Dilated cardiomyopathy, a heart muscle disease leading to dilation and
impaired contraction of the left ventricle, is a severe and often familial
disease. It is difficult to diagnose the disease with cardiac ultrasound,
particularly at an early stage when there are only minimal, early changes of
the heart. VTT Technical Research Centre of Finland has developed a method
based on cardiac MRI, currently in research use, to help the physician to
identify disease-related changes of the heart at an early stage.
In dilated cardiomyopathy, the heart dilates and impaired contraction of the
left ventricle leads to heart failure. The disease may be suspected based on
symptoms and an enlarged cardiac shadow revealed in a chest x-ray, for
example. The diagnosis is typically verified by cardiac ultrasound
examination. At an early stage, minimal changes of the heart are difficult to
observe with ultrasound because their distinction from normal variation can
challenge even an experienced cardiologist.
The method developed during VTT's co-operation project utilises database data
on variations in cardiac muscle measured with MRI scans taken from different
projections. Cardiac MRIs of the patient are compared with database data on
normal variation in healthy hearts, and with disease-related variation in
healthy and sick hearts. This corresponds to the knowledge of an experienced
physician on the appearance of cardiac MRI images and their deviations. With
the help of this method developed by VTT, the essential information for
diagnosis is easily available for all physicians regardless of their
experience in interpreting cardiac MRIs.
Measurement values have been identified with the help of MRI to enable
diagnosis at a very early stage of the disease. The key issue of the method is
to develop a new visualisation technique, which enables presentation of
essential information from a very large measurement set in an easily
interpretable form. In addition, this research has developed a disease index
representing the severity of disease, which offers a simple method for
monitoring the disease and its treatment, for example.
The developed methods will be first applied, in a research context, to
research and analysis of changes produced by various diseases and disease
mechanisms. Later the goal is to provide a method for clinical use to assist
physicians in diagnosing. The research will be explored further by applying
the methods in the research of other heart and brain diseases. In addition to
imaging data, the analysis method will include cell metabolism data acquired
from blood samples, for example.
Information on dilated cardiomyopathy
Dilated cardiomyopathy is a severe heart disease, which causes dilation of the
myocardium and is familial in as many as one third of cases. Because of this,
it is recommended that the first-degree family members of the patient, even
those with no symptoms, be examined to identify potential evidence of
incipient disease. To organise monitoring and treatment, it is vital to
identify as reliably as possible all of those, including the symptomless, who
will later be at risk of developing the disease. In some cases, those at risk
of developing the disease can be identified with DNA analysis.
A diseased myocardium can not be healed but the symptoms can be greatly
alleviated with heart failure medication. Incidence of the disease in the
adult population is approximately 36.5/100,000 and markedly lower among
children. In Finland, dilated cardiomyopathy is the leading cause for heart
transplantation and causes a considerable amount of morbidity and premature
mortality among the working population.
Partners of the research are VTT Technical Research Centre of Finland, the
Hospital District of Helsinki and Uusimaa (HUS), the Kuopio University
Hospital (KYS) and the University of Kuopio.