A brain imaging technique has been used for the first time to help identify the signs of hypertrophic cardiomyopathy, a UK study revealed last night.
Researchers from Oxford University say their findings mean that disarray in microscopic heart muscle fibres, which could set off a potentially fatal heart rhythm, can be spotted.
When seen under a microscope, muscles fibres from the hearts of patients who have died suddenly of the condition are arranged abnormally, and do not have the usual alignment that allows heartbeats to spread evenly across the heart’s muscle fibres.
Spotting this disarray would enable doctors to intervene before a sudden cardiac arrest happens, by fitting an implantable cardioverter defibrillator.
The researchers, led by Professors Hugh Watkins and Stefan Neubauer at the Radcliffe Department of Medicine at Oxford University, used diffusion tensor magnetic resonance imaging to track the spread of water molecules within the heart’s muscle to check for muscle fibre disarray non-invasively.
“The problem is that the large movements of a beating heart dwarf the microscopic diffusional motion of the water molecules that we are trying to measure”, said Dr Liz Tunnicliffe, study co-author who developed the diffusion tensor imaging technique for the study. “Recent advances in magnetic resonance technology have now made diffusion tensor imaging of the heart feasible in humans.”
Using the new scan technique, the team saw similar heart muscle disarray patterns in their living hypertrophic cardiomyopathy patients that previous post-mortem studies had found. Patients with the imaging ‘marker’ of disarray were also more likely to have abnormal heart rhythms.
Dr Rina Ariga, lead author and a clinical researcher, said: “This is the first time that we’ve been able to assess disarray non-invasively in living patients with hypertrophic cardiomyopathy.
“We’re hopeful that this new scan will improve the way we identify high-risk patients, so that they can receive an implantable cardioverter defibrillator early to prevent sudden death.”
Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said: “This exciting research opens up the possibility of using a non-invasive scan to better spot heart muscle changes in people with hypertrophic myocardiopathy, find those at risk of a sudden cardiac arrest and ensure they receive the best preventative care.
“Although further work is needed to refine and test this scan, its potential benefit to patients with hypertrophic myocardiopathy is huge. This work is an excellent example of cutting-edge, research-led technology that could change the way we diagnose and treat heart and circulatory diseases.”
Journal of the American College of Cardiology 20 May 2019
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