OUR RESEARCH

Central Research Questions

How can we increase the sensitivity and specificity of predicting future CV events across all populations?
What innovative strategies can improve community response to out-of-hospital cardiac arrest and outcomes?
What is the mental illness burden and associated health services use among patients who survive cardiac arrest?
Is gender bias internet cardiac arrest images impacting public perceptions and willingness to respond?
What modifications can be made to clinical practice and decision making to improve vascular outcomes?
Can we develop novel AI machine-learning based approaches to improve vascular disease risk assessment?
Does improving psychosocial risk factors in females reduce the risk of experiencing future CV events?

Ongoing Projects

CIRCE

Combining Intraplaque Neovascularization with Risk Stratification by Carotid Stress Echo

The study aims to improve the accuracy of stress echo (SE) tests in predicting major adverse cardiovascular events (MACE) by incorporating carotid plaque assessment using ultrasound. Currently, SE tests are commonly used to select patients for angiography but have moderate sensitivity and specificity for cardiovascular outcomes. By adding carotid plaque assessment, specifically evaluating intraplaque neovascularization (IPN) through ultrasound contrast, the study aims to enhance risk prediction for MACE.

CAtCHNet

Community & Athlete Cardiovascular Health Network

Sudden cardiac death is the leading medical cause of death among athletes. Canada’s universities lack a national cardiovascular pre-participation screening program, leading to tremendous variation in practice. We answer this through the development and evaluation of Canada’s first Community & Athletic Cardiovascular Health Network (CAtCH) Centre of Excellence at Queen’s University. This program involves the development of a `CCS Sport Group Module’ which will be a standardized, transferable, guideline-driven, screening questionnaire accessible via an on-line portal. In addition, the program will translate the application of point-of-care ultrasound (POCUS) to augment the physical examination of the athlete and evaluate a new clinical workflow process for athlete ECG screening. The program will serve as the prototype for subsequent implementation on a national scale, enhancing care of athletes across Canada.

ARCTICA

Accelerated Remote Cardiopulmonary Tele-POCUS In COVID-19 Assessment

Cardiopulmonary point-of-care ultrasound (POCUS) is the critical, first-line imaging tool for patients with suspected or confirmed COVID-19 infection. However, this critical, potentially life-saving expertise, is not available in the hands of all providers and is especially lacking in geographically remote or rural regions. Tele-POCUS is an innovative method of streaming images and expertise to and from remote centers. ARCTICA addresses 2 clinical gaps – first by optimizing expert imaging live support to local physicians attending in COVID-19 units that are novice POCUS users, and second by implementing this novel workflow to geographically remote and Northern communities where this expertise is crucially lacking.

Dr. Smith

Delivery in women with metabolic syndrome

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Dr. Alavi

e-CBT for specific targetted populations

Tailors psychotherapy models for individuals through focus groups and validation Specializes in populations with specific diagnoses (e.g., cardiovascular disease, cancer)

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Dr. Cook

Chronic Ischemic Event Recovery

Clinical Research

Discussed professional hockey players' brain scans to identify features that predict greater improvement.
Chronic ischemic neurologic function and recovery

Basic science research

Stroke mechanisms in monkeys
Cognitive decline with mitral valve regurgitation

FRIDA

Female Risk Factors for post-Infarction Depression & Anxiety

Several studies have identified that female patients are at higher risk of adverse mental health outcomes following acute myocardial infarction (AMI). These factors have been correlated with increased morbidity, mortality, and rehospitalization. It is not known which female patients are at highest risk for developing depression and anxiety following AMI. The goal of the FRIDA Study is to identify which psychosocial and CV risk factors place female patients at highest risk of developing depressive and anxious symptoms following an AMI and correlate these factors to outcomes at baseline, 3 and 6 months.

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Dr. Yeates

Hypertension Screening/Management Programs

Conducting community-based research for risk identification Noted less than 30% of the targeted population have had their blood pressure checked Suggested using simplified programs to manage hypertension

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Sandpiper Trust Wildcat Project

CPR & AED Training

Trains people in CPR and defibrillator use for emergencies in hard-to-reach areas. Pilot study launched in Frontenac, aims to reduce response times. Over 120 volunteers since March 27th, 2023.

Previous Collaborations

Our CORE members have an established track record of working together including grants, publications, and cosupervision of trainees. Building rapport amongst our members through regular meetings and team-building activities is of paramount importance to fostering a cohesive environment. The teams (including CINQlab.com, theMotHERSprogram.ca, and OPTT.ca) provide infrastructure, personnel, and scientific guidance.

