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Dr James Rudd PhD, FRCP, FESC

Dr James Rudd, PhD, FRCP, FESC

HEFCE Senior Lecturer in Cardiovascular Medicine

James Rudd is accepting applications for PhD students.


Office Phone: 01223 331504

Departments and Institutes

BHF Cambridge Centre of Excellence:
Principal Investigator
Department of Medicine:
Principal Investigator
Cardiovascular Strategic Research Initiative:
Principal Investigator

Research Interests

In atherosclerosis, inflammation, neovascularisation, hypoxia and calcification are drivers of plaque destabilisation and clinical events such as myocardial infarction and stroke. Conventional x-ray angiography does not provide information about the extent of these processes in the arterial wall, and as a consequence is a poor predictor of future events.

The aim of our research is to use non-invasive imaging to answer four related questions

  1. Can we quantify the degree of arterial inflammation?
  2. Can we track the effects of therapy on arterial inflammation?
  3. Can we use imaging to inform about the biology of arterial disease?
  4. Can imaging improve our predictions about the risk of future clinical events?

Using PET/CT imaging, we can measure the glucose analogue fluorodeoxyglucose (FDG) where it accumulates in plaque macrophages. This allows us to identify symptomatic lesions causing TIA and stroke. We have demonstrated that arterial FDG uptake correlates with the number of cardiovascular risk factors and with the presence of inflammatory biomarkers of inflammation such as CRP and MMP9. Arterial FDG measures are also highly reproducible. Recent work has also revealed that inflamed plaques on PET imaging have larger lipid cores on MR and ultrasound imaging (suggesting vulnerability).

To image coronary artery inflammation, there are several hurdles to overcome, including coronary and respiratory motion and the avid accumulation of FDG by myocardial cells (swamping any potential coronary artery FDG uptake). To overcome these challenges, we are testing several novel PET imaging agents in both clinical and pre-clinical models of vascular disease.

As part of the second aim, we have completed several multi-centre clinical trials of novel anti-atherosclerosis agents (with GSK, Roche, Merck and Genentech). In this work, we use FDG PET/CT as a surrogate marker of vascular inflammation. In this way, we can obtain early readouts of drug efficacy with far fewer subjects than would be needed in a Phase 3 study.

For the third aim, we have applied FDG PET imaging to quantify vascular inflammation in several diseases including rheumatoid arthritis, pulmonary hypertension, COPD and aortic aneurysm (see above) all of which have an excess of unexplained cardiovascular deaths.

We also participating in prospective, multi-centre outcome-driven studies to determine the role of non-invasive imaging, biomarkers, genetic and clinical risk factors in predicting cardiovascular events.

I am the Clinical PI of a £2 million new venture – The EPSRC Mathematics in Healthcare Programme Award – with partners in Medicine, Oncology, Radiology, Biochemistry, Neuroscience and Industry and led from the Department of Mathematics and Statistics  – commencing July 2016.

My research is supported by HEFCE, the British Heart Foundation, the EPSRC, the Wellcome Trust, the Evelyn Trust, the Academy of Medical Sciences and the NIHR Cambridge Biomedical Research Centre.

Keywords

plaque imaging ; screening & risk prediction ; cardiology ; PET ; atherosclerosis ; acute coronary syndrome ; stroke ; hypoxia ; MRI ; aneurysm growth ; Aortic aneurysm ; drug discovery ; heart attack ; magnetic resonance imaging ; imaging

Key Publications

Last 12 publications are listed below - the full list can be accessed here, or nicely formatted here.

