Rajesh Janardhanan

Interests

Teaching

I teach the cardiology core curriculum for the third year medical students at the University of Arizona. I have always received very positive student and peer teaching evaluations.Teach the radiology residents advanced cardiovascular imaging during their rotations in cardiology. I also teach the radiology technical staff on how to optimize image quality during cardiac CTA and Cardiac MRI. Medicine residents and pulmonary fellows are also taught during their rotations in non-invasive cardiology.University of Arizona South Campus Echocardiography Core Curriculum: I am covering all the topics in echocardiography through a series of lectures on Mondays. The lectures are tailored to the sonographers and cardiology fellows. Cover board review sessions in non-invasive imaging for cardiology fellows. Created a database for interesting cases in echocardiographyContributed several teaching modules for the UVA educational website: www.uvarealm.com [Resource for the Active Learning of Medicine]. This is a great resource for learning medicine and cardiology for all levels of trainees. Preceptor for first year medical students of UVA School of Medicine in the Patient Clinical Encounter Program. This is primarily focused on improving history taking and physical exam skills. I volunteer for teaching sessions on the mannequin (HARVEY) to improve auscultation skill for medical students.While working in UK I organized bedside clinical teaching for the MRCP exam for internal medicine residents in UK, monthly lectures on current practice of clinical medicine to update the primary care physicians in UK as well as sessions with coronary care unit nursing staff in EKG rhythm recognition

Courses

No activities entered.

Scholarly Contributions

Chapters

• Janardhanan, R., Chacon-Portillio, M., & Stroud, S. (2021). Echocardiographic Evaluation of Left Ventricular and Left Atrial Strain in Hypertension: Diagnostic, Prognostic and Therapeutic Implications. In Hypertension New Frontiers(pp 383-387). New Delhi, India: Jaypee Brothers Medical Publishers.
• Chacon-Portillo, M., Stroud, S. &., & Janardhanan, R. (2020). Echocardiographic Evaluation of Left Ventricular and Left Atrial Strain in Hypertension: Diagnostic and Therapeutic Implications. In Hypertension: New Frontiers. Textbook of Cardiology. New Dehli, India: Jaypee Brothers Medical Publishers.
• Janardhanan, R., & Pasha, A. K. (2019). Myocarditis and Heart Failure. In Advances and Innovations in Heart Failure, Textbook of Cardiology. Jaypee Brothers Medical Publishing.
• Janardhanan, R., & Marcus, F. I. (2014). Arrhythmogenic right ventricular cardiomyopathy/dysplasia: Clinical presentation, Diagnostic challenges and Differential Diagnosis. In Current Concepts in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia(pp 49-58). Minneapolis, MN: Cardio Text Publishing.
• Bulwer, B., Solomon, S., & Janardhanan, R. (2007). Echocardiographic Assessment of Ventricular Systolic Function. In Essential Echocardiography: A Practical Casebook and DVD(pp 89-117). Totowa, NJ: Humana Press.
• Janardhanan, R. (2004). Myocardial Contract Echocardiography in the Assessment of Patient with Coronary Artery Disease. In Contrast Echocardiography in Clinical Practice(pp 153-166). Milan, Italy: Springer.

