Simple scan can predict risks of serious heart problems

Carrying too much visible fat around the waist and hips is a well-known health risk. However, unseen fat around the heart also poses significant dangers.

Scientists at the University of Virginia (UVA) Health System are developing a non-invasive method to assess these risks, potentially transforming how doctors diagnose and treat heart disease.

Led by Dr. Frederick H. Epstein of UVA’s Department of Biomedical Engineering, the researchers are using magnetic resonance imaging (MRI) to analyze the composition of epicardial adipose tissue – the fat surrounding the heart.

This technique could help doctors pinpoint patients who are at risk for severe heart conditions, such as coronary artery disease, atrial fibrillation, and heart failure. It may also help predict patient responses to treatments, which would enhance care strategies.

Progress in heart imaging

Initial testing has shown promising results. The new MRI technique offers insights that were previously unavailable.

“Using this new MRI technique, we now for the very first time have the ability to know the composition of the fat that accumulates around the heart,” said Dr. Amit R. Patel, a cardiologist at UVA Health.

“This is important because, depending on its makeup, the fat which surrounds the heart has the potential to release damaging substances directly into the heart muscle, leading to serious heart problems.”

Dr. Patel noted that the research could enable patients to convert unhealthy fat into healthier forms using lifestyle changes or medications.

“We believe that by doing so, we will be able to reduce some of the complications associated with heart disease,” he added.

Dual nature of epicardial fat

Epicardial adipose tissue is a type of fat that surrounds the heart. In healthy individuals, this fat plays an important protective role, helping the heart function properly.

However, in people with conditions like obesity, diabetes, high blood pressure, or unhealthy habits like smoking and poor diets, this fat can accumulate excessively. In this case, it may become inflamed and undergo changes that can harm the heart instead of protecting it.

Scientists can now study the composition of this fat by analyzing the types of fatty acids it contains – saturated, monounsaturated, and polyunsaturated.

These insights help doctors identify people at risk of heart disease before symptoms appear. Finding and addressing these risks early can slow down the progression of heart disease, which is one of the leading causes of death worldwide.

Tackling the challenges of heart scans

Capturing clear images of heart fat posed significant technical challenges due to constant heart and lung motion. To overcome this, the team developed advanced computational methods and innovative imaging approaches.

“The ability to make these measurements in epicardial adipose tissue required the use of advanced computational methods that can extract the unique signature of saturated fatty acids from an overall noisy signal,” said Dr. Epstein.

He commended Jack Echols, a biomedical engineering graduate student, for his pivotal contributions.

With these advances, the team can now obtain precise images in a single breath hold, paving the way for real-world applications.

Early findings from heart scans

Tests revealed that the fat surrounding the heart in obese patients with prior heart attacks contained excessive saturated fatty acids.

This discovery suggests that the new MRI technique could help identify at-risk individuals and improve patient outcomes.

“Being able to see the composition of the fat that surrounds the heart will improve our understanding of heart disease and may lead to the development of new treatment strategies in the future,” noted Dr. Patel.

Heart scans and early interventions

The new MRI technique represents a significant leap in heart disease care.

“Epicardial adipose tissue (EAT), the adipose depot positioned between the myocardium and the visceral pericardium, has emerged as an important contributor to cardiovascular disease, particularly in obesity and metabolic heart disease,” explained the researchers.

By providing a clearer picture of this fat composition around the heart, the new imaging technique could empower doctors to intervene earlier and more effectively, reducing the burden of heart disease worldwide.

The findings were published in the journal Magnetic Resonance in Medicine.

The study received funding from the National Institutes of Health, National Institute on Aging, American Heart Association, and other organizations.

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