chiu,

Segmentation of carotid vessel wall is required in vessel wall volume (VWV) and local vessel-wall-plus-plaque thickness (VWT) quantification of the carotid artery. Manual segmentation of the vessel wall is time-consuming and prone to interobserver variability. In this paper, we proposed a convolutional neural network (CNN) to segment the common carotid ... Read more >>

Annu Int Conf IEEE Eng Med Biol Soc (Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference)
[2020, 2020:2043-2046]

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Achieving blood pressure control targets in hypertensive patients of rural China - a pilot randomized trial.

Xiao Huang, Lishun Liu, Yun Song, Lan Gao, Min Zhao, Huihui Bao, Xianhui Qin, Yanqing Wu, Qinghua Wu, Chonglei Bi, Aiping Yue, Chongqian Fang, Hai Ma, Yimin Cui, Genfu Tang, Ping Li, Yan Zhang, Jianping Li, Binyan Wang, Xiping Xu, Hong Wang, Gianfranco Parati, J David Spence, Xiaobin Wang, Yong Huo, Guangliang Chen, Xiaoshu Cheng, ,

<h4>Background</h4>This study aimed to test the feasibility and titration methods used to achieve specific blood pressure (BP) control targets in hypertensive patients of rural China.<h4>Methods</h4>A randomized, controlled, open-label trial was conducted in Rongcheng, China. We enrolled 105 hypertensive participants aged over 60 years, and who had no history of stroke or ... Read more >>

Trials (Trials)
[2020, 21(1):515]

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Risk from low blood pressure in frail older adults: diastolic pressure and pulse pressure are important.

J David Spence,

Blood pressure measurement with a cuff in patients with stiff arteries can be misleading, with false elevation of the diastolic pressure. Coronary flow, and most of the cerebral blood flow occur during diastole. There is a marked diastolic J curve in patients with diastolic pressure <60 mmHg and pulse pressure ... Read more >>

Age Ageing (Age and ageing)
[2020, :]

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Stroke Prevention: A Lifetime of Lessons.

J David Spence,

In 44 years of practicing stroke prevention, I have learned many lessons; in this article, I hope to impart some of them. Three areas of my research are discussed. Controlling resistant hypertension is markedly improved by physiologically individualized therapy based on renin/aldosterone phenotyping; this is particularly important in black patients. ... Read more >>

Stroke (Stroke)
[2020, 51(7):2255-2262]

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New Canadian guideline is wrong to say acetylsalicylic acid is only for patients with symptomatic vascular disease.

J David Spence,

CMAJ (CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne)
[2020, 192(24):E661]

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Impaired Renal Function and Cerebrovascular Disease.

J David Spence,

Angiology (Angiology)
[2020, 71(6):489-490]

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Triglyceride lowering drugs: not just icosapent ethyl.

J David Spence,

Eur Heart J (European heart journal)
[2020, 41(15):1520]

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Choosing the right therapy for a patient with asymptomatic carotid stenosis.

Chrysi Bogiatzi, M Reza Azarpazhooh, J David Spence,

Introduction: Most patients with asymptomatic carotid stenosis (ACS) now have a lower risk with intensive medical therapy than with stenting (CAS) or endarterectomy (CEA); the annual risk of stroke or death with intensive medical therapy is ~ 0.5%, vs. a periprocedural risk with CAS of ~ 2.5-4.1% with CAS, and ... Read more >>

Expert Rev Cardiovasc Ther (Expert review of cardiovascular therapy)
[2020, 18(2):53-63]

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A Voxel-Based Fully Convolution Network and Continuous Max-Flow for Carotid Vessel-Wall-Volume Segmentation From 3D Ultrasound Images.

Ran Zhou, Fumin Guo, M Reza Azarpazhooh, J David Spence, Eranga Ukwatta, Mingyue Ding, Aaron Fenster,

Vessel-wall-volume (VWV) is an important three-dimensional ultrasound (3DUS) metric used in the assessment of carotid plaque burden and monitoring changes in carotid atherosclerosis in response to medical treatment. To generate the VWV measurement, we proposed an approach that combined a voxel-based fully convolution network (Voxel-FCN) and a continuous max-flow module ... Read more >>

IEEE Trans Med Imaging (IEEE transactions on medical imaging)
[2020, 39(9):2844-2855]

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