Journals/Publications

• Kendall, M. R., Chacon, M., & Janardhanan, R. (2023). Incidental Quadricuspid Aortic Valve Demonstrated by Transillumination on Three-Dimensional Transesophageal Echocardiography. CASE (Philadelphia, Pa.), 7(3), 113-115.
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  • QAV is a rare congenital malformation often missed on TTE. • Intervention is typically required in the fifth to sixth decade of life. • Transillumination on 3D TEE offers photorealistic 3D rendering.
• Einstein, A. J., Hirschfeld, C., Williams, M. C., Vitola, J. V., Better, N., Villines, T. C., Cerci, R., Shaw, L. J., Choi, A. D., Dorbala, S., Karthikeyan, G., Lu, B., Sinitsyn, V., Ansheles, A. A., Kudo, T., Bucciarelli-Ducci, C., Nørgaard, B. L., Maurovich-Horvat, P., Campisi, R., , Milan, E., et al. (2022). Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19. Journal of the American College of Cardiology, 79(20), 2001-2017.
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  The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.
• Zandu, M. K., Jagadish, P. S., Williams, A. R., & Janardhanan, R. (2022). A case of biventricular thrombi with complications. BMJ case reports, 15(11).
• Ajmal, M., & Janardhanan, R. (2021). A great mimic of left atrial appendage thrombus in a patient with atrial fibrillation. European heart journal. Case reports, 5(9), ytab310.
• Chacon-Portillo, M., Acharya, T., & Janardhanan, R. (2021). Imaging in heart failure with preserved ejection fraction: insights into echocardiography and cardiac magnetic resonance imaging. Reviews in Cardiovascular Medicine. doi:10.31083/?
• Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Nørgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., , Louw, L., et al. (2021). International Impact of COVID-19 on the Diagnosis of Heart Disease. Journal of the American College of Cardiology, 77(2), 173-185.
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  The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified.
• Hirschfeld, C. B., Mercuri, M., Pascual, T. N., Karthikeyan, G., Vitola, J. V., Mahmarian, J. J., Better, N., Bouyoucef, S. E., Hee-Seung Bom, H., Lele, V., Magboo, V. P., Alexánderson, E., Allam, A. H., Al-Mallah, M. H., Dorbala, S., Flotats, A., Jerome, S., Kaufmann, P. A., Luxenburg, O., , Shaw, L. J., et al. (2021). Worldwide Variation in the Use of Nuclear Cardiology Camera Technology, Reconstruction Software, and Imaging Protocols. JACC. Cardiovascular imaging.
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  This study sought to describe worldwide variations in the use of myocardial perfusion imaging hardware, software, and imaging protocols and their impact on radiation effective dose (ED).
• Shenoy, S., & Janardhanan, R. (2021). Dilated right heart in a young lady with syncope: atrial septal defect masquerading as arrhythmogenic right ventricular cardiomyopathy. European Heart Journal.
• Kern, K. B., Radsel, P., Jentzer, J. C., Seder, D. B., Lee, K. S., Lotun, K., Janardhanan, R., Stub, D., Hsu, C. H., & Noc, M. (2020). Randomized Pilot Clinical Trial of Early Coronary Angiography Versus No Early Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation: The PEARL Study. Circulation, 142(21), 2002-2012.
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  The benefit of emergency coronary angiography after resuscitation from out-of-hospital cardiac arrest is uncertain for patients without ST-segment elevation. The aim of this randomized trial was to evaluate the efficacy and safety of early coronary angiography and to determine the prevalence of acute coronary occlusion in resuscitated patients with out-of-hospital cardiac arrest without ST-segment elevation.
• Prudhvi, K., Kumar, K., Jonnadula, J., & Janardhanan, R. (2020). Right Atrial Thrombosis Provoked by Central Venous Catheter: A Case Report. Cureus, 12(7), e9027.
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  Intracardiac thrombi are not uncommon, but right atrial (RA) thrombi are exceedingly rare. Thrombi can lead to a variety of complications, such as systemic and pulmonary embolism. While various imaging modalities are helpful in the diagnosis, an echocardiogram is the most commonly used one. Principle management of the condition involves anticoagulation. However, management can vary among different patient groups, depending on the location and size of thrombi. We present a case of an RA thrombosis due to dilation of the atria and trauma from an infected central venous catheter in a patient with a past medical history of pulmonary artery hypertension (PAH).
• Thamman, R., & Janardhanan, R. (2020). Cardiac rehabilitation using telemedicine: the need for tele cardiac rehabilitation. Reviews in cardiovascular medicine, 21(4), 497-500.
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  Cardiac Rehabilitation programs have shown to improve outcomes. The COVID-19 pandemic has posed barriers to these programs. A virtual platform might be a good solution to these challenges. Tele Cardiac Rehabilitation and remote patient monitoring provide an excellent alternative practical solution.
• Kern, M. C., Janardhanan, R., Kelly, T., Fox, K. A., Klewer, S. E., & Seckeler, M. D. (2019). Multimodality imaging for diagnosis and procedural planning for a ruptured sinus of Valsalva aneurysm. Journal of cardiovascular computed tomography.
• Janardhanan, R. (2018). Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update. Journal of the Society of Echocardiography. doi:https://doi.org/10.1016/j.echo.2017.11.013
• Janardhanan, R., & Alpert, J. S. (2018). The digital hand-held ultrasound device: A new portable diagnostic tool for healthcare. Will it replace the stethoscope?. American Journal of Medicine.
• Keerthivasan, M. B., Mandava, S., Johnson, K. D., Avery, R., Janardhanan, R., Martin, D. R., Bilgin, A., & Altbach, M. I. (2018). Improved Slice Coverage in Double Inversion Fast Spin Echo with Multi-Band Encoding.. Journal of Cardiac Magnetic Resonance, 20(49).
• Keerthivasan, M. B., Mandava, S., Johnson, K., Avery, R., Janardhanan, R., Martin, D. R., Bilgin, A., & Altbach, M. I. (2018). A multi-band double-inversion radial fast spin-echo technique for T2 cardiovascular magnetic resonance mapping of the heart. Journal of Cardiovascular Magnetic Resonance. doi:10.1186/s12968-018-0470
• Porter, T. R., Mulvagh, S. L., Abdelmoneim, S. S., Becher, H., Belcik, J. T., Bierig, M., Choy, J., Gaibazzi, N., Gillam, L. D., Janardhanan, R., Kutty, S., Leong-Poi, H., Lindner, J. R., Main, M. L., Mathias, W., Park, M. M., Senior, R., & Villanueva, F. (2018). Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 31(3), 241-274.
• Zareba, W., Daubert, J. P., Beck, C. A., Huang, D. T., Alexis, J. D., Brown, M. W., Pyykkonen, K., McNitt, S., Oakes, D., Feng, C., Aktas, M. K., Ayala-Parades, F., Baranchuk, A., Dubuc, M., Haigney, M., Mazur, A., McPherson, C. A., Mitchell, L. B., Natale, A., , Piccini, J. P., et al. (2018). Ranolazine in High-Risk Patients With Implanted Cardioverter-Defibrillators: The RAID Trial. Journal of the American College of Cardiology, 72(6), 636-645. doi:10.1016/j.jacc.2018.04.086
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  Ventricular tachycardia (VT) and ventricular fibrillation (VF) remain a challenging problem in patients with implantable cardioverter-defibrillators (ICDs).
• Anand, S., Sydow, N., & Janardhanan, R. (2017). Papillary fibroelastoma diagnosed through multimodality cardiac imaging: a rare tumour in an uncommon location with review of literature. BMJ case reports, 2017.
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  We describe the case of a woman presenting with transient ischaemic attack, who was found to have a papillary fibroelastoma arising from the aortic wall, an extremely rare location. We describe the multimodality imaging techniques used in diagnosing this patient and review the most recent literature on evaluation and management of patients with cardiac papillary fibroelastomas.
• Basken, R., Bazzell, C. M., Smith, R., Janardhanan, R., & Khalpey, Z. (2017). Advantages and disadvantages of using intravenous tissue Plasminogen activator as salvage therapy for inoperable HeartWare thrombosis. Journal of cardiac surgery, 32(7), 443-446.
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  Device thrombosis is a devastating complication of left ventricular assist devices. The definitive treatment has been device exchange or explant. Evidence of increasing morbidity and mortality with device exchange has shifted strategies toward conservative management. In this report, we detail the use of thrombolytics as salvage therapy in a patient with an occlusive HeartWare ventricular assist device (HeartWare Inc., Framingham, MA) thrombus, resulting in long-term survival without further intervention.
• Basken, R., Cosgrove, R., Bazzell, C. M., Betterton, E. A., Smith, R., Janardhanan, R., & Khalpey, Z. I. (2017). Advantages and Disadvantages of Using Intravenous Tissue Plasminogen Activator (tPA) As Salvage Therapy For Inoperable HeartWare Thrombosis. Journal of Cardiac Surgery.
• Janardhanan, R. (2017). Images/cover art for Echo Research and Practice. Echo Research and Practice; A high-impact, international open access journal.
• Janardhanan, R., Khalpey, Z. I., Alouidor, B., Wong, R., & Venkat, R. (2017). R-Oxy-LVAD: A Novel Minimally- Invasive Off-Pump Method for Central Oxygenation with Biventricular Decompression. Jour Thoracic Cardiovascular Surgery.
• Velasco, O., Beckett, M. Q., James, A. W., Loehr, M. N., Lewis, T. G., Hassan, T., & Janardhanan, R. (2017). Real-Time Three-Dimensional Echocardiography: Characterization of Cardiac Anatomy and Function-Current Clinical Applications and Literature Review Update. BioResearch open access, 6(1), 15-18.
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  Our review of real-time three-dimensional echocardiography (RT3DE) discusses the diagnostic utility of RT3DE and provides a comparison with two-dimensional echocardiography (2DE) in clinical cardiology. A Pubmed literature search on RT3DE was performed using the following key words: transthoracic, two-dimensional, three-dimensional, real-time, and left ventricular (LV) function. Articles included perspective clinical studies and meta-analyses in the English language, and focused on the role of RT3DE in human subjects. Application of RT3DE includes analysis of the pericardium, right ventricular (RV) and LV cavities, wall motion, valvular disease, great vessels, congenital anomalies, and traumatic injury, such as myocardial contusion. RT3DE, through a transthoracic echocardiography (TTE), allows for increasingly accurate volume and valve motion assessment, estimated LV ejection fraction, and volume measurements. Chamber motion and LV mass approximation have been more accurately evaluated by RT3DE by improved inclusion of the third dimension and quantification of volumetric movement. Moreover, RT3DE was shown to have no statistical significance when comparing the ejection fractions of RT3DE to cardiac magnetic resonance (CMR). Analysis of RT3DE data sets of the LV endocardial exterior allows for the volume to be directly quantified for specific phases of the cardiac cycle, ranging from end systole to end diastole, eliminating error from wall motion abnormalities and asymmetrical left ventricles. RT3DE through TTE measures cardiac function with superior diagnostic accuracy in predicting LV mass, systolic function, along with LV and RV volume when compared with 2DE with comparable results to CMR.
• Anand, S., & Janardhanan, R. (2016). Role of cardiac MRI in nonischemic cardiomyopathies. Indian heart journal, 68(3), 405-9.
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  Cardiac magnetic resonance (CMR) with its higher spatial resolution is considered the gold standard for evaluating ventricular mass, volumes, and ejection fraction. CMR can be used for accurate diagnosis of several conditions, especially cardiomyopathies. The purpose of this article is to review the utility of CMR in the diagnosis and management of nonischemic cardiomyopathies. We have reviewed both common and rare types of nonischemic cardiomyopathies in detail and elaborated on the specific CMR findings in each. We believe that CMR is an invaluable tool, not only in differentiating nonischemic from ischemic cardiomyopathy, but also in aiding the accurate diagnosis and management of the subtype of nonischemic cardiomyopathy. CMR should routinely be integrated in the diagnostic workup of various cardiomyopathies.
• Janardhanan, R. (2016). Myocarditis with very high troponins: risk stratification by cardiac magnetic resonance. Journal of thoracic disease, 8(10), E1333-E1336.
• Janardhanan, R., & Kannan, A. (2016). Methamphetamine Cardiotoxicity: Unique Presentation with Multiple Bi-Ventricular Thrombi. The American journal of medicine, 129(1), e3-4.
• Janardhanan, R., & Pasha, A. K. (2016). Acute Severe Aortic Regurgitation: Imaging with Pathological Correlation. North American Journal of Medical Sciences.
• Janardhanan, R., & Pasha, A. K. (2016). Acute Severe Aortic Regurgitation: Imaging with Pathological Correlation. North American journal of medical sciences, 8(3), 167-8.
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  Acute aortic regurgitation (AR) is an important finding associated with a wide variety of disease processes. Its timely diagnosis is of utmost importance. Delay in diagnosis could prove fatal.
• Janardhanan, R., Dwivedi, G., Hayat, S., & Senior, R. (2016). Myocardial contrast echocardiography: a new tool for assessment of myocardial perfusion. Indian heart journal, 57(3), 210-6.
• Janardhanan, R., Kamal, M. U., Riaz, I. B., & Smith, M. C. (2016). Anterior mitral valve aneurysm: a rare sequelae of aortic valve endocarditis. Echo research and practice, 3(1), K7-K13.
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  SummaryIn intravenous drug abusers, infective endocarditis usually involves right-sided valves, with Staphylococcus aureus being the most common etiologic agent. We present a patient who is an intravenous drug abuser with left-sided (aortic valve) endocarditis caused by Enterococcus faecalis who subsequently developed an anterior mitral valve aneurysm, which is an exceedingly rare complication. A systematic literature search was conducted which identified only five reported cases in the literature of mitral valve aneurysmal rupture in the setting of E. faecalis endocarditis. Real-time 3D-transesophageal echocardiography was critical in making an accurate diagnosis leading to timely intervention.
• Janardhanan, R., Yang, B., Kilari, S., Leof, E. B., Mukhopadhyay, D., & Misra, S. (2016). The Role of Repeat Administration of Adventitial Delivery of Lentivirus-shRNA-Vegf-A in Arteriovenous Fistula to Prevent Venous Stenosis Formation. Journal of vascular and interventional radiology : JVIR, 27(4), 576-83.
