Microscopic heart muscle scans

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The cells that make up the heart shorten, fatten and swivel each time the heart beats. In many heart diseases this reshaping of the beating muscle cells doesn’t happen as it should. This can affect the heart’s ability to sufficiently pump blood around the body. Identifying these changes would help doctors understand which patients will benefit from particular treatments or identify heart conditions earlier.

Detecting these changes requires a complex imaging method known as diffusion tensor cardiovascular magnetic resonance (or DTCMR). DTCMR scans are a type of MRI scan, that don’t require injections, medicines or harmful radiation. However, imaging the heart is difficult as it is always moving. Currently, these scans require patients to hold their breath 20 times, each time for 15-20 seconds, to produce just one picture at one location in the heart, with full scans taking an hour to complete. The long scans mean that this is now only used by a handful of university researchers worldwide.

This project, led by Dr Andrew Scott and his team at Imperial College London, aim to make DTCMR scans much faster, using novel, more powerful MRI scanners. The team will develop computer models that will simulate how the heart moves in patients with a range of heart conditions. This will allow them to establish how best to use these new scanners to freeze movement at one point in the heartbeat.

These new DTCMR scans will be tested in healthy people to show how reliable the scans are. Then the scans will be tested on a patient group with hypertrophic cardiomyopathy, as this is a condition where there are known changes to how the heart beats. Finally, the team will compare healthy and patient images to show they can see these changes using the new technique. Once complete, other scientists will be able to use this MRI scanning technique to understand more about how the heart works. Scientists will also use the computer models of the heart movement in their research.

Not only will these results make the scans 10 time faster than at present, meaning they can be collected in 10 minutes, but they will be able to be performed without patients holding their breath. This will make scans easier for patients and allow more of them to be carried out. They will also produce images of the whole heart in different stages of the heartbeat. This will allow for better care for patients after major cardiac events, such a heart attack, as well as allowing for monitoring of people with genetic heart conditions.