Drs. Smith & Johri - PRE-ECLAMPSIA associated with cardiovascular risk factors: 2016 CFI-JELF ($160,000): Reproductive Sciences Vascular Studies Lab - This study looked at the association of history of pre-eclampsia (PE) with carotid strain (arterial stiffness).

Barr LC, Herr JE , Hétu MF , Smith GN , Johri AM (2022) Increased carotid artery stiffness after preeclampsia in a cross-sectional study of postpartum women. Physiol Rep. 10(8): e15276.
Barr LC, Liblik K, Johri AM, Smith GN (2020) Maternal Cardiovascular Function following a Pregnancy Complicated by Preeclampsia. Am J Perinatol. 39(10):1055-64.
Co-Supervision of Trainees - Logan Barr – MSc, Presented at CCC in 2022.

Drs. Brooks & Johri - FOVUS - Focused vascular ultrasound to risk stratify patients with suspected ischemic chest pain in the emergency department: 2016 SEAMO AHSC AFP Innovation Fund ($95,500)– The Emergency Dept. collaborated with CINQ to determine if POCUS could be used to detect subclinical atherosclerosis in patients presenting to the ED with chest pain and predict 30-day CV outcomes. Presented at ASE in 2019.

Hétu MF, SC Brooks, Chan W, Herr EJ, Sivilotti MLA, O’Callaghan N, Latiu V, Newbigging J, Norman PA, Day AG, Hill B, Johri AM (2023) HEART+ Score: Integrating Bedside Carotid Ultrasound to Chest pain Assessment in the Emergency Department. CJEM (in revision)
SC Brooks, Sivilotti MLA, Hétu MF, Norman PA, Day AG, O’Callaghan N, Latiu V, Newbigging J, Hill B, Johri AM (2023). Focused carotid ultrasound to predict major adverse cardiac events among emergency department patients with chest pain. CJEM 25(1): 81–89.

CAtCH Net - Canada’s First Centre of Excellence for the Cardiovascular Screening and Care of the Athlete: A community and athlete cardiovascular health network that developed an athlete screening program at Queen’s. o

Grubic N, Hill B, Allan KS, Dainty KN, Johri AM, Brooks SC (2023) Community Interventions for Out-ofHospital Cardiac Arrest in Resource-Limited Settings: A Scoping Review Across Low, Middle, and HighIncome Countries. Prehospital Emergency Care, 1-21.
Co-Supervision of Trainees - Nicholas Grubic - MSc

Drs. Johri & Cook - VANGUARD - Virtual Histology and Molecular Environment of Atherosclerotic Plaque by a Novel 3D-Guided Ultrasound Tool for Atherosclerosis Risk Detection: 2019 TIME Grant ($75,000) and Philips ($30,000) - VANGUARD looks at 3D carotid ultrasound images from patients undergoing endarterectomy to identify plaque composition. Histological samples are compared to imaging.

Yau O, Adams MA, Cook DJ, Winn LM, Johri AM (2016) Development of a standard carotid artery ultrasound phantom to characterize plaque vulnerability. CJC 1;32(10):S196-7.

Drs. Cook & Brooks - Improved management of frail and elderly patients with traumatic brain injury. 2018- Ontario Centres of Excellence Grant ($1,004,587) - Health Technologies Fund

Drs. Johri & Alavi – FRIDA - The Female Risk Factors for post-Infarction Depression and Anxiety: 2022 HSF-GIA – FRIDA identifies which psychosocial and CV risk factors place female patients at highest risk of developing depressive and anxious symptoms following an AMI. Future: Develop resident trainee program.

Liblik K, Mulvagh SL, Hindmarch CCT, Alavi N, Johri AM (2022) Depression and anxiety following acute myocardial infarction in women. Trends in Cardiovasc Med. 32(6):341-347.
Co-Supervision of Trainees - Kiera Liblik - MSc

Drs. Alavi & Cook - Brain Injury - This study implemented an e-CBT program for OCD to observe its effects on brain activation levels using functional magnetic resonance imaging (MRI).

Stephenson C, Malakouti N, Nashed JY, Salomons T, Cook DJ, Milev R, Alavi N. (2021) Using Electronically Delivered Therapy and Brain Imaging to Understand Obsessive-Compulsive Disorder Pathophysiology: Protocol for a Pilot Study. JMIR Res Protoc. 10(9):e30726.

Drs. Johri & Yeates – Canada and Global vascular health - WAHA collaboration

Co-Supervision of Trainees -Trinity Vey – MSc.

Drs. Brooks & Alavi - Heart & Mind: Psychotherapy platforms for responders using e-CBT tools.