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  To determine if a second dose of a lentivirus mediated small hairpin RNA that inhibits Vegf-A gene expression (LV-shRNA-Vegf-A) can improve lumen vessel area (LVA) of the outflow vein of an arteriovenous fistula (AVF) and decrease venous neointimal hyperplasia.
• Kamal, M. U., Riaz, I. B., & Janardhanan, R. (2016). Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: Current state of the art. Cardiology journal.
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  Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy with a prevalence of 1:500 in the general population. Sudden cardiac death (SCD) is the most feared presentation of HCM. Therefore, it is essential to identify individuals at high risk to prevent SCD. The absence of conventional risk factors does not nullify the risk of HCM related SCD. Although echocardiography is currently the most widely used imaging modality, Cardiac magnetic resonance (CMR) allows detailed characterization of the HCM phenotype, which makes it possible to differentiate HCM from other causes of left ventricular hypertrophy. CMR has the potential to further refine risk stratification. Late gadolinium enhancement (LGE) on CMR is a high risk feature and some data are emerging, which suggest that the presence of LGE should be employed as a marker for major adverse outcomes such as SCD, arrhythmias, systolic and diastolic heart failure. Hence, LGE on CMR may be considered an additional risk factor for SCD in HCM patients and should be incorporated in decision making for implantable cardioverter defibrillator implantation to aid primary prevention. Novel markers such as the extent of myocardial fibrosis on CMR must be accounted for comprehensive risk stratification of HCM patients. The purpose of this review is to discuss the current status and emerging role of CMR in HCM.
• Kannan, A., Lick, S., Teodori, M. F., Brody, E., & Janardhanan, R. (2016). Giant Pulmonary Artery Aneurysm in a 40-Year-Old Woman after Patent Ductus Arteriosus Ligation at 2 Years of Age. Texas Heart Institute journal, 43(3), 274-6.
• Keenan, J. B., Janardhanan, R., Larsen, B. T., & Khalpey, Z. (2016). Aortic valve replacement for Libman-Sacks endocarditis. BMJ case reports, 2016.
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  A 24-year-old man with systemic lupus erythematosus and antiphospholipid syndrome complicated by lupus nephritis presented with acute limb ischaemia secondary to an embolus. Following embolectomy, the patient underwent a transthoracic echocardiogram which revealed a large vegetation on all three cusps of the aortic valve. The patient was taken for an urgent aortic valve replacement with a mechanical valve. Cultures of one cusp remained sterile. Histopathological examination of the remaining two cusps revealed sterile fibrin-rich thrombotic vegetations characteristic of non-bacterial thrombotic endocarditis.
• Natarajan, B., Huang-Tsang, J., & Janardhanan, R. (2016). Screening Asymptomatic Cardiac Sarcoidosis: Role of Cardiac MRI. The American journal of medicine.
• Natarajan, B., Ramanathan, S., Subramaniam, N., & Janardhanan, R. (2016). Idiopathic subvalvular aortic aneurysm masquerading as acute coronary syndrome. BMJ case reports, 2016.
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  Subvalvular aneurysms are the least common type of left ventricular (LV) aneurysms and can be fatal. Subaortic LV aneurysms are much rarer than submitral LV aneurysms and mostly reported in infancy. They can be congenital or acquired secondary to infections, cardiac surgery or trauma. Here, we report a unique presentation of a large, idiopathic subaortic aneurysm in an adult masquerading as an acute coronary syndrome. Diagnosis was made with the help of a CT aortography. Aneurysm was surgically resected with good results. This case highlights the clinical presentation and management of subaortic aneurysms, an important differential for congenital aortic malformations.
• Robinson, E. A., Khalpey, Z. I., & Janardhanan, R. (2016). A 24-year-old male with a painful and cold lower extremity. Heart (British Cardiac Society).
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  A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses. He was immediately taken for embolectomy after discovery of a distal common femoral artery occlusion. The patient's blood cultures remained negative. X-plane imaging on real-time three-dimensional transoesophageal echocardiography (RT-3DTEE) of the aortic valve (figure 1A) and colour Doppler (figure 1B) are shown.
• Robinson, E., Khalpey, Z., & Janardhanan, R. (2016). Libman Sacks Endocarditis: A presentation with Critical Limb Ischemia. J Am Coll Cardiol.
• Shetty, S., Hamoud, N., O' Farrell, K., Lick, S., & Janardhanan, R. (2016). "Loud Continuous murmur" Post Aortic Surgery: A Clue to an Aortic Root to Right Ventricular Outflow Tract Fistula. The American journal of medicine.
• Anand, S., Hamoud, N., Thompson, J., & Janardhanan, R. (2015). Insights into the Mechanism of Severe Mitral Regurgitation: RT-3D TEE Guided Management with Pathological Correlation. Case reports in cardiology, 2015, 961565.
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  Mitral valve perforation is an uncommon but important complication of infective endocarditis. We report a case of a 65-year-old man who was diagnosed to have infective endocarditis of his mitral valve. Through the course of his admission he had a rapid development of hemodynamic instability and pulmonary edema secondary to acutely worsening mitral regurgitation. While the TEE demonstrated an increase in the size of his bacterial vegetation, Real Time 3D TEE was ultimately the imaging modality through which the valve perforation was identified. Through this case report we discuss the advantages that RT-3D TEE has over traditional 2D TEE in the management of valve perforation.
• Avery, A., Janardhanan, R., & Jokerst, C. (2015). Comparison of Image Quality and Aquistion Time of Free-Breathing (FB) Motion Corrected (MOCO) SSFP to current PSIR sequences: Is one Sequence Superior?. Journal of Cardiovascular Magnetic Resonance 2015.
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  17(suppl 1); P18. Euro-SCMRNice, France 2015
• Ghafoor, A., & Janardhanan, R. (2015). Takotsubo cardiomyopathy: Utility of cardiac magnetic resonance to stratify risk for sudden cardiac death. International journal of cardiology, 184, 492-3.
• Janardhanan, R. (2015). Echocardiography In Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy: Can the Technology Survive in the Era of Cardiac Magnetic Resonance Imaging. Cardiology Journal, 22(4), 355-356.
• Janardhanan, R., & Stroud, S. (2017). Echocardiography in Heart Failure with Preserved Ejection Fraction: A Roadmap. Indian Jour of Clinical Cardiology (in press).
• Janardhanan, R., Patel, K., Mizyed, A., & Thompson, J. (2015). Focal Aortic Root Dissection: Diagnosis using Multi- Modality Imaging.. European Heart Journal of Cardiovascular Imaging, Suppl 2, ii148-ii150.
• Janardhanan, R., Raval, U., Lahiri, A., & Senior, R. (2005). Myocardial Contrast Echocardiography and 99mTc-sestamibi gated SPECT in Acute Heart Failure: Diagnosis of Underlying Coronary Artery Disease.. British Cardiac Society.
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  Heart 2004; 90 (suppl II); A34 (British Cardiac Society, Manchester, May 2004)
• Kannan, A., Jahan, K., Lotun, K., & Janardhanan, R. (2015). Prosthetic mitral valve obstruction: role of real-time three-dimensional transesophageal echocardiography in diagnosis. BMJ case reports, 2015.
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  Acute prosthetic valve thrombosis is a potentially serious complication with an incidence as high as 6% per patient-year for prostheses in the mitral position. Accurate diagnosis of the degree of obstruction and differentiation of pannus versus thrombus is critical in determination of the best mode of therapy. We discuss a case of a patient with multiple comorbidities who presented with mechanical mitral valve obstruction where both transthoracic and two-dimensional transesophageal echocardiography (TEE) were limited in making an accurate diagnosis regarding the mechanism of obstruction. Real-time 3D-TEE (RT-3DTEE) was critical in identifying a partial thrombus on the mechanical valve and guided the choice of thrombolysis as the most appropriate intervention, thus avoiding high-risk surgery in this patient with significant multiple comorbidities.
• Kuruvilla, S., Janardhanan, R., Antkowiak, P., Keeley, E. C., Adenaw, N., Brooks, J., Epstein, F. H., Kramer, C. M., & Salerno, M. (2015). Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone. JACC. Cardiovascular imaging, 8(2), 172-80.
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  The goal of this study was to assess the relationship among extracellular volume (ECV), native T1, and systolic strain in hypertensive patients with left ventricular hypertrophy (HTN LVH), hypertensive patients without LVH (HTN non-LVH), and normotensive controls.
• Lata, K., & Janardhanan, R. (2015). Methemoglobinemia: a diagnosis not to be missed. The American journal of medicine, 128(10), e45-6.
• Lee, J. Z., Tey, K. R., Mizyed, A., Hennemeyer, C. T., Janardhanan, R., & Lotun, K. (2015). Mitral valve replacement complicated by iatrogenic left ventricular outflow obstruction and paravalvular leak: case report and review of literature. BMC cardiovascular disorders, 15, 119.
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  Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement.
• Lim, T. K., Burden, L., Janardhanan, R., Dwivedi, G., Chai, P., M, J., Pennell, D., & Senior, R. (2007). Accuracy of contrast echocardiography for the assessment of left ventricular remodeling compared to gated SPECT following acute myocardial infarction: comparison with magnetic resonance imaging. Eur Heart J.
• Pasha, A. K., Jokerst, C. E., & Janardhanan, R. (2015). Myocardial infarction related to a coronary artery aneurysm. The American journal of medicine, 128(2), e5-6.
• Pasha, A., Jokerst, C., & Janardhanan, R. (2015). Chest Pain and Elevated Troponins Without Atherosclerotic Coronary Artery Disease: Value of Non-Invasive Cardiac Imaging. ACC.
• Pasha, A., Jokerst, C., & Janardhanan, R. (2015). Chest Pain and Elevated Troponins Without Atherosclerotic Coronary Artery Disease: Value of Non-Invasive Cardiac Imaging.. American College of Cardiology.
• Yaghmour, N., Thompson, J., & Janardhanan, R. (2015). Left Atrial Mass in a Patient with Tricuspid Valve Endocarditis: An Incidental Finding Causing Diagnostic Confusion. ACC.
• Yaghmour, N., Thompson, J., & Janardhanan, R. (2015). Left Atrial Mass in a Patient with Tricuspid Valve Endocarditis: An Incidental Finding causing Diagnostic Confusion.. American College of Cardiology.
• Kannan, A., & Janardhanan, R. (2014). Hypertension as a risk factor for heart failure. Current hypertension reports, 16(7), 447.
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  Hypertension remains a significant risk factor for development of congestive heart failure CHF), with various mechanisms contributing to both systolic and diastolic dysfunction. The pathogenesis of myocardial changes includes structural remodeling, left ventricular hypertrophy, and fibrosis. Activation of the sympathetic nervous system and renin-angiotensin system is a key contributing factor of hypertension, and thus interventions that antagonize these systems promote regression of hypertrophy and heart failure. Control of blood pressure is of paramount importance in improving the prognosis of patients with heart failure.
• Kannan, A., Das, A., & Janardhanan, R. (2014). An interesting case of cryptogenic stroke in a young man due to left ventricular non-compaction: role of cardiac MRI in the accurate diagnosis. BMJ case reports, 2014.
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  A 28-year-old man arrived for an outpatient cardiac MRI (CMR) study to evaluate cardiac structure. At the age of 24 the patient presented with acute onset expressive aphasia and was diagnosed with ischaemic stroke. Echocardiography at that time was reported as 'apical wall thickening consistent with apical hypertrophic cardiomyopathy'. CMR revealed a moderately dilated left ventricle with abnormal appearance of the left ventricular (LV) apical segments. Further evaluation was consistent with a diagnosis of LV non-compaction (LVNC) cardiomyopathy with a ratio of non-compacted to compacted myocardium measuring 3. There was extensive delayed hyperenhancement signal involving multiple segments representing a significant myocardial scar which is shown to have a prognostic role. Our patient, with no significant cerebrovascular risk factors, would likely have had an embolic stroke. This case demonstrates the role of CMR in accurately diagnosing LVNC in a patient with young stroke where prior echocardiography was non-diagnostic.
• Kannan, A., Poongkunran, C., Jayaraj, M., & Janardhanan, R. (2014). Role of strain imaging in right heart disease: a comprehensive review. Journal of clinical medicine research, 6(5), 309-13.
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  Advances in the imaging techniques of the heart have fueled the interest in understanding of right heart pathology. Recently, speckle tracking echocardiography has shown to aid in understanding various right heart diseases and better management. Its role is well established in diagnosing right heart failure, pulmonary artery hypertension, arrhythmogenic right ventricular dysplasia and congenital heart disease. We review the basic mechanics of speckle tracking and analyze its role in various right heart conditions.
• Kannan, A., Smith, C., Subramanian, S., & Janardhanan, R. (2014). A rare case of prosthetic endocarditis and dehiscence in a mechanical valved conduit. BMJ case reports, 2014.
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  A middle-aged adult patient with a history of aortic root replacement with a mechanical valved conduit and remote chest trauma was referred to our institution with prosthetic endocarditis. Transoesophageal echocardiogram at our institution confirmed a near-complete dehiscence of the prosthetic aortic valve from the conduit, with significant perivalvular flow forming a pseudoaneurysm. The patient underwent a high-risk re-operation, involving redo aortic root replacement with a homograft after extensive debridement of the infected tissue. The patient was discharged to an outside facility after an uncomplicated hospital course, and remains stable.
• Khalpey, Z., Janardhanan, R., Konhilas, J., & Hemphill, C. (2014). First in man: adipose-derived stromal vascular fraction cells may promote restorative cardiac function. The American journal of medicine, 127(5), e11-2.
