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Finnish Heart Research Technology VTT's method eases early diagnosis of severe heart muscle disease



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.