Developing a new imaging method to study blood supply to a thickened heart
Novel and Emerging Technologies (NET) Grant – Dr Erica Dall’Armellina University of Leeds
Small blood vessels in the heart, called microvessels, deliver blood to the heart muscle. Each microvessel supplies a small number of heart muscle cells with oxygen and nutrients. When the supply fails, the tissue can suffer and cells can die. For a good blood supply and healthy heart, two factors are crucial – the vessels need to be unobstructed and function well, and the surrounding structure has to allow for the microvessel to reach the tissue. However, this is not the case in patients with heart disease such as hypertrophic cardiomyopathy (HCM).
About 1 in 500 of the UK population has HCM, although most HCM patients have few, if any symptoms. In HCM patients, the muscular wall of the heart becomes thickened, making the heart muscle stiff and preventing the microvessels from delivering enough blood to the cells. This can have serious consequences and may lead to death.
Cardiac magnetic resonance (CMR) imaging is used to image the muscle of the heart in detail and detect the presence of dead tissue. However, it does not tell us how an abnormal muscle structure impacts on the delivery of oxygen. The aim of this project is to develop a new CMR method to assess how severely the blood supply is affected by the disarray of the microstructure in patients with heart disease including HCM. The technique is called intra-voxel incoherent motion (IVIM).
After optimising the imaging technique in the lab, Dr Dall’Armellina’s team will test it on 10 healthy volunteers to establish normal values for heart structure and blood flow. They will then use the technique on 30 HCM patients to measure how well the heart muscle is supplied with blood and see how this correlates with standard measurements such as the thickness of the heart or the amount of scar tissue.
If the project is successful, the new imaging technique may benefit patients with HCM and other types of heart disease. It may help doctors to assess whether the microvessels are functioning efficiently to supply blood to the heart muscle tissue. By determining at an early stage whether there is poor oxygen delivery due to an abnormal microscopic structure of the heart muscle, doctors could test new medicines to treat the abnormal function of the microvessels. This may lead to new ways to treat the condition early and to avoid serious consequences.