• Kuruvilla, S., Janardhanan, R., Epstein, F. H., Kramer, C. M., & Salerno, M. (2014). Increased Extracellular Volume and Altered Mechanics are Associated with Left Ventricular Hypertrophy in Hypertensive Heart Disease, not Hypertension Alone.. Journal of Cardiovascular Magnetic Resonance.
• Lata, K., & Janardhanan, R. (2014). A rare case presenting as SVC syndrome. J Indian College of Cardiol / SCMR 2014 New Orleans.
• Riaz, I. B., Singh, A., & Janardhanan, R. (2014). Chest pain and elevated troponins in a patient with prior coronary artery disease: a diagnostic dilemma. The American journal of medicine, 127(6), e5-6.
• Riaz, I. B., Truong, T. H., & Janardhanan, R. (2014). Sudden cardiac death: refining risk stratification by cardiovascular magnetic resonance. The American journal of medicine, 127(10), e1-2.
• Anantharam, B., Janardhanan, R., Hayat, S., & Senior, R. (2013). Ischaemic burden determined by myocardial contrast echocardiography predicts mortality in patients with new-onset shortness of breath, suspected heart failure and no previous coronary artery disease. International journal of cardiology, 168(2), 1670-1.
• Cemin, R., Janardhanan, R., Donazzan, L., & Daves, M. (2013). Peripartum cardiomyopathy: moving towards a more central role of genetics. Current cardiology reviews, 9(3), 179-84.
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  Peripartum cardiomyopathy (PCM) is a relatively rare disease with potentially devasting consequences requiring prompt identification and correct treatment. Overall prognosis is good in majority of the cases, although some patients may progress to irreversible heart failure. Early diagnosis is important and effective treatment reduces mortality rates and increases the chance of complete recovery of ventricular systolic function. The aetiology and pathogenesis seems to be multifactorial and poorly understood, with the available literature rather conflicting. In recent years, there has been increased interest in the role played by genetic predisposition in the development of PCM. It probably develops as a result of a complex interaction of pregnancy-associated factors and genetic factors and recently there have been many observations pointing out the central role played by a genetic predisposition. The direct and indirect observations on genetic susceptibility may offer new insights into the pathogenesis of PCM. However, larger studies are needed before advising routine genetic testing in these patients.
• Kuruvilla, S., Janardhanan, R., Keeley, E. C., Yang, Y., Kramer, C. M., & Salerno, M. (2013). Quantifying Myocardial Fibrosis in Hypertensive Left Ventricular Hypertrophy using T1 Mapping. AHA, Dallas 2013.
• Janardhanan, R., & Beller, G. A. (2012). Radionuclide imaging in stage B heart failure. Heart Failure Clinic, 8(2), 191-206. doi:10.1016/j.hfc.2011.11.004
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  This article discusses currently available radionuclide techniques in the diagnostic and prognostic evaluation of patients with chronic heart failure, with a focus on stage B/asymptomatic left ventricular dysfunction. Radionuclide imaging is promising for such patients because it can simultaneously determine left ventricular function, evaluate for the presence of obstructive coronary disease, determine the extent of viable myocardium, and evaluate dyssynchronous left ventricular contraction. Radionuclide imaging can thus provide important noninvasive insights into the pathophysiology, prognosis, and management of patients with asymptomatic left ventricular dysfunction as well as more advanced heat failure.
• Janardhanan, R., Adenaw, N., Jiji, R. S., Brooks, J., Epstein, F. H., Kramer, C. M., & Salerno, M. (2012). Quantifying myocardial fibrosis in hypertensive left ventricular hypertrophy using T1 mapping. Journal of Cardiovascular Magnetic Resonance 2012, 14(Suppl 1):P172.
• Janardhanan, R., Jiji, R. S., Brooks, J., Epstein, F. H., Kramer, C. M., & Salerno, M. (2011). A comparison of methods for determining the partition coefficient of gadolinium in the myocardium using T1 mapping. JCMR 2011, 13(Suppl 1):O81.
• Keeley, E. C., Mehrad, B., Janardhanan, R., Salerno, M., Hunter, J. R., Burdick, M. M., Field, J. J., Strieter, R. M., & Kramer, C. M. (2012). Elevated circulating fibrocyte levels in patients with hypertensive heart disease. Journal of hypertension, 30(9), 1856-61.
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  Autopsy and biopsy studies have shown that there is significantly more fibrosis in hearts of patients with hypertensive heart disease compared to normal hearts. Fibrocytes, a population of circulating bone marrow-derived cells, have been shown to home to tissues and promote scar formation in several diseases, but their role in human hypertensive heart disease has not been investigated to date. Our objective was to determine whether fibrocyte levels are elevated in individuals with hypertensive heart disease.
• Anantharam, B., Janardhanan, R., Hayat, S., Hickman, M., Chahal, N., Bassett, P., & Senior, R. (2011). Coronary flow reserve assessed by myocardial contrast echocardiography predicts mortality in patients with heart failure. European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 12(1), 69-75.
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  the aim of the study was to assess whether myocardial contrast echocardiography (MCE) can predict mortality in patients with heart failure. Myocardial viability, ischaemia, and coronary flow reserve (CFR) are predictors of mortality in patients with heart failure. MCE can assess myocardial viability, ischaemia, and CFR at the bedside. However, its prognostic value is unknown in patients with heart failure.
• Antkowiak, P., Green, J. J., Janardhanan, R., Jiji, R. A., Kramer, C. M., & Kramer, F. H. (2011). First-pass contrast-enhanced imaging versus equilibrium-phase T1 mapping for determining the distribution volume of gadolinium. Journal of Cardiovascular Magnetic Resonance 2011 13(Suppl 1):P17.
• Janardhanan, R., & Kramer, C. M. (2011). Imaging in hypertensive heart disease. Expert review of cardiovascular therapy, 9(2), 199-209.
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  Hypertensive heart disease is the target organ response to arterial hypertension. Left ventricular hypertrophy represents an important predictor for cardiovascular events. Myocardial fibrosis, a common end point in hypertensive heart disease, has been linked to the development of left ventricular hypertrophy and diastolic dysfunction. Echocardiography is clinically useful in the detection of left ventricular hypertrophy and the assessment of diastolic function. Although echocardiography is more widely available, cardiac magnetic resonance has been demonstrated to be more reproducible for the estimation of left ventricular mass. Future developments in cardiac magnetic resonance techniques may facilitate the quantification of diffuse fibrosis that occurs in hypertensive heart disease. Thus, advances in cardiac imaging provide comprehensive, noninvasive tools for imaging left ventricular hypertrophy, diastolic dysfunction, myocardial fibrosis and ischemia observed in hypertensive heart disease. The objective of this article is to summarize the state-of-the-art and the future of multimodality imaging of hypertensive heart disease.
• Salerno, M., Janardhanan, R., Jiji, R. S., Brooks, J., Adenaw, N., Mehta, B., Yang, Y., Antkowiak, P., Kramer, C. M., & Epstein, F. H. (2011). Comparison of methods for determining the partition coefficient of gadolinium in the myocardium using T1 mapping. Journal of magnetic resonance imaging : JMRI, 38(1), 217-24.
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  To develop and validate modified Look-Locker (MOLLI) protocols to generate myocardial T1 maps within clinically acceptable breath-hold durations and to compare partition coefficients (λ) of gadolinium (Gd)-DTPA determined from either bolus injection (BI) or continuous infusion (CI) techniques.
• Dwivedi, G., Janardhanan, R., Hayat, S. A., Lim, T. K., Greaves, K., & Senior, R. (2010). Relationship between myocardial perfusion with myocardial contrast echocardiography and function early after acute myocardial infarction for the prediction of late recovery of function. International journal of cardiology, 140(2), 169-74.
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  Following ST elevation acute myocardial infarction (STEMI) and reperfusion therapy, there are often persistent wall thickening (WT) abnormalities and perfusion defects due to variable degree of myocardial stunning and necrosis. We hypothesised that following STEMI and reperfusion therapy, the extent of residual perfusion assessed by myocardial contrast echocardiography (MCE) and not the extent of WT abnormalities would predict subsequent global recovery of left ventricular (LV) function.
• Janardhanan, R., Henry, Z., Hur, D. J., Lin, C. M., Lopez, D., Reagan, P. M., Rudnick, S. R., Koshko, T. J., & Keeley, E. C. (2010). The snow-shoveler's ST elevation myocardial infarction. The American journal of cardiology, 106(4), 596-600.
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  Heavy snowfall, cold temperatures, and low atmospheric pressure during the winter months have been associated with increased adverse cardiovascular events. However, only a few cases of the "snow shoveler's infarction" have been reported. The investigators describe their experience with 6 patients presenting with ST elevation myocardial infarctions, all within a 24-hour period during an unprecedented snowfall (4 of whom were shoveling snow), and provide a detailed review of previously reported cases of snow shoveler's infarction. Consistent with other reports, most patients reported here had the traditional cardiac risk factors of hypertension, hyperlipidemia, diabetes mellitus, tobacco use, and sedentary lifestyle. Unique to this case series, however, was that the 4 patients who had histories of coronary artery disease and previous coronary artery stenting all presented with subacute stent thromboses documented on coronary angiography performed emergently. Moreover, these patients constituted 25% of all subacute stent thromboses diagnosed in the cardiac catheterization laboratory in the preceding 12 months. In conclusion, these findings suggest that in typically sedentary individuals with cardiac risk factors or histories of coronary artery disease, snow shoveling may trigger ST elevation myocardial infarction and therefore should be avoided. This may be most critical in patients with histories of coronary stent placement, considering that these findings suggest that snow shoveling may precipitate subacute stent thrombosis.
• Cemin, R., Janardhanan, R., & Daves, M. (2009). Peripartum cardiomyopathy: an intriguing challenge. Case report with literature review. Current cardiology reviews, 5(4), 268-72.
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  Peripartum cardiomyopathy is a relatively rare disease, which can have devasting consequences and should be promptly identified and correctly treated. Overall prognosis is good in majority of the cases, although some patients may progress to irreversible heart failure. Early diagnosis is important and effective treatment reduces mortality rates and increases the chance of complete recovery of ventricular systolic function.We report of an interesting case with a favourable outcome and discuss about the clinical presentation, therapy and outcome of this condition.
• Dwivedi, G., Janardhanan, R., Hayat, S. A., Lim, T. K., & Senior, R. (2009). Comparison between myocardial contrast echocardiography and (99m)technetium sestamibi single photon emission computed tomography determined myocardial viability in predicting hard cardiac events following acute myocardial infarction. The American journal of cardiology, 104(9), 1184-8.
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  The extent of residual myocardial viability (MV) after acute myocardial infarction (AMI) is an important determinant of the outcome. Single photon emission computed tomography (SPECT) is widely used to assess MV after an AMI. However, myocardial contrast echocardiography (MCE), a relatively new technique for the assessment of MV, has better spatial and temporal resolution than SPECT. The present study evaluated whether MV determined by MCE is comparable to that determined using SPECT for the prediction of hard cardiac events after an AMI. Accordingly, 99 patients who had undergone simultaneous rest low-power MCE and nitrate-enhanced SPECT 7 days after an AMI were followed up for cardiac death and AMIs. Both MCE perfusion (1 = normal; 2 = reduced; and 3 = absent) and SPECT tracer uptake (0 = normal; 1 = mildly reduced; 2 = moderately reduced; 3 = severely reduced; and 4 = absent) were scored on a 16-segment left ventricular model. The contrast perfusion index and SPECT perfusion index were calculated by adding the respective scores in the 16 segments and dividing by 16. The contrast perfusion index and SPECT perfusion index were used as a measure of the residual MV on MCE and SPECT, respectively. Of the 99 patients recruited, 95 were available for the follow-up examination (follow-up 46 +/- 16 months). A total of 15 events (16%) occurred (8 cardiac deaths and 7 AMIs). Of the clinical, biochemical, echocardiographic, and SPECT markers of prognosis, the only independent predictors of cardiac death and cardiac death or AMI were age and MV as determined by MCE (p = 0.01 and p = 0.002, respectively). In conclusion, MV determined by MCE at rest was superior to nitrate-enhanced SPECT for the prediction of hard cardiac events after AMI.
• Dwivedi, G., Janardhanan, R., Hayat, S. A., Lim, T. K., & Senior, R. (2009). Improved prediction of outcome by contrast echocardiography determined left ventricular remodelling parameters compared to unenhanced echocardiography in patients following acute myocardial infarction. European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology, 10(8), 933-40.
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  Contrast echocardiography has been shown to be a more accurate method of assessing left ventricular (LV) remodelling compared with unenhanced echocardiography after acute myocardial infarction (AMI). However, whether this translated into improved prediction of outcome is not known.
• Dwivedi, G., Janardhanan, R., Hayat, S., Lim, T., Greaves, K., & Senior, R. (2009). Degree of Perfusion Defect Detected by Myocardial Contrast Echocardiography after Acute Myocardial Infarction Independently Predicts Extent of Recovery of Left Ventricular Function. JASE.
