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Pathophysiological mechanisms, new methodologies, improved diagnosis and new treatment

University of Sydney

Grant:
  • Cardiovascular Senior Scientist Grant
Organ System:
  • Cardiovascular
Date Funded:
  • 31 May, 2019
Chief Investigator/s:
  • Professor Martin Ugander

Project summary

Develop and use state-of-the-art magnetic resonance imaging (MRI) to better understand, diagnose, and evaluate a new treatment heart failure.

What is the issue for NSW?

Heart failure is a very common and costly disease that is defined as the inability to pump adequate amounts of blood to meet the body’s needs. A particularly large group of heart failure patients that are difficult to both diagnose and treat, is heart failure due to high blood pressure, diabetes, and/or obesity. This large category of heart failure is particularly associated with three problems, (I) inefficient filling of the heart, (II) thick walls of the heart, and (III) a reduction in blood flow to the smallest vessels of the heart.

These three problems are more common with increasing age, are more common in women and indigenous populations, and have been shown to be associated with hospital admission and death.

What does the research aim to do and how?

The purpose of this research is to develop and use state-of-the-art magnetic resonance imaging (MRI) to better understand, diagnose, and evaluate a new treatment heart failure. Specifically, the research focuses on the challenges related to identifying and treating inefficient filling, thick walls, and small vessel disease.

With regards to evaluating inefficient filling, this requires accurate measurement of the speed of movement of the heart during filling, and blood pressure in different chambers of the heart. We have developed pioneering new MRI methods to measure these movements and pressures, and will be evaluating these new non-invasive MRI measures compared to reference measurements in patients. Furthermore, we have found that surgical reduction in the size of the left atrium of the heart may improve the efficiency of filling. Thus, we will evaluate the ability of this new surgical treatment to improve filling efficiency in patients undergoing open-heart surgery.

With regards to evaluating thick walls of the heart, we have developed new methods to better diagnose thick walls by both MRI and the electrical activity of the heart using electrocardiography (ECG). The accuracy and utility of these new methods will be evaluated in patients. Also, the accuracy of a new ECG method to diagnose small vessel disease, as shown by MRI, will be evaluated.

The development and evaluation of these new diagnostic methods and treatment will establish their utility for use in every day care in patients with heart failure who otherwise currently may be incorrectly diagnosed and lack treatment options.