  1. Joshi, F. R., Manavaki, R., Fryer, T. D., Figg, N. L., Sluimer, J. C., Aigbirhio, F. I., . . . Rudd, J. H. F. (2017). Vascular Imaging With (18)F-Fluorodeoxyglucose Positron Emission Tomography Is Influenced by Hypoxia.. J Am Coll Cardiol, 69(14), 1873-1874. doi:10.1016/j.jacc.2017.01.050
  2. Tarkin, J. M., Joshi, F. R., Evans, N. R., Chowdhury, M. M., Figg, N. L., Shah, A. V., . . . Yu, E. (2017). Detection of Atherosclerotic Inflammation by (68)Ga-DOTATATE PET Compared to [(18)F]FDG PET Imaging.. J Am Coll Cardiol, 69(14), 1774-1791. doi:10.1016/j.jacc.2017.01.060
  3. Vesey, A. T., Jenkins, W. S. A., Irkle, A., Moss, A., Sng, G., Forsythe, R. O., . . . Newby, D. E. (2017). (18)F-Fluoride and (18)F-Fluorodeoxyglucose Positron Emission Tomography After Transient Ischemic Attack or Minor Ischemic Stroke: Case-Control Study.. Circ Cardiovasc Imaging, 10(3). doi:10.1161/CIRCIMAGING.116.004976
  4. Hammad, B., Evans, N. R., RUDD, J. H. F., & Tawakol, A. (2017). Molecular imaging of atherosclerosis with integrated PET imaging.. J Nucl Cardiol. doi:10.1007/s12350-016-0766-y
  5. Joseph, P., Ishai, A., Mani, V., Kallend, D., RUDD, J. H. F., Fayad, Z. A., & Tawakol, A. (2017). Short-term changes in arterial inflammation predict long-term changes in atherosclerosis progression. European Journal of Nuclear Medicine and Molecular Imaging, 44(1), 141-150. doi:10.1007/s00259-016-3524-0
  6. Jenkins, W. S. A., Vesey, A. T., Stirrat, C., Connell, M., Lucatelli, C., Neale, A., RUDD, J. H. F. . . Newby, D. E. (2016). Cardiac αVβ3 integrin expression following acute myocardial infarction in humans.. Heart. doi:10.1136/heartjnl-2016-310115
  7. Singh, P., Emami, H., Subramanian, S., Maurovich-Horvat, P., Marincheva-Savcheva, G., Medina, H. M., RUDD, J. H. F. . .. Tawakol, A. (2016). Coronary Plaque Morphology and the Anti-Inflammatory Impact of Atorvastatin: A Multicenter 18F-Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Study.. Circ Cardiovasc Imaging, 9(12). doi:10.1161/CIRCIMAGING.115.004195
  8. Huang, Y., Teng, Z., Elkhawad, M., Tarkin, J. M., Joshi, N., Boyle, J. R., . . . RUDD, J. H. F. (2016). High Structural Stress and Presence of Intraluminal Thrombus Predict Abdominal Aortic Aneurysm 18F-FDG Uptake: Insights From Biomechanics.. Circ Cardiovasc Imaging, 9(11). doi:10.1161/CIRCIMAGING.116.004656
  9. Pawade, T. A., Cartlidge, T. R. G., Jenkins, W. S. A., Adamson, P. D., Robson, P., Lucatelli, C., .RUDD, J. H. F . .. Dweck, M. R. (2016). Optimization and Reproducibility of Aortic Valve 18F-Fluoride Positron Emission Tomography in Patients With Aortic Stenosis. Circ Cardiovasc Imaging, 9(10). doi:10.1161/CIRCIMAGING.116.005131
  10. van der Valk, F. M., Verweij, S. L., Zwinderman, K. A. H., Strang, A. C., Kaiser, Y., Marquering, H. A., . . . RUDD, J. H. F. (2016). Thresholds for Arterial Wall Inflammation Quantified by (18)F-FDG PET Imaging: Implications for Vascular Interventional Studies.. JACC Cardiovasc Imaging, 9(10), 1198-1207. doi:10.1016/j.jcmg.2016.04.007
  11. Tarkin, J. M., RUDD, J. H. F., Jayne, D. R., Rusk, R. A., & Gopalan, D. (2016). An unusual finding in a 57-year-old woman with new onset hypertension and a diastolic murmur.. Heart. doi:10.1136/heartjnl-2016-309661
  12. Dweck, M. R., Aikawa, E., Newby, D. E., Tarkin, J. M., RUDD, J. H. F., Narula, J., & Fayad, Z. A. (2016). Noninvasive Molecular Imaging of Disease Activity in Atherosclerosis.. Circ Res, 119(2), 330-340. doi:10.1161/CIRCRESAHA.116.307971

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