• Janardhanan, R., Desai, A. S., & Solomon, S. D. (2009). Therapeutic approaches to diastolic dysfunction. Current hypertension reports, 11(4), 283-91.
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  Progressive abnormalities of passive stiffness or active relaxation of the myocardium that impair ventricular filling during diastole may be an important contributor to the development of heart failure in patients with preserved ejection fraction. In this review, we discuss the epidemiology and pathophysiology of diastolic dysfunction and heart failure with preserved ejection fraction, highlighting potential therapeutic approaches and exploring the limited available evidence base for improving clinical outcomes in patients with these challenging entities.
• Kanei, Y., Janardhanan, R., Fox, J. T., & Gowda, R. M. (2009). Multivessel coronary artery thrombosis. The Journal of invasive cardiology, 21(2), 66-8.
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  Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in ST-segment elevation myocardial infarction (STEMI). We describe a 37-year-old male present with inferior wall STEMI who was found to have large thrombi in both the right coronary artery (RCA) and the left anterior descending artery (LAD). We reviewed 23 patients with multivessel thrombosis in acute myocardial infarction in the literature. The mean age of patients was 53 +/- 14 years (32-82 years); 74% were males, and most patients had multiple risk factors for coronary artery disease. The LAD (78%) and RCA (87%) were the arteries involved for most patients. Aspiration thrombectomy was used in 3 cases. Though it is rare, STEMI with multiple culprit arteries can occur, and it is crucial to recognize this condition to determine the proper treatment, since most of these patients are critically ill.
• Verma, A., Hung, C. L., Janardhanan, R., Aurigemmma, G., Thomas, J., Zile, M., & Soloman, M. D. (2009). Relationship Between Arterial Stiffness and Cardiac Structure and Function in Patients With Hypertension and Diastolic Dysfunction. The VALIDD Trial. (Circulation. 2009;120:S1006.).
• Dwivedi, G., Janardhanan, R., Greaves, K., Lim, T. K., Hayat, S., & Senior, R. (2007). The extent of residual contrast perfusion and not left ventricular function predicts late recovery of global contractile function after acute myocardial infarction and reperfusion therapy. J Am Coll Cardiol 2007; (ACC, New Orleans, 2007).
• Dwivedi, G., Janardhanan, R., Hayat, S. A., Swimburn, J. A., & Senior, R. (2007). Myocardial Viability Determined by Myocardial Contrast Echocardiography is Superior to 99mTechnetium Sestamibi Single Photon Emission Computed Tomography in Predicting Hard Cardiac Events Following Acute Myocardial Infarction.. Circulation. 2007; 116(16): p. II 546-b (AHA, Florida 2007.
• Dwivedi, G., Janardhanan, R., Hayat, S. A., Swinburn, J. M., & Senior, R. (2007). Prognostic value of myocardial viability detected by myocardial contrast echocardiography early after acute myocardial infarction. Journal of the American College of Cardiology, 50(4), 327-34.
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  This study sought to determine whether residual myocardial viability determined by myocardial contrast echocardiography (MCE) after acute myocardial infarction (AMI) can predict hard cardiac events.
• Dwivedi, G., Janardhanan, R., Swimburn, J. A., Lim, T. K., & Senior, R. (2007). Improved Prediction of Outcome by Contrast Echocardiography Determined Left Ventricular Function Compared to Unenhanced Echocardiography in Patients Following Acute Myocardial Infarction. ESC, Vienna 2007.
• Hickman, M., Janardhanan, R., Dwivedi, G., Burden, L., & Senior, R. (2007). Clinical significance of perfusion techniques utilising different physiological mechanisms to detect myocardial viability: a comparative study with myocardial contrast echocardiography and single photon emission computed tomography. International journal of cardiology, 114(1), 139-40.
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  Myocardial uptake using (99m)Tc-sestamibi single photon emission computed tomography (SPECT) depends largely on myocardial microvascular volume. Myocardial contrast echocardiography (MCE) is a relatively new technique that detects not only microvascular volume but also blood flow. These differing mechanisms may affect the relative accuracies of MCE and SPECT for detecting myocardial viability (MV) early after acute myocardial infarction (AMI) and thrombolysis. Accordingly 56 patients underwent resting transthoracic echocardiography, low-power MCE and SPECT 7+/-2 days following first AMI and thrombolysis. Contractile reserve (CR) was assessed 3 months following revascularization. The sensitivity and specificity of MCE and SPECT were 83% and 78% (p=ns) and 78% and 45% (p
• Liou, M., Petre, L., Janardhanan, R., Freidman, M., Rachko, M., VanTosh, A., & Bergmann, S. R. (2007). Equivalence of Attenuation Correction and Prone Imaging for Detection of Coronary Artery Disease.. J Nucl Med 2007; 48 (Meeting Abstracts 2): p. 235P (Society of Nuclear Medicine, Washington, 2007).
• Solomon, S. D., Janardhanan, R., Verma, A., Bourgoun, M., Daley, W. L., Purkayastha, D., Lacourcière, Y., Hippler, S. E., Fields, H., Naqvi, T. Z., Mulvagh, S. L., Arnold, J. M., Thomas, J. D., Zile, M. R., Aurigemma, G. P., & , V. I. (2007). Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomised trial. Lancet (London, England), 369(9579), 2079-87.
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  Diastolic dysfunction might represent an important pathophysiological intermediate between hypertension and heart failure. Our aim was to determine whether inhibitors of the renin-angiotensin-aldosterone system, which can reduce ventricular hypertrophy and myocardial fibrosis, can improve diastolic function to a greater extent than can other antihypertensive agents.
• Verma, A., Janardhanan, R., Daley, W. L., Ritter, S., Kaye, W. A., Naqvi, T. Z., Lacourciere, Y., Aurigemmma, G. P., Thomas, J. D., Zile, M. R., & Soloman, S. D. (2008). Urine Albumin/Creatinine Ratio, Cardiac Structure and Diastolic Function in Patients with Hypertension and Diastolic Dysfunction: The VALIDD study.. The VALIDD study. Circulation. 2007; 116(16): p. II 497-c (AHA, Florida 2007).
• Dwivedi, G., Hayat, S. A., Janardhanan, R., & Senior, R. (2006). Myocardial contrast echocardiography: Role in clinical cardiology. Current vascular pharmacology, 4(3), 229-35.
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  Recent updates in the field of echocardiography have resulted in improvements in both image quality and techniques allowing echocardiography to maintain its position as the primary non-invasive imaging modality. In particular, the development of new ultrasound contrast agents and imaging techniques have now made possible the assessment of myocardial perfusion. Myocardial contrast echocardiography utilises acoustically active gas filled microspheres (microbubbles), which have rheology similar to that of red blood cells. The detection of myocardial perfusion during echocardiographic examinations permits simultaneous assessment of global and regional myocardial structure, function, and perfusion, enabling the optimal non-invasive assessment of coronary artery disease. Myocardial contrast echocardiography is equally adept in assessing chronic coronary artery disease as well as acute coronary syndromes. Furthermore, its use is not limited solely to diagnostic assessment. Preliminary evidence suggests that targeted microbubbles may be useful in enhancing delivery of genes / drugs and in clot lysis.
• Dwivedi, G., Hayat, S. A., Janardhanan, R., Ruparelia, N., Lim, T. K., & Senior, R. (2006). Extent of Myocardial Viability Detected by Myocardial Contrast Echocardiography Early after Acute Myocardial Infarction is an Independent Predictor of Hard Cardiac Events. Circulation. 2006;114 (suppl II): I8-569 (AHA, Chicago 2006).
• Dwivedi, G., Hayat, S., Janardhanan, R., Ruparelia, N., & Senior, R. (2006). Extent of myocardial viability detected by myocardial contrast echocardiography early after acute myocardial infarction is an independent predictor of mortality and reinfarction. Eur Heart J, Abstr suppl.
• Dwivedi, G., Janardhanan, R., Greaves, K., Lim, T. K., Hayat, S., & Senior, R. (2006). The extent of residual contrast perfusion and not left ventricular function predicts late recovery of global contractile function after acute myocardial infarction and reperfusion therapy. Eur Heart J.
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  27(abstr suppl): 29
• Dwivedi, G., Janardhanan, R., Hayat, S., & Senior, R. (2006). Detection of residual infarct-related coronary artery stenosis and multivessel disease after thrombolysis: comparison between myocardial contrast echocardiography and single photon emission computed tomography. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 19(5), 546-51.
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  Detection of residual infarct-related artery (IRA) stenosis and multivessel disease (MVD) after thrombolysis has important therapeutic and prognostic implications. Technetium 99m sestamibi single photon emission computed tomography (SPECT) is used for detection of flow-limiting coronary artery disease (CAD). Myocardial contrast echocardiography (MCE) is a new technique developed to assess CAD. We aimed to compare the relative accuracy of vasodilator stress MCE and SPECT for detection of IRA stenosis and MVD after acute myocardial infarction.
• Hayat, S. A., Janardhanan, R., Moon, J. C., Pennell, D. J., & Senior, R. (2006). Comparison between myocardial contrast echocardiography and single-photon emission computed tomography for predicting transmurality of acute myocardial infarction. The American journal of cardiology, 97(12), 1718-21.
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  Contrast-enhanced cardiovascular magnetic resonance imaging (CMR) has been shown to accurately assess transmural extent of infarction, which is an excellent predictor of long-term improvement in contractile function. We assessed the relative accuracy of myocardial contrast echocardiography (MCE) and single-photon emission computed tomography (SPECT) to predict transmural extent of infarction after acute myocardial infarction. MCE, SPECT, and CMR were performed in 40 patients with acute myocardial infarction 7 to 10 days after thrombolysis. CMR was used to divide the transmural extent of infarction into 5 groups: 0%, 1% to 25%, 26% to 50%, 51% to 75%, and 76% to 100% in dysfunctional segments. MCE and SPECT were compared with assessment grades of transmural extent of infarction. There was a significant relation (p50% transmural extent of infarction (nonviable myocardium) was significantly (p=0.02) superior to that of SPECT (70%). Absence of uptake on MCE and SPECT virtually ruled out 50% of the transmural extent of infarction and more sensitive in identifying
• Janardhanan, R., Daley, W. L., Naqvi, T. Z., Mulvagh, S. L., Aurigemma, G., Zile, M., Arnold, J. M., Artis, E., Purkayastha, D., Thomas, J. D., Solomon, S. D., & , V. I. (2006). Rationale and design: the VALsartan In Diastolic Dysfunction (VALIDD) Trial: evolving the management of diastolic dysfunction in hypertension. American heart journal, 152(2), 246-52.
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  Although 50% of hypertensive patients in the community are estimated to have diastolic dysfunction, there is no specific guideline for diastolic dysfunction therapy at present despite the condition's clear association with increased cardiovascular risk. Although the efficacy of angiotensin II receptor blockers (ARBs) in hypertension and left ventricular hypertrophy regression has been established, the effect of angiotensin II receptor blockade on intrinsic parameters of diastolic function has not been evaluated in large-scale studies.
• Janardhanan, R., Kenchaiah, S., Velazquez, E. J., Park, Y., McMurray, J. J., Weaver, W. D., Finn, P. V., White, H. D., Marin-Neto, J. A., O'Connor, C., Pfeffer, M. A., Califf, R. M., Solomon, S. D., & , V. I. (2006). Extent of coronary artery disease as a predictor of outcomes in acute myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. American heart journal, 152(1), 183-9.
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  Left ventricular systolic dysfunction (LVSD) and heart failure (HF) are powerful predictors of poor outcome after acute myocardial infarction (MI). It is not known, however, whether the extent of coronary artery disease (CAD) independently influences cardiovascular (CV) outcomes in these high-risk patients.
• Janardhanan, R., Verma, A., Zile, M., Aurigemmma, G., Naqvi, T. Z., Lacourciere, Y., Hippler, S., Fields, H., Kaye, W., Ritter, S., Thomas, J. D., Arnold, M. O., & Soloman, S. D. (2006). Left ventricular Diastolic Function in a Broad Range of Patients with Hypertension: The Valsartan in Diastolic Dysfunction (VALIDD) Trial.. Circulation. 2006;114 (suppl II): II-525 (AHA, Chicago 2006.
• Lim, T. K., Burden, L., Janardhanan, R., Dwivedi, G., Ping, C., Moon, J., Pennell, D. J., & Senior, R. (2006). Contrast echocardiography versus gated single photon emission computed tomography for the assessment of parameters of left ventricular remodeling after acute myocardial infarction. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 19(3), 280-4.
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  Assessment of parameters of left ventricular (LV) remodeling after acute myocardial infarction (AMI) has both therapeutic and prognostic implication. Contrast echocardiography (CE) has the advantage of simultaneously assessing myocardial perfusion and LV remodeling. We aimed to evaluate the accuracy of CE to assess LV remodeling after AMI compared with technetium-99m sestamibi gated single photon emission computed tomography (SPECT).
• Dwivedi, G., Janardhanan, R., Hickman, M., Jeetley, P., & Senior, R. (2004). Can myocardial contrast echocardiography replace radionuclide perfusion Imaging for the detection of residual stenosis and multivessel disease following acute myocardial infarction?. Eur Heart J 2004 : 25: Suppl p 229 (ESC , Munich 2004).
• Greaves, K., Janardhanan, R., Jeetley, P., Sabharwal, N., Hickman, M., Lim, T. K., Dwivedi, G., & Senior, R. (2004). Hand-Carried Echocardiography Significantly Reduces the Need for Standard Echocardiography in Hospitalized Patients. Heart 2004; 90 (suppl II); A35 BCS, Manchester.
• Greaves, K., Jeetley, P., Hickman, M., Dwivedi, G., Sabharwal, N., Lim, T., Janardhanan, R., & Senior, R. (2005). The use of hand-carried ultrasound in the hospital setting--a cost-effective analysis. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 18(6), 620-5.
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  We sought to assess the accuracy of hand-carried ultrasound (HCU) in the prediction of a normal study, and its cost-effectiveness in reducing the number of standard departmental echocardiograms (SDE) performed on hospital inpatients.
• Hayat, S. A., Janardhanan, R., Moon, J. C., Pennell, D. J., & Senior, R. (2005). Prediction of Transmurality of Acute Myocardial Infarction - Comparison between Myocardial Contrast Echocardiography and Radionuclide Perfusion Imaging. Eur Heart J.
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  Accepted for ESC, Stockholm 2005
• Hickman, M., Janardhanan, R., Dwivedi, G., Burden, L., & Senior, R. (2005). Myocardial Contrast Echocardiography: Validation of a New Bedside Modality for the Detection of Myocardial Viability Following Myocardial Infarction. Heart 2004; 90 (suppl II); A34 (BCS, Manchester, May 2004).
• Hickman, M., Janardhanan, R., Dwivedi, G., Lahiri, A., & Senior, R. (2004). Can resting myocardial contrast echocardiography replace 99mTc-sestamibi gated SPECT for the diagnosis of myocardial viability following acute myocardial infarction.. J Am Coll Cardiol 2004; 43 (5) (Suppl A): 314A (ACC, New Orleans 2004).
• Janardhanan, R. (2005). Baseline Left Ventricular Wall Thickness After Myocardial Infarction Predicts Death or Heart Failure: Findings from the VALsartan In Acute myocardial iNfarcTion. (VALIANT) Trial. Circulation.
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  112(suppl II):II-526 (AHA, Dallas 2005
• Janardhanan, R., Jeetley, P., Burden, L., & Senior, R. (2005). Myocardial Contrast Echocardiography for Distinguishing Ischemic from Non-ischemic First Onset Acute Heart Failure: Insights into the Mechanism of Heart Failure. J Am Society of Echocardiography ASE Boston 2005.
• Janardhanan, R., Kenchaiah, S., Park, Y., McMurray, J., Pfeffer, M. A., Weaver, D. W., Finn, P. V., & Soloman, S. D. (2005). Extent of Coronary Artery Disease as a Predictor of Outcomes in Acute Myocardial Infarction complicated by Heart Failure, Left Ventricular dysfunction, or Both. Eur Heart J.
• Janardhanan, R., Kenchaiah, S., Pfeffer, M. A., McMurray, J. V., Velazquez, E. J., Califf, R. M., Weaver, W. D., Barvik, S., Ertl, G., White, H., Park, Y., Finn, P. V., & Soloman, S. D. (2005). Extent of Coronary Artery Disease and Cardiovascular Outcomes in Acute Myocardial Infarction Complicated by Heart Failure, Left Ventricular Dysfunction, or Both: Findings from the VALsartan In Acute myocardial iNfarcTion (VALIANT) Trial. AHA, Dallas.
• Janardhanan, R., Moon, J. C., Pennell, D. J., & Senior, R. (2005). Myocardial contrast echocardiography accurately reflects transmurality of myocardial necrosis and predicts contractile reserve after acute myocardial infarction. American Heart Journal.
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  Both myocardial contrast echocardiography (MCE) and cardiovascular magnetic resonance (CMR) can identify myocardial necrosis after acute myocardial infarction (AMI). However, transmural extent of infarction (TEI) correlates of myocardial perfusion by MCE after AMI are unknown. We sought to ascertain the ability of MCE to (1) predict TEI as defined by contrast-enhanced CMR and (2) to compare the relative accuracy of these techniques to predict contractile reserve late after AMI.
• Lim, T. K., Burden, L., Janardhanan, R., Ping, C., Moon, J., Pennell, D., & Senior, R. (2005). Improved accuracy of low-power contrast echocardiography for the assessment of left ventricular remodeling compared with unenhanced harmonic echocardiography after acute myocardial infarction: comparison with cardiovascular magnetic resonance imaging. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 18(11), 1203-7.
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  Assessment of left ventricular (LV) remodeling after acute myocardial infarction (AMI) has both therapeutic and prognostic implications. Low-power contrast echocardiography (CE) has the advantage of simultaneously assessing myocardial perfusion and LV remodeling.
• Senior, R., Janardhanan, R., Jeetley, P., & Burden, L. (2005). Myocardial contrast echocardiography for distinguishing ischemic from nonischemic first-onset acute heart failure: insights into the mechanism of acute heart failure. Circulation, 112(11), 1587-93.
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  Distinguishing ischemic from nonischemic origin in patients presenting with acute heart failure (AHF) not resulting from acute myocardial infarction has both therapeutic and prognostic implications. The aim of the study was to assess whether myocardial contrast echocardiography (MCE) can identify underlying coronary artery disease (CAD) as the cause of AHF.
• Dwivedi, G., Janardhanan, R., Hickman, M., & Senior, R. (2005). Can Myocardial Contrast Echocardiography Replace Radionuclide Perfusion Imaging for the Detection of Residual Stenosis and Multivessel Disease Following Acute Myocardial Infarction?. Heart 2004; 90 (suppl II); A34 BCS, Manchester.
• Greaves, K., Janardhanan, R., Jeetley, P., Sabharwal, N., Hickman, M., Lim, T. K., Dwivedi, G., & Senior, R. (2005). Hand-carried echocardiography significantly reduces the need for standard echocardiography in hospitalized patients. Eur Heart J 2004 : 25: Suppl p 485 (ESC, Munich 2004).
• Hickman, M., Janardhanan, R., Dwivedi, G., Burden, L., & Senior, R. (2004). Insights into mechanisms for the detection of myocardial viability following acute myocardial infarction: a comparative study with myocardial contrast echocardiography and SPECT. Eur Heart J :25: Suppl p 373 (ESC, Munich 2004.
• Hickman, M., Janardhanan, R., Dwivedi, G., Burden, L., & Senior, R. (2005). Myocardial Contrast Echocardiography for the Detection of Myocardial Viability Following Myocardial Infarction: A Comparison with Gated Single Photon Emission Computed Tomography. J Am Society of Echocardiography 2004;17(5): p515 (ASE meeting, San Diego, June 2004).
• Hickman, M., Janardhanan, R., Lahiri, A., & Senior, R. (2004). Myocardial Contrast Echocardiography Accurately Predicted Coronary Artery Disease in Patients Presenting with Acute Heart Failure. J Am Coll Cardiol 2004; 43 (5) (Suppl A): 9A (ACC, New Orleans 2004).
• Janardhanan, R. (2004). Myocardial Contrast Echocardiography Accurately Reflects Transmurality of Myocardial Necrosis and Predicts Contractile Reserve after Acute Myocardial Infarction. European Heart Journal.
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  24: Suppl. p699 (ESC, Vienna 2003)
• Janardhanan, R., & Senior, R. (2004). Accuracy of dipyridamole myocardial contrast echocardiography for the detection of residual stenosis of the infarct-related artery and multivessel disease early after acute myocardial infarction. Journal of the American College of Cardiology, 43(12), 2247-52.
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  We aimed to evaluate the ability of vasodilator myocardial contrast echocardiography (MCE) to detect significant infarct-related artery (IRA) stenosis and multivessel disease (MVD) after thrombolysis.
• Janardhanan, R., Burden, L., & Senior, R. (2004). Collateral Blood Flow in the Presence of Persistently Occluded Infarct Related Artery Can Be Accurately Predicted by Myocardial Contrast Echocardiography. J Am Coll Cardiol 2004; 43 (5) (Suppl A): 315A (ACC, New Orleans 2004).
• Janardhanan, R., Burden, L., & Senior, R. (2004). Myocardial Contrast Echocardiography can Reliably Predict Collateral Blood Flow in the Presence of Persistently Occluded Infarct Related Artery. British Cardiac Society.
• Janardhanan, R., Burden, L., & Senior, R. (2004). Usefulness of myocardial contrast echocardiography in predicting collateral blood flow in the presence of a persistently occluded acute myocardial infarction-related coronary artery. The American journal of cardiology, 93(10), 1207-11.
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  Adequate collateral blood flow at rest can sustain myocardial viability despite persistent occlusion of the infarct-related artery (IRA) in acute myocardial infarction (AMI). This has therapeutic and prognostic implications. Studies addressing the value of intravenous myocardial contrast echocardiography (MCE) to detect collateral blood flow after AMI in humans are limited. Accordingly, 70 consecutive patients with AMI underwent low-power intravenous MCE using a Sonovue infusion 7 to 10 days after thrombolysis. Myocardial perfusion detected by MCE was analyzed (qualitatively and quantitatively) in the akinetic segments in 20 patients (29%) with an occluded IRA who subsequently underwent revascularization. Contractile reserve, which is a marker of myocardial viability, was assessed with low-dose dobutamine 12 weeks after mechanical revascularization. Of the 102 akinetic segments (32%), 37 (36%) showed contractile reserve. Contractile reserve was present in 24 of the 29 segments (83%) with homogenous contrast opacification and absent in 60 of the 73 segments (82%) with reduced/absent opacification. Quantitative peak contrast intensity, microbubble velocity, and myocardial blood flow were significantly higher (p
• Janardhanan, R., Hickman, M., Lahiri, A., & Senior, R. (2004). Accuracy of myocardial contrast echocardiography for the prediction of coronary artery disease in patients presenting with acute heart failure: a quantitative validation.. Eur Heart J 2004: 25: Suppl p 373 (ESC, Munich 2004).
• Janardhanan, R., Lahiri, A., Raval, U., Kinsey, C., & Senior, R. (2003). Diagnosis of Coronary Artery Disease in Heart Failure: Role of Myocardial Contrast Echocardiography in Patients with First Presentation of Heart Failure not due to Acute myocardial Infarction.. J Am Coll Cardiol.2003; 41(6 Suppl B): 466 (ACC, Chicago 2003).
• Moon, J. C., De Arenaza, D. P., Elkington, A. G., Taneja, A. K., John, A. S., Wang, D., Janardhanan, R., Senior, R., Lahiri, A., Poole-Wilson, P. A., & Pennell, D. J. (2004). The pathologic basis of Q-wave and non-Q-wave myocardial infarction: a cardiovascular magnetic resonance study. Journal of the American College of Cardiology, 44(3), 554-60.
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  The purpose of this study was to determine the pathologic basis of Q-wave (QW) and non-Q-wave (NQW) myocardial infarction (MI).
• Janardhanan, R., & Senior, R. (2003). Myocardial Contrast Echocardiography Accurately Predicts Residual Infarct Related Artery Stenosis and Multivessel Disease Following Thrombolysis. Circulation 2003; 108: Suppl. p625 AHA, Orlando.
• Janardhanan, R., & Senior, R. (2003). Vasodilator Myocardial Contrast Echocardiography Accurately Predicts Flow-limiting Coronary Artery Stenosis following Thrombolysis in Acute Myocardial Infarction.. European Heart Journal.2003;24: Suppl. p308 (ESC, Vienna 2003.
• Janardhanan, R., Burden, L., & Senior, R. (2003). Myocardial Contrast Echocardiography Reliably Predicts Collateral Blood Flow After Acute Myocardial Infarction.. European Heart Journal 2003; 24:Suppl. p310 (ESC, Vienna 2003).
• Janardhanan, R., Lahiri, A., & Senior, R. (2003). The Electrocardiogram in patients with Acute Heart Failure without signs of Acute Myocardial Infarction is a Poor Predictor of Left Ventricular Systolic Dysfunction.. Heart 2003; 89 (Suppl 1): A6 (BCS, Glasgow 2003).
• Janardhanan, R., Moon, J. C., Pennell, D. J., & Senior, R. (2003). Prediction of the Extent of Myocardial Necrosis and Contractile Reserve after Reperfusion Therapy Following Acute Myocardial Infarction: Comparison between Myocardial Contrast Echocardiography and Contrast Enhanced Cardiovascular Magnetic Resonance.. J Am Coll Cardiol..
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  41(6 Suppl B):433 (ACC
• Janardhanan, R., Raval, U., Kinsey, C., Lahiri, A., & Senior, R. (2003). Detection of Coronary Artery Disease in Heart failure: Role of Myocardial Contrast Echocardiography in patients with first presentation of Heart Failure without Acute Myocardial Infarction.. European Heart Journal 2003; 24: Suppl. p104 (ESC, Vienna 2003).
• Janardhanan, R., Swimburn, J. A., Greaves, K., & Senior, R. (2003). Myocardial Contrast Echocardiography Early After Acute Myocardial Infarction Accurately Predicts Late Functional Recovery. Heart 2003; 89 (Suppl 1): A50 (BCS, Glasgow 2003).
• Janardhanan, R., Swimburn, J. A., Greaves, K., & Senior, R. (2003). Myocardial Contrast Echocardiography using Low Power Continuous Imaging early after Acute Myocardial Infarction accurately predicts Functional Recovery. J Am Coll Cardiol.
• Janardhanan, R., Swinburn, J. M., Greaves, K., & Senior, R. (2003). Usefulness of myocardial contrast echocardiography using low-power continuous imaging early after acute myocardial infarction to predict late functional left ventricular recovery. The American journal of cardiology, 92(5), 493-7.
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  Microvascular perfusion is a prerequisite for ensuring viability early after acute myocardial infarction (AMI). For adequate assessment of myocardial perfusion, both myocardial blood volume and velocity need to be evaluated. Due to its high frame rate, low-power continuous myocardial contrast echocardiography (MCE) can rapidly assess these parameters of myocardial perfusion. We hypothesized that the technique can accurately differentiate necrotic from viable myocardium after reperfusion therapy in AMI. Accordingly, 50 patients underwent low-power continuous MCE using intravenous Optison (Amersham Health, Amersham, Middlesex, United Kingdom) 7 to 10 days after AMI. Myocardial perfusion (contrast opacification assessed over 15 cardiac cycles after the destruction of microbubbles with high energy pulses) and wall thickening were assessed at baseline. Regional and global left ventricular (LV) function was reassessed after 12 weeks. Out of the 297 dysfunctional segments, MCE detected no contrast enhancement during 15 cardiac cycles in 172 segments, of which 160 (93%) failed to show improvement. MCE demonstrated contrast opacification during 15 cardiac cycles in 77 segments, of which 65 (84%) showed recovery of function. The greater the extent and intensity of contrast opacification, the better the LV function at 3 months (p
• Moon, J. C., Perez, D., Elkington, A. G., Taneja, A. K., Wang, D., Janardhanan, R., Senior, R., Poole-Wilson, P., & Pennell, D. J. (2004). The Anatomical Basis of Q-wave vs. Non-Q-wave Myocardial Infarction: Extent Rather than Transmurality.. Heart 2003; 89 (Suppl 1): A9 (BCS, Glasgow 2003).
• Janardhanan, R., Swimburn, J. A., Greaves, K., & Senior, R. (2002). Real Time Myocardial Contrast Echocardiography Early After Acute Myocardial Infarction Accurately Predicts Late Functional Recovery. European Heart Journal 2002; 23: Suppl p548 (ESC, Berlin 2002.
• Janardhanan, R., & Krishnakumar, S. (1997). Senior-Loken syndrome. The Journal of the Association of Physicians of India, 45(11), 889-90.

Presentations

• Janardhanan, R., Kannan, A., Kumar, K., Madhavan, S., & Sridharan, K. (2018, March). Meta-Analysis of Late Gadolinium Enhancement in dilated cardiomyopathy.. American College of Cardiology Scientific Sessions. Orlando, FL: ACC.
• Janardhanan, R., Kannan, A., Kumar, K., Madhavan, S., & Sridharan, K. (2018, March). Meta-Analysis on Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy. Meta-Analysis on Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy. Presented at American College of Cardiology Scientific Sessions. Orlando, FL.
• Janardhanan, R., Kannan, A., Kumar, K., Madhavan, S., & Sridharan, K. (2018, March). Role of Late Gadolinium Enhancement in the Evaluation of Patients with Cardiac Sarcoidosis: A Meta-Analysis. American College of Cardiology Scientific Sessions. Orlando, FL: American College of Cardiology.
• Janardhanan, R., & Pahuja, M. (2017, Spring). Peripartum Cardiomyopathy: Comprehensive Evaluation by Cardiac MRI. SCMR. Baltimore, MD: SCMR.
• Janardhanan, R., & Singh, N. (2017, Spring). A Rare Case of Progressive Pulmonary Valve Disease Post Radiation Therapy. SCMR. Baltimore, MD: SCMR.
• Janardhanan, R., Anand, S., & Gavlick, K. (2017, Spring). Late Gadolinium Enhancement in Patients with Takotsubo Cardiomyopathy: Is that a Predictor for Ventricular Arrhythmias?. SCMR. Baltimore, MD: SCMR.
• Janardhanan, R., Pineda, J., & Shetty, R. (2017, Spring). Acute Myocardial Infarction with Angiographically Normal Coronary Arteries: Accurate Diagnosis by Cardiac MRI. SCMR. Baltimore, MD: SCMR.
• Janardhanan, R., Singh, N., & Wolff, G. (2017, Spring). Extensive Idiopathic Myocardial Calcification in an Octogenarian Female. SCMR. Baltimore, MD: SCMR.
• Janardhanan, R., William, P., & Thajudeen, B. (2017, Spring). Infected Myocardial Calcific Deposit: Value of Multimodality Imaging. SCMR. Baltimore, MD: SCMR.
• Rosado-Toro, J., Janardhanan, R., Altbach, M., & Avery, R. (2017, Spring). Semi-Automated Segmentation of the Right Ventricular Short Axis Derived from Identification of Four Anatomic Landmarks in Long Axis. SCMR. Baltimore: SCMR.
• Avery, R., Janardhanan, R., Nair, V., Krupinski, E., & Desai, A. (2016, Spring). Multiparameter use of Cardiac Magnetic Resonance as a Predictor of Pulmonary Artery Hypertension. SCMR 2016.
• Janardhanan, R. (2016, Fall). Lecture #1: Echocardiography in Emergency Room: Aortic Dissection Lecture #2: How to become RD. International Conference of Echocardiography - Echo India 2016. Madurai, South India: International Conference of Echocardiography.
• Janardhanan, R. (2016, Spring). CMR in Hypertrophic Cardiomyopathy. World Congress on Cardiology & Cardiovascular Medicine. Dubai, UAE.
• Janardhanan, R., & Kannan, A. (2016, Spring). Cardiomyopathy from Methamphetamine Abuse: Rare Presentation with Multiple Bi-Ventricular Thrombi.. SCMR 2016.
• Janardhanan, R., & Natarajan, B. (2016, October). Biventricular Stress-induced cardiomyopathy following acute asthma exacerbation. ACP. San Diego: ACP.
• Janardhanan, R., Sydow, N., & Anand, S. (2016, Spring). Papillary Fibroelastoma: A Known Cause of TIA in an Uncommon Location.. SCMR 2016.
• Kannan, A., Prudhvi, K., Charmarthy, G., Kutti-Sridharan, G., & Janardhanan, R. (2016, Fall). Role of Late Gadolinium Enhancement in Non Ischemic Cardiomyopathy: A Meta Analysis. AHA. New Orleans, LA: AHA.
• Natarajan, B., Huang-Tsang, J., Trowers, E., & Janardhanan, R. (2016, Spring). To Scan or Not to Scan? : Utility of Cardiac MRI in Asymptomatic Sarcoidosis.. for ACP 2016.
• Janardhanan, R., Lotun, K., Thompson, J., & Shetty, R. (2015, June). Closure of Aortic Paravalvular Leak Resulting in Resolution of Transvalvular Leak: Is it a Venturi Effect?. ASE. Boston: American Society of Echocardiography.
• Janardhanan, R., Lotun, K., Thompson, J., & Shetty, R. (2016, June). Closure of Aortic Paravalvular Leak resulting in Resolution of Transvalvular Leak: Is it a Venturi Effect?. American Society of Echocardiography Meeting.
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  Boston, MA
• Janardhanan, R., Tey, k. R., Lee, J. Z., Hennemeyer, C. T., & Lotun, K. (2015, June). A complicated Case of Mitral Valve Replacement: Echo Guided Successful Interventions. American Society of Echocardiography Meeting.
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  Boston, MA
• Saleh, L., Low, S. W., & Janardhanan, R. (2015, March). Infective Vegetation in the Intervalvular Fibrosa; 3D-Transesophageal Echo Aids Accurate Diganosis and Tracks the Natural History.. American College of Cardiology, San Diego.
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  San Diego, CA
• Anand, S., Malo, J., Siddiqi, T., Janardhanan, R., & D, M. (2014, Spring). A Pulmonary Puzzle of Proteinaceous Pathology. ACP, Arizona Chapter.
• Das, A., Kannan, A., Riaz, I., & Janardhanan, R. (2014, Spring). An interesting Case of Cryptogenic Stroke in Young: Role of CMR in the Accurate Diagnosis. SCMR 2014, New Orleans.
• Hamoud, N., Anand, S., Thompson, J., & Janardhanan, R. (2014, Spring). Insights into the Mechanism of Severe Mitral Regurgitation: 3D Guided Managment with Pathological Correlation. American College of Cardiology, Washington DC.
• Janardhanan, R., H, K., Mizyed, A., & Thompson, J. (2014, Spring). Focal Aortic Root Dissection: Accurate Diagnosis by Real Time 3D- Transesophageal Echocardiography. Euro-Echo. Vienna, Austria: Eur Heart J Cardiovasc Imaging.
• Kuruvilla, S., Janardhanan, R., Keeley, E., Epstein, F. H., Kramer, C. M., & Salerno, M. (2014, Spring). Elevated Extracellular Volume and Arterial Stiffness are associated with Left Ventricular Hypertrophy in Hypertensive Heart Disease. American Society of Hypertention.
• Trutter, L. R., & Janardhanan, R. (2014, Spring). Apical Hypertrophic Cardiomyopathy: Challenges in Managment. American College of Cardiology.
• Fernandes, A., Takyar, V., & Janardhanan, R. (2013, Spring). Isolated Pulmonary Valve Endocarditis. American College of Physicians, Arizona Chapter 2013.
• Janardhanan, R., Balachandran, M., Thompson, J. L., & Lotun, K. (2013, Spring). A Challenging Case of Mitral Paravalvular Leaks: Successful 3D-TEE Guided Transcatheter Closure. World Summit on Echocardiography, New Delhi 2013).
• Janardhanan, R., Kannan, A., Subramanian, S., & Smith, M. C. (2014, Spring). Prosthetic Endocarditis and Dehiscence in a Mechanical Valved Conduit: 3D-TEE Guided Diagnosis and Management.. World Summit on Echocardiography, New Delhi 2013.
• Janardhanan, R., Lotun, K., Khalpey, Z., Smith, M. C., Rutter, T., Nemanova, D., & Friedman, M. J. (2013, Spring). Prosthetic Mitral Valve Obstruction: Accurate Diagnosis by 3D-Transesophageal Echocardiography. American Society of Echocardiography Meeting.
• Parvizi, G., Snyder, B., & Janardhanan, R. (2013, Spring). A rare complication of aortic valve endocarditis. American College of Physicians, Arizona Chapter 2013.
• Janardhanan, R., Parker, K. M., Dent, J. M., Akosah, K. O., & Holmes, J. W. (2011, Spring). Quantitative Assessment of Regional Function Using RealTime-Three Dimensional Echocardiography. Validation With Microsphere-based Blood Flow During Regional Ischemia (ASE, Montreal, Canada, 2011).
• Parker, K. M., Janardhanan, R., Chadwell, K. K., Salerno, M., Bourque, J. M., Akosah, K. O., Dent, J. M., & Holmes, J. W. (2011, Spring). Should We Believe What We See? Quantitative Analysis of Three-Dimensional Dobutamine Stress Echo in Low-Risk Patients. JASE 2011 (ASE, Montreal, Canada, 2011.
• Soloman, S. D., Janardhanan, R., Verma, A., Daley, W., Zile, M., Aurigemmma, G., Naqvi, T. Z., Lacourciere, Y., Hippler, S., Fields, H., Kaye, W., Ritter, S., Thomas, J. D., & Arnold, M. O. (2008, March). The Influence of Angiotensin Receptor Blockers and Blood Pressure Lowering on Diastolic Function in Patients with Hypertension and Diastolic Dysfunction: The VALsartan In Diastolic Dysfunction. (VALIDD) Late Breaking Clinical Trial Abstract, New Orleans.
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  Late Breaking Clinical Trial Abstract (presented on March 25th at ACC 2007, New Orleans)
• Verma, A., Zile, M. R., Aurigemmma, G. P., Arnold, J. O., Daley, W. L., LaCourcier, Y., Naqvi, T., Janardhanan, R., Thomas, J. D., & Soloman, S. D. (2008, Spring). Left ventricular concentric remodeling and cardiac function in Patients with Hypertension and Diastolic Dysfunction: the VALIDD Trial.. ACC, Chicago 2008.
• Moon, J. C., Perez, D., Janardhanan, R., Elkington, A. G., Taneja, A. K., Senior, R., Poole-Wilson, P., & Pennell, D. J. (2005, Spring). The pathological basis of Q-wave vs Non-Q-Wave MI. SCMR, Barcelona 2004.
• Dwivedi, D., Janardhanan, R., Hickman, M., Jeetley, P., & Senior, R. (2004, Spring). Can myocardial contrast echocardiography replace radionuclide perfusion Imaging for the detection of residual stenosis and multivessel disease following acute myocardial infarction?. AHA, New Orleans 2004.
• Hayat, S. A., Janardhanan, R., Moon, J. C., Pennell, D. J., & Senior, R. (2005, Spring). Prediction of Transmurality of Acute Myocardial Infarction - Comparison between Myocardial Contrast Echocardiography and Radionuclide Perfusion Imaging. AHA, New Orleans 2004.
• Senior, R., & Janardhanan, R. (2004, November). Accuracy of Vasodilator Myocardial Contrast Echocardiography for Distinguishing Ischemic from Non-ischemic Etiology in Patients Presenting with First Onset Acute Heart Failure.. Presented at the Annual Bubble conference,.
• Janardhanan, R., Lahiri, A., Raval, U., Kinsey, C., & Senior, R. (2003, Spring). 99m-Tc Sestamibi Gated SPECT and Myocardial Contrast Echocardiography in Acute Pulmonary Edema: Diagnosis of underlying Coronary Artery Disease.. (ICNC, Florence 2003.
• Moon, J. C., Elkington, A. G., Taneja, A. K., Wang, D., Senior, R., Janardhanan, R., Poole-Wilson, p., & Pennell, D. J. (2003, Spring). Bases anatomicas del infarto tipo Q versus el infarto no Q: extension en lugar de transmuralidad. Argentinian Congress of Cardiology 2003.

Poster Presentations

• Kubba, S., Airhart, S., Wickstrom, K., Rosado-Toro, J., Desai, A., Janardhanan, R., Vanderpool, R., & Rischard, F. (2019, May). The Inaccuracy of Right Ventricular 3d Echocardiography Is Accentuated by Disease Severity in Pulmonary Arterial Hypertension. American Thoracic Society 2019. Dallas, TX.
• Vanderpool, R., Holmathchi, J., Puri, R., Airhart, S., Erickson, H., Lizarraga, A., Hansen, L., Kubba, S., Janardhanan, R., Naeije, R., Garcia, J., Yuan, J., & Rischard, F. (2019, May). Ratio of Stroke Volume to End-Systolic Volume Predicts Change in Right Ventricular Ejection Fraction in Patients with Pulmonary Arterial Hypertension. American Thoracic Society 2019. Dallas, TX.
• Kannan, A., Kumar, K., Madhavan, S., Sridharan, K. S., & Janardhanan, R. (2018, March). Meta-Analysis of Late Gadolinium Enhancement in Dilated Cardiomyopathy. American College of Cardiology Scientific Sessions 2018. Orlando, FL: ACC.
• Kannan, A., Kumar, K., Madhavan, S., Sridharan, K. S., & Janardhanan, R. (2018, March). Meta-Analysis on Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy. American College of Cardiology Scientific Session 2018. Orlando, FL: ACC.
• Kubba, S., Airhart, S., Wickstrom, K., Rosado-Toro, J., Janardhanan, R., Vanderpool, R., & Rischard, F. (2018, spring). Underestimation of RV Volume by 3D Echocardiography in Patients With Severe PAH. American Heart Association Annual Scientific Session 2018. Chicago, IL.
• Kumar, K., Kannan, A., Madhavan, S., Sridharan, K. S., & Janardhanan, R. (2018, March). Role of Late Gadolinium Enhancement in the Evaluation of Patients With Cardiac Sarcoidosis: A Meta-Analysis.. American College of Cardiology Scientific Sessions 2018. Orlando, FL: ACC.
• Servin, F., Rosado, J. A., Janardhanan, R., Yuan, J., Rischard, F., & Vanderpool, R. (2018, Summer). Assessment of Pulmonary Arterial Structure and its Association with Right Ventricular Function in Pulmonary Arterial Hypertension. Biomechanics, Bioengineering and Biotransport Conference. Seven Springs, PA.
• Janardhanan, R., William, P., & Thajudeen, B. (2017, spring). Infected Myocardial Calcific Deposit: Value of Multimodality Imaging. Society for Cardiovascular Magnetic Resonance. Baltimore, MD.
• Avery, R. J., Janardhanan, R., & Desai, A. (2016, January 27-30). Multiparameter Use of Cardiac Magnetic Resonance as a Predictor of Pulmonary Artery Hypertension. SCMR 19th Annual Scientific Sessions. Los Angeles, California.
• Janardhanan, R., Hamound, N., & Rutter, T. (2016, Summer). A Very Unusual Mass in the Left Atrium: A Rare Presentation of an Aortic Root Abscess. ASE.
• Janardhanan, R., Hamound, N., & Scully, M. S. (2016, Summer). Single Leaflet Device Attachment (SLDA) following MitraClip: Accurate Diagnosis by Real Time 3D-Transesophageal Echocardiography. ASE.
• Janardhanan, R., Shetty, S., Hamound, N., O'Farrell, K., & Lick, S. (2016, Summer). A Rare Case of an Acquired Continuous Murmur: A Complication Following Aortic Valve Replacement. ASE.
• Robinson, E. A., Khalpey, Z., & Janardhanan, R. (2016, Spring). Libman Sacks Endocarditis: A presentation with Critical Limb Ischemia. ACC 2016.
• Avery, R., Janardhanan, R., Krupinski, E. A., Nair, V., & Desai, A. (2015, November). Multiparameter use of cardiac magnetic resonance as a predictor of pulmonary artery hypertension. Annual Scientific Sessions of the Society of Cardiac Magnetic Resonance (SCMR). Los Angeles, CA: Society of Cardiac Magnetic Resonance (SCMR).
• Singh, S., Thompson, J., & Janardhanan, R. (2015, March). Insights into the Mechanism of Acute Severe Aortic Regurgitation: 3D-TEE Guided Management with Pathological Correlation. American College of Cardiology.
• Balachandran, M., Lotun, K., Thompson, J., & Janardhanan, R. (2013, October). A CHALLENGING CASE OF MITRAL PARAVALVULAR LEAKS: SUCCESSFUL 3D-TEE GUIDED TRANSCATHETER CLOSURE. 13. 2ND WORLD ECHOCARDIOGRAPHY SUMMIT. NEW DELHI, INDIA.
• Janardhanan, R., Lotun, K., Khalpey, Z. I., Smith, M. C., Rutter, T., Nemanova, D., & Friedman, M. (2013, June). MITRAL VALVE OBSTRUCTION: ACCURATE DIAGNOSIS BY 3D-TRANSESOPHAGEAL ECHOCARDIOGRAPHY. AMERICAN SOCIETY OF ECHOCARDIOGRAPHY. Minneapolis, MN.
• Lotun, K., & Janardhanan, R. (2013, March). A CASE OF TWIST AND TURNS. AMERICAN COLLEGE OF CARDIOLOGY – SUB MEETING 29TH INTERNATIONAL CONF. OF RECENT ADVANCES IN ECHOCARDIOGRAPHY AND ALLIED TECHNIQUES. San Francisco, CA.

Other Teaching Materials

• Janardhanan, R. (2017. How to do Transesophageal Echocardiography. Indian Academy of Echocardiography. Indian Acaemy of Echocardiography.

Others

• Chacon-Portillo, M., Dhakal, B., & Janardhanan, R. (2020, August). Bioprosthetic aortic valve hemodynamic deterioration secondary to a thrombus.. British Medical Journal.
• Prudhvi, K., Kumar, K., Jonnadula, J., & Janardhanan, R. (2020, July). Right Atrial Thrombosis provoked by central venous catheter: A Case Report. Cureus.
• Janardhanan, R. (2019, June). 3D vs. CMRI for Quantification of Mitral Regurgitation. You Tube, American Society of Echocardiography website and partner sites.
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  Translation of Dr Janardhanan's presentation "3D vs. CMRI for Quantification of Mitral Regurgitation into Chinese and Portuguese to Mp4 for educational purposes.
• Janardhanan, R. (2014, January). Guideline Education: Valvular Heart Disease Case Study on Patients with Severe Aortic Stenosis. website Maintenance for Certification for American College of Cardiology. http://www.cardiosource.org/Lifelong-Learning-and-MOC/Certified-Learning/Case- Vignettes/2014/Valvular-HD/Guideline-Based-Education_Valvular-HD.aspx
• Janardhanan, R., & Gupta, S. (2000, September). Echocardiography in Pericardial Effusion. an online reference. http://rubble.heppell.net/chestnet/t/ecgtut.htm